Timing of Surgical Treatment for High-Grade Acromioclavicular Joint Injuries Does Not Affect Functional Outcomes.

Purpose: To determine, using multivariate regression, whether patient-reported outcomes are associated with surgical timing to account for differences between groups.

Methods: Patients who underwent acromioclavicular (AC) joint surgery from 2010 to 2019 were included if they underwent primary AC joint surgery for a Rockwood grade III-V AC joint separation. Chart review was conducted to determine time from injury to surgery, Rockwood injury grade, and surgical technique.

Long bone fractures with associated vascular injury: Who should go first?

Objectives: Long bone fractures with concomitant vascular injury have the potential to be life and limb threatening injuries, with increased risk for limb loss. There is currently no established surgical order of operations for orthopaedic and vascular intervention. This study compares injury classification, warm ischemia time and patient outcomes in patients with long bone fractures and associated vascular injury after orthopaedic versus vascular primary intervention.

Rates of Reporting and Analyzing Race and Ethnicity in Athlete-Specific Sports Medicine Research: A Systematic Review.

Background: Race- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear.

Purpose: To determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature.

Resident Burnout, Wellness, Professional Development, and Engagement Before and After New Training Schedule Implementation.

Importance: Burnout is a work-related syndrome of depersonalization (DP), emotional exhaustion (EE), and low personal achievement (PA) that is prevalent among internal medicine resident trainees. Prior interventions have had modest effects on resident burnout. The association of a new 4 + 4 block schedule (4 inpatient weeks plus 4 outpatient weeks) with resident burnout has not previously been evaluated.

Risk Factors Associated With Poor Outcomes After Quadriceps Tendon Repair.

Background: Ruptures of the quadriceps tendon present most frequently in older adults and individuals with underlying medical conditions.

Purpose: To examine the relationship between patient-specific factors and tear characteristics with outcomes after quadriceps tendon repair.

Study Design: Case-control study; Level of evidence, 3.

A Quality Improvement Approach to Modification of a Point-of-Care Ultrasound Curriculum.

Background: There is increasing emphasis on resident involvement in quality improvement (QI) efforts, yet resident engagement in QI has remained low for many reasons. Although QI methods are classically applied to clinical processes, there are many opportunities to incorporate QI principles into curricular design and implementation.

Objective: Demonstrate the utility of QI methods when applied to curricular design and the implementation of a novel point-of-care ultrasound portfolio development and quality assurance program at a large internal medicine residency program.

Biomechanics and Injury Prevention for Barefoot/Minimalist Running.

» Biomechanical studies indicate that barefoot/minimalist running coincides with a transition to an anterior foot strike, lower vertical loading rates, higher cadences, less energy absorption at the knee joint, and higher energy absorption at the ankle joint.» The clinical outcome studies indicate improvement of previous injuries and equivocal injury rates in the barefoot/minimal-style running groups.» Foot strike pattern is more important than footwear regarding injury prevention and vertical loading rate.

Return to recreational sports participation following rotator cuff repair in adults over 40 Years of age: outcomes and return to play analysis.

Background: Despite the high prevalence of rotator cuff (RTC) tears in older adults, there is limited literature evaluating the return to recreational sport after repair. The purpose of this study was (1) to assess the patient-reported outcomes and return to sport rates following rotator cuff repair in patients aged more than 40 years with minimum 2-year follow-up; (2) to compare baseline, preoperative and postoperative outcomes, and level of play following repair of self-reported athletes with nonathletes; and (3) to compare return to sport rates in overhead athletes compared to nonoverhead athletes.

Methods: Patients undergoing arthroscopic rotator cuff repair between January 2016 and January 2019 were screened for inclusion.

Therapists' first impression of treatment motivation moderates the relationship between the client-rated therapeutic alliance and drinking outcomes during treatment.

Introduction: First impressions can influence interpersonal relationships for extended periods, with negative first impressions leading to more negative judgments and behaviors between individuals months after their initial meeting. Although common factors such as therapeutic alliance (TA) are well studied, less is known of the potential influence of a therapist's first impression of their client's motivation on TA and drinking outcomes. Based on data from a prospective study of the perceptions of the TA among clients receiving cognitive-behavioral treatment (CBT), this study examined how therapists' first impressions may moderate the relationship between client-rated TA and drinking outcomes during treatment.

Inequalities in the Evaluation of Male Versus Female Athletes in Sports Medicine Research: A Systematic Review.

Background: Female sports participation continues to rise; however, inequalities between male and female athletes still exist in many areas and may extend into medical research.

Purpose: The purpose of this study was to (1) compare the number of published studies evaluating male versus female athletes in various sports and (2) identify which co-ed sports currently underrepresent female athletes in the sports medicine literature.

Study Design: Systematic review; Level of evidence, 4.

Rates of Reporting and Analyzing Patient Sex in Sports Medicine Research: A Systematic Review.

Background: Sex differences in sports medicine are well documented. However, no studies to date have reviewed the rate at which sex is reported and analyzed in the athlete-specific orthopaedic sports medicine literature.

Purpose: To determine the rates of reporting and analyzing patient sex in athlete-specific sports medicine literature.

Exploring US internal medicine resident career preferences: a Q-methodology study.

Career selection in medicine is a complex and underexplored process. Most medical career studies performed in the U.S.

Synthesis, Stereochemical Confirmation, and Derivatization of 12(S),16ϵ-Dihydroxycleroda-3,13-dien-15,16-olide, a Clerodane Diterpene That Sensitizes Methicillin-Resistant Staphylococcus aureus to β-Lactam Antibiotics.

Over the past decades, antibiotic resistance has grown to a point where orthogonal approaches to combating infections caused by resistant bacteria are needed. One such approach is the development of non-microbicidal small molecules that potentiate the activity of conventional antibiotics, termed adjuvants. The diterpene natural product 12(S),16ϵ-dihydroxycleroda-3,13-dien-15,16-olide, which we refer to as (-)-LZ-2112, is known to synergize with oxacillin against methicillin-resistant Staphylococcus aureus (MRSA).

Evaluation of a Web-based Psychosocial Education and Peer Support Program for Alcohol Use Concerns.

This outcomes assessment was implemented to evaluate a web-based alcohol use recovery program, Tempest Sobriety School (TSS), and to provide a model for outcome evaluation. Adults (=541) enrolled in TSS were assessed at pre-program start and Month 2, 6, and 12. Participants reported decreased alcohol use, drug use, craving for alcohol, and alcohol use disorder symptoms over the course of the program; changes were maintained at Month 6 and 12.

Development of a National Academic Boot Camp to Improve Fellowship Readiness.

Pulmonary and critical care medicine (PCCM) fellowship requires a high degree of medical knowledge and procedural competency. Gaps in fellowship readiness can result in significant trainee anxiety related to starting fellowship training. To improve fellowship readiness and alleviate anxiety for PCCM-bound trainees by improving confidence in procedural skills and cognitive domains.

The Cone Flare Crush Modified-T (CFCT) stenting technique for coronary artery bifurcation lesions.

Background: The present study is a prospective observational single arm clinical investigation, with parallel bench test interrogation, aimed at investigating the technical feasibility, safety and clinical outcomes with the cone flare crush modified-T (CFCT) bifurcation stenting technique. Bifurcation percutaneous coronary intervention (PCI) remains an area of ongoing procedural evolution. More widely applicable and reproducible techniques are required.

Reductions in Drinking Predict Increased Distress: Between- and Within-Person Associations between Alcohol Use and Psychological Distress During and Following Treatment.

Background: As the nature of the association between alcohol use disorder (AUD) and other disorders is not well understood, the ways in which psychological distress changes during the course of treatment for AUD are relatively unknown. Existing literatures posit 2 competing hypotheses such that treatment for AUD concurrently decreases alcohol use and psychological distress or treatment for AUD decreases alcohol use and increases psychological distress. The current study examined the ways in which psychological distress changed as a function of treatment for AUD, including the relationship between psychological distress and drinking behaviors.

Factors Associated With Discharge Home Among Medical ICU Patients in an Early Mobilization Program.

Objectives: One goal of early mobilization programs is to facilitate discharge home after an ICU hospitalization, but little is known about which factors are associated with this outcome. Our objective was to evaluate factors associated with discharge home among medical ICU patients in an early mobilization program who were admitted to the hospital from home.

Design: Retrospective cohort study of medical ICU patients in an early mobilization program.

Effects of Therapist Feedback on the Therapeutic Alliance and Alcohol Use Outcomes in the Outpatient Treatment of Alcohol Use Disorder.

Background: It is widely accepted that the therapeutic alliance (TA) is a mediator of psychotherapy effects, but evidence is sparse that the TA is an actual mechanism of behavior change. The purpose of this study was to provide the first systematic evidence regarding the TA as a mechanism of change in the treatment of alcohol use disorder (AUD).

Methods: Participants were 155 adult men and women presenting for individual outpatient treatment of AUD.

Midterm follow-up of total hip arthroplasty in a patient with contralateral Van Nes rotationplasty for congenital proximal femoral focal deficiency.

Total hip arthroplasty is a durable and effective operation in those with normal gait patterns. However, to our knowledge, there is no current literature on longevity in patients who have had a contralateral Van Nes rotationplasty for proximal femoral focal deficiency. We found evidence that patients who underwent rotationplasty have increased demands on the contralateral extremity and higher percentage of their gait cycle on the unaffected extremity.

Does probiotic consumption reduce antibiotic utilization for common acute infections? A systematic review and meta-analysis.

Background: Overall reduction of antibiotic use is a widely adopted public health goal. Given evidence that consuming probiotics reduce the incidence, duration and/or severity of certain types of common acute infections, we hypothesized that probiotics are associated with reduced antibiotic use. This systematic review of randomized controlled trials (RCTs) assessed the impact of probiotic supplementation (any strain, dose or duration), compared to placebo, on antibiotic utilization for common, acute infections in otherwise healthy people of all ages.