Non-union of the greater tuberosity in patients undergoing reverse total shoulder arthroplasty for proximal humerus fracture: Is it associated with worse outcomes?

Background: 4-part proximal humerus fractures are complex injuries that are often associated with comminution of the greater tuberosity. The purpose of this study is to evaluate the functional outcomes of 4-part humerus fractures that are treated with reverse total shoulder arthroplasty (rTSA) and correlate these outcomes with the healing status of the greater tuberosity.

Material And Methods: A retrospective observational study was performed including 65 patients who underwent rTSA following a 4-part proximal humerus fracture.

PACE: Data-Driven Virtual Agent Interaction in Dense and Cluttered Environments.

We present PACE, a novel method for modifying motion-captured virtual agents to interact with and move throughout dense, cluttered 3D scenes. Our approach changes a given motion sequence of a virtual agent as needed to adjust to the obstacles and objects in the environment. We first take the individual frames of the motion sequence most important for modeling interactions with the scene and pair them with the relevant scene geometry, obstacles, and semantics such that interactions in the agents motion match the affordances of the scene (e.

Single Incision Modified Tension Slide Technique in Distal Biceps Repair: Improved Load to Failure While Reducing Surgical Pitfalls.

Historically, distal biceps tendon repair through the tension slide technique (TST) using a cortical button has yielded the strongest published repair measured by observed gap formation in both cyclic and maximal load to failure. The modified tension slide technique (MTST) was developed in order to provide the surgeon with a technically simpler and biomechanically more effective way to reduce gap formation and consistently seat/bottom-out the tendon within the bone tunnel through a more direct line of pull. In order to compare the biomechanics of the MTST to the TST, we used 24 matched bovine extensor tendons, and conducted maximal load to failure and cyclical load to failure testing using an Instron 5566 machine.

How to Shoot and Edit High-Quality Surgical Videos for Hand and Upper Extremity Surgery.

A surgical video can improve patient care, surgical education, as well as scientific presentations and publications. Previous authors have outlined a basic understanding of how to produce high-quality surgical videos. With continuous technological improvements in video-filming hardware and editing software, multiple options for producing high-quality surgical videos are available.

Overweight, Obesity, and Lung Function in Children and Adults-A Meta-analysis.

Background: There is conflicting evidence on the effect of obesity on lung function in adults and children with and without asthma. We aimed to evaluate the relation between overweight or obesity and lung function, and whether such relationship varies by age, sex, or asthma status.

Methods: We searched PubMed, Scopus, CINAHL, Cochrane, and EMBASE for all studies (in English) reporting on obesity status (by body mass index) and lung function, from 2005 to 2017.

Impact of recent guideline changes on aspirin prescribing after knee arthroplasty.

Background: Prior to 2012, the American Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP) differed in their recommendations for postoperative pharmacologic venous thromboembolism prophylaxis (VTEP) after total joint arthroplasty. More specifically, aspirin (ASA) monotherapy was not endorsed by the ACCP as an acceptable prophylaxis. In 2012, the ACCP supported ASA monotherapy compared with no prophylaxis.

Obesity and Airway Dysanapsis in Children with and without Asthma.

Rationale: For unclear reasons, obese children with asthma have higher morbidity and reduced response to inhaled corticosteroids.

Objectives: To assess whether childhood obesity is associated with airway dysanapsis (an incongruence between the growth of the lungs and the airways) and whether dysanapsis is associated with asthma morbidity.

Methods: We examined the relationship between obesity and dysanapsis in six cohorts of children with and without asthma, as well as the relationship between dysanapsis and clinical outcomes in children with asthma.

Methods to study glycoproteins at the blood-brain barrier using mass spectrometry.

Glycosylation is the most common posttranslational modification of proteins in mammalian cells and is limited mainly to membrane and secreted proteins. Glycoproteins play several key roles in the physiology and pathophysiology of the blood-brain barrier (BBB) and are attractive as diagnostic markers and therapeutic targets for many neurological diseases. However, large-scale glycoproteomic studies of the BBB have been lacking, largely due to the complexity of analyzing glycoproteins and a lack of available tools for this analysis.

Prevention of surgical resident attrition by a novel selection strategy.

Objective(s): We modified the resident selection strategy in an attempt to reduce resident attrition (RA).

Summary Background Data: Despite implementation of the Accreditation Council for Graduate Medical Education work rules, lifestyle and generational priorities have fostered a persistent and relatively high attrition rate for surgical trainees.

Methods: An independent external review of residents who left the training program and a detailed analysis of the resident selection strategy were performed by an organizational management expert.

Flagellar glycosylation in Clostridium botulinum.

Flagellins from Clostridium botulinum were shown to be post-translationally modified with novel glycan moieties by top-down MS analysis of purified flagellin protein from strains of various toxin serotypes. Detailed analyses of flagellin from two strains of C. botulinum demonstrated that the protein is modified by a novel glycan moiety of mass 417 Da in O-linkage.

Contributions of surgical residents to patient satisfaction: impact of residents beyond clinical care.

Purpose: Little is known about the relationship between resident performance and patient satisfaction. To this end, our institution added housestaff-specific questions to Press-Ganey surveys (Press-Ganey, South Bend, Indiana) administered to patients. This study sought to investigate the impact residents have on patients' overall rating of care compared with faculty and nursing staff.

The Patient Safety Leadership Academy at the University of Pennsylvania: the first cohort's learning experience.

Background: We based the Patient Safety Leadership Academy (PSLA) on the premise that improving management skills could improve patient safety and employee satisfaction.

Study Design: Fellows completed baseline surveys on leadership skills knowledge, patient safety knowledge, and program goals. They completed the same surveys 7 months later at the final PSLA session.

Flagellin diversity in Clostridium botulinum groups I and II: a new strategy for strain identification.

Strains of Clostridium botulinum are traditionally identified by botulinum neurotoxin type; however, identification of an additional target for typing would improve differentiation. Isolation of flagellar filaments and analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed that C. botulinum produced multiple flagellin proteins.

Living long with short bowel syndrome: a historical case of twenty-nine years of living with home parenteral nutrition.

Background: This paper traces the 29-year survival of Robert Thomas, who received home parenteral nutrition (PN), and contrasts his oral narrative with the clinical history of PN.

Methods: Interviews, chart review, review of the literature, and historical analysis.

Results: Bobby Thomas was part of an early group of patients scattered throughout the country who, with their medical team, provided the foundation for more successful survival with home PN.

Patterns and predictions of resident misbehavior--a 10-year retrospective look.

Background: Surgical educators are charged with ensuring that their trainees conduct themselves in a professional manner. The authors retrospectively reviewed a 10-year experience of incident reports on surgical housestaff to determine patterns and predictors of behavior.

Methods: A retrospective review of all letters, e-mails, and incident reports was conducted for general surgery residents from 1995 to 2005.

How do surgical residents and non-physician practitioners play together in the sandbox?

Introduction: The reduction of resident work hours due to the 80-hour workweek has created pressure on academic health-care systems to find "replacement residents." At the authors' institution, a group of nurse practitioners (NPs) and physician assistants (PAs), collectively referred to as non-physician practitioners (NPPs), were hired as these reinforcements, such that the number of NPPs (56) was almost twice the number of clinical categorical surgery residents (37). An experienced leader with national credibility was hired to run the NPP program.

Surgeon contribution to hospital bottom line: not all are created equal.

Objective: We hypothesized that surgeon productivity is directly related to hospital operating margin, but significant variation in margin contribution exists between specialties.

Summary Background Data: As the independent practitioner becomes an endangered species, it is critical to better understand the surgeon's importance to a hospital's bottom line. An appreciation of surgeon contribution to hospital profitability may prove useful in negotiations relating to full-time employment or other models.