Sex, Race, and Ethnic Diversity of the Emerging U.S. Orthopaedic Sports Medicine Workforce Is Limited.

Purpose: To analyze the demographics and trends of orthopaedic surgeons entering the U.S. orthopaedic sports medicine workforce over the past decade.

Both Ends of the Leash: Animals in Australian Residential Aged Care Facilities, Views of Experienced Animal Trainers/handlers Working in Residential Aged Care Facilities.

Research on animals in residential aged care facilities (RACFs) mainly focuses on the residents with little apparent concern for animal welfare. In the context of documented human welfare breaches in the sector the question arises - how do Australian RACF approach animal welfare. To understand animals' lived experiences in this context experienced dog-trainers with RACF employment history were interviewed.

The Effect of Spaced Repetition on Learning and Knowledge Transfer in a Large Cohort of Practicing Physicians.

Purpose: Spaced repetition is superior to repeated study for learning and knowledge retention, but literature on the effect of different spaced repetition strategies is lacking. The authors evaluated the effects of different spaced repetition strategies on long-term knowledge retention and transfer.

Method: This prospective cohort study, conducted from October 1, 2020, to July 20, 2023, used the American Board of Family Medicine Continuous Knowledge Self-Assessment (CKSA) to assess learning and knowledge transfer of diplomates and residents.

Performance Evaluation of the Generative Pre-trained Transformer (GPT-4) on the Family Medicine In-Training Examination.

Objective: In this study, we sought to comprehensively evaluate GPT-4 (Generative Pre-trained Transformer)'s performance on the 2022 American Board of Family Medicine's (ABFM) In-Training Examination (ITE), compared with its predecessor, GPT-3.5, and the national family residents' performance on the same examination.

Methods: We utilized both quantitative and qualitative analyses.

Cannabidiol prevents LPS-induced inflammation by inhibiting the NLRP3 inflammasome and iNOS activity in BV2 microglia cells via CB2 receptors and PPARγ.

Neuroinflammation stands as a critical player in the pathogenesis of diverse neurological disorders, with microglial cells playing a central role in orchestrating the inflammatory landscape within the central nervous system. Cannabidiol (CBD) has gained attention for its potential to elicit anti-inflammatory responses in microglia, offering promising perspectives for conditions associated with neuroinflammation. Here we investigated whether the NLRP3 inflammasome and inducible nitric oxide synthase (iNOS) are involved in the protective effects of CBD, and if their modulation is dependent on cannabinoid receptor 2 (CB2) and PPARγ signalling pathways.

COVID-19 Impact on Family Medicine Residents Exam Performance.

Background And Objectives: The COVID-19 pandemic began interrupting family medicine residency training in spring 2020. While a decline in scores on the American Board of Family Medicine In-Training Examination (ITE) has been observed, whether this decline has translated into the high-stakes Family Medicine Certification Examination (FMCE) is unclear. The goal of this study was to systematically assess the magnitude of COVID-19 impact on medical knowledge acquisition during residency, as measured by the ITE and FMCE.

Perilunate Dislocations: Reduction and Stabilization.

Background: The all-dorsal scapholunate reconstruction technique is indicated for the treatment of scapholunate injuries in cases in which the carpus is reducible and there is no arthrosis present. The goal of this procedure is to reconstruct the torn dorsal portion of the scapholunate ligament in order to stabilize the scaphoid and lunate.

Description: A standard dorsal approach to the wrist, extending from the third metacarpal distally to the distal radioulnar joint, is utilized.

Two-Year Survivorship and Patient-Reported Outcomes of a Prospectively Enrolled Cohort of INFINITY Total Ankle Arthroplasties.

Background: The INFINITY total ankle implant is a widely and successfully used option for total ankle arthroplasty. The purpose of this study is to assess the 2-year survivorship, complication rates, patient-reported outcomes, and radiologic findings of prospectively enrolled patients undergoing a fixed-bearing total ankle arthroplasty (TAA). This study sought to determine if factors such as traditional vs patient-specific instrumentation, preoperative degree of arthritis, deformity, or etiology of arthritis impact surgical or clinical outcomes.

Preoperative Opioid Therapy Correlated With Increased Rate of Complications in Foot and Ankle Surgery.

Background: The purpose of this study is to determine whether patients with a history of preoperative opioid use will have an increased likelihood of postoperative opioid use and complications after undergoing forefoot, hindfoot, or ankle surgery.

Methods: A retrospective review was conducted on forefoot, hindfoot, and ankle surgeries between 2015 and 2020 with a single fellowship-trained orthopaedic foot and ankle surgeon at an academic medical center. A total of 326 patients (356 feet) were included with a mean follow-up up of 2.

Preoperative Opioid Use Predicts Poorer Outcomes of Total Ankle Arthroplasty and Hindfoot Fusions.

Background: This study aimed to determine the impact of preoperative opioid use on outcomes of patients undergoing ankle or hindfoot arthrodesis, or total ankle arthroplasty (TAA).

Methods: We conducted a retrospective review of 190 patients undergoing an ankle or hindfoot arthrodesis (n=122) or TAA (n=68) between December 2015 and September 2020 with a single fellowship-trained orthopaedic foot and ankle surgeon at an academic medical center. Data collected included demographics, medical comorbidities, treatment history, complications and reoperation rates, patient-reported outcome measures (PROMs) (eg, Foot and Ankle Outcome Score [FAOS]), and opioid use.

Constraining the Nuclear Symmetry Energy with Multimessenger Resonant Shattering Flares.

Much effort is devoted to measuring the nuclear symmetry energy through neutron star (NS) and nuclear observables. Since matter in the NS core may be nonhadronic, observables like radii and tidal deformability may not provide reliable constraints on properties of nucleonic matter. By performing the first consistent inference using ensembles of core and crust equations of state from astrophysical and nuclear data, we demonstrate that coincident timing of a resonant shattering flare (RSF) and gravitational wave signal during binary NS inspiral probes the crust-core transition region and provides constraints on the symmetry energy comparable to terrestrial nuclear experiments.

Risks of Chronic Preoperative Opioid Use on Distal Radius Surgery Outcomes.

Background: The purpose of this study was to determine the influence of chronic preoperative opioid use on complications, reoperation rates, and postoperative opioid use among patients undergoing open reduction and internal fixation (ORIF) of distal radius fractures.

Methods: A retrospective review of 111 patients who underwent ORIF of a distal radius fracture from 2019 to 2021 at an academic medical center by the same fellowship-trained orthopedic hand surgeon was conducted. Patient demographics, medical comorbidities, perioperative details, surgical complications, and patient-reported outcome measures were analyzed.

Differences in Physician Performance and Self-rated Confidence on High- and Low-Stakes Knowledge Assessments in Board Certification.

Introduction: Evidence links assessment to optimal learning, affirming that physicians are more likely to study, learn, and practice skills when some form of consequence ("stakes") may result from an assessment. We lack evidence, however, on how physicians' confidence in their knowledge relates to performance on assessments, and whether this varies based on the stakes of the assessment.

Methods: Our retrospective repeated-measures design compared differences in patterns of physician answer accuracy and answer confidence among physicians participating in both a high-stakes and a low-stakes longitudinal assessment of the American Board of Family Medicine.

Preoperative Hypoalbuminemia Not Associated With Total Ankle Arthroplasty Outcomes.

Background.: This study aims to investigate the effect of hypoalbuminemia on the rates of 30-day complication, readmission, and reoperation following total ankle arthroplasty (TAA).

Methods.

Long-Term Oral Steroid Use: A Unique Risk Factor in 4-Corner Fusion Compared With Other Wrist Salvage Operations.

Introduction: Salvage procedures such as proximal row carpectomy, 4-corner fusion, total wrist arthroplasty, and total wrist arthrodesis are commonly used at the end stages of wrist arthritis. These operations have high complication rates, and significant controversy exists regarding the selection of procedure. Long-term oral glucocorticoid therapy has previously been identified as a risk factor for complications in multiple orthopedic procedures.

Low Preoperative Albumin Associated With Increased Risk of Superficial Surgical Site Infection Following Midfoot, Hindfoot, and Ankle Fusion.

Background: This study investigates the effect of malnutrition, defined by hypoalbuminemia, on rates of complication, readmission, reoperation, and mortality following midfoot, hindfoot, or ankle fusion.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried from 2005 to 2019 to identify 500 patients who underwent midfoot (n = 233), hindfoot (n = 261), or ankle (n = 117) fusion. Patients were stratified into normal (n = 452) or low (n = 48) albumin group, which was defined by preoperative serum albumin level <3.

Fur, Fin, and Feather: Management of Animal Interactions in Australian Residential Aged Care Facilities.

Animal-assisted interventions (AAI) have been occurring in Australian Residential Aged Care Facilities (RACF) for more than 40 years and may relieve loneliness and improve quality of life. The presence of animals in RACF poses an inherent risk to residents and the animals involved. Little is known about the policies and guidelines for including animals in the Australian RACF.

National incidence and trends of bicycle injury.

Bicycle utilization continues to increase annually, and this trend was recently accelerated by the coronavirus disease of 2019 pandemic. There is limited epidemiologic data, however, regarding the prevalence and nature of bicycle-related injuries. Therefore, the purpose of this study is to characterize trends in bicycle-related injuries.

Risk Factors for 30-Day Complications and Unplanned Reoperation Following Surgical Treatment of Distal Radius Fractures.

Background: The purpose of this study was to identify demographic data, medical comorbidities, and perioperative factors that are associated with increased risk of overall surgical complications, wound complications, and reoperation within 30 days of open reduction and internal fixation (ORIF) of distal radius fractures.

Methods: All adult patients undergoing ORIF of distal radius fractures in the National Surgical Quality Improvement Program database between 2005 and 2020 were identified. Patients were excluded for secondary procedures, open/infected injuries, or inpatient surgical setting.

Pumpkin carving knife injuries: National incidence and trends of hand injury.

Introduction: Seasonal media reports often describe the dangers of pumpkin carving, yet little data exists regarding the actual incidence of hand injuries resulting from pumpkin carving. The purpose of this study is to describe, quantify, and trend ED encounters associated with pumpkin-related knife injuries.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for pumpkin-related knife injuries from 2012 to 2021.