A Narrative Review of Key Studies in Medical Education in 2023: Applying the Current Literature to Educational Practice and Scholarship.

Pediatric clinician educators face the challenge of juggling clinical practice with teaching responsibilities. The balancing act is even more challenging when one considers the need to stay current with evidence from clinical and medical education literature. In this narrative review of 2023 medical education literature, the Academic Pediatric Association Education Committee's Top Articles team summarizes high-yield articles that possess the potential to significantly influence pediatric clinician educator teaching and practice.

Decoding the Reference Letter: Strategies to Reduce Unintentional Gender Bias in Letters of Recommendation.

Introduction: There is a growing body of literature on gender bias in letters of recommendation (LORs) in academic medicine and the negative effect of bias on promotion and career advancement. Thus, increasing knowledge about gender bias and developing skills to mitigate it is important for advancing gender equity in medicine. This workshop aims to provide participants with knowledge about linguistic bias (focused on gender), how to recognize it, and strategies to apply to mitigate it when writing LORs.

Infant in extremis: respiratory failure secondary to lower airway infantile hemangioma.

Background: Infantile hemangiomas (IHs) are vascular tumors that commonly affect infants and usually regress spontaneously or can be easily treated as an outpatient with topical beta-blockers. However, IHs that present in the airway may cause life-threatening symptoms due to airway obstruction or risk of bleeding. Here we present the first documented case of an infant with rapid deterioration and acute respiratory failure secondary to a lower airway hemangioma.

A Scoping Review and Appraisal of Extracorporeal Membrane Oxygenation Education Literature.

Background: Despite a recent rise in publications describing extracorporeal membrane oxygenation (ECMO) education, the scope and quality of ECMO educational research and curricular assessments have not previously been evaluated.

Objective: The purposes of this study are ) to categorize published ECMO educational scholarship according to Bloom's educational domains, learner groups, and content delivery methods; ) to assess ECMO educational scholarship quality; and ) to identify areas of focus for future curricular development and educational research.

Methods: A multidisciplinary research team conducted a scoping review of ECMO literature published between January 2009 and October 2021 using established frameworks.

Maintaining Social Distancing: Video and Just-in-Time In Situ Simulation During the COVID-19 Pandemic.

Respiratory failure and cardiopulmonary arrest in patients with SARS-CoV-2 infection require life-saving procedures that aerosolize virus and increase risk of transmission. To educate faculty, trainees, and staff on safe practices, a video with embedded questions was created demonstrating intubation and cardiopulmonary resuscitation in pediatric SARS-CoV-2+ patients. Just-in-time in situ simulations of these scenarios were also carried out while adhering to isolation and social distancing protocols.

Evaluation of Three Postal Invitational Strategies to Increase Survey Response Rates in a Combat-Injured U.S. Military Population: Findings From the Wounded Warrior Recovery Project.

The survival rate of those injured in combat in overseas contingency operations is higher than in previous conflicts. There is a need to assess the long-term psychosocial and quality of life outcomes of those injured in combat, yet surveying this population presents inherent challenges. As part of a large-scale, longitudinal examination of patient-reported outcomes of service members injured on deployment, the present manuscript evaluated the effectiveness of three postal strategies on response rates: (1) mailing a study prenotification postcard, (2) mailing the survey invitation in a larger envelope, and (3) including a small cash preincentive ($2).

Preliminary study of hearing protection and non-impact, blast-induced concussion in US military personnel.

Primary Objective: To examine the relationship between hearing protection and non-impact, blast-induced concussion in US military personnel.

Research Design: Retrospective cohort study.

Methods And Procedures: A total of 501 US service members from the Expeditionary Medical Encounter Database with hearing protection status reported either 'worn' or 'not worn' were eligible for analysis.

Tympanoplasty following Blast Injury.

Objectives To assess outcomes following tympanoplasty for blast-induced tympanic membrane perforations in a military population. Study Design Case series with chart review. Setting Tertiary care medical centers.

mTOR Inhibition by Everolimus Does Not Impair Closure of Punch Biopsy Wounds in Renal Transplant Patients.

Background: Mammalian target of rapamycin (mTOR) inhibitors are approved to prevent allograft rejection and control malignancy. Unfortunately, they are associated with adverse effects, such as wound healing complications that detract from more extensive use. There is a lack of prospective wound healing studies to monitor patients treated with mTOR inhibitors, such as everolimus or sirolimus, especially in nondiabetics.

Bilateral Dilated Nonreactive Pupils in a Neonate After Surgery.

Fixed and dilated pupils are disturbing when encountered during a physical examination in the pediatric intensive care unit, particularly when sedation or neuromuscular blockade confounds the neurologic examination. Rocuronium, a nondepolarizing neuromuscular drug, does not cross the blood-brain barrier and is not considered a causative agent for fixed mydriasis. We report a case of bilateral fixed and dilated pupils in a 1-week-old low-birth-weight neonate, which we contend was secondary to centrally mediated neuromuscular blockade.

Post-traumatic Stress Disorder Among Navy Health Care Personnel Following Combat Deployment.

U.S. Navy health care personnel are exposed to an array of psychological stressors during combat deployment.

Airway Management in Severe Combat Maxillofacial Trauma.

Objectives: Airway stabilization is critical in combat maxillofacial injury as normal anatomical landmarks can be obscured. The study objective was to characterize the epidemiology of airway management in maxillofacial trauma.

Study Design: Retrospective database analysis.

Obesity impairs γδ T cell homeostasis and antiviral function in humans.

Obese patients are susceptible to increased morbidity and mortality associated with infectious diseases such as influenza A virus. γδ T cells and memory αβ T cells play key roles in reducing viral load by rapidly producing IFN-γ and lysing infected cells. In this article we analyze the impact of obesity on T lymphocyte antiviral immunity.

Characteristics of maxillofacial injuries and safety of in-theater facial fracture repair in severe combat trauma.

The study objectives were to characterize maxillofacial injuries and assess the safety of in-theater facial fracture repair in U.S. military personnel with severe combat trauma from Iraq and Afghanistan.

Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees.

Morphine and fentanyl are frequently used for analgesia after trauma, but there is debate over the advantages and disadvantages of these opioids. Among combat amputees, intravenous (IV) morphine (vs IV fentanyl) after injury was associated with reduced likelihood of posttraumatic stress disorder (PTSD). The previous results were based on military health diagnoses over 2 yr postinjury.

Dwell time and psychological screening outcomes among military service members with multiple combat deployments.

Recent studies have found that longer dwell times, or the period of time between deployments, may be protective against combat-related psychological outcomes. The purpose of this study was to examine the association between dwell time and psychological morbidity, while accounting for combat exposure. U.

A study protocol for tracking quality of life among U.S. service members wounded in Iraq and Afghanistan: the Wounded Warrior Recovery Project.

There is a need for more work to understand the quality of life (QOL) outcomes of survivors of Operations Enduring Freedom and Iraqi Freedom combat injury to improve care and treatment, and prevent poor physical, psychological, and social outcomes. We describe the study design and methods of the Wounded Warrior Recovery Project, a study supported by the Department of Defense that will track close to 10,000 military personnel wounded in Operations Enduring Freedom and Iraqi Freedom. The overall objective of the 6-year longitudinal study is to track changes in QOL and describe variations in those changes as they relate to sociodemographic factors, injury characteristics, service-related factors, clinical/diagnostic measures including traumatic brain injury and posttraumatic stress disorder, and medical procedures and services.

Blast-related ear injuries among U.S. military personnel.

Blast-related ear injuries are a concern during deployment because they can compromise a servicemember's situational awareness and adversely affect operational readiness. The objectives of this study were to describe blast-related ear injuries during Operation Iraqi Freedom, identify the effect of hearing protection worn at the point of injury, and explore hearing loss and tinnitus outcomes within one year after injury. The Expeditionary Medical Encounter Database was used to identify military personnel who survived blast-related injury, and it was linked with outpatient medical databases to obtain diagnoses of hearing loss and tinnitus.

Effect of dwell time on the mental health of US military personnel with multiple combat tours.

Objective: We investigated the association of the length of time spent at home between deployments, or dwell time, with posttraumatic stress disorder (PTSD) and other mental health disorders.

Methods: We included US Marine Corps personnel identified from military deployment records who deployed to Operation Iraqi Freedom once (n = 49,328) or twice (n = 16,376). New-onset mental health diagnoses from military medical databases were included.

Weight changes among male Navy personnel deployed to Iraq or Kuwait in 2005-2008.

The objective of this study was to identify changes in weight that occurred during deployment to Iraq or Kuwait between 2005 and 2008. Data on length and type of deployment among 16,365 male U.S.

Cigarette smoking, body mass index, and physical fitness changes among male navy personnel.

Introduction: Cigarette smoking has been reported to be higher among deployed military men than among similarly aged civilian or nondeployed men, but the short-term effect of smoking on physical fitness among these young healthy men is unclear. This study examined self-reported smoking status and change in objectively measured fitness over 1-4 years while controlling for body mass index (BMI).

Methods: This study included a large sample of male U.

Postinjury depression is a serious complication in adolescents after major trauma: injury severity and injury-event factors predict depression and long-term quality of life deficits.

Background: Little is known about the impact of postinjury depression after major trauma in adolescents. A prospective epidemiologic study was conducted to examine depression in injured adolescents. Specific objectives of this report are to identify risk factors for depression onset and the impact of depression on quality of life (QoL) outcomes.