Outcomes in Knot vs Knotless Surgery in Labrum Tears

A Bankart lesion is a tear of the anterior and inferior glenoid labrum. The primary method of repairing this lesion is to sew the detached part back to the joint, however there is a relatively newer method of doing so that does not involve tying a knot in the joint which may cause less joint irritation. The question our research project attempted to answer was: How do the long-term outcomes associated with knotless Bankart labrum repairs compare with the knot repairs? A retrospective cohort study was done with Rothman Institute Bankart lesion patients from 2010-2016. Data was gathered over phone calls and responses to certain categorical questions like motion, function, stability and return to OR were measured on a scale 0-3. The mean score of these categories was calculated and many of them were close to identical. One category where there was some degree of difference was stability (0=no subluxation, 3=recurrent dislocation). Those who had the knot surgery reported a mean of 1.53 level of instability and those who had the knotless surgery reported a mean of 1.13. It was previously hypothesized that the knotless surgery would have fewer detrimental effects and although this is possible with a lower instability rating, the results were not statistically significant since the p-value was 0.43. However, it is possible that this result can be clinically significant for surgeons when deciding which surgical technique to employ

The Impact of Caregiver and Community Education On Influenza Vaccination Acceptance

Introduction: Pediatric populations are particularly vulnerable to influenza, and rely on parental approval of the pediatric influenza vaccine (PIV). We conducted a survey to better understand our community’s perspective on the PIV. Methods: An urban pediatric clinic’s records were gathered for the 2017-2019 flu seasons (i.e., pre-survey period). Surveys were distributed during the 2019-2020 flu season to assess vaccination status and their reasoning for acceptance or rejection of the PIV for their child(ren). Children vaccination rates were divided into 3 groups: 6 months-3 years, 3-5 years, and 5-18 years. Results: During the 2017-2018 flu season, the overall vaccination rate (n=1791) was 34.1%. For the 2018-2019 flu season, the overall vaccination rate (n=1795) was 41.7%. During the 2019-2020 flu season, the overall vaccination rate (n=1620) increased to 45.3%. This was a statistically significant increase from 2018-2019 flu season (p=0.035). The most common reason to vaccinate was, I do not want my child to get the flu/the shot reduces the likelihood of child getting the flu (52.2% in \u3c5 years age group, 56.5% in \u3e5 years age group). The most common reason to not vaccinate was, I do not want the flu shot for my child (35.7% in \u3c5 years age group, 38.6% in \u3e5 years age group). Discussion: Understanding community perceptions will allow for efficacious educational materials and allow healthcare providers to tailor their strategies for the sake of preventive medicine and community health

Screening for Inhalational Anthrax Due to Bioterrorism: Evaluating Proposed Screening Protocols

Eleven known cases of bioterrorism-related inhalational anthrax (IA) were treated in the United States during 2001. We retrospectively compared 2 methods that have been proposed to screen for IA. The 2 screening protocols for IA were applied to the emergency department charts of patients who presented with possible signs or symptoms of IA at Inova Fairfax Hospital (Falls Church, Virginia) from 20 October 2001 through 3 November 2001. The Mayer criteria would have screened 4 patients (0.4%; 95% CI, 0.1%-0.9%) and generated charges of 1900 dollars. If 29 patients (2.6%; 95% CI, 1.7%-3.7%) with \u3eor=5 symptoms (but without fever and tachycardia) were screened, charges were 13,325 dollars. The Hupert criteria would have screened 273 patients (24%; 95% CI, 22%-27%) and generated charges of 126,025 dollars. In this outbreak of bioterrorism-related IA, applying the Mayer criteria would have identified both patients with IA and would have generated fewer charges than applying the Hupert criteria

Primary Care Physician Productivity & Patient Satisfaction: A Mayo Clinic\u27s Community Practice Study

Research has shown a positive association between patient experience and improved patient outcomes. Provider burnout has been associated with decreased quality, safety, patient experience and productivity. Leaders at Mayo conducted a study to explore the relationship between patient satisfaction and physician productivity. In this webinar, Dr. Thomas Howell dives into the results of a study using data from Press Ganey patient satisfaction surveys and a secondary analysis of patient satisfaction scores related to continuous years of service. Presentation: 56:1

Strontium mineralization of shark vertebrae

Determining the age of sharks using vertebral banding is a vital component of management, but the causes of banding are not fully understood. Traditional shark ageing is based on fish otolith ageing methods where growth bands are assumed to result from varied seasonal calcification rates. Here we investigate these assumptions by mapping elemental distribution within the growth bands of vertebrae from six species of sharks representing four different taxonomic orders using scanning x-ray fluorescence microscopy. Traditional visual growth bands, determined with light microscopy, were more closely correlated to strontium than calcium in all species tested. Elemental distributions suggest that vertebral strontium bands may be related to environmental variations in salinity. These results highlight the requirement for a better understanding of shark movements, and their influence on vertebral development, if confidence in age estimates is to be improved. Analysis of shark vertebrae using similar strontium-focused elemental techniques, once validated for a given species, may allow more successful estimations of age on individuals with few or no visible vertebral bands. © 2016 Macmillan Publishers Limite

Trial to Improve Inter-professional Practice Behaviors at a Student-Run, Free Clinic

The Indiana University Student Outreach Clinic (IUSOC) is a student-run, free clinic on the east side of Indianapolis. Students from eleven different disciplines (pharmacy, social work, occupational therapy, physical therapy, law, dentistry, global health, optometry, public health, nursing and medicine), covering three institutions (Indiana University, Butler University, and the University of Indianapolis), volunteer at the IUSOC. This study is a randomized-controlled intervention designed to improve inter-professional practice knowledge and behaviors within the IUSOC. On intervention clinic days, all clinic volunteers will gather in a huddle before seeing patients for a structured didactic information session. The session will highlight the importance of screening patients for comorbid conditions and subsequently referring patients to the appropriate clinic partners through inter-professional consultations. Clinic volunteers will receive a knowledge sheet that lists the top roles of each partner organization, in addition to a description of the screening tool, to be utilized on intervention days. The information session, knowledge sheet handout, and screening tool will not be employed on clinic control days. The primary aim is to assess the efficacy of the intervention by tracking and comparing the number of consults made during control and intervention days. The secondary aims are to investigate the impact of the intervention on collaboration and relationships among the professions represented at the clinic, to assess professional students’ knowledge of services provided by partner organizations, and to assess volunteer satisfaction of inter-professional relationships. We propose the intervention will increase the number of partner-to-partner consults and improve the measures listed above. Students will be surveyed using the Interprofessional Socialization and Valuing Scale, along with other survey tools developed by IUSOC research scientists. The project aims enhance inter-professional practice behaviors in students, as well as offer insight into the roles of healthcare professional and explore attitudes regarding teamwork in a healthcare setting. Learning Objectives: Describe how IPE measures in a student-run, free clinic setting may be structured to improve teamwork among volunteers. Knowledge regarding how an innovative screening and knowledge protocol may lead to increased inter-professional practice behaviors among student volunteers. Explore personal attitudes and values regarding teamwork in a healthcare setting

Imaging high-dimensional spatial entanglement with a camera

The light produced by parametric down-conversion shows strong spatial entanglement that leads to violations of EPR criteria for separability. Historically, such studies have been performed by scanning a single-element, single-photon detector across a detection plane. Here we show that modern electron-multiplying charge-coupled device cameras can measure correlations in both position and momentum across a multi-pixel field of view. This capability allows us to observe entanglement of around 2,500 spatial states and demonstrate Einstein-Podolsky-Rosen type correlations by more than two orders of magnitude. More generally, our work shows that cameras can lead to important new capabilities in quantum optics and quantum information science.Comment: 5 pages, 4 figure

Genetically Programmed Differences in Epidermal Host Defense between Psoriasis and Atopic Dermatitis Patients

In the past decades, chronic inflammatory diseases such as psoriasis, atopic dermatitis, asthma, Crohn’s disease and celiac disease were generally regarded as immune-mediated conditions involving activated T-cells and proinflammatory cytokines produced by these cells. This paradigm has recently been challenged by the finding that mutations and polymorphisms in epithelium-expressed genes involved in physical barrier function or innate immunity, are risk factors of these conditions. We used a functional genomics approach to analyze cultured keratinocytes from patients with psoriasis or atopic dermatitis and healthy controls. First passage primary cells derived from non-lesional skin were stimulated with pro-inflammatory cytokines, and expression of a panel of 55 genes associated with epidermal differentiation and cutaneous inflammation was measured by quantitative PCR. A subset of these genes was analyzed at the protein level. Using cluster analysis and multivariate analysis of variance we identified groups of genes that were differentially expressed, and could, depending on the stimulus, provide a disease-specific gene expression signature. We found particularly large differences in expression levels of innate immunity genes between keratinocytes from psoriasis patients and atopic dermatitis patients. Our findings indicate that cell-autonomous differences exist between cultured keratinocytes of psoriasis and atopic dermatitis patients, which we interpret to be genetically determined. We hypothesize that polymorphisms of innate immunity genes both with signaling and effector functions are coadapted, each with balancing advantages and disadvantages. In the case of psoriasis, high expression levels of antimicrobial proteins genes putatively confer increased protection against microbial infection, but the biological cost could be a beneficial system gone awry, leading to overt inflammatory disease