Notes

[Clinical characteristics of genetic nephrogenic diabetic issues insipidus].
Scleral structural abnormalities were present outside of the optic nerve as well.
Swept-source OCT clearly delineated the papillary and peripapillary abnormalities of morning glory syndrome. Scleral structural abnormalities were present outside of the optic nerve as well.
A 17-year-old adolescent boy presented with continued knee pain, swelling, and mechanical symptoms after anterior cruciate ligament (ACL) reconstruction with partial meniscectomy. The patient eventually underwent ACL revision surgery that was without complications. BI-4020 Postoperatively, the well leg grew firm with associated neurological deficits, and physical examination confirmed compartment syndrome of the lower leg compartments that resolved with emergency fasciotomy. The patient proceeded on normal postoperative course.

Compartment syndrome of the well leg is a rare complication in the field of sports medicine, owing to the relatively healthy and young demographic, but providers should nonetheless be vigilant to prevent disastrous sequalae.
Compartment syndrome of the well leg is a rare complication in the field of sports medicine, owing to the relatively healthy and young demographic, but providers should nonetheless be vigilant to prevent disastrous sequalae.
A 60-year-old woman with avascular necrosis of the right humeral head underwent anatomical total shoulder arthroplasty (TSA); however, recurrent posterior dislocation occurred 13 months postoperatively. We performed bone block grafting of an autologous iliac crest to the posterior glenoid and posterior capsular plication, after which satisfactory postoperative shoulder function without residual joint instability was achieved.

The presented case had recurrent posterior dislocation after TSA without any abnormal findings in the prosthetic components. Posterior bone block grafting with capsular plication should be considered a viable option for posterior instability after anatomical TSA.
The presented case had recurrent posterior dislocation after TSA without any abnormal findings in the prosthetic components. Posterior bone block grafting with capsular plication should be considered a viable option for posterior instability after anatomical TSA.
A 33-year-old man who had experienced polytraumatic injury from a motorcycle collision 5 months previously presented to the clinic with right ankle pain. On physical examination, anterior ankle tenderness was present, and imaging revealed a previously unrecognized nondisplaced talar body fracture with a chondral defect. The patient underwent arthroscopy of the right ankle, which influenced the senior author to perform a medial malleolar osteotomy and subsequent open reduction internal fixation with micronized allogenic cartilage matrix.

Arthroscopy provides valuable information for the surgical planning of talar nonunions, and allogenic cartilage matrix graft may provide benefit with associated chondral defects.
Arthroscopy provides valuable information for the surgical planning of talar nonunions, and allogenic cartilage matrix graft may provide benefit with associated chondral defects.
Many models of competency-based medical education (CBME) emphasize assessing entrustable professional activities (EPAs). Despite the centrality of EPAs, researchers have not compared rater entrustment decisions for the same EPA across workplace- and simulation-based assessments. This study aimed to explore rater entrustment decision making across these 2 assessment settings.

An interview-based study using a constructivist grounded theory approach was conducted. Gastroenterology faculty at the University of Toronto and the University of Calgary completed EPA assessments of trainees' endoscopic polypectomy performance in both workplace and simulation settings between November 2019 and January 2021. After each assessment, raters were interviewed to explore how and why they made entrustment decisions within and across settings. Transcribed interview data were coded iteratively using constant comparison to generate themes.

Analysis of 20 interviews with 10 raters found that participants (1) held multiple meaam leaders might also consider how to fulfill raters' criteria for comfortably making entrustment decisions by ensuring clear definitions and purposes when designing and integrating workplace- and simulation-based assessments.
Participants spoke about and defined entrustment variably, which appeared to produce variability in how they judged entrustment across participants and within and across assessment settings. These rater idiosyncrasies suggest that programs implementing CBME must consider how such variability affects the aggregation of EPA assessments, especially those collected in different settings. Program leaders might also consider how to fulfill raters' criteria for comfortably making entrustment decisions by ensuring clear definitions and purposes when designing and integrating workplace- and simulation-based assessments.
A 25-year-old man involved in a jet skiing accident experienced a traumatic excision of his distal fibula in conjunction with other lower extremity injuries. He subsequently underwent a reconstruction of his lateral malleolus using an ipsilateral free vascularized fibular graft (FVFG) from his proximal fibular shaft, resulting in a preserved and stabilized ankle joint at 1 year.

Traumatic distal fibular excision is a rare injury that can be successfully managed using an FVFG, with fusion of the distal syndesmosis and a symmetric ankle mortise observed at the 1-year follow-up.
Traumatic distal fibular excision is a rare injury that can be successfully managed using an FVFG, with fusion of the distal syndesmosis and a symmetric ankle mortise observed at the 1-year follow-up.
Early grant support for junior faculty members appears to positively influence their career trajectory. The authors sought to determine whether provision of grant support that enables early-career faculty members to conduct clinical, basic science, or educational research improves their academic success and enhances retention.

The authors compared career development and retention among 30 Cohn Fellowship recipients and 31 nonrecipients who participated in the same mentoring program. An award of $20,000 to the fellowship recipients ensured protected time for research for 1 year. Academic productivity of both groups was monitored for 6 years.

The authors found statistically significant differences between the 2 groups regarding research funding and scholarly productivity. The Cohn Fellowship recipients received a total of $14.7 million in external funding vs $3.7 million for nonrecipients, reflecting mean funding of $588,116 and $196,658 per person, respectively ( P < .01). Recipients published a total of 174 peer-reviewed articles vs 26 for nonrecipients, reflecting a mean of 7 and 1 per person, respectively ( P < .01). Recipients gave a total of 268 presentations vs 25 for nonrecipients, with a mean of 11 and 1 per person, respectively ( P < .01). Furthermore, 8 of the 25 recipients who stayed at Rush University (32%) were promoted to associate professor compared with 2 of the 19 (11%) nonrecipients ( P = .15). A majority of the Cohn Fellows (25; 83%) stayed at Rush University during the study compared with 61% of nonrecipients ( P = .06). These findings suggest that even small amounts of research support received early in a career can benefit the faculty and the university as a whole.

We plan to continue gathering data to increase sample size and analyze outcomes for specific variables (e.g., time, rank, gender, promotion, retention).
We plan to continue gathering data to increase sample size and analyze outcomes for specific variables (e.g., time, rank, gender, promotion, retention).Virtual care, introduced previously as a replacement for in-person visits, is now being integrated into clinical care delivery models to complement in-person visits. The COVID-19 pandemic sped up this process. The rapid uptake of virtual care at the start of the pandemic prevented educators from taking deliberate steps to design the foundational elements of the related learning environment, including workflow, competencies, and assessment methods. Educators must now pursue an informed and purposeful approach to design a curriculum and implement virtual care in the learning environment. Engaging learners in virtual care offers opportunities for novel ways to teach and assess their performance and to effectively integrate technology such that it is accessible and equitable. It also offers opportunities for learners to demonstrate professionalism in a virtual environment, to obtain a patient's history incorporating interpersonal and communication skills, to interact with multiple parties during a patient encounter (patient, caregiver, translator, telepresenter, faculty member), to enhance physical examination techniques via videoconferencing, and ideally to optimize demonstrations of empathy through "webside manner." Feedback and assessment, important features of training in any setting, must be timely, specific, and actionable in the new virtual care environment. Recognizing the importance of integrating virtual care into education, leaders from across the United States convened on September 10, 2020, for a symposium titled, "Crossing the Virtual Chasm Rethinking Curriculum, Competency, and Culture in the Virtual Care Era." In this article, the authors share recommendations that came out of this symposium for the implementation of educational tools in the evolving virtual care environment. They present core competencies, assessment tools, precepting workflows, and technology to optimize the delivery of high-quality virtual care that is safe, timely, effective, efficient, equitable, and patient-centered.In addition to restrictions on conducting research, COVID-19-related travel bans and scientific meeting cancellations have negatively affected scholars in the Clinical and Translational Science Award (CTSA) Mentored Career Development Award (KL2) program. In response, a national virtual visiting scholar program was developed to provide opportunity for KL2 scholars to be virtual visiting professors at another CTSA hub, meet faculty and scholars, and expand networks and build collaborations. This article describes the design and short-term outcomes of the virtual CTSA Visiting Scholar Program. In 2020, a working group designed core program elements and developed an application and selection process. Anonymized surveys were sent to scholars post visit and to scholars and program directors 6 months post visit to evaluate their experience and solicit suggestions for improvements. Between November 2020 and May 2021, 56 KL2 scholars and 27 hubs participated. Forty-five (80.4%) participating scholars responded to the initial survey. Nearly all scholars (44, 97.7%) agreed their experience was valuable. All respondents indicated they would recommend the program to other KL2 scholars. For the 6-month survey, the response rate was 87.5% (49/56). Within 6 months of their visit, 36 (73.5%) respondents had contacted at least one person at the host hub and for 17 (34.7%) respondents, new collaborations with the host hub ensued. Twenty-five of 27 (92.6%) host hubs responded to the survey. Most (21, 84.0%) agreed that hearing visiting scholar talks was valuable to their own scholars and 23 (92%) indicated likelihood of their hub participating in future round of the program. The virtual Visiting Scholar Program provided KL2 scholars an opportunity to virtually visit another CTSA hub, present their research, and meet with faculty and other scholars to expand their networks. Although geared to KL2 scholars, this model is potentially generalizable to other nationally coordinated career development programs.
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