Notes

Predictive aspects influencing long-term survivorship associated with ASR metal-on-metal overall hip arthroplasty.
This pretest-posttest pilot study was to examine the effects of how olfactory stimulation (OS) influenced swallowing function in older adults. Forty-four community-dwelling older residents (24 OS & 20 control) from southern Taiwan were recruited. Participants in the intervention group administered pre-meal OS using odor and flavor inhalation. The study found that physiological responses for different food textures significantly differed between groups at post-test (p ≤ .02). Within the experimental group, swallowing function, and individual satisfaction showed significant differences before and after the odor inhalation over time (p  less then  .01, η p 2  = 0.16-0.33). An individual's satisfaction to their own swallowing capacity was largely enhanced by the significant interaction between time and group (F[1, 42] = 11.34, p = .002, η p 2  = 0.21), but not for physiological response to OS and swallowing function. The results suggest OS may be advantageous to improving physiological response to OS, swallowing function and satisfaction with swallowing capacity in older adults.The conversation strategies patients and clinicians use are important in determining patient satisfaction and adherence, and health outcomes following patient education-yet most studies are rife with surveys and interviews which often fail to account for real-time interaction. Conversation analysis (CA) is a powerful but underused sociological and linguistic technique aimed at understanding how interaction is accomplished in real-time. In the current manuscript, we provide a primer to CA in an effort to make the technique accessible to patient education researchers including; The history of CA, identifying and collecting data, transcription conventions, data analysis, and presenting the findings. Ultimately, this article provides an easily digestible demonstration of this analytic technique.Community hospitals may be able to increase revenue by diversifying into non-inpatient service lines. BAY 11-7821 A model predicting this kind of diversification has not been developed. Data from community hospitals in Wisconsin was analyzed to explain diversification into non-inpatient service lines. Principal components analysis was applied to the services offered to identify factors. The derived factor scores were analyzed using multiple linear regression. Two distinct noninpatient identities were identified a vertically integrated acute hospital and a hospital diversified into community-based services. Regression analysis revealed that horizontal integration was related to vertical integration into non-inpatient service lines. link2 Community hospitals belonging to alliances and systems had lower vertical integration scores.
Transplantation is the optimal management for patients with end-stage renal disease. In Ethiopia, the first national kidney transplantation center was opened at St. Paul's Hospital Millennium Medical College in September 2015. The aim of this study was to explore providers' views and experiences of the past to present at this center.

A qualitative study design was employed from 1
November to 15
December, 2019. To ensure that appropriate informants would provide rich study data, 8 health care providers and top management members were purposefully chosen for in-depth interviews. A maximum variation sampling method was considered to include a representative sample of informants. Interviews were digitally audio-recorded, and transcribed verbatim. Transcribed data was coded and analyzed using Qualitative Data Analysis (QDA) Minor Lite software and Microsoft-Excel.

The participants (5 males and 3 females) approached were from different departments of the renal transplant center, and the main hospital. Eigltitude of challenges were faced during and after the establishment of the first renal transplant center in Ethiopia. Providers discharge their responsibility through a proper compassion for patients. Concerned stakeholders should actively collaborate to improve the quality of renal transplant services in the center.
Program directors (PDs) play a crucial role in the competitiveness of the residency selection process and in mentoring the next generation of physicians. With this mandate comes the need to evaluate PDs on their own academic performance. We aimed to evaluate the distinguishing characteristics of anesthesiology residency programs with a focus on academic productivity of PDs and to investigate how these characteristics affect the Doximity program rank.

We identified anesthesiology program rankings from 2019 Doximity standings and divided them into quartiles (Q1-Q4). PD academic history and bibliometric indices (H-index, number of publications and citations) were collected through program websites, PubMed, Scopus, Google Scholar, and Accreditation Council for Graduate Medical Education (ACGME) websites.

A total of 152 active anesthesiology programs and PDs were identified across the United States. Among the 152 PDs, 32% (n = 49) were women and 68% (n = 103) were men. There were differences between the Q1 vsize, female residents' percentage, ACGME approval date, number of ACGME-approved fellowships, as well as PDs' research productivity.
Junior faculty in academic medicine often struggle with establishing their careers, resulting in low promotion and high attrition rates. Fellows also grapple with the decision to pursue careers in academic medicine. We report on the implementation and evaluation of a novel faculty and fellows exchange program that promotes career development.

In 2017, the University of California San Francisco created a reciprocal faculty exchange program called the Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP). ViSiPAP expanded to involve 17 institutions across the United States. Fellows from 3 of the institutions were paired with faculty mentors to create Fellow/Faculty ViSiPAP. An initial postparticipation survey was sent after each exchange, and a follow-up survey in 2020 assessed ViSiPAP's impact.

Fifty-three faculty participated in ViSiPAP and gave 66 presentations, and 20 fellows from 3 institutions gave 20 presentations. The initial postparticipation survey response rate was 88%, and the follow-up cessfully introduced the participants into the pediatric anesthesia community and jumpstarted academic careers. Participation in ViSiPAP led to increased scholarly output and assisted with faculty promotion. This combined fellow/faculty exchange program is a novel approach to professional development and is broadly applicable to other disciplines in academic medicine.
Social media remains a growing platform for physicians to facilitate learning, network, and disseminate information. The Coronavirus Disease 2019 (COVID-19) pandemic has challenged traditional medical student recruitment and outreach. Instagram is a platform that can be used by residency programs to increase engagement and as a potential recruitment tool. link3 The authors present social media failed and successful strategies used to increase engagement and gain new followers.

In June 2020, an initiative began to use Instagram on a more frequent and intentional basis. Three different strategies were implemented during the pandemic mirroring Twitter posts, increasing multimedia, and leveraging Instagram Stories. The outcomes of interest included number of followers and engagement on posts. Data were collected October 2020.

After June 1, 2020, the @mayoanesthesia account gained 1000 followers through 127 days, an average of 4.26 new followers each day. Before June 1, there were 24 total posts over 3.3 years with a total of 458 followers. Three different strategies were implemented at different times during the pandemic. During the mirroring Twitter posts period, the mean number of interactions per post was 14.5. During the second phase after separating the Twitter and Instagram strategy, the mean number of interactions per post increased to 57.8.

Residency programs can creatively, yet methodically, use Instagram posts to increase social media engagement during resident recruitment season during the COVID-19 pandemic and likely beyond.
Residency programs can creatively, yet methodically, use Instagram posts to increase social media engagement during resident recruitment season during the COVID-19 pandemic and likely beyond.Complete dislocations of the trapezoid are very uncommon injuries. The authors present a case of open palmar trapezoid fracture-dislocation with significant displacement of the fracture, acute carpal tunnel syndrome and other concomitant carpometacarpal injuries. A review of the literature search for palmar trapezoid dislocations and treatments was performed.The mechanism for growth plate fusion is not fully understood yet. We present the first reported Seymour fracture (Salter Harris I) in an adult with failed growth plate fusion. The management of Seymour fractures should be according to radiological bone age rather than actual age.Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) is a progressive disorder associated with deficiency of mitochondrial aspartyl-tRNA synthetase, a homodimer encoded by the gene DARS2. There is a wide range in age of onset of symptoms, typically from childhood to adulthood, with very few cases of infantile onset disease reported. We report a child at age 10 years with perinatal onset of symptoms evidenced by congenital microcephaly with progression to severe but non-lethal epileptic encephalopathy and spastic quadriplegia. A comprehensive epilepsy focused gene panel performed as a trio with parents detected a novel homozygous DARS2 variant. This variant is located at the dimer interface in a critical catalytic domain and is expected to result in markedly reduced enzyme activity which likely explains the severe and early onset symptoms in this case.
There are no clear criteria for antifungal de-escalation after initial empirical treatments. We hypothesized that early de-escalation (ED) (within 5 days) to fluconazole is safe in fluconazole-susceptible candidemia with controlled source of infection.

This is a multicenter post hoc study that included consecutive patients from 3 prospective candidemia cohorts (2007-2016). The impact of ED and factors associated with mortality were assessed.

Of 1023 candidemia episodes, 235 met inclusion criteria. Of these, 54 (23%) were classified as the ED group and 181 (77%) were classified as the non-ED group. ED was more common in catheter-related candidemia (51.9% vs 31.5%;
 = .006) and episodes caused by
, yet it was less frequent in patients in the intensive care unit (24.1% vs 39.2%;
 = .043), infections caused by
(0% vs 9.9%;
 = .016), and candidemia from an unknown source (24.1% vs 47%;
 = .003). In the ED and non-ED groups, 30-day mortality was 11.1% and 29.8% (
 = .006), respectively. Chronic hip strategies.
The increasing shortage of specialized health care services contributes to the ongoing HIV epidemic. Telemedicine (TM) is a potential tool to improve HIV care, but little is known about its effectiveness when compared with traditional (face-to-face [F2F]) care in rural populations. The objective of this study was to compare the effectiveness of HIV care delivered through TM with the F2F model.

We conducted a retrospective chart review of a subset of patients with HIV who attended a TM clinic in Dublin, Georgia, and an F2F clinic in Augusta, Georgia, between May 2017 and April 2018. All TM patients were matched to F2F patients based on gender, age, and race. HIV viral load (VL) and CD4 count gain were compared using
test and Mann-Whitney
statistics.

Three hundred eighty-five patients were included in the analyses (F2F = 200; TM = 185). The mean CD4 in the TM group was higher (643.9 cells/mm
) than that of the F2F group (596.3 cells/mm
;
 < .001). There was no statistically significant difference in VL reduction, control, or mean VL (F2F = 416.
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