Notes

Sinus Venosus ASDs: Image and Percutaneous Closing.
We assessed whether tobacco screening provides clinically meaningful information about other substance use, including alcohol and other drug use, potentially facilitating targeting of screening for substance use. Using data from the Veterans Aging Cohort Study survey sample (VACS; N = 7510), we calculated test performance characteristics of tobacco use screening results for identification of other substance use including sensitivity, specificity, positive-likelihood-ratio (+LR = [sensitivity/(1-specificity)] increase in odds of substance use informed by a positive tobacco screen), and negative-likelihood-ratio (-LR [(1-sensitivity)/specificity] reduction in odds of substance use informed by a negative tobacco screen). The sample was 95% male, 75% minority, and 43% were current and 33% were former smokers. Never smoking, versus any history, indicated an approximate four-fold decrease in the odds of injection drug use (-LR = 0.26), an approximate 2.5-fold decrease in crack/cocaine (-LR = 0.35) and unhealthy alcohol use (-LR = 0.40), an approximate two-fold decrease in marijuana (-LR = 0.51) and illicit opioid use (-LR = 0.48), and an approximate 30% decrease in non-crack/cocaine stimulant use (-LR = 0.75). Never smoking yielded more information than current non-smoking (never/former smoking). Positive results on tobacco screening were less informative than negative results; current smoking, versus former/never smoking, provided more information than lifetime smoking and was associated with a 40% increase in the odds of non-crack/cocaine stimulant use (+LR = 1.40) and opioid use (+LR = 1.44), 50% increase in marijuana use (+LR = 1.52) and injection drug use (+LR = 1.55), and an 80-90% increase in crack/cocaine use (+LR = 1.93) and unhealthy alcohol use (+LR = 1.75). When comprehensive screening for substance use is not possible, tobacco screening may inform decisions about targeting substance use screening.Bicycling has multiple health benefits. Child-rearing may influence bicycling, but little is known about the impact of this between men's and women's bicycling, or of number and ages of children on bicycling. This study examined the longitudinal associations between having dependent children and bicycling for transportation and recreation over 4 years among mid-aged men and women. Data were from the HABITAT study (Australia). We analysed data from three survey waves (2007, 2009, 2011) using multilevel logistic regression stratified by gender (n = 7758). Findings indicate that having dependent children was associated with bicycling for transportation and recreation in contrasting ways for men and women. The odds of bicycling were higher in men with ≥2 children aged under 18y than men without children (transportation OR = 1.93, 95% CI 1.26, 2.98; recreation OR = 2.37, 95% CI 1.67, 3.37). Over time, the odds of recreational bicycling were lower in women with ≥2 children than women without children (OR = 0.83, 95% CI 0.73, 0.93). However, for both men and women, the odds of recreational bicycling were higher in those with children aged 6-12y than those with younger or older children (men OR = 1.86, 95% CI 1.39, 2.49; women OR = 1.79, 95% CI 1.31, 2.46). Interventions to promote bicycling must therefore consider gendered differences in bicycling for travel and active leisure, and family circumstances. An opportunity to promote bicycling might be to target parents with children aged 6-12y.Introduction Current methods of managing osteomyelitic voids after debridement are inadequate and result in significant morbidity to patients. Synthetic ceramic void fillers are appropriate for non-infected bone defects but serve as a nidus of re-infection in osteomyelitis after debridement. CERAMENT G (CG) is an injectable ceramic bone void filler which contains gentamicin and is currently being evaluated for use in osteomyelitic environments after debridement due to its theoretical ability to serve as a scaffold for healing while eliminating residual bacteria after debridement through the elution of antibiotics. The goal of this study was to evaluate (1) the rate of persistent infection and (2) new bone growth of a debrided osteomyelitic defect in a rat model which has been treated with either gentamicin-impregnated ceramic cement (CERAMENT G) or the same void filler without antibiotics (CERAMENT, CBVF). Methods Osteomyelitis was generated in the proximal tibia of Sprague Dawley rats, subsequently debrided, and the defect filled with either (1) CG ( n = 20 ), (2) CBVF ( n = 20 ), or (3) nothing ( n = 20 ). Each group was euthanized after 6 weeks. Infection was detected through bacterial culture and histology. Bone growth was quantified using microCT. Results Infection was not detected in defects treated with CG as compared with 35 % of defects ( 7 / 20 ) treated with CBVF and 50 % ( 10 / 20 ) of empty defects ( p = 0.001 ). ABT-199 order Bone volume in the defect of CG-treated rats was greater than the CBVF (0.21 vs. 0.17, p = 0.021 ) and empty groups (0.21 vs. 0.11, p less then 0.001 ) at 6 weeks after implantation. Conclusions Ceramic void filler with gentamicin (CERAMENT G) decreased the rate of persistent infection and increased new bone growth as compared to the same void filler without antibiotics (CERAMENT) and an empty defect in a rat model of debrided osteomyelitis.Objectives The purpose of this case series is to describe the orthopedic management of pubic symphysis osteomyelitis with an emphasis on the key principles of treating bony infection. Furthermore, we sought to identify whether debridement of the pubic symphysis without subsequent internal fixation would result in pelvic instability. Methods A retrospective chart review was performed to identify all cases of pubic symphysis osteomyelitis treated at both institutions from 2011 to 2020. Objective outcomes collected included infection recurrence, change in pubic symphysis diastasis, sacroiliac (SI) joint diastasis, and ambulatory status. Subjective outcome measures collected included the numeric pain rating scale (NPRS) and the 36-Item Short Form Survey (SF-36). Pubic symphysis diastasis was measured as the distance between the two superior tips of the pubis on a standard anterior-posterior (AP) view of the pelvis. SI joint diastasis was measured bilaterally as the joint space between the ileum and sacrum approxir pubic symphysis osteomyelitis of aggressive local debridement with local antibiotic therapy. Additionally, debridement of the pubic symphysis without subsequent internal fixation did not result in pelvic instability, as determined by pelvic radiographs and ability to fully weight bear postoperatively.In view of the fact that traditional strip surface defect detection and recognition methods cannot adapt to the changing actual detection environment, and deep learning-based detection and recognition methods have high requirements for data volume, a new strip surface defect detection and recognition based on deep transfer learning is proposed. Method First, the ResNet network trained based on the ImageNet dataset is transferred to the Faster R-CNN classic target detection algorithm. In order to deal with the problem of large differences in defect scales, the regional recommendation network in Faster R-CNN is improved and designed. A multi-scale regional recommendation network (MS-RPN) is proposed. The strip surface defect data set is used for experimental verification. The experimental results show that compared with Faster R-CNN, the proposed method has higher accuracy and is more suitable for strip surface defect detection applications. The proposed method has an accuracy of 84.14%, 88.81%, 88.35%, 92.86%, 92.86% and 92.53 for detecting scratches, bruises, cracks, oil stains and black spots, respectively.Climate-induced relocation is expected to become an adaptive response for one sector of the society that is otherwise already in a vulnerable situation and often living in remote areas, that is, Indigenous Peoples. Several Latin American countries have referred to planned relocation or managed retreat as one of their adaptation strategies within their Nationally Determined Contributions to the United Nations Framework Convention on Climate Change. However, a gap in academic analysis exists regarding not only the potential impacts but also the consequences of climate-induced planned relocations both in the broader context of Latin America and in the specific case of Indigenous Peoples living in that region. In addition, academia has so far underexplored the adverse impacts of managed retreat on Indigenous Peoples, such as the loss of a sense of community, culture, and traditional knowledge. Against this background, this article offers an overview on two key cases of climate-induced (planned) relocation of Indigenous Peoples in Latin America and the Caribbean (the Gunayala people in the San Blás archipelago in Panama and the case of the densely Indigenous-inhabited Mexican state of Chiapas), explores whether managed retreat has been or may become a tool or a threat, and provides a list of specific policy recommendations to be taken into consideration in similar cases.
The COVID-19 pandemic created an unprecedented residency application cycle that required the use of virtual interviews. The inaugural class of applicants participating in virtual interviews were surveyed concerning their preferences and suggestions for future application cycles.

A survey was distributed to 349 individuals who applied for an integrated plastic surgery residency position at three institutions during the 2020-21 application cycle. Responses were analyzed to determine the most popular attributes of virtual interviews.

Response rate was 44%. Eighty-six percent of applicants valued having time to consider their interview offers before scheduling; however, nearly one-third felt the instructions provided by programs lacked clarity and did not abide by the American Council of Academic Plastic Surgeons guidelines. Eighty-two percent of applicants valued having a preinterview social, and most preferred smaller breakout rooms organized by themes. A short interview day (less than three hours) was associated with less applicant familiarity with the program, its people, and its location when compared with medium (three to seven hours) and long (more than seven hours) interview days (
< 0.001 for all). Eighty percent of applicants preferred an interview day where they were placed into interview rooms by a program coordinator.

The virtual interview format can be optimized in many ways to benefit both applicants and programs. The data presented in this article provide suggestions for future iterations of virtual interviews.
The virtual interview format can be optimized in many ways to benefit both applicants and programs. The data presented in this article provide suggestions for future iterations of virtual interviews.Objectives A retrospective study in patients presenting out of hospital cardiac arrest (OHCA) to assess the impact of early cardiac catheterization on survival and cerebral performance category (CPC) on discharge. Background The role of early coronary angiography in OHCA patients remains controversial. The cardiac arrest hospital prognosis (CAHP) scoring system has not been validated in the US population. Methods Inclusion criteria were OHCA patients with a sustained return of spontaneous circulation (ROSC), presumed cardiac cause of arrest, and elements to calculate CAHP score. We compared in-hospital mortality rates and final inpatient CPC in patients who underwent early cardiac catheterization to those with delayed or no cardiac catheterization. We assessed the performance of the CAHP score in the entire OHCA population using receiver-operator curve (ROC) analysis. Results A hundred and fifty-eight patients were included, of which 39 underwent early cardiac catheterization. The mortality rate of the early catheterization group was lower than the delayed or no catheterization group (41% vs 61.
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