Training Background Research Articles

Antibiotic prophylaxis for dental procedures after joint arthroplasty: a cross-sectional survey of orthopaedic surgeons about current practices

Background: Periprosthetic joint infection is a rare, but potentially devastating complication that can occur after prosthetic joint replacement. In 2016, the American Academy of Orthopaedic Surgeons (AAOS) revised its Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. The objective of this study was to survey orthopaedic surgeons regarding their use of prophylactic antibiotics in arthroplasty patients undergoing dental procedures. Additionally, the authors inquired whether surgeons who have undergone arthroplasty procedures themselves practice the antibiotic prophylaxis when faced with decisions regarding their own joints. Methods: The authors surveyed currently practicing orthopaedic surgeons in the United States who perform joint arthroplasty procedures. The questions pertained to demographic data, training background, type of employment, arthroplasty type and volume, antibiotic prophylaxis practices, and awareness of the AAOS/American Dental Association (ADA) recommendations. Results: Two hundred, fourteen surveys were completed, though not all respondents answered every question. Most surgeons (149 of 200, 74.5%) routinely recommend prophylactic antibiotics for all patients with total joint arthroplasties who undergo dental procedures. The majority of the surgeons (163 of 199, 81.9%) reported that they are aware of the current AAOS/ADA guidelines, but that did not have a substantial effect on whether they routinely recommend prophylactic antibiotics (P=0.74). Conclusions: Most orthopaedic surgeons surveyed said they understand the AAOS/ADA guidelines, but that they routinely prescribe prophylactic antibiotics for arthroplasty patients undergoing dental procedures. These prescribing practices have no significant relationship with their knowledge of the AAOS AUC, years of experience, volume, specialty, employment, or personal history of joint replacement. Level of Evidence: Level IV, cross-sectional survey

Impact factors in a Curriculum Vitae for scholarship application

Introduction. Scholarship applicants often receive different advice on what should be included in their Curriculum Vitae (CV). This study aims to investigate what the essential components of a CV being prepared for scholarships are, how to present them, and what their level of impact is. Materials and Methods. The authors sent an online structured questionnaire to 7512 corresponding authors of recent published papers in Scopus; 124 completed questionnaires were returned. Recommended elements for a CV were chosen according to the Delphi consensus technique with a threshold of 50%. Results. This survey revealed that headings, bullet points and careful error checking were essential parts of the layout. For the content of the CV, besides publications, education and training background, research experience and research interest were also necessary. Moreover, almost all respondents ranked publications as the most important qualification of an academic scholarship candidate. Publications also came first as the most impressive factor, followed by awards and honours. The number of publications, quality of journal, impact factor and total citation should be presented in publication section. The importance of publications in getting academic scholarships is significantly emphasized in this recent study. Conclusions. Having research experience and papers in peer review journals, are highly recommended for students seeking academic scholarships.

O IMPACTO ACADÊMICO DO SIMPÓSIO DE ENDOSCOPIA E CIRURGIA MINIMAMENTE INVASIVA DA COLUNA VERTEBRAL DA ASSOCIAÇÃO MEXICANA DE CIRURGIÕES DA COLUNA VERTEBRAL - AMCICO

ABSTRACT Introduction: The interest in spinal endoscopy is rising, particularly among younger spine surgeons. Formalized postgraduate training programs for endoscopic spinal surgery techniques are lacking behind. Methods: The authors performed a retrospective survey study amongst participants of the 2022 AMCICO endoscopic surgery symposium. Descriptive and correlative statistics were done on the surgeon’s responses recorded in multiple-choice questions. In addition, surgeons were asked about their clinical experience and preferences with spinal endoscopy, training background, the types of lumbar endoscopic decompression they perform by approach, and future training requirements. SPSS (version 27) statistical software package was used for data analysis. Descriptive statistic measures were used to count responses and calculate the mean, range, standard deviation, and percentages. In addition, chi-square statistics were used to determine the strength of the association between factors. Results: The online survey was accessed by 321 surgeons, of which 92 completed it (53.4%). Demographic data showed the majority of responding surgeons being orthopedic surgeons (73.6%) and under the age of 50 (69.2%), with over half (51.1%) having less than three months of formalized training in endoscopic spinal surgery techniques. Most surgeons practiced uni-portal (58.9%) versus bi-portal (3.4%) spinal endoscopy. The transforaminal approach (65.5%) was preferred over the interlaminar method (34.4%). The bi-portal technique was indicated almost exclusively for the lumbar spine (94.8%). For endoscopically assisted spinal fusions, a uni-portal approach was preferred by 72% of surgeons over a bi-portal procedure (24.5%). 84.1% of respondents were interested in navigation, of which 30.7% preferred optical over electromagnetic technology (18.2%). Robotics was of interest to 51.1% of survey participants. Respondents’ bias was estimated with course attendance assessments, with 37% of surgeons having attended all three days, 27.2% two days, and 16.3% one day. One-fifth of responding spine surgeons did not participate in any curriculum activities but completed the survey. The academic impact of the AMCICO endoscopy symposium was high, with 68.1% of respondents indicating interest in continued training and 61.1% of trainees ready to apply their newly acquired knowledge base to clinical practice. Conclusion: The interest in spinal endoscopy surgery techniques and protocols is high among AMCICO members. Many surgeons are interested in learning advanced endoscopic surgical techniques to integrate the technology into their surgical procedure portfolio to address common painful conditions of the degenerative spine beyond herniated discs and foraminal stenosis. The authors concluded that its academic impact was high based on the responses given by the participating surgeons. Level of evidence III; Retrospective study.

The role of inseminators in the success of pregnancy outcome in Bali Cattle

The inseminators contribute an important role in the success of insemination therefore the research was conducted to evaluate the expertise and background of inseminators on the success of pregnancy outcomes. Seven inseminators from two districts were interviewed and related to their ability to do artificial insemination in Bali cattle in 2018. Reproductive data from January to December 2018 were analysed to determine their inseminator's performance from 2 districts (Kota Bengkulu and Bengkulu Tengah). One-way analysis of variance was tested to analyze the differences among inseminators on the result of AI pregnancy outcome, and a t-test was performed to determine whether the means pregnancy outcomes from two areas are different. Duncan's multiple range test was used to determine the significance of the difference between groups. The step-wise regression was applied to determine the strongest correlated variable. The result showed that conception rate (CR) and calving rate (CvR) differed significantly (P<0.05) among the inseminators, CR (81.30% vs 65.02) and CvR (76.68% vs 62.36%) also different between two districts. While the step-wise regression results showed that educational background, experience, age, and centre or unit for AI training become excluded variables while training (Assisted Reproductive Technology and pregnancy diagnosis) showed the strongest correlation with the pregnancy outcome. In conclusion pregnancy outcome differs between the two regencies and advanced training (Assisted Reproductive Technology and pregnancy diagnosis) showed the strongest correlation with the pregnancy outcome and the quality of the centre or unit for AI training is similar.

IMPACTOS DA FACILITAÇÃO NEUROMUSCULAR PROPRIOCEPTIVA NA FLEXIBILIDADE DOS ATLETAS DE BOXE CHINÊS

ABSTRACT Introduction: Flexibility is one of the essential physical qualities of athletes and Chinese boxing. Proprioceptive neuromuscular facilitation stretching is an effective method to improve flexibility. This method is widely used in various sports. Objective: Analyze the practical effects of stretching by proprioceptive neuromuscular facilitation on Chinese boxing athletes. Methods: This work selected 12 male athletes as research subjects. The athletes were randomly divided into two groups. Flexibility in one group of athletes trained with PNF stretching. Another group of athletes underwent regular training. Mathematical statistics were used to process the flexibility data of the two groups. Results: There were significant differences in the maximum linear velocity in the ankle joint and in the maximum linear velocity in the knee joint between the athletes after training with the experimental stretching (P<0.05). Conclusion: This paper concludes that the application of stretching method with proprioceptive neuromuscular facilitation can improve the flexibility of athletes. The research results of this paper provide background for flexibility training in competition and teaching. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Pipeline to Military Orthopaedic Leadership: 20 Years of Race and Gender Diversity Trends Within Military Orthopaedic Surgery Fellowship Training.

The lack of trainees from underrepresented race and gender backgrounds in orthopaedic surgery fellowship training has been well reported in the literature. The purpose of this study was to investigate the demographic trends of federally sponsored military orthopaedic surgery fellows in the Army, Navy, and Air Force. We hypothesize that there has been an increase in women selected for fellowship but that there has been no change in the race demographics of military fellows over the past 2 decades. A retrospective review of all available demographic data collected by the Army, Air Force, and Navy since the beginning of tracking federally funded fellowship training in orthopaedic surgery was completed (1998-2021). Data were grouped into 4-year periods for analysis to closely mirror the military assignment cycle. Three hundred sixty-two military orthopaedic surgery fellowship board selectees were included in our analysis. The proportion of women fellows increased from 3% (n = 2/69) over 2001 to 2004 to 21% (n = 17/82) during 2017 to 2020 (p < 0.05). Fellows who identified as White comprised 82% (n = 297) of the cohort during the study period. Individuals who identified as Asian were the next highest proportion of fellows at 4% (n = 16), followed by Black (n = 14, 4%) and Hispanic (n = 13, 3%). Individuals who identified as Native Hawaiian/Pacific Islander represented 1% (n = 3), and an additional 6% (n = 20) fellows identified as "other" or "undeclared." Over the 20-year study period, representation of Asian, Black, Native Hawaiian, and Hispanic fellows did not increase (p = 0.79, 0.81, 0.45, 0.34, respectively). Within military orthopaedics, there has been increased representation of women in fellowship training over the past 20 years. However, the proportion of fellows from underrepresented racial and ethnic groups has remained stagnant. One barrier to improving gender and race representation is the currently imprecise and inconsistent collection of demographic information. Importantly, fellowship training has a direct effect on future leadership opportunities within the military orthopaedic surgery community. A more diverse leadership may help to inspire future generations of military orthopaedic surgeons. IV.

Effect Analysis of Botox Combined with Rehabilitation Training on Upper Limb Spasm after Hemiplegia

To analyze the effect of botox on upper limb spasm after hemiplegia after stroke under the background of rehabilitation training is the main objective of the study. The data was collected from 100 patients with upper limb spasm after hemiplegia after stroke treated in Rehabilitation Medicine Department of Zhejiang Hospital from May 2020 to June 2022. These patients were randomly divided into 50 each and included in the study group and the control group. The study group received botox therapy in the context of rehabilitation training, while the control group only received rehabilitation training. The effects of the two groups were compared after treatment. After treatment by different methods, modified Ashworth scale, Fugl-Meyer assessment, the modified Barthel index, specific quality of life scale scores and total effective rate of the study group were better than those of the control group (p<0.05). Botulinum toxin combined with rehabilitation training has obvious effect on upper limb spasticity of hemiplegia after stroke, which can reduce muscle tension, effectively relieve the degree of upper limb spasticity, improve the upper limb motor function and enhance the ability of living. The use of botulinum toxin in rehabilitation training is worthy of promotion.

Self-Efficacy towards Inclusive Education among Foreign Exchange Teachers in North Dakota

This descriptive-correlational study investigated the self-efficacy among foreign exchange teachers in handling students with disabilities in an inclusive classroom and it also identified the variables that had significant influence on their self-efficacy. The study consisted of 32 Filipino exchange teachers in special education and general education from a public school district in North Dakota, USA for school year 2021–2022. Data were collected electronically using a standardized tool that measured the self-efficacy to teach in inclusive classrooms and participants voluntarily accomplished the tool. The results revealed that the teachers had the highest level of efficacy in teaching students with disabilities in relation to collaboration, while their lowest level of efficacy is in managing the inappropriate behavior of the students with disabilities. The multiple linear regression analysis indicated that their teaching assignment whether they are special education teachers or general education teachers had a significant influence on their self-efficacy. Meanwhile, the variables like the grade level they belong to, the number of years of teaching in the U.S., and having experience in handling students with special needs did not have significant effect on their self-efficacy. Overall, the teachers’ high score was indicative of their positive teaching efficacy towards inclusion. This showed that the teachers believe in their ability in carrying out necessary activities that promote inclusive education. The results also implied that having specialized training and educational background in special education can influence their ability in implementing inclusive practices. It is recommended that the exchange teachers are given professional development programs that will enhance their effectiveness in handling students with special needs.

Intertrochanteric femur fractures: a current concepts review

Intertrochanteric fractures are common injuries around the hip, especially among the elderly. With the rising incidence of these injuries, they are expected to double by 2050. Incidence rates are higher in females than males and in white patients than black African patients. Osteoporosis weakens the local trochanteric anatomic support leading to an increased susceptibility to fractures. Disruption of the posteromedial calcar region results in fracture instability. Optimal lag screw position and fracture reduction are significant determinants for postoperative outcomes. The tip apex distance and reduction criteria determine lag screw cut-out risk and fracture reduction quality, respectively. A calcar-referenced tip apex distance is comparable if not better than the tip apex distance in predicting cut-out risk. Optimal reduction is in slight valgus, a positive medial cortex apposition and smooth anterior cortex apposition. High mortality rates are observed with non-surgical treatment. Surgical management is therefore the gold standard for intertrochanteric fractures. Treatment options are categorised into extramedullary fixation, intramedullary fixation and proximal femur replacement. They include the dynamic hip screw (DHS), cephalomedullary nails (CMN) and arthroplasty. Although still in use, the proximal femur locking plate is falling out of favour due to high complication rates. Fracture stability and pattern influence the treatment choice. There is, however, a growing use of CMNs which has been attributed to surgical training background. Modification of older CMN designs has improved treatment outcomes. Systematic meta-analyses of randomised controlled trials (RCTs) do not show superiority of one treatment option over another; therefore, there is no consensus on the best treatment choice. The proximal femur nail antirotation (PFNA) has better outcomes compared to other fixation options with respect to intraoperative blood loss and Harris hip scores. As a group, CMNs have a better 120-day postoperative quality of life compared to the DHS. No significant difference in complications has been found between treatment options. In light of the anticipated increased incidence of intertrochanteric fracture, more work is needed in planning national resource allocation, devising preventative methods and improving clinical interventions in South Africa. Level of evidence: Level 5

An Iterative GLRT for Hyperspectral Target Detection Based on Spectral Similarity and Spatial Connectivity Characteristics

Recently, a generalized likelihood ratio test (GLRT)-based multipixel target detector for hyperspectral imagery was proposed. With joint exploitation of the pixels occupied by a target of interest, the detection performance was significantly improved. However, it still faces a pixel selection problem in practice. In this paper, we address the pixel selection problem for the multipixel target detector in practice. First, we propose an adaptive target pixel selection method based on spectral similarity and spatial connectivity characteristics. Second, we propose a method to collect the pixels spatially closest to the target pixels as the training background pixels so that their residual background component share the same statistical characteristics with high probability. To exclude potential target pixels in the collected training background pixels, an iterative version of the GLRT-based multipixel target detector is proposed. It is easy to set the key parameters of the proposed method, which is attractive in practice. Experimental results on four real hyperspectral datasets show that the proposed method outperforms its counterparts in terms of detection performance.

Construction and Management of Chemistry Public Experimental Teaching Platform under Concentrated Training Background

Construction and Management of Chemistry Public Experimental Teaching Platform under Concentrated Training Background

Challenges facing fishermen in Bardawil lake, north Sinai, Egypt

Bardawil Lake is considered one of the most important and purest Egyptian lakes. However, in recent years, a relative decrease in the quantity and value of production and a qualitative change has been observed in the fish produced by the lake. Hence, this study aimed to identify the most important problems facing the fishermen in Bardawil Lake and their suggestions to overcome them. This study was conducted in North Sinai Governorate, Data were collected using a focus group discussion method with 90.6% of the board's members of fishing associations (58 respondents). in addition, A random sample of 346 fishermen through a personal interview from May to December 2020. The results indicated the high age levels of fishermen (X̅ = 50.44) and the high illiteracy rate among them (58.57%) despite their high experience in the fishing profession, but unfortunately, it was not based on a training background as 69.65% of the respondent fishermen did not receive any training courses. only 13.45% of them depended on the agricultural extension as the main source of technical information, which indicates a clear absence of the agricultural extension role with the fishermen in the lake. The most important obstacles facing the respondent fishermen were the weak income from the fishing profession 89.88%, the weak role of agricultural extension 86.42%, the insufficiency of the role of fishing cooperatives 83.82%, While their most important suggestions were to activate the laws regulating the fishing process 90.17% and to prevent illegal fishing 84.68%. The study recommends developing fish extension and providing it with specialists in the fields of fisheries development to play a more effective role in this field.

Skill Improvement Needs of Electrical Installation Teachers for Productive Skill Development in Ondo State Technical Colleges Students

The study carried out an investigation on skill improvement needs of electrical installation teachers for productive skill development in Ondo State technical colleges students. A descriptive research of the survey type was adopted for this study. The population for the study are teachers teaching electrical installation in technical colleges in Ondo State. The sample for the study is the entire population of teachers teaching electrical installation. The instrument used for the data collection was a questionnaire tagged Electrical Installation Skills Questionnaire (EISQ). The instrument was face validated by three lecturers who are experts in Technology and vocational Education in Ekiti State University, Ado-Ekiti. The reliability of the instrument was established using Cronbach Alpha Reliability technique which yielded the reliability coefficient of 0.86. This was considered a high reliability. After the data collection, the mean and standard deviation were employed to analyze the data at 0.05 level of significance. The findings of the study revealed that electrical installation trade teachers training background lack quality in terms technical skills required of them that were not sufficiently possessed by them which gives rise to low skills with which they train students of electrical installation trade in Technical colleges in Ondo State of Nigeria. Based on the findings of this study, it was recommended that Teachers of electrical installation in technical colleges should be given in-service training to enable them continuously updating their teaching skills in planning for effective teaching of skills, instructional implementation and instructional evaluation among others.

Necessity for up-scaling resource mobilization for implementation of competency-based curriculum at basics education cycle

School resources comprise necessary materials, both financial and human. A growth towards evidence-based allocation and utilization of school resources is affected by inadequate capacity of the school managers, ministry of education, parents and non-governmental organizations. Inadequate teaching and learning resources limit individual schools' strength to make judicial decisions on equitable trade-offs in education resource demand, supply and consumption. This work sought to identify the locally available resources for utility in competency-based- curriculum implementation, improve the available resources for enhancing teaching and learning, and analyze factors militating against effective mobilization and utilization of resources at the basic education level. Online surveys were used in collecting secondary data. Journals, internet, textbooks and research reports were sampled for data gathering through a stratified sampling technique. The findings showed that the rural-urban migration factors significantly affect trained teachers from arid areas by moving away from their local homes to towns in search of jobs. When learners fail to interact adequately with qualified teachers, the consequences are dire, resulting in learners' poor acquisition of competencies. It was ascertained that more than 70% of the teachers teaching at Kakuma Refugee Camp were not sensitive to learners' plights. This was due to their weak and inadequate education and training background coupled with poor teaching and learning resources. 60% of the tutors at Kakuma Refugee Camp were untrained in pedagogical and andragogical skills necessary for giving instructions in a competency-based curriculum. It was established that the cost of needed materials and training for improving CBC implementation was expensive. Therefore, action research could explore avenues for economies of scale by sharing materials and coordinating purchases between and among neighborhood schools. This is because the critical mass of activities under CBC such as arts, music and sports all create new opportunities for supply chains that present avenues for partnering with organizations that support basic education activities that has remained unexploited. In conclusion, the national and county government's department of pre-primary and basic education level should generate guidance on the use of alternative and low-cost materials for teaching to alleviate the persistent shortages of teaching resources.&#x0D; &#x0D; Key Words: resources, mobilization, utilization; competency-based-curriculum; enhancing teaching and learning,

Medical Leadership in Inpatient Rehabilitation Facilities in the United States.

Inpatient rehabilitation facilities treat patients with extensive postacute care rehabilitation needs. Physiatrists are uniquely trained in the complexities of such patients; however, not all inpatient rehabilitation facilities use physiatrists as medical leadership. This study identifies the training background and credentials of medical directors in all inpatient rehabilitation facilities within the United States. Using Internet search, e-mail, and telephone communication, the following data were collected: medical director credential and specialty information, board certification rates and years of practice experience, as well as bed numbers for each inpatient rehabilitation facilities listed on The Centers for Medicare and Medicaid Services Website. Data were collected between November 2019 and November 2020. Of the 1114 open facilities, 85% have medical directors with a doctor of medicine degree, while 13% have a doctor of osteopathic medicine degree. Two percent reported no physician medical director. Physiatry is the most common specialty (80%), followed by internal medicine, family medicine, neurology, orthopedic surgery, general surgery, and medicine/pediatrics. The mean number of beds per facility is 35.6 (median, 24; range, 4-350). There is an average of 11.4 inpatient rehabilitation facility beds per 100,000 people nationally. Physiatry is the predominant specialty to fulfill medical leadership at inpatient rehabilitation facilities, although there remains room for growth. In addition, doctor of medicine degrees greatly outnumber doctor of osteopathic medicine degrees in medical leadership.

The Social Media Presence of Professional Sports Team Physicians Is High Among Major League Soccer, Major League Lacrosse, Major League Rugby, Winter Olympics, and Women’s National Basketball Association, But Highest Among MLS Team Physicians

To quantify the social media utilization of professional sports team physicians on popular platforms and analyze differences between physician users and physician non-users for smaller major professional sports: Major League Soccer (MLS), Major League Lacrosse (MLL), Major League Rugby (MLR), Winter Olympics (WO) and Women's National Basketball Association (WNBA). Physicians for the MLS, MLL, MLR, WO, and WNBA were identified and characterized based on training background, practice setting, years of experience, and geographic location. Social media presence on Facebook, Twitter, LinkedIn, Instagram, and ResearchGate were determined. Differences between social media users and non-users were analyzed via chi-squared tests for nonparametric variables. Secondary analysis consisted of univariate logistic regression to identify associated factors. 86 team physicians were identified. 73.3% of physicians had at least one social media profile. 80.2% of physicians were orthopedic surgeons. Specifically, 22.1% had a professional Facebook page, 24.4% had a professional Twitter page, 58.1% had a LinkedIn profile, 25.6% a ResearchGate profile, and 9.3% an Instagram account. All physicians with a social media presence were fellowship-trained. Seventy-three percent of team physicians in the MLS, MLL, MLR, WO, or WNBA have social media presence, with over half using LinkedIn. Fellowship-trained physicians were significantly more likely to use social media, and 100% of physicians with social media presence were fellowship trained. MLS and WO team physicians were significantly more likely to use LinkedIn (P= .02). MLS team physicians were significantly more likely to use social media overall (P= .004). No other metric significantly impacted social media presence. The influence of social media is vast. It is important to explore the extent that sports team physicians utilize social media and how this use may influence patient care.

Safety at high altitude: the importance of emotional dysregulation on pilots' risk attitudes during flight.

Aviation psychology is very interested in understanding how personological and psychological variables influence flight performances. Indeed, risk attitudes have been considered as a risk factor for aviation accidents. In this context, emotions and coping style are key variables which could influence concentration by affecting cognition and attention. In addition, the specific training backgrounds seemed to be associated with differences in in-flight accident rates. The aim of the present study was to investigate the association between age, sex, flight experience, emotional dysregulation, coping styles, flight licenses, and pilots' risk attitudes. Eighty pilots completed an online survey composed of ad hoc questionnaire for sociodemographic and work-related information's and self-report questionnaires that assessed emotional dysregulation, coping styles, and risk attitudes. Results showed that older age and emotional dysregulation were associated with higher risk attitudes in pilots. Moreover, emotional dysregulation seemed to promote worse self-confidence. Ultralight pilots appeared to be more risk-oriented and less self-confident than civil pilots, while more flight experience appeared to favorite greater self-confidence. In conclusion, the study suggests the importance of promoting interventions based on sharing pilots' difficulties and emotions and promoting safe attitudes with special attention to ultralight pilots, age, and sex differences.

Characteristics of Canadian physicians and their associations with practice patterns: a scoping review.

Physician characteristics such as education and sociodemographic attributes are associated with particular practice patterns, such as practice in rural settings. Understanding the Canadian context of such associations can inform medical school recruitment and health workforce decision-making. The objective of this scoping review was to report the nature and extent of the literature on associations between characteristics of physicians in Canada and physicians' practice patterns. Eligibility criteria: We included studies reporting associations between 1) the education or sociodemographic attributes of practicing physicians or residents in Canada and 2) practice patterns, including career choice, practice setting, and populations served. We searched five electronic databases (MEDLINE (R) ALL, Embase, ERIC, Education Source and Scopus) for quantitative primary studies and reviewed reference lists of included studies for additional studies. Data were extracted using a standardized data charting form. Our search yielded 80 studies. Sixty-two examined education, evenly divided between undergraduate and postgraduate. Fifty-eight examined physicians' attributes, most focusing on sex/gender. The majority of studies focused on the outcome of practice setting. We found no studies examining race/ethnicity or socioeconomic status. Many studies in our review found positive associations between (i) rural training or rural background and rural practice setting and (ii) location of training or physicians' origin and practice in that location, consistent with previous literature. Associations for sex/gender were mixed, suggesting it may be a less useful target for workforce planning or recruitment aiming to address gaps in health care provision. More research is needed on the association of characteristics, particularly race/ethnicity and socioeconomic status, with career choice and populations served.

Interobserver reliability of biplanar radiography is unaffected by clinical factors relevant to individuals at risk of pathological lower limb torsion

BackgroundAssessments of lower limb torsion are ubiquitous in clinical gait analysis practice as pathologic lower limb rotational deformity may contribute to gait abnormalities, anterior knee pain, as well as other debilitating conditions. Understandably, the overall utility of any torsional assessment is dependent on the measurement method’s intrinsic accuracy, precision, and robustness to clinical interference factors. Recently, biplanar radiography (BPR) measurements of torsion have been shown to be both accurate and precise, but the robustness of BPR to potential interference factors is unknown. Research questionHow robust are BPR lower limb torsional assessments to six potential interference factors: amount of torsion, skeletal maturity, radiograph quality, prior osteotomy, presence of implants, and observer training background and experience? MethodsIn this retrospective cohort study, four observers of diverse backgrounds and experience generated digital 3D reconstructions of 44 lower limbs using BPR images obtained during standard of care visits (age range 7–35 years). From each reconstruction, four lower limb torsional parameters were computed: femoral torsion, femorotibial rotation, tibial torsion, and transmalleolar axis equivalent. The mean absolute deviation (MAD) of each torsional parameter – calculated across the four observers – was used as the measure of reliability and tested against all interference factors. ResultsResults demonstrated that the average MAD was 2.1 degrees for femoral torsion, 3.0 degrees for transmalleolar axis equivalent, 3.8 degrees for femorotibial rotation, and 4.7 degrees for tibial torsion. None of the six potential interference factors were found to systematically influence BPR reliability across all four torsional parameters. Of the factors found to statistically influence one or more torsional parameter, none affected MAD values to a clinically meaningful extent. SignificanceIn addition to being accurate and precise, BPR appears to be robust to several clinical factors relevant to children and young adults with or at risk for pathological lower limb torsion.

Detection of Bottle Marine Debris Using Unmanned Aerial Vehicles and Machine Learning Techniques

Bottle marine debris (BMD) remains one of the most pressing global issues. This study proposes a detection method for BMD using unmanned aerial vehicles (UAV) and machine learning techniques to enhance the efficiency of marine debris studies. The UAVs were operated at three designed sites and at one testing site at twelve fly heights corresponding to 0.12 to 1.54 cm/pixel resolutions. The You Only Look Once version 2 (YOLO v2) object detection algorithm was trained to identify BMD. We added data augmentation and image processing of background removal to optimize BMD detection. The augmentation helped the mean intersection over the union in the training process reach 0.81. Background removal reduced processing time and noise, resulting in greater precision at the testing site. According to the results at all study sites, we found that approximately 0.5 cm/pixel resolution should be a considerable selection for aerial surveys on BMD. At 0.5 cm/pixel, the mean precision, recall rate, and F1-score are 0.94, 0.97, and 0.95, respectively, at the designed sites, and 0.61, 0.86, and 0.72, respectively, at the testing site. Our work contributes to beach debris surveys and optimizes detection, especially with the augmentation step in training data and background removal procedures.