This study confirmed the hypothesis that the osseous densification technique would increase primary stability, bone mineral density, and the percentage of bone at the implant surface compared with drilling. By preserving bulk bone, it is hypothesized that the healing process will be accelerated due to the bone matrix, cells, and biochemicals that are maintained in situ and autografted along the surface of the osteotomy site. The healing response requires further study in vivo.

The study provides data on the rotational traction of shoe-surface interfaces currently employed in football. As football shoe and surface designs continue to be updated, new evaluations of their performance must be assessed under simulated loading conditions to ensure that player performance needs are met while minimizing injury risk.

No abstract

Leaning forward while landing appears to protect the ACL by increasing the shock absorption capacity and knee flexion angles and decreasing anterior shear force due to the knee joint compression force and quadriceps muscle activation. Conversely, landing upright appears to be ACL harmful by increasing the post-impact force of landing and quadriceps muscle activity while decreasing knee flexion angles, all of which lead to a greater tibial anterior shear force and ACL loading. ACL injury prevention programmes should include exercise regimens to improve sagittal plane body position control during landing motions.

The study documented that for an experimentally induced gap fracture in canine tibiae, a plate-rod combination is a significantly less compliant fixation method in torsion and compression, compared with an interlocking nail. Considering the deleterious effects of torsional deformation on bone healing, a plate-rod combination may represent a biomechanically superior fixation method, compared with an interlocking nail, for the treatment of dogs with comminuted tibial diaphyseal fractures.

Purpose Entrustable professional activities (EPAs) are a hot topic in undergraduate medical education (UME); however, the usefulness of EPAs as an assessment approach remains unclear. The authors sought to better understand the literature on EPAs in UME through the lens of the 2010 Ottawa Conference Criteria for Good Assessment. Method The authors conducted a scoping review of the health professions literature (search updated February 2018), mapping publications to the Ottawa Criteria using a collaboratively designed charting tool. Results Of the 1,089 publications found, 71 (6.5%) met inclusion criteria. All were published after 2013. Forty-five (63.4%) referenced the 13 Core Entrustable Professional Activities for Entering Residency developed by the Association of American Medical Colleges (AAMC). Forty (56.3%) were perspectives, 5 (7.0%) were reviews, and 26 (36.6%) were prospective empirical studies. The publications mapped to the Ottawa Criteria 158 times. Perspectives mapped more positively (83.7%) than empirical studies (76.7%). Reproducibility did not appear to be a strength of EPAs in UME; however, reproducibility, equivalence, educational effect, and catalytic effect all require further study. Inconsistent use of the term “EPA” and conflation of concepts (activity vs assessment vs advancement decision vs curricular framework) limited interpretation of published results. Overgeneralization of the AAMC’s work on EPAs has influenced the literature. Conclusions Much has been published on EPAs in UME in a short time. Now is the time to move beyond opinion, clarify terms, and delineate topics so that well-designed empirical studies can demonstrate if and how EPAs should be implemented in UME.

No abstract

Decreased white and gray matter volumes have been reported in youth with type 1 diabetes mellitus (T1DM), but the effects of hyperglycemia on white matter integrity have not been quantitatively assessed during brain development. We performed diffusion tensor imaging, using two complimentary approaches—region-of-interest and voxelwise tract-based spatial statistics—to quantify white matter integrity in a large retrospective study of T1DM youth and control participants. Exposure to chronic hyperglycemia, severe hyperglycemic episodes, and severe hypoglycemia, as defined in the Diabetes Control and Complications Trial (DCCT), were estimated through medical records review, HbA1c levels, and interview of parents and youth. We found lower fractional anisotropy in the superior parietal lobule and reduced mean diffusivity in the thalamus in the T1DM group. A history of three or more severe hyperglycemic episodes was associated with reduced anisotropy and increased diffusivity in the superior parietal lobule and increased diffusivity in the hippocampus. These results add microstructural integrity of white matter to the range of structural brain alterations seen in T1DM youth and suggest vulnerability of the superior parietal lobule, hippocampus, and thalamus to glycemic extremes during brain development. Longitudinal analyses will be necessary to determine how these alterations change with age or additional glycemic exposure.