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Dines, HR, Nixon, J, Lockey, SJ, Herbert, AJ, Kipps, C, Pedlar, CR, Day, SH, Heffernan, SM, Antrobus, MR, Brazier, J, Erskine, RM, Stebbings, GK, Hall, ECR, and Williams, AG. Collagen gene polymorphisms previously associated with resistance to soft-tissue injury are more common in competitive runners than nonathletes. J Strength Cond Res 37(4): 799–805, 2023—Single-nucleotide polymorphisms (SNPs) of collagen genes have been associated with soft-tissue injury and running performance. However, their combined contribution to running performance is unknown. We investigated the association of 2 collagen gene SNPs with athlete status and performance in 1,429 Caucasian subjects, including 597 competitive runners (354 men and 243 women) and 832 nonathletes (490 men and 342 women). Genotyping for COL1A1 rs1800012 (C > A) and COL5A1 rs12722 (C > T) SNPs was performed by a real-time polymerase chain reaction. The numbers of "injury-resistant" alleles from each SNP, based on previous literature (rs1800012 A allele and rs12722 C allele), were combined as an injury-resistance score (RScore, 0–4; higher scores indicate injury resistance). Genotype frequencies, individually and combined as an RScore, were compared between cohorts and investigated for associations with performance using official race times. Runners had 1.34 times greater odds of being rs12722 CC homozygotes than nonathletes (19.7% vs. 15.5%, p = 0.020) with no difference in the rs1800012 genotype distribution (p = 0.659). Fewer runners had an RScore 0 of (18.5% vs. 24.7%) and more had an RScore of 4 (0.6% vs. 0.3%) than nonathletes (p < 0.001). Competitive performance was not associated with the COL1A1 genotype (p = 0.933), COL5A1 genotype (p = 0.613), or RScore (p = 0.477). Although not associated directly with running performance among competitive runners, a higher combined frequency of injury-resistant COL1A1 rs1800012 A and COL5A1 rs12722 C alleles in competitive runners than nonathletes suggests these SNPs may be advantageous through a mechanism that supports, but does not directly enhance, running performance. [ABSTRACT FROM AUTHOR]

Brazier, J, Antrobus, M, Stebbings, GK, Day, SH, Callus, P, Erskine, RM, Bennett, MA, Kilduff, LP, and Williams, AG. Anthropometric and physiological characteristics of elite male rugby athletes. J Strength Cond Res 34(6): 1790–1801, 2020 —This is the first article to review the anthropometric and physiological characteristics required for elite rugby performance within both rugby union (RU) and rugby league (RL). Anthropometric characteristics such as height and body mass, and physiological characteristics such as speed and muscular strength, have previously been advocated as key discriminators of playing level within rugby. This review aimed to identify the key anthropometric and physiological properties required for elite performance in rugby, distinguishing between RU and RL, forwards and backs and competitive levels. There are differences between competitive standards such that, at the elite level, athletes are heaviest (RU forwards ~111 kg, backs ~93 kg; RL forwards ~103 kg, backs ~90 kg) with lowest % body fat (RU forwards ~15%, backs ~12%; RL forwards ~14%, backs ~11%), they have most fat-free mass and are strongest (back squat: RU forwards ~176 kg, backs ~157 kg; RL forwards ~188 kg, backs ~168 kg; bench press: RU forwards ~131 kg, backs ~118 kg; RL forwards ~122 kg, backs ~113 kg) and fastest (10 m: RU forwards ~1.87 seconds, backs ~1.77 seconds; 10 m: RL forwards ~1.9 seconds, backs ~1.83 seconds). We also have unpublished data that indicate contemporary RU athletes have less body fat and are stronger and faster than the published data suggest. Regardless, well-developed speed, agility, lower-body power, and strength characteristics are vital for elite performance, probably reflect both environmental (training, diet, etc.) and genetic factors, distinguish between competitive levels, and are therefore important determinants of elite status in rugby. [ABSTRACT FROM AUTHOR]

PURPOSE: The D-variant of the angiotensin-1 converting enzyme (ACE) gene is associated with higher circulating and tissue ACE activity. Some studies have suggested a similar association of genotype with muscle strength or the gain in strength in response to training. This study has assessed the relationship between circulating ACE activity, strength, and the response to training. METHODS: Eighty-one untrained men were tested for quadriceps muscle strength, and 44 of these performed an 8-wk program of dynamic strength training of the quadriceps muscle group. Venous blood was obtained for assessment of circulating ACE activity before and after the training program. ACE genotype was also determined. RESULTS: At baseline, circulating ACE activity was significantly correlated with isometric (r = 0.25-0.29, P < 0.02) and isokinetic (r = 0.38, P < 0.0005) quadriceps muscle strength. ACE genotype also seemed to be related to pretraining muscle strength. However, circulating ACE activity showed no significant association with the 9-14% mean increases of muscle strength in response to the training intervention. ACE genotype also showed no association with the training-induced change in muscle strength. Circulating ACE activity did not change significantly after the training program. CONCLUSIONS: The data support a role for ACE in the regulation of human skeletal muscle strength, but do not confirm a role in altering the response to short-term training. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of high-intensity, eccentric-only muscle actions of the leg extensors on (a) serum biomarkers of collagen degradation (hydroxyproline [HYP] and C-terminal telopeptide of type I collagen [C1M]) and synthesis (pro-c1a1) and (b) the time course of changes in maximal voluntary isometric contraction (MVIC) and ratings of muscle soreness after the eccentric-only exercise bout. Twenty-five recreationally active men (mean ± SD: age = 21.2 ± 2.0 years) completed 5 sets of 10 bilateral, eccentric-only dynamic constant external resistance muscle actions of the leg extensors at a load of 110% of their concentric leg extension 1 repetition maximum. Analysis of variances (p < 0.05) and a priori planned pairwise comparisons using Bonferroni corrected (p < 0.0167) paired t tests were used to examine mean changes in blood biomarkers from baseline to 48 hours postexercise as well as in MVIC and soreness ratings immediately, 24 hours, and 48 hours postexercise. There were increases in HYP (3.41 ± 2.37 to 12.37 ± 8.11 µg⋅ml-1; p < 0.001) and C1M (2.50 ± 1.05 to 5.64 ± 4.89 µg⋅L-1; p = 0.003) from preexercise to 48 hours postexercise, but no change in pro-c1 α1. Maximal voluntary isometric contraction declined immediately after the exercise bout (450.44 ± 72.80 to 424.48 ± 66.67 N-m; p = 0.002) but recovered 24 hours later, whereas soreness was elevated immediately (6.56 ± 1.58; p < 0.001), 24 hours (3.52 ± 1.53; p < 0.001), and 48 hours (2.60 ± 1.32; p = 0.001) postexercise. The eccentric-only exercise bout induced increases in collagen degradation but had no effect on collagen synthesis. These findings provide information for clinicians to consider when prescribing exercise after an acute injury or surgery. [ABSTRACT FROM AUTHOR]

Grainger, A, Heffernan, S, Waldron, M, and Sawczuk, T. Autonomic nervous system indices of player readiness during elite-level rugby union game-week microcycles. J Strength Cond Res 36(11): 3173–3178, 2022—Elite-level rugby union (RU) is a high-intensity contact sport that involves large training and match volumes across a season, which can lead to postmatch fatigue. Autonomic nervous system (ANS) regulation and perceived fatigue have been suggested to relate to measures of training and match load in RU. However, there have been no studies to assess specific ANS variables in elite RU during in-season microcycles. Player readiness during game-week microcycles was measured via heart rate variability (HRV) indices, direct current potential and self-reported well-being among 13, elite, male RU players. To enable comparison, data collection days were categorized in relation to their proximity to match day, ranging from match day minus 3 (MD − 3), to match day plus 3 (MD + 3). Differences between match days were evaluated using general linear models and Cohen's d effect sizes. There were significant differences between MD and MD + 1 for ANS indices (RMSSD p = 0.04, d = −0.66, 95% CI 0.11–1.20; the standard deviation of NN intervals p = 0.04, d = −0.66, 95% CI 0.12–1.20; total power p = 0.05, d = −0.65, 95% CI 0.11–1.20) and wellness measures (readiness p = 0.18; d = −2.33, 95% CI, 1.54–3.13; energy p = 0.02; d = −2.24, 95% CI 1.44–3.03; soreness p = 0.00; d = −2.42, 95% CI 1.63–3.23). Match day plus 3 effects were significantly greater than MD + 1 in several ANS responses, with wellness recovering at a slower time-course than ANS responses. Measures of HRV are dysregulated postmatch, but based on their rapid recovery thereafter, using HRV to assess readiness of elite-level players in RU across a weekly microcycle could be limited and requires further investigation. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Moreland, E, Borisov, OV, Semenova, EA, Larin, AK, Andryushchenko, ON, Andryushchenko, LB, Generozov, EV, Williams, AG, and Ahmetov, II. Polygenic profile of elite strength athletes. J Strength Cond Res 36(9): 2509–2514, 2022—Strength is a heritable trait with unknown polygenic nature. So far, more than 200 DNA polymorphisms associated with strength/power phenotypes have been identified majorly involving nonathletic populations. The aim of the present study was to investigate individually and in combination the association of 217 DNA polymorphisms previously identified as markers for strength/power phenotypes with elite strength athlete status. A case-control study involved 83 Russian professional strength athletes (53 weightlifters, 30 powerlifters), 209 Russian and 503 European controls. Genotyping was conducted using micro-array analysis. Twenty-eight DNA polymorphisms (located near or in ABHD17C , ACTG1 , ADCY3 , ADPGK , ANGPT2 , ARPP21 , BCDIN3D , CRTAC1 , DHODH , GBE1 , IGF1 , IL6 , ITPR1 , KIF1B , LRPPRC , MMS22L , MTHFR , NPIPB6 , PHACTR1 , PLEKHB1 , PPARG , PPARGC1A , R3HDM1 , RASGRF1 , RMC1 , SLC39A8 , TFAP2D , ZKSCAN5 genes) were identified to have an association with strength athlete status. Next, to assess the combined impact of all 28 DNA polymorphisms, all athletes were classified according to the number of "strength" alleles they possessed. All highly elite strength athletes were carriers of at least 22 (up to 34) "strength" alleles, whereas 27.8% of Russian controls had less than 22 "strength" alleles (p < 0.0001). The proportion of subjects with a high (≥26) number of "strength" alleles was significantly greater in highly elite strength athletes (84.8%) compared with less successful strength athletes (64.9%; odd ratio [OR] = 3.0, p = 0.042), Russian (26.3%; OR = 15.6, p < 0.0001) or European (37.8%; OR = 6.4, p < 0.0001) controls. This is the first study to demonstrate that the likelihood of becoming an elite strength athlete depends on the carriage of a high number of strength-related alleles. [ABSTRACT FROM AUTHOR]

Neto, SLdA, Herrera, JJB, Rosa, TS, de Almeida, SS, Silva, GCB, Ferreira, CES, dos Santos, MAP, Silvino, VO, de Melo, GF. Interaction between ACTN3 (R577X), ACE (I/D), and BDKRB2 (−9/+9) polymorphisms and endurance phenotypes in Brazilian long-distance swimmers. J Strength Cond Res 36(6): 1591–1595, 2022—This study investigated the interactions between the polymorphisms ACTN3 (R577X), ACE (I/D), and BDKRB2 (−9/+9) and their association with endurance phenotypes in Brazilian long-distance swimmers. Twenty-six volunteers (aged 18–30 years) were divided into 2 groups as follows: 19 subelite athletes formed the pool swimming experts (PSE: 400–1500 m) group and 7 elite athletes the open water swimming experts (OWSE: 5–25 km) group. ACTN3 (R577X), ACE (I/D), and BDKRB2 (−9/+9) polymorphisms were genotyped through polymerase chain reaction. A nonathletes control (CON) group derived from studies with the Brazilian population was created. Hardy-Weinberg equilibrium (X2) was observed in all groups. The total genotype score (TGS) associated with endurance phenotypes was used in this study. A significance level was established at p ≤ 0.05. PSE and CON groups had very similar genotyping distribution. The OWSE group had a greater frequency for the genotypes XX (57.1%), ID (57.1%), and the alleles X (71.4%) and I (57.2%) than CON and PSE groups (XX = 21.1 and 21.1%; ID = 47.1 and 52.6% [ p > 0.05]; X = 44.0 and 42.1%; I = 45.3 and 42.1%, respectively). Considering BDKRB2 , OWSE and PSE groups had a greater frequency of +9/+9 than the CON group (42.9% and 31.6 vs. 27.5%, respectively). Although the expected genotypic distribution was not verified among athletes, the TGS revealed small supremacy of 3–5 typical alleles in the OWSE group (54.8 ± 26.7%) compared with the PSE group (41.2 ± 17.8%) (p = 0.072; confidence interval = 95%; effect size = 0.95). The OWSE group seem to have benefited from the best genotype profile verified for ACTN3 and ACE. However, the results of this work should be approached with caution because of the small number of athletes and polymorphisms assessed. [ABSTRACT FROM AUTHOR]

Grishina, EE, Zmijewski, P, Semenova, EA, Cieszczyk, P, Huminska-Lisowska, K, Michalowska-Sawczyn, M, Maculewicz, E, Crewther, B, Orysiak, J, Kostryukova, ES, Kulemin, NA, Borisov, OV, Khabibova, SA, Larin, AK, Pavlenko, AV, Lyubaeva, EV, Popov, DV, Lysenko, EA, Vepkhvadze, TF, Lednev, EM, Bondareva, EA, Erskine, RM, Generozov, EV, and Ahmetov, II. Three DNA polymorphisms previously identified as markers for handgrip strength are associated with strength in weightlifters and muscle fiber hypertrophy. J Strength Cond Res 33(10): 2602-2607, 2019-Muscle strength is a highly heritable trait. So far, 196 single nucleotide polymorphisms (SNPs) associated with handgrip strength have been identified in 3 genome-wide association studies. The aim of our study was to validate the association of 35 SNPs with strength of elite Russian weightlifters and replicate the study in Polish weightlifters. Genotyping was performed using micro-array analysis or real-time polymerase chain reaction. We found that the rs12055409 G-allele near the MLN gene (p = 0.004), the rs4626333 G-allele near the ZNF608 gene (p = 0.0338), and the rs2273555 A-allele in the GBF1 gene (p = 0.0099) were associated with greater competition results (total lifts in snatch and clean and jerk adjusted for sex and weight) in 53 elite Russian weightlifters. In the replication study of 76 sub-elite Polish weightlifters, rs4626333 GG homozygotes demonstrated greater competition results (p = 0.0155) and relative muscle mass (p = 0.046), adjusted for sex, weight, and age, compared with carriers of the A-allele. In the following studies, we tested the hypotheses that these SNPs would be associated with skeletal muscle hypertrophy and handgrip strength. We found that the number of strength-associated alleles was positively associated with fast-twitch muscle fiber cross-sectional area in the independent cohort of 20 male power athletes (p = 0.021) and with handgrip strength in 87 physically active individuals (p = 0.015). In conclusion, by replicating previous findings in 4 independent studies, we demonstrate that the rs12055409 G-, rs4626333 G-, and rs2273555 A-alleles are associated with higher levels of strength, muscle mass, and muscle fiber size. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether biological markers of muscle damage and inflammation coincide with subjective measures of muscle fatigue and sleep quality among Division I collegiate wrestlers. The goal was to provide practitioners with noninvasive techniques to evaluate a wrestler's inflammatory state. Subjects from the Central Michigan University Division I collegiate wrestling team (n = 6) were analyzed on 6 separate occasions throughout the course of the competitive season and post season. Biological measurements (creatine kinase [CK], interleukin [IL]-6, tumor necrosis factor alpha [TNF-α], IL-1β, IL-10) and subjective measurements (fatigue, muscle soreness, and sleep quality) were performed. The self-reported level of muscle soreness and fatigue was significantly higher from preseason through midseason, but leveled off late into the season. Creatine kinase followed a similar pattern early into the season compared with preseason and decreased at the end of season. Plasma TNF-α and IL-8 levels increased modestly late into season compared with preseason. Sleep quality correlated with plasma levels of IL-8 (r² = 0.120, p < 0.05). Subjects experienced muscle soreness and fatigue early in the competitive season, along with an increase in markers of muscle damage. This may indicate an adaptive response to the training load. Low-grade systemic inflammation increased late into the season, and correlated with poor sleep quality. Based on these data, wrestlers may benefit by additional recovery time early into the season to prevent muscle fatigue and damage. As the season progresses, low-grade inflammation may be prevented or monitored by tracking the quality of sleep. [ABSTRACT FROM AUTHOR]

Miscommunications during patient handoff can lead to harm. The I-PASS bundle has been shown to improve safety outcomes. Although effective training reliably improves verbal handoffs, research has demonstrated a lack of effect on written handoffs. The objective was to compare written handoff before and after integration of a standardized electronic health record (EHR) tool. Interns at a large urban academic medical center underwent I-PASS handoff training. The EHR handoff tool was then revised to prompt the I-PASS components. Handoff documents were obtained before and after the intervention. More handoffs included Illness Severity (33% to 59%, P < .001) and Action List (65% to 83%, P = .005) after the intervention. There was no change in handoffs with miscommunications (12.5% to 10%, P = .566) or omissions (8% to 11%, P = .447). Handoffs including tangential or unrelated information decreased (20% to 4%, P = .001). A written handoff tool can reinforce the effect of training and increase adherence to I-PASS. [ABSTRACT FROM AUTHOR]

Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution's ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers. Comparison of preintervention and postintervention results from the 1-month pilot revealed that within a 24-hour period, DE-PASS reduced the number of intensive care unit transfers by 58% ( P = .393), the number of rapid-response team calls by 39% ( P = .637), and time to inpatient order by 31% ( P = .004). ED physicians' and hospitalists' satisfaction with DE-PASS increased. Reduction in intensive care unit transfers was sustained after the pilot ( P = .029). DE-PASS feasibility was evidenced by 100% uptake. By stratifying patients by risk level, DE-PASS reduced admission-to-evaluation times for unstable patients, potentially improving patient safety. [ABSTRACT FROM AUTHOR]

Orysiak, J, Mazur-Różycka, J, Busko, K, Gajewski, J, Szczepanska, B, and Malczewska-Lenczowska, J. Individual and combined influence of ACE and ACTN3 genes on muscle phenotypes in polish athletes. J Strength Cond Res 32(10): 2776–2782, 2018—The aim of this study was to examine the association between angiotensin-converting enzyme (ACE) and α-actinin-3 (ACTN3) genes, independently or in combination, and muscle strength and power in male and female athletes. The study involved 398 young male (n = 266) and female (n = 132) athletes representing various sport disciplines (ice hockey, canoeing, swimming, and volleyball). All were Caucasians. The following measurements were taken: height of jump and mechanical power in countermovement jump (CMJ) and spike jump (SPJ), and muscle strength of 10 muscle groups (flexors and extensors of the elbow, shoulder, hip, knee, and trunk). The insertion-deletion (I/D) polymorphism of ACE and the R577X polymorphism of ACTN3 were typed using polymerase chain reaction (PCR) and polymerase chain reaction—restriction fragment length polymorphism (PCR-RFLP), respectively. The genotype distribution of the ACE and ACTN3 genes did not differ significantly between groups of athletes for either sex. There was no association between ACE and ACTN3 genotypes (alone or in combination) and sum of muscle strength, height of jump or mechanical power in both jump tests (CMJ and SPJ) for male and female athletes. These findings do not support an influential role of the ACE and ACTN3 genes in determining power/strength performance of elite athletes. [ABSTRACT FROM AUTHOR]

Introduction: Due to the current COVID-19 pandemic, surgical training has become increasingly challenging due to required social distancing. Therefore, the use of virtual reality (VR)-simulation could be a helpful tool for imparting surgical skills, especially in minimally invasive environments. Visual spatial ability (VSA) might influence the learning curve for laparoscopic surgical skills. However, little is known about the influence of VSA for surgical novices on VR-simulator training regarding the complexity of different tasks over a long-term training period. Our study evaluated prior VSA and VSA development in surgical trainees during VR-simulator training, and its influence on surgical performance in simulator training., Methods: In our single-center prospective two-arm randomized trial, VSA was measured with a tube figure test before curriculum training. After 1:1 randomization, the training group (TG) participated in the entire curriculum training consisting of 48 different VR-simulator tasks with varying difficulty over a continuous nine-day training session. The control group (CG) performed two of these tasks on day 1 and 9. Correlation and regression analyses were used to assess the influence of VSA on VR-related surgical skills and to measure procedural abilities., Results: Sixty students (33 women) were included. Significant improvements in the TG in surgical performance and faster completion times were observed from days 1 to 9 for the scope orientation 30° right-handed (SOR), and cholecystectomy dissection tasks after the structured 9-day training program. After training, the TG with pre-existing low VSA scores achieved performance levels similar to those with pre-existing high VSA scores for the two VR simulator tasks. Significant correlations between VSA and surgical performance on complex laparoscopic camera navigation SOR tasks were found before training., Conclusions: Our study revealed that that all trainees improved their surgical skills irrespective of previous VSA during structured VR simulator training. An increase in VSA resulted in improvements in surgical performance and training progress, which was more distinct in complex simulator tasks. Further, we demonstrated a positive relationship between VSA and surgical performance of the TG, especially at the beginning of training. Our results identified pre-existing levels of VSA as a predictor of surgical performance., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2.8. Categorical residents had higher burnout severity than noncategorical residents (2.9 vs 2.7, P = .005). Postgraduate year 2 residents had the highest burnout severity by year (3.1, P < .001). Residents on inpatient rotations had higher burnout severity than residents on outpatient or consultation rotations (3.1 vs 2.2 vs 2.2, P < .001). Night float rotations had the highest severity (3.8). Burnout remains a significant problem even with recent duty hour modifications. [ABSTRACT FROM AUTHOR]

Operating room (OR) to intensive care unit (ICU) handoffs are complex and known to be associated with adverse events and patient harm. The authors hypothesized that handoff quality diminishes during nights/weekends and that bedside handoff practices are similar between ICUs of the same health system. Bedside OR-to-ICU handoffs were directly observed in 2 surgical ICUs with different patient volumes. Handoff quality measures were compared within the ICUs on weekdays versus nights/weekends as well as between the high- and moderate-volume ICUs. In the high-volume ICU, transmitter delivery scores were significantly better during off hours, while other measures were not different. High-volume ICU scores were consistently better than those in the moderate-volume ICU. Bedside handoff practices are not worse during off hours and may be better in ICUs used to a higher patient volume. Specific handoff protocols merit evaluation and training to ensure consistent practices in different ICU models and at different times. [ABSTRACT FROM AUTHOR]

This study examines whether implementing a resident shift work schedule (RSWS) alone or combined with a hospitalist-led model system (HMS/RSWS) affects patient care outcomes or costs at a pediatric tertiary care teaching hospital. A retrospective sample compared pre- and postintervention groups for the most common primary discharge diagnoses, including asthma and cellulitis (RSWS intervention) and inflammatory bowel disease and diabetic ketoacidosis (HMS/RSWS intervention). Outcome variables included length of stay, number of subspecialty consultations, and hospitalization charges. For the RSWS intervention, the preintervention (n = 107) and postintervention (n = 92) groups showed no difference in any of the outcome variables. For the HMS/RSWS intervention, the preintervention (n = 98) and postintervention (n = 69) groups did not differ in demographics or length of stay. However, subspecialty consultations increased significantly during postintervention from 0.83 to 1.52 consults/hospitalization ( P < .01) without significantly increasing hospitalization charges. Neither the RSWS nor HMS/RSWS intervention affected patient care outcomes at a pediatric tertiary care teaching hospital. [ABSTRACT FROM AUTHOR]

Purpose of Review: With social media use continuing to increase in popularity, ophthalmologists use social media daily for interactions with patients, colleagues, and the academic community., Recent Findings: The potential reach of social media is overwhelmingly encouraging, but academic organizations have much work to do in order to compete for viewership on social media platforms, and users need to remain vigilant of easily spread misinformation. Individual ophthalmology practices can tailor their social media presence to attract and educate patients. Using hashtags to supplement the experience of academic conferences has boosted engagement both of attendees and other interested parties. As an effective indicator of the popularity of different subjects in medicine, new studies are leveraging social media for epidemiological models. Finally, social media is emerging as a powerful tool for patient advocacy in ophthalmology., Summary: The accessibility of social media uniquely positions it to educate patients, disseminate public eye health initiatives, and increase the reach of individual physicians. It is also able to enhance the academic experience of conferences, connecting new research colleagues, and is becoming the subject of epidemiologic studies itself. Whether using social media for patient education, research, clinical practice, or patient advocacy, ophthalmologists will find social media an increasingly important workplace contributor., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted increasingly stringent requirements governing resident hours and supervision, with the goals of improving patient safety, resident well-being, and resident education. Although the changes initially stemmed from a catastrophic outcome in a patient treated with psychotropic medications and behavioral restraints, and have been in place over a decade, many psychiatrists are not familiar with these changes and with their potential effects and "side effects" on today's trainees and faculty. The authors review the history leading to these changes, summarize the revised requirements, and review representative literature regarding the impact of the changes. The existing studies of the impact of the new requirements on improving patient safety, resident well-being, and resident education are inconclusive, and most editorials, perspectives, and surveys of faculty and residents reflect a lack of enthusiasm for the changes. They go on to suggest the need for evidence-based outcome studies prior to the institution of further major changes in ACGME requirements. [ABSTRACT FROM AUTHOR]