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Course-based undergraduate research experiences (CUREs) offer students opportunities to engage in critical thinking and problem solving. However, quantitating the impact of incorporating research into undergraduate courses on student learning and performance has been difficult since most CUREs lack a comparable traditional course as a control. To determine how course-based research impacts student performance, we compared summative assessments of the traditional format for our upper division immunology course (2013-2016), in which students studied known immune development and responses, to the CURE format (2017-2019), in which students studied the effects of genetic mutations on immune development and responses. Because the overall class structure remained unaltered, we were able to quantitate the impact of incorporating research on student performance. Students in the CURE format class performed significantly better on quizzes, exams, and reports. There were no significant differences in academic levels, degree programs, or grade point averages, suggesting improved performance was due to increased engagement of students in research.

The Facility for Rare Isotope Beams (FRIB) began operation with 1 kW beam power for scientific users in May 2022 upon completion of 8 years of project construction. The ramp-up to the ultimate beam power of 400 kW, planned over a 6-year period, will enable the facility to reach its full potential for scientific discovery in isotope science and applications. In December 2023, a record-high beam power of 10.4 kW uranium was delivered to the target. Technological developments and accelerator improvements are being made over the entire facility and are key to completion of the power ramp-up. Major technological developments entail the phased deployment of high-power beam-intercepting systems, including the charge strippers, the charge selection systems, the production target, and the beam dump, along with support systems, including non-conventional utilities (NCU) and remote handling facilities. Major accelerator improvements include renovations to aging legacy systems associated with experimental beam lines and system automation for improved operational efficiency and better machine availability. Experience must be gained to safely handle the increased radiological impacts associated with high beam power; extensive machine studies and advanced beam tuning procedures are needed to minimize uncontrolled beam losses for the desired operating conditions. This paper discusses the technological developments and accelerator improvements with emphasis on major R&D efforts.

The Yuma myotis bat (Myotis yumanensis) is a small vespertilionid bat and one of 52 species of new world Myotis bats in the subgenus Pizonyx. While M. yumanensis populations currently appear relatively stable, it is one of 12 bat species known or suspected to be susceptible to white-nose syndrome, the fungal disease causing declines in bat populations across North America. Only two of these 12 species have genome resources available, which limits the ability of resource managers to use genomic techniques to track the responses of bat populations to white-nose syndrome generally. Here we present the first de novo genome assembly for Yuma myotis, generated as a part of the California Conservation Genomics Project. The M. yumanensis genome was generated using a combination of PacBio HiFi long reads and Omni-C chromatin-proximity sequencing technology. This high-quality genome is one of the most complete bat assemblies available, with a contig N50 of 28.03 Mb, scaffold N50 of 99.14 Mb, and BUSCO completeness score of 93.7%. The Yuma myotis genome provides a high-quality resource that will aid in comparative genomic and evolutionary studies, as well as inform conservation management related to white-nose syndrome.

Background: Propofol as an intravenous (IV) induction agent frequently causes significant hypotension and requires monitoring and prompt intervention. The plethysmographic waveform, obtained from a pulse oximeter, relies on two components of light absorption-red and infrared, representing changes in blood volume and cardiovascular status of the patient. Aims and Objectives: The current study aimed to obtain a baseline value and positive predictive value (PPV) of plethysmographic variability index (PVI) to predict hypotension and also compare the PPV of PVI and perfusion index (PI) to predict hypotension induced by propofol. Materials and Methods: Seventy patients posted for elective surgery were first given IV crystalloids 2 h before surgery and then induced with propofol IV. Hemodynamic parameters, PI and PVI were recorded from baseline until 3 min post-intubation. Hypotension was defined as a fall in systolic blood pressure >30% or mean arterial pressure (MAP)

Abstract Objective The economic crisis in Lebanon, which began in 2019, has affected the healthcare system and patients' incomes. The aim of this study was to analyze the obstacles faced by people with epilepsy (PWE) during this crisis and to assess its impact on their quality of life. Methods The method used was a cross‐sectional study conducted among PWE aged 18–65 years, who were asked to complete a comprehensive questionnaire covering sociodemographic aspects, clinical aspects, the impact of the economic crisis, and the QOLIE‐31 (version 1.0), validated in English and Arabic, which assesses the quality of life of PWE. Results 71 patients were included in the study with an average age of 35.2 years [23.5; 62.5] (53.5% were males). Their average QOLIE‐31 score was 50.3 (+/− 17.9). A significant proportion (71%) of patients reported difficulties during the crisis, with 25% reporting having had seizure‐related injuries in the years 2022–2023 and 36.6% reporting an increase in seizure frequency compared to that prior to 2020. Moreover, many patients had to change (33.8%) or discontinue (18.3%) antiseizure medications, due to drug shortages, rising costs, and high gas prices. To mitigate these challenges, patients sought solutions such as obtaining medications from abroad (34%) or through donations (8%) or purchasing from the black market (8%). Low quality of life was associated with unemployment, low education level, the presence of focal seizures with impaired awareness or generalized seizures, polytherapy, seizure‐related injuries, and medication changes during the economic crisis. Significance These results highlight the considerable challenges faced by PWE in Lebanon during the economic crisis, emphasizing the negative effect of the crisis on their quality of life and seizure control. Plain Language Summary This study analyzed the obstacles faced by 71 people with epilepsy during Lebanon's economic crisis and showed that many patients had to change (33.8%) or discontinue (18.3%) antiseizure medications, due to drug shortages, rising costs, and high gas prices. To mitigate these challenges, patients sought solutions such as obtaining medications from abroad (34%) or through donations (8%) or purchasing from the black market (8%). This affected their quality of life. In fact, low quality of life was associated with unemployment, low education level, focal seizures with impaired awareness or generalized seizures, polytherapy, seizure‐related injuries, and medication changes.

Background: Explicit funding and industry affiliation are believed to potentially impact medical research. There have been an increasing number of studies that have evaluated this relationship. The purpose of this study is to determine whether industry affiliation influences the outcomes of randomized controlled trials that investigate the effectiveness of platelet-rich plasma (PRP) in the treatment of lateral epicondylitis. Methods: A search of PubMed, SPORTDiscus, and SCOPUS was performed using the search terms “lateral epicondylitis” and “platelet-rich plasma” as well as “tennis elbow” and “platelet-rich plasma.” Only studies from 2010 to present were considered. Final texts were then analyzed for industry affiliation and treatment efficacy. When determining whether a study was industry-affiliated, explicit financial supporters of the study, stated conflicts of interest, American Academy of Orthopaedic Surgeons disclosures, and the Centers for Medicare and Medicaid Services open payments database were assessed. Study outcomes were categorized as favorable, analogous, or unfavorable based on achieving a statistically significant (P

Mutualistic interactions between species are widespread and important for community structure and ecosystem function. In a changing environment, the proximate mechanisms that maintain mutualisms affect their stability and susceptibility to perturbation. In ant-plant mutualisms, ants defend their host plants against herbivores or competing plants in exchange for housing or food. While the phenomenon of species exchanging services for resources is well documented, how such arrangements are maintained is not. There are at least four hypothesized mechanisms through which plants use sugar to induce ant defense against herbivores. Three such hypotheses (“deficit”, “fuel for foraging”, “predictable rewards”) predict that the appearance of a new sugar source near the host plant would increase the rate of ant attacks against herbivores, but the fourth hypothesis (“attract and distract”) predicts the opposite. To examine how the mutualism between Triplaris americana and Pseudomyrmex dendroicus would be affected, we simulated the appearance of a novel sugar source at a random half of 34 T. americana trees with P. dendroicus colonies. Compared to control colonies, those with access to the sugar source were less likely to attack herbivorous insects (Nasutitermes sp. termites). Thus, our findings support the “attract and distract” hypothesis. We infer that this ant-plant mutualism could be destabilized by the appearance of an alternative sugar source, such as a nectar-producing plant or honeydew-excreting insect. More broadly, we conclude that the mechanisms responsible for maintaining mutualistic relationships are relevant for understanding how ecological communities are affected by environmental change. Abstract in Spanish is available with online material.

Frailty is a multidimensional geriatric syndrome characterized by decreased physiological reserve, making patients more vulnerable to stressors, such as surgery and anesthesia. In neuroanesthesia, frailty is particularly relevant due to the high-risk nature of neurosurgical procedures and the potential for significant perioperative stress. Although there are several studies on the implications of frailty in spine surgery, there are lacunae in the knowledge understanding and frailty risk assessment in the cranial cohort of neurosurgical patients. A systemic review process with a qualitative data analysis of the available literature was used to extract data for this review. By identifying, acknowledging, and addressing the knowledge gaps in our understanding of frailty, specifically the cranial cohort, and developing a neuroanesthesia-specific frailty risk index, along with establishing best practice strategy guidelines and institutional protocols, neuroanesthesiologists will enhance and optimize outcomes.

Millet, a vital and nutritionally dense cereal extensively cultivated in Sub-Saharan Africa, plays a key role in ensuring food security. This study investigates the starch synthase (SS) gene family, which is crucial for starch biosynthesis and influences various plant functions and stress responses. While the specific roles of SS genes in millet under drought conditions are not fully elucidated, this research provides a thorough analysis of the SS gene family in millet. A total of twelve millet SS genes (SiSSs) were identified and classified into four subfamilies (I–IV) through gene structure and phylogenetic analysis. The SiSS genes were unevenly distributed across millet chromosomes, with cis-acting elements associated with plant growth and stress defense being identified. Quantitative PCR (qPCR) revealed dynamic and varied expression patterns of SiSSs in different tissues under drought stress. Millet plants subjected to drought conditions showed higher tissue starch content and increased starch synthase activity compared to controls. Importantly, the expression levels of the twelve SiSSs were positively correlated with both starch content and synthase activity, suggesting their significant role in drought tolerance. This study enhances our understanding of the millet SS gene family and highlights the potential of these genes in breeding programs aimed at developing drought-resistant millet varieties. Further research is recommended to validate these findings and delve deeper into the mechanisms underlying drought tolerance.

The purpose of this manuscript is to examine the implications of the current ideological underpinnings of sport education programs (SEPs) in the United States (U.S.) and present a new equity-minded and anti-ism sport education (EASE) framework that reflects a paradigm shift towards equity-mindedness, anti-ism, cultural responsiveness, inclusive excellence, and transformational leadership. The sport industry has transformed from modest recreational activities for leisure entertainment at the local levels into a multi-billion-dollar global corporatized industry with far-reaching economic, political and sociocultural impacts. Despite the growth in popularity of SEPs, a major area of concern is the lack of critical reflection on their sociopolitical and cultural origins of the curriculum and corresponding metrics of success. Thus, we argue current SEPs (e.g. sport management, sport administration, sport leadership, sport business, parks and recreation, and sport entertainment, hospitality, and tourism) perpetuate colorblind racism, sexism, and classism based on their philosophical foundations. In an effort to reflect a responsiveness to an increasingly global and multicultural sport industry, we present a new EASE framework for preparing professionals to ignite transformational change in and through sport in the twenty-first century.

Category: Hindfoot; Other Introduction/Purpose: Insertional Achilles tendinopathy (IAT) is one of the most common causes of posterior heel pain and affects thousands of patients every year. Enthesophytes can form at the Achilles tendon insertion in response to excessive loads and lead to pain and discomfort. There is limited evidence regarding patient factors associated with likelihood of failing non-operative management, specifically the size of the enthesophyte and its proximity to the posterior heel skin. The purpose of this study was to investigate the relationship between radiographic characteristics of retrocalcaneal enthesophytes in IAT and likelihood of failing non-operative management. Methods: A retrospective cohort study of 295 patients diagnosed IAT with symptomatic enthesophytes were identified and separated into operative and nonoperative cohorts. A power analysis was conducted and determined that a minimum of 100 patients within each cohort was required. All patients had lateral weight bearing radiographs which were used to measure the Calcaneal Spur-to-Skin Distance (CSK), Calcaneal Spur Width (CSW), Calcaneal Spur Height (CSH), and the Fowler-Philip Angle (FPA). Demographic and radiographic parameters were compared between both groups. Multivariate regression analysis was performed to identify independent risk factors associated with failing nonoperative management. Results: The operative group had significantly smaller CSK (6.0 mm vs. 6.6 mm; p = .02), larger CSW (7.9 mm vs 6.2 mm; p < .001), and larger CSH (14.1 mm vs. 11.1 mm; p < .001) compared to the nonoperative group. There was no significant between-group difference in FPA (61.9° nonoperative vs 63.3° operative; p = .052). Multivariate logistic regression analysis demonstrated CSK, CSW, and CSH as independent risk factors for failing nonoperative management. Conclusion: Radiographic measurements of retrocalcaneal enthesophytes are a simple and reliable method for predicting which patients have a higher likelihood of failing nonoperative management of IAT.

Background:. Statistically nonsignificant randomized clinical trial (RCT) results are challenging to interpret, as they are unable to prove the absence of a difference between treatment groups. Bayesian analysis offers an alternative statistical framework capable of providing a comprehensive understanding of nonsignificant results. Methods:. This cross-sectional study conducted a post hoc Bayesian analysis of statistically nonsignificant outcomes from RCTs published in Plastic and Reconstructive Surgery from 2013 to 2022. Bayes factors representing the probability of the absence of a difference, or the null hypothesis of no difference, were calculated and examined. P values and Bayes factors of these outcomes were also compared with assessment of their association. Results:. In 73 studies with 176 statistically nonsignificant outcomes, 160 (91%) indicated evidence for the absence of a difference (Bayes factor > 1). For 110 (63%) of these, the Bayes factor was between 1 and 3, indicating weak evidence for the absence of a difference; 16 (9.1%) results supported the presence of a difference (Bayes factor < 1). A greater P value was independently associated with a larger Bayes factor (β = 2.6, P

Category: Other; Sports Introduction/Purpose: On its current trajectory, AI chatbots may become the primary source of information for patient education material in the field of orthopaedics. Despite this, there has been no evaluation of the accuracy and validity of foot and ankle patient education material generated by AI platforms. The purpose of this study was to perform a comparative analysis of foot and ankle patient education material generated by the ai chatbots, as they compare to the AOFAS recommended patient education website, footcaremd.org. Methods: ChatGPT, Google Bard, and Bing AI were used to generate patient educational materials on ten of the most common foot and ankle conditions. The content from these ai language model platforms was analyzed and compared with footcaremd.org for accuracy of included information. Accuracy was determined for each of the ten conditions on a basis of included information regarding background, symptoms, causes, diagnosis, treatments, surgical options, recovery procedures, and risks or preventions. Results: When compared to the reference standard of the AOFAS website: footcaremd.org, the AI language model platforms consistently scored below 60% in accuracy rates in all categories of the articles analyzed. ChatGPT was found to contain an average of 46.2% of key content across all included conditions when compared to footcaremd.org. Comparatively, Google Bard contained an average of 36.5% and Bing AI contained 28.0% of information included on footcaremd.org. Conclusion: AI language model generated patient education regarding common foot and ankle conditions provides limited content accuracy across all three AI chatbot platforms. Clinicians should be aware of the increasing popularity of these platforms and be prepared to answer questions or clarify misunderstandings, and when appropriate direct patients to more validated education material such as footcaremd.org.

Category: Other; Basic Sciences/Biologics Introduction/Purpose: Occupational exposure to high levels of noise increases the risk of noise induced hearing loss (NIHL), resulting in significant long term quality of life implications. Hearing protection is recommended if occupational noise exposure routinely exceeds 85 dB. The purpose of this study was to determine if foot and ankle surgeons are exposed to excessive levels of noise, thus putting them at an increased risk for NIHL. Methods: A prospective review was conducted of intraoperative recordings during a variety of foot and ankle procedures. Recordings were categorized into three sub-groups: trauma, deformity correction and degenerative conditions, and soft tissue procedures. Noise levels were reported as maximum dB level (MDL), defined as the highest sound pressure level during the measurement period, and time-weighted average (TWA), defined as the average dB level projected over an 8-hour period. Dose was reported as the percentage of allowable daily noise, with projected dose reported as the measured dose projected over an 8-hours period. Results: 193 recordings consisting of 45.5% deformity correction and degenerative conditions, 27.2% soft tissue procedures, and 29.2% trauma cases. Maximal and average noise exposures were similar for all procedures (p=0.077 and p=0.090, respectively), with an average MDL of 98.9 dB and TWA of 60.5 dB. Procedures also did not significantly differ in dose (p=0.273), even when projected over an 8-hour period (p=0.362). The average MDL of TAA and arthrodesis procedures was 102.0 dB, with 52% of all deformity correction and degenerative procedures having an MDL over 100dB. Conclusion: Foot and ankle surgeons are typically not exposed to dangerous levels of occupational noise; however, specific procedures such as arthrodesis and TAA routinely achieve dangerous noise levels. Implementing protective measures is crucial for those who regularly perform these types of procedures due to the increased risk of developing NIHL.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Resiliency is the ability to recover from stressful events and has been shown to correlate with patient outcomes following certain orthopaedic procedures. The purpose of this study was to determine the relationship between resiliency and outcomes following TAA. Methods: A retrospective analysis of patients undergoing primary TAA between April 2015 and September 2022 was performed (N =83). Data included demographics, comorbidities, complications, pre- and post-operative visual analog scale (VAS) pain and Foot and Ankle Ability Measure (FAAM) functional scores, Brief Resilience Scale (BRS) scores and surgical satisfaction. Patients were defined as having low resilience (LR), normal resilience (NR), or high resilience (HR) based on a BRS score of < 3, 3-4.30, and > 4.3, respectively. Results: High resilience patients had significantly higher postoperative FAAM ADL, Sports, and Overall scores as well as a significantly greater increase from preoperative scores compared to LR and NR patients. Low resilience patients had significantly lower FAAM Sports and Overall scores compared to normal and high resilience patients. BRS scores positively correlated with postoperative FAAM scores. We found no difference in satisfaction or VAS between the three cohorts. Conclusion: Although functional improvements following TAA are expected, those patients with HR at baseline are more likely to experience greater improvements in functional outcomes following surgery.

Teeth are a key vertebrate innovation; their evolution is generally associated with the origin of jawed vertebrates. However, tooth-like structures already occur in jawless stem-gnathostomes; heterostracans bear denticles and morphologically distinct tubercles on their oral plates. We analysed the histology of the heterostracan denticles and plates to elucidate their morphogenesis and test their homology to the gnathostome oral skeleton. We identified a general model of growth for heterostracan oral plates that exhibit proximal episodic addition of tubercle rows. The distal hook exhibits truncated lamellae compatible with resorption, but we observe growth layers to be continuous between denticles. The denticles show no evidence of patterns of apposition or replacement indicating tooth homology. The oral plates and dermal skeleton share the same histological layers. The denticles grew in a manner comparable to the oral plate tubercles and the rest of the dermal skeleton. Our test of phylogenetic congruence reveals that the distribution of internal odontodes is discontinuous, indicating that the capacity to form internal odontodes evolved independently several times among stem-gnathostomes. Our results support the ‘outside-in’ hypothesis and the origin of teeth through the spread of odontogenic competence from extra-oral to oral epithelia and the subsequent co-option to a tooth function in gnathostomes.

Purpose: To investigate the characteristics and rate of sociodemographic variables reported in randomized controlled trials (RCTs) studying platelet-rich plasma (PRP) injections in the treatment of knee osteoarthritis (OA). Methods: In January 2024, PubMed, Scopus, and Web of Science databases were queried for the phrase “Platelet-Rich Plasma Knee Osteoarthritis.” Included studies were RCTs investigating PRP use in knee OA published in English between 2012 and 2023. Each RCT was inspected for patient age and sex or gender as well as the following sociodemographic variables: race, ethnicity, insurance status, income, housing status, work status, and education. Data were presented in a descriptive fashion and analyzed using χ2 test and Fisher’s exact test to compare 2 and 3 categorical variables, respectively, with significance defined as P < .05. Results: From 2012 through 2023, 71 RCTs met inclusion criteria. Included publications reported both age and sex or gender in 71/71 papers (100%). Reporting rates for other sociodemographic variables were as follows: race (3/71, 4.23%), work status (5/71, 7.04%), and education (3/71, 4.23%). No studies included the ethnicity, insurance status, income, or housing status of the enrolled patients. There was no difference in reporting sociodemographic variables by journal (P = .083) or by year of publication (P = .340). Sociodemographic variables were reported significantly less frequently than age and sex or gender (P < .001). Conclusions: In this study, we found that age and sex or gender are always reported in RCTs of PRP use for knee OA. However, other sociodemographic variables, such as race, work status, and education, that may be important to understand are rarely reported. Clinical Relevance: Sociodemographic variables may affect outcomes in knee osteoarthritis. It is important to understand which of these variables are most studied and which variables are most overlooked. This will help us better understand the quality of the available information.

Background: Preoperative assessment of risk for emergency laparotomy may enhance decision making with regards to urgency or perioperative critical care admission and promote a more informed consent process for patients. Accordingly, we aimed to assess the performance of risk assessment tools in predicting mortality after emergency laparotomy. Methods: PubMed, Embase, the Cochrane Library and CINAHL were searched to 12 February 2022 for observational studies reporting expected mortality based on a preoperative risk assessment and actual mortality after emergency laparotomy. Study screening, data extraction, and risk of bias using the Downs and Black checklist were performed in duplicate. Data on setting, operation undertaken, expected and actual mortality rates were extracted. Meta-analysis was planned but not possible due to heterogeneity. This study is registered with PROSPERO, CRD42022299227. Results: From 10,168 records, 82 observational studies were included. 17 risk assessment tools were described, the most common of which were P-POSSUM (42 studies), POSSUM (13 studies), NELA (12 studies) and MPI (11 studies). Articles were published between 1990 and 2022 with the most common country of origin being the UK (33 studies) followed by India (11 studies). Meta-analysis was not possible. Observed mortality and expected mortality based on risk assessment is reported for each study and generally shows most studies show accurate risk prediction. Conclusions: This review synthesises available literature to characterise the performance of various risk assessment tools in predicting mortality after emergency laparotomy. Findings from this study may benefit those undertaking emergency laparotomy and future research in risk prediction.

Although there is an expansive literature on public attitudes towards the welfare state, we know comparatively little about public attitudes toward child protection. Gauging public opinion about the state's role in protecting children is complicated by the contested ideas that underlie the field. Child protection lies at the nexus between competing values about state obligations to allow unfettered parental freedom or to permit constraints on some parental behaviors. At issue is also the notion of balancing the individual rights of the parties involved: parents and children. Similar to the larger welfare state literature, public attitudes about child protection may be shaped by core human values. This study includes representative samples of the public in Norway and California (n = 2148), countries that are commonly viewed as representative of social democratic and liberal welfare state regimes. Respondents reviewed a vignette portraying a child at risk of harm and were asked a series of questions to gauge whether and/or how the state might constrain the parent's behavior, questions pertaining to the rights of children, and their views about core human values. Findings indicate that residents of Norway were more likely to favor the values of security and equal rights, and Californians more likely to favor the value of self-direction. Contrary to the larger body of welfare state literature which suggests that human values help explain public attitudes about welfare provisions, in general, this study did not find that human values generally explained differences in country attitudes toward constrained parenting or toward children's rights. Findings offer an exploratory first step in expanding notions about child protection as nested in welfare states.