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This study considers the questions, “How do teacher candidates conceptualize the relationship among historians, history teachers, and history students?” and “How is this understanding revealed in candidates’ representation of the work they do in classrooms as history teachers?” Using a case study approach, researchers gathered data from fifteen teacher candidates in a teacher preparation program in the Midwestern United States. The data consisted of participants’ responses to three questions (What do historians do? What do history teachers do? What do history students do?) and their selections of and rationale for including artifacts in a portfolio designed to showcase “who they are” as history teachers as represented by their developing pedagogical content knowledge in history. The researchers’ findings reveal a discrepancy exists between teacher candidates’ emerging beliefs about their responsibilities as teachers and the work that they chose to highlight after having completed clinical experiences. Specifically, the findings suggest a critical disconnect exists between what teacher candidates are taught about teaching history, what they believe about teaching history, and the opportunities that they have in clinical experiences to enact these ideas. This research highlights the central yet often unexamined role of emerging teachers’ epistemic understandings in shaping opportunities for pedagogical reform in history.

This is a large-scale, multi-author collaborative autoethnographic study exploring the concept of building a tangible teaching commons on the example of the Scholarship of Teaching and Learning (SoTL) Commons Conference. The project organizers sought to provide a big tent and extended an invitation to attendees to respond to a series of writing prompts about their conference experience. Collaborative writing took place asynchronously over an approximately 60-day period following the close of the conference and generated ≈ 20,000 words. This corpus became the basis for a three-stage emergent coding process, conducted by the four-member steering commit-tee, which led to the identification of three primary themes from the collective experiences of the 2023 SoTL Commons Conference attendees: SoTL as pedagogy, SoTL as a community of scholars, and SoTL as scholarship. Despite some limitations to what the sense of commons represents, the project highlighted the respondents’ spirit of appreciative inquiry, a signature mindset of SoTL and engaged participants who were new to the field. We argue that it acted as a form of academic hospitality itself; enabling the sharing of practice, deepening of reflection, strengthening of research skills, fostering of social connections, and, by extension, the advancement of the field as a community of scholars.

Introduction: Suboptimal glycaemic control in hospitalised patients is associated with an increased risk of complications, mortality, and extended hospital stays. Managing and treating high blood sugar readings is a common task that junior doctors often encounter. This project was designed to assess and improve the skillset of foundation doctors in managing hyperglycaemia and insulin use in hospitalised patients at a district general hospital. Method: A survey was conducted to evaluate the self-rated confidence of foundation doctors in managing hyperglycaemia. To evaluate their knowledge of hyperglycaemia management, a quiz was conducted with clinical scenarios based on hyperglycaemia. The quiz consisted of five questions, and a score of 80% or higher (at least four correct answers) was deemed satisfactory. Following the first Plan-Do-Study-Act (PDSA) cycle, an interactive teaching session based on Joint British Diabetes Society (JBDS) guidelines1 was provided to all foundation doctors in the trust. This session was designed around clinical scenarios to ensure maximum engagement. In the second PDSA cycle, a local protocol based on JBDS1 and GIRFT (Getting It Right First Time)2 guidelines was developed for the inpatient management of hyperglycaemia. The quiz was repeated after each cycle to measure the efficacy of the intervention. Results and discussion: 35 foundation doctors took part in the survey to rate their confidence in managing high blood sugar levels in inpatients independently. 68.5% of the participants reported being slightly confident in their abilities while 22.8% expressed no confidence at all.In the first cycle of this project, 23 foundation doctors participated in the quiz on inpatient management of hyperglycaemia and insulin use. Only 6 (26.085%) scored 80% or higher, indicating suboptimal knowledge. After the clinical scenario-based teaching session, 19 of the 23 participants (82.6%) scored 80% or higher, demonstrating the significant impact of this teaching approach in improving management of inpatient hyperglycaemia.In the second cycle, 22 junior doctors participated. Following the introduction of newly developed hospital guidelines for inpatient hyperglycaemia management, the results of the study were overwhelmingly positive, with 86.3% of the participating doctors, (19 out of 22), scoring 80% or higher, providing a compelling demonstration of the importance of implementing well-designed guidelines for effectively managing inpatient hyperglycemia in hospital settings. Conclusion: Effective management of hyperglycaemia is a critical clinical skill that requires both teaching and practice. However, junior doctors often lack the necessary knowledge and confidence to effectively manage hyperglycaemia. Incorporating clinical scenario-based teaching sessions into foundation year training programmes can help bridge knowledge gaps where the use of polls and quizzes encourages active participation from all participants. Additionally, clear and concise local guidelines on inpatient hyperglycaemia management and insulin use would be imperative. By utilising these approaches in tandem, we can equip our junior doctors with the skills and knowledge necessary to provide optimal care for their patients with diabetes.

Background: Coronavirus disease (COVID) created unprecedented challenges, especially for high-volume elective subspecialties like total joint arthroplasty. Limited inpatient capacity and resource conservation led to new outpatient selection criteria and site of service changes. As a Michigan Arthroplasty Registry Quality Collaborative Initiative quality project, demographic changes, complications, and differential effects on inpatient vs outpatient centers pre- and post-COVID were analyzed. Methods: The registry identified all total joint arthroplasty at hospitals and ASCs/HOPDs between 07/2019-12/2019 and 07/2020-12/2020. These intervals represented pre-COVID and post-COVID elective surgery shutdowns. Case volumes, demographics, and 90-day complications were compared. Results: Comparing 2020 to 2019, hospital volumes decreased (−9% total hip arthroplasty [THA], −17% total knee arthroplasty [TKA]), and ambulatory surgery center (ASC)/hospital outpatient department (HOPD) increased (+84% THA, +125% TKA). Entering 2020, ASC/HOPD patients were older (P = .0031, P < .0001: THA, TKA), had more American Society of Anesthesiologists score 3-4 (P = .0105, P = .0021), fewer attended joint class (P < .0001, P < .0001), and more hips were women (P = .023). Hospital patients had higher preoperative pain scores (P = .0117, P < .0001; THA, TKA), less joint education attendance (P < .0001, P < .0001), younger TKAs (P = .0169), and more American Society of Anesthesiologists score 3-4 (0.0009). After propensity matching, there were no significant differences between site of service for 90-day fractures, deep vein thromboses or pulmonary embolisms, infection, or hip dislocations. Hospital THAs had higher readmissions (P = .0003) and TKAs had higher 30-day emergency department visits (P = .005). ASC/HOPD patients were prescribed higher oral morphine equivalents (P < .0001, P < .0001; THA, TKA). Conclusions: COVID’s elective surgery shutdown caused a dramatic site of service shift. Traditional preoperative education was negatively impacted, and older and sicker patients became outpatients. But short-term complications were not increased in ASCs/HOPDs. These site of service and associated patient demographic changes may be safely sustained.

Abstract Background Remarkably little research has been published on chronic exertional compartment syndrome (CECS) of the forearm. This study investigated forearm flexor compartment pressure pre- and post-exercise in elite motorbike racers clinically diagnosed with CECS and assessed their grip strength before and after arm pump exercise. Methods Elite motorbike riders with a clinical diagnosis of CECS of the right forearm when racing were recruited during the opening rounds of a British Superbike season. Their grip strength and forearm flexor compartment pressures were measured before and after a set exercise programme. Results Of the 11 riders recruited to the study, 10 completed the full testing regime. The mean pre-exercise forearm compartment pressures [11.7 mmHg (range 7–17 mmHg)] significantly increased post-exercise [30.5 mmHg (range 15–45 mmHg)], with a mean increase of 18.80 mmHg (P

BackgroundNatural language processing (NLP) methods are powerful tools for extracting and analyzing critical information from free-text data. MedTaggerIE, an open-source NLP pipeline for information extraction based on text patterns, has been widely used in the annotation of clinical notes. A rule-based system, MedTagger-total hip arthroplasty (THA), developed based on MedTaggerIE, was previously shown to correctly identify the surgical approach, fixation, and bearing surface from the THA operative notes at Mayo Clinic. ObjectiveThis study aimed to assess the implementability, usability, and portability of MedTagger-THA at two external institutions, Michigan Medicine and the University of Iowa, and provide lessons learned for best practices. MethodsWe conducted iterative test-apply-refinement processes with three involved sites—the development site (Mayo Clinic) and two deployment sites (Michigan Medicine and the University of Iowa). Mayo Clinic was the primary NLP development site, with the THA registry as the gold standard. The activities at the two deployment sites included the extraction of the operative notes, gold standard development (Michigan: registry data; Iowa: manual chart review), the refinement of NLP algorithms on training data, and the evaluation of test data. Error analyses were conducted to understand language variations across sites. To further assess the model specificity for approach and fixation, we applied the refined MedTagger-THA to arthroscopic hip procedures and periacetabular osteotomy cases, as neither of these operative notes should contain any approach or fixation keywords. ResultsMedTagger-THA algorithms were implemented and refined independently for both sites. At Michigan, the study comprised THA-related notes for 2569 patient-date pairs. Before model refinement, MedTagger-THA algorithms demonstrated excellent accuracy for approach (96.6%, 95% CI 94.6%-97.9%) and fixation (95.7%, 95% CI 92.4%-97.6%). These results were comparable with internal accuracy at the development site (99.2% for approach and 90.7% for fixation). Model refinement improved accuracies slightly for both approach (99%, 95% CI 97.6%-99.6%) and fixation (98%, 95% CI 95.3%-99.3%). The specificity of approach identification was 88.9% for arthroscopy cases, and the specificity of fixation identification was 100% for both periacetabular osteotomy and arthroscopy cases. At the Iowa site, the study comprised an overall data set of 100 operative notes (50 training notes and 50 test notes). MedTagger-THA algorithms achieved moderate-high performance on the training data. After model refinement, the model achieved high performance for approach (100%, 95% CI 91.3%-100%), fixation (98%, 95% CI 88.3%-100%), and bearing surface (92%, 95% CI 80.5%-97.3%). ConclusionsHigh performance across centers was achieved for the MedTagger-THA algorithms, demonstrating that they were sufficiently implementable, usable, and portable to different deployment sites. This study provided important lessons learned during the model deployment and validation processes, and it can serve as a reference for transferring rule-based electronic health record models.

Aims: To describe the incidence of adverse clinical outcomes related to COVID-19 infection following corticosteroid injections (CSI) during the COVID-19 pandemic. To describe the incidence of positive SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) testing, positive SARS-COV2 IgG antibody testing or positive imaging findings following CSI at our institution during the COVID-19 pandemic. Methods: A retrospective observational study was undertaken of consecutive patients who had CSI in our local hospitals between 1 February and 30June 2020. Electronic patient medical records (EPR) and radiology information system (RIS) database were reviewed. SARS-CoV-2 RT-PCR testing, SARS-COV2 IgG antibody testing, radiological investigations, patient management, and clinical outcomes were recorded. Lung findings were categorized according to the British Society of Thoracic Imaging (BSTI) guidelines. Reference was made to the incidence of lab-confirmed COVID-19 cases in our region. Results: Overall, 1,656 lab-confirmed COVID-19 cases were identified in our upper tier local authority (UTLA), a rate of 306.6 per 100,000, as of 30June 2020. A total of 504 CSI injections were performed on 443 patients between 1 February and 30June 2020. A total of 11 RT-PCR tests were performed on nine patients (2% of those who had CSI), all of which were negative for SARS-CoV-2 RNA, and five patients (1.1%) received an SARS-CoV-2 IgG antibody test, of which 2 (0.5%) were positive consistent with prior COVID-19 infection, however both patients were asymptomatic. Seven patients (1.6%) had radiological investigations for respiratory symptoms. One patient with indeterminate ground glass change was identified. Conclusion: The incidence of positive COVID-19 infection following corticosteroid injections was very low in our cohort and no adverse clinical outcomes related to COVID-19 infection following CSI were identified. Our findings are consistent with CSI likely being low risk during the COVID-19 pandemic. The results of this small observational study are supportive of the current multi-society guidelines regarding the judicious use of CSI.

Autophagy-related protein 8 (ATG8) is a highly conserved ubiquitin-like protein that modulates autophagy pathways by binding autophagic membranes and a number of proteins, including cargo receptors and core autophagy components. Throughout plant evolution, ATG8 has expanded from a single protein in algae to multiple isoforms in higher plants. However, the degree to which ATG8 isoforms have functionally specialized to bind distinct proteins remains unclear. Here, we describe a comprehensive protein-protein interaction resource, obtained using in planta immunoprecipitation (IP) followed by mass spectrometry (MS), to define the potato ATG8 interactome. We discovered that ATG8 isoforms bind distinct sets of plant proteins with varying degrees of overlap. This prompted us to define the biochemical basis of ATG8 specialization by comparing two potato ATG8 isoforms using both in vivo protein interaction assays and in vitro quantitative binding affinity analyses. These experiments revealed that the N-terminal β-strand-and, in particular, a single amino acid polymorphism-underpins binding specificity to the substrate PexRD54 by shaping the hydrophobic pocket that accommodates this protein's ATG8-interacting motif (AIM). Additional proteomics experiments indicated that the N-terminal β-strand shapes the broader ATG8 interactor profiles, defining interaction specificity with about 80 plant proteins. Our findings are consistent with the view that ATG8 isoforms comprise a layer of specificity in the regulation of selective autophagy pathways in plants.

As historians have increasingly explored the complex historical relationship between race, class, and institutions such as the federal government in shaping contemporary American society, historical sources such as the Federal Housing Association’s Underwriting Manual (1938) provide provocative opportunities for teaching. Brief excerpts from the Manual are a small window through which to examine the underappreciated role of the U.S. federal government in creating and sustaining a racialized version of the American Dream. The result is an opportunity to equip students, as citizens, with the historical thinking skills and sources to examine the enduring historical arc of racial injustice and resistance in the United States that serves as the foundation for the Black Lives Matter movement.

Background: Biomechanists are often asked to provide expert opinions in legal proceedings, especially personal injury cases. This often involves using deterministic analysis methods, although the expert is expected to opine using a civil standard of “more likely than not” that is inherently probabilistic. Methods: A method is proposed for converting a class of deterministic biomechanical models into hybrid Bayesian networks that produce a probability well suited for addressing the civil standard of proof. The method was developed for spinal injury during lifting. Its generalizability was assessed by applying it to slip and fall events based on the coefficients of friction at the shoe–floor interface. Results: The proposed method is shown to be generalizable beyond lifting by applying it to a slip and fall event. Both the lifting and slip and fall models showed that incorporating evidence of injury could change the probabilities of critical quantities exceeding a threshold from “less likely than not” to “more likely than not.” Conclusions: The present work shows that it is possible to develop Bayesian networks for legal use based on laws of engineering mechanics and probabilistic descriptions of measurement error and human variability.

As historians have increasingly explored the complex historical relationship between race, class, and institutions such as the federal government in shaping contemporary American society, historical sources such as the Federal Housing Association’s Underwriting Manual (1938) provide provocative opportunities for teaching. Brief excerpts from the Manual are a small window through which to examine the underappreciated role of the U.S. federal government in creating and sustaining a racialized version of the American Dream. The result is an opportunity to equip students, as citizens, with the historical thinking skills and sources to examine the enduring historical arc of racial injustice and resistance in the United States that serves as the foundation for the Black Lives Matter movement.

This paper details the work of a group of learning disabled people (people with intellectual disabilities) who contribute to the teaching of students undertaking a degree program at one of the UK's most elite universities. Traditional notions relating to knowledge production within academia are examined and we demonstrate how the participation of learning disabled people in classroom teaching challenges these. Drawing on the work of Freire (1972) the paper demonstrates how co-teaching by learning disabled people has a transformative impact on educational experiences. Finally, the current changes impacting the UK higher education sector are detailed and we explore how these changes are negatively impacting on courses that seek to move away from traditional approaches to pedagogy.

GENERATIVE ARTIFICIAL INTELLIGENCE IS a headspace and a technology--as much an event playing out in our minds as it is a material reality emerging at our fingertips. Fast and fluent, [...]

OBJECTIVE: Evaluation of the benefits and risks of performing open lung biopsy (OLB) in critically ill, ventilator dependent intensive care unit patients.

Realism Confronts Utopia Wonder Confronts Certainty: Russian Writers on the Timeless Questions and Why Their Answers Matter Gary Saul Morson Cambridge, MA: Harvard University Press, 2023. Announcing Aleksandr Solzhenitsyn's selection [...]

The Religious Revolution: The Birth of Modern Spirituality, 1848-1898 Dominic Green New York, NY: Farrar, Straus and Giroux, 2022. Having already recounted God's life through popular biographies of Jesus and [...]

The article examines the evolution of supply chains, shifting from Adam Smith's early observations to modern reflections on their vast, complex nature. Topics discussed include the philosophical concept of the sublime in relation to supply chains, the growing intricacy of global production networks, and the impact of technological advancements on logistics and global commerce.

George Steiner was called many things across his lengthy writing career--sage, pedant, philosopher, snob, the last great European intellectual, a 'mimic' staging a decades-long 'impression of the world's most learned [...]

The Age of Surveillance Capitalism: The Fight for a Human Future at the New Frontier of Power Shoshana Zuboff New York, NY: PublicAffairs, 2019. Consider four news stories from the [...]

The Enlightenment: The Pursuit of Happiness, 1680-1790 Ritchie Robertson New York, NY: Harper, 2021. What is happiness? Every era has entertained this question. Yet as Ritchie Robertson, Taylor Professor of [...]

There's no shortage of debate about friendship. --Aristotle, Nicomachean Ethics, 8.1.33 (1) COMPLAINTS ABOUT THE DECLINE OF friendship have become a staple of conversation in our digital times. But before [...]