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davembmd.bsky.social
Pediatric Orthopaedic and Spine Surgeon In Phoenix Arizona. Father of 4. Grandad. Surgical innovation. Additive prototyping. Woodwork. Applied regression analysis. Author. Curious.
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High IF ≠ better research. Med IF=2.2 (IQR 2.37). Top-10 IF → low-bias RCTs 13% in ’99, 30% in ’09 (P<0.02) vs 4% & 12%. High IF >3 → > RCTs w/ sample-size calc, alloc seq, ITTa. Low IF <2 → low-bias RCTs 4% in ’99, 8% in ’09. More centers & authors → ↑IF. Ind-funding & sig outcomes ≠ IF (P>0.05).

As social media turns into slop, maybe we can go back to personal websites, listed in human-curated directories. I mean, why not? If we brought gifs back, surely we can bring the "homepage" back. After all, homepages were the gif's original habitat.

My purely occasional notification that, if you want to see a couple guys bumble their way through writing a novel, Ty and I have a pretty cheap Patreon where we’re doing exactly that. It starts “It was raining the day Josephine Ayari saw her doppelganger.” www.patreon.com/JamesSACorey...

A very good morning to you, and may the day ahead present itself as a canvas upon which you can skillfully imprint the full breadth of your intellect and capabilities.

I must now impart my commendations for the unparalleled privilege of our association as prelude to my departure for the evening as I undertake my abscondance with profound decorum & convey my most dignified farewell. May your upcoming results reflect the culmination of your efforts.

Please be accepted with minor revisions! #phdchat #phdjourney #phd #phdstudent #phdlife #thesis #academicsky

Project with UTSA teaching IR in MSK RADS

I shall now depart. May the remainder of your evening unfold like a meadow kissed by dusk, where each blade of grass stands in silent testimony to the beauty of stillness. We shall doubtlessly reconvene on the morrow.

Physician CEOs ↗ success: US Kaiser & Veterans Health turned around by doc CEOs. Canada: McGill, Ottawa Hosp, Sunnybrook, St. Michael’s, Univ Health all w/doc CEOs → strong qual focus & staff respect. Docs vital in change mgmt, qual care, ↓ errors, ↑ pt satisfaction, team culture.

Top-100 US hosp(2009) in 3 specialties(Cancer, Digest, Heart): Doc CEO hosp ↗ qual scores(Cancer: 31.63 vs 23.61, p<0.001; Digest: +9.19 pts, p<0.001; Heart: +9.06 pts, p<0.001). ‘Honor Roll’(top-21 hosp): 76% doc CEOs(16/21); doc CEO hosp qual 18.38 vs 12.60 non-doc CEO hosp.

6162 US hosp (2019): 383(6%) doc CEO. HCAHPS: doc CEO hosp ↗ pt recommend (ρ=0.076,p=0.002); 10% doc CEO hosp rated top(5) vs 5% non-doc CEO hosp. Bivar odds recommend: doc CEO hosp 1.70x non-doc(p=0.001). Multivar adj odds still + but NS(AOR=1.38,p=0.06).

Here is my powerpoint from ORS on the effect of pre-operative visualization on outcomes. Please add anything I missed or I left out and give in your training programs. docs.google.com/presentation...

UU hires MD PhD CEO x.com/bobcartermd/...

Multilevel Ponte osteotomies vs facetectomies in AIS. n=35; osteo n=18, facet n=17. Osteo ↑blood loss (97 vs 66mL/level, p=0.01), ↑op time (31 vs 23min/level, p<0.001). No diff coronal corr (84 vs 83%), kyphosis Δ (8° vs 1°). No benefit in routine Ponte.

Shared with permission: 9yo at Time 0, 3 months and 8 months; treated with cuff and collar non-op

Meet the Editor: Elvin Geng, our new co-Editor-in Chief for Implementation Science Communications, participates in a Q&A about the field and his own research interests, including a crisis point in HIV care, as well as his vision & hopes for the journal. communities.springernature.com/posts/meet-t...

The U.S. faces a projected shortage of 86,000 physicians by 2036, hitting vascular surgery, ophthalmology, and family medicine hardest. Rural areas will suffer most, with burnout fueling the crisis. More solutions are needed. 🩺💻

Viewpoint: Francesca Celletti, Francesco Branca, and Jeremy Farrar from the @who.int discuss factors associated with the prevalence of obesity worldwide and whether the novel #GLP-1 RAs can help unlock a health system's response to the obesity pandemic. ja.ma/411MznH #MedSky

In the spirit of collegial advancement, would you consider unveiling that precious jewel of your practice: the most clutch and useful post-operative regimen for pediatric orthopedic trauma? It would be an honor to learn from the insights of this conflagration of surgical minds.

This is true and here is why: both AI and bias use extrapolating regression predictive models based on limited information to predict something. Stereotypes are this as well. Making an uneducated guess on limited info as a shortcut.

Welcome to Season 2 of the Orthobullets Podcast Today's Foundations episode will focus on the topic of the Femoral Shaft Fractures. Listen wherever you listen to podcasts or by clicking the link below! bit.ly/3XaS1nk #orthosky #medsky

HGT for scoli (>90° Cobb), kyphosis, cervical trauma. Pts: Severe deformity. Correction: Coronal/sagittal ↓30–35%, trunk ht ↗5cm. ↗ lung vol 14.9%. HGT duration: 4–6wks, 66–85% correction in 2wks. Risks: Pin infections (33%), CN palsy (10%), BMD ↓ post-HGT. Final: Gradual correction safer vs acute.

TikTok study (n=220 post, 84M views). Creators: 64% pts, 18% fam/friends, 8% HCPs. DISCERN avg=15.9/75, 97% vids rated poor/very poor. BIPOC=11% creators, but had >views (p=.046). Theme: 51% +tone, 24% neutral, 25%- ,embarrass (p=.031). 40% vids → surgery, 12% bracing. HCP engagement in SM critical.

Bracing in scoliosis

BrAIST→↑brace time=↓surg (dose-response). ≥70% in-brace corr=best. Night-only ok for <25° in young pts. Contra: T-apex>T7-8, BMI↑. CAD/CAM TLSO=Cobb↓, preferred. iButton tracks 90d wear. Wean @Sanders 7B (↓1cm/y), Collagen X<3ng/dL. <40°T=1.5-2y f/u, >40°=multi-y.

321 peds ortho emerg surg (2010-2020), 57 (18%) nonfasted, 264 (82%) fasted. 1 pt (fasted) had mild adverse event (0.3%), 0 in nonfasted grp. GETA: 276 (86%), LMA: 45 (14%). RSI: 31 (9.7%). No ↑ pulm comp in nonfasted. Power analysis → N=2067 needed for P<0.05. www.jposna.org/index.php/jp...

N=18 pts, mean age 13±2 yrs, 33% male. Preop Cobb 75°±24°, postop 29°±18° (61%±22% CR). DONC onset 3-120h postop (78% <24h). 50% had hypotension (MAP <5th %ile). 89% reoperated, 61% had implant removal. 39% had spinal cord infarcts, 86% w/ infarcts had minimal recovery. Mean blood loss 897±882mL.

In the spirit of collegial advancement, would you consider unveiling that precious jewel of your practice: the most clutch and useful post-operative regimen for pediatric orthopedic trauma? It would be an honor to learn from the insights of this conflagration of surgical minds.

When you all ask me old person questions

What causes clinicians to actually change practice when a paper is published?

In honor of black inventors. #BlackHistoryMonth

High preop test rates (51.3%) → inertia in workflow. Reflexive ordering key barrier, driven by habit, hierarchy, & fear of cancellations. Lack of feedback loops → blind spots in impact. AI & real-time data feedback proposed to reinforce adherence & counter cognitive inertia.

Here is the link to the PowerPoint version of my pediatric fx remodeling talk. Make it your own; no need to credit me. Please just share the power of fracture remodeling, (which of course is best monitored under the care of an orthopaedist). docs.google.com/file/d/1i28t...

My wife had this last year. I will say a Bidet should be covered DME.

As an animated GIF?