This narrative inquiry study explores the experiences of faculty and students engaged in virtual partnerships within an online graduate instructional design program. By collecting and analyzing participants' personal stories, the study seeks to understand how such experiences impact individuals’ construction of meaning around collaboration, learning, instructional design competencies, and professional development in fully virtual environments. The analysis revealed several narrative threads that highlight how virtual student-faculty partnerships foster authentic engagement in situated learning contexts, support the development of professional identities, and cultivate digital communities of practice within instructional design. The findings offer practical insights for integrating meaningful collaborations into online instructional design education and suggest implications for improving program design, enhancing instructional quality, and supporting professional development in the field of instructional design.

In the contemporary educational landscape, the fusion of technology with traditional pedagogical methods has revolutionized the way knowledge is imparted and acquired. However, cultural contexts significantly influence the efficacy of technology integration in learning environments. This study explores the factors within the technology acceptance model (TAM) framework that shape individuals’ attitudes and behavioral intentions toward using educational technologies. The TAM serves as a theoretical framework to understand individuals’ behavioral intentions to use technology, focusing on perceived usefulness and ease of use. We interviewed 12 experts from diverse cultural backgrounds in cultural studies, educational technology, and cross-cultural psychology. Findings reveal that cultural attitudes, learning preferences, educational content accessibility, and interactive learning experiences positively influence behavioral intentions, attitudes, perceived usefulness, and ease of use of technology. We identified ten key themes as predictors of technology adoption through thematic analysis. The study’s implications emphasize the need for culturally responsive technology integration in educational environments, advocating for technologies that accommodate diverse cultural backgrounds and learning preferences. This research contributes to the field by providing valuable insights into the cultural factors that facilitate technology adoption, offering valuable guidelines for developing inclusive and effective educational technologies.

Detecting thermal Unruh radiation from accelerated electrons has presented a formidable challenge due not only to technical difficulties but also for lack of conceptual clarity about what is actually seen by a laboratory observer. We give a summary of the current interpretations along with a simpler heuristic description that draws on the analogy between the Unruh effect and radiation from a two-level atomic system. We propose an experiment to test whether there is emission of thermal photons from an accelerated electron.

This paper reports on a case study that examined the challenges faced and strategies adopted by Thai teachers when remote teaching during the COVID-19 pandemic. It further provides a comprehensive strategy for addressing the ongoing global pandemic in terms of education. We used a mixed methods design to collect both quantitative and qualitative data from K-12 Thai teachers (N = 235) and performed 42 semi-structured interviews. The results indicated that most Thai teachers have the necessary knowledge to design suitable content for remote teaching. However, they must further develop their administration and leadership skills. The main challenges and strategies for Thai teachers remain in the areas of student motivation, assessment, and classroom management. Furthermore, ranking from high to low, Thai teachers preferred face-to-face instruction, blended/hybrid instruction and hyflex among different instructional delivery modalities. We conclude the paper by discussing possible alternative instructional delivery modalities and their implications for K-12 remote learning and instruction.

The treatment of massive irreparable rotator cuff tears has been a controversial topic with multiple procedures described. Research trends have been growing rapidly over the past decade resulting in a greater understanding of its natural evolution. No singular superior procedure has been described. Rather, treatment options should be weighed in the setting of patient expectations, comorbidities, and the findings from clinical examinations. Based on the current literature, practitioners should be aware of the available treatment options and the most appropriate settings for employing each option. This review discusses the history of massive irreparable rotator cuff tears and evaluates each treatment option based on the highest quality of research available.

Nail plate constructs (NPC) have shown promising results in complex lower extremity peri-articular fractures as well as in peri-prosthetic fractures. The combination of both implants allows for improved mechanical stability and immediate weight bearing. The use of NPC has not been described in the upper extremity in the literature. We herein describe potential indications and surgical technique for NPC usage for complex upper extremity trauma and reconstruction.

As the COVID-19 pandemic shut down most face-to-face instructions and services in higher education, universities struggled to continue teaching and serving students. In particular, student services like academic advising were significantly impacted, as most advising is conducted in person. The use of synchronous communication technology was suddenly increased to continue advising students, employing Remote Academic Advising (RAA). Three researchers at a state university in the southeast USA conducted a case study to understand the experiences of using RAA by academic advisors. The study included 11 academic advisors from different academic colleges and areas who were engaged in RAA to provide advising service to students during the 2020–2021 academic year. Four themes emerged after a reiterative process of coding and analysing the interview responses. The four themes were a slow transition to using RAA, RAA can also be relational, RAA can promote more awareness of mental health and RAA should be part of regular advising practice. The discussion section includes recommendations for advancing RAA as regular practice through a concerted effort of promotion, leadership and effective use of RAA with synchronous communication technology among the advising community on campus.

In higher education, digital badging programs can supplement a student's degree by helping them connect their experiences on-campus to those outside of the classroom, encouraging them to think and apply the knowledge they gain from their college or university to real-world situations. This article discusses the perceptions of participants in a pilot digital badge program to identify important milestones, collaborative efforts, and barriers believed to be instrumental in designing a successful digital badge initiative through a school–university partnership. The purpose of this exploratory case study was to understand how students and members of a school–university partnership perceived the use of an earned digital badge to embrace the legitimacy of instructional technology competencies that can be used as career currency. Data collection included student and partner interviews, badge assessment results, and meeting documentation. Results of the study were framed using Rogers’ ( 2003 ) innovation diffusion theory to identify the critical characteristics of the pilot digital badge initiative through a school–university partnership. Results found that relevance to professional opportunities, value to stakeholders, and sustainability plans contributed to relative advantage, compatibility, trialability, and observability. Additionally, results found communication and timing contributed to complexity barriers. Results of the current study will be used to further develop a successful digital badge initiative through an ongoing school–university partnership.

The use of synchronous communication technology has significantly increased in recent years for communications in online learning and instruction, especially since the COVID-19 pandemic. Synchronous communication technology, such as Zoom, Google Meets, and Microsoft Teams, is widely adopted by academic advisors to continue their advising services as many universities were forced to move their traditional in-person academic advising to remote academic advising (RAA) in an online format. In this context, we explored the knowledge, experiences, and perceptions of students and academic advisors at a state university using synchronous communication technology for RAA during the COVID-19 pandemic. The study includes data collected from 539 sets of data from students and 28 from advisors. Through descriptive data analysis, the study revealed knowledge and a variation of perception gaps among students, in addition to students and academic advisors for RAA. With research results, we discuss the implications for effective RAA, concluding with suggestions for effective uses of synchronous communication technology to conduct RAA for academic advisors.

»:The induced membrane technique (IMT) takes advantage of an osteoinductive environment that is created by the placement of a cement spacer into a bone defect. »:Most commonly, a polymethylmethacrylate (PMMA) spacer has been used, but spacers made from other materials have emerged and achieved good clinical outcomes. »:The IMT has demonstrated good results for long-bone repair; however, more research is required in order to optimize union rates as well as delineate more precise indications and surgical timing.

Study Design: This was a retrospective cohort study. Objective: The aim of this study was to investigate associations between time to surgical intervention and outcomes for central cord syndrome (CCS) patients. Background: As surgery is increasingly recommended for patients with neurological deterioration CCS, it is important to investigate the relationship between time to surgery and outcomes. Materials and Methods: CCS patients were isolated in Nationwide Inpatient Sample database 2005−2013. Patients were grouped by time to surgery: same-day, 1-day delay, 2, 3, 4−7, 8−14, and >14 days. Means comparison tests compared patient factors, perioperative complications, and charges across patient groups. Controlling for age, comorbidities, length of stay, and concurrent traumatic fractures, binary logistic regression assessed surgical timing associated with increased odds of perioperative complication, using same-day as reference group. Results: Included: 6734 CSS patients (64% underwent surgery). The most common injury mechanisms were falls (30%) and pedestrian accidents (7%). Of patients that underwent surgery, 52% underwent fusion, 30% discectomy, and 14% other decompression of the spinal canal. Breakdown by time to procedure was: 39% same-day, 16% 1-day, 10% 2 days, 8% 3 days, 16% 4−7 days, 8% 8−14 days, and 3% >14 days. Timing groups did not differ in trauma status at admission, although age varied: [minimum: 1 d (58±15 y), maximum: >14 d (63±13 y)]. Relative to other groups, same-day patients had the lowest hospital charges, highest rates of home discharge, and second lowest postoperative length of stay behind 2-day delay patients. Patients delayed >14 days to surgery had increased odds of perioperative cardiac and infection complications. Timing groups beyond 3 days showed increased odds of VTE and nonhome discharge. Conclusions: CCS patients undergoing surgery on the same day as admission had lower odds of complication, hospital charges, and higher rates of home discharge than patients that experienced a delay to operation. Patients delayed >14 days to surgery were associated with inferior outcomes, including increased odds of cardiac complication and infection.

PURPOSE:To investigate what effect decreased opioid prescribing following hip arthroscopy had on Press-Ganey satisfaction survey scores.METHODS:A retrospective review of prospectively collected data was conducted on patients who underwent primary hip arthroscopy for femoroacetabular impingement between October 2014 and October 2019. Inclusion criteria consisted of complete Press-Ganey survey information, no history of trauma, fracture, connective tissue disease, developmental hip dysplasia, autoimmune disease, or previous hip arthroscopy. Groups were separated based on date of surgery relative to implementation of an institutional opioid reduction policy that occurred in October 2018. Prescriptions were converted to milligram morphine equivalents (MME) for direct comparison between different opioids.RESULTS:A total of 113 patients met inclusion criteria, 88 preprotocol and 25 postprotocol. There were no statistically significant differences between groups with respect to patient demographics or intraoperative pathologies (P > .05). Average opioid prescription dropped from 249.6 ± 152 MME (equivalent to 33.3 tablets of oxycodone 5 mg) preprotocol to 108.6 ± 84.7 MME (equivalent to 14.5 tablets of oxycodone 5 mg) postprotocol; P = .0002. There were no statistically significant differences in Press-Ganey survey scores between pre- and postprotocol groups (P > .05).CONCLUSIONS:A reduction in opioids prescribed after a hip arthroscopy is not associated with any statistically significant difference in patient satisfaction with pain management, as measured by the Press-Ganey survey.LEVEL OF EVIDENCE:Level III, retrospective comparative study.

PURPOSE:Previous research has demonstrated that there is a statistically significant relationship between hip arthroscopy outcomes and age. The purpose of this research was to investigate the link, if any, between hip arthroscopy outcomes and intraoperative pathology as well as with both patient age and sex. METHODS:All male patients 14 years of age or older who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and who had a 2-year patient-reported outcome scores were analyzed. These patients were separated into three age-based cohorts (< 30 years old, 30 to 45 years old, and > 45 years old). These cohorts were then analyzed and compared with respect to patient demographic information, intraoperative pathology, and functional outcome scores for statistical significance, set at p < 0.05. RESULTS:At 2-year follow-up, there was a significant difference seen between the modified Harris Hip scores (mHHS) of the < 30 years old and > 45 years old cohorts with a mean difference of 10.2 (92.05 ± 10.3 and 81.89 ± 16.7, p = 0.044). The results of an ANOVA comparing 2-year non-arthritic hip scores (NAHS) were not statistically significant (p = 0.196). At 2-year follow up, the NAHS scores were 92.18 ± 10.3, 87.76 ± 15.6, and 84.63 ± 15.9 for the < 30 years old, 30 to 45 years old, and > 45 years old cohorts, respectively. When analyzing cohorts for rates of achieving a minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS), however, there were no statistically significant differences between groups. CONCLUSIONS:The results of this study suggest that males of all ages have generally good and similar outcomes following hip arthroscopy for FAI as determined by their similar rates of achieving both MCID and PASS.

» Tranexamic acid (TXA) is a drug used to control hemorrhage by preventing the breakdown of fibrin. » TXA is a cost-effective treatment for trauma patients across a variety of economic settings. » Concerns of TXA causing thromboembolic events (TEEs) in orthopaedic trauma patients are not supported by evidence. » TXA has been shown to reduce blood loss in hip fracture surgery.

Study Design. Retrospective review. Objective. Identify co-occurring perioperative complications and associated predictors in a population of patients undergoing surgery for adult spinal deformity (ASD). Summary of Background Data. Few studies have investigated the development of multiple, co-occurring complications following ASD-corrective surgery. Preoperative risk stratification may benefit from identification of factors associated with multiple, co-occurring complications. Methods. Elective ASD patients in National Surgical Quality Improvement Program (NSQIP) 2005 to 2016 were isolated; rates of co-occurring complications and affected body systems were assessed via cross tabulation. Random forest analysis identified top patient and surgical factors associated with complication co-occurrence, using conditional inference trees to identify significant cutoff points. Binary logistic regression indicated effect size of top influential factors associated with complication co-occurrence at each factor's respective cutoff point. Results. Included: 6486 ASD patients. The overall perioperative complication rate was 34.8%; 28.5% of patients experienced one complication, 4.5% experienced two, and 1.8% experienced 3+. Overall, 11% of complication co-occurrences were pulmonary/cardiovascular, 9% pulmonary/renal, and 4% integumentary/renal. By complication type, the most common co-occurrences were transfusion/urinary tract infection (UTI) (24.3%) and transfusion/pneumonia (17.7%). Surgical factors of operative time ≥400 minutes and fusion ≥9 levels were the strongest factors associated with the incidence of co-occurring complications, followed by patient-specific variables like American Society of Anesthesiologists (ASA) physical status classification grade ≥2 and age ≥65 years. Regression analysis further showed associations between increasing complication number and longer length of stay (LOS), (R 2 = 0.202, P < 0.001), non-home discharge (R 2 = 0.111, P = 0.001), and readmission (R 2 = 0.010, P < 0.001). Conclusion. For surgical ASD patients, the overall rate of co-occurring perioperative complications was 6.3%. Body systems most commonly affected by complication co-occurrences were pulmonary and cardiovascular, and common co-occurrences included transfusion/UTI (24.3%) and transfusion/pneumonia (17.7%). Increasing number of perioperative complications was associated with greater LOS, non-home discharge, and readmission, highlighting the importance of identifying risk factors for complication co-occurrences. Level of Evidence: 3

A 43-year-old male with a congenital absence of his left T1 rib developed a left-sided T1-T2 spinal facet joint arthrosis and stenosis and clinical signs and symptoms of T1 radiculopathy. The patient was treated with a decompressive laminotomy and partial medial facetectomy resulting in immediate resolution of symptoms. This report should alert clinicians to consider this potential etiology when evaluating patients with thoracic radiculopathy.

When COVID-19 struck, higher education experienced major disruptions. Important functions like academic advising were no exception, and the traditional face-to-face model shifted online with remote academic advising (RAA), which uses synchronous communication technologies (e.g., Zoom, Microsoft Teams, Google Meets). In this quantitative research study, 569 students completed an online survey that produced 539 sets of valid data for analysis. Findings showed no significant differences in students' knowledge or experiences with RAA according to their demographic independent variables such as gender, age, ethnicity, major, and RAA experiences. However, significant differences in student opinions on RAA were found among different age and gender groups. The paper identifies barriers to implementing RAA with suggestions to overcome these barriers when utilizing RAA.

Emerging digital technologies have transformed many aspects of our lives, including how we teach and learn. They have also stimulated the curiosity and imagination of early adopters across fields who see potentially tremendous benefits. Virtual Reality (VR) and Augmented Reality (AR) are exhibiting the potential to optimise experiential learning, to overcome the lack of interactivity in traditional educational methods, and to motivate learners to stay engaged in authentic and immersive learning experiences. This qualitative case study investigates the perceptions of early adopters of AR and VR and their impacts on teaching and learning through a semi-structured interview. The data analysis revealed several themes including enhanced interactivity, increased effectiveness and efficiency, psychological and emotional training, targeted experiences with authentic learning, improved learning retention and learner satisfaction. The findings suggest that VR and AR can improve teaching and learning in unique ways and afford numerous important benefits to educators and learners.