Citations

Objective: To develop, implement, and evaluate a novel process used for residency application review that deemphasizes metrics known to create bias with the goal of interviewing and matching a more diverse resident cohort. Methods: Between 2020 and 2023, a novel standardized rubric and application review process were developed and implemented at the authors’ academic training program. The rubric deemphasized USMLE scores, honor society membership, and number of publications while utilizing an AI-driven pre-sort of applications, facilitating holistic review. This weighted applicant attributes identified in personal statements, life experiences, achievements in community, leadership roles, otolaryngology-specific impressions highlighted in letters of recommendation, and otolaryngology-specific research and publications similarly to academic metrics (clerkship grades and standardized test scores). Demographics of applicants interviewed and matched into our program were compared pre- and post-implementation using descriptive statistics. Results: Using a standardized rubric to review residency applications that deemphasizes traditional metrics, the authors’ otolaryngology residency program has interviewed, ranked, and matched more diverse candidates. As a result, from 2019 to 2022, the overall resident cohort has diversified from 4% historically marginalized residents to 24%, from 28% female residents to 44%, and from 33% of residents outside our geographic region to 66%. Conclusion: There is significant underrepresentation among otolaryngology residents. Selection based upon USMLE Step 1 scores, honor society membership, and number of publications have been shown to restrict diversity. Purposeful holistic review increases diversity in interviewed and matched resident cohort.

ABSTRACT Introduction Etripamil is a fast‐acting intranasally self‐administered calcium‐channel blocker developed for termination of paroxysmal supraventricular tachycardia (PSVT). Prior studies have demonstrated safety and efficacy of etripamil for PSVT termination following an initial medically supervised test dose during sinus rhythm. NODE‐303 is an open‐label, single‐arm study that evaluated etripamil for multiple, at‐home PSVT episodes, without test dose before first use. Methods Patients applied an ECG monitor at symptom onset and self‐administered etripamil (70 mg) if a vagal maneuver was unsuccessful. ECG monitoring occurred for ≥ 1 h following study drug administration. A repeat 70‐mg dose was introduced during the study for symptoms persisting 10 min after the first dose. Safety measures included treatment‐emergent adverse events (TEAEs) and ECG arrhythmia‐surveillance. Efficacy measures were captured for PSVT termination during treatment of each of the multiple episodes. Results 1054 perceived PSVT episodes were etripamil‐treated in 503 of 1116 patients enrolled. TEAEs within 24 h were mostly mild or moderate and localized: 30.2% of patients experienced nasal discomfort, nasal congestion (13.9%), rhinorrhea (13.1%), epistaxis (7.4%). TEAE frequencies decreased across multiple PSVT episodes and were similar for single versus repeat doses. For first PSVT episodes, 70.5% of patients converted to sinus rhythm by 60 min post etripamil (median time to conversion = 18.3 min [14.2–25.6]). Conversion in earlier episodes was consistently predictive of conversion in subsequent episodes. Conclusions Etripamil nasal spray self‐administered in a real‐world setting was well tolerated, effective, and had a consistent safety profile as a single‐ or repeat‐dose regimen across multiple PSVT episodes. Trial Registration: ClinicalTrials.gov NCT04072835

Abstract Meniscus allograft transplant (MAT) can provide meaningful improvement in patient outcomes in those who are otherwise meniscus deficient. A common finding in the setting of a failed MAT is meniscus extrusion. Meniscus centralization is a technique performed to reduce the meniscus to its intra‐articular location and has been shown to improve postoperative pain and function in patients with an extruded meniscus. Prior techniques have been described for meniscus centralization in the setting of a meniscus root tear or with the use of single tension devices that are tensioned after meniscocapsular fixation. We present a minimally invasive technique for meniscus centralization that can be performed in conjunction with MAT using a centralization stabilization suture and re‐tensionable root‐fixation subchondral anchors that can be secured prior to meniscocapsular fixation. Technique Video video See video under supplementary data.

Abstract Jagim, AR, Horswill, CA, Dobbs, WC, Twohey, EE, Tinsley, GM, Fields, JB, and Jones, MT. Minimum wrestling weight for high school girls wrestling: Time to revisit minimal body fat percent. J Strength Cond Res 39(3): 332–339, 2025—The purpose of this study was to determine whether an alternative body fat percentage (BF%) could be established as a safer margin for minimal wrestling weight (MWW) determination by evaluating the distribution of BF% and MWW values naturally occurring for high school girls wrestling. Data from the 2022–2023 high school season were retrospectively analyzed. In total, 33,321 female wrestlers completed skinfold (SKF) assessments or bioelectrical impedance analysis (BIA) in accordance with sport governing body mandates for weight certification. Frequency statistics and descriptive analysis were performed to compute normative MWW and BF% profiles. Body fat percentage thresholds of 12% (12MWW) and the BF% value defining the lowest fifth percentile were used to determine the resulting MWW and minimum weight class for each method. The median ± interquartile range for BF% was 28.3 ± 9.2%. There was a difference ( p < 0.001) in BF% values between BIA (28.4 ± 6.8%) and SKF (29.4 ± 7.6%), but a trivial effect size (ES = 0.14). The fifth percentile for BF% was 19%, which was used for alternative MWW determination (19MWW). 12MWW and 19MWW were 11.2 ± 6.4 kg ( p < 0.001; ES = 1.8) and 8.6 ± 7.7 kg ( p < 0.001; ES = 1.1) lower than the body mass of the wrestlers at the time of weight certification. Nearly all BF% values were above the 12% threshold currently used to determine MWW. Current body weights were more than 9.1 kg above MWW values for both 12MWW and 19MWW. Increasing the minimum BF% threshold from 12 to 19% would affect a small percentage of wrestlers and improve the margin of safety for those intent on achieving a lower weight class.

Abstract Magee, MK, Fields, JB, Jagim, A, Lockard, B, Miller, A, Stroiney, D, and Jones, MT. Estimation of whole-body bone mineral density through air displacement plethysmography in a large sample of elite athletes. J Strength Cond Res 39(4): 427–432, 2025—Dual-energy x-ray absorptiometry (DXA) is used to determine bone mineral density (BMD) and body composition. Regulations and cost may limit DXA's utility in some athletic settings. Air displacement plethysmography (ADP), while able to measure body composition, does not measure BMD. The purpose was to evaluate the influence of body composition parameters obtained from ADP on BMD. Collegiate athletes (males, n = 153; females, n = 208) underwent ADP and DXA assessments. For ADP testing, the Brozek equation was used to estimate body fat percent (BF%) and fat-free mass (FFM) from body density. Dual-energy x-ray absorptiometry tests were completed to obtain BMD using the whole-body scan mode. Stepwise regression was conducted using age, body mass, height, sex, race, FFM (ADP), BF% (ADP), and sport type as independent variables. Total BMD (DXA) was the dependent variable. Accuracy and precision of the final equation were evaluated through Bland–Altman and linear regression. The final regression equation yielded an R 2 of 0.691 with race, mass, BF%, age, and sport type as significant predictors ( p < 0.05) of BMD. Bland–Altman and linear regression showed systematic {95% confidence interval [CI] (−0.619 to −0.360)} and proportional bias (95% CI [0.173–0.374]). Although an ADP-derived regression equation may not provide a precise prediction of BMD, it may be useful to establish risk for low BMD if DXA is unavailable. Dual-energy x-ray absorptiometry may not be feasible for some athletic programs; therefore, an estimation equation for BMD derived from ADP values is advantageous for practitioners. This equation may assist in screening athletes for risk of low BMD.

Abstract Kuhlman, NM, Jagim, AR, Jones, MT, Feit, MK, and Fields, JB. A comparison of match external load demands across women’s collegiate field sports. J Strength Cond Res 39(2): 234–241, 2025—Historically, soccer (SOC), lacrosse (LAX), and field hockey (FH) have been grouped together as “field sports” due to their intermittent nature of match play and similar physiological demands. However, questions have emerged regarding potential variations in demands between sports. The purpose of this study was to compare external match workloads between collegiate women's SOC, LAX, and FH, and examine within-sport positional differences. Athletes (SOC: n = 15; LAX: n = 15; FH: n = 14) wore a global positioning system device during all matches throughout a competitive season. External load metrics included in the analysis were total distance (TD), sprint distance (SD), accelerations (>3 m·s −2 ), sprint efforts (SE), player load (PL), PL per minute (PL/min), top speed (m·s −1 ), and distances covered in select speed zones. Soccer performed higher external load volumes (TD, PL) ( p ≤ 0.025) but incurred lower intensities (SD, SE, accelerations) ( p < 0.001) compared with LAX and FH. Within-sport positional differences were apparent in SOC ( p < 0.001–0.018), LAX ( p < 0.001–0.045), and FH ( p < 0.001–0.004). However, FH exhibited more positional variance in external load metrics compared with SOC or LAX. Field hockey midfielders covered greater volumes (TD, PL) compared with attackers and defenders ( p < 0.001), while attackers sustained greater intensities (SD, SE, top speed) compared with midfielders and defenders ( p < 0.004). Results indicate that there are significant differences in external workload parameters between sports and across positions. Practitioners should tailor sport-specific and position-specific programs to match demands, and future research should explore the proposed categorizations of LAX as a “fast collision invasion sport,” FH as a “fast contact invasion sport,” and SOC as a “slow contact invasion sport.”

Background Coronavirus Disease 2019 (COVID-19) has led to dramatic changes including social distancing, closure of schools, travel bans, and issues of stay-at-home orders. The health-care field has been transformed with elective procedures and on-site visits being deferred. Telemedicine has emerged as a novel mechanism to continue to provide care. However, there remains a paucity of data regarding its efficacy in nutrition support, especially in patients with chronic intestinal failure (CIF). Objective Describe the utilization of telehealth in the routine management of CIF, particularly in the initiation and training of home parenteral nutrition (HPN). Methods A case series presenting our experience with the use of telemedicine to provide training for HPN for three patients. The manuscript describes the utility of telehealth in providing remote and adequate training for patients commenced on HPN during COVID-19 pandemic. Results Since the onset of the COVID-19 pandemic, we have successfully provided virtual training to three patients, including two who were noted to be severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive and one patient who could not be transferred to our facility for training. For SARS-CoV-2 positive patients, the risk of transmission to nursing staff with 8–10 h of face-to-face training in two cases was felt to be too significant for in-person training. We determined that the best option would be to stabilize parenteral nutrition in the hospital and perform virtual training. Although virtual training was successfully performed, it was felt that training in this manner took much longer, required frequent adjustment of the tablet device to ensure patient remained in field of view, and made it difficult to connect with the patient emotionally. Conclusions Telemedicine has significantly improved care provided during COVID-19 as a modality for effective training on HPN, while in-person communication was significantly limited due to the pandemic. However, when possible, it should be used in a manner that complements but does not supplant standard care.

Importance Multiparametric magnetic resonance imaging (MRI), with or without prostate biopsy, has become the standard of care for diagnosing clinically significant prostate cancer. Resource capacity limits widespread adoption. Biparametric MRI, which omits the gadolinium contrast sequence, is a shorter and cheaper alternative offering time-saving capacity gains for health systems globally. Objective To assess whether biparametric MRI is noninferior to multiparametric MRI for diagnosis of clinically significant prostate cancer. Design, Setting, and Participants A prospective, multicenter, within-patient, noninferiority trial of biopsy-naive men from 22 centers (12 countries) with clinical suspicion of prostate cancer (elevated prostate-specific antigen [PSA] level and/or abnormal digital rectal examination findings) from April 2022 to September 2023, with the last follow-up conducted on December 3, 2024. Interventions Participants underwent multiparametric MRI, comprising T2-weighted, diffusion-weighted, and dynamic contrast–enhanced (DCE) sequences. Radiologists reported abbreviated biparametric MRI first (T2-weighted and diffusion-weighted), blinded to the DCE sequence. After unblinding, radiologists reported the full multiparametric MRI. Patients underwent a targeted biopsy with or without systematic biopsy if either biparametric MRI or multiparametric MRI was suggestive of clinically significant prostate cancer. Main outcomes and measures The primary outcome was the proportion of men with clinically significant prostate cancer. Secondary outcomes included the proportion of men with clinically insignificant cancer. The noninferiority margin was 5%. Results Of 555 men recruited, 490 were included for primary outcome analysis. Median age was 65 (IQR, 59-70) years and median PSA level was 5.6 (IQR, 4.4-8.0) ng/mL. The proportion of patients with abnormal digital rectal examination findings was 12.7%. Biparametric MRI was noninferior to multiparametric MRI, detecting clinically significant prostate cancer in 143 of 490 men (29.2%), compared with 145 of 490 men (29.6%) (difference, −0.4 [95% CI, −1.2 to 0.4] percentage points; P = .50). Biparametric MRI detected clinically insignificant cancer in 45 of 490 men (9.2%), compared with 47 of 490 men (9.6%) with the use of multiparametric MRI (difference, −0.4 [95% CI, −1.2 to 0.4] percentage points). Central quality control demonstrated that 99% of scans were of adequate diagnostic quality. Conclusion and relevance In men with suspected prostate cancer, provided image quality is adequate, an abbreviated biparametric MRI scan, with or without targeted biopsy, could become the new standard of care for prostate cancer diagnosis. With approximately 4 million prostate MRIs performed globally annually, adopting biparametric MRI could substantially increase scanner throughput and reduce costs worldwide. Trial registration ClinicalTrials.gov Identifier: NCT04571840