American Board of Internal Medicine

Summary: During Hurricane Helene, misinformation spread rapidly across media platforms, complicating public understanding and response efforts. As the storm neared, false information fueled confusion and anxiety, particularly among vulnerable populations, undermining the effectiveness of official, fact-based communication. Much of this misinformation originated on social media, where users shared unverified and often sensationalized updates about the hurricane’s impact. This phenomenon highlighted the dangers of “weaponized health communication.” Traditional and non-traditional media played significant roles in spreading misinformation. In the rush to deliver updates, news outlets reported on speculative scenarios, sometimes based on unnamed sources, which blurred the lines between fact and fiction. This resulted in conflicting messages, leaving the public uncertain about which actions to take and which guidance to trust. A public health, disaster management, and medicine literature review examined how misinformation (MDM) spreads during crises. Case studies from domestic and international contexts revealed key themes about state-sponsored information operations, the role of social media, and the challenges posed by public distrust. These insights informed potential countermeasures to mitigate MDM in future crises. Various organizations, including governments, militaries, and non-governmental institutions, have developed strategies to counter MDM in public health and disaster contexts. However, widespread distrust in government and the effectiveness of MDM campaigns on social media complicate these efforts. Countermeasures like Inoculation Theory, which has been used to combat climate science denial and anti-vaccine misinformation, show promise in mitigating malicious MDM. By using targeted messaging to “inoculate” the public against false narratives, these methods could help protect vulnerable populations during critical events.

Background: Prone trans-psoas (PTP) interbody fusion is a minimally invasive technique for sagittal correction in adult spinal deformity. Advantages include enhanced lordosis due to prone positioning and avoidance of patient repositioning. The same approach allows for anterior longitudinal ligament release, which may improve lordotic correction. However, limited data exist on the combined technique, prompting this investigation into postoperative complications and radiographic outcomes of PTP interbody fusion versus combined PTP with anterior longitudinal ligament (ALL) release (PTP-ALL). Methods: A retrospective cohort study was conducted at a tertiary academic center from November 2020 to October 2023. Patients were grouped into two cohorts: PTP and PTP-ALL. Radiographic outcomes included changes in segmental lordosis, lumbar lordosis, L4-S1 lordosis, pelvic incidence-lumbar lordosis (PI-LL) mismatch, T1-pelvic angle, and sagittal vertical axis. Complications assessed were wound infections, venous thromboses, transfusions, and mortalities. Welch’s modified two-sample t-tests and chi-squared tests were used for analysis. Results: Twenty-two patients underwent PTP and six underwent PTP-ALL. There were no significant differences in operative time ( P =0.443), length of stay ( P =0.169), or estimated blood loss ( P =0.795). No complications occurred in the PTP-ALL group. Compared to PTP, PTP-ALL achieved greater improvements in segmental lordosis (9.3° vs. 1.6°, P =0.134), lumbar lordosis (30.6° vs. 8.5°, P =0.003), L4-S1 lordosis (10.2° vs. 6°, P =0.25), and PI-LL mismatch correction (25.8° vs. 8.9°, P =0.036). Conclusions: PTP with ALL release may be a safe and effective option to enhance sagittal correction in adult spinal deformity without increasing perioperative complications. However, the small sample size limits the generalizability of these findings and underscores the need for further study. Level of Evidence: III

With 24 patents granted for different catheters stents and other medical devices, Dr Heuser served as a principal investigator to research the safety and/or effectiveness of more than 100 medical devices and 50 pharmaceutical products and participated in more than 100 research studies.He authored numerous articles, textbooks and medical manuscripts, and was frequently invited to international medical conferences to present findings of research originating in Phoenix.Dr Heuser developed the first catheter treatment for leakage of the mitral valve, which has presaged the catheter treatment that is now available routinely for narrowing or leakage of the mitral valve.His hydrophilic or "water loving" wire, co-developed with an engineer, is utilized in approximately 20% in all angioplasty procedures performed worldwide.The covered stent that Dr Heuser co-invented is currently used in every catheter lab worldwide that performs angioplasty and stenting.

The National Board of Medical Examiners® Comprehensive Basic Science Self-Assessment (CBSSA) is a 200-item web-administered multiple-choice examination built to the same test specifications in content and statistics as the United States Medical Licensing Examination® Step 1 to help students assess their readiness and familiarize themselves with the content and format of Step 1. This study investigated the relationship between last-attempt CBSSA scores and first-attempt Step 1 pass-fail outcomes based on a large and recent sample of 23,271 US and Canadian medical students who took CBSSA under standard timing conditions between February 23, 2022 and March 1, 2023 and subsequently took Step 1 for the first time under standard timing conditions. The number of CBSSA attempts, when students took CBSSA in relation to their first Step 1 attempt, and the interaction between the different levels of these two factors were investigated. Separate binary logistic regressions were performed with last-attempt CBSSA score as the independent variable and first-attempt Step 1 pass-fail outcome as the dependent variable for the entire study group as well as sub-groups who took Step 1 within 1-2 weeks, 3-4 weeks, 5-6 weeks, and over 6 weeks of their last CBSSA attempt. All models were statistically significant. The relationship between the last CBSSA and first Step 1 was statistically different across the different time intervals, except for those within 5-6 weeks and over 6 weeks. The highest classification accuracy was for students testing within 1-2 weeks. Results suggest that CBSSA remains an effective tool to gauge readiness for Step 1.

The ability to pursue family planning goals is integral to gender equity in any field. Procedural specialties pose occupational risks to pregnancy. As the largest procedural specialty, general surgery provides an opportunity to understand family planning, workplace support for parenthood, obstetric outcomes, and the impact of these factors on workforce well-being, gender equity, and attrition. To examine pregnancy and parenthood experiences, including mistreatment and obstetric outcomes, among a cohort of US general surgical residents. This cohort study involved a cross-sectional national survey of general surgery residents in all programs accredited by the Accreditation Council for Graduate Medical Education after the 2021 American Board of Surgery In-Training Examination. Female respondents who reported a pregnancy and male respondents whose partners were pregnant during clinical training were queried about pregnancy- and parenthood-based mistreatment, obstetric outcomes, and current well-being (burnout, thoughts of attrition, suicidality). Primary outcomes included obstetric complications and postpartum depression compared between female residents and partners of male residents. Secondary outcomes included perceptions about support for family planning, pregnancy, or parenthood; assisted reproductive technology use; pregnancy/parenthood-based mistreatment; neonatal complications; and well-being, compared between female and male residents. A total of 5692 residents from 325 US general surgery programs participated (81.2% response rate). Among them, 957 residents (16.8%) reported a pregnancy during clinical training (692/3097 [22.3%] male vs 265/2595 [10.2%] female; P < .001). Compared with male residents, female residents more frequently delayed having children because of training (1201/2568 [46.8%] females vs 1006/3072 [32.7%] males; P < .001) and experienced pregnancy/parenthood-based mistreatment (132 [58.1%] females vs 179 [30.5%] males; P < .001). Compared with partners of male residents, female residents were more likely to experience obstetric complications (odds ratio [OR], 1.42; 95% CI, 1.04-1.96) and postpartum depression (OR, 1.63; 95% CI, 1.11-2.40). Pregnancy/parenthood-based mistreatment was associated with increased burnout (OR, 2.03; 95% CI, 1.48-2.78) and thoughts of attrition (OR, 2.50; 95% CI, 1.61-3.88). Postpartum depression, whether in female residents or partners of male residents, was associated with resident burnout (OR, 1.93; 95% CI, 1.27-2.92), thoughts of attrition (OR, 2.32; 95% CI, 1.36-3.96), and suicidality (OR, 5.58; 95% CI, 2.59-11.99). This study found that pregnancy/parenthood-based mistreatment, obstetric complications, and postpartum depression were associated with female gender, likely driving gendered attrition. Systematic change is needed to protect maternal-fetal health and advance gender equity in procedural fields.

On July 1, 2023, Family Medicine residencies entered the new world of competency-based residency education. The new residency standards[1][1] greatly reduce the number of month or hour based requirements and, instead, expect residencies to assess competence explicitly across a wide variety of