Integrating ChatGPT in Orthopedic Education for Medical Undergraduates: Randomized Controlled Trial.

BACKGROUND: ChatGPT is a natural language processing model developed by OpenAI, which can be iteratively updated and optimized to accommodate the changing and complex requirements of human verbal communication. OBJECTIVE: The study aimed to evaluate ChatGPT's accuracy in answering orthopedics-related multiple-choice questions (MCQs) and assess its short-term effects as a learning aid through a randomized controlled trial. In addition, long-term effects on student performance in other subjects were measured using final examination results. METHODS: We first evaluated ChatGPT's accuracy in answering MCQs pertaining to orthopedics across various question formats. Then, 129 undergraduate medical students participated in a randomized controlled study in which the ChatGPT group used ChatGPT as a learning tool, while the control group was prohibited from using artificial intelligence software to support learning. Following a 2-week intervention, the 2 groups' understanding of orthopedics was assessed by an orthopedics test, and variations in the 2 groups' performance in other disciplines were noted through a follow-up at the end of the semester. RESULTS: ChatGPT-4.0 answered 1051 orthopedics-related MCQs with a 70.60% (742/1051) accuracy rate, including 71.8% (237/330) accuracy for A1 MCQs, 73.7% (330/448) accuracy for A2 MCQs, 70.2% (92/131) accuracy for A3/4 MCQs, and 58.5% (83/142) accuracy for case analysis MCQs. As of April 7, 2023, a total of 129 individuals participated in the experiment. However, 19 individuals withdrew from the experiment at various phases; thus, as of July 1, 2023, a total of 110 individuals accomplished the trial and completed all follow-up work. After we intervened in the learning style of the students in the short term, the ChatGPT group answered more questions correctly than the control group (ChatGPT group: mean 141.20, SD 26.68; control group: mean 130.80, SD 25.56; P=.04) in the orthopedics test, particularly on A1 (ChatGPT group: mean 46.57, SD 8.52; control group: mean 42.18, SD 9.43; P=.01), A2 (ChatGPT group: mean 60.59, SD 10.58; control group: mean 56.66, SD 9.91; P=.047), and A3/4 MCQs (ChatGPT group: mean 19.57, SD 5.48; control group: mean 16.46, SD 4.58; P=.002). At the end of the semester, we found that the ChatGPT group performed better on final examinations in surgery (ChatGPT group: mean 76.54, SD 9.79; control group: mean 72.54, SD 8.11; P=.02) and obstetrics and gynecology (ChatGPT group: mean 75.98, SD 8.94; control group: mean 72.54, SD 8.66; P=.04) than the control group. CONCLUSIONS: ChatGPT answers orthopedics-related MCQs accurately, and students using it excel in both short-term and long-term assessments. Our findings strongly support ChatGPT's integration into medical education, enhancing contemporary instructional methods. TRIAL REGISTRATION: Chinese Clinical Trial Registry Chictr2300071774; https://www.chictr.org.cn/hvshowproject.html ?id=225740&v=1.0.

AP-HTPB propellant combustion under strain conditions with laser absorption spectroscopy.

Understanding the combustion behaviors of solid propellant with different levels of strains is of practical interest. In this work, an experimental study of the effects of static and dynamic strains on the burning rate, temperature, CO, and C O 2 formation of aluminized ammonium perchlorate (AP)-hydroxyl terminated poly-butadiene (HTPB) propellant combustion was presented at initial pressures of 0.1 MPa, 0.2 MPa, and 0.5 MPa. The strains were being applied onto solid propellant by exerting static and cyclic loadings. The propellant burning rate was acquired by a 4 kHz high-speed photography system, and the combustion temperature, CO, and C O 2 column densities were measured at 10 kHz through laser absorption spectroscopy (LAS). At atmospheric pressure, it was demonstrated that the propellant burning rate increased with tensile stress and decreased with compressive stress. The measured flame temperature showed a similar correlation with strains as compared to the propellant burning rate. At elevated pressures, the increase of the propellant burning rate due to tensile stress was more evident, while the difference in combustion temperatures was less significant. For the cyclic strain condition, the variations of the measured C O 2 and CO column densities were consistent with the static strain condition.

In Situ Reactor-Integrated Electrospray Ionization Mass Spectrometry for Heterogeneous Catalytic Reactions and Its Application in the Process Analysis of High-Pressure Liquid-Phase Lignin Depolymerization.

Process analysis of heterogeneous catalytic reactions such as lignin depolymerization is essential to understand the reaction mechanism at the molecular level, but it is always challenging due to harsh conditions. Herein, we report an operando process analysis strategy by combining a microbatch reactor with high-resolution mass spectrometry (MS) via a reactor-integrated electrospray ionization (R-ESI) technique. R-ESI-MS expands the applications of traditional in situ MS to a heterogeneous and high-pressure liquid-phase system. With this strategy, we present the evolution of a series of monomers, dimers, and oligomers during lignin depolymerization under operando conditions (methanol solvent, 260 °C, ∼8 MPa), which is the first experimental elucidation of a progressive depolymerization pathway and evidence of repolymerization of active monomers. The proposed R-ESI-MS is crucial in probing depolymerization intermediates of lignin; it also provides a flexible strategy for process analysis of heterogeneous catalytic reactions under operando conditions.

A Modified Mason-Allen Suture Enhancement Technique (Sunglasses Loop) for Single-Row Repair of Medium-to-Large Rotator Cuffs.

We propose a single-row repair method for medium-to-large rotator cuff rotator cuff tears using a modified Mason-Allen suture enhancement technique (sunglasses loop), which uses high-tensile modified Mason-Allen sutures to close the medial rotator cuff tissues to form a sunglasses loop, resets the rotator cuff tissues via traction with the high-tensile suture, repairs the rotator cuff in a single row with triple-loaded suture anchor (anchor with 3 high-strength sutures), and finally employs an outer row of staples to secure the suture to the lateral aspect of the greater tuberosity, preventing the tendon from pulling out. This method uses a special sunglasses-shaped suture loop, which produces an increase in holding power and a reduction in tension relative to other single-row repair techniques and reduces the rate of rotator cuff retear.