Basketball vs. Hockey-The Changing Face of Sport-Related Injuries in Canada.

OBJECTIVE: To characterize and compare the incidence of basketball-related, soccer-related, and hockey-related injuries over a 10-year period. DESIGN: Cohort analysis of sport-related injuries using multiple Ontario healthcare databases. SETTING: Emergency department visits in Ontario, Canada. PATIENTS: Any patient who sustained musculoskeletal injuries sustained while playing basketball, soccer, or hockey between 2006 and 2017 were identified. ASSESSMENT OF RISK FACTORS: Sport of injury, age, sex, rurality index, marginalization status, and comorbidity score. MAIN OUTCOME MEASURES: Annual Incidence Density Rates of injury were calculated for each sport, and significance of trends was analyzed by assessing overlap of 95% confidence intervals. RESULTS: One lakhs eighty five thousand eighty hundred sixty-eight patients (median age: 16 years, interquartile range 13-26) received treatment for sport-related injuries (basketball = 55 468; soccer = 67 021; and hockey = 63 379). The incidence of basketball-related and soccer-related injuries increased from 3.4 (3.3-3.5) to 5.6 (5.5-5.7) and 4.4 (4.3-4.5) to 4.9 (4.8-5) per 10 000 person years, respectively, whereas the incidence of hockey-related injuries decreased from 4.7 (4.6-4.8) to 3.7 (3.6-3.8). Patients with basketball injuries were more marginalized (3.01 ± 0.74) compared with patients with soccer and hockey injuries (2.90 ± 0.75 and 2.72 ± 0.69, respectively). CONCLUSIONS: Accurate regional epidemiologic information regarding sports injuries can be used to guide policy development for municipal planning and sport program development. The trends and demographic patterns described highlight general and sport-specific injury patterns in Ontario. Populations with the highest incidence of injury, most notably adolescents and men older than 50, may represent an appropriate population for injury risk prevention.

Advancing Cancer Therapy Predictions with Patient-Derived Organoid Models of Metastatic Breast Cancer.

The poor outcome of metastasized breast cancer (BC) stresses the need for reliable personalized oncology and the significance of models recapitulating the heterogeneous nature of BC. Here, we cultured metastatic tumor cells derived from advanced BC patients with malignant ascites (MA) or malignant pleural effusion (MPE) using organoid technology. We identified the characteristics of tumor organoids by applying immunohistochemistry and mutation analysis. Tumor organoids preserved their expression patterns and hotspot mutations when compared to their original metastatic counterpart and are consequently a well-suited in vitro model for metastasized BC. We treated the tumor organoids to implement a reliable application for drug screenings of metastasized cells. Drug assays revealed that responses are not always in accord with expression patterns, pathway activation, and hotspot mutations. The discrepancy between characterization and functional testing underlines the relevance of linking IHC stainings and mutational analysis of metastasized BC with in vitro drug assays. Our metastatic BC organoids recapitulate the characteristics of their original sample derived from MA and MPE and serve as an invaluable tool that can be utilized in a preclinical setting for guiding therapy decisions.

Propagating the "SEAD": Exploring the Value of an Overnight Call Shift in the Surgical Exploration and Discovery (SEAD) Program.

OBJECTIVE: Attrition of general surgery residents highlights a need to support well-informed specialty selection. This study evaluated preclerkship medical students' perception of overnight call shifts in surgical career exploration. DESIGN: A mixed-methods design was used, involving entry and postcall shift surveys and focus groups. Survey data characterized the population and call shift, guided focus group segmentation by baseline interest in surgery, and provided context for interpretation of qualitative data. Focus groups were transcribed and analyzed with a phenomenological approach using thematic analysis. SETTING: Call shifts took place at the University of Toronto's Sunnybrook Health Sciences Centre and St. Michael's Hospital, 2 Level 1 trauma centers in Toronto, Canada. PARTICIPANTS: Twenty-five first-year medical students participating in the Surgical Exploration and Discovery program. RESULTS: Sixty-four percent (n = 16) of the participants were male. Students in the high interest group (n = 9) had more prior operating room exposure than students in the moderate (n = 12) and low (n = 4) interest groups (p = 0.039). Most students valued participating in a call shift; 80% (n = 20) rated the experience "positive" or "very positive." Thematic analysis yielded 2 categories of themes: (1) Valuable aspects of the experience, including being part of a team, mentorship, understanding the clerk's role, dispelling misconceptions, trial of working overnight, and influencing interest in a surgical career; and (2) Determinants of an enjoyable experience, including resident engagement and number of traumas. CONCLUSIONS: An overnight call shift experience was valuable to preclerkship medical students regardless of baseline interest in surgery. While it only influenced a few students' specialty preferences, exposure facilitated a better understanding of a unique component of surgical careers and provided valuable mentorship. These findings support implementing calls shifts in other curricular or extracurricular programs to make the experience more widely available and enable earlier, informed career decision-making.