lar retractor system) without fusion is adequate. LEVEL OF EVIDENCE Level III.STUDY DESIGN This is a retrospective study. OBJECTIVE The objective of this study was to investigate the surgical outcomes of postural instability and its predictors in patients with cervical myelopathy (CM). SUMMARY OF BACKGROUND DATA Although several studies have shown impaired postural stability in CM patients, there remains a paucity of literature examining its surgical outcome. MATERIALS AND METHODS Postural stability was assessed using a stabilometer preoperatively, at the early phase (3-6 months postoperatively), and 1-year postoperatively, employing 2 stabilometric parameters sway area [SwA (cm) the amount of sway of gravity center assessed by the outer peripheral area of the stabilogram] and sway density [SwD (/cm) the indicator of proprioceptive reflexes calculated by the locus length of the stabilogram per SwA]. Twenty-seven healthy age-matched, sex-matched, and body mass index-matched subjects were recruited as controls. To investigate the predictors of postoperative postural instability, univariaal postoperative postural instability was a greater level of preoperative postural instability. In CM patients, to achieve better surgical outcome of postural stability, surgical intervention is recommended before the symptoms related to bodily imbalance deteriorate. LEVEL OF EVIDENCE Level III.Superiority and equivalence trials are 2 commonly encountered methods of designing randomized controlled trials. Traditionally, the goal of a randomized controlled trial is to show superiority. However, in more recent times, there has been a tendency to show equivalence in clinical randomized trials. These differing conclusions at first glance seem to be drawn on the basis of the results of the respective trials. However, to accurately reach these conclusions, there are stark contrasts in the methodologies of these different study types. This article provides a brief overview of superiority and equivalence trials, highlights the differences between the 2, and their relevance to orthopedic surgery.OBJECTIVES To investigate the safety, feasibility, and possible adverse events of single-dose human umbilical cord-derived mesenchymal stem cells in patients with moderate-to-severe acute respiratory distress syndrome. DESIGN Prospective phase I clinical trial. SETTING Medical center in Kaohsiung, Taiwan. PATIENTS Moderate-to-severe acute respiratory distress syndrome with a PaO2/FIO2 ratio less than 200. INTERVENTIONS Scaling for doses was required by Taiwan Food and Drug Administration as follows the first three patients received low-dose human umbilical cord-derived mesenchymal stem cells (1.0 × 10 cells/kg), the next three patients with intermediate dose (5.0 × 10 cells/kg), and the final three patients with high dose (1.0 × 10 cells/kg) between December 2017 and August 2019. MEASUREMENTS AND MAIN RESULTS Nine consecutive patients were enrolled into the study. In-hospital mortality was 33.3% (3/9), including two with recurrent septic shock and one with ventilator-induced severe pneumomediastinum and subcutaneous emphysema. No serious prespecified cell infusion-associated or treatment-related adverse events was identified in any patient. Serial flow-cytometric analyses of circulating inflammatory biomarkers (CD14CD33/CD11b+CD16+/CD16+MPO+/CD11b+MPO+/CD14CD33+) and mesenchymal stem cell markers (CD26+CD45-/CD29+CD45-/CD34+CD45-/CD44+CD45-/CD73+CD45-/CD90+CD45-/CD105+CD45-/CD26+CD45-) were notably progressively reduced (p for trend less then 0.001), whereas the immune cell markers (Helper-T-cell/Cytotoxity-T-cell/Regulatory-T-cell) were notably increased (p for trend less then 0.001) after cell infusion. CONCLUSIONS The result of this phase I clinical trial showed that a single-dose IV infusion of human umbilical cord-derived mesenchymal stem cells was safe with favorable outcome in nine acute respiratory distress syndrome patients.OBJECTIVES To identify risk factors and develop a prediction score for in-hospital symptomatic venous thromboembolism in critically ill patients. DESIGN Retrospective cohort study. SETTING Henry Ford Health System, a five-hospital system including 18 ICUs. PATIENTS We obtained data from the electronic medical record of all adult patients admitted to any ICU (total 264 beds) between January 2015 and March 2018. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Symptomatic venous thromboembolism was defined as deep vein thrombosis, pulmonary embolism, or both, diagnosed greater than 24 hours after ICU admission and confirmed by ultrasound, CT, or nuclear medicine imaging. A prediction score (the ICU-Venous Thromboembolism score) was derived from independent risk factors identified using multivariable logistic regression. Of 37,050 patients who met the eligibility criteria, 529 patients (1.4%) developed symptomatic venous thromboembolism.  https://www.selleckchem.com/products/sw033291.html  The ICU-Venous Thromboembolism score consists of six independent predictorr venous thromboembolism. The ICU-Venous Thromboembolism score can identify patients at increased risk for venous thromboembolism.INTRODUCTION The presence of discrimination, bullying, sexual harassment, and harassment (DBSH) in the healthcare workplace negatively affects the health and well-being of providers and is associated with poor mental health, low self-esteem, high levels of absenteeism, and low levels of productivity. METHODS The American Academy of Orthopaedic Surgeons (AAOS) developed and distributed a survey to a subset of AAOS members to assess the climate of workplace safety and overall workplace culture. Women and underrepresented minority (URM) AAOS members and an equal number of randomly selected non-URM men were invited to participate in the survey. RESULTS Nine hundred twenty-seven of 5,638 (16.4%) members responded to the survey. Sixty-six percent of respondents reported experiencing DBSH behavior with specific exposures to DBSH of 79%, 55%, 47%, and 40%, respectively. Women (81%) were more likely than men (35%) to have experienced these behaviors. Fifty-eight percent of respondents reported that their workplaces were equipped to deal effectively with DBSH behaviors.