OBJECTIVES Assess the overall level of burnout in pediatric critical care medicine fellows and examine factors that may contribute to or protect against its development. DESIGN Cross-sectional observational study. SETTING Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs across the United States. SUBJECTS Pediatric critical care medicine fellows and program directors. INTERVENTIONS Web-based survey that assessed burnout via the Maslach Burnout Inventory, as well as other measures that elicited demographics, sleepiness, social support, perceptions about prior training, relationships with colleagues, and environmental burnout.  https://www.selleckchem.com/products/PD-0332991.html  MEASUREMENTS AND MAIN RESULTS One-hundred eighty-seven fellows and 47 program directors participated. Fellows from 30% of programs were excluded due to lack of program director participation. Average values on each burnout domain for fellows were higher than published values for other medical professionals. Personal accomplated with higher burnout by means of lower personal accomplishment (r = -1.64; p = 0.0255) and higher emotional exhaustion (r = 0.246; p = 0.0007). Except for tangible support, all other forms of social support showed a small to moderate correlation with lower burnout. CONCLUSIONS Pediatric critical care medicine fellows in the United States are experiencing high levels of burnout, which appears to be influenced by demographics, fellow perceptions of their work environment, and satisfaction with career choice. The exclusion of fellows at 30% of the programs may have over or underestimated the actual level of burnout in these trainees.STUDY DESIGN Prospective cohort study. OBJECTIVE To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce. METHODS We included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses. RESULTS At 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3-L4. The model for poor recovery included lower educational level, prior back surgery, and disc herniation at L3-L4. Following internal validation, the explained variance (Nagelkerke R) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor. CONCLUSION The outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated. LEVEL OF EVIDENCE 3.STUDY DESIGN A retrospective clinical study of patients who were treated from January 2011 to December 2018 and met our criteria. OBJECTIVE The aim of this study to investigate the relationship between radiographic spinopelvic parameters and the health-related quality of life (HRQOL) in pretreatment de novo degenerative lumbar scoliosis (DNDLS) patients with concomitant lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA DNDLS has garnered attention because of the increasing aged population. Unlike other types of spine deformities, DNDLS may occur with concomitant LSS. Radiographic spinopelvic parameters are important for evaluating spine alignment in these patients; however, the association between these parameters and the HRQOL is unknown. METHODS Data from 204 patients diagnosed with DNDLS and concomitant LSS were reviewed. HRQOL was assessed using the visual analog scale (VAS) scores (for the back and leg), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, and Scoliosis e HRQOL in patients with concomitant DNDLS and LSS. T1PA, T1ST, and L1PA can effectively assess pretreatment HRQOL. LEVEL OF EVIDENCE 4.By blocking the oxygen binding sites on the hemoglobin molecule, chronic low dose carbon monoxide administration may produce similar effects as exposure to altitude. PURPOSE To determine the effect of chronic low dose CO-application on hemoglobin mass (Hbmass) and VO2max. METHODS For three weeks, eleven healthy and moderately trained males inhaled a CO-bolus five times per day to increase their HbCO concentration by ~ 5%. Another eleven subjects received a placebo. Hbmass, serum erythropoietin concentration [EPO], ferritin, and basic hematological parameters were determined before and weekly during and until three weeks after the CO-inhalation period. VO2max tests on a cycle ergometer were performed before and after the CO administration period. RESULTS In the CO-group, Hbmass increased from 919 ±69g to 962 ±78g in week 3 (p less then 0.001) and was maintained for the following three weeks. Reticulocytes (%) and IRF significantly increased after one week. [EPO] tended to increase after one week (p=0.07) and was suppressed in the post period (p less then 0.01). Ferritin decreased during the inhalation period (from 106 ±37ng/ml to 72 ±37 ng/ml, p less then 0.001). VO2max tended to increase from 4230 ±280 ml/min to 4350 ±350 ml/min (p less then 0.1) immediately after the inhalation period and showed a significant relationship to the change in Hbmass (y=4.1x -73.4, r=0.70, p less then 0.001). CONCLUSIONS Chronic continuous exposure to low dose carbon monoxide enhances erythropoietic processes resulting in a 4.8% increase in Hbmass. The individual changes in Hbmass were correlated to the corresponding changes in VO2max. Examination of ethical and safety concerns is warranted prior to the implementation of low dose CO inhalation in the clinical/athletic setting as a tool for modifying Hbmass.