It is estimated that more than 600,000 people will die of cancer in the United States in 2020. Annual cancer diagnoses throughout the country are expected to rise in the coming years, which may further strain the American healthcare system. As such, it is vital that public health campaigns intended to reduce cancer morbidity and mortality are successful. Monthly cancer awareness campaigns have been used in the past to raise awareness and funding for various malignancies. One notable example is the ‘Pink October’ campaign to raise awareness for breast cancer. There has been limited study, however, on the effectiveness of cancer awareness campaigns for other cancers such as colorectal cancer, prostate cancer and cervical cancer. High-profile media coverage of celebrity cancer diagnoses and/or cancer-related deaths is another method by which knowledge of common cancers is dispersed to the public. In this study, we evaluate the impact of monthly cancer awareness campaigns as well as celebrity cancer diagnoses and/or deaths on Internet search traffic regarding various malignancies. We used the Google Trends database to evaluate public interest in 13 different cancers (and their respective cancer screening methods, when applicable) from January 2010 to June 2020. Public interest in 6 of 13 cancers (cervical cancer, colorectal cancer, skin cancer, ovarian cancer, breast cancer and lung cancer) was significantly higher in their respective awareness months when compared to the rest of the year. Furthermore, peak public interest for 9 of 13 cancers was associated with a media-event such as a monthly awareness campaign or celebrity diagnoses and/or death. Our findings illustrate the important role that the media plays in facilitating public interest in common cancers and their screening methods. Cancer awareness months can serve as an effective tool to increase Internet search traffic regarding a given malignancy. In the future, public health agencies can attempt to utilise increased search traffic to better educate the public, raise funds and improve enrolment in cancer screening programmes that reduce cancer morbidity and mortality.

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Objective: To evaluate the union rate and rate of postoperative complications in patients with septic nonunions of the humerus after a two-stage reconstruction using a free vascularized fibula graft.Design: Retrospective case series.Setting: Academic, tertiary referral center.Patients/Participants: Adult patients with staged reconstruction for infected nonunion of the humerus with at least 2 years follow-up after vascularized fibula graft transfer.Intervention: First, infected nonunion debridement with antibiotic spacer and external fixator placement. After antimicrobial treatment, free vascularized fibula transfer with internal fixation.Main Outcome Measurements: Time to union, pain, affected extremity range of motion, and function.Results: 10 patients with septic humerus nonunion treated with staged reconstruction using a free vascularized fibula graft, with a mean follow-up of 32.3 months were included. After the two-stage reconstruction using a free fibula, radiographic union was achieved in 6/10 patients, with a mean time to union of 19.9 weeks. The remaining 4 patients required an additional procedure with graft augmentation and/or implant revision. After the revision procedure, union was noted in 3/4 patients, 21 weeks postoperatively. Mean patient visual analog scale pain scores improved from 5.8 preoperatively to 0.9 at final follow-up (P = 0.02). Postoperatively, mean elbow flexion was 110 6 20 degrees and extension 15 6 7.5 degrees. Conclusion:A two-stage reconstruction using a free fibula graft can be used in patients with septic nonunions of the humerus in the setting of multiple failed prior surgeries and compromised local biology. Additional procedures may be needed in some to achieve final union.

Introduction Ophthalmology departments have been stated to be among the least diverse clinical departments at United States medical schools. Improvement requires recruiting a pipeline of diverse trainees. Residency program Web sites represent a potential diversity and inclusion recruitment tool. This study assesses how ophthalmology residency program Web sites demonstrate a commitment to diversity and inclusion. Methods We analyzed the diversity and inclusion content of 116 ophthalmology residency program Web sites in April 2021. Main outcome measures were the presence of 12 diversity and inclusion elements on program Web sites, based on prior work and Accreditation Council for Graduate Medical Education guidelines: nondiscrimination statement, diversity and inclusion message, community resources, extended faculty or resident biographies (including hobbies, etc.), faculty photos, resident photos, additional financial resources for trainees, wellness resources, mental health resources, health disparities/community engagement, and diversity council. We used Mann–Whitney U and Kruskal–Wallis tests to assess whether residency program characteristics such as rank, size, university affiliation, and geographic location were associated with commitment to diversity and inclusion on affiliated residency Web sites. Results Ophthalmology residency program Web sites included a mean of 4.4 ± 2.1 diversity elements. Sixteen percent of programs featured more than half (7 + ) of the evaluated diversity elements. The most featured common diversity elements included resident photos (85.3%), faculty photos (78.4%), and community resources (64.3%). Extended faculty biographies (2.6%), mental health resources (9.5%), and diversity council information (11.2%) were less commonly showcased. Top-ranked programs (7.6 ± 1.8, p < 0.0001) and university-based/-affiliated programs (4.7 ± 2.8, p = 0.0039) displayed more diversity elements than lower-ranked (4.1 ± 1.8) and community-based programs (2.8 ± 1.7). Conclusion Most ophthalmology residency program Web sites feature less than half of the 12 diversity and inclusion elements included in this study, suggesting room for improvement. By drawing attention to program diversity and inclusion efforts, Web sites offer a potential tool for residency programs to consider in their recruitment efforts for diverse trainees. Incorporating the diversity and inclusion elements analyzed in this study represents a low-burden way to signal a greater commitment to diversity that could help programs recruit diverse applicants.

IntroductionNecrotizing soft tissue infection (NSTI) of the upper extremity (UE) is a rapidly progressing infection that requires early diagnosis and emergent treatment to decrease risks of loss of limb or life. Clinical presentation, particularly of early NSTI, can appear similar to serious cellulitis or abscess. The purpose of this study was to identify factors that are associated with NSTI rather than serious cellulitis and abscess to differentiate patients with similar clinical presentations. MethodsThis study uses a retrospective cohort design that compares patients ultimately diagnosed with UE NSTI versus those diagnosed with UE serious cellulitis or abscess. Cohorts were matched using the Laboratory Risk Indicators for Necrotizing Fasciitis (LRINEC) score in the setting of UE soft tissue infection. Laboratory values, vital signs, subjective symptoms, and social factors including substance abuse and domiciled status were recorded. Continuous variables were compared using the Mann-Whitney U test, whereas categorical variables were compared using the chi-squared test or the Fisher exact test (for expected values less than 5). A binary logistic regression for continuous and categorical variables was also performed. Significance was set at p<0.05. Univariate and multivariate analyses were performed. ResultsMultivariate statistical analysis and clinical interpretation of data identified four factors more associated with a diagnosis of NSTI than serious cellulitis or abscess: elevated lactate on hospital presentation, a patient-reported history of fever, male gender, and homelessness. ConclusionsIn patients with upper extremity infections, the clinical presentation of NSTI and serious cellulitis or abscess may appear similar. In this retrospective cohort of patients matched with LRINEC scores, elevated lactate, subjective fever, male gender, and homelessness were significantly associated with NSTI rather than serious cellulitis or abscess.