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Introduction It is common practice to obtain follow-up radiographs of non-operatively treated isolated greater tuberosity (GT) fractures 1 to 2 weeks after trauma. However, the majority of non-operatively treated GT fractures remain stable and do not require reconsideration of the initial treatment decision. Radiological follow-up therefore might be unnecessary. Our primary objective was to study whether radiological folow-up changes the initial treatment recommendation, hypothesizing no change. Materials and methods Radiographs of 25 patients diagnosed with an isolated GT fracture were selected from our hospital database and presented on a web-based platform. Sixty-eight trauma- and orthopedic surgeons evaluated these radiographs. First the radiographs directly post-trauma and then, in random order, the radiographs 5-14 days post-trauma alongside the first radiographs. Each observer evaluated each set of radiographs once. The observers answered which treatment they would recommend (non-operative/operative), and how certain they were about their advice (absolutely certain, certain, some doubt, very uncertain). Recommendation-consistency and inter-observer agreement are presented as percentages and intra class correlation coefficients (ICC). Results Overall, 84% (95% CI 82.1–85.8) of treatment recommendations was unchanged after evaluation of the second radiograph. Agreement within each observer ranged from 60 to 98%. The mean proportion of patients about whom the observers were (absolutely) certain of their recommendation increased from 70% at the first evaluation to 83% at the second evaluation (12.8; 95% CI 9.8–15.9). Furthermore, the ICC between the surgeons improved from 0.37 (95% CI 0.26–0.54) for the first evaluation to 0.60 (95% CI 0.47–0.74) for the second. Conclusion In 16% of the patients the treatment recommendation for an isolated GT fracture changed after the evaluation of radiographs 1 to 2 weeks post-trauma. In addition, surgeons were more certain about their recommendation and there was less inter-observer variation. Radiological follow-up of a non-operatively treated isolated GT fracture therefore seems justifiable. Level of evidence III, diagnostic study.

In this case study, we illustrate the great potential of experimental mathematics and symbolic computation, by rederiving, ab initio, Onsager's celebrated solution of the twodimensional Ising model in zero magnetic field. Onsager's derivation is extremely complicated and ad hoc, as are all the subsequent proofs. Unlike Onsager's, our derivation is not rigorous, yet it is absolutely certain (even if Onsager did not do it before), and should have been acceptable to physicists who do not share mathematicians' fanatical (and often misplaced) insistence on rigor.

As a general practitioner working in the poor suburbs of Yemen, the “bread and butter” of my work is treating infectious diseases. You can never predict, however, what the next patient on the list will bring into consultation. One particular example stands out in my memory. A young man arrived at my clinic. He was very reserved and seemed a very quiet person. His complaints were nonspecific: pains and aches in his lower abdomen, chest, axilla. He said he got a headache — whenever he scratched his head. In my long years of practice, I have gotten used to these sorts of funny and odd complaints, that often can't be pinpointed or sorted out. He seemed completely normal, if somewhat detached and uncooperative. I finished my brief examination and started to reassure him that there was nothing wrong. But I offered to do some tests just to make absolutely certain that all was right. There was a brief moment of silence and then he said: “Doctor, I know that there is nothing wrong with me, except for one thing.” I listened carefully. He continued: “I am 20 years old now and my penis is like that of a 3-year-old child!” So that was that. His other symptoms were a fiction designed to help him overcome his fear of relating his real problem. When I examined his genitalia, everything seemed perfectly normal —except, of course, for his really small-sized organ. I confess that, at that moment, I thought of the dozens of spam emails that I had received about penis enlargement. And I genuinely wished that I could offer him a pharmaceutical solution. But I had no clue where such therapies are sold in Yemen. So, I concluded the consultation by providing my sincere assurance that, as long as “it is working fine, there is nothing to worry about.” He left the clinic. I could see that he was not satisfied. And I thought later, even in the poorest settings, where thousands of people die annually as a result of infectious diseases, some concerns are universal. — Dr. Yasir Hameed, Taiz, Yemen. Figure. In every country, there will also be men who think that size matters. Image by: Photos.com

I first met Todd in 1961. We were both graduate students in the Psychology Department at the University of Washington. I was in the clinical program, and Todd was a student in the developmental program working with Sidney Bijou and Donald Baer at the Institute for Child Development (later the Developmental Psychology Laboratory). The Institute for Child Development was where the behaviorists and the behaviorists-in-training hung out. It was across the campus from Denny Hall, the building where most of the psychology department was located. I was never sure whether this was systematically planned or a simple happenstance of where room for several preschools and laboratory space was available. Whatever was the case, the separation created a unique culture where graduate students, postdoctoral fellows, and faculty were mixed together in a way that generated frequent interactions, discussions, heated arguments, and productive collaborative research. Everyone knew what research everyone else was doing. We knew it because we brought our graphs with the latest data to lunch gatherings, we argued about the meaning and importance of the results, and we suggested better ways of doing the study, whatever the topic of research was. In short, it was an exciting and energetic atmosphere that paradoxically generated both intense competition and lifelong collaboration. We all appreciated and encouraged each other's work. At the same time, all of us were absolutely certain that we knew a better way to conduct the research or to analyze the data, and we were not at all reluctant to describe, at great length, how to improve each other's research. It was, in short, an ideal situation for graduate education. A large part, no doubt, was due to the participants, among whom were the staff and faculty members, Sidney Bijou, Don Baer, Bill Hopkins, Eileen Allen, and Jay Birnbrauer; research associates and postdoctoral fellows, Mont Wolf, Bob Wahler, Bud Wexler, Barbara Etzel, Bob Orlando, and Ivar Lovaas; and graduate students, Todd, Warren Steinman, Vance Hall, Rob Hawkins, Bob Peterson, and me.