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Background: Historical MCL (medial collateral ligament) reconstruction (MCLR) techniques have focused on the superficial MCL (sMCL) to restore valgus stability while frequently ignoring the importance of the deep MCL (dMCL) in controlling tibial external rotation. The recent recognition of the medial ligament complex importance has multiple studies revisiting medial anatomy and questioning contemporary MCLR techniques. Purpose: To assess whether (1) an isolated sMCL reconstruction (sMCLR), (2) an isolated dMCL reconstruction (dMCLR), or (3) a novel single-strand short isometric construct (SIC) would restore translational and rotational stability to a knee with a dMCL and sMCL injury. Study Design: Controlled laboratory study. Methods: Biomechanical testing was performed on 14 fresh-frozen cadaveric knee specimens using a custom multiaxial knee activity simulator. The specimens were divided into 2 groups. The first group was tested in 4 states: intact, after sectioning the sMCL and dMCL, isolated sMCLR, and isolated dMCLR. The second group was tested in 3 states: intact, after sectioning the sMCL and dMCL, and after single-strand SIC reconstruction (SICR). In each state, 4 loading conditions were applied at 0°, 20°, 40°, 60°, and 90° of knee flexion: 8-N·m valgus torque, 5-N·m external rotation torque, 90-N anterior drawer, and combined 90-N anterior drawer plus 5-N·m tibial external rotation torque. Anterior translation, valgus rotation, and external rotation of the knee were measured for each state and loading condition using an optical motion capture system. Results: sMCL and dMCL transection resulted in increased laxity for all loading conditions at all flexion angles. Isolated dMCLR restored external rotation stability to intact levels throughout all degrees of flexion, yet valgus stability was restored only at 0° of flexion. Isolated sMCLR restored valgus and external rotation stability at 0°, 20°, and 40° of flexion but not at 60° or 90° of flexion. Single-strand SICR restored valgus and external rotation stability at all flexion angles. In the combined anterior drawer plus external rotation test, isolated dMCL and single-strand SICR restored stability to the intact level at all flexion angles, while the isolated sMCL restored stability at 20° and 40° of flexion but not at 60° or 90° of flexion. Conclusion: In the cadaveric model, single-strand SICR restored valgus and rotational stability throughout the range of motion. dMCLR restored rotational stability to the knee throughout the range of motion but did not restore valgus stability. Isolated sMCLR restored external rotation and valgus stability in early flexion. Clinical Relevance: In patients with anteromedial rotatory instability in the knee, neither an sMCLR nor a dMCLR is sufficient to restore stability. [ABSTRACT FROM AUTHOR]

Background: The Michigan State College of Human Medicine began as an experiment to teach medical students in community-based settings and to create a primary care workforce for the state. Decades later, CHM faced internal and external challenges that spurred creation of a new curriculum - the Share Discovery Curriculum - founded on learning by doing and other learning theories. Methods: A curricular design group (CDG) developed guiding principles for reform. Based on this, pedagogies and structures were selected to achieve this vision and developed into a curricular structure. Components of the first-year curriculum were piloted with a group of students and faculty members. Results: Six guiding principles were endorsed, grounded in learning theories such as Dewey's Learning by Doing. Based upon these, several key features of the new curriculum emerged: learning communities; one-on-one coaches for students; symptom-based presentations for content; simulation, authentic clinical tasks, flipped classrooms, and modified practice-based learning as primary teaching modalities; early, integrated clinical and scientific learning; milestones as course learning objectives; and a multidimensional, competency-based assessment system. Discussion: The process and outcomes described here are intended as an exemplar for schools undertaking curricular change. Early stakeholder engagement, faculty development, sustainable administrative systems, and managing complexity are core to the success of such endeavors. [ABSTRACT FROM AUTHOR]

This article presents a rereading of Buddhist scriptures from the Pāli Nikāyas in the light of Christopher Beckwith's 2015 theory that Pyrrho professed early Buddhist ideas. This changes, above all, how we read one of the central terms in Buddhism, dukkha / duḥkha (usually "suffering," now "unreliable" or "precarious"). I argue that many scriptures make better sense with Pyrrho's reading and, moreover, that it reveals a depth of wisdom in many otherwise obscure passages in early Buddhist teachings. Through an exploratory, hermeneutic method, the article suggests a reconceptualization of Buddhist scriptures and philosophy in the light of Pyrrho. [ABSTRACT FROM AUTHOR]

This essay defends a Buddhist answer to the question of how a skeptical tradition might account for its moral position. Two domains in Buddhist thought and practice are often considered to be dissimilar, perhaps contradictory. On the one hand, there is an aspiration to nirvana and a philosophy that describes everything as "emptiness" and rejects, with apparent universality, "attachment to views." On the other hand, Buddhist traditions of practice recommend actions based in compassion and loving kindness, and the cultivation of contentment, introspective awareness, and peace of mind. It is argued that these arenas are not in conflict, but are linked through Buddhist psychology, wherein the proven limitations of concepts are quite explicitly leveraged to show that beings hampered by such limits ought to think and act with epistemic humility. The result is not nihilism, but a method for improving our perspectives on ourselves and our society—a method that may serve as a model for humanistic research. [ABSTRACT FROM AUTHOR]

Learning communities (LCs) have been identified as a structure to support student wellness as well as create a positive learning environment and have been increasingly adopted in undergraduate medical education (UGME). In 2016, Michigan State University College of Human Medicine made curricular changes which integrated basic, social, and clinical sciences. One of the major strategies adopted to deliver this integrated curriculum was to create LCs that served as a central scaffold for students' academic development. Our primary aim is to describe how the school utilized LC faculty to deliver this core integrated curriculum. Students were surveyed about their perceptions of the effectiveness of the LCs in delivering an integrated science curriculum. Student academic performance in the new curriculum was compared to that of students from the legacy curriculum as a measure of the effectiveness of the curricular changes. The percentage of students in each class who responded to surveys ranged between 78.7% and 95.8%. Mean Likert responses (1 = strongly disagree; 5 = strongly agree) for statements 'the Faculty Fellow is effective in helping me learn the scholar group content', 'the Faculty Fellow is an effective teacher in our scholar group', and 'the Faculty Fellow is well prepared for our scholar group' ranged from 4.37 to 4.78, 4.72 to 4.76, and 4.81 to 4.86, respectively. In addition, a comparison of summative exam scores of the new curriculum's students to the legacy curriculum's students demonstrated comparable or better performances in the new curriculum. Utilizing LCs to deliver an integrated science curriculum is an underutilized strategy in UGME. Surveys on student satisfaction and academic performance are encouraging. Additional outcome measures are planned to continually evaluate this innovative multifaceted integration. [ABSTRACT FROM AUTHOR]

The fourth author's middle initial is incorrect. The correct name is: Christopher J. Mooney. The correct citation is: Gold JG, Knight CL, Christner JG, Mooney CJ, Manthey DE, Lang VJ (2022) Clinical reasoning education in the clerkship years: A cross-disciplinary national needs assessment. PLOS ONE 17(8): e0273250. https://doi.org/10.1371/journal.pone.0273250.By Jonathan G. Gold; Christopher L. Knight; Jennifer G. Christner; Christopher J. Mooney; David E. Manthey and Valerie J. LangReported by Author; Author; Author; Author; Author; Author [Extracted from the article]