Recently, the Federation of State Medical Boards and the National Board of Medical Examiners, cosponsors of the United States Medical Licensing Examination (USMLE), changed the USMLE Step 1 results from a three-digit score to a pass/fail format. The purpose of this study was to analyze the opinions of program directors (PDs) to predict how the evaluation of orthopaedic surgery residency applicants will change following the change. A 17-question online survey was distributed to PDs via e-mail. This survey covered program demographics, questions regarding the relative importance of various factors for selection of interviews, and perceived changes and effect of the scoring change. Responses were aggregated and analyzed. PDs indicated that the three highest scored factors were (1) failure in prior attempts in USMLE/COMLEX examinations (4.7), (2) audition elective/rotation within your department (4.5), and (3) personal prior knowledge of the applicant (4.1). In addition, 38 PDs (81.1%) anticipate that they will require USMLE Step 2 clinical knowledge scores for interview consideration. Most orthopaedic surgery PDs think that the change in score reporting for the USMLE Step 1 will result in additional requirements and changes in how programs select applicants and do not support the decision.Most orthopaedic surgery PDs think that the change in score reporting for the USMLE Step 1 will result in additional requirements and changes in how programs select applicants and do not support the decision.Osteomyelitis of the acetabulum is a rare condition accounting for only 12% of pelvic osteomyelitis cases. This report describes a previously healthy 10-year-old girl with subacute acetabular osteomyelitis and subsequent development of secondary septic arthritis of the hip. The patient presented with 3 weeks of groin pain, elevated erythrocyte sedimentation rate and C-reactive protein, synovial thickening of the hip on ultrasonography and diffuse signal uptake in the acetabulum on magnetic resonance imaging. Despite antibiotic therapy, her symptoms worsened clinically, and repeat Magnetic resonance imaging images showed worsening of the osteomyelitis with likely extension through the acetabulum and into the joint. A hip aspirate was positive for Fusobacterium, an atypical anaerobe. Hip arthroscopy, with identification of the site of extrusion and then extensive débridement and irrigation, was successful in helping to control and ultimately eradicate the infection. The patient regained normal hip function and returned to full activities. This case demonstrates how hip arthroscopy can serve as an important surgical treatment modality for acetabular osteomyelitis with intraarticular extension in addition to septic arthritis of the hip. Within the geriatric hip fracture population, there exists a subset of patients whose length of inpatient hospital stay is excessive relative to the average. A better understanding of the risk factors associated with this group would be of value so that targeted prevention efforts can be properly directed. ENOblock order The goal of this study was to identify and characterize the risk factors associated with an extended length of hospital stay (eLOS) in the geriatric hip fracture population. In addition, a statistical model was created to predict the probability of eLOS in a geriatric hip fracture patient. The National Surgical Quality Improvement Program database (2005 to 2018) was searched for patients aged ≥65 years who underwent hip fracture surgery. Patients with a hospital stay greater than or equal to 14 days were considered to have an eLOS. A multivariate logistic regression model using 24 patient characteristics from two-thirds of the study population was created to determine independent risk factors predictivelthcare system as a whole.Among geriatric hip fracture patients, particular efforts should be directed toward optimizing those with preoperative risk factors for eLOS. Preemptive measures to target the postoperative complications with the strongest eLOS association may be beneficial for both the patient and the healthcare system as a whole.T cells are involved in control of coronavirus disease 2019 (COVID-19), but limited knowledge is available on the relationship between antigen-specific T cell response and disease severity. Here, we used flow cytometry to assess the magnitude, function, and phenotype of SARS coronavirus 2-specific (SARS-CoV-2-specific) CD4+ T cells in 95 hospitalized COVID-19 patients, 38 of them being HIV-1 and/or tuberculosis (TB) coinfected, and 38 non-COVID-19 patients. We showed that SARS-CoV-2-specific CD4+ T cell attributes, rather than magnitude, were associated with disease severity, with severe disease being characterized by poor polyfunctional potential, reduced proliferation capacity, and enhanced HLA-DR expression. Moreover, HIV-1 and TB coinfection skewed the SARS-CoV-2 T cell response. HIV-1-mediated CD4+ T cell depletion associated with suboptimal T cell and humoral immune responses to SARS-CoV-2, and a decrease in the polyfunctional capacity of SARS-CoV-2-specific CD4+ T cells was observed in COVID-19 patients with active TB. Our results also revealed that COVID-19 patients displayed reduced frequency of Mycobacterium tuberculosis-specific CD4+ T cells, with possible implications for TB disease progression. These results corroborate the important role of SARS-CoV-2-specific T cells in COVID-19 pathogenesis and support the concept of altered T cell functions in patients with severe disease.Down syndrome (DS), caused by trisomy of chromosome 21, occurs in 1 of every 800 live births. Early defects in cortical development likely account for the cognitive impairments in DS, although the underlying molecular mechanism remains elusive. Here, we performed histological assays and unbiased single-cell RNA-Seq (scRNA-Seq) analysis on cerebral organoids derived from 4 euploid cell lines and from induced pluripotent stem cells (iPSCs) from 3 individuals with trisomy 21 to explore cell-type-specific abnormalities associated with DS during early brain development. We found that neurogenesis was significantly affected, given the diminished proliferation and decreased expression of layer II and IV markers in cortical neurons in the subcortical regions; this may have been responsible for the reduced size of the organoids. Furthermore, suppression of the DSCAM/PAK1 pathway, which showed enhanced activity in DS, using CRISPR/Cas9, CRISPR interference (CRISPRi), or small-molecule inhibitor treatment reversed abnormal neurogenesis, thereby increasing the size of organoids derived from DS iPSCs.