Case Presentation: We report a case of an 89-year-old female who presented with pain in her right shoulder following a fall onto her outstretched hand. Upon presentation, her right hand was held behind her head and elbow held above her head in flexion. There was obvious deformity seen and felt in her axilla. Radiograph of the shoulder showed an inferior shoulder dislocation and impacted humeral neck fracture. Given her age and comorbid osteoporosis, a bedside reduction was performed by orthopedics where the humeral head was intentionally dislocated from the humeral shaft. Thirteen days after the initial shoulder dislocation, the patient’s shoulder was successfully repaired by open reduction.

Discussion: Luxatio erecta, which means “erect dislocation” in Latin, refers to an inferior shoulder dislocation. It accounts for less than 1% of shoulder dislocations. Our case report highlights an inferior shoulder dislocation with a rare, concomitant humeral neck fracture, managed via staged reduction by orthopedics with intentional dislocation of the humeral head given concern over patient’s age and osteoporosis. The patient was eventually successfully repaired via arthroplasty within two weeks.

Keywords: inferior shoulder dislocation; luxatio erecta; shoulder pain.

Introduction: The coronavirus disease 2019 pandemic forced a rapid transition of in-class residency conferences to online residency conferences; little is known about learners’ perceptions of this new didactic environment. Understanding learners’ perceptions of virtual classrooms can help inform current and future best practices for online, synchronous, graduate medical education.

Methods: We surveyed emergency medicine and internal medicine residency programs at a large urban academic medical center about their perceptions of synchronous online residency conferences.

Results: Residents reported a preference for in-class interactions with peers (85%) and lecturers (80%), with 62% reporting decreased levels of engagement with lecturers during online conferences. Residents reported performing nearly twice as many non-conference-related activities (eg, email, exercise) during online conferences vs in-class conferences. Residents felt that the following methods improved engagement during online conferences: lecturers answering chat questions; small group sessions; and gamification of lectures.

Conclusion: Synchronous online residency conferences were associated with decreased engagement and attention by learners. Simple methods to increase interactivity may help improve the online classroom experience and cultivate novel teaching environments that better support current learning styles.

The issue of connectivity in roaded landscapes is a controversial one. Conservationists argue for significant expenditures on wildlife-friendly highway designs, while opponents fight against such spending. A recent study evaluating wildlife use of underpasses in the Adirondack region of New York ran headlong into this controversy, inadvertently fueling a debate about the general efficacy of wildlife underpasses through misleading coverage of research results in the popular press. This poster will detail the road traveled by this project: from conception through implementation, to the publicizing of results and the subsequent media fallout, and will conclude with the steps taken to clarify the study conclusions and lessons learned about publicizing science that is of public and political interest. Because the proposed construction of the “Rooftop Highway” between Interstates 81 and 87 could effectively complete the isolation of the 24,000km2 Adirondack Park, measures to mitigate negative impacts on wildlife are a priority in the region. The Wildlife Conservation Society (WCS) and the New York State Museum (NYSM) recently partnered on a small research project investigating the extent to which underpasses and culverts constructed under a nearby Adirondack highway (I-87) were utilized by wildlife. Although these structures were not explicitly designed for wildlife, they might still function as animal passageways. Interviews with NY DOT and other agency personnel strongly encouraged implementation of a study of this nature to help inform the design of new wildlife crossings. During a six-week period in spring 2002, we monitored 19 culverts and underpasses of various types along a 141-km stretch of I-87 using camera traps and supplemental footprint tracking. The results of this study, published in spring 2003 in the Adirondack Journal of Environmental Studies, made it clear that culverts along I-87 benefited humans, but were rarely utilized by wildlife, pointing to the low conservation value of unplanned culverts for large Adirondack wildlife. A secondary message was that wildlife passages under future roads and highways should be designed to curb human use of such passages. A draft press release by the authors accurately summarizing the study results was unintentionally distorted in institutional press releases from WCS and NYSM media offices. Local newspapers that picked up the story generally interviewed the authors and offered accurate coverage that focused on the costs and benefits of the proposed “Rooftop Highway.” This perspective was lost, however, in small pieces printed in the Washington Post and the New York Times. These stories distorted the study’s findings that almost no animals used the small I-87 culverts, by incorrectly claiming that wildlife underpasses universally do not work for wildlife. The lack of interviews for these national stories further deprived the authors of an opportunity to clarify this point. While the full impact of the Washington Post article is difficult to judge, it has apparently been cited by some officials and decision-makers as evidence against the effectiveness of wildlife underpasses. This misrepresentation of our results was a blow to all those working to improve connectivity in roaded landscapes, including the authors. We describe the steps taken by the scientists and institutions involved in this study to move constructively forward from this point. We also draw attention to the political climate surrounding this particular issue and a large volume of email exchanges, both of which served to greatly magnify the impact of this relatively minor study.