Community Outreach in Breast Imaging: What Radiologists Can Do to Close the Gap for the Uninsured Population.

After implementation of the Affordable Care Act in 2010, the uninsured population of the United States decreased significantly. As of 2022, there were approximately 26.4 million uninsured individuals in the United States. The lack of coverage and access to services disproportionally affect minority groups in the country, reflecting the influence of the social determinants of health in their uninsured status. Use of screening mammography, an effective modality that results in early detection of and decreased mortality from breast cancer, was delayed or postponed by women of all races due to lockdowns and fear during the COVID-19 pandemic. Since then, the return to mammographic screening has lagged among minorities, further increasing their disproportionate screening gap. Radiologists-and more specifically breast imagers-must recognize these issues, as people who are uninsured and part of minority groups are diagnosed with breast cancer at later stages and have higher mortality rates, less continuity of care, and overall lower survival. The purpose of this article is to familiarize radiologists with the uninsured population, explain how they are disproportionally affected by breast cancer, and propose strategies that breast imagers can pursue to improve screening access and decrease compliance gaps for this patient population. ©RSNA, 2023 See the invited commentary by Nguyen in this issue. Quiz questions for this article are available through the Online Learning Center.

Challenges in Interpretation of US Breast Findings in the Emergency Setting.

Emergencies in breast imaging are infrequent but not rare. Although infectious conditions such as mastitis and breast abscess are the most common breast diseases encountered in acute care settings, other entities that may require additional imaging or different treatment approaches are also seen and include traumatic injury and breast cancer. While mammography is widely available for breast evaluation in outpatient facilities, most emergency departments do not have mammography units. This makes evaluation of patients with breast disease incomplete in the acute care setting and emphasizes the role of appropriate US techniques for interpretation. It also highlights the importance of effective sonographer-to-radiologist communication to ensure patient safety and diagnostic accuracy, especially in an era of increasing adoption of teleradiology. The authors discuss the challenges in image acquisition and remote interpretation that are commonly faced by radiologists when they assess breast anomalies in the emergency setting. They present strategies to overcome these challenges by describing techniques for proper US evaluation, highlighting the importance of sonographer-radiologist communication, defining the goals of the evaluation, reviewing common differential diagnoses, and providing appropriate follow-up recommendations. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.

Giant Cell Arteritis in an Elderly Female With Pulmonary Tuberculosis.

Giant cell arteritis (GCA) is a type of systemic vasculitis that primarily affects people over the age of 50 and affects the medium to large arteries. GCA's clinical manifestations can be varied and non-specific, similar to those observed in atherosclerosis. Here, the authors present a case of an elderly woman with pulmonary tuberculosis with GCA masquerading as atherosclerosis.

Sustainable Development Goal for Quality Education (SDG 4): A study on SDG 4 to extract the pattern of association among the indicators of SDG 4 employing a genetic algorithm.

Sustainable Development Goals (SDG) are at the forefront of government initiatives across the world. The SDGs are primarily concerned with promoting sustainable growth via ensuring wellbeing, economic growth, environmental legislation, and academic advancement. One of the most prominent goals of the SDG is to provide learners with high-quality education (SDG 4). This paper aims to look at the perspectives of the Sustainable Development Goals improvised to provide quality education. We also analyze the existing state of multiple initiatives implemented by the Indian government in the pathway to achieving objectives of quality education (SDG 4). Additionally, a case study is considered for understanding the association among the observed indicators of SDG4. For this purpose, exploratory data analysis, and numerical association rule mining in combination with QuantMiner genetic algorithm approaches have been applied. The outcomes reveal the presence of a significant degree of association among these parameters pointing out the fact that understanding the impact of one (or more) indicator on other related indicators is critical for achieving SDG 4 goals (or factors). These findings will assist governing bodies in taking preventive measures while modifying existing policies and ensuring the effective enactment of SDG 4 goals, which also will subsequently aid in the resolution of issues related to other SDGs.

Crystal structure of N-[(2S,5R)-4-oxo-2,3-diphenyl-1,3-thia-zinan-5-yl]acetamide 0.375-hydrate.

The asymmetric unit of the title compound, C18H18N2O2S.0.375H2O, has two independent organic mol-ecules (A and B) and 3/4 of a water mol-ecule distributed over three sites. In mol-ecule A, the 1,3-thia-zine ring is in a boat conformation, with the C atoms at the 2- and 5-positions out of the plane. The angle between the two phenyl rings is 51.70 (12)°. In mol-ecule B, the thia-zine ring is in a half-chair conformation, with the S atom forming the back of the half-chair. The angle between the two phenyl rings is 84.44 (14)°. The A mol-ecule features an intra-molecular N-H⋯O hydrogen bond, which closes an S(5) ring motif. In the crystal, the corresponding N-H grouping of the B mol-ecule participates in an inter-molecular hydrogen bond to the A mol-ecule. The A mol-ecule participates in a C-H⋯O inter-action back to the B mol-ecule, whilst the B mol-ecule features an intra-molecular C-H⋯O link, which generates an S(10) loop.

2,3-Diphenyl-2,3-di-hydro-4H-pyrido[3,2-e][1,3]thia-zin-4-one.

In the racemic title compound, C19H14N2OS, the two phenyl substituents on the 1,3-thia-zine ring are almost perpendicular to the pyridine ring which is fused to the thia-zine ring [inter-ring dihedral angles = 87.90 (8) and 85.54 (7)°]. The dihedral angle between the two phenyl rings is 75.11 (7)°. The six-membered thia-zine ring has an envelope conformation with the ortho-related C atom forming the flap. The crystals exhibit face-to-edge aromatic-ring interactions with the nearest C-H⋯C distance equal to 3.676 (3) Å.

Clinical role of radiography for thoracic spine fractures in daily practice in the MDCT era: a retrospective review of 255 trauma patients.

PURPOSE: To retrospectively assess the diagnostic efficacy of radiography in detecting vertebral body fractures of the thoracic spine compared with MDCT, to assess the confounding factors reducing the diagnostic efficacy, and to investigate the outcomes of radiographically overlooked patients. MATERIALS AND METHODS: Two hundred fifty-five patients suspected of thoracic spine fractures were enrolled. We assessed the diagnostic efficacy of radiography for the patients sub-grouped based on five confounding factors: chest abnormalities, head injuries, cervical spine fractures, upper extremity injuries, and age of 65 years or older. We investigated the outcomes of radiographically overlooked patients. RESULTS: Three hundred fifty-one vertebral body fractures were detected. The per-fracture sensitivities and specificities were 55 % and 94 % for vertebral body fractures and 41 and 99 % for unstable fractures. In patients with upper extremity injuries or aged 65 years or older, radiography was less sensitive in detecting the unstable fractures (P < 0.05). Nineteen patients were overlooked by radiography; two had neurological deficits and needed surgical fixation; 15 with no neurological deficit were conservatively treated with uneventful outcomes. CONCLUSION: Radiography had low sensitivity but high specificity. In daily practice, primary use of MDCT is beneficial for patients with neurological deficit or upper extremity injuries or elderly patients.