Harnessing ChatGPT dialogues to address claustrophobia in MRI - A radiographers' education perspective.

INTRODUCTION: The healthcare sector invests significantly in communication skills training, but not always with satisfactory results. Recently, generative Large Language Models, have shown promising results in medical education. This study aims to use ChatGPT to simulate radiographer-patient conversations about the critical moment of claustrophobia management during MRI, exploring how Artificial Intelligence can improve radiographers' communication skills. METHODS: This study exploits specifically designed prompts on ChatGPT-3.5 and ChatGPT-4 to generate simulated conversations between virtual claustrophobic patients and six radiographers with varying levels of work experience focusing on their differences in model size and language generation capabilities. Success rates and responses were analysed. The methods of radiographers in convincing virtual patients to undergo MRI despite claustrophobia were also evaluated. RESULTS: A total of 60 simulations were conducted, achieving a success rate of 96.7% (58/60). ChatGPT-3.5 exhibited errors in 40% (12/30) of the simulations, while ChatGPT-4 showed no errors. In terms of radiographers' communication during the simulations, out of 164 responses, 70.2% (115/164) were categorized as "Supportive Instructions," followed by "Music Therapy" at 18.3% (30/164). Experts mainly used "Supportive Instructions" (82.2%, 51/62) and "Breathing Techniques" (9.7%, 6/62). Intermediate participants favoured "Music Therapy" (26%, 13/50), while Beginner participants frequently utilized "Mild Sedation" (15.4%, 8/52). CONCLUSION: The simulation of clinical scenarios via ChatGPT proves valuable in assessing and testing radiographers' communication skills, especially in managing claustrophobic patients during MRI. This pilot study highlights the potential of ChatGPT in preclinical training, recognizing different training needs at different levels of professional experience. IMPLICATIONS FOR PRACTICE: This study is relevant in radiography practice, where AI is increasingly widespread, as it explores a new way to improve the training of radiographers.

Opinions on advanced practice among diagnostic and therapeutic radiographers: Survey results of an European congress of radiology study.

INTRODUCTION: The exploration of Advanced Practice (AP) in both diagnostic and therapeutic radiography has become a prominent topic of discussion within the radiographic community, prompting an investigation into radiographers' perceptions and the current global status of advanced roles. This study aimed collect data on radiography and radiation therapy AP career paths, and understand radiographers' perceptions of advanced practice at the European Congress of Radiology (ECR) 2020. METHODS: A concise, 15-question web-based survey was distributed through the EFRS Research Hub during ECR 2020. Topics covered included respondents' demographics, educational background, current radiography skills, the landscape of AP in radiography, potential progression avenues in their countries, and key benefits linked to role advancement. RESULTS: The survey garnered responses from 83 radiographers, with a predominant 79.5% (n = 66) representing Europe. Information on the total number of participants approached during the ECR and thus the resulting response rate is not available. Among the findings, a meaningful portion (30%, n = 25) of participants indicated the absence of AP opportunities in their respective country. Notably, an overwhelming majority (97.5%, n = 81) expressed a personal willingness to embrace AP roles. Areas of particular interest to the respondents included radiography reporting (38.6%, n = 32), performing ultrasound examination (13.2%, n = 11), conducting interventional procedures (13.2%, n = 11) and engaging in radiography research (10.8%, n = 9). CONCLUSION: The study indicates a keen interest among surveyed radiographers in pursuing AP, emphasizing the necessity for role recognition. Education, research and job satisfaction emerged as pivotal for AP progression. Despite this, AP availability in Europe is limited. IMPLICATION FOR PRACTICE: There is a need to recognize and address barriers, provide targeted education and training, and promote job satisfaction to facilitate the development of AP in radiography.

Valproic acid promotes SOD2 acetylation: a potential mechanism of valproic acid-induced oxidative stress in developing systems.

Valproic acid (VPA) is an antiepileptic, bipolar, and migraine medication, which is associated with embryonic dysmorphology, more specifically neural tube defects (NTDs), if taken while pregnant. One mechanism by which VPA may cause NTDs is through oxidative stress that cause disruption of cell signaling. However, mechanisms of VPA-induced oxidative stress are not fully understood. Since VPA is a deacetylase inhibitor, we propose that VPA promotes mitochondrial superoxide dismutase-2 (SOD2) acetylation, decreasing SOD2 activity and increasing oxidant levels. Using the pluripotent embryonal carcinoma cell line, P19, VPA effects were evaluated in undifferentiated and neurodifferentiated cells. VPA treatments increased oxidant levels, oxidized the glutathione (GSH)/glutathione disulfide (GSSG) redox couple, and decreased total SOD and SOD2 activity in undifferentiated P19 cells but not in differentiated P19 cells. VPA caused a specific increase in mitochondrial oxidants in undifferentiated P19 cells, VPA did not alter respirometry measurements. Immunoblot analyses demonstrated that VPA increased acetylation of SOD2 at lysine68 (AcK68 SOD2) in undifferentiated P19 cells but not in differentiated P19 cells. Pretreatments with the Nrf2 inducer, dithiol-3-thione (D3T), in undifferentiated P19 cells prevented increased oxidant levels, GSH/GSSG redox oxidation and restored total SOD and SOD2 activity, correlating with a decrease in AcK68 SOD2 levels. In embryos, VPA decreased total SOD and SOD2 activity and increased levels of AcK68 SOD2, and D3T pretreatments prevented VPA effects, increasing total SOD and SOD2 activity and lowering levels of AcK68 SOD2. These data demonstrate a potential, contributing oxidizing mechanism by which VPA incites teratogenesis in developing systems. Moreover, these data also suggest that Nrf2 interventions may serve as a means to protect developmental signaling and inhibit VPA-induced malformations.

An Investigation of Procedural Radiation Dose Level Awareness and Personal Training Experience in Communicating Ionizing Radiation Examinations Benefits and Risks to Patients in Two European Cardiac Centers.

PURPOSE: Cardiac interventional practitioners need to be appropriately informed regarding radiation dose quantities and risks. Communicating benefit-risk information to patients requires attention as specified in Basic Safety Standards Directive 2013/59/Eurotom. This study investigated the awareness of procedural radiation dose levels and the impact of personal training experience in communicating ionizing radiation benefit-risks to patients. METHODOLOGY: A questionnaire, consisting of 28 questions, was distributed directly to adult and pediatric interventional cardiology specialists at specialized cardiovascular imaging centers in Dublin, Ireland and Milan, Italy. RESULTS: A total of 18 interventional cardiologists (senior registrar to consultant grades with between 2 y to over 21 y experience in cardiac imaging) participated. The majority of participants (n = 17) stated that parents of pediatric and adult patients should be informed of the potential benefits and risk. All participants indicated they had radiation safety training; however, 50% had not received training in radiation examination benefit-risk communication. Despite this, 77.8% (n = 14) participants indicated a high confidence level in successfully explaining risks and/or benefits of cardiac imaging procedures. When asked to estimate effective dose (ED) values for common cardiac imaging procedures less than 50% identified appropriate dose ranges. All participants underestimated procedural dose values based on recent European data. 50% (n = 9) participants answered all questions correctly for a number of true or false radiation risk statements. CONCLUSION: Benefit-risk communication training deficits and inaccurate understanding of radiation dose levels was identified. Further research and training to support clinicians using radiation on a daily basis is required.

Investigation of reference levels and radiation dose associated with abdominal EVAR (endovascular aneurysm repair) procedures across several European Centres.

OBJECTIVES: Endovascular aneurysm repair (EVAR) is considered the treatment of choice for abdominal aortic aneurysms with suitable anatomy. In order to improve radiation safety, European Directive (2013/59) requires member states to implement diagnostic reference levels (DRLs) in radio-diagnostic and interventional procedures. This study aimed to determine local DRLs for EVAR across five European centres and identify an interim European DRL, which currently remains unestablished. METHODS: Retrospective data was collected for 180 standard EVARs performed between January 2014 and July 2015 from five specialist centres in Ireland (n=2) and Italy (n=3). Data capture included: air kerma-area product (PKA), total air kerma at the reference point (Ka,r), fluoroscopic time (FT), number of acquisitions, frame rate of acquisition, type of acquisition, patient height, weight, and gender. RESULTS: The mean values for each site A, B, C, D, and E were: PKAs of 4343 ± 994 µGym2, 18,200 ± 2141 µGym2, 11,423 ± 1390 µGym2, 7796 ± 704 µGym2, 31,897 ± 5798 µGym2; FTs of 816 ± 92 s, 950 ± 150 s, 708 ± 70 s, 972 ± 61 s, 827 ± 118 s; and number of acquisitions of 6.72 ± 0.56, 10.38 ± 1.54, 4.74 ± 0.19, 5.64 ± 0.36, 7.28 ± 0.65, respectively. The overall pooled 75th percentile PKA was 15,849 µGym2. CONCLUSION: Local reference levels were identified. The pooled data has been used to establish an interim European DRL for EVAR procedures. KEY POINTS: • Abdominal endovascular aneurysm repair (EVAR) requires the use of ionising radiation. • EVAR is a minimally invasive procedure for the treatment of abdominal aortic aneurysms. • Diagnostic reference levels (DRLs) are used to monitor patient radiation exposure. • Radiation dose data was collected from five European centres for EVAR procedures. • Local DRLs have been determined and an interim European DRL is proposed.

[Pancreatic pseudocysts: apropos of a case of pancreatitis and the puerperium]. / Pseudoquistes de pancreas: a propósito de un caso de panceatitis y puerperio.

A 26 years old white patient with diagnosis of a pancreatitis and pancreatic pseudocyst during the puerperium is reported. Among the most important diagnostic procedure we have used are the endoscopy, Rx and TC. Cholecystectomy showed many small stones. Gastrocystostomy was done. Pancreatitis is as often in multiparous patients as in primipara. Near the 80% of the cases appear during the third term of pregnancy and puerperium. Many etiologycal factor play a role in the development of this disease, cholelithiasis being 65% of them. Mother-faetal mortality is near 20%.

Pseudoquistes de pancreas: a propósito de un caso de panceatitis y puerperio. / [Pancreatic pseudocysts: apropos of a case of pancreatitis and the puerperium]

A 26 years old white patient with diagnosis of a pancreatitis and pancreatic pseudocyst during the puerperium is reported. Among the most important diagnostic procedure we have used are the endoscopy, Rx and TC. Cholecystectomy showed many small stones. Gastrocystostomy was done. Pancreatitis is as often in multiparous patients as in primipara. Near the 80

of the cases appear during the third term of pregnancy and puerperium. Many etiologycal factor play a role in the development of this disease, cholelithiasis being 65

of them. Mother-faetal mortality is near 20

.

Pseudoquistes de pancreas: a proposito de un caso de pancreatitis y puerperio. / Pancreatic pseudocysts: apropos of a case of pancreatitis and puerperium

Se reporta un caso de pancreatitis y pseudoquistes pancreaticos en una paciente de 26 anos durante el puerperio. Dentro de los estudios diagnosticos efectuados, tuvieron relevancia la seriada esofagogastroduodenal, gastroduodenofibroscopia y TAC. Se efectuo en un primer tiempo colecistostomia que evidencio la presencia de numerosos calculos pequenos y en un segundo tiempo gastrocistostomia. La pancreatitis, es tan frecuente en multiparas como en las primiparas, siendo el tercer trimestre y el puerperio, los periodos que reunen casi el 80% de los casos. Las causas etiologicas son multiples, asociandose la litiasis biliar en el 65%. La mortalidad materno fetal oscila en el 20%

Pseudoquistes de pancreas: a proposito de un caso de pancreatitis y puerperio. / Pancreatic pseudocysts: apropos of a case of pancreatitis and puerperium

Se reporta un caso de pancreatitis y pseudoquistes pancreaticos en una paciente de 26 anos durante el puerperio. Dentro de los estudios diagnosticos efectuados, tuvieron relevancia la seriada esofagogastroduodenal, gastroduodenofibroscopia y TAC. Se efectuo en un primer tiempo colecistostomia que evidencio la presencia de numerosos calculos pequenos y en un segundo tiempo gastrocistostomia. La pancreatitis, es tan frecuente en multiparas como en las primiparas, siendo el tercer trimestre y el puerperio, los periodos que reunen casi el 80% de los casos. Las causas etiologicas son multiples, asociandose la litiasis biliar en el 65%. La mortalidad materno fetal oscila en el 20%