Imaging of Disease and Normal Variant Patterns in Pediatric Hips.

The pediatric hip undergoes significant changes from infancy through adolescence. Proper maturation is crucial for the development of a stable and functional hip joint. Imaging interpretation of the pediatric hip requires distinguishing normal variants and maturation patterns from pathology. We review femoral ossification centers, variants, and conditions that affect the proximal femur, such as Legg-Calvé-Perthes disease; the acetabulum, such as developmental hip dysplasia; the acetabular labrum, such as femoroacetabular impingement; and synovial pathology in children through adolescence. Understanding the spectrum of hip conditions and using advanced imaging techniques are essential for the accurate diagnosis and effective management of pediatric hip disorders.

The Value of an Elective in Business and Leadership for Medical Students.

This report describes the impact of the implementation of an elective in business and leadership targeted to preclinical medical students. Of the 42 students who completed the elective, 30 (71%) completed the survey. Students reported that they had a better understanding of the U.S. healthcare system (p <.01), had a better understanding of the role of physician-leaders (p <.01), and were more inclined to pursue managerial positions in medicine during their career (p <.01). We determined that an elective in business and leadership in medicine is a valuable addition to the standard undergraduate medical curriculum to enhance medical student exposure to the principles of the business of medicine and physician leadership.

Enhancing Culturally Appropriate Care: The Role of Nurse Leaders.

Although culturally appropriate care is vital to quality of care, many barriers exist to implementing culturally appropriate care in practice. Nurse leaders are in a position where they can act toward addressing some of the barriers and engage nursing staff in strategies to promote the implementation of culturally appropriate care practices on a unit. This article is an opinion piece wherein the authors illustrate leadership strategies that advocate for and nurture a practice where nursing staff are supported to apply their culturally appropriate skills in practice.

Assessing AI-Powered Patient Education: A Case Study in Radiology.

RATIONALE AND OBJECTIVES: With recent advancements in the power and accessibility of artificial intelligence (AI) Large Language Models (LLMs) patients might increasingly turn to these platforms to answer questions regarding radiologic examinations and procedures, despite valid concerns about the accuracy of information provided. This study aimed to assess the accuracy and completeness of information provided by the Bing Chatbot-a LLM powered by ChatGPT-on patient education for common radiologic exams. MATERIALS AND METHODS: We selected three common radiologic examinations and procedures: computed tomography (CT) abdomen, magnetic resonance imaging (MRI) spine, and bone biopsy. For each, ten questions were tested on the chatbot in two trials using three different chatbot settings. Two reviewers independently assessed the chatbot's responses for accuracy and completeness compared to an accepted online resource, radiologyinfo.org. RESULTS: Of the 360 reviews performed, 336 (93%) were rated "entirely correct" and 24 (7%) were "mostly correct," indicating a high level of reliability. Completeness ratings showed that 65% were "complete" and 35% were "mostly complete." The "More Creative" chatbot setting produced a higher proportion of responses rated "entirely correct" but there were otherwise no significant difference in ratings based on chatbot settings or exam types. The readability level was rated eighth-grade level. CONCLUSION: The Bing Chatbot provided accurate responses answering all or most aspects of the question asked of it, with responses tending to err on the side of caution for nuanced questions. Importantly, no responses were inaccurate or had potential to cause harm or confusion for the user. Thus, LLM chatbots demonstrate potential to enhance patient education in radiology and could be integrated into patient portals for various purposes, including exam preparation and results interpretation.

The Association Between Food Security and Mammography Screening: Cross-Sectional Survey Results From the National Health Interview Survey.

OBJECTIVE: There are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants. METHODS: Female respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features. RESULTS: In all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P < .001) and very low food security (P < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P = .009) were less likely to report screening. DISCUSSION: In a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.

Factors associated with survey response in hand surgery research.

BACKGROUND: A low response rate is believed to decrease the validity of survey studies. Factors associated with nonresponse to surveys are poorly characterized in orthopaedic research. QUESTIONS/PURPOSES: This study addressed whether (1) psychologic factors; (2) demographics; (3) illness-related factors; and (4) pain are predictors of a lower likelihood of a patient returning a mailed survey. METHODS: One hundred four adult, new or return patients completed questionnaires including the Pain Catastrophizing Scale, Patient Health Questionnaire-9 depression scale, Short Health Anxiety Index, demographics, and a pain scale (0-10) during a routine visit to a hand and upper extremity surgeon. Of these patients, 38% had undergone surgery and the remainder was seen for various other conditions. Six months after their visit, patients were mailed the DASH questionnaire and a scale to rate their satisfaction with the visit (0-10). Bivariate analysis and logistic regression were used to determine risk factors for being a nonresponder to the followup of this study. The cohort consisted of 57 women and 47 men with a mean age of 51 years with various diagnoses. Thirty-five patients (34%) returned the questionnaire. Responders were satisfied with their visit (mean satisfaction, 8.7) and had a DASH score of 9.6. RESULTS: Compared with patients who returned the questionnaires, nonresponders had higher pain catastrophizing scores, were younger, more frequently male, and had more pain at enrollment. In logistic regression, male sex (odds ratio [OR], 2.6), pain (OR, 1.3), and younger age (OR, 1.03) were associated with not returning the questionnaire. CONCLUSIONS: Survey studies should be interpreted in light of the fact that patients who do not return questionnaires in a hand surgery practice differ from patients who do return them. Hand surgery studies that rely on questionnaire evaluation remote from study enrollment should include tactics to improve the response of younger, male patients with more pain. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Multiple field-based methods to assess the potential impacts of seismic surveys on scallops.

Marine seismic surveys are an important tool to map geology beneath the seafloor and manage petroleum resources, but they are also a source of underwater noise pollution. A mass mortality of scallops in the Bass Strait, Australia occurred a few months after a marine seismic survey in 2010, and fishing groups were concerned about the potential relationship between the two events. The current study used three field-based methods to investigate the potential impact of marine seismic surveys on scallops in the region: 1) dredging and 2) deployment of Autonomous Underwater Vehicles (AUVs) were undertaken to examine the potential response of two species of scallops (Pecten fumatus, Mimachlamys asperrima) before, two months after, and ten months after a 2015 marine seismic survey; and 3) MODIS satellite data revealed patterns of sea surface temperatures from 2006-2016. Results from the dredging and AUV components show no evidence of scallop mortality attributable to the seismic survey, although sub-lethal effects cannot be excluded. The remote sensing revealed a pronounced thermal spike in the eastern Bass Strait between February and May 2010, overlapping the scallop beds that suffered extensive mortality and coinciding almost exactly with dates of operation for the 2010 seismic survey. The acquisition of in situ data coupled with consideration of commercial seismic arrays meant that results were ecologically realistic, while the paired field-based components (dredging, AUV imagery) provided a failsafe against challenges associated with working wholly in the field. This study expands our knowledge of the potential environmental impacts of marine seismic survey and will inform future applications for marine seismic surveys, as well as the assessment of such applications by regulatory authorities.

Internet self-diagnosis in hand surgery.

BACKGROUND: Some Internet sites have programs that attempt to help patients find their diagnosis based on symptoms. This study tested the null hypothesis that there are no factors associated with correspondence between online diagnosis and the hand surgeon's diagnosis in an outpatient hand and upper extremity surgeons' office. METHODS: Eighty-six outpatients were prospectively enrolled and used WebMD® symptom checker to guess their diagnosis. We collected demographic information, hours spent on the Internet per week, and the following questionnaires: Pain Catastrophizing Scale (PCS) and Center of Epidemiologic Studies Depression scale (C-ESD). RESULTS: Thirty-three percent of online diagnoses matched the final diagnosis of the hand surgeon. Factors associated with an online diagnosis corresponding to the hand surgeon's diagnosis included sex (women) and patients who studied their symptoms online prior to the visit. The best multivariable model included sex, more years of education, and prior use of the Internet to research their medical condition and explained 15 % of the variation in correspondence of diagnosis. CONCLUSIONS: The majority of online diagnoses for hand and upper extremity conditions do not correspond with the diagnosis of the treating hand surgeon. Psychological factors do not influence the correspondence of online diagnosis with the hand surgeon's diagnosis. LEVEL OF EVIDENCE: Prognostic, level II.