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Introduction: Radiologic interpretation is a skill necessary for all physicians to provide quality care for their patients. However, some medical students are not exposed to Digital Imaging and Communications in Medicine (DICOM) imaging manipulation until their third year during clinical rotations. The objective of this study is to evaluate how medical students exposed to DICOM manipulation perform on identifying anatomical structures compared to students who were not exposed., Methods: This was a cross-sectional cohort study with 19 medical student participants organized into a test and control group. The test group consisted of first-year students who had been exposed to a new imaging anatomy curriculum (n = 9). The control group consisted of second-year students who had not had this experience (n = 10). The outcomes measured included quiz performance, self-reported confidence levels, and eye-tracking data., Results: Students in the test group performed better on the quiz compared to students in the control group (p = 0.03). Confidence between the test and control groups was not significantly different (p = 0.16), though a moderate to large effect size difference was noted (Hedges' g = 0.75). Saccade peak velocity and fixation duration between the groups were not significantly different (p = 0.29, p = 0.77), though a moderate effect size improvement was noted in saccade peak velocity for the test group (Hedges' g = 0.49)., Conclusion: The results from this study suggest that the early introduction of DICOM imaging into a medical school curriculum does impact students' performance when asked to identify anatomical structures on a standardized quiz., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Edward Via College of Osteopathic Medicine Institutional Review Board issued approval (2022-086). The Edward Via College of Osteopathic Medicine Institutional Review Board, Blacksburg, VA deemed this project exempt. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Worley et al.)

Introduction Medical education is a rigorous and demanding journey that requires intellectual ability and emotional resilience. Burnout among medical students is a growing concern as it affects individuals' well-being and can have long-term implications on the quality of patient care. Recognizing the protective effects of healthy lifestyle factors such as sleep, physical activity, eating patterns, and screen time, various institutions have implemented wellness programs to promote students' mental and physical well-being. Objectives The main objective of this study was to assess for variations and associations between first- and second-year osteopathic medical students' physical activity, eating patterns, sleep, perceived stress, and phone screen use across 10 different time points throughout the school year. The secondary objective was to assess the impact of month-long health behavior challenges among participants in the five areas studied. Methods A prospective cohort study was performed regarding first- and second-year medical students' physical activity, eating patterns, sleep, perceived stress, and phone screen use, as respectively assessed by the Physical Activity Vital Sign and smartphone step count data; Starting the Conversation diet assessment; Single Item Sleep Quality Scale and a portion of the Pittsburgh Sleep Quality Index; Perceived Stress Scale; and smartphone screen time use data. The assessments, built-in Qualtrics (Qualtrics International Inc., Provo, USA), were sent via email and class-wide GroupMe text message at 10-time points, capturing the beginning, middle, and end of curricular blocks and seasonal breaks. Participants could win one of 20 $25 Amazon gift cards each time they completed the assessment. Behavior challenges were implemented at six of the 10-time points and focused on facilitating health behavior change among participants. Results The response rate for the 10 assessments was low, ranging from 7% to 13%. The means (±SD) for each outcome of interest combined across the 10 time points were as follows: physical activity = 112 (±100) minutes/week; step count = 4,627 (±3179) steps/day; water intake = 5.6 (±4.0) cups/day; diet score = 6.3 (±2.1) where 0 = most healthful and 16 = least healthful; perceived stress = 6.6 (±5.8) where 0 = lowest and 40 = highest; sleep = 6.7 (±1.0) hours/night; sleep quality = 6.3 (±1.8) where 0 = terrible and 10 = excellent; and phone screen time = 328.5 (±147) minutes/day. Statistical analysis indicated variation (p<0.05) in physical activity minutes, steps per day, water intake, diet score, and phone screen time minutes over time. Given low participation, only 6 of the 10 behavior challenges were implemented, in which the participation rate ranged from 36% to 65% of assessment participants. Conclusion Results indicate room for improvement regarding lifestyle factors among medical students' physical activity, eating patterns, sleep, perceived stress, and phone screen time use. A primary limitation of this study is the low participation rate. Building on these efforts, students are developing and delivering monthly wellness workshops, including a research component., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Edward Via College of Osteopathic Medicine (VCOM) Institutional Review Board issued approval 2022-037. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: The budget of this project consisted entirely of incentives to maximize participation in the 10 time-point assessments. Two hundred Amazon gift cards worth $25 each were ordered (total budget of $5,000), supplying 20 gift cards per assessment. Participants were entered into a lottery to win 1 of 20 gift cards for each assessment that they completed. The funding/sponsor was the American Association of Colleges of Osteopathic Medicine (AACOM). No conflicts of interest with this project and the funding are identified. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Machireddy et al.)

Purpose: This study asked whether, if provided with education on heart-healthy habits, elementary school children in Abbeville, Greenwood, and Saluda counties in South Carolina would retain and desire to implement healthy nutrition and increased exercise. We hypothesized that teaching children about heart-healthy habits would increase their activity levels and improve their desire to be active., Methods: This was a longitudinal survey study. Children at local after-school programs were given a pre-survey, the Kids' Activity and Nutrition Questionnaire (KAN-Q), to assess their activity levels, diet, and knowledge of heart health. The children had a 15-minute educational period followed by an interactive program. Students completed the same survey at each of the three sessions., Findings: A total of 44 children answered the survey questions at the beginning of each session. Out of the 10 behavioral questions, six indicated a favorable shift towards adopting healthier habits. Whole grain consumption increased to 71% from 32% ( p <0.01). Vegetable consumption increased from 39% to 88%, and fruit consumption increased from 68% to 92% ( p <0.01). There was a 30% decrease in the consumption of sugary drinks ( p <0.01), and a reduction in hours watching television ( p =0.05). All four knowledge-based questions had an increase in correct responses across the three sessions ( p <0.01)., Conclusion: To augment behavior, a dual approach of education on nutrition and exercise leads to improved nutrition choices and exercise habits for primary prevention of cardiovascular risk factors in elementary school-aged children. These habits improve adherence to increased physical activity and better nutrition after school., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Edward Via College of Osteopathic Medicine Institutional Review Board issued approval 1937076-4. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Deal et al.)

Purpose Community screening programs have been in effect since they were utilized in the 19th century at county fairs. A free pediatric health screening program was created by an osteopathic medical school in South Carolina in collaboration with a pediatric dental outreach organization to engage the local underserved community and train community-minded medical professionals. This study sought to demonstrate the efficacy and need for a student-run monthly pediatric health screening program in an underserved pediatric demographic. Methods A retrospective study of preexisting de-identified data obtained from a student-run health screening program was analyzed to determine the efficacy of the screening program in detecting chronic health risk factors in children in an underserved population. Patients were recruited through a partnership with a free dental clinic for underserved and uninsured children. Patients who attended the clinic were offered the opportunity to have a free, comprehensive health assessment following their dental visit. The function of this program was unique in that uninsured, underserved patients were provided free dental care and a free health assessment. Pediatric patients were screened for basic health information such as weight, height, BMI, vision, cardiovascular health, hypertension, asthma (reported via questionnaire by either the parent or child when applicable), nutrition, and lead poisoning (via questionnaire). The program also offered families additional support by connecting them to local resources and answering any questions they had about their children's health. Data from 14 health screening events was collected for quality improvement and efficacy monitoring. Descriptive analyses were performed. Results and analysis The health screening program assessed 124 children between October 2021 and March 2023 over 14 health screening events. The patients ranged from one year old to 26 years old, with a mean age of 9.65 years. Patients were predominantly Hispanic (79.67%). About one-third (27.64%) of children who were screened had positive findings associated with increased risk for chronic disease. Nearly half (43.90%) of families that were screened requested further information on ways to obtain health insurance and regular primary care services (utilized Access Health). Of the one-third of children with positive risk factors, 12.20% reported positive findings associated with asthma. Of the patients with positive risk factors, 8.94% had vision abnormalities, most of whom had not been seen by an ophthalmologist. This preliminary analysis will be followed by a secondary analysis that further investigates patient demographics (primarily Hispanic) as well as age distribution across various risk factors. Conclusion This pediatric health screening program has demonstrated a basic level of efficacy by successfully identifying increased risk for chronic disease in the underserved pediatric population. The need for these screening events was highlighted by the identification of untreated positive findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Munz et al.)

This study aims to provide an updated review comparing the complication rates and clinical outcomes of intramedullary nails and locking plates (LPs) in displaced proximal humerus fracture (PHF) management. We performed a systematic review of the Cochrane Central Register of Controlled Trials, Clinical Trials Registry, EMBASE, and PubMed. Studies with level III evidence or higher comparing intramedullary nails and LPs used for internal fixation of displaced PHFs were included. The Methodological Index for Nonrandomized Studies (MINORS) criteria and Cochrane Handbook for Systematic Reviews of Interventions 5.2.0 were used to assess the risk of bias. Our meta-analysis included a comparison of method-related complications, pain scores, range of motion (ROM), and functional scores. A total of 13 comparative studies were included: five randomized controlled trials, three prospective cohort studies, and five retrospective cohort studies. The total number of patients included was 1,253 (677 in the LP group and 576 in the intramedullary nail group). Superior Constant-Murley scores and external rotation ROM were found in the LP group during the early postoperative period. However, long-term functional scores and complication rates were comparable between the two groups. We conclude that intramedullary nailing and LP fixation are both equally effective for the treatment of displaced PHFs. Neither treatment appears superior at this time, and more large-scale randomized controlled trials should be conducted to further evaluate the potential benefit of LPs in the early postoperative period., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, D'Almeida et al.)

Objective To determine knowledge and comfort in discussing the human papillomavirus (HPV) vaccine among a sample of physicians practicing in South Carolina. Methods This descriptive cross-sectional study utilized a 33-question survey assessing knowledge of HPV, the HPV vaccine, and comfort in discussing associated topics with patients among a sample of physicians across the state of South Carolina. Descriptive and correlational analyses were performed. Results Of the total 66 participants, most self-reported having sufficient knowledge about HPV, yet responses to fact-based questions yielded an average score of only 7.03/13. Most felt comfortable discussing HPV, while some reported discomfort discussing sex-related topics (3.6%). A positive significant correlation was determined between having sufficient knowledge of HPV and comfort levels discussing both HPV and sex-related topics ((p-value < 0.001), (p = .0028)), comfort levels discussing HPV and comfort levels discussing sex (p = .0030), and comfort level discussing sex and previous communication training (Mantel-Haenszel chi-square = 0.0447). Conclusions The results of this study support the role of future interventions aimed at increasing the HPV knowledge base and training in discussions of sex for providers to help increase HPV vaccination rates in South Carolina., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Diaz Rijo et al.)