Control versus Choice in Deciding Career Pathway in Plastic Surgery: The Perfect Ratio.

Background: The decisions and components of a career in medicine have changed. Historically, a career selection was often a decision between joining an institution or academic center versus the fiscal risks associated with private practice. This created a relatively simple risk versus reward equation: those in private practice made more money if it went well.

Bias, Prejudice, Discrimination, Racism, and Social Determinants: The Impact on the Health and Well-Being of Latino Children and Youth.

This narrative review focuses on the impact of bias, prejudice, discrimination, racism (BPDR), social determinants of health, and structural racism on Latino children's health and well-being. The race/ethnicity, country of origin, immigrant/generational status, limited English proficiency (LEP), acculturation level, and social class of Latino children and their parents can heighten or modify the impact of BPDR. These differences have been shown to affect BPDR among Latino adults and presumably for their children.

Impact of Racism on the Diversification of the Pediatric Workforce.

This narrative review examines the impact of racism in academic pediatrics. We begin with our challenges in diversifying the pediatric physician workforce and the downstream impact of selection and recruitment practices compounded by disparities in resident dismissal rates. We present best practices in recruitment and resources from academic societies and institutions, including examples of successful holistic review processes.

Equity in Pediatric Hospital-Based Safety and Quality Improvement.

There are well-documented inequities in the quality of care and health outcomes of minoritized youth. Patient safety and quality improvement (QI) work with an equity focus has been identified as an important strategy to remedy these existing inequities. In this article, we will present evidence of inequities in pediatric hospital-based care, describe root causes with a focus on structural racism, highlight existing frameworks for applying equity principles to patient safety and QI, and provide best practices and recommendations on evaluating patient safety and QI data towards advancing equity in pediatric hospital-based care.

(Re)assessing Clinical Spaces: How do we Critically Provide Mental Health and Disability Support and Effective Care for Black and Brown Young People who are Impacted by Structural Violence and Structural Racism?

We open this article by asking you to consider that the magnitude of racism present in clinical spaces is much larger and more in depth than we can ever begin to cover. In this spirit, we are going to provide you with some context to think about the problem of racism and mental health and disability and ways to deconstruct the problem through the lens of structural violence and structural racism. We offer you a brief discussion on and a definition of structural violence and structural racism and then tie them to two case studies to help contextualize how racism currently exists within the medical field.

Anti-Asian American, Native Hawaiian, and Pacific Islander Racism in Academic Pediatrics: Recommendations for Training, Research, and Clinical Practice.

This paper discusses how anti-Asian American, Native Hawaiian, and Pacific Islander (AANHPI) racism affects pediatric training, research, and clinical practice. Extant research shows that racism and discrimination are social determinants of health that impact AANHPI populations, including youth. AANHPI youth face significant health disparities and a wide range of barriers to health care access.

Firearm-Related Unintentional Childhood Injury in Israel.

The rise in demand for firearm licenses in Israel due to the ongoing 2023-2024 Israel-Gaza War, coupled with the easing of regulations for issuing weapons, is expected to lead to a significant increase in the incidence of firearms among civilians. This situation calls for a special awareness of civilian populations of the dangers posed to children by the high prevalence of firearms. We therefore present trends in firearm-related incidents resulting in unintentional mortality and morbidity of children ages 0-17 between the years 2008-2023 in Israel.

Digoxin Discontinuation in Patients With HFrEF on Beta-Blockers: Implication for Future 'Knock-Out Trials' in Heart Failure.

Background: National heart failure guidelines recommend quadruple therapy with renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors for patients with heart failure with reduced ejection fraction (HFrEF), most of whom also receive loop diuretics. However, the guidelines are less clear about the safe approaches to discontinuing older drugs whose decreasing or residual benefit is less well understood. The objective of this study was to examine whether digoxin can be safely discontinued in patients with HFrEF receiving beta-blockers.

Management of Late-Term and Postterm Pregnancy.

Postterm pregnancy is defined as a pregnancy that has reached 42 weeks' gestation and late-term pregnancy includes 41 weeks' and 0 days' to 41 weeks' and 6 days' gestation. Accurate first-trimester dating is essential for determining or verifying gestational age. Ideal management of late-term and postterm pregnancy involves shared decision-making on timing of planned delivery based on risks and preferences.

Testing the Ability and Limitations of ChatGPT to Generate Differential Diagnoses from Transcribed Radiologic Findings.

Background The burgeoning interest in ChatGPT as a potentially useful tool in medicine highlights the necessity for systematic evaluation of its capabilities and limitations. Purpose To evaluate the accuracy, reliability, and repeatability of differential diagnoses produced by ChatGPT from transcribed radiologic findings. Materials and Methods Cases selected from a radiology textbook series spanning a variety of imaging modalities, subspecialties, and anatomic pathologies were converted into standardized prompts that were entered into ChatGPT (GPT-3.

Analgesic Use of Virtual Reality for Burn Dressing Changes in Low- and Middle-income Countries: A Feasibility Study.

Background: The paucity of pain management options in resource-limited settings is a significant and systemically unaddressed problem. To improve global health equity, it is important to bridge this gap in care without introducing the peril of opioid dependence. We present a proof-of-concept case series wherein virtual reality (VR) was successfully used to manage discomfort in patients undergoing burn dressing changes in sub-Saharan Africa.

Thin-film implants for bioelectronic medicine.

Bioelectronic medicine offers a revolutionary approach to treating disease by stimulating the body with electricity. While current devices show safety and efficacy, limitations, including bulkiness, invasiveness, and scalability, hinder their wider application. Thin-film implants promise to overcome these limitations.

Predictors of Early Intervention Referral after a Positive Developmental Screen in Community Primary Care Clinics.

Background: Primary care physicians (PCPs) may rely upon factors other than screening test scores in making referral decisions to developmental services. This study investigated which patient, provider, and screening test factors predict a PCP's IDEA Part C Early Intervention (EI) referral after a positive screening test result.

Methods: Child demographics, developmental screening test results and EI referral decisions were collected via medical record review of 2756 15-, 18-, 24- and 30-month well-child checks conducted at seven community primary care clinics in four Oregon counties, in 2020-2021.