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Osteoid osteoma is a benign bone tumor commonly affecting young individuals, with a rare occurrence in older adults. It typically presents with night pain relieved by nonsteroidal anti-inflammatory drugs and is characterized radiographically by a small, radiolucent nidus surrounded by reactive sclerosis. We present a 70-year-old female patient with persistent right hip pain, initially diagnosed as arthritis, who underwent total hip arthroplasty. Preoperative imaging findings were inconclusive, showing edema and degenerative changes without a definitive lesion. Histopathological examination of the arthroplasty specimen revealed a nodule consistent with osteoid osteoma. This report highlights the diagnostic challenge of osteoid osteoma in elderly patients, where symptoms may be atypical and overlap with other conditions like osteoarthritis., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Conventional pelvic exenteration (PE) comprises the removal of all or most central pelvic organs and is established in clinical practise. Previously, tumours involving bone or lateral sidewall structures were deemed inoperable due to associated morbidity, mortality, and poor oncological outcomes. Recently however high-complexity PE is increasingly described and is defined as encompassing conventional PE with the additional resection of bone or pelvic sidewall structures. This observational cohort study aimed to assess surgical outcomes, health-related quality of life (HrQoL), decision regret, and costs of high-complexity PE for more advanced tumours not treatable with conventional PE. Methods: High-complexity PE data were retrieved from a prospectively maintained quaternary database. The primary outcome was overall survival. Secondary outcomes were perioperative mortality, disease control, major morbidity, HrQoL, and health resource use. For cost-utility analysis, a no-PE group was extrapolated from the literature. Results: In total, 319 cases were included, with 64 conventional and 255 high-complexity PE, and the overall survival was equivalent, with medians of 10.5 and 9.8 years ( p = 0.52), respectively. Local control ( p = 0.30); 90-day mortality (0.0% vs. 1.2%, p = 1.00); R0-resection rate (87% vs. 83%, p = 0.08); 12-month HrQoL ( p = 0.51); and decision regret ( p = 0.90) were comparable. High-complexity PE significantly increased overall major morbidity (16% vs. 31%, p = 0.02); and perioperative costs (GBP 37,271 vs. GBP 45,733, p < 0.001). When modelled against no surgery, both groups appeared cost-effective with incremental cost-effectiveness ratios of GBP 2446 and GBP 5061. Conclusions: High-complexity PE is safe and feasible, offering comparable survival outcomes and HrQoL to conventional PE, but with greater morbidity and resource use. Despite this, it appears cost-effective when compared to no surgery and palliation.

Objective: To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity., Methods: Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome., Results: Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n = 24 studies), followed by global ED psychopathology (n = 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma., Conclusion: Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention., (© 2024 The Author(s). Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Purpose: A sensorimotor examination is the gold standard for strabismus diagnosis and quantification but requires a highly skilled examiner and may be limited by a child's cooperation. Virtual reality (VR) employs eye-tracking technology to monitor eye position and may be able to measure strabismus. The aim of this study was to assess a prototype VR-simulated alternate cover test to detect and measure strabismus., Design: Prospective, masked diagnostic test study., Methods: Patients aged 5-18 years with visual acuity of 20/80 or better were prospectively enrolled to undergo strabismus measurements using a VR simulated alternate cover test (Olleyes, Inc., Summit, NJ) followed by an alternate cover test performed by a masked pediatric ophthalmologist or orthoptist. The main outcome measure was correlation between gold standard and VR-obtained strabismus measurements (in prism diopters [PD]) in primary gaze at near using Pearson correlation coefficients and Bland-Altman analysis with limits of agreement (LOA). A secondary measure was the diagnostic accuracy for the VR headset to detect strabismus., Results: A total of 85 participants were enrolled, mean ± standard deviation age was 10.8 ± 3.8 years, 45.9% (39/85) male. 40.0% (34/85) had strabismus: 17.7% (15/85) esotropia, 22.4% (19/85) exotropia, and 5.9% (5/85) vertical strabismus. 52.9% (18/34) of strabismus was intermittent. The overall correlation between VR and gold standard strabismus measurements was moderate but significant (r = 0.42, 95% CI 0.22, 0.58, P < .001), and correlation was strong for esotropia and constant deviations (r = 0.74, 95% CI 0.38, 0.91, P = .001 and r = 0.74, 95% CI 0.39, 0.91, P < .001, respectively). In participants with horizontal strabismus, Bland-Altman analysis showed a mean difference between standard and VR measurements of 3.55 ± 8.33 PD for esotropia (upper and lower LOA 19.89, -12.78 PD) and 17.15 ± 11.20 PD for exotropia (LOA 39.09 and -4.79 PD). Sensitivity for detecting strabismus was low: 27.6% (95% CI 12.7, 47.2), but specificity was high: 87.5% (95% CI 75.9, 94.8)., Conclusions: A prototype VR simulated alternate cover test showed a moderate but significant correlation with the gold standard sensorimotor examination and correlation was strong in those with esotropia and constant deviations. While the level of agreement demonstrated by this novel VR technology is promising, further improvements are needed before clinical deployment. However, this study demonstrates that VR has the potential to expand our ability to detect, measure, and monitor strabismus., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Aim: To examine undergraduate nursing students' sense of belonging as they transitioned from online to in-person learning., Design: A mixed-method design employing a Sense of Belonging Survey and three open-ended questions., Methods: Participants were first-year undergraduate nursing students who were back to in-person learning after 3 years of online learning during the pandemic. The survey was administered online in April 2023 using Qualtrics survey software. The survey data were analysed using descriptive statistics, and the open-ended questions were analysed by deductive thematic analysis., Results: Seventy-five (48%) of the 155 potential participants responded to the survey. The mean score on the Sense of Belonging Survey was 74%, a positive finding suggesting that many participants feel that they 'belong' in the classroom. Three overarching themes were identified in response to the open-ended questions: factors supporting students' sense of belonging, factors hindering students' sense of belonging and strategies for faculty, administrators and students to increase a sense of belonging., Conclusion: Understanding the factors that contribute to or hinder nursing students' sense of belonging during this transition will assist in developing strategies to mitigate challenges, foster a positive learning environment and enhance the overall sense of belonging among nursing students., Impact: The first year of a nursing programme is crucial for student retention as students require tailored programmes and strategies to support their success. Examining and analysing the transition from online to in-person classroom settings is crucial to identifying strategies to enhance and support first-year students' sense of belonging and academic success. Exploring nursing students' experiences of belonging during transitions contributes to a more inclusive and equitable educational experience, fostering an environment where all students can thrive and succeed., Patient or Public Contribution: Not applicable., (© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)