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OBJECTIVE: To understand the status of pre-procedural safety practices in radiological examinations at radiology residency training institutions in various Asian regions. METHODS: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice. RESULTS: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic. CONCLUSION: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care. ADVANCES IN KNOWLEDGE: This is the first multicenter survey study to elucidate pre-procedural safety practices in radiological examinations in seven Asian regions.

Background: Growing evidence suggests that marrow adipocytes play an active role in the regulation of bone metabolism and hematopoiesis. However, research on the relationship between bone and fat in the context of hematological diseases, particularly β‐thalassemia, remains limited. Purpose: To investigate the relationship between marrow fat and cortical bone thickness in β‐thalassemia and to identify key determinants influencing these variables. Study Type: Prospective. Subjects: Thirty‐five subjects in four subject groups of increasing disease severity: 6 healthy control (25.0 ± 5.3 years, 2 male), 4 β‐thalassemia minor, 13 intermedia, and 12 major (29.1 ± 6.4 years, 15 male). Field Strength/Sequence: 3.0 T, 3D fast low angle shot sequence and T1‐weighted turbo spin echo. Assessment: Analyses on proton density fat fraction (PDFF) and R2* values in femur subregions (femoral head, greater trochanter, intertrochanteric, diaphysis, distal) and cortical thickness (CBI) of the subjects' left femur. Clinical data such as age, sex, body mass index (BMI), and disease severity were also included. Statistical Tests: One‐way analysis of variance (ANOVA), mixed ANOVA, Pearson correlation and multiple regression. P‐values <0.05 were considered significant. Results: Bone marrow PDFF significantly varied between the femur subregions, F(2.89,89.63) = 44.185 and disease severity, F(1,3) = 12.357. A significant interaction between subject groups and femur subregions on bone marrow PDFF was observed, F(8.67,89.63) = 3.723. Notably, a moderate positive correlation was observed between PDFF and CBI (r = 0.33–0.45). Multiple regression models for both PDFF (R2 = 0.476, F(13,151) = 10.547) and CBI (R2 = 0.477, F(13,151) = 10.580) were significant. Significant predictors for PDFF were disease severity (βTMi = 0.36, βTMa = 0.17), CBI (β = 0.24), R2* (β = −0.32), and height (β = −0.29) while for CBI, the significant determinants were sex (β = −0.27), BMI (β = 0.55), disease severity (βTMi = 2.15), and PDFF (β = 0.25). Data Conclusion: This study revealed a positive correlation between bone marrow fat fraction and cortical bone thickness in β‐thalassemia with varying disease severity, potentially indicating a complex interplay between bone health and marrow composition. Evidence Level: 2 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Even though COVID-19 as a global crisis is now declared over, Catholics' desire to undertake spiritual pilgrimages has not returned to pre-pandemic levels. This is a key issue that operators of Marian tourism destinations in Indonesia currently face. This study aims to help managers of Maria Cave pilgrimage destinations develop a sustainable Marian pilgrimage, particularly in Indonesia. The findings can provide valuable insights that can inform strategies to revitalise and sustain the Marian religious tourism sector in Indonesia post-COVID. Employing the case study method, the findings indicate that long-term development is critical for creating a sustainable Marian pilgrimage climate. Some of the key elements of the long-term development include pilgrimage destination managers being aware of pilgrims' needs and desires post-pandemic. Managers of tourist destinations too can no longer ignore pilgrims' demands for a safe environment free from health risks. Further, they must also take into account and address any negative or damaging aspects of these destinations. Additionally, social media marketing plays a pivotal role in the viability of pilgrimage destinations. [ABSTRACT FROM AUTHOR]

Objectives: Accurate subtyping of breast cancer is crucial for its diagnosis, management, and prognostication. This study aimed to determine the association of magnetic resonance imaging (MRI) breast features with the molecular subtype and aggressiveness of breast cancer in a multi-ethnic population. Methods: Treatment-naive patients with invasive breast carcinoma were included in this retrospective study. Breast MRI features were recorded based on the American College of Radiology-Breast Imaging Reporting and Data System (ACR-BIRADS) criteria, with tumour size, and apparent diffusion coefficient value (ADC). The statistical association was tested with Pearson Chi-Square Test of Independence for categorical data or the Kruskal-Wallis/ Mann Whitney U test for numerical data between the MRI features and molecular subtype, receptor status, tumour grade, lymphovascular infiltration (LVI) and axillary lymph node (ALN). Multinomial logistic regression was used to test the predictive likelihood of the significant features. The breast cancer subtypes were determined via immunohistochemistry (IHC) and dual-color dual-hapten in-situ hybridization (D-DISH). The expression statuses of ER, PR, and HER-2, LVI, and ALN were obtained from the histopathology report. The ER / PR / HER-2 was evaluated according to the American Society of Clinical Oncology / College of American Pathologists. Results: The study included 194 patients; 41.8% (n = 81) Chinese, 40.7% (n = 79) Malay, and 17.5% (n = 34) Indian, involving 71.6%(n = 139) luminal-like, 12.9%(n = 25) HER-2 enriched, and 15.5%(n = 30) Triple-negative breast cancer (TNBC). TNBC was associated with rim enhancement (p = 0.002) and peritumoral oedema (p = 0.004). HER-2 enriched tumour was associated with larger tumour size (p = 0.041). Luminal-like cancer was associated with irregular shape (p = 0.005) with circumscribed margin (p = 0.003). Other associations were ER-negative tumour with circumscribed margin (p = 0.002) and PR-negative with round shape (p = 0.001). Tumour sizes were larger in ER-negative (p = 0.044) and PR-negative (p = 0.022). Rim enhancement was significantly associated with higher grade (p = 0.001), and moderate peritumoral oedema with positive axillary lymph node (p = 0.002). Conclusion: Certain MRI features can be applied to differentiate breast cancer molecular subtypes, receptor status and aggressiveness, even in a multi-ethnic population. [ABSTRACT FROM AUTHOR]