BACKGROUND: Acute pancreatitis is observed more frequently in the pediatric age. Currently, there are recommendation guidelines for its proper diagnosis and treatment. The objective of this study was to evaluate the level of knowledge of the international recommendations on acute pancreatitis in pediatrics of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition in a group of pediatricians.
METHODS: Observational, multicenter study, through a survey applied to pediatricians and pediatric residents.
RESULTS: 48.8% of physicians had prior knowledge of the guidelines for the treatment of acute pancreatitis in children. 72.4% knew the current criteria for the diagnosis of acute pancreatitis. There were no differences in the majority of responses between pediatricians and pediatric residents.
CONCLUSIONS: Although only half of the respondents followed the guidelines for diagnosis and treatment of acute pancreatitis, about three-quarters adequately use the criteria for diagnosis. There is adequate knowledge about the prescription of antibiotics and pancreatitis follow-up. There is lack of knowledge on the recommendation of monitoring vital signs and the precise time to perform cholecystectomy in the pancreatitis of biliary origin.
UNASSIGNED: La pancreatitis aguda se observa con mayor frecuencia en la edad pediátrica. Actualmente existen guías de recomendaciones para su adecuado diagnóstico y tratamiento. El objetivo de este estudio fue evaluar el nivel de conocimiento de las recomendaciones internacionales sobre pancreatitis aguda de la North American Society for Pediatric Gastroenterology, Hepatology and Nutrition en un grupo de pediatras.
UNASSIGNED: Estudio observacional, multicéntrico, mediante una encuesta aplicada a médicos pediatras y médicos pediatras en formación.
RESULTS: El 48.8% de los médicos tenían conocimiento de las guías para tratamiento de pancreatitis aguda en niños. El 72.4% conocían los criterios actuales para el diagnóstico de pancreatitis aguda. No hubo diferencias en la mayoría de las respuestas entre médicos pediatras y médicos pediatras en formación.
CONCLUSIONS: Aunque solo la mitad de los encuestados conocían la guía para el diagnóstico y el tratamiento de la pancreatitis aguda, cerca de tres cuartas partes utilizan adecuadamente los criterios para el diagnóstico. Existe adecuado conocimiento sobre la prescripción de antibióticos y el seguimiento posterior a la pancreatitis aguda. Hay déficit en el conocimiento sobre las recomendaciones de la monitorización de los signos vitales y el momento adecuado para realizar la colecistectomía ante una pancreatitis de origen biliar.

BACKGROUND: The Restylane portfolio of soft tissue fillers spans a wide range of indications, due in part to their complementary manufacturing technologies [non-animal stabilized hyaluronic acid (NASHA) and Optimal Balance Technology (OBT/XpresHAn)]. Using an array of products, injectors can achieve a holistic, natural looking effect for their patients. However, with a wide range of products it may be difficult to choose an optimal combination.
OBJECTIVE: Simplify and align global use recommendations for NASHA versus OBT products.
METHODS: Two pre-meeting surveys were completed by 11 key opinion leaders with international representation, with the goal of collecting information regarding their current injection practices for various anatomical regions of the face (i.e., temporal region, forehead, tear trough, lateral zygoma, anteromedial cheek, nose, pyriform aperture, nasolabial fold, perioral area, lips, labiomental crease, marionette lines, chin, and jawline). The data collected from these surveys was subsequently discussed in a consensus group meeting involving 11 voting members and 3 nonvoting members.
RESULTS: Top product recommendations were identified for each anatomical area, along with secondary and tertiary recommendations that can also be used under defined circumstances. Recommendations were provided based on a consideration of elements such as patient features (e.g., skin thickness, bone structure), the desired aesthetic outcome, experience of the injector, and the preferred injection technique.
CONCLUSIONS: A majority consensus regarding the top NASHA versus OBT product choice for each anatomical region of the face was reached. These recommendations represent international agreement regarding the use of Restylane products.

BACKGROUND: Given the increasing adoption of clinical ultrasound in medicine, it is essential to standardize its application, training, and research.
OBJECTIVE: The purpose of this document is to provide consensus recommendations to address questions about the practice and operation of clinical ultrasound units. Nineteen experts and leaders from advanced clinical ultrasound units participated. A modified Delphi consensus method was used.
RESULTS: A total of 137 consensus statements, based on evidence and expert opinion, were considered. The statements were distributed across 10 areas, and 99 recommendations achieved consensus.
CONCLUSIONS: This consensus defines the most important aspects of clinical ultrasound in the field of Internal Medicine, with the aim of standardizing and promoting this healthcare advancement in its various aspects. The document has been prepared by the Clinical Ultrasound Working Group and endorsed by the Spanish Society of Internal Medicine.

BACKGROUND: In order to eliminate tuberculosis (TB) in the USA, primary care providers must take on an expanded role in the diagnosis and management of latent tuberculosis infection (LTBI). Clinical practice guidelines and recommendations exist for LTBI management, but there is a need for innovative tools to improve medical students\' and residents\' knowledge of evidence-based practices for LTBI testing and treatment.
OBJECTIVE: To assess the impact of LTBI-ASSIST, a free online decision support aid, as a novel educational tool and mechanism of delivering clinical practice guidelines for medical trainees.
METHODS: A single site, randomized controlled trial of trainees delivered by electronic survey.
METHODS: Medical students and Internal Medicine residents at the Johns Hopkins University School of Medicine.
METHODS: Participants were randomized in 1:1 ratio to receive the US clinical practice guidelines and recommendations for Latent TB management (control arm) or the guidelines plus an introduction to LTBI-ASSIST (LTBI-ASSIST arm) as they completed a case-based knowledge assessment and reported confidence with domains of LTBI care.
METHODS: (1) Proportion of questions answered correctly on a case-based knowledge assessment; (2) change in reported confidence with domains of LTBI care.
RESULTS: One hundred and thirty participants completed the knowledge assessment. Those randomized to receive the LTBI-ASSIST Tool performed better on the case-based knowledge assessment with a mean score of 75.9% (95% CI: 70.6-81.1), compared to 57.4% (52.8-62.0) in the group that received the guidelines only (p <0.001). Similarly, the LTBI-ASSIST group reported a higher change in confidence (measured as post-assessment confidence minus pre-assessment confidence), compared to the control group, in six of the seven domains of LTBI care.
CONCLUSIONS: LTBI-ASSIST can be an effective supplement to existing guidelines in educating medical trainees and helping providers find evidence-based, guideline-supported answers for questions encountered in clinical practice.
BACKGROUND: NIH Clinical Trial Registry No. NCT05772065.

BACKGROUND: The integration of artificial intelligence (AI) into clinical practice is transforming both clinical practice and medical education. AI-based systems aim to improve the efficacy of clinical tasks, enhancing diagnostic accuracy and tailoring treatment delivery. As it becomes increasingly prevalent in health care for high-quality patient care, it is critical for health care providers to use the systems responsibly to mitigate bias, ensure effective outcomes, and provide safe clinical practices. In this study, the clinical task is the identification of heart failure (HF) prior to surgery with the intention of enhancing clinical decision-making skills. HF is a common and severe disease, but detection remains challenging due to its subtle manifestation, often concurrent with other medical conditions, and the absence of a simple and effective diagnostic test. While advanced HF algorithms have been developed, the use of these AI-based systems to enhance clinical decision-making in medical education remains understudied.
OBJECTIVE: This research protocol is to demonstrate our study design, systematic procedures for selecting surgical cases from electronic health records, and interventions. The primary objective of this study is to measure the effectiveness of interventions aimed at improving HF recognition before surgery, the second objective is to evaluate the impact of inaccurate AI recommendations, and the third objective is to explore the relationship between the inclination to accept AI recommendations and their accuracy.
METHODS: Our study used a 3 × 2 factorial design (intervention type × order of prepost sets) for this randomized trial with medical students. The student participants are asked to complete a 30-minute e-learning module that includes key information about the intervention and a 5-question quiz, and a 60-minute review of 20 surgical cases to determine the presence of HF. To mitigate selection bias in the pre- and posttests, we adopted a feature-based systematic sampling procedure. From a pool of 703 expert-reviewed surgical cases, 20 were selected based on features such as case complexity, model performance, and positive and negative labels. This study comprises three interventions: (1) a direct AI-based recommendation with a predicted HF score, (2) an indirect AI-based recommendation gauged through the area under the curve metric, and (3) an HF guideline-based intervention.
RESULTS: As of July 2023, 62 of the enrolled medical students have fulfilled this study\'s participation, including the completion of a short quiz and the review of 20 surgical cases. The subject enrollment commenced in August 2022 and will end in December 2023, with the goal of recruiting 75 medical students in years 3 and 4 with clinical experience.
CONCLUSIONS: We demonstrated a study protocol for the randomized trial, measuring the effectiveness of interventions using AI and HF guidelines among medical students to enhance HF recognition in preoperative care with electronic health record data.
UNASSIGNED: DERR1-10.2196/49842.

UNASSIGNED: Script concordance testing is widely practiced to foster and assess clinical reasoning. Our study aimed to develop script concordance test (SCT) in the specialty of otolaryngology and test the validation using panel response pattern and consensus index.
UNASSIGNED: The methodology was an evolving pattern of constructing SCTs, administering them to the panel members, and optimizing the panel with response patterns and consensus index. The SCT\'s final items were chosen to be administered to the students.
UNASSIGNED: We developed 98 items of SCT and administered them to 20 panel members. The mean score of the panel members for these 98 items was 79.5 (standard deviation [SD] = 4.4). The consensus index calculated for the 98-item SCT ranged from 25.81 to 100. Sixteen items had bimodal and uniform response patterns; the consensus index improved when eliminated. We administered the rest 82 items of SCT to 30 undergraduate and ten postgraduate students. The mean score of undergraduate students was 61.1 (SD = 7.5) and that of postgraduate students was 67.7 (SD = 6.3). Cronbach\'s alpha for the 82-item SCT was 0.74. Excluding the 22 poor items, the final SCT instrument of 60 items had a Cronbach\'s alpha of 0.82.
UNASSIGNED: Our study revealed that a consensus index above 60 had a good item-total correlation and be used to optimize the items for panel responses in SCT, necessitating further studies on this aspect. Our study also revealed that the panel response clustering pattern could be used to categorize the items, although bimodal and uniform distribution patterns need further differentiation.

The present study aimed to compile and develop a professional guideline for health-care providers in Iran regarding cyberspace usage. This was a mixed-methods study, conducted in three phases. In the first phase, the principles of ethics in cyberspace were collected through a review of the literature and available documents, and were then subjected to content analysis. In the second phase, the views of experts on medical ethics, virtual education, information technology and medical education, as well as clinical sciences experts and representatives of medical students and graduates were evaluated using the focus group method. In the third phase, the draft was evaluated by various stakeholders. Finally, after receiving the comments, the necessary modifications were applied to the guideline. The professional guideline for the use of cyberspace by health-care professionals comprised 30 codes in 5 domains, including the general regulations domain, care and treatment, research, education, and personal development. This guideline presents the various ways professionalism can be maintained in cyberspace interactions. Adherence to the principles of professionalism in cyberspace is required to protect and preserve the public trust in health-care professionals.

Medical care must be supported by research that meets reliable, valid, ethical, and reproducible principles. However, an essential fraction of research carried out in the medical field is inadequately reported due to omitting relevant information when it is published. This reduces their impact and the possibility that other researchers can realize critical appraisal, thereby compromising their application within medical practice. Because of this, guidelines have been developed to reduce this problem; their purpose is to increase research reports\' methodological quality, transparency, validity, and reliability. Despite their importance, incorporating these guidelines in various journals and the knowledge and use by a significant part of the medical community is limited. In this context, this article aims to synthesize the main guidelines for reporting research in medicine.
La atención médica debe estar sustentada en investigaciones que cumplan principios confiables, válidos, éticos y reproducibles; sin embargo, una parte importante de las investigaciones realizadas en el campo médico son reportadas de manera inadecuada debido a que omiten información de trascendencia cuando son publicadas, lo cual disminuye su impacto y la posibilidad de que otros investigadores puedan evaluarlas de manera crítica y objetiva, comprometiendo con ello su aplicación dentro de la práctica médica. En un esfuerzo por atenuar este problema se han desarrollado guías cuya finalidad es incrementar la calidad metodológica, la transparencia, la validez y la fiabilidad de los reportes de investigación. No obstante su importancia, la incorporación de estas guías en diversas revistas, así como su conocimiento y utilización por una parte importante de la comunidad médica, son limitados. Dado este contexto, el objetivo del presente artículo es sintetizar las principales guías que existen para reportar investigaciones en medicina.

Wilderness medicine education is one of the fastest growing facets of both graduate and undergraduate medical education. Currently, there are curriculum guidelines for both student electives and fellowships in wilderness medicine. However, there are no guidelines for resident elective curricula. The student/resident education committee of the Wilderness Medical Society (WMS) convened a task force to develop curriculum guidelines for these electives.
A survey of previously described core wilderness medicine topics was sent to a cohort of educators involved in wilderness medicine resident electives. They were asked to rank topics on the basis of their importance of being included on a Likert scale. Multivariate analysis of medians was used to distinguish among topics to determine which topics were voted most and least necessary for a curriculum.
Of the database members contacted, 35 responded to the survey. The described current state of residency electives was that 16 institutions offered their own elective (46%). For subject preferences, multivariate analysis of scoring distribution medians demonstrated a significantly higher pattern of responses (P<0.01) for subjects with a median of 3 (must include) than for the lowest-scoring subjects that had a median of 1 (can include). Every topic was rated \"must\" by at least 1 respondent. Topics were further subdivided into an educational framework reflecting a common approach to education of wilderness medicine fellows focusing on education, leadership, knowledge, and skills.
There was a wide variety in the ranking of topics; however, there were multiple topics on which a consensus for inclusion was reached. These topics are organized and presented here as a suggested curriculum by the student/resident education committee of the WMS.

The novel coronavirus disease (COVID-19) pandemic has dramatically changed education systems as most governments around the world closed schools to prevent outbreaks on campus. Medical education was not immune from these policies, and medical students were deprived of opportunities, particularly in clinical training. To determine how countries worldwide have responded to the pandemic, we conducted a literature review of the policies and guidelines of four countries: Japan, the United States (USA), the United Kingdom (UK) and Australia, as well as case reports of faculty and medical students up to September, 2020. Although the methods of implementation were unique to each country, the concept of \"returning medical students to live education as quickly and safely as possible\" was common. However, the extent to which students and faculty members became engaged in the treatment process of COVID-19 varied. While some countries endorsed students to work as members of medical staff to treat COVID-19, other countries took measures to ensure the safety of both medical students and patients. We await further reports worldwide in order to better understand the strategies employed by different nations in preparation for future possible infection outbreaks.