3. A Newly Established Quality and Competency "Making Use of Information, Science and Technology" / 医学教育

Due to the importance of developing physicians' competencies to utilize information, science, and technology, the 2022 revision of the Model Core Curriculum for Medical Education newly established guidelines for qualities and competencies, which it refers to as "Competencies to utilize information, science, and technology." The Model Core Curriculum outlines these qualities as "understanding the ever-developing information society and practicing medical research and treatment while utilizing information, science and technology such as artificial intelligence." The guidelines are organized by the three perspectives of "ethical viewpoints and rules for dealing with information, science and technology," "principles of information, science and technology necessary for medicine and its surrounding society," and "utilization of information, science and technology in the medical field." The objectives of the course were set from the three perspectives of "ethics and rules for dealing with information, science and technology," "principles of information, science and technology necessary for medicine and the society surrounding it," and "utilization of information, science and technology in medical practice." We looked back on the process of formulating these qualities and competencies, which will become increasingly important, and discussed their future prospects.

Low-flow aortic stenosis and preserved left ventricular ejection fraction.

Valvular aortic stenosis (AS) is the most frequent valvular disease in developed countries. Treatment decisions in AS are mainly based upon the symptomatic status of the patient and the severity of AS. Doppler echocardiography represents the standard tool for detecting and assessing the severity of the disease. Under the same denomination of severe AS [aortic valve area (AVA) < 1 cm(2)], several entities might be identified that differ in terms of trans-valvular flow rates and pressure gradients development. From a clinical standpoint, severe AS (AVA < 1 cm(2)) can be subdivided into 4 flow-gradient patterns: normal flow/low gradient (NF/LG), normal flow/high gradient (NF/HG), low flow/high gradient (LF/HG) and low flow/low gradient (LF/LG). The most commonly described entity is the paradoxical low-flow, low-gradient severe AS state, in which the stroke volume is unexpectedly reduced, despite preserved left ventricular (LV) ejection fraction. In daily practice, misdiagnosing this clinical condition might lead to an inappropriate timing of follow-up with an unnecessary delay of aortic valve replacement (AVR), which may, in turn, have a negative impact on patient outcome.