La inteligencia artificial en los procesos editoriales y la evaluación por pares / Artificial Intelligence in the Editorial Process and Peer Review

Resumen La narrativa mitológica de Epimeteo y Prometeo, retratada por Platón, sirve de introducción a la importancia de la inteligencia artificial (IA). El hombre se caracteriza en este mito, frente al resto de criaturas, por tener un don divino: la capacidad de crear herramientas. La IA representa un avance revolucionario al sustituir la labor intelectual humana, destacando su capacidad para generar nuevo conocimiento de forma autónoma. En el ámbito científico, la IA agiliza la revisión por pares y mejora la eficiencia en la evaluación de manuscritos, además de aportar elementos creativos, como la reescritura, traducción o creación de ilustraciones. Sin embargo, su implementación debe ser ética, limitada a un asistente y bajo la supervisión experta para evitar errores y abusos. La IA, una herramienta divina en evolución, requiere que cada uno de sus avances se estudie y aplique críticamente.

Abstract The mythological story of Epimetheus and Prometheus, as told by Plato, serves as an introduction to the meaning of artificial intelligence (AI). In this myth, man, unlike other creatures, is endowed with a divine gift: the ability to create tools. AI represents a revolutionary advance, replacing human intellectual labour and emphasising its ability to autonomously generate new knowledge. In the scientific field, AI is speeding up peer review processes and increasing the efficiency of manuscript evaluation, while also contributing creative elements such as rewriting, translating or creating illustrations. However, its use must be ethical, limited to an assisting role, and subject to expert oversight to prevent errors and misuse. AI, an evolving divine tool, requires critical study and application of each of its advances.

Fatores clínicos do bem-estar de mulheres em parturição: perspectivas deontológicas e da bioética principialista / Clinical factors of women in labor well-being: deontological and bioethical principlism perspectives / Factores clínicos del bienestar de la mujer en trabajo de parto: perspectivas deontológicas y de la bioética principialista

Objetivo: avaliar os fatores clínicos associados ao bem-estar das mulheres durante o trabalho de parto e parto à luz da bioética principialista e da deontologia. Método: estudo transversal com abordagem quantitativa. Participaram 396 puérperas internadas em um hospital municipal do sudoeste da Bahia, e os dados foram coletados no período de janeiro a maio de 2023, após aprovação do comitê de ética em pesquisa. Os dados foram organizados no software Excel e analisados via SPSS v.25. a partir da regressão logística multinomial. Resultados: a maior parte da amostra apresentou bem-estar com assistência em saúde, mulheres que tiveram parto realizado por profissionais não médicos apresentaram mais chances de níveis de bem-estar "adequado". E mulheres que não tiveram a via de parto cesárea apresentaram aumento de chances de bem-estar. Conclusão: é necessário que os profissionais reflitam sobre suas ações, condicionando-as à humanização no parto, em observância aos princípios bioéticos.

Objective: to evaluate the clinical factors associated with women's well-being during labor and delivery in the light of bioethics principlism and deontology. Method: a cross-sectional study with a quantitative approach was conducted. It involved 396 postpartum women admitted to a municipal hospital in the southwest of Bahia. Data were collected from January to May 2023, after approval from the research ethics committee. The data were tabulated using Excel software and analyzed using SPSS v.25 through Multinomial Logistic Regression. Results: majority of the sample exhibited well-being with health care assistance. Women who underwent delivery performed by non-medical professionals showed higher chances of "adequate" levels of well-being. Additionally, women who did not undergo cesarean delivery showed increased chances of well-being. Conclusion: It is necessary for professionals to reflect on their actions, conditioning them to the humanization of childbirth, according to bioethical principles.

Objetivo: evaluar los factores clínicos asociados al bienestar de la mujer durante el trabajo de parto y parto a la luz de la bioética y la deontología principialista. Método: estudio transversal con enfoque cuantitativo. Incluyó 396 puérperas ingresadas en un hospital municipal del suroeste de Bahía. Recolección de datos de enero a mayo de 2023, con aprobación del comité de ética en investigación. Los datos se tabularon en el software Excel y se analizaron mediante SPSS v.25. utilizando regresión logística multinomial. Resultados: la mayoría de las participantes de la muestra presentó bienestar con la atención para la salud; las que tuvieron partos realizados por profesionales no médicos tenían más probabilidades de tener niveles "adecuados" de bienestar; las que no tuvieron parto por cesárea tenían mayores probabilidades de tener bienestar. Conclusión: es necesario que los profesionales reflexionen sobre sus acciones y las adecuen para humanizar el parto, respetando los principios bioéticos.

The Impact of Clinical Ethics Consultations on Physicians in a Latin American Context.

Clinical bioethics plays a significant role in hospital settings through bioethics consultations, which focus on providing ongoing assistance in complex situations within the doctor-patient dynamic. These consultations entail regular interaction between physicians and clinical bioethicists. This situation prompts an exploration into how bioethics consultations affect physicians. The current research aims to understand the influence of bioethics consultations on physicians' bioethical knowledge by analyzing the lexical content in their patients' medical records. Medical records are a synthesis carried out by physicians, often reflecting collaborative efforts, and capturing verbal statements indicative of thought processes suggestive of learning. The study is a sequential mixed-methods design with a retrospective descriptive approach, comparing medical records from the early years of the Department of Humanism and Bioethics' operation (2013-2015) to the more recent ones (2019). Technical bioethical terminology such as "therapeutic effort limitation," "futility," "beneficence," and "respect for autonomy" is more prevalent in recent medical records. This trend may stem from the positive impact of bioethics consultations conducted by the Department, with haptic communication serving as a particularly effective form of interaction with others during experiences of moral distress. This appears to be characteristic of cultures like those in Latin America.

António Egas Moniz: From pioneering brain imaging to controversial psychosurgery. A 150th birthday celebration.

António Egas Moniz, born in 1874, was a pioneer in neurology, neurosurgery and psychiatry who brought about important changes in the 1920s using groundbreaking brain imaging techniques, such as cerebral angiography. This innovative procedure allowed the visualization of brain structures, leading to many advances in neurology and neurosurgery. Moniz also made noteworthy contributions to psychosurgery, including the development of prefrontal lobotomy. Although initially praised for his inventive techniques, lobotomy sparked ethical debates and public controversies due to its adverse effects and questionable scientific foundation. Moniz's was awarded the Nobel Prize in Physiology or Medicine in 1949 and received various honors in Portugal for his scientific, literary, and artistic achievements. His work continues to influence the field of neuroscience, and angiography remains a crucial imaging method for diagnosing and treating brain disorders. Moniz's complex legacy highlights the intricate balance between medical advances, ethical considerations, and public perceptions in the history of medicine.

Sociopolitical, clinical, and ethical challenges of sustainable fracture care in Haiti.

INTRODUCTION: In low- and middle-income countries such as Haiti, musculoskeletal injuries are the leading cause of morbidity and mortality. Untreated injuries can contribute to decreased mobility, leading to disability and reduced productivity for individuals. The accessibility of timely fracture care poses a substantial challenge in Haiti, where socioeconomic instability and recent surges in gang violence exacerbate an already strained healthcare infrastructure. This manuscript delves into the intricate barriers to sustainable fracture care in Haiti, shedding light on the sociopolitical landscape and clinical challenges that influence the delivery of orthopedic services. ETHICAL DISCUSSION: The ethical considerations in providing fracture care in Haiti are multifaceted, including classic medical principles, self-preservation in the face of violence, issues of justice in resource and service allocation, and concerns of nonmaleficence in the context of international volunteers. These ethical dilemmas arise from the complex interplay of limited resources, the dangers posed by the current sociopolitical climate, and the involvement of international aid in a vulnerable healthcare system. CONCLUSION: To address the clinical and ethical conflicts of providing fracture care in Haiti, solutions include education and training of Haitian orthopedic surgeons, capacity building of healthcare facilities, and establishing ethical standards for international volunteers. This comprehensive approach is vital for advancing sustainable fracture care in Haiti and other resource-limited settings.

Adolescents' healthcare decisional capacity in the clinical context: a theoretical study and model.

OBJECTIVE: To provide a theoretical study and model for the bioethical foundations of the factors that influence adolescents' healthcare decisional capacity. SOURCES: Materials from diverse sources, including indexed articles in recognized databases and official government documents, were examined for a purposefully selected sample. The research consisted of two stages: selection of documents and reflective thematic analysis, followed by the preparation of a report. The analysis adopted a phenomenological stance and a reflective view compatible with human rights. To reduce bias and ensure the robustness of the results, measures such as data triangulation were employed. Ethical measures were taken to ensure data integrity, including considerations of anonymity and conflicts of interest in the selected studies. SUMMARY OF THE FINDINGS: It was possible to list intrinsic and extrinsic factors of the adolescent patient that influence their decisional capacity regarding health. A theoretical model was developed to discuss these factors for evaluation by means of an infographic. CONCLUSIONS: It seems clear that the evaluation of healthcare decisional capacity of adolescents must position itself ethically regarding the tension between the moral duty to respect the self-determination of the able subject and the need to protect adolescents decidedly unable to make a specific health decision at a given time.

Ética Clínica, Social y de Salud Pública: reflexiones y desafíos en la atención a dilemas éticos / Clinical, Social and Public Health: reflections and challenges in addressing ethical dilemmas

RESUMEN Introducción: este estudio vincula premisas y fundamentaciones éticas, para el análisis de dimensiones involucradas en el diseño de políticas públicas de salud y reformas de salud, desde la perspectiva social, del ámbito clínico y de salud pública. Metodología: se utilizaron recursos tecnológicos y plataformas de búsqueda, aplica criterios de inclusión y exclusión para seleccionar artículos originales relevantes, a través de revisión sistematizada de la literatura, en bases de datos Medline, Ibecs, Pubmed, Scielo, BVS, Scopus, Web of Science, en inglés y español, acerca de la ética desde la perspectiva clínica, social y de la salud pública, organizando la información en tablas científicas. Resultados: las condiciones de vida digna de individuos de cualquier estrato social, se relacionan a las garantías de atención sanitaria y preservación de condiciones de vida que impactan directamente en la salud y el bienestar, debiendo ser respaldados por las instituciones y la sociedad. Conclusión: los marcos regulatorios, conectados a los derechos humanos, deben garantizar el acceso equitativo a la atención a la salud, sin discriminación, en el marco de la participación comunitaria, la privacidad y el dialogo social, influyendo en la formulación de políticas, la rendición de cuentas, la prevención de conflictos de interés y la evaluación continua de la efectividad, conducentes al más alto impacto de las intervenciones en salud.

ABSTRACT Introduction: this study links ethical premises and foundations to analyze the dimensions involved in the design of public health policies and health reforms from a social, clinical and public health perspective. Methodology: technological resources and search platforms, applications of inclusion and exclusion criteria were used to select relevant original articles, through a systematic review of the literature, in Medline, Ibecs, Pubmed, Scielo, BVS, Scopus, Web of Science databases, in English and Spanish, about ethics from the clinical, social and public health perspective, organizing the information in scientific tables. Results: the decent living conditions of individuals from any social stratum are related to the guarantees of health care and preservation of living conditions that directly impact health and well-being, and must be supported by institutions and society. Conclusion: regulatory frameworks, connected to human rights, must guarantee equitable access to health care, without discrimination, within the framework of community participation, privacy and social dialogue, influencing policy formulation, accountability, prevention of conflicts of interest and continuous evaluation of effectiveness, leading to the highest impact of health interventions.

[Predatory journals: What are they and how to avoid them?] / Las revistas depredadoras: ¿qué son y cómo evitarlas?

Currently, a large number of predatory journals have proliferated. Their purpose is to obtain fraudulent profits by promising the rapid publication of scientific works, without fulfilling the services of quality review. These publishers have managed to copy the models of open access journals, which is why they are increasingly difficult to identify, coupled with the fact that many of them have opened spaces in the most important indexes of scientific journals, such as Medline, Web of Science (WoS), Scopus, Embase, among others. These publishers cheat not only the authors of the research they intend to publish but also the readers and general public with publications that have not been reviewed and evaluated properly by a system of peers or academic experts. Therefore, the aim of this work is to make known some of the most common practices of predatory journals, so that anyone interested in the editorial process, whether as an author, editor or reader, has the elements to identify these fraudulent journals, and this bad practice in the editorial process.

Actualmente han proliferado una gran cantidad de revistas depredadoras, cuyo fin es obtener ganancias fraudulentas mediante la promesa de la publicación rápida de trabajos científicos, sin cumplir con los servicios de una revisión de calidad. Estas editoriales han logrado copiar los modelos de las revistas con acceso abierto, por lo que cada vez son más difíciles de identificar, aunado a que muchas de ellas se han abierto espacios en los índices más importantes de las revistas científicas, como Medline, Web of Science (WoS), Scopus, Embase, entre otros. Estas editoriales defraudan no solo a los autores de las investigaciones que intentan publicar sino también a los lectores y al público en general con publicaciones que no han sido debidamente revisadas y evaluadas por un sistema de pares o expertos académicos. Por lo tanto, el objetivo de este trabajo es dar a conocer algunas de las prácticas más comunes de las revistas depredadoras para que toda persona interesada en el proceso editorial, ya sea como autor, editor o lector, tenga los elementos para identificar estas revistas fraudulentas y esta mala práctica en el proceso editorial.

Unveiling the ethical void: Bias in reference citations and its academic ramifications.

Citation bias receives scant attention in discussions of ethics. However, inaccurate citation may lead to significant distortions in scientific understanding. Although ethnical and gender citation disparities have been proposed as critical aspects, there are other contributors to citation distortions, like region-based citation bias, that, although less recognized within the scientific community, are equally important. While the foundations of scientific citation include acknowledging pioneers, giving credit to related work, and providing background reading, other more subjective or even questionable criteria are often used when constructing a reference lists. Here, we discuss the potential causes and ethical concerns of citation bias, emphasizing the role of international- or region-based citation bias as one of the most harmful aspects of this ethical breach. We argue that the international scientific community should be aware of this problem and recognize its consequences, which include hindering the accurate dissemination of science, marginalizing underrepresented voices in academia, and impeding scientific progress. We advocate that scientists should compile their reference lists with the same seriousness and integrity they apply to all other aspects of their research.

Performance of ChatGPT in Solving Questions From the Progress Test (Brazilian National Medical Exam): A Potential Artificial Intelligence Tool in Medical Practice.

Background The use of artificial intelligence (AI) is not a recent phenomenon, but the latest advancements in this technology are making a significant impact across various fields of human knowledge. In medicine, this trend is no different, although it has developed at a slower pace. ChatGPT is an example of an AI-based algorithm capable of answering questions, interpreting phrases, and synthesizing complex information, potentially aiding and even replacing humans in various areas of social interest. Some studies have compared its performance in solving medical knowledge exams with medical students and professionals to verify AI accuracy. This study aimed to measure the performance of ChatGPT in answering questions from the Progress Test from 2021 to 2023. Methodology An observational study was conducted in which questions from the 2021 Progress Test and the regional tests (Southern Institutional Pedagogical Support Center II) of 2022 and 2023 were presented to ChatGPT 3.5. The results obtained were compared with the scores of first- to sixth-year medical students from over 120 Brazilian universities. All questions were presented sequentially, without any modification to their structure. After each question was presented, the platform's history was cleared, and the site was restarted. Results The platform achieved an average accuracy rate in 2021, 2022, and 2023 of 69.7%, 68.3%, and 67.2%, respectively, surpassing students from all medical years in the three tests evaluated, reinforcing findings in the current literature. The subject with the best score for the AI was Public Health, with a mean grade of 77.8%. Conclusions ChatGPT demonstrated the ability to answer medical questions with higher accuracy than humans, including students from the last year of medical school.

Social media for radiologists: opportunities and challenges.

The use of social media in medicine offers unprecedented opportunities for social interaction. Activity on platforms such as X (formerly Twitter), Instagram, Facebook, and LinkedIn plays crucial roles in various medical services, particularly regarding patients' access to information and healthcare services, medical education, and professional networking. However, the integration of social media into healthcare is not challenge-free and has certain pitfalls. In this article, we address several critical issues that compromise the reliability and effectiveness of social media as a professional healthcare resource, particularly in the field of radiology. We discuss possible solutions and tips and tricks to facilitate the use of this valuable tool to our advantage and in a reliable manner.

Questões e tensões da história da fonoaudiologia contadas a partir de seus documentos normatizadores / Issues and tensions in the history of speech therapy told from its standardizing documents / Cuestiones y tensiones en la historia de la logopedia contadas a partir de sus documentos normalizadores

Introdução: A Fonoaudiologia é uma profissão jovem, mas sua regulamentação, entretanto, é fruto de um longo processo, iniciado algumas décadas antes. Vários documentos deixam marcas desta trajetória e contam histórias das questões e tensões presentes no momento de sua elaboração. Objetivos: Discutir a questão da autonomia do profissional da Fonoaudiologia a partir da análise de alguns de seus documentos normatizadores, considerando dois momentos significativos: a) a mudança de tecnólogo para profissional de nível superior, em 1981 e b) a ameaça de perda de direitos na ocasião da tramitação do Projeto de Lei do Ato Médico, em 2001. Método: Pesquisa documental, descritiva exploratória, de caráter qualitativo. Resultados: A palavra diagnóstico aparece de forma implícita no texto da Lei 6965/81 e no primeiro Código de Ética, em 1984, e de forma explícita, enquanto competência do fonoaudiólogo, nos códigos de 1995 e 2004. A palavra autonomia não aparece na Lei nem no código de 1984. É mencionada de forma restrita no código de 1995 e apenas referida como autonomia profissional ampla no código de 2004. Conclusão: Analisar as questões e as tensões presentes na elaboração de documentos normativos de uma profissão permite destacar o conjunto de valores, as disputas de poder e o caráter ético e político presente nestas definições. Permite também perceber o quanto estes processos são dinâmicos, incessantes e, ainda, o quanto algumas situações se colocam no tempo presente, resgatando debates antigos. (AU)

Introduction: Speech therapy is a young profession, but its regulation, however, is the result of a long process, started a few decades earlier. Several documents leave marks of this trajectory and tell stories of the issues and tensions present at the time of their preparation. Objectives: To discuss the issue of the autonomy of Speech Therapy professionals based on the analysis of some of their standardizing documents, considering two significant moments: a) the change from technologist to higher education professional, in 1981 and b) the threat of loss of rights in occasion of the processing of the Medical Act Bill, in 2001. Method: Documentary, exploratory, qualitative research. Results: The word diagnosis appears implicitly in the text of Law 6965/81 and in the first Code of Ethics, in 1984, and explicitly, as a speech therapist competence, in the codes of 1995 and 2004. The word autonomy does not appear in the Law nor in the 1984 code. It is mentioned in a restricted way in the 1995 code and only referred to as broad professional autonomy in the 2004 code. Conclusion: Analyzing the issues and tensions present in the preparation of normative documents for a profession allows us to highlight the set of values, power disputes and the ethical and political character present in these definitions. It also allows us to understand how dynamic and incessant these processes are and, also, how much some situations arise in the present time, rescuing old debates. (AU)

Introducción: La logopedia es una profesión joven, pero su regulación, sin embargo, es el resultado de un largo proceso, iniciado algunas décadas antes. Varios documentos dejan huellas de esta trayectoria y cuentan historias de los problemas y tensiones presentes en el momento de su preparación. Objetivos:Discutir la cuestión de la autonomía de los profesionales de Logopedia a partir del análisis de algunos de sus documentos normativos, considerando dos momentos significativos: a) el paso de tecnólogo a profesional de educación superior, en 1981 y b) la amenaza de pérdida de derechos con motivo de la tramitación del Proyecto de Ley Médica, en 2001. Método: Investigación documental, exploratoria, cualitativa. Resultados: La palabra diagnóstico aparece implícitamente en el texto de la Ley 6965/81 y en el primer Código de Ética, de 1984, y explícitamente, como competencia del logopeda, en los códigos de 1995 y 2004. La palabra autonomía no aparece en la Ley ni en el código de 1984. Se menciona de forma restringida en el código de 1995 y sólo se la denomina amplia autonomía profesional en el código de 2004. Conclusión: Analizar las cuestiones y tensiones presentes en la elaboración de documentos normativos para una profesión permite resaltar el conjunto de valores, las disputas de poder y el carácter ético y político presentes en estas definiciones. También nos permite comprender cuán dinámicos e incesantes son estos procesos y, también, cuánto surgen algunas situaciones en la actualidad, rescatando viejos debates. (AU)

Investigación preclínica en animales. Pautas actuales / Preclinical animal research. Current guidelines

El uso de animales en experimentación científica está regulado por normativas diseñadas para garantizar la ética y el bienestar de los animales. A nivel mundial las regulaciones varían, pero muchos países como Argentina adoptan directrices establecidas por organizaciones internacionales como la Oficina de Protección de los Derechos de los Animales, EE.UU. (Animal Welfare Office) y el Instituto Nacional de Salud, EE.UU. (National Institute of Health). Los protocolos que se elaboran teniendo en cuenta las recomendaciones de estas entidades deben ser revisados por comités de ética para asegurarse que se cumplan con los estándares internacionales. En resumen, las pautas actuales buscan equilibrar el avance científico con la ética, asegurando que el uso de animales en investigación sea racional, humanitario y respetando el bienestar animal.(AU)

The use of animals in scientific experiments is regulated by guidelines designed to ensure ethics and welfare of animals. Regulations vary around the world, but many countries, such as Argentina, follow guidelines established by international organizations such as the US Office of Animal Welfare and the US National Institutes of Health. Protocols developed using the recommendations of these entities must be reviewed by ethics committees to ensure that they follow international standards. In summary, the current guidelines seek to strike a balance between scientific progress and ethics, ensuring that the use of animals in research is rational, humane and respects animal welfare.(AU)

Investigation of environmental ethics, spiritual health, and its relationship with environmental protection behaviors in nursing students.

Objective: To investigate the relationship between environmental ethics, spiritual health, and environmental behavior among nursing students. Methods: In this cross-sectional study, 200 iranian students from the Chabahar Nursing School were selected using a simple random sampling method. The data collection tool included a questionnaire on demographic information, knowledge, attitudes and behaviors towards the environment, environmental ethics, and spiritual health. Partial least squares structural equation modeling (PLS-SEM) was utilized to evaluate the conceptual framework in this study. Results: The mean score for environmental ethics among nursing students was 65.73±10.61 out of 100. Most of the students (47%) had desirable environmental ethics. The knowledge structure (ß=0.46) predicted attitude. The attitude structure also predicted environmental behavior (ß=0.28) and spiritual health (ß=0.31). Ultimately, the results showed that spiritual health and environmental ethics predict environmental behavior directly and indirectly (p<0.001). Conclusion: Spiritual health and environmental ethics were strong predictors of environmental behavior. Therefore, it is necessary to take into account not only students' spiritual health but also their ethical behaviors to promote environmental protection behaviors in the future.

Ethical regulation of biomedical research in Brazil: a quality improvement initiative.

BACKGROUND: Q-CEP (Qualificação dos Comitês de Ética em Pesquisa que compõem o Sistema CEP/Conep) is a nationwide project resulting from a partnership between the Brazilian National Research Ethics Commission (Conep), the Ministry of Health and Hospital Moinhos de Vento (HMV). It was developed to consolidate policy for ethical review of research with human beings in all members of the CEP/Conep System, Brazil's national system of institutional review boards. The aim of this study was therefore to report on the experience and results of the Q-CEP project. METHODS: An observational, retrospective study includes data from the Q-CEP, obtained from visits to all the institutional research ethics committees (RECs) in the country. The actions implemented by Q-CEP were part of a two-step process: (i) training visits to each REC; (ii) development of distance learning modules on strategic topics pertaining to research ethics evaluation. The data presented herein cover step one (training visits), defined by Q-CEP as the diagnostic stage of the project. For a country with social and economics inequalities such as Brazil, this is a particularly important stage; an accurate picture of reality is needed to inform planning of quality improvement strategies. RESULTS: In 2019-2021, Q-CEP visited 832 RECs and trained 11,197 people. This sample covered almost all active RECs in the country; only 4 (0.5%) were not evaluated. Of the 94 items evaluated, 62% did not reach the target of at least 80% compliance and around 1/4 (26%) were below 50% compliance. The diagnostic stage of the process revealed inadequacies on the part of the RECs in their ethical reviews. The analysis of informed consent forms showed compliance in only 131 RECs (15.74%). The description of pending issues made by RECs in their reports was compliant in 19.33% (n = 161). Administrative and operational aspects were also considered inadequate by more than half of the RECs. CONCLUSIONS: Overall, Brazilian RECs showed poor compliance in several aspects of their operation, both in ethics evaluation and in other processes, which justifies additional training. The Q-CEP project is part of a quality improvement policy promoted by the Brazilian Ministry of Health. The data obtained in the diagnostic step of the project have contributed to the qualification and consolidation of one of the world's largest research ethics evaluation systems.

ChatGPT in Urology: Bridging Knowledge and Practice for Tomorrow's Healthcare, a Comprehensive Review.

Background: Among emerging AI technologies, Chat-Generative Pre-Trained Transformer (ChatGPT) emerges as a notable language model, uniquely developed through artificial intelligence research. Its proven versatility across various domains, from language translation to healthcare data processing, underscores its promise within medical documentation, diagnostics, research, and education. The current comprehensive review aimed to investigate the utility of ChatGPT in urology education and practice and to highlight its potential limitations. Methods: The authors conducted a comprehensive literature review of the use of ChatGPT and its applications in urology education, research, and practice. Through a systematic review of the literature, with a search strategy using databases, such as PubMed and Embase, we analyzed the advantages and limitations of using ChatGPT in urology and evaluated its potential impact. Results: A total of 78 records were eligible for inclusion. The benefits of ChatGPT were frequently cited across various contexts. In educational/academic benefits mentioned in 21 records (87.5%), ChatGPT showed the ability to assist urologists by offering precise information and responding to inquiries derived from patient data analysis, thereby supporting decision making; in 18 records (75%), advantages comprised personalized medicine, predictive capabilities for disease risks and outcomes, streamlining clinical workflows and improved diagnostics. Nevertheless, apprehensions were expressed regarding potential misinformation, underscoring the necessity for human supervision to guarantee patient safety and address ethical concerns. Conclusion: The potential applications of ChatGPT hold the capacity to bring about transformative changes in urology education, research, and practice. AI technology can serve as a useful tool to augment human intelligence; however, it is essential to use it in a responsible and ethical manner.

Developing an Evidence-Based Ethics Education Program for Surgical Residents in Guatemala.

OBJECTIVE: This study assessed 2 modalities for teaching responsible conduct of research and human subjects protection (RCR/HSP) to surgical residents in Guatemala-an "off the shelf" online curriculum and a new in-person curriculum specific to the local context. METHODS: In 2018, 160 surgical residents in 3 large urban hospitals in Guatemala City completed 2 online programs in RCR/HSP. Residents in the intervention arm also completed 7 weeks of in-person training. Pre- and post-assessments tested awareness of key concepts with particular attention to international and Guatemalan research regulations. Group differences in matched (pre- and post-) mean scores were analyzed using t-tests. RESULTS: One hundred forty residents completed pre- and post-training assessments and were included in the analytic sample. Overall mean scores improved modestly from 52.7 to 58.7 points out of 100. Intervention-arm trainees reported greater confidence in recognizing ethical issues, understanding legal and ethical requirements for research, and identifying, reporting and avoiding scientific misconduct than control-arm trainees. CONCLUSION: Given the limited availability of RCR/HSP faculty, financial resources, and time in the surgical training schedule, the investigators recommend that academic authorities in Guatemala consider online training programs in RCR/HSP in all surgical residency programs as an affordable and scalable strategy to build ethical research skills in its surgical workforce. Investment in human resources to support in-person ethics education as a way to build self-efficacy in ethical decision-making should be considered.