Citations

ABSTRACT Background and Aims Artificial intelligence (AI) is increasingly integrated into gastrointestinal (GI) endoscopy, yet limited data exist on how patients and endoscopists perceive its use. This study aimed to evaluate users' values and preferences regarding AI in endoscopy to support effective implementation and inform guideline development. Methods As part of the World Endoscopy Organization (WEO) AI committee initiatives, two structured international surveys were conducted—one for patients and one for practicing endoscopists. Thirteen AI‐related statements were presented to patients via an established online platform, while 23 statements were shared with endoscopists through professional networks. Responses were captured using 5‐point Likert scales and analyzed with non‐parametric tests, including subgroup comparisons by age, gender, and endoscopic experience. Results A total of 1237 patients and 476 endoscopists participated. Most patients supported AI in image analysis (75.5%) but emphasized the need for endoscopist oversight (92.3%). Among endoscopists, 90.3% believed AI improves endoscopy quality, and 85.3% believed it benefits outcomes. Concerns were raised about liability (47%), operator dependency (34.8%), and procedure time (49%). Most respondents felt primary responsibility for AI‐related errors should rest with the endoscopist. Younger and male patients reported greater trust in AI. Conclusions Patients and endoscopists are generally supportive of AI in GI endoscopy, especially as an adjunct to human expertise. However, key concerns—including accountability, trust, and clinical integration—must be addressed to ensure responsible and effective adoption.

ABSTRACT Interactions between clinical pharmacists and industry partners continue to evolve as health care increases in complexity and technology assumes a more dominant role. To address the corresponding ethical challenges, the 2025 Industry Relations Committee of the American College of Clinical Pharmacy (ACCP) was charged with updating the 2008 ACCP position statement, Pharmacists and Industry: Guidelines for Ethical Interactions . This update expands its perspective, reflecting the broader and more influential roles pharmacists play across the health care ecosystem. All clinical pharmacist–industry interactions should be grounded in improving patient care. Through this lens, six recommendations are provided: (1) Pharmacists should not engage in industry partnerships or collaborations that might unduly influence objectivity, independence, or fairness in clinical and professional judgments; (2) Pharmacists should disclose and mitigate financial, consulting, or other relationships that constitute potential conflicts of interest and should not participate in activities where an existing conflict cannot be resolved; (3) Pharmacists who participate in industry‐sponsored research should follow accepted ethical, regulatory, and scientific standards; (4) Pharmacists providing continuing education programs or developing drug information materials should maintain control of content; ensure their content is fair, balanced, and free from bias; and disclose and mitigate any conflicts; (5) Formal instruction on ethical interactions with industry professionals should begin early and continue through all stages of pharmacist education, training, and professional development; (6) Pharmacists should maintain the confidentiality and privacy of patients and other health care professionals when working with industry partners. Questions to guide personal industry interactions are provided. This paper does not detail every emerging area (e.g., artificial intelligence, social media), but recommendations are applicable wherever clinical pharmacists leverage their professional expertise. By maintaining a critical, discerning, and ethical approach to industry collaborations, clinical pharmacists can uphold professional obligations while contributing to the advancement of evidence‐based practice, ultimately prioritizing patient welfare.

ABSTRACT Hospital‐at‐Home (HaH) programs provide acute care in patients' homes, reducing hospitalization and improving patient experience. While crucial in traditional settings, antimicrobial stewardship (AMS) in HaH programs remains understudied. This manuscript explores the potential benefits of AMS in HaH and the role of infectious diseases (ID) pharmacists in optimizing antimicrobial therapy. Key challenges in implementing AMS in HaH include medication delivery logistics, treatment regimen adjustments, and unique administration techniques. ID pharmacists can address these challenges by providing expertise in antimicrobial selection, dosing, and duration, as well as identifying opportunities for de‐escalation and intravenous (IV) to oral conversions. By integrating AMS into HaH programs, health care systems can improve patient outcomes, reduce antimicrobial resistance, and optimize resource utilization. Further research and training programs are needed to fully realize the potential of AMS in this emerging model of care.

Introduction Cerebellar transcranial direct current stimulation (tDCS) combined with language therapy can aid in chronic aphasia recovery, but the neural mechanisms and biomarkers of treatment efficacy remain uncertain. Methods In this secondary analysis of data from a previously conducted clinical trial, we used a randomized, double-blind, sham-controlled, within-subject crossover design with a study sample of 19 participants with post-stroke aphasia. We assessed the degree to which baseline properties of cerebro-cerebellar white matter tracts can predict or moderate longitudinal treatment effects at three time points: post-treatment, 2 weeks post-treatment, and 2 months post-treatment. Tract properties were measured by fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI). We also tested whether there are differential effects between trained and untrained language tasks and between cerebellar tDCS polarity (anodal and cathodal). Results Baseline measures of tracts connecting the left lesioned cortex to the right posterolateral cerebellum (stimulation target) influenced treatment gains for untrained tasks, relative to sham control. In contrast, for the trained task, treatment gains were influenced by baseline measures of tracts connecting the non-stimulated left cerebellum with the contralateral right cerebral cortex. Although there were no consistent effects from cerebellar tDCS polarity, a highly consistent pattern emerged across all tasks and tracts. Specifically, language improvements were predicted by a baseline tract profile (i.e., higher FA and lower MD) typically associated with higher white matter integrity, especially within the context of stroke-induced white matter decline. Discussion These findings corroborate the potential for baseline tract properties as a biomarker of treatment efficacy and support the notion that adjuvant (cerebellar tDCS + language) therapy preferentially benefits individuals with relatively preserved structural connections within functionally relevant networks. Clinical trial registration ClinicalTrials.gov , identifier (NCT02901574).

Introduction Craniofacial hyperplasia is a disorder where the face and head do not fully develop. This leads to difficulties in airway management in those undergoing general anesthesia (GA), requiring consideration in anesthetic planning with GA and intubation versus approaches with regional/spinal anesthesia. Case Presentation A 54-year-old male (45 kg, 172.7 cm) presented for a penile implant insertion for severe erectile dysfunction following radical prostatectomy. He was classified as ASA physical status class III. Management and Outcomes Pertinent medical history included craniofacial hypoplasia from childhood surgical interventions and radiation for sinus cancer (rhabdomyosarcoma), moderate mitral regurgitation, mild tricuspid regurgitation, pulmonary hypertension, recurrent esophageal strictures, and anemia. Spinal anesthesia was selected over GA. Airway complications were avoided, and cardiopulmonary stability was preserved while maintaining adequate analgesic coverage. Conclusion Craniofacial hypoplasia patients require individualized anesthesia planning that anticipates complications. Spinal anesthesia can be used in these patients to avoid airway and hemodynamic complications.

Objectives: To summarize recent high-quality trials and provide an update to the original 2022 American College of Radiology Appropriate Use Criteria for Treatment of Locoregional Gastric Adenocarcinoma. This multi-specialty-led committee included gastrointestinal radiation and medical oncology, gastroenterology, radiology, and surgical oncology. Methods: Using the population, intervention, comparator, outcome, timing, and study design framework, the evidence was assessed using Cochrane and PRISMA 2020 methodology. Eligible studies included prospective Phase II/II trials and select retrospective studies published between 5/1/2020 and 8/1/2025 in the Embase, Medline, and Pubmed databases. Study type and quality were assessed. Well-established RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options. Results: ARS AUC recommendations include adjuvant FLOT chemotherapy for localized gastric adenocarcinoma after neoadjuvant FLOT and surgery, poCT or perioperative chemoimmunotherapy for localized gastric adenocarcinoma, adjuvant chemotherapy +/− CRT for localized gastric adenocarcinoma that undergoes upfront surgery, and systemic therapy alone for localized gastric adenocarcinoma in a medically inoperable patient. Conclusions: This updated ARS AUC summary provides guidelines for the multimodality treatment of resectable gastric adenocarcinoma.