Performance of artificial intelligence in bariatric surgery: comparative analysis of ChatGPT-4, Bing, and Bard in the American Society for Metabolic and Bariatric Surgery textbook of bariatric surgery questions.

BACKGROUND: The American Society for Metabolic and Bariatric Surgery (ASMBS) textbook serves as a comprehensive resource for bariatric surgery, covering recent advancements and clinical questions. Testing artificial intelligence (AI) engines using this authoritative source ensures accurate and up-to-date information and provides insight in its potential implications for surgical education and training. OBJECTIVES: To determine the quality and to compare different large language models' (LLMs) ability to respond to textbook questions relating to bariatric surgery. SETTING: Remote. METHODS: Prompts to be entered into the LLMs were multiple-choice questions found in "The ASMBS Textbook of Bariatric Surgery, second Edition. The prompts were queried into 3 LLMs: OpenAI's ChatGPT-4, Microsoft's Bing, and Google's Bard. The generated responses were assessed based on overall accuracy, the number of correct answers according to subject matter, and the number of correct answers based on question type. Statistical analysis was performed to determine the number of responses per LLMs per category that were correct. RESULTS: Two hundred questions were used to query the AI models. There was an overall significant difference in the accuracy of answers, with an accuracy of 83.0% for ChatGPT-4, followed by Bard (76.0%) and Bing (65.0%). Subgroup analysis revealed a significant difference between the models' performance in question categories, with ChatGPT-4's demonstrating the highest proportion of correct answers in questions related to treatment and surgical procedures (83.1%) and complications (91.7%). There was also a significant difference between the performance in different question types, with ChatGPT-4 showing superior performance in inclusionary questions. Bard and Bing were unable to answer certain questions whereas ChatGPT-4 left no questions unanswered. CONCLUSIONS: LLMs, particularly ChatGPT-4, demonstrated promising accuracy when answering clinical questions related to bariatric surgery. Continued AI advancements and research is required to elucidate the potential applications of LLMs in training and education.

Análisis de los textos escolares del estudiante de ciencias naturales en primer ciclo básico desde la perspectiva de la terminología anatómica internacional / Analysis of science and biology school textbooks in primary from the perspective of international anatomical terminology

A pesar de los esfuerzos por generar una terminología unificada, hoy en día aún se implementan términos morfológicos obsoletos en diferentes contextos, como por ejemplo, los textos escolares, que son herramientas ampliamente utilizadas por el sistema escolar chileno. Se analizó la terminología morfológica utilizada en textos del estudiante de enseñanza básica (1° básico a 6° básico) propuestos por el Ministerio de Educación de Chile. Este análisis se realizó comparando los términos hallados en los textos mencionados, con la terminología morfológica propuesta por la federación internacional de terminología anatómica. Además, se propone una traducción al español para aquellos términos que se encuentran erróneos en los textos analizados. Los resultados muestran que de un total de 254 términos el 35,8 % es incorrecto. De estos, los más mencionados por los textos son: sistema locomotor, sistema circulatorio, brazo, entre otros. Frente a esto, se concluye que es importante que los textos escolares utilizados en el sistema educativo sean revisados por expertos, para evitar obstáculos en el aprendizaje de la anatomía.

SUMMARY: Despite efforts to generate a unified terminology, obsolete morphological terms are still used in different contexts, such as school textbooks, which are tools widely used by the Chilean school system. The morphological terminology used in texts for elementary school students (grades 1 to 6) proposed by the Chilean Ministry of Education was analyzed. This analysis was carried out by comparing the terms found in the school texts with the morphological terminology proposed by the international federation of anatomical terminology. In addition, a translation into Spanish is proposed for those terms that are found to be erroneous in the texts analyzed. The results show that out of a total of 254 terms, 35.8 % are incorrect. Among the terms with errors, the most mentioned by the texts are: locomotor system, circulatory system, arm, among others. In view of this, we conclude that it is important that the textbooks used in the educational system be reviewed by experts to avoid obstacles in the learning of anatomy.

Legacy of Syriac-Aramaic Scholars in Transmitting Neurosurgical Knowledge Between Antiquity and the Middle Ages.

The link between ancient Greek medicine and the Arabic translation period in the 9th century cannot be understood without studying the contributions of Syriac scholars. With their mastery of Greek and the related Semitic languages of Syriac and Arabic, they initiated a scientific translation process with methods that prevail to this day. In this paper, we reviewed Hunayn Ibn Isshaq's Ten Treatises on the Eye to elucidate the original contributions of the Syriac physicians to the field of neurologic surgery. We analyzed the oldest known diagram of orbital anatomy along with Hunayn's genuine ideas on the optic nerve anatomy and pathology, optic chiasm, afferent pupillary reflex, and papilledema and venous congestion. We also reviewed the neurosurgical elements found in the Syriac Book of Medicines including the thought process in localizing neurologic deficits based on clinical experience and anatomic dissections and the earliest recorded description of brachial plexus pathology.

Video-Based Coaching: An Efficient Learning and Teaching Modality for Pediatric Surgery and Pediatric Urology Training Program.

Objective: The development of integrated multimedia operating rooms has made possible to record surgical procedures mainly in minimally invasive surgery (MIS) and robotic surgery. This modality of video storage allows the trainees to study surgical procedures based on video analysis. The aim of this study is to compare two learning methods of surgical procedures, operative textbooks and video-based coaching, in a group of 10 pediatric surgery trainees. Patients and Methods: We selected five surgical procedures to study: three MIS procedures, Nissen fundoplication, partial nephrectomy, and cholecystectomy; and two robotic procedures, Lich-Gregoir reimplantation for vesicoureteral reflux and Henderson-Hynes pyleoplasty for ureteropelvic junction obstruction. Ten trainees were divided into two groups of 5 each, Group 1 (G1) and Group 2 (G2). G1 studied the procedures analyzing videos, G2 studied the same procedure classically reading textbooks. Tutors prepared a questionnaire of 100 multianswered questions that was submitted to both groups, divided into 20 questions for each surgical technique. The questionnaire focused on the different steps of surgical techniques. Results: Analyzing the 10 questionnaires, G1 (video group) obtained a median result of 82 exact answers (74-97), whereas G2 (textbook group) obtained a median result of 64.2 correct answers (53-79). Analyzing statistically the results of two groups, using unpaired t-Student's test with a level of statistical significance >95%, the results of G1 were statistically significantly better that G2 with a P = .0265 for the average scores. Conclusion: Video-based coaching to learn surgical techniques is a novel, feasible, and excellent modality for supplementing surgical techniques learning for pediatric surgery trainees. Objective evaluation using a multianswered questionnaire demonstrates that video-based coaching in pediatric surgery is statistically better than textbook classic education. We suggest to adopt this teaching modality in every surgical training program above all to teach MIS and robotic surgery.

Are textbook lungs really normal? A cadaveric study on the anatomical and clinical importance of variations in the major lung fissures, and the incomplete right horizontal fissure.

INTRODUCTION: The lungs have three main fissures: the right oblique fissure (ROF), right horizontal fissure (RHF), and left oblique fissure (LOF). These can be complete, incomplete or absent; quantifying the degree of completeness of these fissures is novel. Standard textbooks often refer to the fissures as complete, but awareness of variation is essential in thoracic surgery. MATERIALS AND METHODS: Fissures in 81 pairs of cadaveric lungs were classified. Oblique fissures were measured from lung hila posteriorly to the lung hila anteriorly; and the RHF measured from the ROF to the anteromedial lung edge. The degree of completeness of fissures was expressed as a percentage of the total projected length were they to be complete. The frequency and location of accessory fissures was noted. RESULTS: LOF were complete in 66/81 (81.5%), incomplete in 13/81 (16.0%) and absent in 2/81 (2.47%); ROF were complete in 52/81 (64.2%), incomplete in 29/81 (35.8%) and never absent; RHF were more variable, complete in 18/81 (22.2%), incomplete in 54/81 (66.7%) and absent in 9/81 (11.1%). LOF and ROF were on average 97.1% and 91.6% complete, respectively, being deficient posteriorly at the lung hila. The RHF on average 69.4% complete, being deficient anteromedially. There were accessory fissures in 10 left and 19 right lungs. CONCLUSIONS: This study provides a projection of the anatomy thoracic surgeons may encounter at operation, in particular the variable RHF. This knowledge is essential for optimal outcomes in both benign and oncological procedures influenced by the fissures.

[Discrepancies in medical textbooks and their impact on medical school students]. / Discordances entre les référentiels des collèges d'enseignants en médecine et leur impact sur les étudiants en médecine.

BACKGROUND: Textbooks endorsed by national medical specialty societies and colleges are used as official references for faculty and national examinations. Oncology is transdisciplinary, practiced and taught by oncologists but also by other specialists. We aimed at identifying discrepancies between chapters on cancers in different official specialty textbooks and evaluating their impact on students. MATERIAL AND METHODS: Volunteer 6th-year medical students of the Sorbonne University faculty were paired and asked to list the discrepancies between all official specialty textbooks addressing a given cancer and then individually asked to evaluate the impact of discrepancies on their learning experience. RESULTS: In March 2018, the 17 cancers listed in the French medical school education program were addressed in 14 official specialty textbooks (2 to 4 textbooks/cancer). Out of a class of 390 students, 78 volunteered and were paired; each cancer was analyzed by 3 pairs of students (1 or 2 cancers/pair); 154 discrepancies were reported (range: 4-18 per cancer). Discrepancies induced doubt and anxiety in students; 85% considered that harmonization should be achieved for all topics of the national medical school program. CONCLUSIONS: Discrepancies between official textbook are frequent, generate anxiety in students and impact learning experience.

De la razón moral a la de experto: discursos y prácticas sobre la salud en los manuales escolares del franquismo (1936-1975) / Da razão moral à especializada: discursos e práticas sobre saúde nos livros escolares de Franco (1936-1975) / From moral reason to expert reason: discourses and practices on health in Franco's school textbooks (1936-1975)

El propósito del presente trabajo es analizar la cultura de la salud promovida en las escuelas primarias españolas bajo el ideario del régimen franquista (1936-1975). Para ello, hemos indagado en los manuales escolares del periodo, recursos fundamentales en el proceso de enseñanza-aprendizaje, con los que se trató de modificar la conducta de la población en relación con la salud y la enfermedad. Desde un enfoque etnográfico hemos analizado tanto el discurso sobre las prácticas infantiles, como el ideario de cuerpo y salud promovido. Si bien, disciplina y control social propios del régimen dejaron su impronta en la salud enseñada, las transformaciones sociales y políticas lo fueron modulando hacia una noción de salud menos moralizadora pero más deudora del discurso experto. (AU)

O objetivo deste trabalho é analisar a cultura da saúde promovida nas escolas primárias espanholas sob a ideologia do regime franquista (1936-1975). Para este fim, investigamos os livros escolares do período, recursos fundamentais no processo ensino-aprendizagem, que foram utilizados para tentar modificar o comportamento da população em relação à saúde e à doença. A partir de uma abordagem etnográfica, analisamos tanto o discurso sobre as práticas das crianças quanto à ideologia do corpo e da saúde promovida. Embora a disciplina e o controle social do regime tenham deixado sua marca na saúde ensinada, as transformações sociais e políticas o modulavam no sentido de uma noção menos moralizadora de saúde, mas mais endividada com o discurso dos especialistas. (AU)

The purpose of this paper is to analyse the culture of health promoted in Spanish primary schools under the ideology of the Franco regime (1936-1975). To this end, we have investigated the school textbooks of the period, fundamental resources in the teaching-learning process, which were used to try to modify the behaviour of the population in relation to health and illness. From an ethnographic approach, we have analysed both the discourse on children's practices and the ideology of body and health promoted. Although the regime's own discipline and social control left their mark on the health taught, social and political transformations gradually modulated it towards a less moralising notion of health that was more indebted to expert discourse. (AU)

Análisis de los textos escolares de ciencias naturales y biología desde la perspectiva de la terminología anatómica internacional: sistema cardiovascular / Analysis of science and biology school textbooks from the perspective of the international anatomical terminology: cardiovascular system

RESUMEN: Los textos escolares en Chile siguen siendo un recurso educativo ampliamente utilizado por los profesores/as, por lo tanto, son herramientas pedagógicas que deben contar con una correcta terminología, garantizando una comunicación eficiente y precisa. En este sentido, la Terminología Anatómica Internacional aborda la organización de nombres de estructuras humanas, sin embargo, se ha observado que aún existen problemas en la correcta denominación de estructuras, generando problemas de comunicación entre profesionales y estudiantes de ciencias. En esta investigación se analizaron los términos histológicos, embriológicos y anatómicos del sistema cardiovascular humano presentes en los libros de texto escolares de 7º a 12vo grado de Ciencias Naturales y Biología, impartidos por el Ministerio de Educación de Chile. El análisis fue realizado comparando los términos utilizados en los textos con los términos oficiales del Programa Federativo Internacional de Terminologías Anatómicas y del Comité Federativo Internacional en Terminología Anatómica. Los resultados indican que el 25 % de términos analizados presentan errores y de ellos un 100 % corresponden a sinonimias. Se concluye que persisten errores en la adecuada denominación de las estructuras del cuerpo humano en los textos escolares. Al respecto, se sugiere una serie de líneas de trabajo que deberán reunir a los profesores/as y especialistas como anatomistas y biólogos para corregir los errores existentes.

SUMMARY: School textbooks in Chile remain an educational resource widely used by teachers, therefore, they are pedagogical tools that must have a correct terminology, ensuring efficient and accurate communication. In this sense, The International Anatomical Terminology addresses the organization of names of human structures. However, it has been observed that there are still problems in the correct naming of structures, creating communication problems between professionals and science students. In this research, the histological, embryological, and anatomical terms of the human cardiovascular system present in school textbooks from 7th to 12th grade of Sciences and Biology, taught by the Chilean Ministry of Education, were analyzed. The analysis was carried out by comparing the terms used in the texts with the official terms of the Federative International Programme for Anatomical Terminology and International Federative Committee for Anatomical Terminology. The results indicate that 25 % of the terms analyzed have errors and of these 100 % correspond to synonyms. It is concluded that errors persist in the proper naming of the structures of the human body in school textbooks. In this regard, a series of lines of work are suggested, that should bring together teachers and specialists such as anatomists and biologists to correct existing errors.

A comprehensive validation of the novel 8th edition of American Joint Committee on Cancer staging manual for the long-term survivals of patients with non-functional pancreatic neuroendocrine neoplasms.

Histologically, the World Health Organization has classified pancreatic neuroendocrine neoplasms (p-NENs) into well-differentiated pancreatic neuroendocrine tumors (G1/G2 p-NETs) and poorly-differentiated pancreatic neuroendocrine carcinoma (G3 p-NECs) based on tumor mitotic counts and Ki-67 index. Recently, the 8th edition of American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging manual has incorporated some major changes in 2017 that the TNM staging system for p-NENs should only be applied to well-differentiated G1/G2 p-NETs, while poorly-differentiated G3 p-NECs be classified according to the new system for pancreatic exocrine adenocarcinomas. However, this new manual for p-NENs has seldom been evaluated.Data of patients with both G1/G2 and G3 non-functional p-NENs (NF-p-NENs) from our institution was retrospectively collected and analyzed using 2 new AJCC 8th staging systems. We also made survival comparisons between the 8th and 7th edition system separately for different subgroups.For G1/G2 NF-p-NETs, there were 52 patients classified in AJCC 8th edition stage I, 40 in stage II, 41 in stage III and 19 in stage IV. As for G3 NF-p-NECs, 17, 19, 24, and 18 patients were respectively defined from AJCC 8th edition stage I to stage IV. In terms of the AJCC 7th staging system, the 230 patients with NF-p-NENs were totally distributed from stage I to stage IV (94, 63, 36, 37, respectively). For the survival analysis of both G1/G2 NF-p-NETs and G3 NF-p-NECs, the AJCC 7th edition system failed to discriminate the survival differences when compared stage III with stage II or stage IV (P > .05), while the 8th edition ones could perfectly allocate patients into 4 statistically different groups (P < .05). The HCIs of AJCC 8th stage for G1/G2 NF-p-NETs [HCI=0.658, 95% confidence interval (CI)=0.602-0.741] and stage for G3 NF-p-NECs (HCI=0.704, 95% CI=0.595-0.813) was both statistically larger than those of AJCC 7th stage for different grading NF-p-NENs [(HCI=0.578, 95% CI=0.557-0.649; P=.031), (HCI=0.546, 95% CI=0.531-0.636; P = .019); respectively], indicating a more accurate predictive ability for the survivals of NF-p-NENs.Our data suggested the 2 new AJCC 8th staging systems were superior to its 7th edition for patients with both G1/G2 NF-p-NETs and G3 NF-p-NECs.

The Development of Kraepelin's Concept of Dementia Praecox: A Close Reading of Relevant Texts.

In 1893 and 1896, in his fourth and fifth textbook editions, Emil Kraepelin brought together 3 syndromes to form the first and second of his 2 prequels to dementia praecox (DP), a definitive version of which he would propose in his 1899 sixth textbook edition. These syndromes, which would become hebephrenic DP, catatonic DP, and paranoid DP, each had distinct histories. Hebephrenic DP was derived from syndromes first proposed by Hecker, and catatonic DP was derived from syndromes first proposed by Kahlbaum, and then both were substantially revised. Kraepelin created paranoid DP de novo from a division of his early broad delusional syndrome Verrücktheit, distinguishing it from paranoia. Two of these syndromes (catatonic DP and paranoid DP) were present in different forms in his earlier textbook editions, and 1 syndrome (hebephrenic DP) was not. In his 2 prequels, the 3 syndromes were listed together with a brief preface. In the sixth textbook edition, they became "clinical forms" of DP with a lengthy integrative introduction. Much more than in his prequels, in his sixth edition, Kraepelin stitched these 3 syndromes together, emphasizing their shared signs, symptoms, and course. Hebephrenia was the core of Kraepelin's DP concept, while the paranoid subtype fitted least comfortably within his framework. His term dementia was meant in a broad sense consistent with both short-term and rare long-term recoveries. Kraepelin was a pragmatist, not a purist, in his nosologic work and focused both on clinical features and course and outcome. He experimented with various nosologic categories, willing to revise earlier formulations in the light of new data. He was more tentative about his conclusions than many who followed him.

Open Educational Resource Textbook Impact on Students in an Introductory Nutrition Course.

OBJECTIVE: To determine if student outcomes, usage, perceptions, and engagement differ between introductory nutrition courses that used an open educational resource (OER) textbook compared with a traditional textbook. DESIGN: Cross-sectional. SETTING: College introductory nutrition course. PARTICIPANTS: Students enrolled in introductory nutrition courses that used a traditional textbook or an OER textbook. INTERVENTION: Implementation of an OER textbook in all introductory nutrition courses during 1 semester. MAIN OUTCOME MEASURE(S): Usage, perceptions, and engagement with the textbook were evaluated by an online survey. Student outcome data (eg, grades) were collected from the learning management system at the end of the semester. ANALYSIS: Differences in student outcomes, usage, perceptions, and engagement were determined by t tests. Open-ended responses on textbook likes and dislikes were evaluated by thematic analysis. RESULTS: The number of students who completed the introductory nutrition course with a traditional textbook (n = 346) was higher than those who completed the course with an OER textbook (n = 311). There was no difference in student outcomes between textbooks. P values for student usage ranged from <.001 to .001, <.001 for engagement, and <.001 to .001 for perception with the OER textbook, with significantly better P values for outcomes than those with the traditional textbook. The $0 cost and place-based nature were noted as positive attributes of the OER textbook, whereas students appreciated the format and visual appeal of the traditional textbook. CONCLUSIONS AND IMPLICATIONS: Academic performance in introductory nutrition was not affected by an OER textbook. An OER textbook for introductory nutrition may be an appropriate solution for institutions seeking to reduce student costs.