Follow Informed Patient Consent in Clinical Teaching in Order to Achieve a Truly Patient-Centered Approach.

Patient- and disease-focused clinical teaching is considered the cornerstone of medical education. Current clinical teaching is increasingly taking place in outpatient settings, but this can cause discomfort to patients. Although many professional organizations have developed a set of ethical considerations in response to this issue to use these considerations to guide clinics in their outpatient procedures, these guidelines are not well adhered to in outpatient practice. My experience as an eczema patient in a dermatology outpatient is good evidence of this. In my opinion, there is nothing inherently wrong with the pedagogy of medical students observing clinical interactions in outpatient settings; the real problem lies in not informing the patient of the medical student's presence or allowing the patient to exercise his or her right of refusal. Therefore, the following recommendations are made: First, academic medical centers should provide regular training to doctors and medical students to ensure that they are fully aware of what is contained in the ethical guidelines established by the professional organizations and that they recognize the importance of adhering to these guidelines in clinical practice. Second, each clinical teaching activity should have the informed consent of the patient and be based on the patient's wishes. Finally, it is recommended that hospitals establish appropriate evaluation mechanisms to assess doctors' compliance with the ethical guidelines and provide continuing education and training for doctors and medical students who fail to comply.

Other possible perspectives for solving the negative outcome penalty paradox in the application of artificial intelligence in clinical diagnostics.

Artificial intelligence (AI), represented by machine learning, artificial neural networks and deep learning, is impacting all areas of medicine, including translational research (from bench to bedside to health policy), clinical medicine (including diagnosis, treatment, prognosis and healthcare resource allocation) and public health. At a time when almost everyone is focused on how to better realise the promise of AI to transform the entire healthcare system, Dr Appel calls for public attention to the AI in medicine and the negative outcome penalty paradox. Proposing this topic has deepened our thinking about the application of AI in clinical diagnostics, and also prompted us to find more effective ways to integrate AI more effectively into future clinical practice. In addition to Dr Appel's insightful advice, I hope to offer three other possible perspectives, including changing public perceptions, re-engineering clinical practice processes and introducing more stakeholders, to further the discussion on this topic.

Cdc42 expression in cervical cancer and its effects on cervical tumor invasion and migration.

The aim of the present study was to examine Cdc42 expression in cervical cancer and explore its effects on invasion and migration capability of cervical cancer cells. Immunohistochemistry was used to detect Cdc42 expression in normal cervical tissues as well as CIN I or below, CIN II or above, and cervical cancer tissues. Western blot analysis was used to explore Cdc42 expression in normal cervical cell line Crl-2614 and cervical cancer cell line HeLa. Plasmids of constitutively active Cdc42 (Cdc42 CA), wild-type Cdc42 (Cdc42 WT) and dominant negative Cdc42 (Cdc42 DN) were transfected, respectively, into HeLa cells to investigate the impacts of Cdc42 on migration and invasion of cervical cancer cells using Transwell and on cytoskeleton microfilaments using confocal microscopy after immunofluorescence staining. Cdc42 expression was gradually increased in the order of cervical tissues with CIN I or below, CIN II or above and cancer, showing significant difference (P<0.05), and was significantly higher in HeLa cells than in Crl-2614 cells (P<0.05). Migration ability of HeLa cells transfected with Cdc42 CA was significantly higher than that of non-transfected, as well as Cdc42 WT- or Cdc42 DN-transfected HeLa cells (P<0.05). Overexpression of Cdc42 CA can promote filopodia formation in HeLa cells. We concluded that Cdc42 overexpression significantly improved the ability of cervical cancer cells to migrate possibly due to improved pseudopodia formation.