Professional Societies Research Articles

Start with muscle mass or muscle strength in diagnosis and management of sarcopenia? A systematic review of guidance documents.

Sarcopenia has garnered extensive attention in clinical practice since its high prevalence and significant impact on clinical outcomes. Multiple organizations have published guidance documents on sarcopenia, offering evidence-based recommendations for clinical practice and/or research. We aimed to appraise the methodological quality of the included documents and synthesize available recommendations for the screening, diagnosis, and intervention of sarcopenia. We conducted a search on PubMed, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, guideline database, and guideline organizations and professional societies websites for clinical practices, consensus statements and position papers in terms of sarcopenia, muscle atrophy or muscle loss published before April 17, 2023. The AGREE II instrument was used by three independent reviewers to assess the methodological quality of these documents. Thirty-six guidance documents published between 2010 and 2023 were included. Seven documents fulfilled ≥ 50% of all the AGREE II domains. Seven underwent a Delphi process and six graded the strength of the recommendations. The process of screening (n=21), early diagnosis of sarcopenia (n=12), diagnosis of sarcopenia and severe sarcopenia (n=10), and management (n=21) were increasingly recommended. SARC-F (n=14) was the most recommended screening tool, and the assessment of muscle function was considered the first step in diagnosing sarcopenia. The management strategy for both age-related and disease-related sarcopenia mainly focused on exercise and nutrition intervention. The guidance documents have provided referential recommendations that have great guiding significance. But the inconsistency in recommendations and variation in methodological rigour suggests that high-quality evidence is lacking yet.

Growth charts for use at birth and in the neonatal period: Recommendations of the French Neonatal Society.

The use of different growth charts can lead to confusion in discussions between professionals. There are obstetric charts (of fetal growth) and neonatal charts (of measurements at birth and of postnatal growth). These charts can be descriptive (derived from an unselected population) or prescriptive (derived from of a population at low risk and with optimal conditions for growth). (1) To describe available charts for infants at birth and in the neonatal period and compare them, and (2) to recommend one or more charts for use in neonatology in France. Bibliographic research was conducted on MEDLINE and completed by the guidelines of professional societies. Antenatal information about fetal growth restriction (FGR) or fetuses identified as small-for-gestational-age using Intrauterine charts must be integrated into the identification of newborns at risk, but the use of Intrauterine charts to evaluate birthweight is not recommended to allow consistency with postnatal charts used in neonatal practice. Z-score variations using the updated Fenton postnatal charts are the most appropriate for the assessment of birthweight and postnatal growth for infants born preterm. These charts are sex-specific, include the three measurements (length, weight, and head circumference) and enable longitudinal follow-up of growth up to 50 weeks of corrected age and are linked to the WHO charts at term. The French Audipog charts, although are individualized, accessible online and can be used in maternity units to evaluate birthweight for term infants, but do not allow the follow-up of postnatal growth, while Fenton charts may be used to evaluate birthweight and postnatal growth in the first month for hospitalized term infants. The updated Fenton charts are the neonatal charts that best suit the objectives of pediatricians in France for monitoring the growth of preterm newborns. The use of the Audipog charts at term remains an alternative in maternity wards, while Fenton charts can be used for hospitalized term newborns.

The role of family history in predicting germline pathogenic variant carriers who develop pancreatic cancer: Results of a multicenter collaboration.

Pancreatic ductal adenocarcinoma (PDAC) surveillance is recommended for some individuals with a pathogenic or likely pathogenic variant (PV/LPV) in a PDAC susceptibility gene; the recommendation is often dependent on family history of PDAC. This study aimed to describe PDAC family history in individuals with PDAC who underwent genetic testing to determine the appropriateness of including a family history requirement in these recommendations. Individuals with PDAC with a germline heterozygous PV/LPV in ATM, BRCA1, BRCA2, EPCAM, MLH1, MSH2, MSH6, PALB2, or PMS2 (PV/LPV carriers) were assessed for family history of PDAC in first-degree relatives (FDRs) or second-degree relatives (SDRs) from nine institutions. A control group of individuals with PDAC without a germline PV/LPV was also assessed. The study included 196 PV/LPV carriers and 1184 controls. In the PV/LPV carriers, 25.5% had an affected FDR and/or SDR compared to 16.9% in the control group (p=.004). PV/LPV carriers were more likely to have an affected FDR compared to the controls (p=.003) but there was no statistical difference when assessing only affected SDRs (p=.344). Most PV/LPV carriers who developed PDAC did not have a close family history of PDAC and would not have met most current professional societies' recommendations for consideration of PDAC surveillance before diagnosis. However, PV/LPV carriers were significantly more likely to have a family history of PDAC, particularly an affected FDR. These findings support family history as a risk modifier in PV/LPV carriers, and highlight the need to identify other risk factors.

Assessment of the Educational and Training Modalities in Point-of-Care Ultrasound (POCUS) for Anesthesiologists.

Point-of-care ultrasound (POCUS) has been developed as a critical tool for diagnostic patient evaluation and clinical management. Its transcendence into anesthesiology necessitates appropriate and effective educational strategies to assist in the development of anesthesia POCUS learners. Several professional societies, including the American Society of Anesthesiologists (ASA), American Society of Regional Anesthesia (ASRA), and Accreditation Council for Graduate Medical Education (ACGME) for anesthesiology have established minimum training standards for POCUS education for anesthesiologists, residents, and fellows.1,4 The article at hand aims to summarize and provide insight into the various educational modalities utilized in POCUS training, incorporate these strategies in the established "Indication, Acquisition, Interpretation, and Medical decision-making" (I-AIM) framework, and include recommendations on the minimum number of POCUS exams to aid in achieving competency.3.

Factors that influence the formation and impact of mentorship relationships for OB/GYN residents

Background Mentorship is critical for successful careers in academic medicine. There is a gap in the literature regarding specific qualities that make effective mentorship relationships for Obstetrics and Gynecology (OB/GYN) residents. This study aimed to identify the attributes most valued by OB/GYN residents in their mentorship relationships and to explore the factors influencing their choice of mentors. Methods We conducted a cross-sectional survey among OB/GYN residents, distributed electronically November 2021-March 2022. Demographic data, mentor qualities, satisfaction with current mentorship and mentee factors were identified. The survey incorporated questions adapted from the validated Ideal Mentor Scale assessing three mentor attributes: Integrity, Guidance, and Relationship. Data analysis involved descriptive statistics, Student’s t-tests, chi-squared tests, and Fisher’s Exact tests where appropriate. Results 48 of 60 (80%) of surveyed residents responded. Among the respondents, 72.9% were female and 29.1% identified as non-white. Integrity emerged as the most valued Ideal Mentor attribute. No statistically significant gender-based differences were observed in the preferences for mentor characteristics including gender of a mentor. Non-white respondents placed greater importance on having a mentor of the same race (p<0.01). Residents interested in subspecialties expressed a stronger preference for mentors with fellowship training (p<0.01) and shared research experiences (p=0.03). Conclusions OB/GYN residents seek mentors characterized by integrity and who are active in research and professional societies aligned with their interests. The data highlight the importance of considering race and subspecialty preferences in fostering influential and equitable mentorship for all residents.

Reimagining Colorectal Cancer Screening: Innovations and Challenges with Dr. Aasma Shaukat.

Colorectal cancer (CRC) currently ranks as the third most common cancer and the second leading cause of cancer-related deaths worldwide, posing a significant global health burden to the population. Recent studies have reported the emergence of a new clinical picture of the disease, with a notable increase in CRC rates in younger populations of <50 years of age. The American Cancer Society (ACS) now recommends CRC screening starting at age 45 for average-risk individuals. Dr. Aasma Shaukat's Keynote Conference highlights the critical need for updated screening strategies, with an emphasis on addressing the suboptimal adherence rates and the effective management of the growing burden of CRC. Lowering the adenoma detection screening age can facilitate early identification of adenomas in younger asymptomatic patients, altering the epidemiologic landscape. However, its implications may not be as profound unless a drastic shift in the age distribution of CRC is observed. Currently, various screening options are available in practice, including stool-based tests like multitarget stool DNA (mtDNA) tests, fecal immunochemical testing (FIT), and imaging-based tests. In addition to existing screening methods, blood-based tests are now emerging as promising tools for early CRC detection. These tests leverage innovative techniques along with AI and machine learning algorithms, aiding in tumor detection at a significantly earlier stage, which was not possible before. Medicare mandates specific criteria for national coverage of blood-based tests, including sensitivity ≥ 74%, specificity ≥ 90%, FDA approval, and inclusion in professional society guidelines. Ongoing clinical trials, such as Freenome, Guardant, and CancerSEEK, offer hope for further advancements in blood-based CRC screening. The development of multicancer early detection tests like GRAIL demonstrates a tremendous potential for detecting various solid tumors and hematologic malignancies. Despite these breakthroughs, the question of accessibility and affordability still stands. The ever-evolving landscape of CRC screening reflects the strength of the scientific field in light of an altered disease epidemiology. Lowering screening age along with the integration of blood-based tests with existing screening methods holds great potential in reducing the CRC-related burden. At the same time, it is increasingly important to address the challenges of adaptation of the healthcare system to this change in the epidemiologic paradigm.

How are pediatricians treating molluscum contagiosum? results from in-depth interviews

Molluscum contagiosum is a common, often persistent viral skin infection affecting children, and spread by infected individuals or objects. No molluscum management guidelines exist and only two FDA treatments have been approved in the last year, thus placing pediatricians in a clinical conundrum if molluscum treatment is warranted. When MC is particularly bothersome or persistent, parental anxiety may influence treatment. In-depth interviews with 25 pediatricians provided insight into the current MC treatment landscape and drivers of therapeutic intervention. This study reveals the important influence parental anxiety, patient characteristics, and parental involvement have on pediatrician’s molluscum management and treatment intervention practices. Professional society endorsed molluscum management guidelines and the use of safe and efficacious FDA-approved therapies would fill therapeutic gaps.

Midrange, Differential, Meaningful, and Multidisciplinary: Reflections on JCR’s Epistemic Culture

Abstract Scientific communities such as journals or professional societies have their own ways of creating and sharing knowledge called “epistemic cultures.” Drawing on prior reflexive scholarship and conversations with eight preeminent consumer researchers, this article explores some of the central tenets of epistemic culture at the Journal of Consumer Research (JCR): midrange scope, differential insight, meaningful impact, and multidisciplinary field. It also provides some guidance to new consumer researchers on how to accomplish epistemic fluency.

Is the accounting curricula keeping up with sustainability development?

ABSTRACT There is continuing demand from practitioners, standard setters, and regulators for accountants to have the knowledge and competencies to contribute to sustainable business practices, reporting, and assurance. Educators at all levels of the accounting curricula have a responsibility to upskill. This research examines the extent of sustainability education among all levels of accounting curricula. Publicly available course information at three levels in New Zealand – secondary school, university, and professional accounting – was analysed using content analysis. The research finds a lack of sustainability education at all accounting curricula levels, with uneven coverage that is focused on sustainability broadly with questionable breadth and depth. This inconsistency among accounting educators results in accounting graduates with varied exposure to sustainability. This research calls for collective responsibility and collaborative leadership among educators, professional accounting bodies, practitioners, standard setters, regulators, and society to ensure sustainability education keeps pace with the development of sustainability accounting practice globally.

Disparities in integrating non-invasive prenatal testing into antenatal healthcare in Australia: a survey of healthcare professionals

BackgroundNon-invasive prenatal testing (NIPT) has been clinically available in Australia on a user-pays basis since 2012. There are numerous providers, with available tests ranging from targeted NIPT (only trisomies 21, 18, and 13 +/- sex chromosome aneuploidy) to genome-wide NIPT. While NIPT is being implemented in the public health care systems of other countries, in Australia, the implementation of NIPT has proceeded without public funding. The aim of this study was to investigate how NIPT has been integrated into antenatal care across Australia and reveal the successes and challenges in its implementation in this context.MethodsAn anonymous online survey was conducted from September to October 2022. Invitations to participate were sent to healthcare professionals (HCPs) involved in the provision of NIPT in Australia through professional society mailing lists and networks. Participants were asked questions on their knowledge of NIPT, delivery of NIPT, and post-test management of results.ResultsA total of 475 HCPs responded, comprising 232 (48.8%) obstetricians, 167 (35.2%) general practitioners, 32 (6.7%) midwives, and 44 (9.3%) genetic specialists. NIPT was most commonly offered as a first-tier test, with most HCPs (n = 279; 60.3%) offering it to patients as a choice between NIPT and combined first-trimester screening. Fifty-three percent (n = 245) of respondents always offered patients a choice between NIPT for the common autosomal trisomies and expanded (including genome-wide) NIPT. This choice was understood as supporting patient autonomy and informed consent. Cost was seen as a major barrier to access to NIPT, for both targeted and expanded tests. Equitable access, increasing time demands on HCPs, and staying up to date with advances were frequently reported as major challenges in delivering NIPT.ConclusionsOur findings demonstrate substantial variation in the clinical implementation of NIPT in Australia, including in the offers of expanded screening options. After a decade of clinical use, Australian clinicians still report ongoing challenges in the clinical and equitable provision of NIPT.

Pulmonary Embolism in Pregnancy: A Review for Clinical Practitioners.

Diagnostic and therapeutic decision-making in pregnancy with suspected pulmonary embolism (PE) is challenging. European and other international professional societies have proposed various recommendations that are ambiguous, probably due to the unavailability of randomized controlled trials. In the following sections, we discuss the supporting diagnostic steps and treatments. We suggest a standardized diagnostic work-up in pregnant patients presenting with symptoms of PE to make evidence-based diagnostic and therapeutic decisions. We strongly recommend that clinical decisions on treatment in pregnant patients with intermediate- or high-risk pulmonary embolism should include a multidisciplinary team approach involving emergency physicians, pulmonologists, angiologist, cardiologists, thoracic and/or cardiovascular surgeons, radiologists, and obstetricians to choose a tailored management option including an interventional treatment. It is important to be aware of the differences among guidelines and to assess each case individually, considering the specific views of the different specialties. This review summarizes key concepts of the diagnostics and acute management of pregnant women with suspected PE that are supportive for the clinician on duty.

Point-of-Care Ultrasound Psychomotor Learning Curves: A Systematic Review of the Literature.

Use of point-of-care ultrasound (POCUS) in clinical medicine and inclusion in medical training is increasing. Some professional societies recommend that 25-50 POCUS examinations be completed for each application learned; however, the amount of practice required is not well studied. As such, a better understanding of the learning curves of POCUS psychomotor skills is needed. This systematic review characterizes the learning curves for POCUS psychomotor skill acquisition. With the assistance of a research librarian, the available literature through August 28, 2023, was identified. The titles and abstracts, and then the full text were reviewed by two reviewers to screen for inclusion. All studies included after full-text review then underwent data extraction and analysis. The search identified 893 unique studies. Forty-five studies underwent full-text review, with 17 meeting full inclusion criteria. Substantial heterogeneity was noted in study design, duration of education, number and type of learners, and methods for statistical analysis. Clear and validated definitions for learning endpoints, such as plateau points or competency, are lacking. Learning curves and endpoints differ for different applications of POCUS. The results are overall supportive of the recommendations to complete 25-50 examinations per application of POCUS learned. However, specific applications require more practice than others. Certain applications, such as cardiac and the Focused Assessment with Sonography in Trauma (FAST) exams, are closer to 50; while others, such as soft tissue, airway, and eye require no more than 25.

Does the Innovation Fund Improve Healthcare Provision? A Critical Assessment of the Status of Implementing Successful Innovation Fund Projects into Healthcare Practice

Since 2015, the Federal Joint Committee (G-BA)'s Innovation Fund has been supporting projects in health services research and new health service models ("Neue Versorgungsformen", NVF). By the end of 2022, 211 projects in the NVF category had been funded. A key objective is the transfer of successful projects into standard care. This article analyzes previous projects regarding their incorporation into routine care based on transfer recommendations of the Innovation Fund Committee ("Innovationsausschuss" IA). Descriptive analysis of all projects completed by August 1, 2023 with transfer recommendations in the "NVF" funding stream. Presentation by topic, project duration, time until IA transfer decision, categorization, and number of institutions and organizations (recipients) addressed per project, their feedback published on the G-BA website, response rates per recipient group, and a content classification and interpretation of exemplary feedback. Recommendations based on the results and their discussion in an expert workshop. Out of 57 NVF projects, 17 had a transfer recommendation. A total of 57 feedback responses were received from a total of 431 recipients addressed by the IA across these projects. Response rates varied significantly. One-third of inquiries to the G-BA and its member organizations received a response (31%), while only every fifth inquiry to federal states (18%) and professional societies (18%) got a response. Less than one in ten inquiries to the Federal Ministry of Health (8%), administrative bodies (6%), and the German Medical Association (0%) received a response. Project-specific feedback within a recipient group was often contradictory or limited to regional scope. The transfer process reveals significant structural and procedural obstacles regarding the incorporation of projects evaluated as successful into routine health care. To ensure that funding from the innovation fund is most effectively used, there needs to be a realistic chance of successful transfer of positive project outcomes into routine care. The DNVF recommends stronger involvement of rule-competent institutions, mandatory publication of responses, structured moderation of the transfer process, expanding types of selective contracts, financing of implementation phases and of studies drawing on results across successful NVF projects.

Preoperative evaluation of adult patients before elective, non-cardiothoracic surgery : A joint recommendation of the German Society for Anesthesiology and Intensive Care Medicine, the German Society for Surgery and the German Society for Internal Medicine

The 70recommendations summarize the current status of preoperative risk evaluation of adult patients prior to elective non-cardiothoracic surgery. Based on the joint publications of the German scientific societies for anesthesiology and intensive care medicine (DGAI), surgery (DGCH), and internal medicine (DGIM), which were first published in 2010 and updated in 2017, as well as the European guideline on preoperative cardiac risk evaluation published in 2022, acomprehensive re-evaluation of the recommendation takes place, taking into account new findings, the current literature, and current guidelines of international professional societies. The revised multidisciplinary recommendation is intended to facilitate astructured and common approach to the preoperative evaluation of patients. The aim is to ensure individualized preparation for the patient prior to surgery and thus to increase patient safety. Taking into account intervention- and patient-specific factors, which are indispensable in the preoperative risk evaluation, the perioperative risk for the patient should be minimized and safety increased. The recommendations for action are summarized under "General Principles(A)," "Advanced Diagnostics(B)," and the "Preoperative Management of Continuous Medication(C)." For the first time, arating of the individual measures with regard to their clinical relevance has been given in the present recommendation. Ajoint and transparent agreement is intended to ensure ahigh level of patient orientation while avoiding unnecessary preliminary examinations, to shorten preoperative examination procedures, and ultimately to save costs. The joint recommendation of DGAI, DGCH and DGIM reflects the current state of knowledge as well as the opinion of experts. The recommendation does not replace the individualized decision between patient and physician about the best preoperative strategy and treatment.

A Scholarly Dialog on Recent Trends in National Institutes of Health's Funding for the Thyroid Field.

Background: The National Institutes of Health (NIH) is the major funding agency for biomedical research in the United States. To initiate a scholarly dialog about research and career development in the thyroid field, here we reviewed recent trends in NIH funding for this area. We used the Research Portfolio Online Reporting Tool database to estimate the level of NIH extramural support during 2013-2022 (number of active grants/year and $amount/year weighed by the total number of active grants/year and $amount/year), provided by the NIH to the thyroid field. We determined that in 2013, the NIH supported ∼140 grants/year, totaling almost $50 million/year, the majority in the form of R01 grants. Within the thyroid field, support was evenly split between thyroid cancer and thyroid hormone metabolism and action subareas. In the subsequent years (2014-2022), the total number of active grants peaked at 150/year ($55 million) in 2014 but progressively decreased to about 100 active grants/year ($30 million) in 2022. This trend occurred while the NIH budget increased from $29 to $46 billion/year. Globally, the number of thyroid-related publications increased by ∼70% during the study period, and the fractional contribution of several countries remained relatively stable, except for China which increased by ∼600%. Remarkably, the fraction of thyroid-related publications in the United States sponsored by the NIH decreased from 5.5% to 3.1% of the global number. Conclusion: These results constitute a very concerning scenario for research and education in the thyroid field. We appeal to the NIH, the professional societies in endocrinology and thyroidology, and all other relevant stakeholders such as thyroid-related professionals and thyroid patients to engage in further discussions to identify the root causes of this trend and implement an action plan to stabilize and eventually reverse this situation.

A Commentary on Recent Announcements by The American Professional Society on the Abuse of Children and Child Maltreatment.

In a recent issue of Child Maltreatment (2023 vol. 28 (4)), an editorial by Palusci et al. and a commentary by Briggs et al. were published. These two publications express the American Professional Society on the Abuse of Children (APSAC) Board's and the Child Maltreatment editorial team's stance relative to Diversity, Equity, Inclusion and Justice (DEIJ). The current commentary expresses a range of concerns regarding how APSAC and Child Maltreatment plan to advance DEIJ through their editorial policies.

Appropriate Use Criteria Committees: The Professional Society Role in the Development and Implementation of Appropriate Use Criteria

Vascular surgeons have the ability to manage and intervene on numerous vascular diseases of both the arterial and venous systems. With the growing number of interventions available as endovascular technology evolves, it is important to determine when a procedure is safely indicated for a vascular surgery patient. Appropriate Use Criteria (AUC) offers synthesized clinical information and practice standards that can aid clinicians in making these management decisions. Professional societies, such as the Society for Vascular Surgery (SVS), bring experts in the field together to collaborate and create AUC for various vascular diseases and interventions. It is essential to publish these criteria in peer-reviewed journals as well as make them available on public websites, making the information available to vascular surgeons as well as to interventionalists from other specialties who also treat patients with vascular disease. Cardiology, interventional radiology, and interventional nephrology are some other specialties who perform procedures for vascular disease, and vascular interventions by non-surgeon specialists continue to increase [1]. SVS has published AUCs on intermittent claudication, carotid disease, and abdominal aneurysm management. These are intended to guide practice, but also have highlighted areas for improvement that would allow for more universal implementation of AUCs in vascular patient care across medical specialties. Increased intersocietal participation and perhaps inclusion of government and other payer participation will allow Professional Society sponsored AUCs to evolve, resulting in coordinated, appropriate care for vascular surgery patients.

Unification of Efforts to Improve Global Access to Cancer Therapeutics: Report From the 2022/2023 Access to Essential Cancer Medicines Stakeholder Summit.

There is an urgent need to improve access to cancer therapy globally. Several independent initiatives have been undertaken to improve access to cancer medicines, and additional new initiatives are in development. Improved sharing of experiences and increased collaboration are needed to achieve substantial improvements in global access to essential oncology medicines. The inaugural Access to Essential Cancer Medicines Stakeholder Meeting was organized by ASCO and convened at the June 2022 ASCO Annual Meeting in Chicago, IL, with two subsequent meetings, Union for International Cancer Control World Cancer Congress held in Geneva, Switzerland, in October 2022 and at the ASCO Annual Meeting in June of 2023. Invited stakeholders included representatives from cancer institutes, physicians, researchers, professional societies, the pharmaceutical industry, patient advocacy organizations, funders, cancer organizations and foundations, policy makers, and regulatory bodies. The session was moderated by ASCO. Past efforts and current and upcoming initiatives were initially discussed (2022), updates on progress were provided (2023), and broad agreement on resulting action steps was achieved with participants. Summit participants recognized that while much work was ongoing to enhance access to cancer therapeutics globally, communication and synergy across projects and organizations could be enhanced by providing a platform for collaboration and shared expertise. The summit resulted in new cross-stakeholder insights and planned collaboration addressing barriers to accessing cancer medications. Specific actions and timelines for implementation and reporting were established.

Fertility education on Instagram: advertisements vs. educational content analysis for posts in Bahasa (Indonesian language).

As one of Indonesia's major social media platforms, Instagram provides abundant information, including fertility topics. However, fertility information in Bahasa (Indonesian language) had never been mapped before. This study aims to determine the prevalence, authorship, and types of fertility-related information in Bahasa shared on Instagram using hashtag and content analysis. Additional outcomes included a comparison of post content stratified by author type (healthcare providers vs. non-healthcare providers). Five hashtags comprising fertility terms in Bahasa (Indonesian language) were derived. Content analysis was performed on the top 100 posts for each hashtag to determine the authorship and content type. The contents posted by healthcare providers were analyzed and compared to those published by non-healthcare providers. Our search yielded 3883000 posts for the five most popular hashtags. The three most popular hashtags were 'promil', 'program hamil' and 'bayitabung'. Authorship of the top posts for each hashtag was predominantly by for-profit healthcare institutions (27.6%), followed by commercial alternative/herbal medicine (20.2%), patients (20%), physicians (11.8%), allied health professionals (3.2%), professional societies (0.8%), and others (16.4%). Of these posts, 35.4% were advertisements, 28% were related to patient experience, and 18% were educational. Healthcare provider groups were more likely to author educational posts than advertisements, while non-healthcare providers were more likely to post content for commercial purposes (P < 0.001). Fertility-related posts were dominated by for-profit healthcare institutions and alternative/herbal medicines for commercial purposes. The physician group authored more of the educational content. There is plenty of room for optimal utilization of social platforms as educational media.

State of art of robotic prostatectomy: the way we do it in Catalonia, Spain

Introduction and objectiveRobotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR “state of art” in Catalonia, Spain. Material and methodsThis was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20. Results59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage.Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07−0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07−127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087–201.27), but there was no correlation with time the bladder catheter or days hospitalized. ConclusionsThe study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.