Self-Reported Time-at-Bedside and Its Association with In-Training Examination Scores of Residents in Japan.

Background: Time-at-bedside plays a central role in clinical medicine. However, the amount of time Japanese clinical residents spend at patients' bedsides remains unexplored.

Objective: To quantify time-at-bedside and examine its association with in-training examination scores during clinical residency in Japan.

Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study.

Background: Lower gastrointestinal perforation (LGP) is an acute abdominal condition associated with a high mortality rate. Timely and accurate diagnosis is crucial. Nevertheless, a diagnostic delay has been estimated to occur in approximately one-third of the cases, and the factors contributing to this delay are yet to be clearly understood.

Low-inflammatory lipid nanoparticle-based mRNA vaccine elicits protective immunity against H5N1 high-pathogenicity avian influenza virus with reduced adverse reactions.

Messenger RNA vaccines based on lipid nanoparticles (mRNA-LNPs) are promising vaccine modalities. However, mRNA-LNP vaccines frequently cause adverse reactions such as swelling and fever in humans, partly due to the inflammatory nature of LNP. Modification of the ionizable lipids used in LNP is one approach to avoid these adverse reactions.

Residency Program Directors' Perspectives on Overtime Duty Hours and Professional Development Time in Japan.

Purpose: This study aimed to explore the perspectives of residency program directors in Japan regarding overtime duty hours and the balance between clinical training and self-improvement activities. This study explores the impact of work-hour regulations on resident well-being and training quality, contributing to global discourse on medical education reform.

Participants And Methods: A cross-sectional survey was distributed to 701 residency training hospitals across Japan to investigate their readiness for new duty-hour limits under the Medical Care Act, which categorizes working hours into Level A (960 hours/year), Level B (1440 hours/year), and Level C-1 (1920 hours/year).

A novel resident physician examination using clinical simulation video to assess clinical competence in Japan: a cross-sectional study.

Background: The general medicine in-training examination (GM-ITE) assesses physicians' clinical knowledge. This study expanded on findings from a previous pilot study to assess the relationship between general medicine in-training examination (GM-ITE) scores and the diagnostic skills of resident physicians in Japan by employing an innovative clinical simulation video (CSV-IE).

Methods: This multicenter cross-sectional study included 4,677 resident physicians who took the GMITE between January 17 and 30, 2023.

A Questionnaire Study of Leadership in General Medicine: General Physicians in Japan are Facing Challenges in Education and Research.

Purpose: General physicians are required to demonstrate diverse leadership skills depending on their environment. It is essential for them to understand the characteristics of the medical institutions to which they belong and put this understanding into practice. Leadership skills are acquired through experience and training, and their acquisition is a goal in various medical training programs.

Enhancing Clinical Reasoning Education: Implementing Case Conferences with Semantic Qualifiers and the Dual-Process Theory.

Clinical reasoning skills are crucial for physicians. In clinical reasoning conferences using real cases, medical students, residents, and senior residents can follow experts' clinical reasoning processes. However, supervisors may struggle to clearly articulate their clinical reasoning process.

Facilitating Trust Calibration in Artificial Intelligence-Driven Diagnostic Decision Support Systems for Determining Physicians' Diagnostic Accuracy: Quasi-Experimental Study.

Background: Diagnostic errors are significant problems in medical care. Despite the usefulness of artificial intelligence (AI)-based diagnostic decision support systems, the overreliance of physicians on AI-generated diagnoses may lead to diagnostic errors.

Objective: We investigated the safe use of AI-based diagnostic decision support systems with trust calibration by adjusting trust levels to match the actual reliability of AI.

Adapting Artificial Intelligence Concepts to Enhance Clinical Decision-Making: A Hybrid Intelligence Framework.

Purpose: Artificial intelligence (AI) holds great potential for revolutionizing health care by providing clinicians with data-driven insights that support more accurate and efficient clinical decisions. However, applying AI in clinical settings is often challenging due to the complexity and vastness of medical information. This perspective article explores how AI development methodologies can be adapted to support clinicians in their decision-making processes, emphasizing the importance of a hybrid approach that combines AI capabilities with clinicians' expertise.

The relation between resident mentorship and in-training examination scores: A nation-wide, cross-sectional study in Japan.

Background: Mentorship is a dynamic reciprocal relationship, wherein a novice (mentee) grows with the encouragement of an advanced careerist (mentor). It is widely implemented in medical training programs. However, there are few reports on mentorship's educational effects in the Japanese context.

A Stealthiness Evaluation of Main Chain Carboxybetaine Polymer Modified into Liposome.

Acrylamide polymers with zwitterionic carboxybetaine (CB) side groups have attracted attention as stealth polymers that do not induce antibodies when conjugated to proteins. However, they induce antibodies when modified onto liposomes. We hypothesized that antibodies are produced against polymer backbones rather than CB side groups.

Enhancing English Presentation Skills with Generative Artificial Intelligence: A Guide for Non-native Researchers.

This commentary explores the utilization of generative artificial intelligence (AI), particularly Google Gemini (previously Bard), in enhancing English presentation skills among non-native researchers. We present a step-by-step methodology for using Google Gemini's Speech-to-Text and Text-to-Speech features. Our findings suggest that Google Gemini effectively aids in draft presentations, pronunciation practice, and content verification, tapping into an area often unexplored-using AI for presentation skills in scientific research.

Association between physicians' maldistribution and core clinical competency of resident physicians: a nationwide cross-sectional study.

Objectives: With physician maldistribution recognised as a global issue, Japan implemented the physician uneven distribution (PUD) index as a strategic measure. Currently, there is a lack of objective assessment of core clinical competencies in regions influenced by varying levels of physician distribution. In this study, we objectively assess the core clinical competencies in regions affected by physician maldistribution and explore the relationship between the PUD index and the clinical competencies of resident physicians.

Hepatitis B Virus-KMT2B Integration Drives Hepatic Oncogenic Processes in a Human Gene-edited Induced Pluripotent Stem Cells-derived Model.

Background & Aims: Hepatitis B virus (HBV)-DNA integration into the host genome contributes to hepatocellular carcinoma (HCC) development. KMT2B is the second most frequent locus of HBV-DNA integration in HCC; however, its role and function remain unclear. We aimed to clarify the impact of HBV-KMT2B integration in HCC development using a human genome-edited induced pluripotent stem cell (iPSCs) model.

Impact of disclosing a working diagnosis during simulated patient handoff presentation in the emergency department: correctness matters.

Introduction: Diagnostic errors in emergency departments (ED) are a significant concern and exacerbated by cognitive biases during patient handoffs. The timing and accuracy of disclosing working diagnoses during these handoffs potentially influence diagnostic decisions, yet empirical evidence remains limited.

Materials And Methods: This parallel, quasi-experimental study involved 40 interns from Japanese teaching hospitals, randomly assigned to control or intervention groups.

Lessons in clinical reasoning - pitfalls, myths, and pearls: a case of persistent dysphagia and patient partnership.

Objectives: Diagnostic excellence underscores the patient-centered diagnosis and patient engagement in the diagnostic process. In contrast to a patient-centered diagnosis, a doctor-centered diagnosis with a lack of patient engagement may inhibit the diagnostic process due to the lack of responsibility, disrupted information, and increased effect of cognitive biases, particularly in a situation where multiple physicians are involved. In this paper, we suggest a promising idea to enhance patient engagement in the diagnostic process by using written information by a patient about their perspective and experience, which can fill the gaps needed for diagnosis that doctors cannot find alone.