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Risk engineers conduct comprehensive risk assessments for many types of large projects, often singularly focused on the technical assessment. Overlooking comprehensive community stakeholders in the assessment process increases stakeholder skepticism, apprehension, and mistrust regarding safety, health and welfare of nearby stakeholders, for complex projects. Social experts repeatedly document connections between problem framing, communication processes, and risks. This paper considers formalizing connections between the risk register to stakeholder perceptions and communication plans. A theoretical Risk Perception Management (RPM) plan connects risks into communication plans based upon including social expert suggestions for four large projects: two bio-safety-level 4 (BSL-4) laboratories and two levee system assessment projects. The concept of a Risk Perception Management (RPM) Plan integrated with the risk register is presented. The paper shows how the RPM concept iteratively captures stakeholder perceptions to build associated communication plans, thus potentially increasing risk assessment value for stakeholders and decision-makers. [ABSTRACT FROM AUTHOR]

The article reports on the participation of several urologists in an international urology journal club for 12 months through the microblogging website Twitter. The club attracted 189 participants from 19 countries and six continents. The contribution of social media to the active involvement of professionals are mentioned.

Introduction: Assessments in medical education play a central role in evaluating trainees' progress and eventual competence. Generative artificial intelligence is finding an increasing role in clinical care and medical education. The objective of this study was to evaluate the ability of the large language model ChatGPT to generate examination questions that are discriminating in the evaluation of graduating urology residents., Methods: Graduating urology residents representing all Canadian training programs gather yearly for a mock examination that simulates their upcoming board certification examination. The examination consists of a written multiple-choice question (MCQ) examination and an oral objective structured clinical examination. In 2023, ChatGPT Version 4 was used to generate 20 MCQs that were added to the written component. ChatGPT was asked to use Campbell-Walsh Urology, AUA, and Canadian Urological Association guidelines as resources. Psychometric analysis of the ChatGPT MCQs was conducted. The MCQs were also researched by 3 faculty for face validity and to ascertain whether they came from a valid source., Results: The mean score of the 35 examination takers on the ChatGPT MCQs was 60.7% vs 61.1% for the overall examination. Twenty-five of ChatGPT MCQs showed a discriminating index >0.3, the threshold for questions that properly discriminate between high and low examination performers. Twenty-five percent of ChatGPT MCQs showed a point biserial >0.2, which is considered a high correlation with overall performance on the examination. The assessment by faculty found that ChatGPT MCQs often provided incomplete information in the stem, provided multiple potentially correct answers, and were sometimes not rooted in the literature. Thirty-five percent of the MCQs generated by ChatGPT provided wrong answers to stems., Conclusions: Despite what seems to be similar performance on ChatGPT MCQs and the overall examination, ChatGPT MCQs tend not to be highly discriminating. Poorly phrased questions with potential for artificial intelligence hallucinations are ever present. Careful vetting for quality of ChatGPT questions should be undertaken before their use on assessments in urology training examinations.

The incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are thought to be the main drivers of insulin secretion in individuals with sulfonylurea (SU)-treated KCNJ11 permanent neonatal diabetes. The aim of this study was to assess for the first time the incretin hormone response to carbohydrate and protein/fat in adults with sulfonylurea-treated KCNJ11 permanent neonatal diabetes compared with that of controls without diabetes. Participants were given a breakfast high in carbohydrate and an isocaloric breakfast high in protein/fat on two different mornings. Incremental area under the curve and total area under the curve (0-240 minutes) for total GLP-1 and GIP were compared between groups, using non-parametric statistical methods. Post-meal GLP-1 and GIP secretion were similar in cases and controls, suggesting this process is adenosine triphosphate-sensitive potassium channel-independent. Future research will investigate whether treatments targeting the incretin pathway are effective in individuals with KCNJ11 permanent neonatal diabetes who do not have good glycemic control on sulfonylurea alone., (© 2023 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

Background: Patient education is a fundamental aspect of self-management of diabetes. The aim of this study was to understand whether a social media platform is a viable method to deliver education to people with diabetes and understand if people would engage and interact with it., Methods: Education sessions were provided via 3 platforms in a variety of formats. "Tweetorials" and quizzes were delivered on the diabetes101 Twitter account, a virtual conference via Zoom and video presentations uploaded to YouTube. Audience engagement during and after the sessions were analyzed using social media metrics including impressions and engagement rate using Twitter analytics, Tweepsmap, and YouTube Studio., Results: A total of 22 "tweetorial" sessions and 5 quizzes with a total of 151 polls (both in tweetorial and quiz sessions) receiving a total of 21,269 votes took place. Overall, the 1-h tweetorial sessions gained 1,821,088 impressions with an engagement rate of 6.3%. The sessions received a total of 2,341 retweets, 2,467 replies and 10,060 likes. The quiz days included 113 polls receiving 16,069 votes. The conference covered 8 topics and was attended live by over 100 people on the day. The video presentations on YouTube have received a total of 2,916 views with a watch time of 281 h and 8,847 impressions., Conclusion: Despite the limitations of social media, it can be harnessed to provide relevant reliable information and education about diabetes allowing people the time and space to learn at their own pace.

High-throughput (HT) screening drug discovery, during which thousands or millions of compounds are screened, remains the key methodology for identifying active chemical matter in early drug discovery pipelines. Recent technological developments in mass spectrometry (MS) and automation have revolutionized the application of MS for use in HT screens. These methods allow the targeting of unlabelled biomolecules in HT assays, thereby expanding the breadth of targets for which HT assays can be developed compared to traditional approaches. Moreover, these label-free MS assays are often cheaper, faster, and more physiologically relevant than competing assay technologies. In this review, we will describe current MS techniques used in drug discovery and explain their advantages and disadvantages. We will highlight the power of mass spectrometry in label-free in vitro assays, and its application for setting up multiplexed cellular phenotypic assays, providing an exciting new tool for screening compounds in cell lines, and even primary cells. Finally, we will give an outlook on how technological advances will increase the future use and the capabilities of mass spectrometry in drug discovery., (© 2022 The Authors. Published under the terms of the CC BY 4.0 license.)

Background: The International Urology Journal Club attracts global participation; however, its effectiveness as an educational resource is undetermined., Objective: To evaluate the effectiveness of the international Twitter-based urology journal club (#urojc) using Kirkpatrick's evaluation model and to quantify the development of #urojc into a robust educational platform., Design, Setting, and Participants: A 13-item survey was sent to 3127 followers of #urojc. Twitter metrics including number of users, tweets, and impressions during 24 mo of operation were obtained via a third-party service "Symplur." Tweets were qualitatively analyzed to assess for relevance. Kirkpatrick's four-level evaluation model (reaction, learning, behavior, and results) was applied to analyze impact and effectiveness., Results and Limitations: Survey participation rate was 48% (after accounting for spam and inactive accounts). The reaction (Kirkpatrick level 1) to #urojc was overwhelmingly positive. Consultant urologists were the most active participants while trainees reported highest educational value. As much as 45% of junior consultant urologists and trainees reported a change in practice as a result of #urojc participation. The number of unique users of #urojc almost doubled from yr 1 to 2. The number of tweets per month and author participation increased from yr 1 to 2. The proportion of content-relevant tweets remained stably high at approximately 60%. This study was unable to document any impact on knowledge, behavior, or outcomes of #urojc (Kirkpatrick levels 2-4). Silent observers who do not follow #urojc were not captured., Conclusions: To our knowledge, this is the first time Kirkpatrick's evaluation model has been applied to a journal club. The reaction to #urojc among survey responders is positive with change in practice also reported. It appears that #urojc achieves level 1 of Kirkpatrick's evaluation model. Further investigation is required for levels 2-4. Twitter-based journal clubs draw robust global participation and have inspired journal clubs in other specialties., Patient Summary: This report highlights the importance of the International Urology Journal Club as a potential educational resource of consultant urologists and trainees alike. Global participation was a major advantage of this platform. This journal club has inspired other medical specialties to follow suit., (Copyright © 2019 European Association of Urology. All rights reserved.)

Introduction: Crowdfunding is becoming an increasingly used resource for patients to cover costs related to medical care. These costs can be related directly to treatments or indirectly to loss of income or travel-related costs. Little is known as to the extent of which crowdfunding is used for urological disease here in Canada. This study offers a first look at the prevalence of crowdfunding for urological disease and the factors surrounding its use., Methods: In January 2020, we queried the GoFundMe internal search engine for fundraising campaigns regarding urological ailments. Results were categorized according to the major organs of urological disease., Results: Crowdfunding campaigns are very prevalent within several areas of urology. Prostate cancer and chronic kidney disease represent the most frequent reason for campaigns. Fundraising goals and actual funds raised for malignant disease were significantly more than for benign disease. Interestingly, there was a significant portion of crowdfunding campaigns to cover costs for non-conventional treatments and transplant tourism., Conclusion: Crowdfunding use to help cover direct and indirect costs of medical care is becoming increasingly apparent through several facets of medicine. This study shows that this statement holds true when looking at patients with urological disease in Canada. As urologists, we need to be aware of this trend, as it highlights the often-unforeseen financial burdens experienced by our patients.

Competing Interests: Conflicts of Interest: No conflict of interest to state by either author.