Declan G. Murphy

Background: Generative AI (GenAI) frameworks, such as generative pre-trained transformer (GPTs) and large language models (LLMs), promise to transform clinical and research practices. Informed human opinion is key to guiding appropriate technological development and task refinement. Detailed data on how GPTs/LLMs powered-Chatbots usage, perceived risks and benefits among physicians has evolved over time and their impact on clinical and academic activities remain unclear. The aim of this study is to assess how the use of GPTs/LLMs chatbots by professionals working in urology has changed over time in the setting of academic and clinical activities. Methods: A one-year follow-up prospective cross-sectional survey was conducted among urology professionals. Results were reported highlighting the differences in baseline characteristics of participants and their responses between the initial release (April 20th, 2023 and May 5th, 2023) and re-deployment of the survey 12 months after chi square and t-test were used to compare categorical and continuous variables. Results: A total of 129 participants completed the second survey. Eighty-six percent of participants reported having used any GPTs/LLMs chatbot for academic tasks, a significant increase from the previous survey (52.4%; P<0.001). When asked if they were using GPTs/LLMs chatbots more in academic settings compared to one year prior, 70.1% of participants answered affirmatively. Participants, when asked about the use of GPT/LLMs in particular clinical tasks after one year, reported less frequent use for deciding treatment options (18.6% vs. 31.0%; P=0.03) and patient follow-up care (10.1% vs. 21.4%; P=0.02). When participants were asked if they were using LLM chatbots more in clinical settings compared to one year before, 35.6% answered affirmatively. Conclusions: GPTs/LLMs have a consolidated role in academic tasks, with increasing usage, while some resistance to their use in clinical practice remains. These results are relevant for driving the human-centered development of GenAI technology.

With the availability of PSMA-PET scans, it is controversial whether pelvic lymph node dissection (PLND) at the time of radical prostatectomy (RP) is still the most reliable and accurate staging modality for lymph node assessment. Furthermore, the oncological benefit of PLND remains unclear. The aim of this study was to assess whether omitting PLND in patients undergoing RP for prostate cancer (PCa) is associated with the risk of tumor recurrence and progression to metastasis. In this longitudinal multicenter cohort study, we reviewed data of 2346 consecutive patients with PCa who underwent RP with (n = 1650) and without (n = 696) extended PLND between January 1996 and December 2021. Recurrence-free survival and metastasis-free survival (MFS) were analyzed as a time-to-event outcome using Kaplan-Meier analyses with log-rank tests. To assess the effect of PLND, we created multivariable Cox proportional hazards models adjusting for relevant clinical and demographic characteristics. Median follow-up was 44 months. There was no difference in recurrence-free survival between men who had a PLND and those who did not (HR, 1.07, 95% CI, 0.87-1.32, P = .52). Patients with D'Amico high-risk disease (PSA >20 µg/L and/or International Society of Urological Pathology grade group ≥4) demonstrated a significantly prolonged MFS if they underwent PLND (HR, 0.57, 95% CI, 0.36-0.91, P = .02). PLND also improved MFS in patients with intermediate-risk disease (HR, 0.48, 95% CI, 0.25-0.90, P = .023). Further significant prognostic variables for MFS on multivariable Cox proportional hazards regression were PSA, International Society of Urological Pathology grade group, and pathological T-stage. PLND improves MFS in patients with D'Amico intermediate-risk and high-risk PCa and may therefore be considered in men undergoing RP.

Background: The Forum of European Heads and Deans of Dental Schools (FEHDD) was re-established in 2007 to provide a means of bringing together European Dental School Deans, Heads and their deputies to explore current topics of interest. One such topic is leadership development and succession. The importance of leadership succession in oral health professional academic settings is well noted. With some suggesting leadership in this arena is facing a recruitment and retention crisis, FEHDD developed and launched in 2017, a 'Competency Framework for Aspiring Deans and Heads of European Dental Schools'. The framework was updated in 2024. Objective: The aim of this paper is to summaries the development and updating processed that was followed by FEHDD and to raise awareness of the framework with relevant stakeholders. The 2024 framework has been further supported by an online tool to enable faculty track their development.

Background: This paper provides a transcript of the address made by Prof Sibylle Vital, ADEE European Affairs Officer to a meeting in the European Parliament hosted by Members of European Parliament, MEP Andriukaitis & MEP Kulja at the session entitled 'Better oral health on the European agenda'. During the address Prof Vital's key speaking points were: (1) The need for a Unified Dental Education Framework in Europe: Despite ADEE's efforts, dental education across Europe remains fragmented in key areas such as programme length, clinical training and teaching methods. Unlike other professions with standardised European curricula, dentistry lacks a common framework, creating challenges for students and professionals in terms of mobility and quality assurance. (2) ADEE's Proactive Role in Shaping Dental Education: As a path to Solutions ADEE has actively worked to bridge the gaps in European dental education by developing key frameworks such as the Graduating European Dentist (GED) and LEADER quality improvement approach. These frameworks focus on competency-based education rather than merely listing subjects, ensuring that graduates possess the skills and capabilities required for safe and effective practice. (3) Call for Legislative and Policy Support: ADEE urges policymakers to update the Professional Qualifications Directive to define clear competencies for dental graduates, standardise clinical training across the EU, allocate funding for oral health education research and promote quality assurance in higher education.

Objective: To perform a systematic review and meta-analysis of post-radical cystectomy (RC) mortality and complications in older people to aid decision-making pertinent to RC, as bladder cancer is typically a disease of older people, yet older people are less likely than their younger peers to undergo RC, predominantly due to concerns about morbidity and mortality of surgery. Methods: A systematic search of MEDLINE, Scopus and Ovid Emcare was performed in May 2023 for all studies in the past 20 years that reported mortality and/or complications in the 90-days following RC. All studies reporting mortality or complication outcomes in patient groups aged >75 years were included. Exclusion criteria included partial, or organ-sparing cystectomy, non-English language articles, and <20 patients aged >75 years. Results: A total of 76 studies were included, with data from 58 504 older patients across five continents and 19 countries. Post-RC 90-day mortality was 11% in studies reporting outcomes for patients aged ≥80 years, and 7% in studies of patients aged ≥75 years. The 90-day mortality was higher in patients aged ≥80 years compared to patients aged <80 years (odds ratio [OR] 3.42, 95% confidence interval [CI] 1.62-7.22). Older people were more likely to experience a minor (Clavien-Dindo Grade I-II) postoperative complication than younger patients (OR 1.17, 95% CI 1.01-1.36), whereas there was no difference for major complications (Clavien-Dindo Garde III-IV; OR 1.00, 95% CI 0.63-1.60). A higher co-morbid status was more strongly correlated with 90-day mortality in older patients than in younger patients. Conclusions: Older patients face higher postoperative mortality following RC than younger patients. Postoperative outcomes should be weighed against the high risk of cancer-specific death if no curative treatment is offered. Older people must be monitored closely postoperatively to try and prevent death as a result of escalation from minor and major complications.

Study of the Dosimetry, Safety and Potential Benefit of 177Lu-PSMA-617 Radionuclide Therapy Prior to Radical Prostatectomy in Men With High-risk Localised Prostate Cancer