(18)F-FDG PET-CT can help characterize various thymic lesions noted on conventional imaging modalities. However, larger prospective studies are further required to substantiate these findings.

Objective: To understand better the public perception and comprehension of medical technology such as artificial intelligence (AI) and robotic surgery. In addition to this, to identify sensitivity to their use to ensure acceptability and quality of counseling. Subjects and Methods: A survey was conducted on a convenience sample of visitors to the MN Minnesota State Fair (n = 264). Participants were randomized to receive one of two similar surveys. In the first, a diagnosis was made by a physician and in the second by an AI application to compare confidence in human and computerbased diagnosis. Results: The median age of participants was 45 (interquartile range 28-59), 58% were female (n = 154) vs 42% male (n = 110), 69% had completed at least a bachelor's degree, 88% were Caucasian (n = 233) vs 12% ethnic minorities (n = 31) and were from 12 states, mostly from the Upper Midwest. Participants had nearly equal trust in AI vs physician diagnoses. However, they were significantly more likely to trust an AI diagnosis of cancer over a doctor's diagnosis when responding to the version of the survey that suggested that an AI could make medical diagnoses (p = 9.32e-06). Though 55% of respondents (n = 145) reported that they were uncomfortable with automated robotic surgery, the majority of the individuals surveyed (88%) mistakenly believed that partially autonomous surgery was already happening. Almost all (94%, n = 249) stated that they would be willing to pay for a review of medical imaging by an AI if available. Conclusion: Most participants express confidence in AI providing medical diagnoses, sometimes even over human physicians. Participants generally express concern with surgical AI, but they mistakenly believe that it is already being performed. As AI applications increase in medical practice, health care providers should be cognizant of the potential amount of misinformation and sensitivity that patients have to how such technology is represented.

Study Need and Importance: Radical cystectomy (RC) for the management of muscle-invasive bladder cancer remains a morbid procedure with high rates of perioperative complications. 1,2 The role of preoperative immunonutritional supplementation (pre-INS) in improving post-RC outcomes is promising and needs further validation. 3e5 What We Found: We performed a retrospective review of 204 patients who underwent RC for bladder cancer at a single institution, comparing patients who received oral L-arginine-based pre-INS and those who did not. Preoperative features, postoperative complications, and readmission data were collected. Outcomes of interest included development of high-grade (Clavien-Dindo IIIeV) complications, readmission within 30 days, ileus, total parenteral nutrition requirement, postoperative infection, and length of stay (see table ). Multivariable logistic regression (MLoR) analysis was used to identify predictive factors for our outcomes. On MLoR, adjusting for age, gender, body mass index (BMI), Charlson comorbidity index, undergoing neoadjuvant chemotherapy, and operative features, pre-INS was a significant predictor of postoperative infection (Fisher p[0.02; OR[0.35), but not for other outcomes of interest. Limitations: Limitations of this study include its retrospective nature and its reliance on the presumption that all patients given pre-INS were fully compliant with taking the supplement. Furthermore, while preoperative albumin levels and BMI were not significantly different between the 2 patient groups, we were unable to directly assess patient perioperative nutritional status and sarcopenia, 2 increasingly recognized independent predictors of perioperative morbidity. Finally, enhanced recovery after surgery (ERAS) protocol implementation rates were high in both pre-INS and control groups (100% vs 72%, respectively), potentially confounding our findings, although pre-INS remained a significant predictor for postoperative infection after accounting for ERAS in our MLoR models. Interpretation for Patient Care: A short course of preoperative immunonutrition with an inexpensive Larginine-based supplement prior to RC is associated with significant reduction in postoperative infection, one of the most common complications of RC.

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