TopMedTalk

ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Andy Cumpstey and James Bowness interview Carolina Haylock-Lore, the president of the World Federation of Societies of Anesthesiologists (WFSA).

She explains the WFSA's role as a global organization with 151 member societies from 158 countries and its strategic priorities of advocacy, collaboration, and education. Noting its status as a WHO non-state actor since 1984 and as the voice for about half a million anesthesiologists to promote safe, affordable, timely anesthesia across the continuum of care. They discuss the need for stronger recognition of anesthesiology and physician-led practice, highlight global health challenges and rural care, a...

Recorded at ASA Anesthesiology 2026 in San Diego, hosts Andy Cumpstey and Harriet Hopf speak with Patrick Velliky, Chief External Affairs Officer and Senior Vice President for Government Affairs at HaloMD, about misconceptions around the No Surprises Act (NSA) independent dispute resolution (IDR) process and its cost impact.

Velliky argues many studies cite total arbitration awards without a pre-NSA baseline, and his emergency medicine analysis comparing like-for-like out-of-network (OON) claims found OON spending is 13%–50% lower post-NSA, with modeled savings depending on assumptions about payments for the ~90% of eligible claims not going to IDR.

He discusses the qu...

At the EBPOM World Congress in London, Andy Cumpstey interviews Professor Michael Scott, Chair of the Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center (URMC) in Rochester, New York for TopMedTalk's Perioperative Profile series.

Scott, recounts growing up in Bath in the UK, studying medicine at Birmingham, and funding medical school through award-winning travel photography that later informed medical teaching resources and WHO's LifeBox work.

He describes extensive travel, including China, Nepal, Peru, Gaza, and Myanmar, and how experiences shifted him toward medicine and then anesthesia after time in emergency medicine.

ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Kate Leslie and Andy Cumpstey speak with Bonnie Milas, clinical professor of anesthesiology and critical care medicine at the University of Pennsylvania and American Society of Anesthesiologists (ASA) President Patrick Giam.

The discussion covers addiction, overdose prevention, and pain management. Milas, who lost two adult sons to accidental fentanyl poisonings, advocates putting naloxone and basic response training in the hands of families and communities. She explains overdose signs (unresponsiveness, pinpoint pupils, slow/shallow breathing, cyanosis), calling 911, rescue breathing/CPR, and that naloxone is an easy, safe nasal spray now available over t...

This edition of TopMedTalk at Anesthesiology 2026 in San Diego, features Kate Leslie and Sol Aronson interviewing Major Zachary Affrin, a pediatric anesthesiologist at Tripler Army Medical Center in Hawaii, and Captain Joy Ferré, a PGY3 anesthesiology resident at Brooke Army Medical Center/SAUHEC.

They discuss paths into military medicine and anesthesiology, including HPSP and Uniformed Services University, and emphasize early leadership opportunities, subspecialty development supported by the Army (including Affrin's fellowship at Children's Hospital of Philadelphia), and work-life balance with unique military experiences. Ferré describes Global Health Engagement mission trips, highlighting a Panama trip that delivered 80 cataract, co...

ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Andy Cumpstey and Harriet Hopf interview Shahid Ali, Assistant Professor of Anesthesiology and the Director of Cardiac Anesthesia at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, about automated anesthesia technologies.

Ali contrasts automated inhaled delivery via end-tidal control (now available in the US) with target-controlled infusions (common outside the US but not FDA-approved), explains anesthesia goals and workflows, and describes how clinicians set age-adjusted MAC targets while the system adjusts vapor concentration and fresh gas flow, including a "purge" function to hasten wake-up.

He highlights s...

ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Kate Leslie and Sol Aronson speak with David L. Hepner, MD, MPH. Associate Professor of Anaesthesia at Harvard Medical School and Bradley R. Cohn, MD, Regional Medical Director and the Chair of Perioperative Medicine for Kaiser Permanente Northern California (KPNC) / The Permanente Medical Group about the American Society of anesthesiologists (ASA) Center for Perioperative Medicine (CPMed) and its push to move perioperative care from fragmented episodes to a coordinated continuum.

They describe CPMed's origins in October 2022, its multidisciplinary and international "big tent" approach, and efforts in education and training, including adding p...

TopMedTalk's coverage of ANESTHESIOLOGY® 2026 (the annual meeting of the American Society of Anesthesiologists) in San Diego begins, with Kate Leslie and Andy Cumpstey introducing this year's hosting team.

Hosts including Mike Grocott, Sol Aronson, James Bowness and new team member Harriet Hoff discuss meeting highlights such as the Emery A. Rovenstine Memorial Lecture from Anesthesiology editor-in-chief James Rathmell and the keynote by Will Flannery (Dr. Glaucomflecken).

They emphasize perioperative medicine momentum, networking opportunities, and plans for upcoming TopMedTalk interviews on AI (including Mission Control UCSD and large language models) and perioperative profiles with Carol Peden, El...

Host James Bowness and co-host Andy Cumpsty introduce another TopMedTalk AI series recorded at St Andrews University with Alasdair Taylor, a Consultant Anaesthetist at NHS Tayside who runs an exam-focused anatomy course ("Anatomy for the FRCA") and now leads a two-day regional anaesthesia "Regional Anesthesia: Plan A blocks" course aimed mainly at stage two registrars.

Supported by NHS Education for Scotland and technology funding, the course is oversubscribed, attracts delegates internationally, has expanded to ICU and emergency medicine applications, and has trained nearly 200 delegates—about 10% of Scotland's anaesthetists.

The course combines cadaveric anatomy teaching from in...

At the Evidence Based Perioperative Medicine (EBPOM) World Congress, and the first World Congress of Enhanced Post-Operative Care (EPOC), Andy Cumpsty interviews Deena Harji, Consultant Robotic and Colorectal Surgeon at the Manchester University NHS Foundation Trust (MFT) and the Professor of Robotics and Digital Healthcare Technologies, alongside Cathy Price, Consultant in Pain Medicine at Southampton NHS Foundation Trust.

Harji covers the rapid UK adoption of surgical robotics, noting potential benefits such as lower systemic inflammatory response, less pain, faster recovery, and earlier discharge, while acknowledging implementation has outpaced evidence on clinical and cost effectiveness.

Price...

At the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) held in Auckland, New Zealand, Kate Leslie and Andy Cumpstey interview ANZCA president David Story and the ASM New Zealand Visitor Tim Walsh about what inspired them to pursue a career in research and how they support emerging research leaders.

David Story is Professor and Chair, Department of Critical Care, University of Melbourne, Australia, and Consultant Anaesthetist at the Austin Hospital, Australia. Tim Walsh is Professor of Critical Care at the University of Edinburgh and Honorary...

Recorded in Prato, Italy at the 8th Collaborative Clinical Trials in Anesthesiology meeting.

Desiree Chappell and guest co-host Mark Priestley interview Professor Karim El-Boghdadly, Consultant Anaesthetist and Clinical Lead for Theatres, Anaesthesia, and Peri-operative Medicine at Guy's and St Thomas' NHS Foundation Trust, as well as an Honorary Reader at King's College London about the perioperative implications of GLP-1 receptor agonists.

El-Boghdadly explains expanding GLP-1 use, delayed gastric emptying, and why early "hold for a week" guidance may be impractical. He describes a UK trainee research network observational study across ~130 hospitals collecting ~47,000 cases, including ~1,300 GLP-1...

This month's TopMedTalk Classic was originally aired in 2019 but remains very relevant today.

Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust, and an expert on frailty. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available?

TopMedTalk's back catalogue contains over 2000 episodes covering all aspects of perioperative medicine. We'd love...

Recording from TopMedTalk at EBPOM in Dingle, Ireland, Kate Leslie and Imogen Fecher-Jones interview Oliver Pratt, Consultant Anaesthetist at Salford Royal Hospital, Chair of the Primary FRCA Structured Oral Examinations for the Royal College of Anaesthetists, and a Medical Officer for the Kinder Mountain Rescue Team and Joe Cosgrove, a Consultant in Anaesthesia and Intensive Care Medicine at the Newcastle upon Tyne Hospitals NHS Foundation Trust, a Primary FRCA Examiner for the Royal College of Anaesthetists, and the Critical Care Outreach Lead specializing in advance care planning. He is also Events Medicine Doctor for Durham County Cricket Club and...

This month's Perioperative Profile features Duminda Wijeysundera, Professor in the Department of Anesthesiology and Pain Medicine and IHPME at the University of Toronto, and a Staff Physician at St. Michael's Hospital, who holds the Endowed Chair in Translational Anesthesiology Research, serves as Head of Science at SPHERE, acts as a Senior Adjunct Scientist at ICES, and is a Trustee for the International Anesthesia Research Society (IARS).

He describes growing up across Sri Lanka, the US, Singapore, and Canada, and how adaptability and cultural sensitivity shaped him; he entered medicine for scientific interest and stability, switched from internal...

Recorded at the Evidence Based Perioperative Medicine (EPBOM) World Congress in London, this TopMedTalk episode, presented by Andy Cumpstey, features Guy Ludbrook, Professor of Anaesthesia and Head of Acute Care Medicine at the University of Adelaide and resident Georgia Cadzow, discussing the Perioperative Quality Initiative (POQI)

POQI is a not-for-profit that uses a formal Delphi process to distill evidence and expert consensus into publishable clinical recommendations on topics such as perioperative hypotension, acute kidney injury, delirium, health economics, and fluid therapy.

Georgia describes the iterative POQI meeting format, including pre-reading, small-group drafting, plenary workshopping, and...

Today's TopMedTalk AI podcast was recorded at the Association of Anaesthetists of Great Britain and Ireland in London. It features Andy Cumpstey and Desiree Chappell and their guests, John Whittle, honorary associate professor of Perioperative medicine at University College London and  Duncan McPherson, Head of the clinical team at QMD Services and Anesthesiologist and Honorary Professor at University College London.

We discuss how early AI research shares core requirements with other research—especially data safety and governance—while medical device regulation applies the same legal principles to AI as to other devices: safety and performance, alongside separate data p...

At the 58th Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell interview Heather Nixon, SOAP immediate past president and Section Chief for Obstetric Anesthesiology; Section Chief for Simulation, Education, and Training Department of Anesthesiology University of Illinois, about SOAP's educational mission, governance, outreach, and special interest groups.

Nixon describes her focus on intraoperative pain during caesarean delivery after a sentinel event and how listening to patient narratives, including The Retrievals (Season 2), highlighted issues such as dismissal of pain, communication failures, and cultural bias. She outlines SOAP's toolkit response...

Recorded at ANZCA and the Faculty of Pain Medicine's Annual Scientific Meeting in Auckland, TopMedTalk hosts Andy Cumstey and Kate Leslie interview visiting pain research leaders, Professor Irene Tracey, the Vice-Chancellor of the University of Oxford and Professor Lesley Colvin, the Chair of Pain Medicine at the University of Dundee and an Honorary Consultant in Anaesthesia and Pain Medicine at NHS Tayside.

They discuss how thinking has shifted from chronic pain as a simple transition from acute pain, to a distinct disease with separate mechanisms and early "pre-vulnerability" factors including stress-axis disruption and reduced endogenous inhibition. Colvin...

At EBPOM 2026 live from the British Library in London, Joff Lacy and Imogen Fecher-Jones speak with Malcolm West and Tim Baker, clinical co-leads for the National Clinical Audit of Perioperative Care (NCAPC), an NHS England mandated and HQIP-funded initiative managed by the Royal College of Anaesthetists to audit major elective surgery in England and publicly funded Jersey.

They outline the audit's denominator (major surgery with anaesthetist involvement and >24-hour stay), year-one focus cohorts (thoracic, major gynaecology, major hip/knee orthopaedics, and lower GI/colorectal surgery), and aims to improve data quality and reduce unwarranted variation. The team...

This month's TopMedTalk Classic has been digitally remastered for you and we've added the Q&A which wasn't part of the original podcast.

We're featuring a talk first broadcast in 2018, featuring BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia.

BobbieJean discusses whether perioperative risk in frail patients can be managed, emphasizing that current risk tools underweight frailty and functional outcomes. Using cases and data from U.S. nursing home residents, she highlights high postoperative mortality and functional decline after procedures such as colectomy and...

At the Collaborative Clinical Trials meeting in Prato, Italy, Mike Grocott and co-host Mark Priestley speak with Sachin Kheterpal, University of Michigan Medical School's Associate Dean for Research Information Technology and the Robert B Sweet Professor and Kelley M. Kidwell, Chair of the Department of Anesthesiology and Professor of Biostatistics at the University of Michigan School of Public Health and Senior Associate Dean for Faculty Affairs .

Kidwell explains sequential multiple assignment randomized trials (SMART) as multi-stage designs that randomize at key decision points to evaluate treatment sequences, distinguishing them from adaptive trials and addressing misconceptions about sample...

In this TopMedTalk perioperative profile, host Andy Cumpstey interviews Professor Dan Sessler, Vice President for Clinical and Outcomes Research and Professor of Anesthesiology and Biostatistics at UTHealth Houston (McGovern Medical School), about his career as a perioperative trialist with over 1,000 publications.

Sessler describes his scientific family background, early inspiration from clinical trials through Henry Kaplan's Hodgkin's work, and a shift from planned pediatric oncology to anesthesiology. He recounts building a research career starting with perioperative thermoregulation at UCLA and UCSF, then expanding into broad outcomes research, ultimately founding a large Department of Outcomes Research at the Cleveland...

At The International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA) meeting in Montreal, TopMedTalk hosts Mike Grocott and former editor-in-chief Desiree Chappell speak with FAER board members Dr. Rebecca A. Aslakson, Chair and Professor with Tenure, Department of Anesthesiology, University of Vermont Health Network and Dr. Michael Gropper, Professor and Chair of the UCSF Department of Anesthesia and Perioperative Care, about the Foundation for Anesthesia Education and Research (FAER).

We describe how FAER's early-career support—especially the Mentored Research Training Grant—helped launch our guest's own research trajectories and facilitates transition to larger fund...

In Scotland at St Andrews, TopMedTalk AI hosts Andy Cumpstey and James Bowness discuss AI in regional anaesthesia with Bernard Victor Delvaux, staff anesthesiologist at the Centre Hospitalier Privé Claude Galien in Quincy-sous-Sénart, France.

Bowness describes a regional anaesthesia course using AI-augmented ultrasound imaging, augmented reality simulated needling, and cadaveric ultrasound with real needle insertion. Delvaux discusses his research in AI-assisted nerve recognition, explains supervised model development through large-scale ultrasound image annotation for GE Healthcare's C-NERF, and they explore how to evaluate AI beyond pixel-based metrics toward clinically oriented utility and safety, including differences in usefulness fo...

Recorded at the excellent ANESTHESIOLOGY® 2025 in San Antonio. Hear Andy Cumpstey and Mike Grocott interview Paul Myles, a Professor of Anaesthesiology and Perioperative Medicine at Monash University in Melbourne, Australia.

Here we focus upon his group's approach to large pragmatic, multicenter international trials and the process of selecting and developing study questions within a clinical trials network. Miles presents the ITACS trial (intravenous iron treatment for anaemia before cardiac surgery), designed because anaemia is common (~30%) in elective cardiac surgery and is associated with increased complications, longer hospital stay, mortality, and greater transfusion requirements, while prior randomized evidence s...

This presentation was recorded at the Evidence Based Perioperative Medicine (EBPOM) 2026 Annual Global Meeting.

It features Nicolai Bang-Foss, Consultant, head of GI and orthopaedic anaesthesia, Hvidovre University Hospital, Denmark

His main research field is the perioperative care of the elderly emergency patient. Specific areas of research have been regional analgesia, transfusion thresholds, outreach programs and perioperative logistics as well as perioperative haemodynamics.

He describes wide European variation in postoperative pathways driven largely by ICU bed capacity, with Scandinavian countries running lean systems that push PACUs toward 24-hour, higher-acuity perioperative units and preoperative optimization...

Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this episode of TopMedTalk sees Andy Cumpstey speaking with a panel of experts about the VITAL trial: a pragmatic randomised controlled trial about volatile vs total intravenous anaesthesia (TIVA) for major non-cardiac surgery in adult patients. The primary outcome was days alive and out of hospital at 30 days.

Despite finding no significant differences in the primary outcome, the trial reveals that patients receiving TIVA anesthesia experience better recovery, with less postoperative nausea and other side effects. The conversation also touches on the trial mechanics, related...

At the ANZCA Annual Scientific Meeting in Auckland, Kate Leslie and Andy Cumpstey discuss ANZCA's Emerging Leaders Conference (ELC), a retreat-style program held immediately before the ASM for clinicians within five years of achieving FANZCA, with allowances for career disruptions.

Their guests, Dr Saana Taylor FANZCA and Dr Vik Singh FANZCA, co-conveners of this year's ELC, describe shaping this year's New Zealand-hosted ELC with an Aotearoa focus, naming it Te Herenga Matua ("the pursuit of consciousness") and emphasizing collaboration, communication, wellbeing, compassion, and equity.

The program included Māori and Pacific health sessions, leadership self-reflection, a...

From the 58th annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP) in Montreal, Mike Grocott and new co-host Joe Larvin speak with SOAP president Ron George about SOAP's growth to over 1,000 attendees and its international, collaborative community.

George outlines his career from Dalhousie to UCSF and back to Canada as director of obstetric anesthesia at Mount Sinai Hospital in Toronto, highlighting its high-risk referral practice and large, internationally diverse fellowship program. He reflects on his presidency's focus on mission alignment and partnerships, including work with the New York State Society of Anesthesia, discussions with...

This classic TopMedTalk piece was originally cast in April 2020.

The debate 'Direct laryngoscopes should be consigned to history', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece, where the debate is outlined in advance.

We get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply...

Live from Euroanaesthesia 2026 in Rotterdam, Kate Leslie and Andy Cumpstey speak with Laszlo Vutskits and Hugh Hemmings ahead of the "Hot Topics in General Anaesthesiology" lecture.

Vutskits discusses reports of devastating neurologic outcomes after minor procedures in previously healthy patients, linked in a Spanish series to a shared mitochondrial DNA haplotype traced to Venezuela, including a rare ND4 complex I mutation; cybrid and fibroblast experiments showed clinically relevant sevoflurane rapidly suppresses oxidative phosphorylation but reversibly on washout, while propofol (tested without lipid) did not.

Hemmings highlights the DAS 2026 airway management guidance advocating video laryngoscopy as...

Recorded live at the ANZCA Annual Scientific Meeting in Auckland, Kate Leslie interviews Professor Alan Merry for a perioperative profile, covering his retirement from clinical practice, ongoing research supervision, and work on environmental sustainability.

Merry recounts being raised by a single mother in Zimbabwe, studying medicine at the Godfrey Huggins School of Medicine in Harare, and moving to New Zealand amid the Rhodesian Bush War. He describes entering anaesthesia after initially planning psychiatry, then becoming involved in New Zealand medical manslaughter law reform following prosecutions of clinicians, helping achieve the Crimes Amendment Act 1997's higher "major departure"...

At the EBPOM World Congress in London; TopMedTalk's Andy Cumpsty sits down for an exclusive interview with Amy Slogrove, editor-in-chief of the new journal, The Lancet Surgery and Anaesthesiology, ahead of its public launch on 20 July and a planned first issue in early 2027.

Dr Slogrove, a South Africa–based pediatrician and epidemiologist, explains the journal's aim - to bring surgery and anaesthesiology together across the perioperative space, emphasizing research integrity, rigor, and ethics, supported by clinical peer review.

She outlines the editorial team, submission route via thelancet.com/surgery, expected decision timelines, and peer-review approach. Th...

Recorded live at the EBPOM World Congress in London, this episode of TopMedTalk AI features host James Bowness and co-host Amy Gomes speaking with Joe Harris, anaesthesia resident and Innovation Fellow in Anaesthesia at University College London Hospitals (UCLH) NHS Foundation Trust and Sanjay Wijayatilake, Consultant in Anaesthesia and Neuro Intensive Care MedicineBarking, Havering and Redbridge University Hospitals NHS Trust about "AI demand signaling" in intensive care.

Harris explains the demand-signaling method—surveying clinicians on key problems, translating these into candidate AI use cases, prioritizing them via a Delphi panel, then exploring them in multidisciplinary workshops—to ensu...

At the International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell speak with Dr Faye Evans, Senior Associate in Perioperative Anesthesia at Boston Children's Hospital and Associate Professor of Anaesthesia at Harvard Medical School and Director of Partnerships on the Board of Directors for the World Federation of Societies of Anaesthesiologists (WFSA).

The conversation covers efforts to improve access to safe surgery and anesthesia for children globally. Evans explains the WFSA as a society of over 150 member societies focused on advocacy, safety, quality, publications...

At the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) held in Auckland, New Zealand, Kate Leslie and Andy Cumpstey interview Neel Desai about non-opioid multi-modal analgesia, especially the use of paracetamol/NSAID combinations for minor surgery.

Dr Neel Desai is a Consultant Anaesthetist at Guys and St Thomas's Hospital, London, UK. He is supported by AFT Pharmaceuticals.

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The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th...

Joff Lacey and Imogen Fecher-Jones interview six oral abstract finalists at this years' EBPOM.

Nora Cruz Rodriguez; Association Between Participation in Remote Prehabilitation and High-Dependency Unit Length of Stay After Oesophagectomy and Radical Cystectomy: A Retrospective Cohort.

Alexios Dosis; Remote wearable monitoring as a preoperative risk assessment tool.

Ned Douglas; The Fluids, Atomoxetine or Midodrine (FAME) pilot trial.

Tom Scodellaro; The new normal: CPET findings in patients aged 80 years and older.

Gerry O'Callaghan; Preventing and Reducing Re-Presentations and Admissions following surgery, new thinking required.

Sandy (Alexander) Jackson...

This month's TopMedTalk Classic is particularly topical: first broadcast back in 2018 but relevant once again after the recent news of an Ebola outbreak in the Democratic Republic of the Congo.

Originally recorded at the Intensive Care Society State of the Art Meeting in London, Desiree Chappell and Monty Mythen speak with Dan Martin, OBE, now Professor at the University of Plymouth and Consultant in Intensive Care Medicine at University Hospitals Plymouth NHS Trust, about the critical care management of Ebola and other viral haemorrhagic fevers.

Dan Martin describes the Royal Free Hospital's role as the...

This piece is essential listening for anyone interested in modern academic publishing.

Recorded at the Collaborative Clinical Trials Meeting in Prato, Italy, TopMedTalk hosts Kate Leslie and Mike Grocott speak with Eric Rubin (Editor-in-Chief, New England Journal of Medicine) and Jocelyn Clark (International Editor, BMJ) about medical publishing.

The conversation covers, engaging with clinical researchers and seeing impactful work. How AI can help authors—especially non-native English speakers—while raising concerns about confidentiality, inaccurate or fabricated content, reviewer misuse, governance policies that struggle to keep pace, and AI-generated correspondence overwhelming journals.

They explore how...