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Italy was initially one of the worse affected countries by the novel coronavirus . Medical students frequenting hospitals are more susceptible to be infected by the virus but also able to see the effects of the pandemic from the frontline. The aim of this study was to assess the COVID-19 related knowledge, behavioral changes, and perceptions of Italian medical students within the first 90 days after the onset of the outbreak in Italy. A national crosssectional study was conducted from 23rd April to 31st April 2020. Participants were Italian medical students whose knowledge, behavioral changes, and perceptions of the COVID-19 pandemic were assessed. The survey consisted of: demographics, COVID-19 related general knowledge, behavioral changes, and perceptions of the pandemic. A total of 520 students answered the survey. The majority of the students' ages ranged from 21 to 25 years old (345, 66.3%). Only 48.6% stated that they had received a formal education about COVID-19 from their medical institutions. However, all the students declared that they tried to inform themselves, mostly through WHO, CDC, UpToDate (56%), but also (21.6%) through national guidelines, social networks (Facebook, Instagram, and YouTube) (11.5%), and other sources (10.9%). Italian medical students demonstrated a high level of COVID-19-related general knowledge as well as self-reported preventative behavioral changes but only had a moderate risk perception regarding the pandemic. They improved their health habits but questioned the reliability of information and handling of the pandemic by health authorities.

Volume 148, Number 3 • Viewpoints 529e with Accreditation Council for Graduate Medical Education core competencies. 4 However, and despite these notable efforts, there remains a paucity of attention targeted toward the continuity of medical education in surgical anatomy, a topic that remains particularly relevant as an essential competency for senior medical students before beginning postgraduate training in plastic surgery.To address this educational disparity, our group developed and implemented an online virtual anatomy teaching curriculum designed to help keep medical students up to date, prepared, and on-track for surgical rotations ahead. Topics covered thus far include the thorax, brachial plexus, forearm, hand, anterior abdominal wall, back, and lower extremity, with upcoming sessions scheduled for head and neck, craniofacial, intraabdominal, and pelvic anatomy. These sessions were designed not to replace core anatomy teaching, but rather to help reinforce essential concepts and discuss different surgical techniques, medical abnormalities, and clinically relevant variations, thus simulating and complementing intraoperative and clinical learning. [See Video (online), which shows a short segment from a breast anatomy lecture (image courtesy of Jad Abi-Rafeh).] Our initiative has so far amassed interest from 227 medical students; the majority of them (80 percent) are in their second and third years of medical training. Most recently, 68 percent of participants attended from our local institution, with the remainder representing local and international trainees from the United States, Canada, Mexico, Colombia, Indonesia, and The Netherlands. With the support of Plastic and Reconstructive Surgery's social medial channels, interest from international attendees continues to grow. Through before-and-after tests administered to participants, a significant improvement in average test scores was observed following virtual learning (from 46 percent to 76 percent; p < 0.05), with retention of knowledge subsequently established at 2-week followup. All sessions are recorded in real time and remain available for future reference by all participants.The role of virtual teaching resources in plastic surgery education continues to grow, with notable advantages established for both trainees and educators alike. 3 Advancements in the field of simulation and virtual teaching in plastic surgery have complemented timely transitions to competency-based training curricula. 5 Plastic surgeons must continue innovating and responding to evolving educational challenges to help foster excellence in our field. Thus, it is the authors' wish that through this correspondence, the validity, efficacy, and reliability of virtual training platforms in surgical education is demonstrated, to help address evolving educational challenges and training the next generation of surgeons, during the time of the COVID-19 pandemic, and beyond.

Biliary tumors are rare diseases with major clinical unmet needs. Standard imaging modalities provide neither a conclusive diagnosis nor robust biomarkers to drive treatment planning. In several neoplasms, texture analyses non-invasively unveiled tumor characteristics and aggressiveness. The present manuscript aims to summarize the available evidence about the role of radiomics in the management of biliary tumors. A systematic review was carried out through the most relevant databases. Original, English-language articles published before May 2021 were considered. Three main outcome measures were evaluated: prediction of pathology data; prediction of survival; and differential diagnosis. Twenty-seven studies, including a total of 3605 subjects, were identified. Mass-forming intrahepatic cholangiocarcinoma (ICC) was the subject of most studies (n = 21). Radiomics reliably predicted lymph node metastases (range, AUC = 0.729–0.900, accuracy = 0.69–0.83), tumor grading (AUC = 0.680–0.890, accuracy = 0.70–0.82), and survival (C-index = 0.673–0.889). Textural features allowed for the accurate differentiation of ICC from HCC, mixed HCC-ICC, and inflammatory masses (AUC > 0.800). For all endpoints (pathology/survival/diagnosis), the predictive/prognostic models combining radiomic and clinical data outperformed the standard clinical models. Some limitations must be acknowledged: all studies are retrospective; the analyzed imaging modalities and phases are heterogeneous; the adoption of signatures/scores limits the interpretability and applicability of results. In conclusion, radiomics may play a relevant role in the management of biliary tumors, from diagnosis to treatment planning. It provides new non-invasive biomarkers, which are complementary to the standard clinical biomarkers; however, further studies are needed for their implementation in clinical practice.

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