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Machine learning applications in stroke medicine:advancements,challenges,and future prospectives

Neural Regeneration Research 2024年第4期19卷 769-773页

作者： Mario Daidone Sergio Ferrantelli Antonino Tuttolomondo Internal Medicine and Stroke care Ward Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of Palermo Molecular and Clinical Medicine PhD program University of Palermo

Stroke is a leading cause of disability and mortality worldwide,necessitating the development of advanced technologies to improve its diagnosis,treatment,and patient *** recent years,machine learning techniques have emerged as promising tools in stroke medicine,enabling efficient analysis of large-scale datasets and facilitating personalized and precision medicine *** abstract provides a comprehensive overview of machine learning’s applications,challenges,and future directions in stroke *** introduced machine learning algorithms have been extensively employed in all the fields of stroke *** learning models have demonstrated remarkable accuracy in imaging analysis,diagnosing stroke subtypes,risk stratifications,guiding medical treatment,and predicting patient *** the tremendous potential of machine learning in stroke medicine,several challenges must be *** include the need for standardized and interoperable data collection,robust model validation and generalization,and the ethical considerations surrounding privacy and *** addition,integrating machine learning models into clinical workflows and establishing regulatory frameworks are critical for ensuring their widespread adoption and impact in routine stroke *** learning promises to revolutionize stroke medicine by enabling precise diagnosis,tailored treatment selection,and improved *** research and collaboration among clinicians,researchers,and technologists are essential for overcoming challenges and realizing the full potential of machine learning in stroke care,ultimately leading to enhanced patient outcomes and quality of *** review aims to summarize all the current implications of machine learning in stroke diagnosis,treatment,and prognostic *** the same time,another purpose of this paper is to explore all the future perspectives these techniques can provide in combating this disabling dis

关键词： cerebrovascular disease deep learning machine learning reinforcement learning stroke stroke therapy supervised learning unsupervised learning

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重症监护疼痛观察工具印尼语版的跨文化调适及心理测量学分析

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International Journal of Nursing Sciences 2024年第1期11卷 113-119页

作者： Luthfi Fauzy Asriyanto Nur Chayati master of Nursing program Postgraduate ProgramUniversitas Muhammadiyah YogyakartaIndonesia School of Nursing Faculty of Medicine and Health SciencesUniversitas Muhammadiyah YogyakartaIndonesia

目的重症监护疼痛观察工具(Critical-care Pain Observation Tool, CPOT)是评估ICU危重症和/或意识水平下降患者疼痛最准确的方法之一。本研究旨在翻译印尼语版CPOT,并验证其效度和信度。方法研究包括初始翻译.综合翻译结果、回译、专... 详细信息

目的重症监护疼痛观察工具(Critical-care Pain Observation Tool, CPOT)是评估ICU危重症和/或意识水平下降患者疼痛最准确的方法之一。本研究旨在翻译印尼语版CPOT,并验证其效度和信度。方法研究包括初始翻译.综合翻译结果、回译、专家委员会验证.印尼语版工具验证5个步骤。2022年9月- -12月在印度尼西亚4所医院ICU中,对52例患者在翻身前、翻身过程中和翻身后15min进行疼痛评估。使用疼痛程度温度计(Faces Pain Thermometer, FPT)作为金标准来评估CPOT的校标效度。采用内容效度和校标效度评估量表的效度;采用Cronbach's a系数和评分者之间- -致性评估工具的信度。结果患者翻身过程中CPOT评分高于翻身前和翻身后。印尼语版CPOT条目水平内容效度指数为0.75~1.00,量表内容效度指数为0.93。患者CPOT与FPT评分呈正相关(0.877-0.983 ,P<0.01)。CPOT的Cronbach's a系数为0.82,评分者之间测量结果一致性水平均较高(k值范围0.739-0.834 ,P<0.01)。结论印尼语版CPOT用于评估危重症和/或意识水平降低患者的疼痛是有效和可靠的。

关键词：重症监护疼痛评估病人信度效度

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Reflections on COPD comorbidities

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Chinese Medical Journal 2024年第12期137卷 1504-1506页

作者： Zhenming He Yue Wang Lin Shan Yan Mou Yunhuan Liu Guanhua Ma Yanxu Wu Huili Zhu Jeffrey L.Curtis Shilei Cui Haiyan Ge Department of Pulmonary and Critical care Medicine Huadong HospitalFudan UniversityShanghai 200040China Medical Service VA Ann Arbor Healthcare SystemAnn ArborMI 48105USA Pulmonary&Critical care Medicine Division Department of Internal MedicineUniversity of MichiganAnn ArborMI 48109USA Graduate program in Immunology University of MichiganAnn ArborMI 48109USA

To the Editor:Chronic obstructive pulmonary disease(COPD)is a common disease among the elderly,affecting over one-third of the elderly population *** progressive decline in lung function characteristic of COPD significantly impacts the quality of life and employability of affected individuals,resulting in a substantial direct and indirect socioeconomic *** frequently has comorbidities involving other organ *** all elderly COPD patients present with one or more comorbid conditions,collectively exacerbating health and economic *** viral and bacterial infections remain the most common triggers for COPD exacerbations(ECOPD).

关键词： morbid lung collective

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lmpact of non-canonical ALK fusion on the efficacy of targeted therapy in non-small cell lung cancer

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Chinese Medical Journal 2024年第12期137卷 1468-1470页

作者： Hao Zeng Qi Wei Yuan Tang Yuanyuan Zhang Sihan Tan Qin Huang Xin Pu Yalun Li Panwen Tian Department of Pulmonary and Critical care Medicine West China HospitalSichuan UniversityChengduSichuan 610041China Department of Pathology West China HospitalSichuan UniversityChengduSichuan 610041China Department of Pulmonary and Critical care Medicine Lung Cancer CenterWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Pulmonary and Critical care Medicine State Key Laboratory of Respiratory Health and MultimorbidityPrecision Medicine Key Laboratory of Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuan 610041China

To the Editor:With the wide application of next-generation sequencing(NGS),a number of EML4-ALK fusion partners or coexisting(non)-EML4-ALK and non-EML4-ALK have been detected in non-small cell lung cancer(NSCLC).Although targeted therapies for patients with metastatic NSCLC and actionable mutations dramatically change how these patients are treated,studies have demonstrated differences in progression-free survival(PFS)among patients based on different ALK fusion partners.

关键词： targeted lung NSCLC

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Roles of THEM4 in the Akt pathway:a double-edged sword

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第7期25卷 541-556页

作者： Wen XIE Weidong LIU Lei WANG Bin ZHU Cong ZHAO Ziling LIAO Yihan LI Xingjun JIANG Jie LIU Caiping REN NHC Key Laboratory of Carcinogenesis Department of NeurosurgeryXiangya HospitalCentral South UniversityChangsha 410008China National Clinical Research Center for Geriatric Disorders Xiangya HospitalCentral South UniversityChangsha 410008China The Key Laboratory of Carcinogenesis and cancer Invasion of the Ministry of Education Cancer Research InstituteSchool of Basic Medical ScienceCentral South UniversityChangsha 410078China Department of Critical care Medicine Hainan Hospital of Chinese PLA General HospitalHainan Province Clinical Medical CenterSanya 572013China

The protein kinase B(Akt)pathway can regulate the growth,proliferation,and metabolism of tumor cells and stem cells through the activation of multiple downstream target genes,thus affecting the development and treatment of a range of *** superfamily member 4(THEM4),a member of the thioesterase superfamily,is one of the Akt kinase-binding *** studies on the mechanism of cancers and other diseases have shown that THEM4 binds to Akt to regulate its ***,THEM4 was considered an endogenous inhibitor of Akt,which can inhibit the phosphorylation of Akt in diseases such as lung cancer,pancreatic cancer,and liver cancer,but subsequently,THEM4 was shown to promote the proliferation of tumor cells by positively regulating Akt activity in breast cancer and nasopharyngeal carcinoma,which contradicts previous *** these two distinct views,this review summarizes the important roles of THEM4 in the Akt pathway,focusing on THEM4 as an Akt-binding protein and its regulatory relationship with Akt phosphorylation in various diseases,especially *** work provides a better understanding of the roles of THEM4 combined with Akt in the treatment of diseases.

关键词： Protein kinase B(Akt) Thioesterase superfamily member 4(THEM4) Tumor proliferation Tumor metastasis

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Evolving landscape of treatments targeting the microenvironment of liver metastases in non-small cell lung cancer

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Chinese Medical Journal 2024年第9期137卷 1019-1032页

作者： Lingling Zhu Xianzhe Yu Xiaojun Tang Chenggong Hu Lei Wu Yanyang Liu Qinghua Zhou Lung cancer Center Lung Cancer InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China Key Laboratory of Drug Targeting and Drug Delivery Systems Ministry of EducationWest China School of PharmacyCollege of Polymer Science and EngineeringSichuan UniversityChengduSichuan 610041China Department of Gastrointestinal Surgery Chengdu Second People’s HospitalChengduSichuan 610041China Department of Critical care Medicine West China HospitalSichuan UniversityChengduSichuan 610041China Core Facility of West China Hospital Sichuan UniversityChengduSichuan 610041China Department of Medical Oncology Cancer CenterWest China HospitalSichuan UniversityChengduSichuan 610041China

Liver metastases(LMs)are common in lung *** substantial advances in diagnosis and treatment,the survival rate of patients with LM remains low as the immune-suppressive microenvironment of the liver allows tumor cells to evade the immune *** impact of LMs on the outcomes of immune checkpoint inhibitors in patients with solid tumors has been the main focus of recent translational and clinical *** evidence indicates that the hepatic microenvironment delivers paracrine and autocrine signals from non-parenchymal and parenchymal ***,these microenvironments create pre-and post-metastatic conditions for the progression of ***,we reviewed the epidemiology,physiology,pathology and immunology,of LMs associated with non-small cell lung cancer and the role and potential targets of the liver microenvironment in LM in each phase of ***,we reviewed the current treatment strategies and challenges that should be overcome in preclinical and clinical *** approaches target liver elements as the basis for future clinical trials,including combinatorial interventions reported to resolve hepatic immune suppression,such as immunotherapy plus chemotherapy,immunotherapy plus radiotherapy,immunotherapy plus anti-angiogenesis therapy,and surgical resection.

关键词： Non-small cell lung cancer Liver metastasis Combination therapy Immune checkpoint inhibitors Immune tolerance Immunotherapy

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A novel deep generative model for mRNA vaccine development: Designing 5′ UTRs with N1-methyl-pseudouridine modification

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Acta Pharmaceutica Sinica B 2024年第4期14卷 1814-1826页

作者： Xiaoshan Tang Miaozhe Huo Yuting Chen Hai Huang Shugang Qin Jiaqi Luo Zeyi Qin Xin Jiang Yongmei Liu Xing Duan Ruohan Wang Lingxi Chen Hao Li Na Fan Zhongshan He Xi He Bairong Shen Shuai Cheng Li Xiangrong Song Institute of Systems Genetics Department of Critical Care MedicineFrontiers Science Center for Disease-related Molecular NetworkState Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan UniversityChengdu 610000China Department of Computer Science City University of Hong KongHong Kong 99907China Department of Biology Brandeis UniversityBostonMA 02453USA

Efficient translation mediated by the 5'untranslated region(5'UTR)is essential for the robust efficacy of mRNA ***,the N1-methyl-pseudouridine(m1)modification of mRNA can impact the translation efficiency of the 5'*** discovered that the optimal 5'UTR for m1y-modified mRNA(m1y-5'UTR)differs significantly from its unmodified counterpart,high-lighting the need for a specialized tool for designing mly-5'UTRs rather than directly utilizing high-expression endogenous gene 5'*** response,we developed a novel machine learning-based tool,Smart5UTR,which employs a deep generative model to identify superior m1y-5'UTRs in *** tailored loss function and network architecture enable Smart5UTR to overcome limitations inherent in existing *** a result,Smart5UTR can successfully design superior 5'UTRs,greatly benefiting mRNA vaccine ***,Smart5UTR-designed superior 5'UTRs significantly enhanced antibody titers induced by COVID-19 mRNA vaccines against the Delta and Omicron variants of SARS-CoV-2,surpassing the performance of vaccines using high-expression endogenous gene 5'UTRs.

关键词： mRNA vaccine Machine learning 5'UTR mRNA design Sequence design N1-Methyl-pseudouridine COVID-19 SARS-CoV-2

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Prognostic value of time-varying dead space estimates in mechanically ventilated patients with acute respiratory distress syndrome

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Journal of Intensive Medicine 2024年第2期4卷 187-193页

作者： Lianlian Jiang Hui Chen Jianfeng Xie Ling Liu Yi Yang Jiangsu Provincial Key Laboratory of Critical care Medicine Department of Critical Care MedicineZhongda HospitalSchool of MedicineSoutheast UniversityNanjingJiangsuChina Department of Critical care Medicine The First Affiliated Hospital of Soochow UniversitySoochow UniversitySuzhouJiangsuChina

Background The dead space fraction(VD/VT)has proven to be a powerful predictor of higher mortality in acute respiratory distress syndrome(ARDS).However,its measurement relies on expired carbon dioxide,limiting its widespread application in clinical *** estimates employing routine variables have been found to be reliable substitutes for direct measurement of VD/*** this study,we evaluated the prognostic value of these dead space estimates obtained in the first 7 days following the initiation of *** This retrospective observational study was conducted using data from the Chinese database in intensive care(CDIC).Eligible participants were adult ARDS patients receiving invasive mechanical ventilation while in the intensive care unit between 1st January 2014 and 31st March *** collected data during the first 7 days of ventilation to calculate various dead space estimates,including ventilatory ratio(VR),corrected minute ventilation(V_(Ecorr)),VD/VT(Harris–Benedict),VD/VT(Siddiki estimate),and VD/VT(Penn State estimate)longitudinally.A time-dependent Cox model was used to handle these time-varying *** A total of 392 patients(median age 66[interquartile range:55–77]years,median SOFA score 9[interquartile range:7–12])were finally included in our analysis,among whom 132(33.7%)patients died within 28 days of ***(hazard ratio[HR]=1.04 per 0.1 increase,95%confidence interval[CI]:1.01 to 1.06;P=0.013),V_(Ecorr)(HR=1.08 per 1 increase,95%CI:1.04 to 1.12;P1.3,V_(Ecorr)>7.53,a

关键词： Acute respiratory distress syndr ome Mechanical ventilation Dead space 28-day mortality

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Diagnosis and therapy of tacrolimus toxicity in a liver transplant recipient during COVID-19 treatment

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 326-330页

作者： Feng Zhu Yi-Ming Wang Ming Ni Yuan Liang Jie-Hui Huang Xue-Hao Wang Feng Cheng Ling Lu Hepatobiliary Center The First Affiliated Hospital of Nanjing Medical UniversityKey Laboratory of Liver TransplantationChinese Academy of Medical SciencesNHC Key Laboratory of Liver TransplantationResearch Unit of Liver Transplantation and Transplant ImmunologyChinese Academy of Medical SciencesNanjing 210000China Department of Respiratory and Critical care Medicine Wuxi Fifth People’s HospitalWuxi 214000China Jiangsu Key Laboratory of cancer Biomarkers Prevention and TreatmentCollaborative Innovation Center for Cancer Personalized MedicineNanjing Medical UniversityNanjing 210000China

To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].However,treatment selection for immunosuppressed patients,such as liver recipients,remains uncertain due to potential drug interactions and the risk of immunosuppressant dosage adjustment,which can cause liver injury[2].

关键词： dosage treatment antagonist

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Gastrointestinal manifestations of critical ill heatstroke patients and their associations with outcomes:A multicentre,retrospective,observational study

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World Journal of Gastroenterology 2024年第4期30卷 346-366页

作者： Yu-Cong Wang Xin-Yang Jin Zheng Lei Xiao-Jiao Liu Yu Liu Bang-Guo Zhang Jian Gong Lie-Tao Wang Lv-Yuan Shi Ding-Yuan Wan Xin Fu Lu-Ping Wang Ai-Jia Ma Yi-Song Cheng Jing Yang Min He Xiao-Dong Jin Yan Kang Bo Wang Zhong-Wei Zhang Qin Wu Department of Critical care Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina School of Pharmacy Macao University of Science and TechnologyMacao 999078China Department of Critical care Medicine The First People's Hospital of Ziyang CityZiyang 641399Sichuan ProvinceChina Department of Critical care Medicine The First People's Hospital of Guanghan CityChengdu 618399Sichuan ProvinceChina Department of Critical care Medicine Lezhi County Traditional Chinese Medicine HospitalChengdu 641599Sichuan ProvinceChina Department of Critical care Medicine Chengdu Qingbaijiang District People's HospitalChengdu 610399Sichuan ProvinceChina Department of Critical care Medicine Ziyang People's HospitalChengdu 641399Sichuan ProvinceChina

BACKGROUND Extreme heat exposure is a growing health problem,and the effects of heat on the gastrointestinal(GI)tract is *** study aimed to assess the incidence of GI symptoms associated with heatstroke and its impact on *** To assess the incidence of GI symptoms associated with heatstroke and its impact on *** Patients admitted to the intensive care unit(ICU)due to heatstroke were included from 83 *** history,laboratory results,and clinically relevant outcomes were recorded at ICU admission and daily until up to day 15,ICU discharge,or *** symptoms,including nausea/vomiting,diarrhoea,flatulence,and bloody stools,were *** characteristics of patients with heatstroke concomitant with GI symptoms were *** regression analyses were performed to determine significant predictors of GI *** A total of 713 patients were included in the final analysis,of whom 132(18.5%)patients had at least one GI symptom during their ICU stay,while 26(3.6%)suffered from more than one *** with GI symptoms had a significantly higher ICU stay compared with those *** mortality of patients who had two or more GI symptoms simultaneously was significantly higher than that in those with one GI *** logistic regression analysis revealed that older patients with a lower GCS score on admission were more likely to experience GI *** The GI manifestations of heatstroke are common and appear to impact clinically relevant hospitalization outcomes.

关键词： Extreme heat Flatulence Sunstroke Intensive care units Diarrhea

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