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Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of Intensive Medicine 2024年第1期4卷 34-45页

作者： Darragh O’Reilly Jennifer McGrath Ignacio Martin-Loeches Department of Intensive Care Medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland Department of Respiratory Intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare systems.Its incidence is rising due to poor public awareness and delays in its recognition and subsequent management.In sepsis,mortality increases with every hour left untreated.Artificial intelligence(AI)is transforming worldwide healthcare delivery at present.This review has outlined how AI can augment strategies to address this global disease burden.AI and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional methods.Our review highlights how these models can predict the risk of sepsis and organ failure even before it occurs.This gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of sepsis.The potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare outcomes.Despite these advantages,clinicians have been slow to adopt AI into clinical practice.Some of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical use.Furthermore,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such technologies.Finally,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning Intensive care unit(ICU) Critical care Sepsis

Bridging digital and electromagnetic realms for enhanced wireless communication: current space

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National Science Review 2024年第4期11卷 9-10页

作者： Qammer H.Abbasi james Watt School of Engineering University of Glasgow

Digital, coding, and programmable metasurfaces have attracted widespread attention in wireless communication fields owing to their distinguished capability in manipulating electromagnetic (EM)waves [1]. Metasurfaces consist of planar subwavelength meta-atoms and are a twodimensional form of metamaterials [2].These engineered surfaces can flexibly control the properties of EM waves, such as magnitude, phase, and polarization. In particular, coding metasurfaces provide a bridge between the digital world and the physical world. Accordingly, modeling and analyzing the coding metasurfaces from the perspective of information theory has become one of the most important research focuses of the scientific community [3,4].

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Identification of tumor-suppressor genes in lung squamous cell carcinoma through integrated bioinformatics analyses

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Oncology Research 2024年第1期32卷 187-197页

作者： HENG LI YOUMING LEI GAOFENG LI YUNCHAO HUANG The 2nd Department of Thoracic Surgery The Third Affiliated Hospital of Kunming Medical UniversityYunnan Tumor HospitalKunming650118China The 1st Department of Thoracic Surgery The Third Affiliated Hospital of Kunming Medical UniversityYunnan Tumor HospitalKunming650118China Department of Geriatric Thoracic Surgery The First Affiliated Hospital of Kunming Medical UniversityKunming650032China

Lung cancer is a prevalent malignancy,and fatalities of the disease exceed 400,000 cases worldwide.Lung squamous cell carcinoma(LUSC)has been recognized as the most common pathological form of lung cancer.The comprehensive understanding of molecular features related to LUSC progression has great significance in LUSC prognosis assessment and clinical management.In this study,we aim to identify a panel of signature genes closely associated with LUSC,which can provide novel insights into the progression of LUSC.Gene expression profiles were retrieved from public resources including gene expression omnibus(GEO)and the cancer genome atlas(TCGA)database.Differentially expressed genes(DEGs)between LUSC specimens and normal lung tissues were identified by bioinformatics analyses.A total of 66 DEGs were identified based on two cohorts of data.CytoHubba plugin of Cytoscape software was utilized for the further analyses of the top 10 candidate hub genes including OGN,ABI3BP,MAMDC2,FGF7,FAM107A,SPARCL1,DCN,COL14A1,and MFAP4 and CHRDL1,which showed significant downregulation in LUSC.Two LUSC cell lines were used to validate the functions of CHRDL1 and FAM107A through overexpression experiment.Together,our data revealed novel candidate tumor-suppressor genes in LUSC,suggesting previously unappreciated mechanisms in the progression of LUSC.

关键词： LUSC DEGs WGCNA PPI network Tumor-suppressor

Comprehensive review of hepatocellular carcinoma with portal vein tumor thrombus:state of art and future perspectives

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 221-227页

作者： Paschalis Gavriilidis Timothy M Pawlik Daniel Azoulay Department of Surgery Colchester General HospitalTurner RoadColchester CO45JLUK Department of Surgery The Ohio State Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Department of Hepato-Biliary and Liver Transplantation surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Despite advances in the diagnosis of patients with hepatocellular carcinoma(HCC),70%-80%of patients are diagnosed with advanced stage disease.Portal vein tumor thrombus(PVTT)is among the most ominous signs of advanced stage disease and has been associated with poor survival if untreated.Data sources:A systematic search of MEDLINE(PubMed),Embase,Cochrane Library and Database for Systematic Reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases until December 2022 was conducted using free text and MeSH terms:hepatocellular carcinoma,portal vein tumor thrombus,portal vein thrombosis,vascular invasion,liver and/or hepatic resection,liver transplantation,and systematic review.Results:Centers of surgical excellence have reported promising results related to the individualized surgical management of portal thrombus versus arterial chemoembolization or systemic chemotherapy.Critical elements to the individualized surgical management of HCC and portal thrombus include precise classification of the portal vein tumor thrombus,accurate identification of the subgroups of patients who may benefit from resection,as well as meticulous surgical technique.This review addressed five specific areas:(a)formation of PVTT;(b)classifications of PVTT;(c)controversies related to clinical guidelines;(d)surgical treatments versus non-surgical approaches;and(e)characterization of surgical techniques correlated with classifications of PVTT.Conclusions:Current evidence from Chinese and Japanese high-volume centers demonstrated that patients with HCC and associated PVTT can be managed with surgical resection with acceptable results.

关键词： Hepatectomy Liver surgery Liver neoplasms Portal vein tumor thrombus

Anti-vascular endothelial growth factor drugs combined with laser photocoagulation maintain retinal ganglion cell integrity in patients with diabetic macular edema: study protocol for a prospective, non-randomized, controlled clinical trial

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Neural Regeneration Research 2024年第4期19卷 923-928页

作者： Xiangjun Li Chunyan Li Hai Huang Dan Bai Jingyi Wang Anqi Chen Yu Gong Ying Leng Department of Ophthalmology Affiliated Hospital of Beihua University Department of Endocrinology Affiliated Hospital of Beihua University

The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.

关键词： choroidal thickness diabetic macular edema laser photocoagulation retinal ganglion cell-inner plexiform layer thickness retinal ganglion cells retinal nerve fiber layer thickness thickness of the macular area vascular endothelial growth factor visual acuity

New insights into ATR inhibition in muscle invasive bladder cancer:The role of apolipoprotein B mRNA editing catalytic subunit 3B

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Oncology Research 2024年第6期32卷 1021-1030页

作者： HYUNHO KIM UIJU CHO SOOK HEE HONG HYUNG SOON PARK IN-HO KIM HO JUNG AN BYOUNG YONG SHIM JIN HYOUNG KANG Division of Medical Oncology Department of Internal MedicineSt.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea Department of Pathology St.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea Division of Medical Oncology Department of Internal MedicineSeoul St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoulKorea

Background:Apolipoprotein B mRNA editing catalytic polypeptide(APOBEC),an endogenous mutator,induces DNA damage and activates the ataxia telangiectasia and Rad3-related(ATR)-checkpoint kinase 1(Chk1)pathway.Although cisplatin-based therapy is the mainstay for muscle-invasive bladder cancer(MIBC),it has a poor survival rate.Therefore,this study aimed to evaluate the efficacy of an ATR inhibitor combined with cisplatin in the treatment of APOBEC catalytic subunit 3B(APOBEC3B)expressing MIBC.Methods:Immunohistochemical staining was performed to analyze an association between APOBEC3B and ATR in patients with MIBC.The APOBEC3B expression in MIBC cell lines was assessed using real-time polymerase chain reaction and western blot analysis.Western blot analysis was performed to confirm differences in phosphorylated Chk1(pChk1)expression according to the APOBEC3B expression.Cell viability and apoptosis analyses were performed to examine the anti-tumor activity of ATR inhibitors combined with cisplatin.Results:There was a significant association between APOBEC3B and ATR expression in the tumor tissues obtained from patients with MIBC.Cells with higher APOBEC3B expression showed higher pChk1 expression than cells expressing low APOBEC3B levels.Combination treatment of ATR inhibitor and cisplatin inhibited cell growth in MIBC cells with a higher APOBEC3B expression.Compared to cisplatin single treatment,combination treatment induced more apoptotic cell death in the cells with higher APOBEC3B expression.Conclusion:Our study shows that APOBEC3B’s higher expression status can enhance the sensitivity of MIBC to cisplatin upon ATR inhibition.This result provides new insight into appropriate patient selection for the effective application of ATR inhibitors in MIBC.

关键词： Apolipoprotein B mRNA editing catalytic polypeptide(APOBEC) Ataxia telangiectasia and Rad3-related(ATR) Bladder cancer DNA damage response DNA replication stress

Traumatic lumbar hernia: A systematic review of the literature

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Chinese Journal of Traumatology 2024年第1期27卷 53-57页

作者： Ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios KManatakis Department of Surgery Stony Brook University HospitalStony BrookNew YorkUSA Department of Surgical Oncology St Savvas Cancer HospitalAthensGreece nd Department of Surgery Athens Naval and Veterans HospitalAthensGreece Department of Surgery Naval Hospital of CreteChaniaGreece

Purpose:Traumatic lumbar hernia(TLH)constitutes a protrusion of content through a defect in the posterior abdominal wall,as a result of injury.This rare entity has been described in limited number of cases.Methods:A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology guidelines.The English literature from 1990 until 2021 was reviewed,using PubMed,EMBASE and Google Scholar bibliographic databases,to identify case reports and case series with patients that were diagnosed with TLH.For each eligible study,demographics,clinical presentation,hernia characteristics,preoperative imaging investigations,operation details,and postoperative data were extracted for assessment.statistical analysis was performed on SPSS,version 20.0.Results:A total of 62 studies were included for review,with 164 patients with TLH.Mean age was(42.6±14.3)years(47.6%males,31.1%females,gender not specified in 35 cases).Mean diameter of hernia neck was(6.3±3.1)cm,while the triangles of Petit and Grynfeltt were affected in 74.5%and 14.6%,respectively.Patients diagnosed in the emergency setting account for 54.2%,with CT scan establishing diagnosis in all but one case(97.7%).A delayed diagnosis was made in 45.8%,at a mean 1 year following trauma.Flank bulging(82.8%)and chronic back pain(34.3%)were the most frequent symptoms.In both delayed and acute group,open surgery(63.6%and 92.3%,respectively)was the preferred surgical approach.Postoperative complications were reported in 11.4%of acute and 15.0%of delayed patients.Hernia recurrence was 7%.Conclusions:TLH is uncommon with 164 cases described since 1990.CT scan is the gold standard in diagnosis.Open surgery is generally the preferred approach,particularly in the emergency setting.Acute TLH can be treated either by primary suture repair or mesh,depending on the local conditions,whereas delayed cases usually require a mesh.

关键词： Lumbar hernia Petit Grynfeltt Traumatic lumbar hernia Trauma

Genetic screening of liver cancer:state of the art

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World Journal of Hepatology 2024年第5期16卷 716-730页

作者： Milena Peruhova Sonya Banova-Chakarova Dimitrina Georgieva Miteva Tsvetelina Velikova Department of Gastroenterology University Hospital"Heart and Brain"Burgas 8000Bulgaria Department of Genetics Faculty of BiologySofia University"St.Kliment OhridskiSofia 1164Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria

Liver cancer,primarily hepatocellular carcinoma,remains a global health challenge with rising incidence and limited therapeutic options.Genetic factors play a pivotal role in the development and progression of liver cancer.This state-of-the-art paper provides a comprehensive review of the current landscape of genetic screening strategies for liver cancer.We discuss the genetic underpinnings of liver cancer,emphasizing the critical role of risk-associated genetic variants,somatic mutations,and epigenetic alterations.We also explore the intricate interplay between environmental factors and genetics,highlighting how genetic screening can aid in risk stratification and early detection via using liquid biopsy,and advancements in high-throughput sequencing technologies.By synthesizing the latest research findings,we aim to provide a comprehensive overview of the state-of-the-art genetic screening methods for liver cancer,shedding light on their potential to revolutionize early detection,risk assessment,and targeted therapies in the fight against this devastating disease.

关键词： Hepatocellular carcinoma Liver cancer Genetic screening Risk-associated genetic variants Epigenetic alterations Genetic biomarkers Circulating tumor DNA Next-generation sequencing

Using clinical cases to guide healthcare

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World Journal of Clinical Cases 2024年第9期12卷 1555-1559页

作者： Michael Colwill Samantha Baillie Richard Pollok Andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

Evidence-based practice(EBP)has been the gold standard in healthcare for nearly three centuries and aims to assist physicians in providing the safest and most effective healthcare for their patients.The well-established hierarchy of evidence lists systematic reviews and meta-analyses at the top however these methodologies are not always appropriate or possible and in these instances case-control studies,case series and case reports are utilised to support EBP.Case-control studies allow simultaneous study of multiple risk factors and can be performed rapidly and relatively cheaply.A recent example was during the Coronavirus pandemic where case-control studies were used to assess the efficacy of personal protective equipment for healthcare workers.Case series and case reports also play a role in EBP and are particularly useful to study rare diseases such as inflammatory bowel disease in transgender and gender non-conforming individuals.They are also vital in generating and disseminating early signals and encouraging further research.Whilst these methodologies have weaknesses,particularly with regards to bias and loss of patient confidentiality for rare pathologies,they have an important part to play in EBP and when appropriately utilised can significantly impact upon clinical practice.

关键词： Evidence based medicine Hierarchy of evidence Case reports Case series