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Zahra MA, Al-Taher A, Alquhaidan M, Hussain T, Ismail I, Raya I, Kandeel M. The synergy of artificial intelligence and personalized medicine for the enhanced diagnosis, treatment, and prevention of disease. Drug Metab Pers Ther 2024; 39:47-58. [PMID: 38997240 DOI: 10.1515/dmpt-2024-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION The completion of the Human Genome Project in 2003 marked the beginning of a transformative era in medicine. This milestone laid the foundation for personalized medicine, an innovative approach that customizes healthcare treatments. CONTENT Central to the advancement of personalized medicine is the understanding of genetic variations and their impact on drug responses. The integration of artificial intelligence (AI) into drug response trials has been pivotal in this domain. These technologies excel in handling large-scale genomic datasets and patient histories, significantly improving diagnostic accuracy, disease prediction and drug discovery. They are particularly effective in addressing complex diseases such as cancer and genetic disorders. Furthermore, the advent of wearable technology, when combined with AI, propels personalized medicine forward by offering real-time health monitoring, which is crucial for early disease detection and management. SUMMARY The integration of AI into personalized medicine represents a significant advancement in healthcare, promising more accurate diagnoses, effective treatment plans and innovative drug discoveries. OUTLOOK As technology continues to evolve, the role of AI in enhancing personalized medicine and transforming the healthcare landscape is expected to grow exponentially. This synergy between AI and healthcare holds great promise for the future, potentially revolutionizing the way healthcare is delivered and experienced.
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Affiliation(s)
- Mohammad Abu Zahra
- Department of Biomolecular Sciences, College of Veterinary Medicine, 114800 King Faisal University , Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Abdulla Al-Taher
- Department of Biomolecular Sciences, College of Veterinary Medicine, 114800 King Faisal University , Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Mohamed Alquhaidan
- Department of Biomolecular Sciences, College of Veterinary Medicine, 114800 King Faisal University , Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Tarique Hussain
- Animal Sciences Division, Nuclear Institute for Agriculture and Biology (NIAB), Faisalabad, Pakistan
| | - Izzeldin Ismail
- Department of Biomolecular Sciences, College of Veterinary Medicine, 114800 King Faisal University , Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Indah Raya
- Department of Chemistry, Faculty of Mathematics, and Natural Science, Hasanuddin University, Makassar, Indonesia
| | - Mahmoud Kandeel
- Department of Biomolecular Sciences, College of Veterinary Medicine, 114800 King Faisal University , Al-Hofuf, Al-Ahsa, Saudi Arabia
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelshikh University, Kafrelshikh, Egypt
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Ferrara M, Bertozzi G, Di Fazio N, Aquila I, Di Fazio A, Maiese A, Volonnino G, Frati P, La Russa R. Risk Management and Patient Safety in the Artificial Intelligence Era: A Systematic Review. Healthcare (Basel) 2024; 12:549. [PMID: 38470660 PMCID: PMC10931321 DOI: 10.3390/healthcare12050549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Healthcare systems represent complex organizations within which multiple factors (physical environment, human factor, technological devices, quality of care) interconnect to form a dense network whose imbalance is potentially able to compromise patient safety. In this scenario, the need for hospitals to expand reactive and proactive clinical risk management programs is easily understood, and artificial intelligence fits well in this context. This systematic review aims to investigate the state of the art regarding the impact of AI on clinical risk management processes. To simplify the analysis of the review outcomes and to motivate future standardized comparisons with any subsequent studies, the findings of the present review will be grouped according to the possibility of applying AI in the prevention of the different incident type groups as defined by the ICPS. MATERIALS AND METHODS On 3 November 2023, a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out using the SCOPUS and Medline (via PubMed) databases. A total of 297 articles were identified. After the selection process, 36 articles were included in the present systematic review. RESULTS AND DISCUSSION The studies included in this review allowed for the identification of three main "incident type" domains: clinical process, healthcare-associated infection, and medication. Another relevant application of AI in clinical risk management concerns the topic of incident reporting. CONCLUSIONS This review highlighted that AI can be applied transversely in various clinical contexts to enhance patient safety and facilitate the identification of errors. It appears to be a promising tool to improve clinical risk management, although its use requires human supervision and cannot completely replace human skills. To facilitate the analysis of the present review outcome and to enable comparison with future systematic reviews, it was deemed useful to refer to a pre-existing taxonomy for the identification of adverse events. However, the results of the present study highlighted the usefulness of AI not only for risk prevention in clinical practice, but also in improving the use of an essential risk identification tool, which is incident reporting. For this reason, the taxonomy of the areas of application of AI to clinical risk processes should include an additional class relating to risk identification and analysis tools. For this purpose, it was considered convenient to use ICPS classification.
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Affiliation(s)
- Michela Ferrara
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Giuseppe Bertozzi
- Complex Intercompany Structure of Forensic Medicine, 85100 Potenza, Italy;
| | - Nicola Di Fazio
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Isabella Aquila
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Aldo Di Fazio
- Regional Hospital “San Carlo”, 85100 Potenza, Italy;
| | - Aniello Maiese
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Gianpietro Volonnino
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Raffaele La Russa
- Department of Clinical Medicine, Public Health, Life and Environment Science, University of L’Aquila, 67100 L’Aquila, Italy;
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Derraz B, Breda G, Kaempf C, Baenke F, Cotte F, Reiche K, Köhl U, Kather JN, Eskenazy D, Gilbert S. New regulatory thinking is needed for AI-based personalised drug and cell therapies in precision oncology. NPJ Precis Oncol 2024; 8:23. [PMID: 38291217 PMCID: PMC10828509 DOI: 10.1038/s41698-024-00517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/06/2024] [Indexed: 02/01/2024] Open
Abstract
Until recently the application of artificial intelligence (AI) in precision oncology was confined to activities in drug development and had limited impact on the personalisation of therapy. Now, a number of approaches have been proposed for the personalisation of drug and cell therapies with AI applied to therapy design, planning and delivery at the patient's bedside. Some drug and cell-based therapies are already tuneable to the individual to optimise efficacy, to reduce toxicity, to adapt the dosing regime, to design combination therapy approaches and, preclinically, even to personalise the receptor design of cell therapies. Developments in AI-based healthcare are accelerating through the adoption of foundation models, and generalist medical AI models have been proposed. The application of these approaches in therapy design is already being explored and realistic short-term advances include the application to the personalised design and delivery of drugs and cell therapies. With this pace of development, the limiting step to adoption will likely be the capacity and appropriateness of regulatory frameworks. This article explores emerging concepts and new ideas for the regulation of AI-enabled personalised cancer therapies in the context of existing and in development governance frameworks.
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Affiliation(s)
- Bouchra Derraz
- ProductLife Group, Paris, France
- Groupe de recherche et d'accueil en droit et économie de la santé (GRADES), Faculty of Pharmacy, University Paris-Saclay, Paris, France
| | | | - Christoph Kaempf
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Franziska Baenke
- Carl Gustav Carus University Hospital Dresden, Dresden University of Technology, Dresden, Germany
| | - Fabienne Cotte
- Department of Emergency Medicine, University Clinic Marburg, Philipps-University, Marburg, Germany
| | - Kristin Reiche
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
- Center for Scalable Data Analytics and Artificial Intelligence (ScaDS.AI), Dresden/Leipzig, Germany
- Institute of Clinical Immunology, University Leipzig, Leipzig, Germany
| | - Ulrike Köhl
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
- Institute of Clinical Immunology, University Leipzig, Leipzig, Germany
| | - Jakob Nikolas Kather
- Carl Gustav Carus University Hospital Dresden, Dresden University of Technology, Dresden, Germany
- Else Kröner Fresenius Center for Digital Health, TUD Dresden University of Technology, Dresden, Germany
| | - Deborah Eskenazy
- Groupe de recherche et d'accueil en droit et économie de la santé (GRADES), Faculty of Pharmacy, University Paris-Saclay, Paris, France
| | - Stephen Gilbert
- Carl Gustav Carus University Hospital Dresden, Dresden University of Technology, Dresden, Germany.
- Else Kröner Fresenius Center for Digital Health, TUD Dresden University of Technology, Dresden, Germany.
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Bhattacharya S, Mahato RK, Singh S, Bhatti GK, Mastana SS, Bhatti JS. Advances and challenges in thyroid cancer: The interplay of genetic modulators, targeted therapies, and AI-driven approaches. Life Sci 2023; 332:122110. [PMID: 37734434 DOI: 10.1016/j.lfs.2023.122110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Thyroid cancer continues to exhibit a rising incidence globally, predominantly affecting women. Despite stable mortality rates, the unique characteristics of thyroid carcinoma warrant a distinct approach. Differentiated thyroid cancer, comprising most cases, is effectively managed through standard treatments such as thyroidectomy and radioiodine therapy. However, rarer variants, including anaplastic thyroid carcinoma, necessitate specialized interventions, often employing targeted therapies. Although these drugs focus on symptom management, they are not curative. This review delves into the fundamental modulators of thyroid cancers, encompassing genetic, epigenetic, and non-coding RNA factors while exploring their intricate interplay and influence. Epigenetic modifications directly affect the expression of causal genes, while long non-coding RNAs impact the function and expression of micro-RNAs, culminating in tumorigenesis. Additionally, this article provides a concise overview of the advantages and disadvantages associated with pharmacological and non-pharmacological therapeutic interventions in thyroid cancer. Furthermore, with technological advancements, integrating modern software and computing into healthcare and medical practices has become increasingly prevalent. Artificial intelligence and machine learning techniques hold the potential to predict treatment outcomes, analyze data, and develop personalized therapeutic approaches catering to patient specificity. In thyroid cancer, cutting-edge machine learning and deep learning technologies analyze factors such as ultrasonography results for tumor textures and biopsy samples from fine needle aspirations, paving the way for a more accurate and effective therapeutic landscape in the near future.
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Affiliation(s)
- Srinjan Bhattacharya
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda 151401, Punjab, India
| | - Rahul Kumar Mahato
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda 151401, Punjab, India
| | - Satwinder Singh
- Department of Computer Science and Technology, Central University of Punjab, Bathinda 151401, Punjab, India.
| | - Gurjit Kaur Bhatti
- Department of Medical Lab Technology, University Institute of Applied Health Sciences, Chandigarh University, Mohali, India
| | - Sarabjit Singh Mastana
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK.
| | - Jasvinder Singh Bhatti
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda 151401, Punjab, India.
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Solarte-Pabón O, Montenegro O, García-Barragán A, Torrente M, Provencio M, Menasalvas E, Robles V. Transformers for extracting breast cancer information from Spanish clinical narratives. Artif Intell Med 2023; 143:102625. [PMID: 37673566 DOI: 10.1016/j.artmed.2023.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/11/2023] [Accepted: 07/08/2023] [Indexed: 09/08/2023]
Abstract
The wide adoption of electronic health records (EHRs) offers immense potential as a source of support for clinical research. However, previous studies focused on extracting only a limited set of medical concepts to support information extraction in the cancer domain for the Spanish language. Building on the success of deep learning for processing natural language texts, this paper proposes a transformer-based approach to extract named entities from breast cancer clinical notes written in Spanish and compares several language models. To facilitate this approach, a schema for annotating clinical notes with breast cancer concepts is presented, and a corpus for breast cancer is developed. Results indicate that both BERT-based and RoBERTa-based language models demonstrate competitive performance in clinical Named Entity Recognition (NER). Specifically, BETO and multilingual BERT achieve F-scores of 93.71% and 94.63%, respectively. Additionally, RoBERTa Biomedical attains an F-score of 95.01%, while RoBERTa BNE achieves an F-score of 94.54%. The findings suggest that transformers can feasibly extract information in the clinical domain in the Spanish language, with the use of models trained on biomedical texts contributing to enhanced results. The proposed approach takes advantage of transfer learning techniques by fine-tuning language models to automatically represent text features and avoiding the time-consuming feature engineering process.
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Affiliation(s)
- Oswaldo Solarte-Pabón
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Madrid, Spain; Escuela de Ingeniería de Sistemas, Universidad del Valle, Cali, Colombia.
| | - Orlando Montenegro
- Escuela de Ingeniería de Sistemas, Universidad del Valle, Cali, Colombia
| | | | - Maria Torrente
- Hospital Universitario Puerta de Hierro de Madrid, Madrid, Spain
| | | | - Ernestina Menasalvas
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Madrid, Spain
| | - Víctor Robles
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Madrid, Spain
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Paudyal R, Shah AD, Akin O, Do RKG, Konar AS, Hatzoglou V, Mahmood U, Lee N, Wong RJ, Banerjee S, Shin J, Veeraraghavan H, Shukla-Dave A. Artificial Intelligence in CT and MR Imaging for Oncological Applications. Cancers (Basel) 2023; 15:cancers15092573. [PMID: 37174039 PMCID: PMC10177423 DOI: 10.3390/cancers15092573] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023] Open
Abstract
Cancer care increasingly relies on imaging for patient management. The two most common cross-sectional imaging modalities in oncology are computed tomography (CT) and magnetic resonance imaging (MRI), which provide high-resolution anatomic and physiological imaging. Herewith is a summary of recent applications of rapidly advancing artificial intelligence (AI) in CT and MRI oncological imaging that addresses the benefits and challenges of the resultant opportunities with examples. Major challenges remain, such as how best to integrate AI developments into clinical radiology practice, the vigorous assessment of quantitative CT and MR imaging data accuracy, and reliability for clinical utility and research integrity in oncology. Such challenges necessitate an evaluation of the robustness of imaging biomarkers to be included in AI developments, a culture of data sharing, and the cooperation of knowledgeable academics with vendor scientists and companies operating in radiology and oncology fields. Herein, we will illustrate a few challenges and solutions of these efforts using novel methods for synthesizing different contrast modality images, auto-segmentation, and image reconstruction with examples from lung CT as well as abdome, pelvis, and head and neck MRI. The imaging community must embrace the need for quantitative CT and MRI metrics beyond lesion size measurement. AI methods for the extraction and longitudinal tracking of imaging metrics from registered lesions and understanding the tumor environment will be invaluable for interpreting disease status and treatment efficacy. This is an exciting time to work together to move the imaging field forward with narrow AI-specific tasks. New AI developments using CT and MRI datasets will be used to improve the personalized management of cancer patients.
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Affiliation(s)
- Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Akash D Shah
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Richard K G Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Amaresha Shridhar Konar
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Usman Mahmood
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Richard J Wong
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | | | | | - Harini Veeraraghavan
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
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Mentzel F, Paino J, Barnes M, Cameron M, Corde S, Engels E, Kröninger K, Lerch M, Nackenhorst O, Rosenfeld A, Tehei M, Tsoi AC, Vogel S, Weingarten J, Hagenbuchner M, Guatelli S. Accurate and Fast Deep Learning Dose Prediction for a Preclinical Microbeam Radiation Therapy Study Using Low-Statistics Monte Carlo Simulations. Cancers (Basel) 2023; 15:cancers15072137. [PMID: 37046798 PMCID: PMC10093595 DOI: 10.3390/cancers15072137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
Microbeam radiation therapy (MRT) utilizes coplanar synchrotron radiation beamlets and is a proposed treatment approach for several tumor diagnoses that currently have poor clinical treatment outcomes, such as gliosarcomas. Monte Carlo (MC) simulations are one of the most used methods at the Imaging and Medical Beamline, Australian Synchrotron to calculate the dose in MRT preclinical studies. The steep dose gradients associated with the 50μm-wide coplanar beamlets present a significant challenge for precise MC simulation of the dose deposition of an MRT irradiation treatment field in a short time frame. The long computation times inhibit the ability to perform dose optimization in treatment planning or apply online image-adaptive radiotherapy techniques to MRT. Much research has been conducted on fast dose estimation methods for clinically available treatments. However, such methods, including GPU Monte Carlo implementations and machine learning (ML) models, are unavailable for novel and emerging cancer radiotherapy options such as MRT. In this work, the successful application of a fast and accurate ML dose prediction model for a preclinical MRT rodent study is presented for the first time. The ML model predicts the peak doses in the path of the microbeams and the valley doses between them, delivered to the tumor target in rat patients. A CT imaging dataset is used to generate digital phantoms for each patient. Augmented variations of the digital phantoms are used to simulate with Geant4 the energy depositions of an MRT beam inside the phantoms with 15% (high-noise) and 2% (low-noise) statistical uncertainty. The high-noise MC simulation data are used to train the ML model to predict the energy depositions in the digital phantoms. The low-noise MC simulations data are used to test the predictive power of the ML model. The predictions of the ML model show an agreement within 3% with low-noise MC simulations for at least 77.6% of all predicted voxels (at least 95.9% of voxels containing tumor) in the case of the valley dose prediction and for at least 93.9% of all predicted voxels (100.0% of voxels containing tumor) in the case of the peak dose prediction. The successful use of high-noise MC simulations for the training, which are much faster to produce, accelerates the production of the training data of the ML model and encourages transfer of the ML model to different treatment modalities for other future applications in novel radiation cancer therapies.
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Affiliation(s)
- Florian Mentzel
- Department of Physics, TU Dortmund University, D-44227 Dortmund, Germany
| | - Jason Paino
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Micah Barnes
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Imaging and Medical Beamline, Australian Synchrotron, ANSTO, Clayton, VIC 3168, Australia
- Peter MacCallum Cancer Center, Physical Sciences, Melbourne, VIC 3000, Australia
| | - Matthew Cameron
- Imaging and Medical Beamline, Australian Synchrotron, ANSTO, Clayton, VIC 3168, Australia
| | - Stéphanie Corde
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
- Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Elette Engels
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Imaging and Medical Beamline, Australian Synchrotron, ANSTO, Clayton, VIC 3168, Australia
- Peter MacCallum Cancer Center, Physical Sciences, Melbourne, VIC 3000, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Kevin Kröninger
- Department of Physics, TU Dortmund University, D-44227 Dortmund, Germany
| | - Michael Lerch
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Olaf Nackenhorst
- Department of Physics, TU Dortmund University, D-44227 Dortmund, Germany
| | - Anatoly Rosenfeld
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Moeava Tehei
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Ah Chung Tsoi
- School of Computing and Information Technology, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Sarah Vogel
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Jens Weingarten
- Department of Physics, TU Dortmund University, D-44227 Dortmund, Germany
| | - Markus Hagenbuchner
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
- School of Computing and Information Technology, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Susanna Guatelli
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2500, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2500, Australia
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Artificial Intelligence in Oncology: A Topical Collection in 2022. Cancers (Basel) 2023; 15:cancers15041065. [PMID: 36831407 PMCID: PMC9954205 DOI: 10.3390/cancers15041065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
Artificial intelligence (AI) is considered one of the core technologies of the Fourth Industrial Revolution that is currently taking place [...].
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Zarogoulidis P, Petridis D, Kosmidis C, Sapalidis K, Nena L, Matthaios D, Papadopoulos V, Perdikouri EI, Porpodis K, Kakavelas P, Steiropoulos P. Non-Small-Cell Lung Cancer Immunotherapy and Sleep Characteristics: The Crossroad for Optimal Survival. Diseases 2023; 11:diseases11010026. [PMID: 36810540 PMCID: PMC9944906 DOI: 10.3390/diseases11010026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Non-small-cell lung cancer is still diagnosed at an inoperable stage and systematic treatment is the only option. Immunotherapy is currently considered to be the tip of the arrow as the first-line treatment for patients with a programmed death-ligand 1 ≥ 50. Sleep is known to be an essential part of our everyday life. PATIENTS AND METHODS We investigated, upon diagnosis and after nine months, 49 non-small-cell lung cancer patients undergoing immunotherapy treatment with nivolumab and pemprolisumab. A polysomnographic examination was conducted. Moreover, the patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale (FSS) and the Medical Research Council (MRC) dyspnea scale. RESULTS Tukey mean-difference plots, summary statistics, and the results of paired t-test of five questionnaire responses in accordance with the PD-L1 test across groups were examined. The results indicated that, upon diagnosis, patients had sleep disturbances which were not associated with brain metastases or their PD-L1 expression status. However, the PD-L1 status and disease control were strongly associated, since a PD-L1 ≥80 improved the disease status within the first 4 months. All data from the sleep questionnaires and polysomnography reports indicated that the majority of patients with a partial response and complete response had their initial sleep disturbances improved. There was no connection between nivolumab or pembrolisumab and sleep disturbances. CONCLUSION Upon diagnosis, lung cancer patients have sleep disorders such as anxiety, early morning wakening, late sleep onset, prolonged nocturnal waking periods, daytime sleepiness, and unrefreshing sleep. However, these symptoms tend to improve very quickly for patients with a PD-L1 expression ≥80, because disease status improves also very quickly within the first 4 months of treatment.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 68100 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54646 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6977271974
| | - Dimitrios Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 64556 Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54646 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54646 Thessaloniki, Greece
| | - Lila Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | | | | | - Konstantinos Porpodis
- Pulmonary Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 54768 Thessaloniki, Greece
| | - Paschalis Kakavelas
- Intensive Care Unit, General Clinic Euromedica, Private Hospital, 54667 Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Barczyński B, Frąszczak K, Wnorowski A, Kotarski J. Menopausal Status Contributes to Overall Survival in Endometrial Cancer Patients. Cancers (Basel) 2023; 15:cancers15020451. [PMID: 36672399 PMCID: PMC9856958 DOI: 10.3390/cancers15020451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/28/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Endometrial cancer is the most common female genital tract malignancy in developed countries that occurs predominantly in postmenopausal women. The primary objective of our research was to investigate whether menopause status together with selected conventional prognostic indicators may contribute to overall (all-cause) survival in endometrial cancer patients. For this purpose, we applied the Cox proportional hazards regression model. Patients in advanced FIGO stage showed a relatively poor survival rate. The time since last menstruation and postoperative FSH concentration were identified as unfavorable prognostic factors in our model. Additionally, age at diagnosis, BMI value, adjuvant treatment (brachytherapy), and parity showed no impact on survival. To our knowledge, this is the first study to report a prognostic model for endometrial cancer including exact time from last menstruation as one of the prognostic variables. Due to the fact that there are no stratifying systems to reliably predict survival in patients with endometrial cancer, there is a strong need to revise and update existing models using complementary prognostic indicators. Collection of precise data on various risk factors may contribute to increased accuracy of artificial intelligence algorithms in order to personalize cancer care in the near future.
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Affiliation(s)
- Bartłomiej Barczyński
- 1st Chair and Department of Oncological Gynaecology and Gynaecology, Medical University in Lublin, 20-081 Lublin, Poland
- Correspondence: ; Tel.: +48-50-410-85-58
| | - Karolina Frąszczak
- 1st Chair and Department of Oncological Gynaecology and Gynaecology, Medical University in Lublin, 20-081 Lublin, Poland
| | - Artur Wnorowski
- Department of Biopharmacy, Medical University in Lublin, 20-081 Lublin, Poland
| | - Jan Kotarski
- Independent Laboratory of Cancer Diagnostics and Immunology, Medical University in Lublin, 20-081 Lublin, Poland
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