[THE IMPACT OF ARTIFICIAL INTELLIGENCE AND BIG DATA ON HEALTHCARE].

INTRODUCTION: The fourth industrial revolution has led to a paradigm shift in the world of data; this paper reviews the implications on the medical and health services. These changes include: -The transition to big data: New layers of information such as longitudinal data, OMICS, information from social networks and the internet will be added to the conventional sources of information: anamnesis, physical examination, lab results etc. and will assist in medical decisions. -The transition to medical prediction: The information will allow not only diagnosing the current medical situation, but will also enable predicting the patient's risk level for developing certain diseases in the future. -The transition to artificial intelligence systems: This will enable analysis and generate insights into the vast amount of available information. -The decline in data production and data analysis costs: Much of the information will be collected by the patient himself and derived from his wearable devices. Information that was previously costly and exclusively owned by health officials, will be owned by others including the patient himself. These changes pose risks alongside the opportunities. The pace and quality of incorporating all this data depends on two opposing forces: technological innovation on the one hand, and system barriers on the other. Barriers include objections from users, budgetary constraints, patient privacy and regulatory barriers. The healthcare system must prepare wisely, but quickly, for the dramatic changes.

Regulation of stem cell differentiation by control of retinoic acid gradients in hydrospun 3D scaffold.

Morphogen gradients have been associated with differential gene expression and are implicated in the triggering and regulation of developmental biological processes. This study focused on creating morphogenic gradients through the thickness of hydrospun scaffolds. Specifically, electrospun poly(ε-caprolactone) fibers were loaded with all-trans-retinoic acid (ATRA), and designed to release ATRA at a predetermined rate. Multilayered scaffolds designed to present varied initial ATRA concentrations were then exposed to flow conditions in a bioreactor. Gradient formation was verified by a simple convection-diffusion mathematical model approving establishment of a continuous solute gradient across the scaffold. The biological value of the designed gradients in scaffolds was evaluated by monitoring the fate of murine embryonal carcinoma cells embedded within the scaffolds. Cell differentiation within the different layers matched the predictions set forth by the theoretical model, in accordance with the ATRA gradient formed across the scaffold. This tool bears powerful potential in establishing in vitro simulation models for better understanding the inner workings of the embryo.

Optimizing partition-controlled drug release from electrospun core-shell fibers.

Controlled release of hydrophilic entities, such as peptides, proteins and even pDNA, is difficult to accomplish with conventional approaches. This work suggests one possible approach for controlled release of such actives using electrospun core-shell fiber structures. In particular, we propose strategies for partition control of the release. The fibers consist of two layers, with the outer polymer sleeve serving containing the inner core, in which the drug is encapsulated. By varying the physical and chemical properties of the core and shell solutions, we have shown that the release rate of a hydrophilic drug, metoclopramide hydrochloride, is controllable. Experimental results show a clear difference in the release pattern between monolithic fibers made of hydrophilic and hydrophobic polymers and various core-shell fibers with PCL, PLLA and PLGA 80/20 as shell polymers. The study yields insight into when partition control of release can be achieved in core-shell fibers, and with that, options for controlled release systems for hydrophilic drugs, peptides and pDNA.

A layered ultra-porous scaffold for tissue engineering, created via a hydrospinning method.

In this work we propose a new method titled "layered hydrospinning." In this method, nanofibers are being collected on top of a liquid reservoir and assembled layer-by-layer to form a 3D scaffold. The geometrical features of fabricated hydrospun scaffolds show a porosity of 99% and pores of a diameter over 100 microm. Cells were seeded during the hydrospinning process, thus achieving an initial even density of cells in the scaffold. We show that human embryonic stem cells and mouse myoblasts cultured on the scaffolds were able to infiltrate further into the scaffolds and proliferate to a greater extent, compared to conventional electrospun scaffolds collected on a plate.