Application of Big Data and Artificial Intelligence in COVID-19 Prevention, Diagnosis, Treatment and Management Decisions in China.

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread rapidly and affected most of the world since its outbreak in Wuhan, China, which presents a major challenge to the emergency response mechanism for sudden public health events and epidemic prevention and control in all countries. In the face of the severe situation of epidemic prevention and control and the arduous task of social management, the tremendous power of science and technology in prevention and control has emerged. The new generation of information technology, represented by big data and artificial intelligence (AI) technology, has been widely used in the prevention, diagnosis, treatment and management of COVID-19 as an important basic support. Although the technology has developed, there are still challenges with respect to epidemic surveillance, accurate prevention and control, effective diagnosis and treatment, and timely judgement. The prevention and control of sudden infectious diseases usually depend on the control of infection sources, interruption of transmission channels and vaccine development. Big data and AI are effective technologies to identify the source of infection and have an irreplaceable role in distinguishing close contacts and suspicious populations. Advanced computational analysis is beneficial to accelerate the speed of vaccine research and development and to improve the quality of vaccines. AI provides support in automatically processing relevant data from medical images and clinical features, tests and examination findings; predicting disease progression and prognosis; and even recommending treatment plans and strategies. This paper reviews the application of big data and AI in the COVID-19 prevention, diagnosis, treatment and management decisions in China to explain how to apply big data and AI technology to address the common problems in the COVID-19 pandemic. Although the findings regarding the application of big data and AI technologies in sudden public health events lack validation of repeatability and universality, current studies in China have shown that the application of big data and AI is feasible in response to the COVID-19 pandemic. These studies concluded that the application of big data and AI technology can contribute to prevention, diagnosis, treatment and management decision making regarding sudden public health events in the future.

Different Hepatitis C Virus Infection Statuses Show a Significant Risk of Developing Type 2 Diabetes Mellitus: A Network Meta-Analysis.

BACKGROUND: The role of hepatitis C virus (HCV) infection statuses in the development of type 2 diabetes mellitus (T2DM) has not been completely understood. AIM: To evaluate the prevalence of T2DM in patients with different HCV infection statuses. METHODS: We conducted a systematic study on T2DM risk in five types of individuals with different HCV infection statuses: non-HCV controls, HCV-cleared patients, chronic HCV patients without cirrhosis, patients with HCV cirrhosis and patients with decompensated HCV cirrhosis. Studies published from 2010 to 2019 were selected. Both pairwise and network meta-analyses were employed to compare the T2DM risk among patients with different HCV infection statuses. RESULTS: The pairwise meta-analysis showed that non-HCV (OR = 0.60, 95% CI [0.47-0.78]) had a lower risk of T2DM compared with CHC, while cirrhosis had a significant higher risk (OR = 1.90, 95% CI [1.60-2.26]). Network meta-analysis further demonstrated patients with HCV infection were at a significantly higher risk of T2DM than those without HCV infection or with HCV clearance, while decompensated cirrhosis had a significant higher T2DM risk than non-HCV (OR = 3.84, 95% CI [2.01-7.34]), patients with HCV clearance (OR = 3.17, 95% CI [1.49-6.73]), and CHC patients (OR = 2.21, 95% CI [1.24-3.94]). CONCLUSIONS: HCV infection is a significant risk factor for developing T2DM. CHC, cirrhosis, and decompensated cirrhosis contribute to an increasingly greater risk of T2DM, but HCV clearance spontaneously or through clinical treatment may immediately reduce the risk of the onset and development of T2DM.

Application effect of pneumatic tourniquet with individualized pressure setting in orthopaedic surgery of extremities: A meta-analysis.

AIMS: To evaluate the application effect of individualized pressure setting strategy of pneumatic tourniquet in orthopaedic surgery. BACKGROUND: Some individualized setting pressures of pneumatic tourniquet are lower than the standard pressure recommended in the textbook (Nursing of Operating Room, People's Military Publishing House, 2008). DESIGN: Meta-analysis. DATA SOURCES: CL, WOS, PubMed, CNKI, CBM, VIP and Wan-fang DATA. REVIEW METHODS: We searched studies on the application effect of individualized pressure of pneumatic tourniquet from the establishment date of the databases to September 2017. Study quality was assessed using the quality evaluation method recommended in the Cochrane Handbook 5.1.0 (Higgins, 2011). The primary outcome was inflation pressure. RESULTS: We identified nine studies including 1,200 patients. The individualized pressure setting strategy can provide a lower inflation pressure (four studies), improve haemostatic effect (six studies) and reduce the incidence of related complications (eight studies). CONCLUSIONS: An individualized inflation pressure is recommended when using the tourniquet in orthopaedic surgery. And the setting pressure might be a minimum and efficiency one, by accessing the the systolic blood pressure and limb circumferences of the patient. IMPACT: This study addressed that the individualized pressure setting strategy of pneumatic tourniquet can provide a lower inflation pressure and a higher application value in orthopaedic limb surgery. However, greater attention should be focused on how to unify the individualized pressure setting strategy. Meanwhile, the instructions for use from manufacturers need to be updated. Therefore, it is recommended to conduct a large-sample multi-centre high-quality randomized controlled trial in strict accordance with the CONSORT standard.

Efficacy of radial artery cannulation in treatment of cardiac arrest: A case report.

RATIONALE: Timely treatment and recovery of cardiac arrest in out-of-hospital settings present significant challenges. This report describes a novel method of integrating advanced monitoring techniques such as radial artery cannulation in the treatment of an 85-year-old male patient who suffered an out-of-hospital cardiac arrest (OHCA). PATIENT CONCERNS: The patient, an 85-year-old man, experienced sudden cardiac arrest at home around 4:10 pm on November 22, 2023, characterized by immediate loss of consciousness and absence of pulse, and no response when called by name, necessitating urgent medical intervention. DIAGNOSES: The patient was diagnosed with OHCA by the emergency doctor, which was further confirmed by the absence of spontaneous circulation and respiratory failure. INTERVENTIONS: The patient was treated with manual cardiopulmonary resuscitation (CPR), ventilator-assisted ventilation, internal jugular venous catheterization, medical treatment, mechanical CPR, and supplemented by radial artery cannulation for invasive blood pressure monitoring. This technique was pivotal for real-time hemodynamic assessment. OUTCOMES: The invasive monitoring facilitated the early detection of the return of spontaneous circulation, allowing for the timely cessation of mechanical CPR. Subsequent treatment in the intensive care unit was optimized based on continuous arterial pressure readings, enhancing the stabilization of the patient's condition. LESSONS: This case underscores the significant role of radial artery cannulation for invasive blood pressure monitoring in improving clinical outcomes for patients experiencing OHCA. Integrating radial artery cannulation with other advanced monitoring techniques aids in the early detection of the return of spontaneous circulation and optimizes subsequent intensive care treatment.

Factors affecting the use of artificial intelligence generated content by subject librarians: A qualitative study.

To explore the factors affecting the use of artificial intelligence generated content (AIGC) by subject librarians through understanding their perceptions of AIGC. Interpretive phenomenological analysis (IPA) and technology acceptance model (TAM) were used in semi-structured interviews to explore the external variables of perceived ease of use and perceived usability of AIGC application in subject librarians. The perceptions of subject librarians towards AIGC included performance, risk perceptions, ability enhancement, and affective attitude. Attentions were paid to AIGC's performances in providing customized services, optimizing collection resources and improving cost efficiency. The risk perception involved technical stability, data security, user acceptance and occupational risk, the ability enhancement involved the improvement of personal literacy, innovative ability, and self-confidence through the use of AIGC technology, and the affective attitudes included not only excitement and anticipation for the technical potential of AIGC, but also concerns and skepticism about it, and critical attitudes toward its application in academic settings and the ethical issues it may raise. TAM analysis on the factors affecting the use of AIGC by subject librarians indicates that the external influencing factors of perceived ease of use include personal literacy, innovative ability, self-confidence enhancement and affective attitude; the external influencing factors of perceived usability include precise service, collection resource optimization, cost-effectiveness, technological risk, user acceptance and occupational risk. These factors constitute a theoretical framework for understanding and promoting the acceptance and effective use of AIGC by subject librarians. TAM analysis combined with IPA exploration on the external variables of perceived ease of use and perceived usability of AIGC application can identify the key factors affecting subject librarians' perceptions of AIGC, propose strategies for optimizing librarians' roles, enhancing information recognition ability and privacy protection, thus providing guidance for effective use of AIGC in library.

A case report of Vibrio vulnificus sepsis in a diabetic patient.

Vibrio vulnificus is a facultative anaerobic, alkalophilic, halophilic, mesophilic, Gram-negative bacterium that can cause severe wound infection, sepsis and diarrhea. This paper reported a case of 85-year-old male patient infected with Vibrio vulnificus due to being stabbed by a sea shrimp. This patient also had diabetes with a long history of alcoholism. Due to bacterial pathogenicity and the patient's underlying diseases, his condition deteriorated rapidly. Based on the rapid diagnosis of Vibrio vulnificus using the next-generation sequencing（NGS）technology and blood culture method, as well as the selection of the most effective antibiotics via drug sensitivity test, this patient underwent precise antimicrobial treatment, thorough debridement and drainage within the shortest possible time, and thus the prognosis of this patient was greatly improved. In this paper, we have systematically explored the epidemiology, clinical features, diagnosis and treatment of Vibrio vulnificus infection, thus providing a practical reference for the clinicians to quickly identify and treat possible Vibrio vulnificus infection in diabetic patients after contacting with sea water or seafood.

Evaluation of anthracycline-induced subclinical LV dysfunction by using myocardial composite index and two-dimension speckle tracking echocardiography technique.

Objective: To obtain various myocardial strain parameters by using two-dimension speckle tracking echocardiography (2D-STE) technique, calculate the myocardial composite index (MCI) which combines the global longitudinal strain (GLS) of left ventricle and the left ventricular twist (LVtw), and evaluate their diagnostic efficacies for subclinical left ventricular (LV) dysfunction in patients undergoing anthracycline chemotherapy. Methods: A total of 35 female breast cancer patients, who underwent postoperative chemotherapy in the Department of Thyroid and Breast Surgery of Nantong Third People's Hospital from September 2018 to December 2019 and had successful follow-up, were included into the chemotherapy group, and the patients were evaluated respectively at baseline and in early, interim and later chemotherapy stages according to the course of chemotherapy; in addition, 30 healthy women undergoing physical examination during the same period were included into the control group. In different chemotherapy stages, the data such as left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular ejection fraction (LVEF) were collected by using conventional echocardiography, and various myocardial strain parameters such as GLS, global radial strain (GRS), global circumferential strain(GCS) and LVtw were measured using 2D-STE, and then MCI was calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the application values of various parameters in the diagnosis of early cardiotoxicity. Results: There was a difference in MCI between patients at baseline and in the early chemotherapy stage; there were differences in GLS, LVtw and MCI between patients at baseline and in the interim chemotherapy stage; there were differences in four parameters such as MCI, GLS, LVtw and GCS between patients at baseline and in the later chemotherapy stage; The AUC of MCI was 0.915, when the cutoff value was -210.89 (%×°), the sensitivity and specificity were 84.37% and 90.41%, respectively. Conclusion: MCI combines the longitudinal and torsional motions of myocardium, and thus has a better diagnostic value for early detection of subclinical LV dysfunction caused by anthracycline chemotherapy drugs compared with strain parameters in a single direction.

A ferroptosis associated gene signature for predicting prognosis and immune responses in patients with colorectal carcinoma.

Background: Colorectal carcinoma (CRC) is one of the most prevalent malignancies globally. Ferroptosis, a novel type of cell death, is critical in the development and treatment of tumors. Objective: This study was designed to establish a genetic signature for ferroptosis which has a predictive effect on the outcomes and immunotherapeutic response of CRC. Methods: Data of CRC patients were retrieved from TCGA and GEO databases. The genes associated with ferroptosis were obtained from GeneCards. The genetic signature for ferroptosis was identified by performing Cox regression analysis. Kaplan-Meier and ROC analysis were performed to assess the prognosis role of the genetic signature. CIBERSORT tool was used to identify a potential association of the genetic signature with the immune cells. The potential immunotherapeutic signatures and drug sensitivity prediction targeting this signature were also discussed. Immunohistochemistry was used to detect expression of ferroptosis-associated genes in CRC tissues and adjacent tissues. Results: A ferroptosis-associated gene signature comprised of three genes (CDKN2A, FDFT1, and ACSL6) was developed for prediction of prognosis and evaluation of immune responses in CRC. Patients in the high-risk group tended to have a poor prognosis. In CRC, the ferroptosis-associated gene signature may function as independent predictors. Additionally, the expressional levels of the immune checkpoint proteins PD-L1 and CTLA-4 were substantially increased in the high-risk group. Moreover, we can distinguish between patients based on their immunotherapeutic responses more effectively if we categorize them by this signature. Additionally, candidate compounds were identified for the differentiation of CRC subtypes. Conclusion: The ferroptosis-associated gene signature identified in this study is effective in predicting the prognosis and evaluating immunotherapeutic response in CRC patients, and provides us with novel insights into the potential effect of ferroptosis targeted treatment on CRC.

Prognostic Evaluation of Patients with Rectal Neuroendocrine Neoplasms and Hepatic Metastases: A SEER Database Analysis.

Background: This study is aimed at investigating the clinical characteristics and prognosis-affecting factors of patients with rectal neuroendocrine neoplasms (r-NENs) and hepatic metastases and offering a scientific-theoretical basis for selective use of an optimized treatment method for r-NENs. Methods: This study was retrospectively evaluated based on the analysis of the data from Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. Results: A total of 4,723 r-NEN patients were enrolled in this study, including 168 patients with hepatic metastases (3.56%). Kaplan-Meier analysis revealed that the overall survival (OS) of patients with hepatic metastases receiving primary tumor excision was obviously greater than that of patients without receiving primary tumor excision (OS: nonsurgical patients vs. patients undergoing local resection: P < 0.0001 and nonsurgical patients vs. patients undergoing radical resection: P < 0.0001); the patients with hepatic metastases in the chemotherapy group had a significantly worse prognosis compared with those in the nonchemotherapy group (OS: P = 0.021). Multivariate cox regression analysis revealed that independent affecting factors of overall and tumor-related prognoses in patients with hepatic metastases included tumor grade (G3 and G4), surgical treatment, and chemotherapy. Conclusion: Among r-NEN patients with hepatic metastases, those undergoing radical excision of lower-grade tumors and chemotherapy will have a better prognosis.

Study of effects of anthracycline drugs on myocardial function in breast cancer patients by quantitative analysis of layer-specific strain via 2D-STI technology.

OBJECTIVE: This study aimed to explore the value of layer-specific strain analysis by two-dimensional speckle tracking imaging (2D-STI) in the assessment of myocardial toxicity in breast cancer patients receiving anthracycline chemotherapy. METHODS: Thirty-four breast cancer patients receiving anthracycline chemotherapy were prospectively enrolled. Conventional echocardiography and 2D-STI were evaluated at baseline after the third and sixth cycles of anthracycline chemotherapy. The strains of different layers of left ventricle (LV) including peak systolic longitudinal strain (endo-LS, mid-LS, epi-LS) and circumferential strain (endo-CS, mid-CS, epi-CS) were measured using EchoPAC analysis software. Peak systolic longitudinal strain (MV-LS, PM-LS, AP-LS), circumferential strain (MV-CS, PM-CS, AP-CS) and radial strain (MV-RS, PM-RS, AP-RS) were measured at mitral valve, papillary muscle and apex levels of LV respectively. Global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and left ventricular twist (LVtw) were also analyzed. RESULTS: There was no significant difference in the structural and functional parameters of conventional 2D echocardiography in different cycles of anthracycline chemotherapy (P>0.05); layer specific LS and CS in various cycles decreased layer by layer from inside to outside. LS and CS increased from basal segment to apical segment, while RS showed no obvious gradient characteristics; compared with baseline, GLS and LSs (endo-PM, endo-AP, mid-PM, mid-AP and epi-AP) of LV decreased significantly after the third cycle of chemotherapy (P<0.05); LSs (epi-MV and epi-AP) decreased significantly after the sixth cycle of chemotherapy (P<0.05). No significant changes were detected in layer specific CS, RS and LVtw (P>0.05). CONCLUSION: Layer-specific strain analysis by 2D-STI technology can quantitatively analyze global and regional functions of LV. The myocardial toxicity due to anthracycline chemotherapy can be detected by layer-specific LS of LV in early stage, which is great valuable to guiding clinical early intervention and improving prognosis.