搜索结果：Frontiers in medicine

With the increasing interest in deploying Artificial Intelligence in medicine, we previously introduced HAIM (Holistic AI in Medicine), a framework that fuses multimodal data to solve downstream clinical tasks. However, HAIM uses data in a task-agnostic manner and lacks explainability. To address these limitations, we introduce xHAIM (Explainable HAIM), a novel framework leveraging Generative AI to enhance both prediction and explainability through four structured steps: (1) automatically identifying task-relevant patient data across modalities, (2) generating comprehensive patient summaries, (3) using these summaries for improved predictive modeling, and (4) providing clinical explanations by linking predictions to patient-specific medical knowledge. Evaluated on the HAIM-MIMIC-MM dataset, xHAIM improves average AUC from 79.9% to 90.3% across chest pathology and operative tasks. Importantly, xHAIM transforms AI from a black-box predictor into an explainable decision support system, enabling clinicians to interactively trace predictions back to relevant patient data, bridging AI advancements with clinical utility.

Medicine, including fields in healthcare and life sciences, has seen a flurry of quantum-related activities and experiments in the last few years (although biology and quantum theory have arguably been entangled ever since Schrödinger's cat). The initial focus was on biochemical and computational biology problems; recently, however, clinical and medical quantum solutions have drawn increasing interest. The rapid emergence of quantum computing in health and medicine necessitates a mapping of the landscape. In this review, clinical and medical proof-of-concept quantum computing applications are outlined and put into perspective. These consist of over 40 experimental and theoretical studies. The use case areas span genomics, clinical research and discovery, diagnostics, and treatments and interventions. Quantum machine learning (QML) in particular has rapidly evolved and shown to be competitive with classical benchmarks in recent medical research. Near-term QML algorithms have been trained with diverse clinical and real-world data sets. This includes studies in generating new molecular entities as drug candidates, diagnosing based on medical image classification, predicting patient pe

Land use expansion is linked to major sustainability concerns including climate change, food security and biodiversity loss. This expansion is largely concentrated in so-called frontiers, defined here as places experiencing marked transformations due to rapid resource exploitation. Understanding the mechanisms shaping these frontiers is crucial for sustainability. Previous work focused mainly on explaining how active frontiers advance, in particular into tropical forests. Comparatively, our understanding of how frontiers emerge in territories considered marginal in terms of agricultural productivity and global market integration remains weak. We synthesize conceptual tools explaining resource and land-use frontiers, including theories of land rent and agglomeration economies, of frontiers as successive waves, spaces of territorialization, friction, and opportunities, anticipation and expectation. We then propose a new theory of frontier emergence, which identifies exogenous pushes, legacies of past waves, and actors anticipations as key mechanisms by which frontiers emerge. Processes of abnormal rent creation and capture and the built-up of agglomeration economies then constitute k

This report presents a small language model (SLM) for Japanese clinical and medicine, named NCVC-slm-1. This 1B parameters model was trained using Japanese text classified to be of high-quality. Moreover, NCVC-slm-1 was augmented with respect to clinical and medicine content that includes the variety of diseases, drugs, and examinations. Using a carefully designed pre-processing, a specialized morphological analyzer and tokenizer, this small and light-weight model performed not only to generate text but also indicated the feasibility of understanding clinical and medicine text. In comparison to other large language models, a fine-tuning NCVC-slm-1 demonstrated the highest scores on 6 tasks of total 8 on JMED-LLM. According to this result, SLM indicated the feasibility of performing several downstream tasks in the field of clinical and medicine. Hopefully, NCVC-slm-1 will be contributed to develop and accelerate the field of clinical and medicine for a bright future.

The revolutionary progress in development of next-generation sequencing (NGS) technologies has made it possible to deliver accurate genomic information in a timely manner. Over the past several years, NGS has transformed biomedical and clinical research and found its application in the field of personalized medicine. Here we discuss the rise of personalized medicine and the history of NGS. We discuss current applications and uses of NGS in medicine, including infectious diseases, oncology, genomic medicine, and dermatology. We provide a brief discussion of selected studies where NGS was used to respond to wide variety of questions in biomedical research and clinical medicine. Finally, we discuss the challenges of implementing NGS into routine clinical use.

The success of precision medicine requires computational models that can effectively process and interpret diverse physiological signals across heterogeneous patient populations. While foundation models have demonstrated remarkable transfer capabilities across various domains, their effectiveness in handling individual-specific physiological signals - crucial for precision medicine - remains largely unexplored. This work introduces a systematic pipeline for rapidly and efficiently evaluating foundation models' transfer capabilities in medical contexts. Our pipeline employs a three-stage approach. First, it leverages physiological simulation software to generate diverse, clinically relevant scenarios, particularly focusing on data-scarce medical conditions. This simulation-based approach enables both targeted capability assessment and subsequent model fine-tuning. Second, the pipeline projects these simulated signals through the foundation model to obtain embeddings, which are then evaluated using linear methods. This evaluation quantifies the model's ability to capture three critical aspects: physiological feature independence, temporal dynamics preservation, and medical scenario d

This study examines the clinical decision-making processes in Traditional East Asian Medicine (TEAM) by reinterpreting pattern identification (PI) through the lens of dimensionality reduction. Focusing on the Eight Principle Pattern Identification (EPPI) system and utilizing empirical data from the Shang-Han-Lun, we explore the necessity and significance of prioritizing the Exterior-Interior pattern in diagnosis and treatment selection. We test three hypotheses: whether the Ext-Int pattern contains the most information about patient symptoms, represents the most abstract and generalizable symptom information, and facilitates the selection of appropriate herbal prescriptions. Employing quantitative measures such as the abstraction index, cross-conditional generalization performance, and decision tree regression, our results demonstrate that the Exterior-Interior pattern represents the most abstract and generalizable symptom information, contributing to the efficient mapping between symptom and herbal prescription spaces. This research provides an objective framework for understanding the cognitive processes underlying TEAM, bridging traditional medical practices with modern computat

In practically every industry today, artificial intelligence is one of the most effective ways for machines to assist humans. Since its inception, a large number of researchers throughout the globe have been pioneering the application of artificial intelligence in medicine. Although artificial intelligence may seem to be a 21st-century concept, Alan Turing pioneered the first foundation concept in the 1940s. Artificial intelligence in medicine has a huge variety of applications that researchers are continually exploring. The tremendous increase in computer and human resources has hastened progress in the 21st century, and it will continue to do so for many years to come. This review of the literature will highlight the emerging field of artificial intelligence in medicine and its current level of development.

Noisy labels pose significant challenges for AI model training in veterinary medicine. This study examines expert assessment ambiguity in canine auscultation data, highlights the negative impact of label noise on classification performance, and introduces methods for label noise reduction. To evaluate whether label noise can be minimized by incorporating multiple expert opinions, a dataset of 140 heart sound recordings (HSR) was annotated regarding the intensity of holosystolic heart murmurs caused by Myxomatous Mitral Valve Disease (MMVD). The expert opinions facilitated the selection of 70 high-quality HSR, resulting in a noise-reduced dataset. By leveraging individual heart cycles, the training data was expanded and classification robustness was enhanced. The investigation encompassed training and evaluating three classification algorithms: AdaBoost, XGBoost, and Random Forest. While AdaBoost and Random Forest exhibited reasonable performances, XGBoost demonstrated notable improvements in classification accuracy. All algorithms showed significant improvements in classification accuracy due to the applied label noise reduction, most notably XGBoost. Specifically, for the detectio

This article explores the critical role of statistical analysis in precision medicine. It discusses how personalized healthcare is enhanced by statistical methods that interpret complex, multidimensional datasets, focusing on predictive modeling, machine learning algorithms, and data visualization techniques. The paper addresses challenges in data integration and interpretation, particularly with diverse data sources like electronic health records (EHRs) and genomic data. It also delves into ethical considerations such as patient privacy and data security. In addition, the paper highlights the evolution of statistical analysis in medicine, core statistical methodologies in precision medicine, and future directions in the field, emphasizing the integration of artificial intelligence (AI) and machine learning (ML).

Artificial intelligence (AI) has become increasingly central to precision medicine by enabling the integration and interpretation of multimodal data, yet implementation in clinical settings remains limited. This paper provides a scoping review of literature from 2019-2024 on the implementation of AI in precision medicine, identifying key barriers and enablers across data quality, clinical reliability, workflow integration, and governance. Through an ecosystem-based framework, we highlight the interdependent relationships shaping real-world translation and propose future directions to support trustworthy and sustainable implementation.

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins

In its broadest definition, systems biology is the application of a `systems' way of thinking about and doing cell biology. By implication, this also invites us to consider a systems approach in the context of medicine and the treatment of disease. In particular, the idea that systems biology can form the basis of a personalised, predictive medicine will require that much closer attention is paid to the analytic properties of the feedback loops which will be set up by a personalised approach to healthcare. To emphasize the role that feedback theory will play in understanding personalised medicine, we use the term feedback medicine to describe the issues outlined.In these notes we consider feedback and control systems concepts applied to two important themes in medical systems biology - personalised medicine and combinatorial intervention. In particular, we formulate a feedback control interpretation for the administration of medicine, and relate them to various forms of medical treatment.

The last few years have seen rapid progress in transitioning quantum computing from lab to industry. In healthcare and life sciences, more than 40 proof-of-concept experiments and studies have been conducted; an increasing number of these are even run on real quantum hardware. Major investments have been made with hundreds of millions of dollars already allocated towards quantum applications and hardware in medicine. In addition to pharmaceutical and life sciences uses, clinical and medical applications are now increasingly coming into the picture. This chapter focuses on three key use case areas associated with (precision) medicine, including genomics and clinical research, diagnostics, and treatments and interventions. Examples of organizations and the use cases they have been researching are given; ideas how the development of practical quantum computing applications can be further accelerated are described.

Most of the existing medicine recommendation systems that are mainly based on electronic medical records (EMRs) are significantly assisting doctors to make better clinical decisions benefiting both patients and caregivers. Even though the growth of EMRs is at a lighting fast speed in the era of big data, content limitations in EMRs restrain the existed recommendation systems to reflect relevant medical facts, such as drug-drug interactions. Many medical knowledge graphs that contain drug-related information, such as DrugBank, may give hope for the recommendation systems. However, the direct use of these knowledge graphs in the systems suffers from robustness caused by the incompleteness of the graphs. To address these challenges, we stand on recent advances in graph embedding learning techniques and propose a novel framework, called Safe Medicine Recommendation (SMR), in this paper. Specifically, SMR first constructs a high-quality heterogeneous graph by bridging EMRs (MIMIC-III) and medical knowledge graphs (ICD-9 ontology and DrugBank). Then, SMR jointly embeds diseases, medicines, patients, and their corresponding relations into a shared lower dimensional space. Finally, SMR use

Scientific and technological advances in medicine and systems biology have unequivocally shown that health and disease must be viewed in the context of the interplay among multiple molecular and environmental factors. Understanding the effects of cellular interconnection on disease progression may lead to the identification of novel disease genes and pathways, and hence influence precision diagnostics and therapeutics. To accomplish this goal, the emerging field of network medicine applies network science approaches to investigate disease pathogenesis, integrating information from relevant Omics databases, including protein-protein interaction, correlation-based, gene regulatory, and Bayesian networks. However, this requires analysing and computing large amounts of data. Moreover, if we are to efficiently search for new drugs and new drug combinations, there is a pressing need for computational methods that could allow us to access the immense chemical compound space until now largely unexplored. Finally, at the microscopic level, drug-target chemistry simulation is ultimately a quantum problem, and hence it requires a quantum solution. As we will discuss, quantum computing may be

The last decade has seen an explosion in models that describe phenomena in systems medicine. Such models are especially useful for studying signaling pathways, such as the Wnt pathway. In this chapter we use the Wnt pathway to showcase current mathematical and statistical techniques that enable modelers to gain insight into (models of) gene regulation, and generate testable predictions. We introduce a range of modeling frameworks, but focus on ordinary differential equation (ODE) models since they remain the most widely used approach in systems biology and medicine and continue to offer great potential. We present methods for the analysis of a single model, comprising applications of standard dynamical systems approaches such as nondimensionalization, steady state, asymptotic and sensitivity analysis, and more recent statistical and algebraic approaches to compare models with data. We present parameter estimation and model comparison techniques, focusing on Bayesian analysis and coplanarity via algebraic geometry. Our intention is that this (non exhaustive) review may serve as a useful starting point for the analysis of models in systems medicine.

Type 2 diabetes prevention and treatment can benefit from personalized lifestyle prescriptions. However, the delivery of personalized lifestyle medicine prescriptions is limited by the shortage of trained professionals and the variability in physicians' expertise. We propose an offline contextual bandit approach that learns individualized lifestyle prescriptions from the aggregated NHANES profiles of 119,555 participants by minimizing the Magni glucose risk-reward function. The model encodes patient status and generates lifestyle medicine prescriptions, which are trained using a mixed-action Soft Actor-Critic algorithm. The task is treated as a single-step contextual bandit. The model is validated against lifestyle medicine prescriptions issued by three certified physicians from Xiangya Hospital. These results demonstrate that offline mixed-action SAC can generate risk-aware lifestyle medicine prescriptions from cross-sectional NHANES data, warranting prospective clinical validation.

Recent studies indicate that Generative Pre-trained Transformer 4 with Vision (GPT-4V) outperforms human physicians in medical challenge tasks. However, these evaluations primarily focused on the accuracy of multi-choice questions alone. Our study extends the current scope by conducting a comprehensive analysis of GPT-4V's rationales of image comprehension, recall of medical knowledge, and step-by-step multimodal reasoning when solving New England Journal of Medicine (NEJM) Image Challenges - an imaging quiz designed to test the knowledge and diagnostic capabilities of medical professionals. Evaluation results confirmed that GPT-4V performs comparatively to human physicians regarding multi-choice accuracy (81.6% vs. 77.8%). GPT-4V also performs well in cases where physicians incorrectly answer, with over 78% accuracy. However, we discovered that GPT-4V frequently presents flawed rationales in cases where it makes the correct final choices (35.5%), most prominent in image comprehension (27.2%). Regardless of GPT-4V's high accuracy in multi-choice questions, our findings emphasize the necessity for further in-depth evaluations of its rationales before integrating such multimodal AI m