Literature Watch
An AI-Based Clinical Decision Support System for Antibiotic Therapy in Sepsis (KINBIOTICS): Use Case Analysis
JMIR Hum Factors. 2025 Mar 4;12:e66699. doi: 10.2196/66699.
ABSTRACT
BACKGROUND: Antimicrobial resistances pose significant challenges in health care systems. Clinical decision support systems (CDSSs) represent a potential strategy for promoting a more targeted and guideline-based use of antibiotics. The integration of artificial intelligence (AI) into these systems has the potential to support physicians in selecting the most effective drug therapy for a given patient.
OBJECTIVE: This study aimed to analyze the feasibility of an AI-based CDSS pilot version for antibiotic therapy in sepsis patients and identify facilitating and inhibiting conditions for its implementation in intensive care medicine.
METHODS: The evaluation was conducted in 2 steps, using a qualitative methodology. Initially, expert interviews were conducted, in which intensive care physicians were asked to assess the AI-based recommendations for antibiotic therapy in terms of plausibility, layout, and design. Subsequently, focus group interviews were conducted to examine the technology acceptance of the AI-based CDSS. The interviews were anonymized and evaluated using content analysis.
RESULTS: In terms of the feasibility, barriers included variability in previous antibiotic administration practices, which affected the predictive ability of AI recommendations, and the increased effort required to justify deviations from these recommendations. Physicians' confidence in accepting or rejecting recommendations depended on their level of professional experience. The ability to re-evaluate CDSS recommendations and an intuitive, user-friendly system design were identified as factors that enhanced acceptance and usability. Overall, barriers included low levels of digitization in clinical practice, limited availability of cross-sectoral data, and negative previous experiences with CDSSs. Conversely, facilitators to CDSS implementation were potential time savings, physicians' openness to adopting new technologies, and positive previous experiences.
CONCLUSIONS: Early integration of users is beneficial for both the identification of relevant context factors and the further development of an effective CDSS. Overall, the potential of AI-based CDSSs is offset by inhibiting contextual conditions that impede its acceptance and implementation. The advancement of AI-based CDSSs and the mitigation of these inhibiting conditions are crucial for the realization of its full potential.
PMID:40036494 | DOI:10.2196/66699
Autologous P63+ lung progenitor cell transplantation in idiopathic pulmonary fibrosis: a phase 1 clinical trial
Elife. 2025 Mar 4;13:RP102451. doi: 10.7554/eLife.102451.
ABSTRACT
BACKGROUND: In idiopathic pulmonary fibrosis (IPF) patients, alveolar architectures are lost and gas transfer function would decline, which cannot be rescued by conventional anti-fibrotic therapy. P63+ lung basal progenitor cells are reported to have potential to repair damaged lung epithelium in animal models, which need further investigation in clinical trials.
METHODS: We cloned and expanded P63+ progenitor cells from IPF patients to manufacture cell product REGEND001, which were further characterized by morphology and single-cell transcriptomic analysis. Subsequently, an open-label, dose-escalation autologous progenitor cell transplantation clinical trial was conducted. We treated 12 patients with ascending doses of cells: 0.6x, 1x, 2x and 3.3x106 cells/kg bodyweight. The primary outcome was the incidence and severity of cell therapy-related adverse events (AEs); secondary outcome included other safety and efficacy evaluations.
RESULTS: P63+ basal progenitor cell was safe and tolerated at all doses, with no dose-limiting toxicity or cell therapy-related severe adverse events observed. Patients in three higher dose groups showed significant improvement of lung gas transfer function as well as exercise ability. Resolution of honeycomb lesion was observed in patients of higher dose groups.
CONCLUSIONS: REGEND001 has high safety profile and meanwhile encourages further efficacy exploration in IPF patients.
FUNDING: National High Level Hospital Clinical Research Funding (2022-PUMCH-B-108), National Key Research and Development Plan (2024YFA1108900, 2024YFA1108500), Jiangsu Province Science and Technology Special Project Funding (BE2023727), National Biopharmaceutical Technology Research Project Funding (NCTIB2023XB01011), Non-profit Central Research Institute Fund of Chinese Academy of Medical Science (2020-PT320-005), and Regend Therapeutics.
CLINICAL TRIAL NUMBER: Chinese clinical trial registry: CTR20210349.
PMID:40036154 | DOI:10.7554/eLife.102451
A single cell atlas of the mouse seminal vesicle
G3 (Bethesda). 2025 Feb 28:jkaf045. doi: 10.1093/g3journal/jkaf045. Online ahead of print.
ABSTRACT
During mammalian reproduction, sperm are delivered to the female reproductive tract bathed in a complex medium known as seminal fluid, which plays key roles in signaling to the female reproductive tract and in nourishing sperm for their onwards journey. Along with minor contributions from the prostate and the epididymis, the majority of seminal fluid is produced by a somewhat understudied organ known as the seminal vesicle. Here, we report the first single-cell RNA-seq atlas of the mouse seminal vesicle, generated using tissues obtained from 23 mice of varying ages, exposed to a range of dietary challenges. We define the transcriptome of the secretory cells in this tissue, identifying a relatively homogeneous population of the epithelial cells which are responsible for producing the majority of seminal fluid. We also define the immune cell populations - including large populations of macrophages, dendritic cells, T cells, and NKT cells - which have the potential to play roles in producing the various immune mediators present in seminal plasma. Together, our data provide a resource for understanding the composition of an understudied reproductive tissue, with potential implications for paternal control of offspring development and metabolism.
PMID:40036847 | DOI:10.1093/g3journal/jkaf045
CE-MS Metabolomic and LC-MS Proteomic Analyses of Breast Cancer Exosomes Reveal Alterations in Purine and Carnitine Metabolism
J Proteome Res. 2025 Mar 4. doi: 10.1021/acs.jproteome.4c00795. Online ahead of print.
ABSTRACT
A nanosheath-flow capillary electrophoresis mass spectrometry (CE-MS) system with electrospray ionization was used to profile cationic metabolite cargo in exosomes secreted by nontumorigenic MCF-10A and tumorigenic MDA-MB-231 breast epithelial cells. An in-house-produced sheath liquid interface was developed and machined from PEEK to enable nanoflow volumes. Normalization of CE-MS peak areas to the total UV signal was employed to enhance quantitative accuracy and reduce variability. CE-MS-based metabolomics revealed increased purine synthesis intermediates and increased carnitine synthesis metabolites in MDA-MB-231-derived exosomes, with pathway enrichment indicating the activation of de novo purine pathways and upregulation of carnitine metabolism. In addition, nano-LC-MS-based proteomics revealed differential expression of ecto-5'-nucleotidase (NT5E) and mitochondrial aldehyde dehydrogenase (ALDH9A1), demonstrating metabolic alterations in related enzymatic steps. This study demonstrates the application of nanosheath-flow CE-MS for comprehensive and quantitative exosome metabolomics, uncovering metabolic reprogramming in purine and carnitine pathways between normal and cancerous breast cell lines and providing insight into exosome-mediated signaling of breast cancer metabolism.
PMID:40036676 | DOI:10.1021/acs.jproteome.4c00795
Limelight: An Open, Web-Based Tool for Visualizing, Sharing, and Analyzing Mass Spectrometry Data from DDA Pipelines
J Proteome Res. 2025 Mar 4. doi: 10.1021/acs.jproteome.4c00968. Online ahead of print.
ABSTRACT
Liquid chromatography-tandem mass spectrometry employing data-dependent acquisition (DDA) is a mature, widely used proteomics technique routinely applied to proteome profiling, protein-protein interaction studies, biomarker discovery, and protein modification analysis. Numerous tools exist for searching DDA data and myriad file formats are output as results. While some search and post processing tools include data visualization features to aid biological interpretation, they are often limited or tied to specific software pipelines. This restricts the accessibility, sharing and interpretation of data, and hinders comparison of results between different software pipelines. We developed Limelight, an easy-to-use, open-source, freely available tool that provides data sharing, analysis and visualization and is not tied to any specific software pipeline. Limelight is a data visualization tool specifically designed to provide access to the whole "data stack", from raw and annotated scan data to peptide-spectrum matches, quality control, peptides, proteins, and modifications. Limelight is designed from the ground up for sharing and collaboration and to support data from any DDA workflow. We provide tools to import data from many widely used open-mass and closed-mass search software workflows. Limelight helps maximize the utility of data by providing an easy-to-use interface for finding and interpreting data, all using the native scores from respective workflows.
PMID:40036265 | DOI:10.1021/acs.jproteome.4c00968
Consistent Safety and Efficacy of Sotatercept for Pulmonary Arterial Hypertension in <em>BMPR2</em> Mutation Carriers and Noncarriers: A Planned Analysis of Phase 2, Double-Blind, Placebo-controlled Clinical Trial (PULSAR)
Am J Respir Crit Care Med. 2025 Mar 4. doi: 10.1164/rccm.202409-1698OC. Online ahead of print.
ABSTRACT
OBJECTIVES: To evaluate the effect of genetic variant status on sotatercept efficacy and effect of sotatercept treatment on biomarkers in pulmonary arterial hypertension Methods: PULSAR (NCT03496207) was a phase 2, randomized, controlled study of sotatercept vs placebo added to background therapy for pulmonary arterial hypertension. Participants had DNA sequencing done at baseline to detect genetic variants in disease-associated genes (ACVRL1, BMPR2, CAV1, EIF2AK4, ENG, KCNA3, KCNK3, and SMAD9). Safety (adverse events) and efficacy (pulmonary vascular resistance, 6-minute walk distance) were assessed by variant status and treatment at 24 weeks. Serum levels of BMPR2 mRNA and N-terminal pro-hormone B-type natriuretic peptide were assessed at baseline and 24 weeks by treatment and variant status. Analysis of covariance was used to compare the change from baseline by treatment and variant status.
RESULTS: Of 76 participants included, 25 had pathogenic variants detected (23 BMPR2; 2 other) and 51 had no variants or variants of uncertain significance. BMPR2 mutation carriers were younger and more frequently on triple therapy but had less severe clinical characteristics at baseline. Changes at 24 weeks in pulmonary vascular resistance and 6-minute walk distance did not differ by variant status. BMPR2 gene expression varied less than twofold from baseline over time, irrespective of treatment or variant status. The adverse events profile was generally consistent with that seen in the parent PULSAR study.
CONCLUSIONS: These results suggest consistent safety and clinical efficacy of sotatercept for treatment of pulmonary arterial hypertension, irrespective of BMPR2 variant status. Clinical trial registration available at www.
CLINICALTRIALS: gov, ID: NCT03496207.
PMID:40035659 | DOI:10.1164/rccm.202409-1698OC
Artificial Intelligence-driven and technological innovations in the diagnosis and management of substance use disorders
Int Rev Psychiatry. 2025 Feb;37(1):52-58. doi: 10.1080/09540261.2024.2432369. Epub 2024 Dec 2.
ABSTRACT
Substance Use Disorders (SUD) lead to a collection of health challenges such as overdoses and clinical diseases. Populations that are vulnerable and lack straightforward treatment access are vulnerable to significant economic and social effects linked to SUD. The ongoing advances in technology, especially Artificial Intelligence (AI), promise new ways to reduce the effects of SUD, refine treatment standards, and minimize the risk of relapse through tailored treatment plans. Recent innovations in functional neuroimaging techniques, such as fMRI, have led to the ability to detect brain patterns associated with drug use, and biomarkers in blood testing provide crucial diagnostic support. In addition, digital platforms applied for behavioral assessment supported by AI and natural language processing improve the early recognition of substance consumption trends, allowing for targeted interventions reliant on real-time data. Using pharmacogenetics and resources like mobile apps and wearable devices makes the development of care programs that continuously track substance use, mental health, and physical changes possible. At the core of ethical issues related to the application of AI for SUD are the rights of patients to have their privacy protected to ensure that all people justly have access to these technologies. The advancement of AI models provides significant possibilities to support clinical judgment and enhance patient outcomes.
PMID:40035372 | DOI:10.1080/09540261.2024.2432369
Phage-host interaction in <em>Pseudomonas aeruginosa</em> clinical isolates with functional and altered quorum sensing systems
Appl Environ Microbiol. 2025 Mar 4:e0240224. doi: 10.1128/aem.02402-24. Online ahead of print.
ABSTRACT
Quorum sensing (QS) plays a crucial role in regulating key traits, including the upregulation of phage receptors, which leads to heightened phage susceptibility in Pseudomonas aeruginosa. As a result, higher cell densities typically increase the risk of phage invasions. This has led to speculation that bacteria may have evolved strategies to counterbalance this increased susceptibility. Additionally, non-synonymous mutations in LasR, the master regulator of QS, are common among cystic fibrosis patients, but the impact of these mutations on phage interactions remains poorly understood. Here, we systematically investigated the role of QS in shaping these interactions using bacterial strains with functional or altered QS systems. In the QS-functional strain ZS-PA-35, disruption of the Las system reduces cell susceptibility to the type IV pili-dependent phage phipa2, delaying bacterial lysis during the early logarithmic growth phase. At high cell densities, Las-induced dormancy further inhibits phage proliferation despite enhanced phage adsorption. Notably, nutrient supplementation fully restores phage proliferation in the strains with a functional Las system. In contrast, the QS-deficient strain ZS-PA-05, carrying a LasR mutation, fails to regulate phage-host interactions via QS. Moreover, our findings reveal that within mixed microbial populations, cells benefit from the presence of closely related kin, which collectively reduce prey density and limit phage-host interaction frequencies under nutrient-rich conditions. These results underscore the flexibility of QS-regulated defense strategies, highlighting their critical role in optimizing bacterial resilience against phage predation, particularly in heterogeneous communities most vulnerable to phages.IMPORTANCEBacteria have developed various strategies to combat phage infection, posing challenges to phage therapy. In this study, we demonstrate that Pseudomonas aeruginosa strains with functional or altered quorum sensing (QS) systems may adapt different survival tactics for prolonged coexistence with phages, contingent upon bacterial population dynamics. The dynamics of phage infection highlight the influence of intrinsic heterogeneity mediated by QS, which leads to the emergence of different phage-host outcomes. These variants may arise as a result of coevolutionary processes or coexistence mechanisms of mutational and non-mutational defense strategies. These insights enhance our comprehension of how bacteria shield themselves against phage attacks and further underscore the complexity of such approaches for successful therapeutic interventions.
PMID:40035599 | DOI:10.1128/aem.02402-24
Cone-beam computed tomography (CBCT) image-quality improvement using a denoising diffusion probabilistic model conditioned by pseudo-CBCT of pelvic regions
Radiol Phys Technol. 2025 Mar 4. doi: 10.1007/s12194-025-00892-4. Online ahead of print.
ABSTRACT
Cone-beam computed tomography (CBCT) is widely used in radiotherapy to image patient configuration before treatment but its image quality is lower than planning CT due to scattering, motion, and reconstruction methods. This reduces the accuracy of Hounsfield units (HU) and limits its use in adaptive radiation therapy (ART). However, synthetic CT (sCT) generation using deep learning methods for CBCT intensity correction faces challenges due to deformation. To address these issues, we propose enhancing CBCT quality using a conditional denoising diffusion probability model (CDDPM), which is trained on pseudo-CBCT created by adding pseudo-scatter to planning CT. The CDDPM transforms CBCT into high-quality sCT, improving HU accuracy while preserving anatomical configuration. The performance evaluation of the proposed sCT showed a reduction in mean absolute error (MAE) from 81.19 HU for CBCT to 24.89 HU for the sCT. Peak signal-to-noise ratio (PSNR) improved from 31.20 dB for CBCT to 33.81 dB for the sCT. The Dice and Jaccard coefficients between CBCT and sCT for the colon, prostate, and bladder ranged from 0.69 to 0.91. When compared to other deep learning models, the proposed sCT outperformed them in terms of accuracy and anatomical preservation. The dosimetry analysis for prostate cancer revealed a dose error of over 10% with CBCT but nearly 0% with the sCT. Gamma pass rates for the proposed sCT exceeded 90% for all dose criteria, indicating high agreement with CT-based dose distributions. These results show that the proposed sCT improves image quality, dosimetry accuracy, and treatment planning, advancing ART for pelvic cancer.
PMID:40035984 | DOI:10.1007/s12194-025-00892-4
Application of TransUnet Deep Learning Model for Automatic Segmentation of Cervical Cancer in Small-Field T2WI Images
J Imaging Inform Med. 2025 Mar 4. doi: 10.1007/s10278-025-01464-z. Online ahead of print.
ABSTRACT
Effective segmentation of cervical cancer tissue from magnetic resonance (MR) images is crucial for automatic detection, staging, and treatment planning of cervical cancer. This study develops an innovative deep learning model to enhance the automatic segmentation of cervical cancer lesions. We obtained 4063 T2WI small-field sagittal, coronal, and oblique axial images from 222 patients with pathologically confirmed cervical cancer. Using this dataset, we employed a convolutional neural network (CNN) along with TransUnet models for segmentation training and evaluation of cervical cancer tissues. In this approach, CNNs are leveraged to extract local information from MR images, whereas Transformers capture long-range dependencies related to shape and structural information, which are critical for precise segmentation. Furthermore, we developed three distinct segmentation models based on coronal, axial, and sagittal T2WI within a small field of view using multidirectional MRI techniques. The dice similarity coefficient (DSC) and mean Hausdorff distance (AHD) were used to assess the performance of the models in terms of segmentation accuracy. The average DSC and AHD values obtained using the TransUnet model were 0.7628 and 0.8687, respectively, surpassing those obtained using the U-Net model by margins of 0.0033 and 0.3479, respectively. The proposed TransUnet segmentation model significantly enhances the accuracy of cervical cancer tissue delineation compared to alternative models, demonstrating superior performance in overall segmentation efficacy. This methodology can improve clinical diagnostic efficiency as an automated image analysis tool tailored for cervical cancer diagnosis.
PMID:40035972 | DOI:10.1007/s10278-025-01464-z
An Efficient Approach for Detection of Various Epileptic Waves Having Diverse Forms in Long Term EEG Based on Deep Learning
Brain Topogr. 2025 Mar 4;38(3):35. doi: 10.1007/s10548-025-01111-4.
ABSTRACT
EEG is the most powerful tool for epilepsy discharge detection in brain. Visual evaluation is hard in long term monitoring EEG data as huge amount of data needs to be inspected. Considering the fast and efficient results from deep learning networks especially convolutional networks, and its capability for detection of complex epileptic wave forms, inspired us to evaluate YOLO network for spike detection solution.The most used versions of YOLO (V3, V4 and V7) were evaluated for various epileptic signals. The epileptic discharge wave-forms were first labeled to 9 different signal types, but classified to four group combinations based on their features. EEG data from 20 patients were used under guidance of expert epileptologist. The YOLO networks were all trained for four various class-grouping strategies. The most suitable network to recommend was found to be YOLO-V4, for all four classifying methods giving average sensitivity, specificity, and accuracy of 96.7, 94.3, and 92.8, respectively. YOLO networks have shown promising results in detection of epileptic signals, which by adding some extra measurements this can become a great assistant tool for epileptologists. In addition, besides YOLO's High speed and accuracy in detection of epileptic signals in EEG, it can classify these signals to different morphologies.
PMID:40035961 | DOI:10.1007/s10548-025-01111-4
Accelerated retinal ageing and multimorbidity in middle-aged and older adults
Geroscience. 2025 Mar 4. doi: 10.1007/s11357-025-01581-1. Online ahead of print.
ABSTRACT
The aim of this study is to investigate the association between retinal age gap and multimorbidity. Retinal age gap was calculated based on a previously developed deep learning model for 45,436 participants. The number of age-related conditions reported at baseline was summed and categorized as zero, one, or at least two conditions at baseline (multimorbidity). Incident multimorbidity was defined as having two or more age-related diseases onset during the follow-up period. Linear regressions were fit to examine the associations of disease numbers at baseline with retinal age gaps. Cox proportional hazard regression models were used to examine associations of retinal age gaps with the incidence of multimorbidity. In the fully adjusted model, those with multimorbidity and one disease both showed significant increases in retinal age gaps at baseline compared to participants with zero disease number (β = 0.254, 95% CI 0.154, 0.354; P < 0.001; β = 0.203, 95% CI 0.116, 0.291; P < 0.001; respectively). After a median follow-up period of 11.38 (IQR, 11.26-11.53; range, 0.02-11.81) years, a total of 3607 (17.29%) participants had incident multimorbidity. Each 5-year increase in retinal age gap at baseline was independently associated with an 8% increase in the risk of multimorbidity (HR = 1.08, 95% CI 1.02, 1.14, P = 0.008). Our study demonstrated that an increase of retinal age gap was independently associated with a greater risk of incident multimorbidity. By recognizing deviations from normal aging, we can identify individuals at higher risk of developing multimorbidity. This early identification facilitates patients' self-management and personalized interventions before disease onset.
PMID:40035945 | DOI:10.1007/s11357-025-01581-1
New AI explained and validated deep learning approaches to accurately predict diabetes
Med Biol Eng Comput. 2025 Mar 4. doi: 10.1007/s11517-025-03338-6. Online ahead of print.
ABSTRACT
Diabetes is a metabolic condition that can lead to chronic illness and organ failure if it remains untreated. Accurate detection is essential to reduce these risks at an early stage. Recent advancements in predictive models show promising results. However, these models exhibit inadequate accuracy, struggle with class imbalance, and lack interpretability of the decision-making process. To overcome these issues, we propose two novel deep models for early and accurate diabetes prediction: LeDNet (inspired by LeNet and the Dual Attention Network) and HiDenNet (influenced by the highway network and DenseNet). The models are trained using the Diabetes Health Indicators dataset, which has an inherent class imbalance problem and results in biased predictions. This imbalance is mitigated by employing the majority-weighted minority over-sampling technique. Experimental findings demonstrate that LeDNet achieves an F1-score of 85%, recall of 84%, accuracy of 85%, and precision of 86%. Similarly, HiDenNet achieves accuracy, F1-score, recall, and precision of 85%, 86%, 86%, and 86%, respectively. Both proposed models outperform the state-of-the-art deep learning (DL) models. K-fold cross-validation is applied to ensure models' stability at different data splits. Local interpretable model-agnostic explanations and Shapley additive explanations techniques are utilized to enhance interpretability and overcome the traditional black-box nature of DL models. By providing both local and global insights into feature contributions, these explainable artificial intelligence techniques provide transparency to LeDNet and HiDenNet in diabetes prediction. LeDNet and HiDenNet not only improve decision-making transparency but also enhance diabetes prediction accuracy, making them reliable tools for clinical decision-making and early diagnosis.
PMID:40035798 | DOI:10.1007/s11517-025-03338-6
A novel deep learning framework for automatic scoring of PD-L1 expression in non-small cell lung cancer
Biomol Biomed. 2025 Mar 3. doi: 10.17305/bb.2025.12056. Online ahead of print.
ABSTRACT
A critical predictive marker for anti-PD-1/PD-L1 therapy is programmed death-ligand 1 (PD-L1) expression, assessed by immunohistochemistry (IHC). This paper explores a novel automated framework using deep learning to accurately evaluate PD-L1 expression from whole slide images (WSIs) of non-small cell lung cancer (NSCLC), aiming to improve the precision and consistency of Tumor Proportion Score (TPS) evaluation, which is essential for determining patient eligibility for immunotherapy. Automating TPS evaluation can enhance accuracy and consistency while reducing pathologists' workload. The proposed automated framework encompasses three stages: identifying tumor patches, segmenting tumor areas, and detecting cell nuclei within these areas, followed by estimating the TPS based on the ratio of positively stained to total viable tumor cells. This study utilized a Reference Medicine (Phoenix, Arizona) dataset containing 66 NSCLC tissue samples, adopting a hybrid human-machine approach for annotating extensive WSIs. Patches of size 1000x1000 pixels were generated to train classification models such as EfficientNet, Inception, and Vision Transformer models. Additionally, segmentation performance was evaluated across various UNet and DeepLabV3 architectures, and the pre-trained StarDist model was employed for nuclei detection, replacing traditional watershed techniques. PD-L1 expression was categorized into three levels based on TPS: negative expression (TPS < 1%), low expression (TPS 1-49%), and high expression (TPS ≥ 50%). The Vision Transformer-based model excelled in classification, achieving an F1-score of 97.54%, while the modified DeepLabV3+ model led in segmentation, attaining a Dice Similarity Coefficient of 83.47%. The TPS predicted by the framework closely correlated with the pathologist's TPS at 0.9635, and the framework's three-level classification F1-score was 93.89%. The proposed deep learning framework for automatically evaluating the TPS of PD-L1 expression in NSCLC demonstrated promising performance. This framework presents a potential tool that could produce clinically significant results more efficiently and cost-effectively.
PMID:40035693 | DOI:10.17305/bb.2025.12056
Two-Stage Deep Learning Model for Adrenal Nodule Detection on CT Images: A Retrospective Study
Radiology. 2025 Mar;314(3):e231650. doi: 10.1148/radiol.231650.
ABSTRACT
Background The detection and classification of adrenal nodules are crucial for their management. Purpose To develop and test a deep learning model to automatically depict adrenal nodules on abdominal CT images and to simulate triaging performance in combination with human interpretation. Materials and Methods This retrospective study (January 2000-December 2020) used an internal dataset enriched with adrenal nodules for model training and testing and an external dataset reflecting real-world practice for further simulated testing in combination with human interpretation. The deep learning model had a two-stage architecture, a sequential detection and segmentation model, trained separately for the right and left adrenal glands. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) for nodule detection and intersection over union for nodule segmentation. Results Of a total of 995 patients in the internal dataset, the AUCs for detecting right and left adrenal nodules in internal test set 1 (n = 153) were 0.98 (95% CI: 0.96, 1.00; P < .001) and 0.93 (95% CI: 0.87, 0.98; P < .001), respectively. These values were 0.98 (95% CI: 0.97, 0.99; P < .001) and 0.97 (95% CI: 0.96, 0.97; P < .001) in the external test set (n = 12 080) and 0.90 (95% CI: 0.84, 0.95; P < .001) and 0.89 (95% CI: 0.85, 0.94; P < .001) in internal test set 2 (n = 1214). The median intersection over union was 0.64 (IQR, 0.43-0.71) and 0.53 (IQR, 0.40-0.64) for right and left adrenal nodules, respectively. Combining the model with human interpretation achieved high sensitivity (up to 100%) and specificity (up to 99%), with triaging performance from 0.77 to 0.98. Conclusion The deep learning model demonstrated high performance and has the potential to improve detection of incidental adrenal nodules. © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Malayeri and Turkbey in this issue.
PMID:40035671 | DOI:10.1148/radiol.231650
Unveiling the Future: A Deep Learning Model for Accurate Detection of Adrenal Nodules
Radiology. 2025 Mar;314(3):e250387. doi: 10.1148/radiol.250387.
NO ABSTRACT
PMID:40035670 | DOI:10.1148/radiol.250387
Hybrid ladybug Hawk optimization-enabled deep learning for multimodal Parkinson's disease classification using voice signals and hand-drawn images
Network. 2025 Mar 4:1-43. doi: 10.1080/0954898X.2025.2457955. Online ahead of print.
ABSTRACT
PD is a progressive neurodegenerative disorder that leads to gradual motor impairments. Early detection is critical for slowing the disease's progression and providing patients access to timely therapies. However, accurately detecting PD in its early stages remains challenging. This study aims to develop an optimized deep learning model for PD classification using voice signals and hand-drawn spiral images, leveraging a ZFNet-LHO-DRN. The proposed model first preprocesses the input voice signal using a Gaussian filter to remove noise. Features are then extracted from the preprocessed signal and passed to ZFNet to generate output-1. For the hand-drawn spiral image, preprocessing is performed with a bilateral filter, followed by image augmentation. Here also, the features are extracted and forwarded to DRN to form output-2. Both classifiers are trained using the LHO algorithm. Finally, from the output-1 and output-2, the best one is selected based on the majority voting. The ZFNet-LHO-DRN model demonstrated excellent performance by achieving a premium accuracy of 89.8%, a NPV of 89.7%, a PPV of 89.7%, a TNR of 89.3%, and a TPR of 90.1%. The model's high accuracy and performance indicate its potential as a valuable tool for assisting in the early diagnosis of PD.
PMID:40035544 | DOI:10.1080/0954898X.2025.2457955
Artificial intelligence in the detection and treatment of depressive disorders: a narrative review of literature
Int Rev Psychiatry. 2025 Feb;37(1):39-51. doi: 10.1080/09540261.2024.2384727. Epub 2024 Jul 30.
ABSTRACT
Modern psychiatry aims to adopt precision models and promote personalized treatment within mental health care. However, the complexity of factors underpinning mental disorders and the variety of expressions of clinical conditions make this task arduous for clinicians. Globally, major depression is a common mental disorder and encompasses a constellation of clinical manifestations and a variety of etiological factors. In this context, the use of Artificial Intelligence might help clinicians in the screening and diagnosis of depression on a wider scale and could also facilitate their task in predicting disease outcomes by considering complex interactions between prodromal and clinical symptoms, neuroimaging data, genetics, or biomarkers. In this narrative review, we report on the most significant evidence from current international literature regarding the use of Artificial Intelligence in the diagnosis and treatment of major depression, specifically focusing on the use of Natural Language Processing, Chatbots, Machine Learning, and Deep Learning.
PMID:40035375 | DOI:10.1080/09540261.2024.2384727
Logic-based machine learning predicts how escitalopram attenuates cardiomyocyte hypertrophy
Proc Natl Acad Sci U S A. 2025 Mar 11;122(10):e2420499122. doi: 10.1073/pnas.2420499122. Epub 2025 Mar 4.
ABSTRACT
Cardiomyocyte hypertrophy is a key clinical predictor of heart failure. High-throughput and AI-driven screens have the potential to identify drugs and downstream pathways that modulate cardiomyocyte hypertrophy. Here, we developed LogiRx, a logic-based mechanistic machine learning method that predicts drug-induced pathways. We applied LogiRx to discover how drugs discovered in a previous compound screen attenuate cardiomyocyte hypertrophy. We experimentally validated LogiRx predictions in neonatal cardiomyocytes, adult mice, and two patient databases. Using LogiRx, we predicted antihypertrophic pathways for seven drugs currently used to treat noncardiac disease. We experimentally validated that escitalopram (Lexapro) and mifepristone inhibit hypertrophy of cultured cardiomyocytes in two contexts. The LogiRx model predicted that escitalopram prevents hypertrophy through an "off-target" serotonin receptor/PI3Kγ pathway, mechanistically validated using additional investigational drugs. Further, escitalopram reduced cardiomyocyte hypertrophy in a mouse model of hypertrophy and fibrosis. Finally, mining of both FDA and University of Virginia databases showed that patients with depression on escitalopram have a lower incidence of cardiac hypertrophy than those prescribed other serotonin reuptake inhibitors that do not target the serotonin receptor. Mechanistic machine learning by LogiRx discovers drug pathways that perturb cell states, which may enable repurposing of escitalopram and other drugs to limit cardiac remodeling through off-target pathways.
PMID:40035765 | DOI:10.1073/pnas.2420499122
Angiogenic factor AGGF1 is a general splicing factor regulating angiogenesis and vascular development by alternative splicing of SRSF6
FASEB J. 2025 Mar 15;39(5):e70443. doi: 10.1096/fj.202403156R.
ABSTRACT
AGGF1 encodes an angiogenic factor that causes vascular disease Klippel-Trenaunay syndrome when mutated. AGGF1 also acts at the top of the genetic regulatory hierarchy for mesodermal differentiation of hemangioblasts, multipotent stem cells for differentiation of blood cells and vascular cells. Alternative splicing (AS) is a post-transcriptional process that generates multiple mature mRNAs from a single primary transcript (pre-mRNA), producing protein diversity. Deregulation of AS leads to many human diseases. The physiological role and mechanism of AGGF1 in AS are not clear. Full-length transcriptome sequencing of human pulmonary artery endothelial cells (HPAECs) with AGGF1 silencing revealed 63 121 genes, including 1144 new unannotated genes, and showed that AGGF1 is a general splicing factor regulating AS of 436 genes, including SRSF6 regulating AS of many target genes. AGGF1 promoted the skipping of exon 3 that produces the full-length SRSF6 protein, an evolutionarily conserved AS event. Overexpression of full-length SRSF6 reversed the reduced cell proliferation, migration, and capillary tube formation of HPAECs with AGGF1 silencing. Knockdown of SRSF6 and overexpression of the shorter, alternatively spliced isoform of SRSF6 both inhibited HPAEC proliferation, migration, and capillary tube formation, whereas opposite results were obtained for overexpression of full-length SRSF6. Knockdown of srsf6 impaired development of ISVs in zebrafish, whereas overexpression of srsf6 enhanced vascular development and partially rescued impaired ISV development in zebrafish embryos with aggf1 knockdown. Overall, our findings reveal that AGGF1 is a general splicing factor, and that AGGF1-mediated exon 3 skipping of SRSF6 pre-mRNA is important for endothelial cell functions, angiogenesis, and vascular development.
PMID:40035560 | DOI:10.1096/fj.202403156R
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