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BackgroundEnsuring access to accurate and verified information is essential for effective patient treatment and diagnosis. Although health workers rely on the internet for clinical data, there is a need for a more streamlined approach. ObjectiveThis systematic review aims to assess the current state of artificial intelligence (AI) and natural language processing (NLP) techniques in health care to identify their potential use in electronic health records and automated information searches. MethodsA search was conducted in the PubMed, Embase, ScienceDirect, Scopus, and Web of Science online databases for articles published between January 2000 and April 2023. The only inclusion criteria were (1) original research articles and studies on the application of AI-based medical clinical decision support using NLP techniques and (2) publications in English. A Critical Appraisal Skills Programme tool was used to assess the quality of the studies. ResultsThe search yielded 707 articles, from which 26 studies were included (24 original articles and 2 systematic reviews). Of the evaluated articles, 21 (81%) explained the use of NLP as a source of data collection, 18 (69%) used electronic health records as a data source, and a further 8 (31%) were based on clinical data. Only 5 (19%) of the articles showed the use of combined strategies for NLP to obtain clinical data. In total, 16 (62%) articles presented stand-alone data review algorithms. Other studies (n=9, 35%) showed that the clinical decision support system alternative was also a way of displaying the information obtained for immediate clinical use. ConclusionsThe use of NLP engines can effectively improve clinical decision systems’ accuracy, while biphasic tools combining AI algorithms and human criteria may optimize clinical diagnosis and treatment flows. Trial RegistrationPROSPERO CRD42022373386; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=373386

IntroductionExosomes produced by the protozoan parasite Leishmania (LeishEXO) are well-established drivers of virulence, though mechanisms underlying their exacerbation of experimental leishmaniasis remain elusive. Expression of Annexin A1 (ANXA1), a protein implicated in exosome-mediated pathologies and viral internalization, has been shown to correlate with cutaneous leishmaniasis severity. Given ANXA1’s regulation of myeloid cells – the canonical hosts for Leishmania – we studied the potential role of ANXA1 and its receptors FPR1/2 in exerting LeishEXO’s effects.MethodsMurine and in vitro ANXA1-/- models were used to study the generation of protective TH1 responses during experimental L. major infection with and without LeishEXO. Recruitment of inflammatory cells was assessed using a peritoneal cell recruitment assay and immunophenotyping, and production of inflammatory mediators was measured using a cytokine and chemokine array. Treatment of experimental models with FPR2 antagonist WRW4 and FPR1/2 agonist WKYMVm was used to delineate the role of the FPR/ANXA1 axis in LeishEXO-mediated hyperpathogenesis.ResultsWe established that ANXA1 deficiency prohibits LeishEXO-mediated pathogenesis and myeloid cell infection, with minimal alterations to adaptive and innate immune phenotypes. FPR2 blockade with WRW4 similarly inhibited leishmanial hyperpathogenesis, while direct activation of FPRs with WKYMVm enhanced infection and recapitulated the LeishEXO-mediated phenotype. This research describes LeishEXO’s utilization of the ANXA1/FPR axis to facilitate parasitic internalization and pathogenesis, which may be leveraged in the development of therapeutics for leishmaniasis.

PurposeRenal replacement therapy (RRT) is used in hyperammonemia to reduce the concentration of ammonia in the blood. In the case of plasma hyperosmolarity, RRT can also rapidly decrease plasma osmolarity, which may increase cerebral edema in these patients and favor the occurrence of brain herniation.MethodsWe conducted a retrospective clinical study in a tertiary care university-affiliated hospital. All patients admitted in a Pediatric Intensive Care Unit (PICU), less than 18 years old with ammonemia >150 µmol/L and who underwent RRT between January 2015 and June 2023 were included. We collected data on plasma osmolarity levels, osmolar gap and blood ammonia levels before and during RRT.ResultsEleven patients were included (10 with acute liver failure and 1 with a urea cycle disorders). Their mean age was 36.2 months. Before RRT, the median highest measured osmolarity was 320 (305–324) mOsm/L, whereas the median calculated osmolarity was 303 (293–314) mOsm/L, corresponding to an osmolar gap of 14 mOsm/L. Ammonia blood level over 400 µmol/L are significantly associated with higher plasma osmolarity (P-Value

Ocean beaches are a major recreational attraction in many coastal cities, requiring accurate visitor counts for infrastructure planning and value estimation. We developed a novel method to assess beach usage on the Gold Coast, Australia, using 507 drone surveys across 24 beaches. The surveys covered 30 km of coastline, accounting for different seasons, times of day, and environmental conditions. Two AI models were employed: one for counting people on land and in water (91–95% accuracy), and another for identifying usage types (85–92% accuracy). Using drone data, we estimated annual beach usage at 34 million people in 2022/23, with 55% on land and 45% in water—approximately double the most recent estimate from lifeguard counts, which are spatially limited and prone to human error. When applying similar restrictions as lifeguard surveys, drone data estimated 15 million visits, aligning closely with lifeguard counts (within 9%). Temporal (time of day, day of the week, season) and spatial (beach location) factors were the strongest predictors of beach usage, with additional patterns explained by weather variables. Our method, combining drones with AI, enhances the coverage, accuracy, and granularity of beach monitoring, offering a scalable, cost-effective solution for long-term usage assessment.

Foxp3+ TREG cells have been at the focus of intense investigation for their recognized roles in preventing autoimmunity, facilitating tissue recuperation following injury, and orchestrating a tolerance to innocuous non-self-antigens. To perform these critical tasks, TREG cells undergo deep epigenetic, transcriptional, and post-transcriptional changes that allow them to adapt to conditions found in tissues both at steady-state and during inflammation. The path leading TREG cells to express these tissue-specialized phenotypes begins during thymic development, and is further driven by epigenetic and transcriptional modifications following TCR engagement and polarizing signals in the periphery. However, this process is highly regulated and requires TREG cells to adopt strategies to avoid losing their regulatory program altogether. Here, we review the origins of tissue-resident TREG cells, from their thymic and peripheral development to the transcriptional regulators involved in their tissue residency program. In addition, we discuss the distinct signalling pathways that engage the inflammatory adaptation of tissue-resident TREG cells, and how they relate to their ability to recognize tissue and pathogen-derived danger signals.

The effects of porcine circovirus type 2b (PCV2b) and porcine reproductive and respiratory syndrome virus (PRRSV) co-infection in epithelial cells of the swine respiratory tract is unknown. In the present study, the newborn pig trachea cell line NPTr-CD163, which is permissive to both viruses, was persistently infected with PCV2b and then with PRRSV. Viral replication, cell viability, cytokines’ mRNA expression, and modulation of cellular genes expression were evaluated in infected cells. In NPTr-CD163 co-infection model, PCV2b replication was enhanced while PRRSV replication was suppressed. Cell viability was significantly decreased during PCV2b single infection and co-infection compared to mock-infected and PRRSV single infected cells. However, no difference was observed in cell viability between PCV2b and PCV2b/PRRSV infected cells. The IL6, IL8 and IL10 mRNA expression was significantly higher in co-infected cells compared to PCV2b and PRRSV single infected cells. Moreover, the IFN-α/β expression was significantly reduced in co-infected cells compared to PCV2b infected cells whereas it remained higher compared to PRRSV infected cells. The differential gene expression analysis revealed that the mRNA expression level of the cellular gene DUSP1 was significantly higher in all PRRSV infection models compared to PCV2b single infected cells. Knockdown of DUSP1 expression in co-infected cells significantly reduced PCV2b replication, suggesting a role for DUSP1 in PCV2b/PRRSV pathogenesis.

Introduction Non-alcoholic fatty liver disease (NAFLD) is increasingly prevalent in obese adolescents. Increased systemic inflammation and decreased gut microbial diversity linked to obesity affect the liver and are also associated with cardiovascular diseases in adulthood. However, NAFLD and vascular alterations are reversible.Methods and analysis This pilot study evaluated the feasibility of a prospective open-label randomised controlled trial evaluating the effects of polyphenols on NAFLD and vascular parameters in obese adolescents. Children aged 12–18 years with hepatic steatosis (n=60) will be recruited. The participants will be randomised with a 1:1 allocation ratio to receive polyphenol supplementation one time per day for 8 weeks along with the clinician-prescribed treatment (group B, n=30) or to continue the prescribed treatment without taking any polyphenols (group A, n=30). The outcome measures will be collected from both the groups at day 1 before starting polyphenol supplementation, at day 60 after 8 weeks of supplementation and at day 120, that is, 60 days after supplementation. The changes in hepatic steatosis and vascular parameters will be measured using liver and vascular imaging. Furthermore, anthropometric measures, blood tests and stool samples for gut microbiome analysis will be collected. After evaluating the study’s feasibility, we hypothesise that, as a secondary outcome, compared with group A, the adolescents in group B will have improved NAFLD, vascular parameters, systemic inflammation and gut microbiome.Ethics and dissemination This study is approved by Health Canada and the hospital ethics. Participants and their parents/tutors will both provide consent. Trial results will be communicated to the collaborating gastroenterologists who follow the enrolled participants. Abstracts and scientific articles will be submitted to high-impact radiological societies and journals. ClinicalTrials.gov ID: NCT03994029. Health Canada authorisation referral number: 250 811. Protocole version 13, 2 June 2023.Trial registration number NCT03994029.