[Second game, 37th move and Fourth game 78th move]
VOKÓ Zoltán1
NOVEMBER 30, 2020
Lege Artis Medicinae - 2020;30(11)
DOI: https://doi.org/10.33616/lam.30.043
Review
VOKÓ Zoltán1
NOVEMBER 30, 2020
Lege Artis Medicinae - 2020;30(11)
DOI: https://doi.org/10.33616/lam.30.043
Review
Szöveg nagyítása:
[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, because “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]
Lege Artis Medicinae
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Lege Artis Medicinae
[Hungarian professional periodicals started quite late in European context. Their publishing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termination of professional journals (War of Independence 1848-1849, First and Second World Wars), however there were periods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Medicinae (according to its subtitle: New Hungarian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]
Lege Artis Medicinae
[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hungarian professional journals. Our results show that in recent years LAM has gained international reputation despite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional system. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]
Lege Artis Medicinae
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Lege Artis Medicinae
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Lege Artis Medicinae
[In the Laboratory of Systems Neuroscience of the Institute of Experimental Medicine, our main objective is the better understanding of the brain mechanisms of cognitive functions. We investigate the nervous system basis of learning, memory, attention and decision-making not only in normal conditions but also in pathological ones, especially concerning the neurodegenerative dementias such as Alzheimer’s and Parkinson’s disease.
Our main profile is conducting animal studies, but we carry out human research too in collaboration with clinical partners. We analyse multichannel, i.e. multidimensional electrophysiological signals using both classical and modern statistical methods and new and powerful machine learning algorithms.
This study presents the activity of our team, while focusing on artificial intelligence applications.
]
Clinical Neuroscience
The aim of the study was to investigate the question: Can MRI radiomics analysis of the periaqueductal gray region elucidate the pathophysiological mechanisms underlying various migraine subtypes, and can a machine learning model using these radiomics features accurately differentiate between migraine patients and healthy individuals, as well as between migraine subtypes, including atypical cases with overlapping symptoms?
Lege Artis Medicinae
[Indication for recanalization therapy of acute ischemic stroke is based on imaging procedures. In order to minimize the time loss passing by recognizing the condition and the transfer of images to other facility, we established a stroke imaging network (eStroke network) supported by Artificial Intelligence (AI) in Hungary. Our study aims to present this system.
Organized by the National Institute of Mental Health, Neurology, and Neurosurgery (NIMNN), we included a total of 28 stroke centers, among them 4 thrombectomy centers. An earlier network of the University of Pécs and the widened network parallel with the NIMNN project cover 10 centers thus the service is now available in 38 stroke centers of this country. Stroke CT scans are automatically transmitted via the central teleradiology server to a central image processing server which analyzes the size of the ischemic area (ASPECT score), detects large vessel occlusion and it’s localization, analyzes the quality of collateral circulation and standard CT perfusion parameters using an AI based software (eStroke, Brainomix Ltd.). Results and processed images are sent automatically back to the PACS system of the sending institution and that of the concerning thrombectomy center and become available in anonymous form via cloud by desktop computers or mobile application.
During the first year of operation, the system has processed 38,060 scans of 16,276 patients. In NIMNN experience by samples of 65 and 152 cases, for drip and ship patients the time from the first alerting of the ambulance service, until arrival at the thrombectomy center was reduced by 38 minutes from 4:18 to 3:40 minutes.
Building an AI based central stroke imaging network for improving of stroke care’s results is technically feasible. Operation of the eStroke system is capable of reducing patient transportation times, however, further optimization is needed. ]
Journal of Nursing Theory and Practice
[The paper discusses latest developments in the field of artificial intelligence (AI) and its applications for the future of nursing care and services. Authors emphasize that AI should not be treated as a threat to nurses but as a potential support that may relieve nurses from performing routine tasks which can be automated by AI and robotics. The article cites examples from international experiments with AI and nursing robots that make the case for the controlled and intelligent use of technology in support of a nursing workforce that experiences pressures and stress because of increasing workloads and decreasing number of nursing staff. Authors call for the recognition that nurses fall behind in participating in the development of future nurse specific technologies, also due to the fact that nurses receive no education in the field of AI and robotics. Authors conclude that for nurses to stay in the driving seat of future nurse technologies, graduate and/or postgraduate level education for nurses in AI and robotics is a must.]
Lege Artis Medicinae
[The progress of molecular information based on personalized precision medicine has reached a new milestone. Actually, about 6 million mutations of 600 genes may be related to the development of cancer, and on average, 3-4 of these “driver” mutations are present in each patient. Due to the progress in molecular diagnostics, we can now routinely identify the molecular profile of tumors in clinical settings. By clinical translation, there are actually available more than 125 targeted pharmaceuticals and hundreds of such therapies are under clinical trial. As a result, we have many first-line and licenced treatment options to be elected by molecular information as the optimal one for every patient. There is an increasing need for complex informatics solutions by medical software. Geneticists, molecular biologists, molecular pathologists, molecular pharmacologists are already using bioinformatics and interpretation software on their daily work. Today, online digital tools of artificial intelligence are also available for physicians for assisted treatment planning. Telemedicine, videoconferencing provide solutions for interdisciplinary virtual molecular tumor boards, which democratizes the access to precision oncology for all doctors and patients. ]
1.
Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]2.
Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]3.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?4.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey5.
Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]1.
2.
Clinical Oncology
[Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up]3.
Clinical Oncology
[Pharmacovigilance landscape – Lessons from the past and opportunities for future]4.
5.
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