Generative artificial intelligence in healthcare: A scoping review on benefits, challenges and applications.

BACKGROUND: Generative artificial intelligence (GAI) is revolutionizing healthcare with solutions for complex challenges, enhancing diagnosis, treatment, and care through new data and insights. However, its integration raises questions about applications, benefits, and challenges. Our study explores these aspects, offering an overview of GAI's applications and future prospects in healthcare. METHODS: This scoping review searched Web of Science, PubMed, and Scopus . The selection of studies involved screening titles, reviewing abstracts, and examining full texts, adhering to the PRISMA-ScR guidelines throughout the process. RESULTS: From 1406 articles across three databases, 109 met inclusion criteria after screening and deduplication. Nine GAI models were utilized in healthcare, with ChatGPT (n = 102, 74 %), Google Bard (Gemini) (n = 16, 11 %), and Microsoft Bing AI (n = 10, 7 %) being the most frequently employed. A total of 24 different applications of GAI in healthcare were identified, with the most common being "offering insights and information on health conditions through answering questions" (n = 41) and "diagnosis and prediction of diseases" (n = 17). In total, 606 benefits and challenges were identified, which were condensed to 48 benefits and 61 challenges after consolidation. The predominant benefits included "Providing rapid access to information and valuable insights" and "Improving prediction and diagnosis accuracy", while the primary challenges comprised "generating inaccurate or fictional content", "unknown source of information and fake references for texts", and "lower accuracy in answering questions". CONCLUSION: This scoping review identified the applications, benefits, and challenges of GAI in healthcare. This synthesis offers a crucial overview of GAI's potential to revolutionize healthcare, emphasizing the imperative to address its limitations.

A single-center, open-labeled, randomized, 6-month, parallel-group study to assess the safety and efficacy of allogeneic cultured keratinocyte sheet transplantation for deep second-degree burn wounds: rationale and design of phase I/II clinical trial.

BACKGROUND: Burn-related injuries are a major global health issue, causing 180,000 deaths per year. Early debridement of necrotic tissue in association with a split-thickness skin graft is usually administered for some of the 2nd- and 3rd-degree injuries. However, this approach can be complicated by factors such as a lack of proper donor sites. Artificial skin substitutes have attracted much attention for burn-related injuries. Keratinocyte sheets are one of the skin substitutes that their safety and efficacy have been reported by previous studies. METHODS: Two consecutive clinical trials were designed, one of them is phase I, a non-randomized, open-label trial with 5 patients, and phase II is a randomized and open-label trial with 35 patients. A total number of 40 patients diagnosed with 2nd-degree burn injury will receive allogenic keratinocyte sheet transplantation. The safety and efficacy of allogeneic skin graft with autograft skin transplantation and conventional treatments, including Vaseline dressing and topical antibiotic, will be compared in different wounds of a single patient in phase II. After the transplantation, patients will be followed up on days 3, 7, 10, 14, 21, and 28. In the 3rd and 6th months after the transplantation scar, a wound closure assessment will be conducted based on the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale. DISCUSSION: This study will explain the design and rationale of a cellular-based skin substitute for the first time in Iran. In addition, this work proposes this product being registered as an off-the-shelf product for burn wound management in the country. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT) IRCT20080728001031N31, 2022-04-23 for phase I and IRCT20080728001031N36, 2024-03-15 for phase II.

Outcomes of combined phacoemulsification/intraocular lens implantation and silicon oil removal.

PURPOSE: To evaluate the outcomes and complications of simultaneous silicon oil removal (SOR) and phacoemulsification and intra ocular lens implantation. METHODS: In this retrospective non-comparative case series, the visual, refractive and anatomical outcomes of patients who underwent combined phacoemulsification/silicone oil removal (5700 centistokes) surgery between 2017 and 2019 in a single center were evaluated. RESULTS: Forty-four eyes of 44 patients (eighteen males) were included. The mean age of the patients was 51.45 ± 11.59 years. The primary pathology was tractional retinal detachment (TRD) secondary to diabetic retinopathy in 36 eyes and rhegmatogenous retinal detachment (RRD) in 8 eyes. The median time period between silicone oil tamponade and removal was 9 months. There was no statistically significant difference between best corrected visual acuity (-0.14 ± 0.69 LogMAR, p= 0.19) and intraocular pressure (p= 0.26) before and after the surgery. Mean post-operative spherical equivalent (SE) at last visit was 0.36 ± 1.64 which was different from the target refraction (- 0.5D). After cataract/SOR surgery, one eye (2.3%) developed retinal re-detachment in RRD patient. Vitreous hemorrhage occurred in nine eyes (20.5%) which all had TRD as the primary pathology. CONCLUSION: Combined phacoemulsification, silicone oil and IOL implantation removal surgery seems to be a safe and useful procedure with high success rate and acceptable visual, refractive and anatomical outcomes.