ABSTRACT
Several advanced imaging techniques are now available for endoscopists managing inflammatory bowel disease (IBD) patients. These tools, including dye-based and virtual chromoendoscopy, probe-based confocal laser endomicroscopy and endocytoscopy, are increasingly innovative applications in clinical practice. They allow for a more in-depth and refined evaluation of the mucosal and vascular bowel surface, getting closer to histology. They have demonstrated a remarkable ability in assessing intestinal inflammation, histologic remission, and predicting relapse and favorable long-term outcomes. In addition, the future application of molecular endoscopy to predict biological drug responses has yielded preliminary but encouraging results. Furthermore, these techniques are crucial in detecting and characterizing IBD-related dysplasia, assisting endoscopic mucosal resection and submucosal dissection towards a surgery-sparing approach. Artificial intelligence (AI) holds great potential in this promising landscape, as it can provide an objective and reproducible assessment of inflammation and dysplasia. Moreover, it can improve the prediction of outcomes and aid in subsequent therapeutic decision-making. This review aims to summarize the promising role of state-of-the-art advanced endoscopic techniques and related AI-enabled models for managing IBD, paving the way for precision medicine.
Subject(s)
Endoscopic Mucosal Resection , Inflammatory Bowel Diseases , Humans , Artificial Intelligence , Inflammatory Bowel Diseases/diagnosis , Endoscopy, Gastrointestinal/methods , Endoscopy/methods , InflammationABSTRACT
Ovarian cancer is the seventh most common cancer in women and the most frequent cause of gynaecological malignancy-related mortality in women. Currently, no standardized reliable screening test exists. MicroRNA profiling has allowed the identification of signatures associated with diagnosis, prognosis and response to treatment of human tumours. The aim of this study was to determine if a microRNA signature could distinguish between malignant and benign ovarian disease. A training set of 5 serous ovarian carcinomas and 5 benign serous cystadenomas were selected for the initial experiments. The validation set included 20 serous ovarian carcinomas and 20 benign serous cystadenomas. The serum/plasma focus microRNA Exiqon panel was used for the training set. For the validation set a pick and mix Exiqon panel, which focuses on microRNAs of interest was used. A panel of 4 microRNAs (let-7i-5p, miR-122, miR-152-5p and miR-25-3p) was significantly down regulated in cancer patients. These microRNAs target WNT signalling, AKT/mTOR and TLR-4/MyD88, which have previously been found to play a role in ovarian carcinogenesis and chemoresistance. let-7i-5p, miR-122, miR-152-5p and miR-25-3p could act as diagnostic biomarkers in ovarian cancer.
Subject(s)
Biomarkers, Tumor/blood , Cystadenocarcinoma, Serous/diagnosis , MicroRNAs/blood , MicroRNAs/genetics , Ovarian Neoplasms/diagnosis , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/genetics , Case-Control Studies , Cystadenocarcinoma, Serous/blood , Cystadenocarcinoma, Serous/genetics , Female , Follow-Up Studies , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Hemolysis , Humans , Male , Middle Aged , Neoplasm Staging , Ovarian Neoplasms/blood , Ovarian Neoplasms/genetics , Prognosis , RNA, Messenger/genetics , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
OBJECTIVE: The effectiveness of self-help materials may be constrained by failures to undertake recommended exercises or to deploy the techniques that one has learned at the critical moment. The present randomized controlled trial investigated whether augmenting self-help materials with if-then plans (or implementation intentions) could overcome these problems and enhance the self-management of anxiety symptoms. METHOD: At baseline, participants who reported anxiety symptoms completed the Hospital Anxiety and Depression Scale (HADS) and the state version of the State-Trait Anxiety Inventory (STAI). Participants were then randomized via a computer program to standard self-help (n = 86), augmented self-help (n = 90), or no-intervention (n = 86) conditions. Eight weeks later, 95% (n = 249) of the participants completed the HADS and STAI again. RESULTS: Findings showed a significant reduction in anxiety in the augmented self-help condition compared with both the standard self-help and no-intervention conditions (caseness rates on the HADS at follow-up were 21%, 49%, and 44%, respectively). Mediation analyses indicated that the benefits of augmented self-help materials were explained by improved detection of anxiety-related triggers and greater experienced benefits of the self-help techniques. CONCLUSIONS: These findings suggest that implementation intentions offer a valuable supplement to self-help materials that can enhance their impact on outcomes.
