Intravitreal methotrexate infusion for prophylaxis of proliferative vitreoretinopathy after pars plana vitrectomy for rhegmatogenous retinal detachment.

Background: Proliferative vitreoretinopathy (PVR) is the leading cause of recurrent retinal detachment after surgical repair of rhegmatogenous retinal detachment (RRD). Our study aimed to assess the efficacy and safety of intravitreal methotrexate infusion (IMI) for the prevention of PVR after pars plana vitrectomy (PPV) in eyes with RRD. Methods: This prospective comparative interventional study was conducted from September 2020 to November 2021 at Ain Shams University Hospitals, Egypt. We recruited a consecutive, non-randomized sample of 47 eyes of 47 patients with RRD undergoing PPV. Participants were allocated to a control group or an intervention group that received IMI during surgery. Each group was subdivided into subgroups of eyes at high-risk of developing PVR and eyes with established preoperative PVR grade C. Outcome measures at the 3-month postoperative follow-up were the rate of retinal attachment, incidence of PVR, reoperation rate to flatten the retina, and changes in the retina and/or optic nerve function as assessed by full-field electroretinogram and flash visual evoked potential. Results: Data from 47 eyes (23 and 24 eyes in the intervention and control groups, respectively) were evaluated. Subgroups IA, IB, and IIB each included 12 eyes, subgroup IIA included 11 eyes, and all subgroups had comparable sex ratios and age distributions. Postoperative PVR at 1 month and between 1 and 3 months was present in 13% and 4% of eyes in the intervention group, respectively. Reoperation to flatten the retina was required in 2 (9%) eyes in the intervention group, while 22 eyes (96%) had complete flattening of the retina at 3 months. No significant differences were found between the study groups and the corresponding subgroups regarding the outcome measures (all P > 0.05). No adverse events attributable to IMI were detected up to 3 months postoperatively. Conclusions: Although IMI was safe for intraocular use in eyes with RRD and PVR grade C or a high risk of developing PVR, it did not affect the anatomical success rate or development of PVR up to 3 months after PPV. Further multicenter randomized clinical trials with longer follow-up periods and larger sample sizes are needed to verify these preliminary outcomes.

Connecting Data to Insight: A Pan-Canadian Study on AI in Healthcare.

Across Canada, healthcare leaders are exploring the potential of artificial intelligence and advanced analytics to transform the healthcare system. This report shares a summary of the current state of healthcare analytics across major hospitals and public healthcare agencies in Canada. We present information on the current level of investment, data governance maturity, analytics talent and tools and models being leveraged across the nation. The findings point to an opportunity for enhanced collaboration in advanced analytics and the adoption of nascent artificial intelligence technologies in healthcare. The recommendations will help drive adoption in Canada, ultimately improving the patient experience and promoting better health outcomes for Canadians.

Connecting Data to Value: An Operating Model for Healthcare Advanced Analytics.

Artificial intelligence offers the promise to revolutionize the way healthcare is delivered in the future. To capitalize on the value of advanced analytics and artificial intelligence, organizations must focus on building organizational capabilities. This report shares an operating model for insight and change in healthcare comprising six key components: analytics technology and operations, data governance, change and automation, advanced analytics and insights, analytics literacy and strategy and relationship management. The adoption of the proposed model will build core capabilities that will enable organizations to connect data to decision making and realize value from its investment in advanced analytics.

Developing an Artificial Intelligence-Enabled Health Care Practice: Rewiring Health Care Professions for Better Care.

Artificial intelligence (AI) has the potential to impact almost every aspect of health care, from detection to prediction and prevention. The adoption of new technologies in health care, however, lags far behind the emergence of new technologies. Health care professionals and organizations must be prepared to change and evolve to adopt these new technologies. A basic understanding of emerging AI technologies will be essential for all health care professionals. These technologies include expert systems, robotic process automation, natural language processing, machine learning, and deep learning. Health care professionals and organizations must build their capacity and capabilities to understand and appropriately adopt these technologies. This understanding starts with basic AI literacy, including data governance principles, basic statistics, data visualization, and the impact on clinical processes. Health care professionals and organizations will need to overcome several challenges and tackle core structural issues, such as access to data and the readiness of algorithms for clinical practice. However, health care professionals have an opportunity to shape the way that AI will be used and the outcomes that will be achieved. There is an urgent and emerging need for education and training so that appropriate technologies can be rapidly adopted, resulting in a healthier world for our patients and our communities.

Design for a Canadian Digital Health Policy & Practices Observatory.

Canada has struggled to make digital health a reality. We identified 6 key issues that appear to impede progress: 1) an inability to coordinate the actions of a rapidly evolving set of stakeholders, 2) patients who lack the ability and resources to play a meaningful role in health system decision-making, 3) world-class innovation that doesn't reach the market, 4) an inability to kick-start interoperability projects that can catalyze system transformation, 5) an inability to procure early-stage innovative technologies at scale, and 6) an inability to share data seamlessly across organizational silos for patient coordination and care, health system management and research. We propose a set of policies and practices that can help Canada assess, monitor and provide feedback to stakeholders and citizens on how well they are progressing toward seamless digital health.

Galectin-9 binds IgM-BCR to regulate B cell signaling.

The galectin family of secreted lectins have emerged as important regulators of immune cell function; however, their role in B-cell responses is poorly understood. Here we identify IgM-BCR as a ligand for galectin-9. Furthermore, we show enhanced BCR microcluster formation and signaling in galectin-9-deficient B cells. Notably, treatment with exogenous recombinant galectin-9 nearly completely abolishes BCR signaling. We investigated the molecular mechanism for galectin-9-mediated inhibition of BCR signaling using super-resolution imaging and single-particle tracking. We show that galectin-9 merges pre-existing nanoclusters of IgM-BCR, immobilizes IgM-BCR, and relocalizes IgM-BCR together with the inhibitory molecules CD45 and CD22. In resting naive cells, we use dual-color super-resolution imaging to demonstrate that galectin-9 mediates the close association of IgM and CD22, and propose that the loss of this association provides a mechanism for enhanced activation of galectin-9-deficient B cells.