Time for a full digital approach in nephropathology: a systematic review of current artificial intelligence applications and future directions.

INTRODUCTION: Artificial intelligence (AI) integration in nephropathology has been growing rapidly in recent years, facing several challenges including the wide range of histological techniques used, the low occurrence of certain diseases, and the need for data sharing. This narrative review retraces the history of AI in nephropathology and provides insights into potential future developments. METHODS: Electronic searches in PubMed-MEDLINE and Embase were made to extract pertinent articles from the literature. Works about automated image analysis or the application of an AI algorithm on non-neoplastic kidney histological samples were included and analyzed to extract information such as publication year, AI task, and learning type. Prepublication servers and reviews were not included. RESULTS: Seventy-six (76) original research articles were selected. Most of the studies were conducted in the United States in the last 7 years. To date, research has been mainly conducted on relatively easy tasks, like single-stain glomerular segmentation. However, there is a trend towards developing more complex tasks such as glomerular multi-stain classification. CONCLUSION: Deep learning has been used to identify patterns in complex histopathology data and looks promising for the comprehensive assessment of renal biopsy, through the use of multiple stains and virtual staining techniques. Hybrid and collaborative learning approaches have also been explored to utilize large amounts of unlabeled data. A diverse team of experts, including nephropathologists, computer scientists, and clinicians, is crucial for the development of AI systems for nephropathology. Collaborative efforts among multidisciplinary experts result in clinically relevant and effective AI tools.

Gender Biases and Diagnostic Delay in Inflammatory Bowel Disease: Multicenter Observational Study.

BACKGROUND: Female gender could be a cause of diagnostic delay in inflammatory bowel disease (IBD). The aim of this study was to investigate the diagnostic delay in women vs men and potential causes. METHODS: This multicenter cohort study included 190 patients with recent diagnosis of IBD (disease duration <7 months). Reconstruction of the clinical presentation and diagnostic process was carried out in conjunction with the semistructured patient interview, review, and electronic medical records. RESULTS: The median time from symptom onset to IBD diagnosis was longer in women than in men: 12.6 (interquartile range, 3.7-31) vs 4.5 (2.2-9.8) months for Crohn's disease (CD; P = .008) and 6.1 (3-11.2) vs 2.7 (1.5-5.6) months for ulcerative colitis (UC; P = .008). Sex was an independent variable related to the time to IBD diagnosis in Cox regression analysis. The clinical presentation of IBD was similar in both sexes. Women had a higher percentage of misdiagnosis than men (CD, odds ratio [OR], 3.9; 95% confidence [CI], 1.5-9.9; UC, OR 3.0; 95% CI, 1.2-7.4). Gender inequities in misdiagnosis were found at all levels of the health system (emergency department, OR 2.4; 95% CI, 1.1-5.1; primary care, OR 2.5; 95% CI, 1.3-4.7; gastroenterology secondary care, OR 3.2; 95% CI, 1.2-8.4; and hospital admission, OR 4.3; 95% CI, 1.1-16.9). CONCLUSIONS: There is a longer diagnostic delay in women than in men for both CD and UC due to a drawn-out evaluation of women, with a higher number of misdiagnoses at all levels of the health care system.

This paper shows a longer delay in the diagnosis of inflammatory bowel disease in women compared with men for both Crohn's disease and ulcerative colitis. These differences are present at all levels of the health care system, and misdiagnosis is also more common in women.

[Analysis and recording of aggressions in the ICU]. / Análisis y registro de las agresiones en UCI.

The objectives of this study are to determine if aggressions occur by the family or patient against the nursing staff of the Intensive Care Units (ICU), identify if the aggressions received are recorded; specify if the nurses know about the existence of resources available by the hospital site and verify if the nurses understand aggression to be the same thing. We have conducted a descriptive study using a questionnaire done between November and December 2004 regarding aggressions suffered at work. The study sample includes 150 nurses who work in the ICU and Coronary Unit of the Hospital Universitario de Bellvitge (HUB). Inclusion criteria is the nursing staff of the ICU of HUB. The results of the surveys show that there are aggressions in the ICU (62% of those surveyed have been physically assaulted and 68% verbally). Most of these aggressions were only reported verbally (73% in verbal aggressions, 75% in physical aggressions), these hardly being recorded in written form (2.5% of those assaulted verbally and 40% of those assaulted physically). The conclusions of this study are that a high percentage of the ICU nurses have suffered aggressions in their work, with repercussions in their personal and work life. They normally comment the aggressions with colleagues or bosses, although they do not put it in writing.

Análisis y registro de las agresiones en UCI / Analysis and recording of aggressions in the ICU

Los objetivos de este estudio son determinar si se producen agresiones, por parte de la familia o del enfermo, al personal de enfermería de las unidades de cuidados intensivos (UCI); identificar si se registran las agresiones recibidas; concretar si las enfermeras conocen la existencia de los recursos disponibles por parte del centro hospitalario y comprobar si las enfermeras entienden lo mismo por agresión. Se ha llevado a cabo un estudio descriptivo, mediante un cuestionario realizado entre noviembre y diciembre de 2004 respecto a las agresiones sufridas en el trabajo. La muestra a estudio es de 150 enfermeras que trabajan en la UCI y la Unidad Coronaria del Hospital Universitario de Bellvitge (HUB). El criterio de inclusión es el personal de enfermería de UCI del HUB. Los resultados de las encuestas muestran que hay agresiones en UCI (el 62% de los encuestados ha sido agredido físicamente y el 68% verbalmente); la mayoría de estas agresiones sólo se comunican verbalmente (el 73% en agresiones verbales, el 75% en agresiones físicas), apenas se han registrado de forma escrita (el 2,5% de los agredidos verbalmente y el 40% de los agredidos físicamente). Las conclusiones de este estudio son que un alto porcentaje de las enfermeras de UCI ha sufrido agresiones en su trabajo, con repercusiones en su vida personal y laboral. Normalmente, comentan las agresiones a compañeros o superiores, aunque no las dejan por escrito

The objectives of this study are to determine if aggressions occur by the family or patient against the nursing staff of the Intensive Care Units (ICU), identify if the aggressions received are recorded; specify if the nurses know about the existence of resources available by the hospital site and verify if the nurses understand aggression to be the same thing. We have conducted a descriptive study using a questionnaire done between November and December 2004 regarding aggressions suffered at work. The study sample includes 150 nurses who work in the ICU and Coronary Unit of the Hospital Universitario de Bellvitge (HUB). Inclusion criteria is the nursing staff of the ICU of HUB. The results of the surveys show that there are aggressions in the ICU (62% of those surveyed have been physically assaulted and 68% verbally). Most of these aggressions were only reported verbally (73% in verbal aggressions, 75% in physical aggressions), these hardly being recorded in written form (2.5% of those assaulted verbally and 40% of those assaulted physically). The conclusions of this study are that a high percentage of the ICU nurses have suffered aggressions in their work, with repercussions in their personal and work life. They normally comment the aggressions with colleagues or bosses, although they do not put it in writing