Artificial intelligence is likely to perform several roles currently performed by humans, and the adoption of artificial intelligence-based medicine in gastroenterology practice is expected in the ...near future. Medical image-based diagnoses, such as pathology, radiology, and endoscopy, are expected to be the first in the medical field to be affected by artificial intelligence. A convolutional neural network, a kind of deep-learning method with multilayer perceptrons designed to use minimal preprocessing, was recently reported as being highly beneficial in the field of endoscopy, including esophagogastroduodenoscopy, colonoscopy, and capsule endoscopy. A convolutional neural network-based diagnostic program was challenged to recognize anatomical locations in esophagogastroduodenoscopy images,
infection, and gastric cancer for esophagogastroduodenoscopy; to detect and classify colorectal polyps; to recognize celiac disease and hookworm; and to perform small intestine motility characterization of capsule endoscopy images. Artificial intelligence is expected to help endoscopists provide a more accurate diagnosis by automatically detecting and classifying lesions; therefore, it is essential that endoscopists focus on this novel technology. In this review, we describe the effects of artificial intelligence on gastroenterology with a special focus on automatic diagnosis, based on endoscopic findings.
Summary
Background
Tegoprazan is a novel potassium‐competitive acid blocker for the treatment of acid‐related disorders.
Aims
To assess whether tegoprazan is non‐inferior to lansoprazole in terms of ...efficacy and safety in patients with gastric ulcers.
Methods
In this phase 3, double‐blind, active control, multicentre study, 306 gastric ulcer patients were randomised to one of three treatment groups: tegoprazan 50 mg, tegoprazan 100 mg and lansoprazole 30 mg once daily for 4 or 8 weeks. The primary endpoint was the cumulative proportion of patients with healed ulcers confirmed by endoscopy up to 8 weeks from treatment initiation. Symptoms and safety were assessed.
Results
In the full analysis set, the cumulative healing rates at week 8 were 94.8% (91/96) for the tegoprazan 50 mg, 95.0% (94/99) for the tegoprazan 100 mg and 95.7% (89/93) for the lansoprazole 30 mg groups. At week 4, the respective healing rates were 90.6% (87/96), 91.9% (91/99), and 89.2% (83/93). In per protocol analysis, 4‐week healing rates were 95.4% (84/88), 94.6% (88/93) and 92.9% (79/85) for tegoprazan 50 mg, tegoprazan 100 mg and lansoprazole 30 mg, respectively. Both doses of tegoprazan were non‐inferior to lansoprazole in ulcer healing at 4 and 8 weeks. The incidence of drug‐related treatment‐emergent adverse events did not differ among groups. The increase in serum gastrin concentration was not higher in tegoprazan‐treated patients than in lansoprazole‐treated patients.
Conclusions
Tegoprazan 50 or 100 mg were not inferior to lansoprazole 30 mg once daily in the treatment of gastric ulcers.
There is a growing consensus that the physics-based model needs to be coupled with machine learning (ML) model relying on data or vice versa in order to fully exploit their combined strengths to ...address scientific or engineering problems that cannot be solved separately. We propose several methodologies of bridging technology computer-aided design (TCAD) simulation and artificial intelligence (AI) with its application to the tasks for which traditional TCAD faces challenges in terms of simulation runtime, coverage, and so on. AI-emulator that learns fine-grained information from rigorous TCAD enables simulation of process technologies and device in real-time as well as large-scale simulation such as full-pattern analysis of stress without high demand on computational resource. To accelerate atomistic molecular dynamics (MD) simulation, we have done a comparison study of descriptor-based and graph-based neural net potential, and also show their capability with large-scale and long-time simulation of silicon oxidation. Finally, we discuss the use of hybrid modeling of AI- and physics-based model for the case where physical equations are either fully or partially unknown.
Rapid and accurate detection and serotyping of foot‐and‐mouth disease (FMD) virus (FMDV) is essential for implementing control policies against emergent FMD outbreaks. Current serotyping assays, such ...as VP1 reverse transcription‐polymerase chain reaction (RT‐PCR)/sequencing (VP1 RT‐PCR/sequencing) and antigen detection enzyme‐linked immunosorbent assay (ELISA), have problems with increasing serotyping failure of FMDVs from FMD outbreaks. This study was conducted to develop a multiplex real‐time RT‐PCR for specific detection and differential serotyping of FMDV serotype O, A, and Asia 1 directly from field clinical samples. Primers and probes were designed based on 571 VP1 coding region sequences originated from seven pools. Multiplex real‐time RT‐PCR using these primers and probes demonstrated serotype‐specific detection with enhanced sensitivity compared to VP1 RT‐PCR/sequencing for reference FMDV (n = 24). Complete serotyping conformity between the developed multiplex real‐time RT‐PCR and previous VP1 RT‐PCR/sequencing was demonstrated using FMDV field viruses (n = 113) prepared in cell culture. For FMDV field clinical samples (n = 55), the serotyping rates of multiplex real‐time RT‐PCR and VP1 RT‐PCR/sequencing were 92.7% (51/55) and 72.7% (40/55), respectively. Moreover, the developed multiplex real‐time RT‐PCR demonstrated improved FMDV detection (up to 33.3%) and serotyping (up to 67.7%) capabilities for saliva samples when compared with 3D real‐time RT‐PCR and VP1 RT‐PCR/sequencing, during 10 days of challenge infection with FMDV serotype O, A, and Asia 1. Collectively, this study suggests that the newly developed multiplex real‐time RT‐PCR assay may be useful for the detection and differential serotyping of FMDV serotype O, A, and Asia 1 in the field.
Objective
The aim of this pilot study was to test whether a porcine collagenated bone substitute block (PCBB) and collagen membrane (CM) loaded with bone morphogenetic protein‐2 (BMP‐2) used for ...horizontal ridge augmentation differ from PCBB and CM without BMP‐2 regarding the osseointegration of the grafting material and the maintenance of the ridge contour.
Material and methods
Two semi‐saddle bone defects were created in each side of the mandible of six dogs. The defects were randomly allocated to receive one of the following treatments: bone augmentation using (1) PCBB, (2) PCBB loaded with BMP‐2 (PCBB‐BMP2), (3) PCBB + CM and (4) PCBB + CM loaded with BMP‐2 (PCBB + CM‐BMP2). After 12 weeks, one titanium implant was inserted into every site. After 8 weeks, one central histological section of each site was prepared. Histomorphometrical assessments were performed evaluating the augmented area (AA), the area of new bone (NB) (primary outcome), residual bone substitute (BS) and non‐mineralized tissue (NMT) within AA in mm2. In addition, the most coronal and the most buccal localizations of new bone and residual bone substitute, and the most coronal bone‐to‐implant contact were measured in mm.
Results
Clinically, all PCBB were firmly integrated and permitted implant placement. All the implants osseointegrated and exhibited complete hard‐tissue coverage of the buccal surface. Bone ingrowth always reached the central portions of PCBB. AA measured 10.4 ± 4.2 mm2 for PCBB, 11.8 ± 2.8 mm2 for PCBB‐BMP2, 9.8 ± 2.9 mm2 for PCBB + CM and 8.5 ± 2.2 mm2 for PCBB + CM‐BMP2. Only the difference between PCBB‐BMP2 and PCBB + CM‐BMP2 was statistically significant (P = 0.031). NB reached 2.3 ± 1.3 mm2 for PCBB, 2 ± 0.5 mm2 for PCBB‐BMP2, 2.7 ± 1.2 mm2 for PCBB + CM and 1.8 ± 0.7 mm2 for PCBB + CM‐BMP2. There were no statistically significant differences regarding NB, the most coronal and the most buccal localizations of new bone, residual bone substitute and bone‐to‐implant contact (P > 0.05).
Conclusions
The addition of BMP‐2 to PCBB or CM used for horizontal ridge augmentation did not render a statistically significant improvement in the maintenance of the augmented ridge contour and the new bone formation. PCBB with and without CM showed pronounced bone ingrowth and capacity to maintain the augmented ridge contour. In all the regions previously augmented with PCBB, the implants successfully integrated and presented with complete hard‐tissue coverage.
Background and Aim
Little is known regarding the exact burden of inflammatory bowel disease (IBD) in Asian countries because previous epidemiologic studies were hospital based. We aimed to develop ...and validate an operational definition of IBD cases from health insurance claims data and to examine the epidemiological features of IBD in Korea.
Methods
We analyzed stratified sample data from the Korean Health Insurance Review and Assessment (2010–2016) database using 12 different definitions and applied the best definition to the entire (2007–2016) dataset.
Results
The definition that combined the International Classification of Disease 10th revision code with IBD‐specific medications had the best performance characteristics among the 12 tested definitions. During the 8‐year study period, IBD prevalence increased from 25 345 in 2009 to 47 444 in 2016. Over that period, the prevalence of Crohn's disease increased 1.9‐fold (from 16.0/100 000 in 2009 to 29.6/100 000 in 2016) and that of ulcerative colitis increased 1.6‐fold (from 41.4/100 000 in 2009 to 66.0/100 000 in 2016). Similarly, the estimated incidence of Crohn's disease also increased 1.2‐fold (from 2.4 to 2.9 per 100 000) and that of ulcerative colitis rose 1.3‐fold (from 4.0 to 5.3 per 100 000). During the study period, the predominant increase in IBD incidence was among younger individuals, especially those aged < 30 years.
Conclusion
Patients with IBD can be accurately identified using Korean insurance claims data by combining information regarding the International Classification of Disease 10th revision codes and the IBD medications used. The prevalence of IBD continues to increase, with an apparent shift toward younger (< 30 years) age groups.
Background/Aims
The efficacy of probiotics for improving clinical symptoms, altering the fecal microbiota, and regulating serum immune cytokine levels was investigated in patients with irritable ...bowel syndrome-constipation (IBS-C) or functional constipation (FC).
Methods
A randomized, double-blind, placebo-controlled trial was conducted at Kyung Hee University Hospital between October 2016 and February 2017. Consecutive 18–75-year-old patients with diagnosis of IBS-C or FC (based on Rome IV criteria) consumed probiotics (3.0 × 10
8
CFU/g
Streptococcus thermophilus
MG510 and 1.0 × 10
8
CFU/g
Lactobacillus plantarum
LRCC5193) or a placebo daily for 4 weeks (weeks 1–4) and were followed up for a 4-week washout period without intervention (weeks 5–8). The primary outcomes of the study were Bristol Stool Form Scale and Complete Spontaneous Bowel Movements (CSBM). Efficacy was assessed by per protocol.
Results
Stool consistency measured by the Bristol Stool Form Scale was significantly better in the probiotic group (
n
= 88) than in the placebo group (
n
= 83) at 4 and 8 weeks (3.7 ± 1.1 vs. 3.1 ± 1.1 at 8 weeks,
P
= 0.002). No significant difference was found in CSBM. The quality of life was significantly better in the probiotic group than in the placebo group at 4 weeks (
P
= 0.044) and 8 weeks (
P
= 0.049). The relative abundance of
L. plantarum
among the fecal microbiomes was significantly greater in the probiotic group than in the placebo group at 4 weeks (
P
= 0.029). However, the levels of other microbiomes and of serum cytokines (IL-10/IL-12 ratio and TNF-α) did not differ significantly between the two groups.
Conclusions
Probiotics significantly ameliorated stool consistency in patients with chronic constipation. In addition, the beneficial effect of
L. plantarum
on stool consistency remained after the probiotic supplementation was discontinued. The mechanism whereby probiotics benefit patients with chronic constipation should be clarified in further studies.
Post-transplant malignancy is major morbidity complicated in kidney transplantation (KT). In Korea, a few studies have investigated the sex- and age-dependent risk for post-transplant malignancy ...among KT recipients on a large scale.
We utilized a national health insurance database in Korea to investigate the relative risk of post-transplant malignancy in 12,634 KT recipients between 2007 and 2017. The same number of patients with acute appendicitis was included as a control group. The relative risk of malignancy was estimated using a multivariable-adjusted Cox model, and interaction analysis was performed to investigate age- and sex-predominant patterns.
KT recipients had an overall 1.8-fold higher risk for post-transplant malignancy with an increased risk for 14 of 29 cancer types, among which Kaposi's sarcoma, non-Hodgkin's lymphoma, kidney, uterus, and bladder/urinary tract cancers were most prominent. Although the overall risk for post-transplant malignancy was similar between male and female KT recipients, head and neck cancer had a higher risk among male KT recipients, whereas non-Hodgkin's lymphoma and bladder/urinary tract cancer had a higher risk among female KT recipients. Overall, the young (< 50 years) KT recipients had a higher risk for post-transplant malignancy than older ones (≥ 50 years), whose pattern was most prominent in non-Hodgkin's lymphoma. In contrast, breast and nonmelanoma skin cancer showed a higher risk among older KT recipients.
KT recipients had an increased risk for a wide range of cancer types, some of which showed differential risk patterns with age and sex. Our result suggests that focused screening for predominant post-transplant malignancies may be an effective strategy for selected KT recipients.
Background and Aim
A better understanding of seasonal variations in cancer diagnosis may be the first step toward optimal resource distribution in the National Cancer Screening Program (NCSP). This ...study aimed to identify seasonal variations in the diagnosis of the top 10 major cancers in Korea.
Methods
We conducted a retrospective, observational cohort study in participants aged ≥ 20 years between 2012 and 2016 from the Health Insurance Review and Assessment‐National Patient Sample database, previously converted to a common data model. We assessed the overall seasonal variations in the 10 major cancers.
Results
We analyzed the following top 10 cancers: stomach (n = 3435), colorectal (n = 5368), liver (n = 7605), pancreatic (n = 2946), gallbladder (n = 899), lung (n = 1598), prostate (n = 2897), thyroid (n = 1966), breast (n = 1313), and kidney (n = 668) cancers. All cancers showed similar seasonal variations in diagnosis, with a significant winter peak. A winter peak in diagnosis was observed for NCSP‐covered cancers, such as stomach, colon, liver, and breast cancers, as well as other cancers not covered by the NCSP. The winter peak for cancer diagnosis was the highest for breast cancer (74.4%) followed by thyroid (51.0%) and stomach cancers, whereas it was the lowest for pancreatic cancer followed by prostate and colorectal cancers.
Conclusions
Significant seasonal variations were found in the diagnosis of the top 10 major cancers, with a winter peak, which may be explained by the participants' behavior pattern with respect to the NCSP. Our findings suggest that trading off of NCSP healthcare resources between winter and other seasons may be beneficial.
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