Philadelphia College of Osteopathic Medicine
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AI in Early Detection of Gastrointestinal Cancers: Evaluating Harvard’s CHIEF Model and Machine Learning Innovations
Full text linkBACKGROUND
Gastrointestinal (GI) cancers, encompassing colorectal, gastric, esophageal, and pancreatic carcinomas, represent a significant global health burden. The insidious nature of these malignancies often leads to diagnosis at advanced stages, where therapeutic interventions are less effective, resulting in diminished patient survival and quality of life. The challenges associated with traditional diagnostic methods, including their limited sensitivity and specificity, underscore the critical need for innovative approaches to facilitate earlier detection. Early detection is not merely a clinical goal; it is a fundamental strategy to shift the paradigm from late-stage palliation to early-stage cure, thereby improving patient outcomes and reducing the overall healthcare burden.
OBJECTIVE
This review aims to comprehensively explore the burgeoning field of artificial intelligence (AI) in the early detection of GI cancers, focusing on the transformative potential of machine learning models. We seek to elucidate the current state of AI applications in GI cancer diagnostics, highlighting the advancements achieved and identifying the challenges that remain. Specifically, we aim to demonstrate how AI can be leveraged to enhance the precision and efficiency of early detection, ultimately leading to improved patient management.
METHODS
This review synthesizes a broad spectrum of current literature, encompassing research articles, clinical trials, and technical reports, to examine the integration of AI into various diagnostic modalities. We examine the application of AI in endoscopy, where machine learning algorithms detect subtle mucosal abnormalities indicative of early-stage cancers. We also explore AI in imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), to enhance the detection of small, clinically significant lesions. Furthermore, we investigate AI in biomarker analysis, where machine learning models are employed to analyze complex datasets and identify predictive signatures of GI cancers. Particular emphasis is placed on the CHIEF (Colorectal Histological Images for Early Detection) model, a machine learning framework developed by Harvard, a representative example of advanced AI applications in this domain. We analyze the model’s architecture, performance metrics, and clinical utility, providing insights into the potential of AI-driven histological analysis.
RESULTS
By synthesizing current literature, this review highlights the significant advancements in AI-driven strategies for GI cancer detection. We discuss the increased sensitivity and specificity achieved through AI-enhanced diagnostic modalities, demonstrating the potential to improve early detection rates. We also address the challenges associated with AI implementation, including data standardization, model validation, and clinical integration. Moreover, we explore the future directions of AI research in this field, emphasizing the need for collaborative efforts to develop robust and clinically applicable AI models.
CONCLUSION
AI integration into GI cancer diagnostics aims to revolutionize early detection, facilitating earlier interventions and improving patient prognosis. The potential of machine learning models like CHIEF to enhance diagnostic accuracy and efficiency is evident. By leveraging the power of AI, we can move closer to a future where GI cancers are detected at earlier, more treatable stages, leading to improved survival rates and enhanced patient quality of life. Continued research and development in this field are essential to unlock the full potential of AI in combating GI cancers
Sun Safety in Rural Youth: Exploring Knowledge, Preferences, and Behaviors
Full text linkBackground:
Skin cancer is the most common cancer in the U.S., with prolonged sun exposure significantly increasing the risk. Rural youth, particularly in agricultural regions like South Georgia, experience high levels of UV exposure but may lack sufficient knowledge about sun safety. Understanding their awareness, preferences, and behaviors regarding sun protection is crucial for developing effective educational interventions.
Objective:
The primary objective is to survey students in the South Georgia community about their knowledge of sun safety prior and following a presentation on the topic of skin protection. The findings of this survey, as well as the informative presentation will help promote the importance of skin checks, daily sunscreen use, and overall youth empowerment on the topic of sun safety.
Methods:
Middle and high school students at Georgia Christian School in Valdosta, GA, completed pre- and post-surveys evaluating their sun safety knowledge, behaviors, and sources of information. The intervention included a structured presentation covering the risks of UV exposure, effective sun protection methods, and skin cancer prevention strategies.
Results:
Pre-survey data revealed limited sun protection habits, with most students using sunscreen inconsistently. White students reported higher sunscreen use, while Hispanic and Asian students preferred protective clothing. Social influences, including family and social media, shaped students\u27 perceptions of tanning and sun exposure. Post-survey results demonstrated a significant increase in sun safety awareness, with 69% recognizing its importance and 90% reporting confidence in identifying skin cancer signs. Intentional tanning preferences declined, though some students maintained previous attitudes.
Conclusion:
Education significantly improves sun safety knowledge and influences protective behaviors among rural youth. Tailored interventions considering cultural differences can enhance long-term sun safety practices, ultimately reducing skin cancer risks in high-exposure regions
Massive Myocardial Infarction with Ventricular Rupture following Laparoscopic Colectomy for Colorectal Cancer: A Devastating Complication
Full text linkBackground: Laparoscopic surgery offers many advantages over open surgery and this includes colon resections both for benign and malignant diseases. Whereas surgical complications especially infections seem to be lower after the minimally invasive approach, the incidence of postoperative medical complications such as pulmonary embolism or myocardial infarction is not impacted. Massive myocardial infarction with ventricle rupture is an extremely rare and in almost all cases fatal condition. This has not been reported as a postoperative complication.
Case report: A 75 year old male developed stool irregularities and blood per rectum and during work up was found to have a malignant lesion in the ascending colon. He was an active smoker but had no symptoms of coronary artery disease, specifically no chest pain or shortness of breath. After cardiac clearance, he underwent laparoscopic right hemicolectomy. The intra and early postoperative course was uneventful. He passed gas on the third day and had a bowel movement on the 4th day after surgery and plans were made for discharge. However, the next morning he became diaphoretic and developed chest pain and shortness of breath. He lost consciousness and a code was called. He was intubated and brought to the intensive care unit. EKG showed acute myocardial infarction. Due to hemodynamic instability, he underwent CT-scan, which showed extravasation of contrast from the left ventricle with developing cardiac tamponade. After discussing the dismal situation with his wife, comfort care was initiated and the patient died within an hour.
Discussion: To the best of our knowledge a ventricle rupture after laparoscopic surgery or a colectomy has not been reported thus far. One may argue that in long term smokers even without chest pain or shortness of breath and a normal EKG, a more sophisticated workup including echocardiography and/or stress test may have prevented this devastating complication
Investigating matrix metalloproteinase 9 in excitation/inhibition balance and bloodbrain barrier function following early-life seizures in zebrafish
No full textProlonged early-life seizures (ELS) can be associated with a range of long-term neurological consequences, including the development of spontaneous, recurrent seizures or epilepsy later in life. The process through which epilepsy develops is called epileptogenesis. While many cellular and molecular changes have been described that could potentially play a role in post-ELS epileptogenesis, there is still no therapy that can prevent it. One molecule of interest is matrix metalloproteinase 9 (MMP-9), whose levels have been shown to increase significantly following seizure-induced tissue damage. MMP-9 is an enzyme involved in extracellular matrix remodeling, neuroinflammation, and synaptic plasticity, processes that are highly relevant to brain development and function. These MMP-9-related mechanisms may contribute to blood-brain barrier (BBB) disruption and excitation/inhibition (E/I) synaptic imbalance through maladaptive pathways triggered by early-life hyperexcitability. This study aimed to investigate whether ELS caused BBB disruption and/or E/I synaptic imbalance in zebrafish. It also examined whether inhibiting MMP-9 activity following ELS could mitigate these effects. We hypothesized that ELS would disrupt BBB integrity and E/I synaptic balance, and that MMP-9 inhibition would prevent these changes and restore balance between excitatory and inhibitory synaptic expression.
To test these hypotheses, early-life seizures (ELS) were induced in zebrafish larvae using the chemoconvulsant pentylenetetrazol (PTZ). To assess the role of MMP-9, some fish received post-ELS treatment with the MMP-9 inhibitor JNJ0966. Blood-brain barrier (BBB) integrity and synaptic balance were evaluated using tracer injections and immunohistochemistry at later developmental stages. Key findings demonstrated that ELS increased BBB permeability, suggesting a compromise in cerebral vascular integrity. Additionally, ELS altered synaptic expression, with increased excitatory synaptic markers and decreased inhibitory ones at 21 dpf, indicating a long-lasting disruption in the balance between excitation and inhibition. Treatment with the MMP-9 inhibitor JNJ0966 alleviated the excitatory synaptic changes, but did not restore BBB integrity or recover inhibitory synaptic expression. These results suggest that while MMP-9 inhibition can reduce some seizure-induced synaptic alterations, however, it may not fully restore BBB integrity or synaptic balance. This study provides evidence that ELS leads to long-term disruptions in BBB integrity and synaptic balance in zebrafish, potentially via MMP-9 activation. Further optimization of MMP-9 inhibition or exploration of alternative therapeutic targets may be needed to address these changes. These findings highlight the complexity of ELS-induced brain alterations and the potential of targeting MMP-9 as a therapeutic strategy for preventing long-term neurological consequences of early-life seizures
Exploring the Relationship among Postpartum Depression, Cognitive Distortions, and Relationship Satisfaction
Full text linkPostpartum depression is the most prevalent psychological disorder experienced following childbirth, impairs daily functioning, negatively impacts child growth and development, and is linked to maladaptive parent-child interactions. Previous research also suggests a link among distorted thinking, depression symptoms, and interpersonal tension. The current study explores the interplay among postpartum depression symptoms, cognitive distortions, and relationship satisfaction among postpartum individuals. Researchers examined how specific thinking errors, including catastrophizing, mindreading, and labeling, are associated with depression symptoms and relational experiences in the postpartum period. Using a quantitative survey design, data were collected from 90 participants using validated instruments: the Edinburgh Postnatal Depression Scale (EPDS), the Couple Satisfaction Index (CSI), and the Inventory of Cognitive Distortions (ICD). Results indicate a positive relationship between ICD scores and EPDS scores. Further, higher ratings of PPD symptoms and ICD scores were associated with CSI scores. Results also suggest labeling is the strongest positive predictor of PPD symptoms and negative predictor of CSI scores. The current research underscores the importance of integrating effective screening and diagnosis into postpartum care and bolsters the development of targeted interventions aimed at reducing cognitive distortions to improve parental well-being and interpersonal relationships. Implications for early screening, identification, and therapeutic interventions in clinical practice are also discussed
The Role of Teacher Engagement in Enhancing Children’s Organizational Skills: A School-Based Intervention Study
Full text linkExecutive functioning skills, including organization, time management, and planning (OTMP), are critical for an individual across the lifespan. Deficits in these skills can negatively impact academic achievement, social-emotional functioning, and future occupational opportunities and satisfaction. Organizational Skills Training (OST) interventions have been shown to improve OTMP skills in children, however, less is known about the role of teacher engagement in supporting these interventions. The current study examined the relationship between teacher engagement in a school-based Organizational Skills Training-Tier 2 program (OST-T2), and improvements in student organizational skills outcome. Secondary data were analyzed from 96 students in grades 3-6 and their 31 teachers, who participated in a cluster-randomized control trial of OST-T2. Teacher engagement was measured through completion rates of Class Mastermind sheets, and student outcomes were assessed using teacher and parent ratings on the Children’s Organizational Skills Scale (COSS). Findings indicated that students demonstrated improvements in organizational skills over the course of the intervention, however, teacher engagement, as measured by the Class Mastermind sheet completion, was not significantly correlated with changes in student outcomes. Subgroup analyses of students likely to meet ADHD diagnostic criteria yielded similar results. These findings suggest that while OST-T2 interventions are effective in improving organizational skills, teacher engagement as operationalized in this study may not directly influence student outcomes
Single-nuclei multiomics analysis identifies abnormal cardiomyocytes in a murine model of cardiac development.
Full text linkTranscription factors such as Tbx5, Gata4, Mef2c and Pitx2 are required during cardiac development, and in adult cardiac homeostasis. We demonstrate that the gene dosage and modulation of these factors are mediated in vivo by the miR-200 family. Inhibition of a single miR-200 family member within the cluster results in defects of the left ventricle and cardiomyocyte maturation during development. Inhibition of the entire miR-200 family results in a ventricular septal defect and embryonic lethality by embryonic day (E)16.5. Inhibition of each miR-200 family has distinct heart phenotypes in cell specific differentiation and maturation. snRNA-sequencing reveals an immature cardiomyocyte cell state, suggesting reduced differentiation of these cells. The miR-200 family members are critical regulators of early cardiac development through maintaining cardiomyocyte differentiation and maturation. In this report, we identify several transcription factors regulated by miR-200 during heart development, a role for miR-200 in specific heart defects, and an abnormal cardiomyocyte population
Recognizing and addressing medical trauma: An imperative for integrated primary care.
No full textINTRODUCTION: Traumatic stress is an experience that contributes to a variety of medical and behavioral health concerns that present in the primary care context. The intersection of traumatic stress and health care is conceptualized as medical trauma (MT), where individuals receiving health care services are exposed to traumatic stress related to their health care experiences. Currently, MT may be an overlooked and underresearched phenomenon in health care, with significant implications for primary care teams. An understanding of ways to conceptualize, recognize, and address MT in the primary care context is an important step in creating trauma-informed primary care spaces.
METHOD: In this article, we provide a description of MT from the available literature and a method of conceptualizing the experience of traumatic stress related to health care experiences through the enduring somatic threat model.
RESULTS: We identify potential risk factors and health care experiences typically associated with MT. Next, we identify strategies to recognize and address experiences of MT within the context of primary care through an exploration of assessment and intervention strategies. Finally, we provide a brief MT case example to highlight presentation, assessment, and intervention in the primary care context.
DISCUSSION: MT has the potential to significantly affect patients\u27 wellness and quality of life, with the associated biopsychosocial concerns presenting in primary care due to the context and goals of these settings. Future efforts should aim to enhance the integrated primary care team members\u27 ability to conceptualize, assess, and address MT. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Prospective Receptivity and Acceptability of Brief Alcohol Interventions Among Women and Racial/Ethnic Minority Veterans in Primary Care
Full text linkBrief alcohol interventions (BAIs) are an evidence-based practice for addressing hazardous drinking among primary care patients, yet implementation of BAIs in practice has been difficult and disparities have been identified regarding implementing BAIs with women and racial/ethnic minority patients. Further, patient engagement is a commonly identified barrier to BAI implementation. This mixed methods study aimed to assess acceptability of BAIs among women and racial/ethnic minority primary care patients and to identify factors that may impact their receptivity to engaging in a BAI. Qualitative interviews were conducted with 17 patients who had screened positive for hazardous alcohol use. Patients reported neutral to positive acceptability ratings regarding BAIs, and qualitative responses yielded 4 main themes for factors that may impact receptivity to BAIs including: (1) delivery of the BAI, (2) patient-centeredness, (3) personal relevance, and (4) relationship with the provider. Results have potential implications for implementation of BAIs in primary care settings