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Given the recent success of artificial intelligence (AI) in computer vision applications, many pathologists anticipate that AI will be able to assist them in a variety of digital pathology tasks. Simultaneously, tremendous advancements in deep learning have enabled a synergy with artificial intelligence (AI), allowing for image-based diagnosis on the background of digital pathology. There are efforts for developing AI-based tools to save pathologists time and eliminate errors. Here, we describe the elements in the development of computational pathology (CPATH), its applicability to AI development, and the challenges it faces, such as algorithm validation and interpretability, computing systems, reimbursement, ethics, and regulations. Furthermore, we present an overview of novel AI-based approaches that could be integrated into pathology laboratory workflows.

To longitudinally analyze the impact of calcium dobesilate (CaD) treatment on retinal layer thicknesses in patients with moderate or more severe diabetic retinopathy (DR). In this retrospective, longitudinal study, patients with DR exhibiting moderate non-proliferative diabetic retinopathy (NPDR) or more advanced stages were enrolled and divided into two groups: those prescribed CaD for more than 6 months (Group 1) and those not prescribed CaD (Group 2). After the baseline visits, three additional examinations were conducted at 1-year intervals. In total, 128 eyes were included: 38 in Group 1 and 90 in Group 2. Over time, group 2 exhibited significant decreases in ganglion cell complex (GCC) and inner nuclear layer (INL) thicknesses (P < 0.001 and P = 0.002, respectively), while Group 1 did not. Both groups experienced significant reductions in outer nuclear layer (ONL) thickness (P = 0.030 for Group 1 and P < 0.001 for Group 2). Group 2 exhibited a significantly greater decrease in GCC thickness compared with Group 1(P = 0.026). In patients with moderate or more severe DR, the group taking CaD did not show significant reductions in GCC and INL thicknesses over time compared with the group not taking CaD. These findings suggest that CaD could have a protective effect on the inner retina, even in those with more advanced stages than mild DR.

Transforming growth factor-β (TGF-β) promotes tumor invasion and metastasis by inducing epithelial-mesenchymal transition (EMT). EMT is often related with acquisition of stemness characteristics. The objective of this study was to determine whether EMT and stemness characteristics induced by TGF-β might be associated with epigenetic regulation in lung cancer. A human normal lung epithelial cell line and four lung cancer cell lines were treated with TGF-β. Transcriptome analysis of BEAS-2B and A549 cells incubated with TGF-β were analyzed through next-generation sequencing (NGS). Western blotting was carried out to investigate expression levels of epithelial and mesenchymal markers. Wound healing and Matrigel invasion assay, sphere formation assay, and in vivo mice tumor model were performed to evaluate functional characteristics of EMT and stemness acquisition. To investigate whether activation of EMT and stem cell markers might be involved in epigenetic regulation of lung cancer, experiment using a DNA methyltransferase inhibitor (5-azacytidine, AZA), methylation-specific PCR (MSP) and bisulfite sequencing were performed. NGS revealed changes in expression levels of EMT markers (E-cadherin, N-cadherin, fibronectin, vimentin, slug and snail) and stem cell markers (CD44 and CD87) in both BEAS-2B and A549 cells. Functional analysis revealed increased migration, invasion, sphere formation, and tumor development in mice after TGF-β treatment. Expression of slug and CD87 genes was activated following treatment with AZA and TGF-β. MSP and bisulfite sequencing indicated DNA demethylation of slug and CD87 genes. These results suggest that TGF-β induced EMT and cancer stemness acquisition could be associated with activation of slug and CD87 gene by their promoter demethylation.

The gut microbiome plays a pivotal role in modulating cancer therapies, including immunotherapy and chemotherapy. Emerging evidence demonstrates its influence on treatment efficacy, immune response, and resistance mechanisms. Specific microbial taxa enhance immune checkpoint inhibitor efficacy, while dysbiosis can contribute to adverse outcomes. Chemotherapy effectiveness is also influenced by microbiome composition, with engineered probiotics and prebiotics offering promising strategies to enhance drug delivery and reduce toxicity. Moreover, microbial metabolites, such as short-chain fatty acids, and engineered microbial systems have shown potential to improve therapeutic responses. These findings underscore the importance of personalized microbiome-based approaches in optimizing cancer treatments.

To investigate the impact of calcium dobesilate (CaD) on the macular microvasculature in patients with diabetic retinopathy (DR) using optical coherence tomography angiography. In this retrospective study, patients with DR were divided into two groups: those treated with 1 g/day of CaD (Group 1) and those without CaD treatment (Group 2). Following the baseline, patients underwent two additional examinations at 3-month intervals for analysis. The vessel density of the superficial vascular complex (SVD) and deep vascular complex (DVD) were compared against prior assessments. Generalized linear mixed models analyzed factors associated with changes in SVD and DVD over time. A total of 81 eyes were included: 39 in Group 1 and 42 in Group 2. The mean SVD was 21.8 ± 5.7% at baseline, 23.5 ± 6.5% at 3 months, and 23.3 ± 6.1% at 6 months in Group 1, respectively (P = 0.034), with significant changes observed from baseline to 3 months (P = 0.021), but not from 3 to 6 months (P = 0.745). The mean DVD was 18.2 ± 3.4% at baseline, 20.0 ± 3.9% at 3 months, and 19.9 ± 4.1% at 6 months in Group 1, respectively (P = 0.008), showing a significant increase from baseline to 3 months (P = 0.007), but not from 3 to 6 months (P = 0.825). Group 2 showed no significant changes over time in either SVD (P = 0.175) or DVD (P = 0.156). In Group 1, multivariate analysis identified DR severity as significantly associated with changes in SVD (estimate = 5.07, P = 0.016). The administration of CaD positively influences macular microcirculation in DR patients, demonstrating its effectiveness even in advanced stages of the disease.

Recent advancements in electronic medical records (EMRs) have transformed clinical trials and healthcare systems by improving data accuracy, regulatory compliance, and integration with decision support tools. These innovations enhance trial efficiency, streamline patient recruitment, and enable large-scale data analysis while bridging clinical practice with research. Despite these benefits, challenges such as data standardization, privacy concerns, and usability issues persist. Overcoming these barriers through policy reforms, technological innovations, and robust methodologies is essential to maximizing the potential of EMRs. We examine current developments, challenges, and future directions for optimizing EMRs in clinical trials and healthcare delivery.

PurposeTo evaluate serial computed tomography (CT) findings of pulmonary mucormycosis correlated with peripheral blood absolute neutrophil count (ANC).Materials and methodsBetween February 1997 and June 2016, 20 immunocompromised patients (10 males, 10 females; mean age, 48.9 years) were histopathologically diagnosed as pulmonary mucormycosis. On initial (n=20) and follow-up (n=15) CT scans, the patterns of lung abnormalities and their changing features on follow-up scans were evaluated, and the pattern changes were correlated with ANC changes.ResultsAll patients were immunocompromised. On initial CT scans, nodule (≤3cm)/mass (>3cm) or consolidation with surrounding ground-glass opacity halo (18/20, 90%)) was the most common pattern. On follow-up CT, morphologic changes (13/15, 87%) could be seen and they included reversed halo (RH) sign, central necrosis, and air-crescent sign. Although all cases did not demonstrate the regular morphologic changes at the same timeline, various combinations of pattern change could be seen in all patients. Sequential morphologic changes were related with recovering of ANC in 13 of 15 patients.ConclusionPulmonary mucormycosis most frequently presents as consolidation or nodule/mass with halo sign at CT. Morphologic changes into RH sign, central necrotic cavity or air-crescent sign occur with treatment and recovery of ANC.Key points• Pulmonary mucormycosis showed various CT-morphology including CT halo sign• Pulmonary mucormycosis had trends of serial morphologic changes on follow-ups• Recovery of absolute neutrophil count changed CT-morphology of mucormycosis in immune-compromised patients

Background Recently, cancer organoid-based drug sensitivity tests have been studied to predict patient responses to anticancer drugs. The area under curve (AUC) or IC 50 value of the dose-response curve (DRC) is used to differentiate between sensitive and resistant patient‘s groups. This study proposes a multi-parameter analysis method (cancer organoid-based diagnosis reactivity prediction, CODRP) that considers the cancer stage and cancer cell growth rate, which represent the severity of cancer patients, in the sensitivity test. Methods On the CODRP platform, patient-derived organoids (PDOs) that recapitulate patients with lung cancer were implemented by applying a mechanical dissociation method capable of high yields and proliferation rates. A disposable nozzle-type cell spotter with efficient high-throughput screening (HTS) has also been developed to dispense a very small number of cells due to limited patient cells. A drug sensitivity test was performed using PDO from the patient tissue and the primary cancer characteristics of PDOs were confirmed by pathological comparision with tissue slides. Results The conventional index of drug sensitivity is the AUC of the DRC. In this study, the CODRP index for drug sensitivity test was proposed through multi-parameter analyses considering cancer cell proliferation rate, the cancer diagnosis stage, and AUC values. We tested PDOs from eight patients with lung cancer to verify the CODRP index. According to the anaplastic lymphoma kinase (ALK) rearrangement status, the conventional AUC index for the three ALK-targeted drugs (crizotinib, alectinib, and brigatinib) did not classify into sensitive and resistant groups. The proposed CODRP index-based drug sensitivity test classified ALK-targeted drug responses according to ALK rearrangement status and was verified to be consistent with the clinical drug treatment response. Conclusions Therefore, the PDO-based HTS and CODRP index drug sensitivity tests described in this paper may be useful for predicting and analyzing promising anticancer drug efficacy for patients with lung cancer and can be applied to a precision medicine platform.

Diffuse gliomas are the most common primary brain tumors and they vary considerably in their morphology, location, genetic alterations, and response to therapy. In 2016, the World Health Organization (WHO) provided new guidelines for making an integrated diagnosis that incorporates both morphologic and molecular features to diffuse gliomas. In this study, we demonstrate how deep learning approaches can be used for an automatic classification of glioma subtypes and grading using whole-slide images that were obtained from routine clinical practice. A deep transfer learning method using the ResNet50V2 model was trained to classify subtypes and grades of diffuse gliomas according to the WHO’s new 2016 classification. The balanced accuracy of the diffuse glioma subtype classification model with majority voting was 0.8727. These results highlight an emerging role of deep learning in the future practice of pathologic diagnosis.

Broad industrial application of zeolites increases the opportunity of inhalation. However, the potential impact of different types and compositions of zeolite on cytotoxicity is still unknown. Four types of synthetic zeolites have been prepared for assessing the effect on lung fibroblast: two zeolite L (LTL-R and LTL-D), ZSM-5 (MFI-S), and faujasite (FAU-S). The cytotoxicity of zeolites on human lung fibroblast (IMR-90) was assessed using WST1 cell proliferation assay, mitochondrial function, membrane leakage of lactate dehydrogenase, reduced glutathione levels, and mitochondrial membrane potential were assessed under control. Intracellular changes were examined using transmission electron microscopy (TEM). Toxicity-related gene expressions were evaluated by PCR array. The result showed significantly higher toxicity in IMR-90 cells with FAU-S than LTL-R, LTL-D and MFI-S exposure. TEM showed FAU-S, spheroidal zeolite with a low Si/Al ratio, was readily internalized forming numerous phagosomes in IMR-90 cells, while the largest and disc-shaped zeolites showed the lowest toxicity and were located in submembranous phagosomes in IMR-90 cells. Differential expression of TNF related genes was detected using PCR arrays and confirmed using qRT-PCR analysis of selected genes. Collectively, the exposure of different zeolites shows different toxicity on IMR-90 cells.