Challenges and opportunities in the application of artificial intelligence in gastroenterology and hepatology

Artificial intelligence(AI)is an umbrella term used to describe a cluster of interrelated fields.Machine learning(ML)refers to a model that learns from past data to predict future data.Medicine and particularly gastroenterology and hepatology,are data-rich fields with extensive data repositories,and therefore fruitful ground for AI/ML-based software applications.In this study,we comprehensively review the current applications of AI/ML-based models in these fields and the opportunities that arise from their application.Specifically,we refer to the applications of AI/ML-based models in prevention,diagnosis,management,and prognosis of gastrointestinal bleeding,inflammatory bowel diseases,gastrointestinal premalignant and malignant lesions,other nonmalignant gastrointestinal lesions and diseases,hepatitis B and C infection,chronic liver diseases,hepatocellular carcinoma,cholangiocarcinoma,and primary sclerosing cholangitis.At the same time,we identify the major challenges that restrain the widespread use of these models in healthcare in an effort to explore ways to overcome them.Notably,we elaborate on the concerns regarding intrinsic biases,data protection,cybersecurity,intellectual property,liability,ethical challenges,and transparency.Even at a slower pace than anticipated,AI is infiltrating the healthcare industry.AI in healthcare will become a reality,and every physician will have to engage with it by necessity.

Artificial intelligence in gastroenterology and hepatology:Status and challenges

Originally proposed by John McCarthy in 1955,artificial intelligence(AI)has achieved a breakthrough and revolutionized the processing methods of clinical medicine with the increasing workloads of medical records and digital images.Doctors are paying attention to AI technologies for various diseases in the fields of gastroenterology and hepatology.This review will illustrate AI technology procedures for medical image analysis,including data processing,model establishment,and model validation.Furthermore,we will summarize AI applications in endoscopy,radiology,and pathology,such as detecting and evaluating lesions,facilitating treatment,and predicting treatment response and prognosis with excellent model performance.The current challenges for AI in clinical application include potential inherent bias in retrospective studies that requires larger samples for validation,ethics and legal concerns,and the incomprehensibility of the output results.Therefore,doctors and researchers should cooperate to address the current challenges and carry out further investigations to develop more accurate AI tools for improved clinical applications.

COVID-19:Effect on gastroenterology and hepatology service provision and training:Lessons learnt and planning for the future

In late 2019,reports arose of a new respiratory disease in China,identified as a novel coronavirus,severe acute respiratory syndrome coronavirus 2.The World Health Organisation named the disease caused by the virus‘coronavirus disease 2019(COVID-19)’.It was declared a pandemic in early 2020,after the disease rapidly spread across the world.COVID-19 has not only resulted in substantial morbidity and mortality but also significantly impacted healthcare service provision and training across all medical specialties with gastroenterology and Hepatology services being no exception.Internationally,most,if not all‘nonurgent’services have been placed on hold during surges of infections.As a result there have been delayed diagnoses,procedures,and surgeries which will undoubtedly result in increased morbidity and mortality.Outpatient services have been converted to remote consultations where possible in many countries.Trainees have been redeployed to help care for COVID-19 patients in other settings,resulting in disruption to their training-particularly endoscopy and outpatient clinics.This has led to significant anxiety amongst trainees,and risks prolongation of training.It is of the utmost importance to develop strategies that continue to support COVID-19-related service provision,whilst also supporting existing and future gastroenterology and Hepatology services and training.Changes to healthcare provision during the pandemic have generated new and improved frameworks of service and training delivery,which can be adopted in the post-COVID-19 world,leading to enhanced patient care.

国际顶级期刊HEPATOLOGY再次发表我校乙型肝炎病毒研究最新成果

近日,重庆医科大学感染性疾病分子生物学教育部重点实验室在国际肝脏病学领域顶级期刊HEPATOLOGY(影响因子:14.079)在线发表了题为"A functional variant in UBE2L3 contributes to HBV infection and maintains cccDNA stability by inducing degradation of APOBEC3A protein"研究成果。周莉副教授、任吉华博士和博士研究生程胜桃为本篇文章的第一作者,陈娟研究员和黄爱龙教授为共同通讯作者。这是数月来,该杂志又一次发表课题组相关研究工作。

我国学者在Hepatology发表文章日趋上升——Hepatology 4月在线发表4篇来自中国大陆学者的文章

Hepatology是国际肝病学领域最权威的杂志。我国学者从未停止过向Hepatology进军的脚步,在Hepatology杂志上发表的研究成果也呈现了日趋增长的大好趋势。今年4月Hepatology在线发表的文章中,有我国学者4篇学术研究和1篇通信,内容涵盖了乙型肝炎、丙型肝炎和肝癌领域的基础和临床研究,

Comparison of evaluation indexes for Gastroenterology and Hepatology journals in different databases

BACKGROUND Accurate assessment of the quality of academic journals is of great significance.While Journal Impact Factor(JIF),calculated by Clarivate and based upon the Web of Science literature database,and CiteScore(CS),developed by Elseiver and based upon the Scopus database,have enjoyed high uptake worldwide,efforts continue towards creation of other scientometric indexes that will provide evergreater qualitative insights into journal impact.Such efforts have yielded the newly-launched Journal Article Influence Index(JAII),which is based on the Reference Citation Analysis(RCA)database,an open multidisciplinary citation analysis database based on artificial intelligence technology.AIM To evaluate and summarize the similarities and differences between JAII and JIF/CS as journal evaluation indicators,and provide an intuitive method for visual representation of the related data.METHODS We searched the Journal Citation Reports to obtain the 2021 JIF list,downloaded the CS list updated in July on the Scopus website,and collected the comprehensive list of 2022 JAIIs from the RCA database(www.referencecitationanalysis.com).RESULTS Our research results revealed that by breaking through the time limit of mainstream journalevaluation methods, the JAII is able to perform well in data reliability, establishing its benefit as acomplementary scientometric index to JIF and CS.CONCLUSIONJAII provides comprehensive assessment of the quality and performance of journals.

Baishideng’s Reference Citation Analysis database announces the first Journal Article Influence Index of 101 core journals and a list of high-quality academic journals in gastroenterology and hepatology

After three rounds of rigorous evaluation of core journals in gastroenterology andhepatology conducted by the Reference Citation Analysis (RCA) editorial team ofBaishideng Publishing Group (Baishideng), the RCA database of Baishidengofficially released the 2022 Journal Article Influence Index (2022 JAII) of 101 corejournals in gastroenterology and hepatology, for the first time. The list of 101 corejournals can be found at: https://www.referencecitationanalysis.com/Search-Journal. Among them, the highest 2022 JAII is 48.014 and the lowest is 3.900. Thisarticle highlights the top 20 journals, describes the calculation method for the 2022JAII, the evaluation process, and the inclusion principles for journals in the RCA.These steps are the underpinning of the RCA’s empirical journal academicevaluation service by which the digital platform addresses the needs of authors toselect reliable journals for submission, readers to select high-quality literature forreading, and editors to track their own journal citation performance. As such, theRCA core journal list will serve as a useful Find-a-Journal tool. Any interestedparty is welcome to use this journal list and recommend it to their peers.

COVID-19 in gastroenterology and hepatology:Lessons learned and questions to be answered

BACKGROUND Although coronavirus disease 2019(COVID-19)presents primarily as a lower respiratory tract infection,increasing data suggests multiorgan,including the gastrointestinal(GI)tract and liver,involvement in patients who are infected by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).AIM To provide a comprehensive overview of COVID-19 in gastroenterology and hepatology.METHODS Relevant studies on COVID-19 related to the study aim were undertaken through a literature search to synthesize the extracted data.RESULTS We found that digestive symptoms and liver injury are not uncommon in patients with COVID-19 and varies in different individuals.The most common GI symptoms reported are diarrhea,nausea,vomiting,and abdominal discomfort.Other atypical GI symptoms,such as loss of smell and taste and GI bleeding,have also been reported along with the evolvement of COVID-19.Liver chemistry abnormalities mainly include elevation of aspartate transferase,alanine transferase,and total bilirubin.It is postulated to be related to the binding of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)virus to the angiotensin converting enzyme-2 receptor located on several different human cells.CONCLUSION Standardized criteria should be established for diagnosis and grading of the severity of GI symptoms in COVID-19 patients.Gastroenterology and hepatology in special populations,such as children and elderly,should be the focus of further research.Future long-term data regarding GI symptoms should not be overlooked.

Meeting report of the editorial board meeting for World Journal of Hepatology 2019

The first editorial board meeting of the World Journal of Hepatology(WJH)was held on November 8,2019 at the Side Bar Grille,Sheraton Boston Hotel,Boston,MA,United States.Ruo-Yu Ma,Director of Editorial Office,on behalf of the Baishideng Publishing Group(BPG),organized the meeting with the great help of Professor Ke-Qin Hu,Journal Editor-in-Chief.There were six editorial board members,including two Editors-in-Chief and one administrative director of the editorial office at the meeting,discussing future strategies of the journal’s development.The editorial board provided BPG a number of suggestions in regard to the business plan and quality control of the WJH.Regarding the business aspect,the editorial board suggested that BPG should advertise the WJH at the international Hepatology and Gastroenterology conferences and promote the WJH via social media.On the scientific aspect,the editorial board suggested that the assessment systems for managing the reviewers and the editorial board members are necessary,and that the BPG should make efforts to attract more high-quality manuscript submissions.An additional comment was to continue to foster a scientific culture for the journal.In conclusion,it was noted that these new ideas expressed during the meeting will bring the WJH to the next level.In the future,the BPG and the editorial board will increase communication and collaboration in order to further the development of the WJH.

New Year’s greeting and overview of World Journal of Hepatology in 2021

The World Journal of Hepatology(WJH)was launched in October 2009.It mainly publishes articles reporting research findings in the field of hepatology,covering a wide range of topics,including viral hepatitis B and C,non-alcoholic fatty liver disease,alcoholic liver disease,autoimmune and chronic cholestatic liver disease,drug-induced liver injury,cirrhosis,liver failure,hepatocellular carcinoma,coronavirus disease 2019-related liver conditions,etc.As of December 31,2020,the WJH has published 1349 articles,among which,the total cites is 18995 and the average cites per article is 14.In celebrating the New Year,we are pleased to share with you special a New Year’s greeting from the WJH Editors-in-Chief,along with a detailed overview of the journal’s submission,peer review and publishing metrics from 2020.In all,we are appreciative for the substantive support and submissions from authors worldwide,and the dedicated efforts and expertise provided by our invited reviewers and editorial board members.

Saving time and effort:Best practice for adapting existing patientreported outcome measures in hepatology

It is increasingly recognised that collecting patient reported outcome measures(PROMs)data is an important part of healthcare and should be considered alongside traditional clinical assessments.As part of a more holistic view of healthcare provision,there has been an increased drive to implement PROM collection as part of routine clinical care in hepatology.This drive has resulted in an increase in the number of PROMs currently developed to be used in various liver conditions.However,the development and validation of a new PROM is time-consuming and costly.Therefore,before deciding to develop a new PROM,researchers should consider identifying existing PROMs to assess their appropriateness and,if necessary,make adaptations to existing PROMs to ensure their rigour when used with the target population.Little is written in the literature on how to identify and adapt the existing PROMs in hepatology.This article aims to provide a summary of the current literature and guidance regarding identifying and adapting existing PROMs in clinical practice.

Acknowledgments to reviewers of World Journal of Hepatology

Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Hepatology. The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles (including those published in this issue and those rejected for this issue) during the last editing time period.

Acknowledgments to reviewers of World Journal of Hepatology

Many reviewers have contributed their expertise and time to the peer review,a critical process to ensure the quality of World Journal of Hepatology. The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles (including those published in this issue and those rejected for this issue) during the last editing time period.

Acknowledgments to reviewers of World Journal of Hepatology

Many reviewers have contributed their expertise and time to the peer review,a critical process to ensure the quality of World Journal of Hepatology.The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles (including those published in this issue and those rejected for this issue) during the last editing time period.

Hepatology:美国HBV感染者死亡原因分析

HBV是一种严重的全球性感染性疾病,可以导致肝硬化,肿瘤及肝功能失代偿,严重的会导致死亡。虽然全球某些有关于对HBV患者生存的长期报道（台湾,意大利）,但是其他地区的生存统计仍空缺。

European Specialty Examination in Gastroenterology and Hepatology examination-improving education in gastroenterology and hepatology

The Federation of Royal Colleges,the British Society of Gastroenterology(BSG)and the European Section and Board of Gastroenterology and Hepatology developed the European Specialty Examination in Gastroenterology and Hepatology(ESEGH)from the United Kingdom Specialty Certificate Examination,which was the original examination.Since 2018 the Specialty Certificate Examination and the ESEGH were combined into a single exam,identical across Europe and the rest of the world.The ESEGH is mandated in 4 countries(United Kingdom,Switzerland,The Netherlands and Malta)and the number of entries increased from 50 in 2014 to 490 in 2019.Candidates from countries were the ESEGH is not mandated are sitting the Exam,showing us they realize the enormous interest of holding a certificate for knowledge in their Curriculum.We also have an increasing number of candidates from countries outside Europe.

Meeting report of the editorial board meeting for World Journal of Hepatology 2021

The 2021 online editorial board meeting of the World Journal of Hepatology(WJH)was held on January 16,2021.Xiang Li,Director of Production Office on behalf of the Baishideng Publishing Group,organized the meeting.Three Editors-in-Chiefs(EiCs)and 15 Baishideng Publishing Group staff attended the meeting.The meeting goal was to brief EiCs on journal performance and gather ideas for journal development in 2021.In 2020,WJH published 204 articles,a 20%increase compared to 2019,authors were from 32 countries and regions,and the average citation per article was three times.However,attracting high quality original article submissions remains a challenge.The EiCs provided feedback and suggestions centered on four topics:(1)Improve journal quality by building editorial;(2)Improve board engagement by establishing a clear policy and consistent internal communications;(3)Improve peer review quality and efficiency;and(4)Refine the current journal marketing strategy to increase visibility and discoverability.

Endo-hepatology:An emerging field

Gastroenterologists have long been spearheading the care of patients with various forms of liver disease.The diagnosis and management of liver disease has traditionally been a combination of clinical,laboratory,and imaging findings coupled with percutaneous and intravascular procedures with endoscopy largely limited to screening for and therapy of esophageal and gastric varices.As the applications of diagnostic and therapeutic endoscopic ultrasound(EUS)have evolved,it has found a particular niche within hepatology now coined.Here we discuss several EUS-guided procedures such as liver biopsy,shear wave elastography,direct portal pressure measurement,paracentesis,as well as EUSguided therapies for variceal hemorrhage.