Artificial intelligence in sleep medicine:Present and future

Artificial intelligence(AI)has impacted many areas of healthcare.AI in healthcare uses machine learning,deep learning,and natural language processing to analyze copious amounts of healthcare data and yield valuable outcomes.In the sleep medicine field,a large amount of physiological data is gathered compared to other branches of medicine.This field is primed for innovations with the help of AI.A good quality of sleep is crucial for optimal health.About one billion people are estimated to have obstructive sleep apnea worldwide,but it is difficult to diagnose and treat all the people with limited resources.Sleep apnea is one of the major contributors to poor health.Most of the sleep apnea patients remain undiagnosed.Those diagnosed with sleep apnea have difficulty getting it optimally treated due to several factors,and AI can help in this situation.AI can also help in the diagnosis and management of other sleep disorders such as insomnia,hypersomnia,parasomnia,narcolepsy,shift work sleep disorders,periodic leg movement disorders,etc.In this manuscript,we aim to address three critical issues about the use of AI in sleep medicine:(1)How can AI help in diagnosing and treating sleep disorders?(2)How can AI fill the gap in the care of sleep disorders?and(3)What are the ethical and legal considerations of using AI in sleep medicine?

Syntheses and Anti-lung Cancer Effects of Two Novel Dy(Ⅲ)Complexes Based on 1,3,5-Benzenetricarbocylic Acid and 1,3,5-Benzenetrisbenzoic Acid,respectively

The reactions of 1,3,5-benzenetricarbocylic acid（H3BTC） and 1,3,5-benzenetrisbenzoic acid（H3BTB） with Dy（NO3）3·6H2O afford two novel Dy（III） coordination polymers respectively, Dy（BTC）（H2O）DMF（1） and [Dy（BTB）（Et OH）]（DMF）（2）（DMF = N,N-dimethylformamide）. 1 shows a 3D framework composed of available Lewis-acid metal sites which are occupied by the coordinated water molecules, and 2 features a noninterpenetrated open 3D framework with a 5-connected bnn hexagonal topology possessing the point symbol（46.64）. In addition, in vitro antitumor activities of compounds 1 and 2 on three human lung cancer cells（H1975, HCC827 and A549） were further determined.

Allergic bronchopulmonary aspergillosis with marked peripheral blood eosinophilia and pulmonary eosinophilia:A case report

BACKGROUND Allergic bronchopulmonary aspergillosis(ABPA)is an immune-related pulmonary disease caused by sensitization of airway by Aspergillus fumigatus.The disease manifests as bronchial asthma and recurring pulmonary shadows,which may be associated with bronchiectasis.The diagnosis of ABPA mainly depends on serological,immunological,and imaging findings.Pathological examination is not necessary but may be required in atypical cases to exclude pulmonary tuberculosis,tumor,and other diseases through lung biopsy.CASE SUMMARY An 18-year-old man presented with recurrent wheezing,cough,and peripheral blood eosinophilia.Chest computed tomography showed pulmonary infiltration.There was a significant increase in eosinophils in bronchoalveolar lavage fluid.There was no history of residing in a parasite-endemic area or any evidence of parasitic infection.Pathologic examination of bronchoalveolar lavage fluid excluded fungal and mycobacterial infections.The patient was receiving medication for comorbid diseases,but there was no temporal correlation between medication use and clinical manifestations,which excluded drug-induced etiology.Histopathological examination of lung biopsy specimen showed no signs of eosinophilic granulomatosis with polyangiitis,IgG4-related diseases,or tumors.The diagnosis of ABPA was considered based on the history of asthma and the significant increase in serum Aspergillus fumigatus-specific immunoglobulin(Ig)E.Eosinophil-related diseases were excluded through pathological biopsy,which showed typical pathological manifestations of ABPA.CONCLUSION The possibility of ABPA should be considered in patients with poorly controlled asthma,especially those with eosinophilia,lung infiltration shadows,or bronchiectasis.Screening for serum IgE,Aspergillus fumigatus-specific IgE and IgG,and alveolar lavage can help avoid misdiagnosis.

Endothelial PDGF-BB/PDGFR-βsignaling promotes osteoarthritis by enhancing angiogenesis-dependent abnormal subchondral bone formation

The mechanisms that coordinate the shift from joint homeostasis to osteoarthritis(OA)remain unknown.No pharmacological intervention can currently prevent the progression of osteoarthritis.Accumulating evidence has shown that subchondral bone deterioration is a primary trigger for overlying cartilage degeneration.We previously found that H-type vessels modulate aberrant subchondral bone formation during the pathogenesis of OA.However,the mechanism responsible for the elevation of H-type vessels in OA is still unclear.Here,we found that PDGFR-βexpression,predominantly in the CD31^(hi)Emcn^(hi) endothelium,was substantially elevated in subchondral bones from OA patients and rodent OA models.A mouse model of OA with deletion of PDGFR-βin endothelial cells(ECs)exhibited fewer H-type vessels,ameliorated subchondral bone deterioration and alleviated overlying cartilage degeneration.Endothelial PDGFR-βpromotes angiogenesis through the formation of the PDGFR-β/talin1/FAK complex.Notably,endothelium-specific inhibition of PDGFR-βby local injection of AAV9 in subchondral bone effectively attenuated the pathogenesis of OA compared with that of the vehicle-treated controls.Based on the results from this study,targeting PDGFR-βis a novel and promising approach for the prevention or early treatment of OA.

Acute myocardial infarction in twin pregnancy after assisted reproduction:A case report

BACKGROUND Acute myocardial infarction(AMI)during pregnancy is rare,especially in twin pregnancy,and it can endanger the lives of the mother and children.Except for conventional cardiovascular risk factors,pregnancy and assisted reproduction can increase the risk of AMI during pregnancy.AMI develops secondary to different etiologies,such as coronary spasm and spontaneous coronary artery dissection.CASE SUMMARY A 33-year-old woman,with twin pregnancy in the 31st week of gestation,presented to the hospital with intermittent chest tightness for 12 wk,aggravation for 1 wk,and chest pain for 4 h.Combined with the electrocardiogram and hypersensitive troponin results,she was diagnosed with acute ST-elevation myocardial infarction.Although the patient had no related medical history,she presented several risk factors,such as age greater than 30 years,assisted reproduction,and hyperlipidemia.After diagnosis,the patient received antiplatelet and anticoagulant treatment.Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery.After receiving medication,the patient was in good condition.CONCLUSION This case suggests that,with the widespread use of assisted reproductive technology,more attention should be paid to perinatal healthcare,especially when chest pain occurs,to facilitate early diagnosis and intervention of AMI,and the etiology of AMI in pregnancy needs to be differentiated,especially between coronary spasm and spontaneous coronary artery dissection.

An infrequent cause of neonatal upper airway obstruction:Congenital nasal pyriform aperture stenosis presenting to a remote facility

Introduction:Congenital nasal pyriform aperture stenosis(CNPAS)is a rare congenital condition of structural nasal obstruction.Respiratory distress,stertor,and poor feeding are often presenting features.Case Presentation:We report a case of a newborn diagnosed with CNPAS at 3 weeks of life.The diagnosis was missed on a nasoendoscopy at day 3 of life but was realised following a facial CT when the infant presented with ongoing symptoms of upper airway obstruction.Nasal dilation was performed successfully.Conclusion:CNPAS should be considered in any neonate with upper airway obstruction.A normal nasoendoscopy does not exclude the diagnosis.

Non-invasive home ventilation using the average volume assured pressure support feature in an infant with severe bronchopulmonary dysplasia and chronic respiratory failure

Introduction:While majority of infants with bronchopulmonary dysplasia(BPD)can be discharged home without low flow oxygen or on supplemental low flow oxygen,some require long term home mechanical ventilation.Case presentation:We present a case of an extremely premature infant with severe bronchopulmonary dysplasia who was successfully managed at home on a new feature of non-invasive ventilation called average volume assured pressure support(AVAPS)without the need for tracheostomy.The AVAPS feature enables the machine to deliver a consistent tidal volume by automatically adjusting the inspiratory pressure within a set range.Conclusion:The use of AVAPS feature in our case improved ventilation as indicated by a more stable gas exchange profile,making home non-invasive ventilation a more practicable method of managing severe BPD in this infant.