(b) "In 2017, Matthew Williams [of San Francisco had severe abdominal pain and vomited] * * * a CT scan revealed cecal volvulus—a medical emergency in which part of the intestine twists in on itself * * * Within seconds, the AI pointed to three potential triggers for his
symptoms: fatty foods, fermentable fibres, and foods high in oxalate. * * * Clinicopathological conferences [(CPCs) 临床病理讨论会] * * * Then came large language models. Last year, Arjun Manrai, a computer scientist at Harvard, and Thomas Buckley [his persona website AND LinkedIn account states: 'I am a PhD student in the inaugural AI in Medicine Program, in the Department of Biomedical Informatics at Harvard Medical School, advised by Prof Arjun Manrai'], a doctoral student in the university's new AI in Medicine program, started work on an education-and-research tool that was supposed to be capable of solving virtually any CPC. It needed to be able to cite the literature [without citation, nobody knows whether it says is true or false], explain its rationale, and help doctors think through a difficult case. Manrai and Buckley developed a custom version of o3, an advanced 'reasoning model' from OpenAI * * * They named the AI CaBot, in honor of the inventor [Richard Cabot] of CPCs. In July,I travelled to Harvard's Countway Library of Medicine to witness a face-off between CaBot and an expert diagnostician. * * * Daniel Restrepo, an internist at Massachusetts General Hospital [MD, University of South Florida College of Medicine; certified by American Board of Internal Medicine; assistant professor of Harvard Med School] * * * [Restrepo] showing the audience four key symptoms on a Venn diagram. * * * The man's symptoms had arisen too rapidly for lymphoma.'Tempo, tempo, tempo pdefined in Note (b)(i)(A)]!' * * * A slide, generated by the A.I., appeared on the screen.It was titled 'When Ankles, Nodes, and Syncope [borrowed from Latin noun of the same spelling which descended from Ancient Greek noun feminine that is romanized as sunkopḗ, syncope is just a medical term for 'fainting'] Collide.' * * * 'The joints are the star of the show,' it said.It highlighted small nodules that lined some lymphatic vessels [normally lymphatic vessels are invisible; in this patient, though, they (vessels) were distended, hinting lymph flow (back to heart eventually was obstructed, likely by enlarged and inflamed lymph nodes at the hilum] in the man's lungs, as seen in the CT scan. 'Note how they track along the fissures,' CaBot observed. * * * It [CaBot] noted that the patient had high levels of C-reactive protein, a biomarker of inflammation * * * 'Putting it together,' CaBot said,'the single best fit is acute sarcoidosis, manifesting as Löfgren syndrome.' * * * CaBot had occasionally hit a wrong note—for instance, pronouncing 'hilar' as 'hee-lar' instead of 'high-lur' [which is understandable, as AI absorbs large amount of information by reading, not by listening] * * * After CaBot's presentation, one of Manrai’s collaborators, a doctor at Beth Israel Deaconess Medical Center named Adam Rodman [LinkedIn: BA in history and economics from University of North Carolina at Chapel Hill 2003-2007; Certificate in Chinese Language from Beijing Institute of Education 北京教育学院 2005; both MD and MPH from Tulane University, 2009 - 2013; residency in internal medicine in Oregon Health & Science University (OHSU) 2013-2015; certified by American Board of Internal Medicine], got up to share a few remarks. Rodman leads Harvard's efforts to integrate generative AI into its medical-school curriculum. He noted that both Restrepo and CaBot had used a process called differential diagnosis, which begins by considering all potential explanations [in practice, only a few diseases are considered] and then systematically rules out those which don't fit [eg, by ordering clinical tests]."
(i) cecal volvulus
(A) English dictionary:
* volvulus (noun; borrowed from Latin adjective masculine of the same spelling, meaning "tending to roll," from verb volvere to roll + suffix -ulus tending to)
https://en.wiktionary.org/wiki/volvulus
* tempo (n; borrowed from Italian [noun masculine of the same spelling], "time, rate of speed (in music)," going back to Latin [noun neuter] tempus "time")
https://www.merriam-webster.com/dictionary/tempo
(B) Search images.google.com with this word and you will comprehend. Cause of volvulus is unknown. It is a medical emergency and requires surgery, because blood supply to the twisted stomach or intestine is cut-off, the twisted organ may die, and bacteria inside may spill into peritoneal cavity.
(C) peritoneum 腹膜
https://en.wikipedia.org/wiki/Peritoneum
(section 1 Structure, section 1.3 Classification of abdominal structuresL The table lists cecum and transverse colon as "intraperitoneal" (thus subject to volvulus), and both ascending and descending colon, "retroperitoneal."
The top illustration was by Sheridan Delépine
https://en.wikipedia.org/wiki/Sheridan_Delépine
showing where presence or absence of peritoneum in the back of abdominal cavity. Pay attention to where ascending or descending colon would be: these two are covered on three sides (except the backside) by peritoneum. (Delépine is a French surname.)
(D) The oxalate is salt of
oxalic acid
https://en.wikipedia.org/wiki/Oxalic_acid
("Its name is derived from early investigators who isolated oxalic acid from flowering plants of the genus Oxalis, commonly known as wood-sorrels")
(ii) Arjun (Raj) Manrai, PhD. Assistant Professor of (Department of) Biomedical Informatics (DBMI), Harvard Medical School.
https://dbmi.hms.harvard.edu/people/arjun-raj-manrai
("Raj earned an AB in Physics from Harvard College followed by a PhD in Bioinformatics and Integrative Genomics from the Harvard-MIT Division of Health Sciences and Technology (HST)" )
(iii) Venn diagram
https://en.wikipedia.org/wiki/Venn_diagram
(iv) C-reactive protein
https://en.wikipedia.org/wiki/C-reactive_protein
(v) hilum
https://en.wikipedia.org/wiki/Hilum
(may refer to "hilum (anatomy), a part of an organ where structures such as blood vessels and nerves enter the body")
Latin noun neuter hilum meant "trifle."
https://en.wiktionary.org/wiki/hilum
(vi) The following is you and I need to know about sarcoidosis.
(A) The disease sarcoidosis is rare, whose etiology (plain English: cause) is known.
(B) sarcoidosis
https://en.wikipedia.org/wiki/Sarcoidosis
("is a non-infectious granulomatous disease involving abnormal collections of inflammatory cells that form lumps known as granulomata.[2] * * * Diagnosis of sarcoidosis is a matter of exclusion [meaning excluding other diseases which have specific tests and the last man standing is sarcoidosis], as there is no specific test")
(C) Ancient Greek-English dictionary:
* σάρξ (noun feminine; romanization sárx): "flesh"
https://en.wiktionary.org/wiki/σάρξ
(D) "Sarcoidosis is a rare condition * * * There is currently no cure but symptoms can usually be managed with medicine." United Kingdom: National Health Service (NHS)
(vii) Löfgren syndrome
https://en.wikipedia.org/wiki/Löfgren_syndrome
("It was described in 1953[3] by Sven Halvar Löfgren, a Swedish clinician.[4]")
|
发表于 
收藏
分享
支持
反对
楼主