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Article ; Online: Ventilator Weaning and Extubation.

Burns, Karen E A / Rochwerg, Bram / Seely, Andrew J E

2024 Volume 40, Issue 2, Page(s) 391–408

Abstract: Increasing evidence supports specific approaches to liberate patients from invasive ventilation including the use of liberation protocols, inspiratory assistance during spontaneous breathing trials (SBTs), early extubation of patients with chronic ... ...

Abstract	Increasing evidence supports specific approaches to liberate patients from invasive ventilation including the use of liberation protocols, inspiratory assistance during spontaneous breathing trials (SBTs), early extubation of patients with chronic obstructive pulmonary disease to noninvasive ventilation, and prophylactic use of noninvasive support strategies after extubation. Additional research is needed to elucidate the best criteria to identify patients who are ready to undergo an SBT and to inform optimal screening frequency, the best SBT technique and duration, extubation assessments, and extubation decision-making. Additional clarity is also needed regarding the optimal timing to measure and report extubation success.
MeSH term(s)	Humans ; Ventilator Weaning ; Airway Extubation ; Noninvasive Ventilation ; Pulmonary Disease, Chronic Obstructive/therapy
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1006423-0
ISSN	1557-8232 ; 0749-0704
ISSN (online)	1557-8232
ISSN	0749-0704
DOI	10.1016/j.ccc.2024.01.007
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Article ; Online: Guiding principles and proposed classification system for the responsible adoption of artificial intelligence in scientific writing in medicine.

Hryciw, Brett N / Seely, Andrew J E / Kyeremanteng, Kwadwo

Frontiers in artificial intelligence

2023 Volume 6, Page(s) 1283353

Abstract: The integration of large language models (LLMs) and artificial intelligence (AI) into scientific writing, especially in medical literature, presents both unprecedented opportunities and inherent challenges. This manuscript evaluates the transformative ... ...

Abstract	The integration of large language models (LLMs) and artificial intelligence (AI) into scientific writing, especially in medical literature, presents both unprecedented opportunities and inherent challenges. This manuscript evaluates the transformative potential of LLMs for the synthesis of information, linguistic enhancements, and global knowledge dissemination. At the same time, it raises concerns about unintentional plagiarism, the risk of misinformation, data biases, and an over-reliance on AI. To address these, we propose governing principles for AI adoption that ensure integrity, transparency, validity, and accountability. Additionally, guidelines for reporting AI involvement in manuscript development are delineated, and a classification system to specify the level of AI assistance is introduced. This approach uniquely addresses the challenges of AI in scientific writing, emphasizing transparency in authorship, qualification of AI involvement, and ethical considerations. Concerns regarding access equity, potential biases in AI-generated content, authorship dynamics, and accountability are also explored, emphasizing the human author's continued responsibility. Recommendations are made for fostering collaboration between AI developers, researchers, and journal editors and for emphasizing the importance of AI's responsible use in academic writing. Regular evaluations of AI's impact on the quality and biases of medical manuscripts are also advocated. As we navigate the expanding realm of AI in scientific discourse, it is crucial to maintain the human element of creativity, ethics, and oversight, ensuring that the integrity of scientific literature remains uncompromised.
Language	English
Publishing date	2023-11-16
Publishing country	Switzerland
Document type	Journal Article
ISSN	2624-8212
ISSN (online)	2624-8212
DOI	10.3389/frai.2023.1283353
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Optimizing Our Patients' Entropy Production as Therapy? Hypotheses Originating from the Physics of Physiology.

Seely, Andrew J E

Entropy (Basel, Switzerland)

2020 Volume 22, Issue 10

Abstract: ... responsible for the spontaneous formation of fractal structures in space (e.g., multi-scale self-similar tree ... like vascular structures that optimize delivery to and clearance from an organ system) and time (e.g ...

Abstract	Understanding how nature drives entropy production offers novel insights regarding patient care. Whilst energy is always preserved and energy gradients irreversibly dissipate (thus producing entropy), increasing evidence suggests that they do so in the most optimal means possible. For living complex non-equilibrium systems to create a healthy internal emergent order, they must continuously produce entropy over time. The Maximum Entropy Production Principle (MEPP) highlights nature's drive for non-equilibrium systems to augment their entropy production if possible. This physical drive is hypothesized to be responsible for the spontaneous formation of fractal structures in space (e.g., multi-scale self-similar tree-like vascular structures that optimize delivery to and clearance from an organ system) and time (e.g., complex heart and respiratory rate variability); both are ubiquitous and essential for physiology and health. Second, human entropy production, measured by heat production divided by temperature, is hypothesized to relate to both metabolism and consciousness, dissipating oxidative energy gradients and reducing information into meaning and memory, respectively. Third, both MEPP and natural selection are hypothesized to drive enhanced functioning and adaptability, selecting states with robust basilar entropy production, as well as the capacity to enhance entropy production in response to exercise, heat stress, and illness. Finally, a targeted focus on optimizing our patients' entropy production has the potential to improve health and clinical outcomes. With the implications of developing a novel understanding of health, illness, and treatment strategies, further exploration of this uncharted ground will offer value.
Language	English
Publishing date	2020-09-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2014734-X
ISSN	1099-4300 ; 1099-4300
ISSN (online)	1099-4300
ISSN	1099-4300
DOI	10.3390/e22101095
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Glycemic Variability As a Prognostic Factor for Mortality in Patients With Critical Illness: A Systematic Review and Meta-Analysis.

Hryciw, Brett N / Ghossein, Jamie / Rochwerg, Bram / Meggison, Hilary / Fernando, Shannon M / Kyeremanteng, Kwadwo / Tran, Alexandre / Seely, Andrew J E

Critical care explorations

2024 Volume 6, Issue 1, Page(s) e1025

Abstract: Objectives: To perform a systematic review and meta-analysis to evaluate the association of various measures of glycemic variability, including time-domain and complexity-domain, with short-term mortality in patients with critical illness.: Data ... ...

Abstract	Objectives: To perform a systematic review and meta-analysis to evaluate the association of various measures of glycemic variability, including time-domain and complexity-domain, with short-term mortality in patients with critical illness. Data sources: We searched Embase Classic +, MEDLINE, and the Cochrane Database of Systematic Reviews from inception to November 3, 2023. Study selection: We included English language studies that assessed metrics of glycemic variation or complexity and short-term mortality in patients admitted to the ICU. Data extraction: Two authors performed independent data abstraction and risk-of-bias assessments. We used a random-effects model to pool binary and continuous data and summarized estimates of effect using odds ratios and mean difference. We used the Quality in Prognosis Studies tool to assess risk of bias and the Grading of Recommendations, Assessment, Development and Evaluations to assess certainty of pooled estimates. Data synthesis: We included 41 studies ( Conclusions: We found a consistent association between increased measures of glycemic variability and higher short-term mortality in patient with critical illness. Further research should focus on standardized measurements of glycemic variation and complexity, along with their utility as therapeutic targets and prognostic markers.
Language	English
Publishing date	2024-01-11
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2639-8028
ISSN (online)	2639-8028
DOI	10.1097/CCE.0000000000001025
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Continuous Monitoring of Entropy Production and Entropy Flow in Humans Exercising under Heat Stress.

Brodeur, Nicolas / Notley, Sean R / Kenny, Glen P / Longtin, André / Seely, Andrew J E

Entropy (Basel, Switzerland)

2023 Volume 25, Issue 9

Abstract: Complex living systems, such as the human organism, are characterized by their self-organized and dissipative behaviors, where irreversible processes continuously produce entropy internally and export it to the environment; however, a means by which to ... ...

Abstract	Complex living systems, such as the human organism, are characterized by their self-organized and dissipative behaviors, where irreversible processes continuously produce entropy internally and export it to the environment; however, a means by which to measure human entropy production and entropy flow over time is not well-studied. In this article, we leverage prior experimental data to introduce an experimental approach for the continuous measurement of external entropy flow (released to the environment) and internal entropy production (within the body), using direct and indirect calorimetry, respectively, for humans exercising under heat stress. Direct calorimetry, performed with a whole-body modified Snellen calorimeter, was used to measure the external heat dissipation from the change in temperature and relative humidity between the air outflow and inflow, from which was derived the rates of entropy flow of the body. Indirect calorimetry, which measures oxygen consumption and carbon dioxide production from inspired and expired gases, was used to monitor internal entropy production. A two-compartment entropy flow model was used to calculate the rates of internal entropy production and external entropy flow for 11 middle-aged men during a schedule of alternating exercise and resting bouts at a fixed metabolic heat production rate. We measured a resting internal entropy production rate of (0.18 ± 0.01) W/(K·m
Language	English
Publishing date	2023-09-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2014734-X
ISSN	1099-4300 ; 1099-4300
ISSN (online)	1099-4300
ISSN	1099-4300
DOI	10.3390/e25091290
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Article ; Online: Prediction Is Difficult, Especially About Future Unexpected Deterioration.

Seely, Andrew J E

Critical care medicine

2016 Volume 44, Issue 9, Page(s) 1781–1783

Language	English
Publishing date	2016
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000001800
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Barriers and Facilitators to the Implementation and Adoption of a Continuous Quality Improvement Program in Surgery: A Case Study.

ElChamaa, Rima / Seely, Andrew J E / Jeong, Dahn / Kitto, Simon

The Journal of continuing education in the health professions

2022 Volume 42, Issue 4, Page(s) 227–235

Abstract: Introduction: As postoperative adverse events (AEs) drive worsened patient experience, longer length of stay, and increased costs of care, surgeons have long sought to engage in innovative approaches aimed at reducing AEs to improve the quality and ... ...

Abstract	Introduction: As postoperative adverse events (AEs) drive worsened patient experience, longer length of stay, and increased costs of care, surgeons have long sought to engage in innovative approaches aimed at reducing AEs to improve the quality and safety of surgical care. While data-driven AE performance measurement and feedback (PMF) as a form of continuing professional development (CPD) has been presented as a possible approach to continuous quality improvement (CQI), little is known about the barriers and facilitators that influence surgeons' engagement and uptake of these CPD programs. The purpose of this knowledge translation informed CPD study was to examine surgeons' perspectives of the challenges and facilitators to participating in surgical CQI with the broader objective of enhancing future improvements of such CPD interventions. Methods: Using Everett Rogers diffusion of innovations framework as a sampling frame, the participants were recruited across five surgical divisions. An exploratory case study approach, including in-depth semistructured interviews, was employed. Interview transcripts were analyzed and directly coded using the Theoretical Domains Framework. Results: Directed coding yielded a total of 527 coded barriers and facilitators to behavior change pertaining to the implementation and adoption of PMF with the majority of barriers and facilitators coded in four key theoretical domains environmental context and resources, social influences, knowledge, and beliefs about consequences. A key barrier was the lack of support from the hospital necessitating surgeons' self-funding their own PMF programs. Facilitators included having a champion to drive CQI and using seminars to facilitate discussions around CQI principles and practices. Discussion: This study identified multiple barriers and facilitators to surgeons' engagement and uptake of a data-driven PMF system in surgery. A key finding of the study was the identification of the influential role of positive deviance seminars as a quality improvement and patient safety mechanism that encourages surgeon engagement in PMF systems.
MeSH term(s)	Humans ; Quality Improvement ; Surveys and Questionnaires
Language	English
Publishing date	2022-10-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	639445-0
ISSN	1554-558X ; 0894-1912
ISSN (online)	1554-558X
ISSN	0894-1912
DOI	10.1097/CEH.0000000000000461
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Article ; Online: Harmonization of adverse events monitoring following thoracic surgery: Pursuit of a common language and methodology.

Sigler, Gregory / Anstee, Caitlin / Seely, Andrew J E

JTCVS open

2021 Volume 6, Page(s) 250–256

Abstract: Objective: Thoracic surgery carries significant risk of postoperative adverse events (AEs). Multiple international recording systems are used to define and collect AEs following thoracic surgery procedures. We hypothesized that a simple-yet-ubiquitous ... ...

Abstract	Objective: Thoracic surgery carries significant risk of postoperative adverse events (AEs). Multiple international recording systems are used to define and collect AEs following thoracic surgery procedures. We hypothesized that a simple-yet-ubiquitous approach to AE documentation could be developed to allow universal data entry into separate international databases. Methods: AE definitions of the Canadian Association of Thoracic Surgeons (CATS) system and 4 international databases were matched and compared. This consisted of reviewing the definition of each AE as described by their respective database and assessing compatibility with the CATS system. We developed a single set of 4 drop-down menus to enable clear classification and facilitated data entry, using 3 single-select mandatory lists and 1 multiselect optional list classifying type and severity of these events. Results: The CATS data elements were harmonized (ie, perfect or good) with 100% (European Society of Thoracic Surgeons), 89% (Society of Thoracic Surgeons), 74% (Esophagectomy Complications Consensus Group), and 73% (National Surgical Quality Improvement Program) of respective data elements. The addition of 17 AEs and 2 complication modifiers to the CATS system was implemented to achieve complete harmonization. Consequently, 100% of AE data elements currently included in all 4 international databases are perfectly or well-harmonized with the revised 4-choice drop down menu. Conclusions: We describe a framework for a ubiquitously applicable approach to AE monitoring following thoracic surgery harmonized with AE definitions of all major thoracic international associations. Use of this AE collection framework allows for comprehensive evaluation of both the incidence and severity of all AEs after thoracic surgery along with quality indicators.
Language	English
Publishing date	2021-04-02
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-2736
ISSN (online)	2666-2736
DOI	10.1016/j.xjon.2021.03.021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Optimizing Our Patients’ Entropy Production as Therapy? Hypotheses Originating from the Physics of Physiology

Andrew J. E. Seely

Entropy, Vol 22, Iss 1095, p

2020 Volume 1095

Abstract	Understanding how nature drives entropy production offers novel insights regarding patient care. Whilst energy is always preserved and energy gradients irreversibly dissipate (thus producing entropy), increasing evidence suggests that they do so in the most optimal means possible. For living complex non-equilibrium systems to create a healthy internal emergent order, they must continuously produce entropy over time. The Maximum Entropy Production Principle (MEPP) highlights nature’s drive for non-equilibrium systems to augment their entropy production if possible. This physical drive is hypothesized to be responsible for the spontaneous formation of fractal structures in space (e.g., multi-scale self-similar tree-like vascular structures that optimize delivery to and clearance from an organ system) and time (e.g., complex heart and respiratory rate variability); both are ubiquitous and essential for physiology and health. Second, human entropy production, measured by heat production divided by temperature, is hypothesized to relate to both metabolism and consciousness, dissipating oxidative energy gradients and reducing information into meaning and memory, respectively. Third, both MEPP and natural selection are hypothesized to drive enhanced functioning and adaptability, selecting states with robust basilar entropy production, as well as the capacity to enhance entropy production in response to exercise, heat stress, and illness. Finally, a targeted focus on optimizing our patients’ entropy production has the potential to improve health and clinical outcomes. With the implications of developing a novel understanding of health, illness, and treatment strategies, further exploration of this uncharted ground will offer value.
Keywords	maximum entropy production principle ; fractal structures ; complex non-equilibrium systems ; monitoring of scale-invariant variation ; thermodynamics ; Science ; Q ; Astrophysics ; QB460-466 ; Physics ; QC1-999
Subject code	410
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Treating Sepsis: Nearest Neighbors and Predicting Beginnings.

Seely, Andrew J E

Critical care medicine

2016 Volume 44, Issue 6, Page(s) 1261–1262

MeSH term(s)	Base Sequence ; Cluster Analysis ; Humans ; Sepsis
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000001786
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