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Article ; Online: Using chronobiology-based second-generation artificial intelligence digital system for overcoming antimicrobial drug resistance in chronic infections.

Kolben, Yotam / Azmanov, Henny / Gelman, Ram / Dror, Danna / Ilan, Yaron

2023 Volume 55, Issue 1, Page(s) 311–318

Abstract: Antimicrobial resistance results from the widespread use of antimicrobial agents and is a significant obstacle to the effectiveness of these agents. Numerous methods are used to overcome this problem with moderate success. Besides efforts of ... ...

Abstract	Antimicrobial resistance results from the widespread use of antimicrobial agents and is a significant obstacle to the effectiveness of these agents. Numerous methods are used to overcome this problem with moderate success. Besides efforts of antimicrobial stewards, several artificial intelligence (AI)-based technologies are being explored for preventing resistance development. These first-generation systems mainly focus on improving patients' adherence. Chronobiology is inherent in all biological systems. Host response to infections and pathogens activity are assumed to be affected by the circadian clock. This paper describes the problem of antimicrobial resistance and reviews some of the current AI technologies. We present the establishment of a second-generation AI chronobiology-based approach to help in preventing further resistance and possibly overcome existing resistance. An algorithm-controlled regimen that improves the long-term effectiveness of antimicrobial agents is being developed based on the implementation of variability in dosing and drug administration times. The method provides a means for ensuring a sustainable response and improved outcomes. Ongoing clinical trials determine the effectiveness of this second-generation system in chronic infections. Data from these studies are expected to shed light on a new aspect of resistance mechanisms and suggest methods for overcoming them.IMPORTANCE SECTIONThe paper presents the establishment of a second-generation AI chronobiology-based approach to help in preventing further resistance and possibly overcome existing resistance.Key messagesAntimicrobial resistance results from the widespread use of antimicrobial agents and is a significant obstacle to the effectiveness of these agents.We present the establishment of a second-generation AI chronobiology-based approach to help in preventing further resistance and possibly overcome existing resistance.
MeSH term(s)	Humans ; Artificial Intelligence ; Persistent Infection ; Anti-Infective Agents/pharmacology ; Anti-Infective Agents/therapeutic use ; Drug Resistance, Microbial
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2023-01-03
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1004226-x
ISSN	1365-2060 ; 1651-2219 ; 0785-3890 ; 1743-1387
ISSN (online)	1365-2060 ; 1651-2219
ISSN	0785-3890 ; 1743-1387
DOI	10.1080/07853890.2022.2163053
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Subject-Tailored Variability-Based Platform for Overcoming the Plateau Effect in Sports Training: A Narrative Review.

Gelman, Ram / Berg, Marc / Ilan, Yaron

International journal of environmental research and public health

2022 Volume 19, Issue 3

Abstract: The plateau effect in training is a significant obstacle for professional athletes and average subjects. It evolves from both the muscle-nerve-axis-associated performance and various cardiorespiratory parameters. Compensatory adaptation mechanisms ... ...

Abstract	The plateau effect in training is a significant obstacle for professional athletes and average subjects. It evolves from both the muscle-nerve-axis-associated performance and various cardiorespiratory parameters. Compensatory adaptation mechanisms contribute to a lack of continuous improvement with most exercise regimens. Attempts to overcome this plateau in exercise have been only partially successful, and it remains a significant unmet need in both healthy subjects and those suffering from chronic neuromuscular, cardiopulmonary, and metabolic diseases. Variability patterns characterize many biological processes, from cellular to organ levels. The present review discusses the significant obstacles in overcoming the plateau in training and establishes a platform to implement subject-tailored variability patterns to prevent and overcome this plateau in muscle and cardiorespiratory performance.
MeSH term(s)	Adaptation, Physiological/physiology ; Athletes ; Exercise/physiology ; Heart ; Humans ; Sports/physiology
Language	English
Publishing date	2022-02-02
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19031722
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Article ; Online: Using chronobiology-based second-generation artificial intelligence digital system for overcoming antimicrobial drug resistance in chronic infections

Yotam Kolben / Henny Azmanov / Ram Gelman / Danna Dror / Yaron Ilan

Annals of Medicine, Vol 55, Iss 1, Pp 311-

2023 Volume 318

Abstract: AbstractAntimicrobial resistance results from the widespread use of antimicrobial agents and is a significant obstacle to the effectiveness of these agents. Numerous methods are used to overcome this problem with moderate success. Besides efforts of ... ...

Abstract	AbstractAntimicrobial resistance results from the widespread use of antimicrobial agents and is a significant obstacle to the effectiveness of these agents. Numerous methods are used to overcome this problem with moderate success. Besides efforts of antimicrobial stewards, several artificial intelligence (AI)-based technologies are being explored for preventing resistance development. These first-generation systems mainly focus on improving patients’ adherence. Chronobiology is inherent in all biological systems. Host response to infections and pathogens activity are assumed to be affected by the circadian clock. This paper describes the problem of antimicrobial resistance and reviews some of the current AI technologies. We present the establishment of a second-generation AI chronobiology-based approach to help in preventing further resistance and possibly overcome existing resistance. An algorithm-controlled regimen that improves the long-term effectiveness of antimicrobial agents is being developed based on the implementation of variability in dosing and drug administration times. The method provides a means for ensuring a sustainable response and improved outcomes. Ongoing clinical trials determine the effectiveness of this second-generation system in chronic infections. Data from these studies are expected to shed light on a new aspect of resistance mechanisms and suggest methods for overcoming them.IMPORTANCE SECTIONThe paper presents the establishment of a second-generation AI chronobiology-based approach to help in preventing further resistance and possibly overcome existing resistance.Key messagesAntimicrobial resistance results from the widespread use of antimicrobial agents and is a significant obstacle to the effectiveness of these agents.We present the establishment of a second-generation AI chronobiology-based approach to help in preventing further resistance and possibly overcome existing resistance.
Keywords	Digital health ; drug resistance ; chronic infections ; chronobiology ; Medicine ; R
Subject code	006
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Subject-Tailored Variability-Based Platform for Overcoming the Plateau Effect in Sports Training

Ram Gelman / Marc Berg / Yaron Ilan

International Journal of Environmental Research and Public Health, Vol 19, Iss 1722, p

A Narrative Review

2022 Volume 1722

Abstract	The plateau effect in training is a significant obstacle for professional athletes and average subjects. It evolves from both the muscle-nerve-axis-associated performance and various cardiorespiratory parameters. Compensatory adaptation mechanisms contribute to a lack of continuous improvement with most exercise regimens. Attempts to overcome this plateau in exercise have been only partially successful, and it remains a significant unmet need in both healthy subjects and those suffering from chronic neuromuscular, cardiopulmonary, and metabolic diseases. Variability patterns characterize many biological processes, from cellular to organ levels. The present review discusses the significant obstacles in overcoming the plateau in training and establishes a platform to implement subject-tailored variability patterns to prevent and overcome this plateau in muscle and cardiorespiratory performance.
Keywords	training ; variability ; muscle nerve tolerance ; Medicine ; R
Subject code	796
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cold Agglutinin-Mediated Autoimmune Hemolytic Anemia in Association with Antiphospholipid Syndrome.

Gelman, Ram / Kharouf, Fadi / Ishay, Yuval / Gural, Alexander

Acta haematologica

2021 Volume 144, Issue 6, Page(s) 693–697

Abstract: Antiphospholipid syndrome and cold agglutinin-mediated autoimmune hemolytic anemia are 2 distinct immune-mediated hematologic disorders. While no clear association exists between these 2 entities, complement activation is known to occur in both of them. ... ...

Abstract	Antiphospholipid syndrome and cold agglutinin-mediated autoimmune hemolytic anemia are 2 distinct immune-mediated hematologic disorders. While no clear association exists between these 2 entities, complement activation is known to occur in both of them. Herein, we report a unique case of cold agglutinin hemolytic anemia in a patient with a known primary antiphospholipid syndrome.
MeSH term(s)	Anemia, Hemolytic, Autoimmune/diagnosis ; Anemia, Hemolytic, Autoimmune/etiology ; Anemia, Hemolytic, Autoimmune/metabolism ; Antibodies, Antiphospholipid/blood ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnosis ; Antiphospholipid Syndrome/metabolism ; Complement Activation ; Cryoglobulins/adverse effects ; Electrophoresis ; Female ; Humans ; Immunoglobulin M/adverse effects ; Immunoglobulin M/analysis ; Middle Aged
Chemical Substances	Antibodies, Antiphospholipid ; Cryoglobulins ; Immunoglobulin M ; cold agglutinins
Language	English
Publishing date	2021-05-17
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	80008-9
ISSN	1421-9662 ; 0001-5792
ISSN (online)	1421-9662
ISSN	0001-5792
DOI	10.1159/000516295
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Article ; Online: Practicing Emergency Medicine in the Metaverse: A Novel Mixed Reality Casualty Care Training Platform.

Rabotin, Alexandra / Glick, Yuval / Gelman, Ram / Ketko, Itay / Taran, Boris / Fink, Noam / Furer, Ariel

Surgical innovation

2023 Volume 30, Issue 5, Page(s) 586–594

Abstract: Background: Current casualty care training modalities present several challenges, including limited simulation facilities, instructor dependence, lack of standardization, documentation of trainees' performance and training personalization. The study ... ...

Abstract	Background: Current casualty care training modalities present several challenges, including limited simulation facilities, instructor dependence, lack of standardization, documentation of trainees' performance and training personalization. The study presents the design, development and preliminary evaluation of a novel hybrid training platform to address these challenges. Methods: A mixed reality platform was chosen and developed to address field operators' requirements. The platform is easy to operate and can be set up by laypeople within 20-min in multiple environments. Individual-level training documentation is generated autonomously following each session, evaluating 30 aspects of performance. From this, a unique aggregated dataset emerges as a substrate for executives' dashboards and intelligent planning of future sessions. Results: An evaluation process took part using simulator-based training in different stages along the project using a questionnaire (Likert-scale based). Fifty military physicians took part in an identical head injury scenario requiring airway management by endotracheal intubation and were immediately surveyed. Conclusion: TrauMR is an agile hybrid training that harbors the potential to address many of the emerging challenges of training for prehospital care in combat and civilian environments.
MeSH term(s)	Augmented Reality ; Computer Simulation ; Intubation, Intratracheal ; Simulation Training ; Emergency Medicine
Language	English
Publishing date	2023-07-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/15533506231191576
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Article ; Online: Native aortic valve Staphylococcus warneri endocarditis after COVID-19 infection: a case report and a review of literature.

Gelman, Ram / Potruch, Assaf / Oster, Yonatan / Ishay, Yuval / Gur, Chamutal / Beeri, Ronen / Strahilevitz, Jacob

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

2022 Volume 130, Issue 5, Page(s) 270–275

Abstract: We report a case of Staphylococcus warneri native valve endocarditis in an immunocompetent healthy adult, without known risk factors for infective endocarditis, two months following COVID-19 infection, who recovered with conservative treatment. ... ...

Abstract	We report a case of Staphylococcus warneri native valve endocarditis in an immunocompetent healthy adult, without known risk factors for infective endocarditis, two months following COVID-19 infection, who recovered with conservative treatment. Additionally, we reviewed previous cases of native valve endocarditis caused by Staphylococcus warneri and summarized the main clinical implications.
MeSH term(s)	Adult ; Aortic Valve ; COVID-19 ; Endocarditis ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/drug therapy ; Humans ; Staphylococcal Infections/drug therapy ; Staphylococcus
Language	English
Publishing date	2022-03-11
Publishing country	Denmark
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	93340-5
ISSN	1600-0463 ; 0903-4641
ISSN (online)	1600-0463
ISSN	0903-4641
DOI	10.1111/apm.13217
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Article ; Online: Targeting SARS-CoV-2 receptors as a means for reducing infectivity and improving antiviral and immune response: an algorithm-based method for overcoming resistance to antiviral agents.

Gelman, Ram / Bayatra, Areej / Kessler, Asa / Schwartz, Asaf / Ilan, Yaron

Emerging microbes & infections

2020 Volume 9, Issue 1, Page(s) 1397–1406

Abstract: The ongoing severe acute respiratory syndrome pandemic caused by the novel coronavirus 2 (SARS-CoV-2) is associated with high morbidity and mortality rates, and it has created a pressing global need for effective antiviral therapies against it. COVID-19 ... ...

Abstract	The ongoing severe acute respiratory syndrome pandemic caused by the novel coronavirus 2 (SARS-CoV-2) is associated with high morbidity and mortality rates, and it has created a pressing global need for effective antiviral therapies against it. COVID-19 disease pathogenesis is characterized by an initial virus-mediated phase, followed by inappropriate hyperactivation of the immune system leading to organ damage. Targeting of the SARS-CoV-2 viral receptors is being explored as a therapeutic option for these patients. In this paper, we summarize several potential receptors associated with the infectivity of SARS-CoV-2 and discuss their association with the immune-mediated inflammatory response. The potential for the development of resistance towards antiviral drugs is also presented. An algorithm-based platform to improve the efficacy of and overcome resistance to viral receptor blockers through the introduction of personalized variability is described. This method is designed to ensure sustained antiviral effectiveness when using SARS-CoV-2 receptor blockers.
MeSH term(s)	Algorithms ; Animals ; Antiviral Agents/pharmacology ; Betacoronavirus/drug effects ; Betacoronavirus/genetics ; Betacoronavirus/physiology ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/genetics ; Coronavirus Infections/immunology ; Coronavirus Infections/virology ; Drug Resistance, Viral ; Humans ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/genetics ; Pneumonia, Viral/immunology ; Pneumonia, Viral/virology ; Receptors, Virus/antagonists & inhibitors ; Receptors, Virus/genetics ; Receptors, Virus/immunology ; SARS-CoV-2
Chemical Substances	Antiviral Agents ; Receptors, Virus
Keywords	covid19
Language	English
Publishing date	2020-07-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2681359-2
ISSN	2222-1751 ; 2222-1751
ISSN (online)	2222-1751
ISSN	2222-1751
DOI	10.1080/22221751.2020.1776161
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A second-generation artificial intelligence-based therapeutic regimen improves diuretic resistance in heart failure: Results of a feasibility open-labeled clinical trial.

Gelman, Ram / Hurvitz, Noa / Nesserat, Rima / Kolben, Yotam / Nachman, Dean / Jamil, Khurram / Agus, Samuel / Asleh, Rabea / Amir, Offer / Berg, Marc / Ilan, Yaron

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie

2023 Volume 161, Page(s) 114334

Abstract: Introduction: Diuretics are a mainstay therapy for congestive heart failure (CHF); however, over one-third of patients develop diuretic resistance. Second-generation artificial intelligence (AI) systems introduce variability into treatment regimens to ... ...

Abstract	Introduction: Diuretics are a mainstay therapy for congestive heart failure (CHF); however, over one-third of patients develop diuretic resistance. Second-generation artificial intelligence (AI) systems introduce variability into treatment regimens to overcome the compensatory mechanisms underlying the loss of effectiveness of diuretics. This open-labeled, proof-of-concept clinical trial sought to investigate the ability to improve diuretic resistance by implementing algorithm-controlled therapeutic regimens. Methods: Ten CHF patients with diuretic resistance were enrolled in an open-labeled trial where the Altus Care™ app managed diuretics' dosage and administration times. The app provides a personalized therapeutic regimen creating variability in dosages and administration times within pre-defined ranges. Response to therapy was measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) score, 6-minute walk test (SMW), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and renal function. Results: The second-generation, AI-based, personalized regimen alleviated diuretic resistance. All evaluable patients demonstrated clinical improvement within ten weeks of intervention. A dose reduction (based on a three-week average before and last three weeks of intervention) was achieved in 7/10 patients (70 %, p = 0.042). The KCCQ score improved in 9/10 (90 %, p = 0.002), the SMW improved in 9/9 (100 %, p = 0.006), NT-proBNP was decreased in 7/10 (70 %, p = 0.02), and serum creatinine was decreased in 6/10 (60 %, p = 0.05). The intervention was associated with reduced number of emergency room visits and the number of CHF-associated hospitalizations. Summary: The results support that the randomization of diuretic regimens guided by a second-generation personalized AI algorithm improves the response to diuretic therapy. Prospective controlled studies are needed to confirm these findings.
MeSH term(s)	Humans ; Artificial Intelligence ; Diuretics/therapeutic use ; Feasibility Studies ; Heart Failure ; Peptide Fragments/therapeutic use ; Prospective Studies
Chemical Substances	Diuretics ; Peptide Fragments
Language	English
Publishing date	2023-03-09
Publishing country	France
Document type	Clinical Trial ; Journal Article
ZDB-ID	392415-4
ISSN	1950-6007 ; 0753-3322 ; 0300-0893
ISSN (online)	1950-6007
ISSN	0753-3322 ; 0300-0893
DOI	10.1016/j.biopha.2023.114334
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Article ; Online: Targeting SARS-CoV-2 receptors as a means for reducing infectivity and improving antiviral and immune response

Gelman, Ram / Bayatra, Areej / Kessler, Asa / Schwartz, Asaf / Ilan, Yaron

Emerging Microbes & Infections

an algorithm-based method for overcoming resistance to antiviral agents

2020 Volume 9, Issue 1, Page(s) 1397–1406

Keywords	Immunology ; Epidemiology ; Microbiology ; Drug Discovery ; Parasitology ; Virology ; Infectious Diseases ; General Medicine ; covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2681359-2
ISSN	2222-1751
ISSN	2222-1751
DOI	10.1080/22221751.2020.1776161
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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