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In the early morning of March 5, Beijing time, the team of Professor Chen Yundai from the Cardiology Center of the General Hospital of the Chinese People’s Liberation Army published a special report on clinical research at the American Heart Association/World Cardiology (ACC/WCC)2023 Conference. Based on the artificial intelligence CT-FFR technology, the clinical research report on the treatment and follow-up of patients with stable coronary heart disease -TARGET trial, the results will be published simultaneously in the top international journals.CirculationJournal (TOP journal in JCR 1 area, impact factor 39.9).

The research was supported by the National Key R&D Program and the Beijing Science and Technology Rising Star Program, and combined with the research teams of cardiology and radiological imaging departments of several top domestic third-class first-class hospitals such as Beijing anzhen hospital affiliated to Capital Medical University, the Second Affiliated Hospital of Zhejiang University Medical College, Qilu Hospital of Shandong University, the First Affiliated Hospital of Xinjiang Medical University, and tongji hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. The correspondent of this research paper is Professor Chen Yundai, Associate Professor Yang Junjie, Deputy Chief Physician Shan Dongkai and Dr. Wang Xi from the Department of Cardiovascular Medicine of PLA General Hospital are the co-first authors of this paper.

Introduction to research

TARGET study is the first multi-center, randomized and controlled clinical study in the world to evaluate the treatment and management of new stable chest pain patients using the field deployment strategy based on machine learning CT-FFR calculation. The research uses the artificial intelligence CT-FFR computing technology independently developed by China (Keya Medical Technology Co., Ltd.), and a total of 1216 patients from six medical centers in China were selected. The pretest probability of obstructive coronary heart disease in the enrolled patients was medium to high, and coronary CT angiography suggested that there was a critical stenosis of 30%-90%. The researchers randomly divided patients into CT-FFR diagnosis and treatment group (experimental group) or standard diagnosis and treatment group (control group). The main end point of the study was the proportion of patients with non-obstructive coronary artery disease or with obstructive coronary artery disease who did not receive revascularization during the follow-up coronary angiography within 90 days. Secondary end points included major adverse cardiovascular events, quality of life outcomes, improvement of angina symptoms and medical costs.

The results showed that compared with the control group, the proportion of patients with non-obstructive coronary disease or obstructive coronary disease who did not receive revascularization in CT-FFR diagnosis and treatment group decreased significantly (28.3% vs. 46.2%, P<0.001). On the whole, there were more patients receiving revascularization in CT-FFR group than in the control group (49.7% vs. 42.8%, P=0.02), but there was no significant difference in the proportion of MACE during the one-year follow-up (hazard ratio, 0.88; 95%CI, 0.59 to 1.30)。 During the follow-up period, the quality of life and symptoms of the two groups were similar, while the medical cost of CT-FFR treatment group tended to decrease. It is concluded that, compared with the standard diagnosis and treatment strategy represented by cardiac stress examination, the on-site deployment of CT-FFR calculation diagnosis and treatment strategy based on machine learning will significantly reduce the proportion of patients who have found non-obstructive coronary artery disease or do not need intervention within 90 days after coronary angiography. In addition, CT-FFR diagnosis and treatment strategy tends to save medical costs and increase the proportion of revascularization in the selected population. At the same time, CT-FFR strategy is consistent with the traditional path in improving patients’ symptoms or quality of life and the incidence of major clinical adverse vascular events.

Research enlightenment

TARGET research results show that "CT-FFR strategy based on machine learning in the field is feasible, safe and effective".

In the past 10 years, the extensive use of coronary CTA has promoted the diagnosis and treatment process of coronary heart disease in China. According to statistics, in 2017, the total number of coronary CTA angiography examinations in China reached 4.6 million. Therefore, the simple diagnostic function of coronary angiography is weakening, but among the patients who have received coronary angiography in China, most cases have not found obstructive coronary stenosis in the catheter room. Part of the reason for this phenomenon is that functional examination is not widely used or advanced cardiac imaging technology is not available enough. TARGET study further emphasizes that coronary angiography should only be applied to those patients who are most likely to have obstructive coronary stenosis or benefit from revascularization, and CT-FFR strategy will significantly optimize the management of stable coronary heart disease population.

This study adopts the CT-FFR simulation calculation technology-deep pulse fraction independently developed by Keya Medical Technology Co., Ltd., uses deep learning technology to evaluate the physiological function of coronary artery, and uses artificial intelligence technology to evaluate the FFR of coronary angiography image, which is a deep learning technology independently developed and optimized based on the latest development in the field of computer vision. It can quickly and accurately analyze the non-invasive blood flow reserve fraction. In January 2020, this technology was approved as the first NMPA artificial intelligence medical device class III certificate in China, and now it has become the only CT-FFR product in the world that has been triple-certified by NMPA in China, CE in the European Union and FDA in the United States.

Pamela Douglas, MD (Duke Clinical Research Institute, Durham, North Carolina), former president of ACC, led the experiment funded by HeartFlow (PLATFORM and PRECISE research). She pointed out that the most outstanding thing about the TARGET experiment is the novelty of its on-site CT-FFR analysis.

It is indeed possible that the field deployment method is cheaper and can return the results faster. In clinical practice, if CCTA is used as a first-line test, Douglas said, then the question becomes: "If you have borderline lesions, what should you do next?" For her, "this is a little obvious, because CT-FFR is only a software analysis. Although the previous products are very complicated, it is not without risk to make an appointment for a load test and ask the patient to come back later."

It is very important to deploy artificial intelligence computing in the field of TARGET research. "The advantage of using artificial intelligence algorithm is that it provides the possibility of field deployment, avoids the need to transfer sensitive medical data, shortens the calculation time and increases the participation of clinicians." They explained that although FFR can also be calculated by field computational fluid dynamics, this strategy is complex and requires a lot of resources. The convenience of machine learning will contribute to the application of CT-FFR in a wider range of scenarios, adding that "on-site CT-FFR strategy is practical and may be more suitable to meet the clinical practice needs in various clinical environments."

Mourinho has a wide range of highlights in his experience of coaching some top clubs in Europe. However, his most famous night happened in the Champions League in 2010/11, when two mysterious red cards seemed to benefit Real Madrid in the following rounds. Real Madrid’s qualification from Group G has been stabilized, and Mourinho tried to take action in the last game of the group stage against Ajax. Mourinho incarnated as a master of shuffling, clearly instructed Ramos and Alonso, and took the initiative to get two yellow cards and was sent off.

After Ramos and Alonso are sent off, they will be suspended for one game, but they will remain innocent in the most important knockout. Sure enough, Alonso completed this task in an efficient way and took the initiative to apply for a red card and was sent off. Ramos then received a second yellow card. As expected, the referee Craig Thompson did what was expected and sent off the two players. Then, Ramos walked up to the referee and shook hands with him, which made it more obvious that he was accepting Mourinho’s instructions.

Although Mourinho’s bold decision achieved the expected results, it also brought some adverse side effects to Real Madrid. UEFA ordered Real Madrid to pay a huge fine, Mourinho was suspended for two games and fined 40,000 euros, and the club was also fined 120,000 euros. This legendary coach who calls himself "a special one" makes UEFA very angry! Despite his cunning tricks, Mourinho felt the pain of facing his arch-rival Barcelona not once, but twice that season. First of all, Barcelona performed better in the two rounds of the Champions League semi-final and eliminated Real Madrid.

Under the leadership of coach Guardiola, Barcelona also easily won the La Liga championship with a 4-point advantage. Mourinho finally left Real Madrid in 2013 and returned to Chelsea, starting his second coaching career. After winning the Premier League title again at Stamford Bridge, the 60-year-old handsome man’s worth and reputation gradually declined. Before he took charge of Rome in 2021, his teaching achievements at Manchester United and Tottenham Hotspur were unsatisfactory and mixed.

Beta thinks: During coaching Real Madrid, Mu Shuai will do whatever it takes to reach another new height! Mourinho is not only a special one, but also a veritable king of cunning. His unique personal charm attracts countless fans! I hope he can go further in Rome!

So for this news, fans, do you have anything to say? If you like this article, welcome to pay attention to Beta and chat with the stars and the ball game.

Ever since humans realized the importance of robots to human life, they have been focusing on the development of artificial intelligence technology. In these years, the development speed of artificial intelligence technology has been faster and faster, and now there are not only sweeping robots, but even robot attendants.

According to foreign media reports, the humanoid robot developed by a laboratory in the UK appeared in everyone’s sight again. The humanoid robot made a series of human body movements and even smiled in front of the mirror. As soon as the humanoid robot appeared, it was watched by a large number of friends, and its lifelike expressions and actions were once surprising. It can be called the most advanced humanoid robot in the world, and its every move and smile are strikingly similar to others. Once the news spread, it quickly caused a heated discussion among netizens in Guangfa.

After seeing the photos, many netizens will say that if the robot is dressed and put on a hat, it may really think that it is a human being. More people will say that this robot will produce wisdom, and if he has his own wisdom, it will pose a threat to human society. This is not what we are worried about, but what Hawking, a great scientist, once worried about.

Then the question is, if robots are conscious, will they one day replace humans? Will Zeng Lao’s prophecy come true?

Hawking once said when he was alive that he suggested that human beings should not develop robots too vigorously, or they might eventually be destroyed in the hands of robots.

People are conscious, ecstatic, depressed, grateful to those who have helped them, and reflect on their mistakes. People are thinking all the time, producing emotions and thinking all the time. But the robot is not necessarily. After all, it is only controlled by chip technology, and it still depends on people to research and develop it. Humans have the ability to reproduce, but robots haven’t been able to achieve this function yet. There was a famous professor Zeng Lao who boldly predicted that mankind would be destroyed by science and technology. So is the truth really what he said? It is said that science and technology change our lives. How can human beings be destroyed because of science and technology?

It is understood that this humanoid robot developed in the UK can wiggle its shoulders, blink its eyes, even touch its face in front of the mirror, frown and smile. This is not a human being, and the actions it does are what we often do. In addition, we unexpectedly found that the arm joints of humanoid robots are as flexible as those of human beings. If I hadn’t seen its mechanical arm, I would have thought it was a man waving his arm if I had dressed it! However, the walking and moving function of this humanoid robot has yet to be developed. The reason why its facial expression is so realistic is that it is implanted into the human face.

Now, the latest robot developed in the UK is actually regarded as the top robot level. It is the top robot in the world in terms of materials and mechanical technology. Similarly, Japan is also leading in the development of artificial intelligence. Maybe many people know that Japan introduced a beauty robot some time ago, and it can even help Japanese otaku solve their physiological needs. At that time, what they made was very perfect, but they couldn’t make very delicate movements and expressions.

Although technological innovation will bring us infinite convenience, if we rely too much on robots, we will eventually lose our hands-on ability. Robots are artificially developed, developed to serve people and obey human commands. While vigorously developing artificial intelligence, it must be legal and compliant, and robots should be constrained by systems.

According to the current science and technology, it is completely impossible to create robots that are exactly the same as human beings. Robots of this grade can be destroyed instantly even if they have spirituality. What’s more, they themselves are just not too complicated mechanical structures, and they are unlikely to produce spirituality.