Physiological Reviews Podcast

AI in Physiology and Healthcare

As Sir Winston Churchill once said, “Where there is great power, there is great responsibility.” This is the overarching context of our latest episode about the future of artificial intelligence (AI) in physiology and healthcare. Listen as host Dr. Ryan Melvin (University of Alabama at Birmingham) interviews author Dr. James Zou (Stanford University) about the Review by Zhang et al. on “Leveraging Physiology and Artificial Intelligence to Deliver Advancements in Healthcare AI in Physiology and Healthcare.” The authors discuss an important transition in AI –the shift from model development to model deployment, while keeping at the forefront the goal of achieving positive real-world impacts by using AI in healthcare workflows. Zou and co-authors identify 3 key factors in this gap between development and deployment: ensuring AI works reliably and robustly across diverse populations, ensuring the financial sustainability of AI models, addressing new regulatory challenges for AI algorithms. FDA regulators are presented with unique challenges regarding how to continuously evaluate and monitor AI algorithms, while still allowing developers to update algorithms in a relatively frictionless way that ensures algorithms’ behavior is safe and robust. Does AI face a generalizability crisis? According to Dr. Zou, this is an ongoing issue. Instructive fine-tuning, which is intended to make iterative large language models safer, can sometimes lead to surprising AI behavior changes. On the topic of AI and authorship, the experts acknowledge that it is becoming increasingly difficult to distinguish if text is written by AI or by humans, as AI becomes more aligned with human behaviors. This may present unique opportunities, according to Dr. Zou. There are many types of text where human authors would benefit from AI support, for example in generating code and figures, and improving writing quality and precision. In the end, however, humans must take final responsibility for the accuracy of all statements in scholarly articles. How can the medical field play a role in shaping the metrics by which we judge generative AI? Listen to find out.

Angela Zhang, Zhenqin Wu, Eric Wu, Matthew Wu, Michael P. Snyder, James Zou, and Joseph C. Wu Leveraging Physiology and Artificial Intelligence to Deliver Advancements in Healthcare Physiological Reviews, published July 19, 2023. DOI: 10.1152/physrev.00033.2022

The Molecular Athlete: Exercise Physiology from Mechanisms to Medals

What are the key physiological adaptations attained in exercise regimens used by elite athletes to achieve peak performance? In our latest episode of The Physiological Reviews Podcast, Editor-in-Chief Dr. Sadis Matalon (University of Alabama at Birmingham) interviews author and Physiological Reviews Associate Editor Dr. Christoph Handschin (University of Basel, Switzerland) about the new Review by Furrer et al. As Dr. Handschin explains, the basis of all types of muscle adaptations is repeated contractions, but how this is done in terms of training intensity, volume, form, and frequency can dramatically affect training outcomes. Athletes and coaches try to develop the best strategies for training periodization for performance to peak at the time of competition. What roles do sleep, diet, and environment, such as altitude, play in enhancing (or diminishing) exercise performance? Listen as Dr. Matalon and Dr. Handschin discuss experimental and natural product-based performance enhancing substances, wearable devices for tracking exercise performance, and the genetic makeup of individuals that ultimately differentiates athletes from Olympic athletes.

 

Regula Furrer, John A. Hawley, and Christoph Handschin The molecular athlete: exercise physiology from mechanisms to medals Physiological Reviews, published April 23, 2023. DOI: 10.1152/physrev.00017.2022

Genome-wide Association Studies of Cardiovascular Disease

Genetics studies, including genome-wide association studies (GWAS), play an increasingly important role in physiology and pathophysiology studies of cardiovascular disease. Listen as Deputy Editor Dr. Carol Ann Remme interviews authors Prof. Jeanette Erdmann (University of Lübeck, Germany) and Prof. Connie Bezzina (Amsterdam University Medical Center, Netherlands) about their latest Review in Physiological Reviews by Walsh et al. GWAS are aimed at identifying genetic variants for specific traits, and it is essential to study genetic variants in order to understand an individual’s susceptibility to develop specific diseases. Understanding the genetic basis of a disease can lead to identification of therapeutic targets for clinical intervention. Listen as these experts discuss how GWAS can be applied to study both rare disorders, for example Brugada Syndrome, as well as common disorders such as myocardial infarction. The possibilities are numerous for GWAS, including the identification of novel pathophysiological insights into cardiovascular disease mechanisms, as well as (future) development of clinically applicable polygenic risk scores. Listen now to learn more.

 

Roddy Walsh, Sean J. Jurgens, Jeanette Erdmann, and Connie R. Bezzina Genome-wide association studies of cardiovascular disease Physiological Reviews, published April 18, 2023. DOI: 10.1152/physrev.00024.2022

Effects of Climate Change on Ozone and UV-B

How do changes in concentration of stratospheric ozone impact human health and the global ecosystem? In our latest episode Editor-in-Chief Dr. Sadis Matalon interviews lead author Professor Christos Zerefos about the recent Review titled, “The long-term variability of human health related solar ultraviolet-B radiation doses from the 1980s to the end of 21st century.” Because stratospheric ozone is the protective layer which screens harmful UV-B solar radiation, ozone depletion impacts diseases of the eyes and the development of skin cancers. The Montreal Protocol is an international treaty signed in 1987 to protect the ozone layer by eliminating the use of chlorofluorocarbons, which deplete the ozone layer and consequently increase harmful solar ultraviolet-B radiation reaching the earth. By some estimates, according to Professor Zerefos, the Montreal Protocol has prevented 2 million additional cases of melanoma and other skin cancers per year worldwide. Listen as we discuss how global warming will interfere with the expected recovery of the ozone layer by introducing regional changes in UV-B and subsequent detrimental effects on human health. Work continues to monitor global ozone levels because, as Professor Zerefos says, “Science never stops.” He also emphasizes the need to continue our protection from excess exposure in UV-B solar radiation in the decades to come. Listen now to learn more.

 

Christos Zerefos, Ilias Fountoulakis, Kostas Eleftheratos, and Andreas Kazantzidis The long-term variability of human health related solar ultraviolet-B radiation doses from the 1980s to the end of 21st century Physiological Reviews, published April 17, 2023. DOI: 10.1152/physrev.00031.2022

Human Frailty and Its Modulation by Physical Activity

Physiological Reviews Associate Editor Prof. Christoph Handschin speaks with Prof. Paul L. Greenhaff and Prof. Janet M. Lord about their article “Multisystem Physiological Perspective of Human Frailty and Its Modulation by Physical Activity,” published in the April 2023 issue of Physiological Reviews.

Prof. Greenhaff is Professor at the School of Life Sciences at the University of Nottingham and is deputy director of the Medical Research Council (MRC)-Versus Arthritis Centre for Musculoskeletal Ageing Research.

Prof. Lord is Professor at the Institute of Inflammation and Ageing at the University of Birmingham and is the director of the MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research.

• Introduction of the authors [1:06]
• What does the term ‘frailty’ actually mean, and how is it clinically defined? [2:49]
• Are there specific risk factors that increase the chance of becoming frail? [5:18]
• What interventions are useful to guard against frailty? [6:55]
• How important will mechanistic aspects of frailty be in our understanding and treatment of frailty? [13:55]
• Are there things we can do with regard to prevention, the mindset of patients and physicians, and interventions in the clinic? [21:10]
• What advice do the authors have to minimize the impact of frailty, regardless of age? [23:15]
• The importance of remaining mentally active [25:55] 

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A Systematic Review of the Biological Mediators of Fat Taste and Smell

Physiological Reviews Editor-in-Chief Dr. Sadis Matalon speaks with Dr. Paule V. Joseph about her article “A Systematic Review of the Biological Mediators of Fat Taste and Smell,” the first systematic review to be published in Physiological Reviews.

Dr. Joseph is Lasker Clinical Research Scholar, Tenure Track Clinical Investigator, and Chief of the Section of Sensory Science and Metabolism in the Division of Intramural Clinical and Biological Research at the National Institute of Alcohol Abuse and Alcoholism. She has a a joint appointment at the National Institute of Nursing Research. Dr. Joseph’s research focuses on preclinical, clinical, and translational studies of chemosensory disorders. In August 2022, she was selected as the inaugural 2022–2024 American Academy of Nursing Fellow at the National Academy of Medicine. Dr. Joseph is a member of the Physiological Reviews Editorial Board.

• Introduction of Dr. Joseph [1:07]
• Author’s background [2:40]
• Why did Dr. Joseph and her coauthors write a systematic review instead of a narrative review? [6:47]
• Discussion of the main receptors responsible for the sensations of taste and smell, and how their activation relates to obesity [10:12]
• How does SARS-CoV-2 result in loss of taste and smell, and why does it occur following a COVID infection and not with other respiratory viruses? [14:40]
• Are polymorphisms associated with obesity or, conversely, with very low body mass index (BMI)? [19:49]
• Do environmental factors play a role in the regulation of fat and smell receptors? [22:39]
• Suggestions for improving outreach within the nursing community [25:26]

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Systematic Reviews for Basic Scientists: A Different Beast

Physiological Reviews Editor-in-Chief Dr. Sadis Matalon speaks with   
Prof. John P.A. Ioannidis about his editorial “Systematic Reviews for Basic Scientists: A Different Beast,” which focuses on the importance of systematic reviews in scientific research.

Prof. Ioannidis is Professor of Medicine, of Epidemiology and Population Health, and, by courtesy, of Statistics and Biomedical Data Science at Stanford University. He is one of the most cited scientists in the world and is an elected member of numerous national academies. Prof. Ioannidis in an Associate Editor of Physiological Reviews.

• Introduction of Prof. Ioannidis [1:26]
• Author’s background [3:08]
• Discussion of reproducibility in science [5:35]
• Discussion of sample size in research [7:31]
• What exactly is a systematic review, and how can it address bias? [10:41]
• Do systematic reviews have a place in basic research, or should they be used mostly in clinical science? [13:29]
• What is a “living review”? [15:35]
• What does the future hold for the format of review articles? [18:34]
• The importance of collaboration in science [21:50]
• Advice for early-career researchers [24:57]

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The Superoxide Radical Switch in the Biology of Nitric Oxide and Peroxynitrite

Physiological Reviews Associate Editor Prof. Giovanni Mann speaks with Prof. Rafael Radi about his review article “The superoxide radical switch in the biology of nitric oxide and peroxynitrite,” about the life of a scientist, and about advice for early-career researchers.

Prof. Radi is Professor, Chair, and Director of the Centro de Investigaciones Biomédicas (CEINBIO) at the Universidad de la República in Montevideo, Uruguay. Prof. Radi has made significant contributions to our understanding of the mechanisms of nitric oxide-dependent toxicity through its interaction with superoxide anions and the formation of peroxynitrite. He has characterized the biological chemistry of peroxynitrite, its effects on mitochondrial dysfunction and apoptosis, and its role in pathology.

• Introduction of Prof. Radi [0:45]
• Author's background [2:40]
• Advice to early-career investigators seeking to take on a career in research [10:07]
• Discussion of collaboration between professional organizations that facilitates sharing of research among early-career researchers from different countries [13:57]
• Insight into the sources of superoxide, and which in particular Prof. Radi believes contributes primarily to the role of superoxide acting as a ‘radical switch’ [16:37]
• The importance of physiologically relevant oxygen levels in the interplay of nitric oxide, oxygen, and peroxynitrite during experiments [20:54]
• From a translational perspective, can this area of inquiry make any contributions to benefit patients? [25:13]
• Will basic and clinical scientists be able to target specific activators or inhibitors of nitric oxide synthase(s) or nitric oxide donors to individual organs or tissues? [29:07]
• Formation of peroxynitrite under lower oxygen levels [31:28]
• Advice for young people interested in pursuing basic science and/or medicine as a career [35:33]

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Pregnancy and the SARS-CoV-2 Pandemic

Physiological Reviews Editor-in-Chief Dr. Sadis Matalon speaks with Prof. Rebecca M. Reynolds, Prof. Sarah J. Stock, and Prof. Hilary O. D. Critchley about their editorial “Pregnancy and the SARS-CoV-2 Pandemic,” published in the July 2022 issue of Physiological Reviews.

The authors also have contributed a review article on this topic, “Pregnancy and COVID-19,” which was one of the most highly cited articles published in the journal in 2021.

Prof. Reynolds is Professor of Metabolic Medicine at the University of Edinburgh. Her research looks at the ways in which early development in utero can affect health and disease. Prof. Stock is Professor of Maternal and Fetal Health at the University of Edinburgh. Her research examines efforts at reducing preterm birth, stillbirth, and other complications in pregnancy. Prof. Critchley has held a Personal Chair in Reproductive Medicine at the University of Edinburgh since 1999. She is Head of the Deanery of Clinical Sciences at the University of Edinburgh, she is Co-Director of the Medical Research Council Centre for Reproductive Health, and she is Consultant Gynaecologist at the Royal Infirmary in Edinburgh. Her research is aimed at improving our understanding of the basic science of the uterine endometrium. She is an Associate Editor of Physiological Reviews.

• Author introductions [0:41]
• Efficacy of vaccination in diminishing the severity and long-term consequences of COVID-19 [6:44]
• Does COVID-19 vaccination cause any significant side effects for the pregnant woman or the fetus? [8:08]
• Are women who are pregnant at higher risk for COVID infection, and can the virus cross the placenta? [15:53]
• Does SARS-CoV-2 affect the development of preeclampsia? [21:19]
• What kinds of treatments are available -- and safe -- for pregnant women with COVID? Are there any animal models in which interventions may be tested? [24:05]
• What other work is being conducted on this topic? [28:38]
• Discussion of the effects of SARS-CoV-2 infection or COVID vaccination on menstruation [31:27]
• Closing remarks [35:59]

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A Tale of Two Epidemics: HIV and SARS

Physiological Reviews Editor-in-Chief Dr. Sadis Matalon speaks with Michael Saag, MD, of the University of Alabama at Birmingham (UAB) about his editorial “Wonder of wonders, miracle of miracles: the unprecedented speed of COVID-19 science.”

Dr. Saag is Associate Dean for Global Health in the School of Medicine, Director of the UAB Center for AIDS Research and a Professor of Medicine in the Division of Infectious Diseases. He also is the principal investigator of the CFAR Network of Integrated Clinical Systems (CNICS), a network of centers sharing electronic health record data to integrate clinical information from persons infected with HIV. In addition, Dr. Saag is the founding director of the UAB 1917 HIV Clinic, one of the leading HIV clinics in the United States.

• Dr. Saag's experience in treating patients with HIV, and advances in HIV treatment [2:50]
• Why is there no vaccine for HIV? [4:50]
• Is there an animal vector for SARS-CoV-2 as was the case for SARS-CoV-1? [8:17]
• What exactly is “long COVID,” and what are its implications for public health? [12:06]
• Why do vaccinated individuals still contract SARS-CoV-2? [17:08]
• Final thoughts [22:04]

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