Sepsis and septic shock remain major causes of mortality worldwide, affecting approximately 49 million people annually and accounting for an estimated 11 million deaths, representing nearly 20% of all global deaths. Despite sustained efforts in early diagnosis and treatment, sepsis continues to impose a substantial global health burden. Sepsis is defined as a life-threatening organ dysfunction secondary to a dysregulation of the host response to infection. Despite guidelines-based approaches to its diagnosis and therapy, the mortality rates remain higher even in developed countries, reaching up to 30% in intensive care units. High mortality rates in sepsis are largely driven by clinical heterogeneity, highlighting the critical role of epigenetic modulation mechanisms in shaping diverse clinical phenotypes. The main epigenetic mechanisms that modulate the immune response and outcome in sepsis are: DNA methylation, microRNA synthesis, histone modulation, and RNA methylation. This narrative review examines the role of epigenetic mechanisms in sepsis heterogeneity, phenotyping, management, and outcomes, with particular emphasis on the potential contribution of artificial intelligence to the integration of molecular and clinical data for precision medicine. Consequently, the study of AI-integrated strategies for better tailoring of the diversity of epigenetic changes should be prioritized. Thus, machine learning algorithms, deep learning frameworks, and large language models offer helpful insights in redefining the role of AI in sepsis management from this epigenetic perspective. Despite the support of AI in integrating the epigenetic mechanisms into clinical practice, some disadvantages should be also considered like: black box configuration for deep learning frameworks, inequalities from the past data used for training the models, data privacy, ethical concerns, cohort size, number of parameters considered etc. In conclusion, AI tools represent important means in tailoring the personalized decision tree, especially considering the epigenetic influence on the disease course.

Background: The deficit of medical staff in various health care systems points out the need for a more detailed strategic management toward sustainability in human resources. The purpose of this study is to explore the relationships linking self-esteem, self-efficacy, general attitudes, and career preferences among medical students, aiming to provide insights that could support a sustainable career development. Methods: We performed a monocentric observational study that included 157 students. The participants completed four standardized questionnaires evaluating the self-efficacy, the self-esteem, the general attitudes and beliefs, and the perception of medical career specialty. We assessed the relationships between the psychological variables and career preferences. (3) Results: Significant correlations emerged between the students' year of study and the need for achievement, the importance of mentorship, and career decision-making. Clinical students, in particular, placed greater emphasis on gaining practical experience in their chosen field. (4) Conclusions: Our results reaffirm the impact of the occupational psychology in the health care system, providing more sustainability in the career decision. Further research involving larger and more diverse samples is recommended to gain a more comprehensive understanding of how the study of various psychological factors could impact the human resources management in the field.

Liver pathology represents, nowadays, a major cause of mortality and morbidity worldwide. Since MRI helps in limited cases in the differential diagnosis of various pathologies concerning liver tumors, other modern diagnostic strategies should be prioritized. Besides various tumoral biomarkers, contrast-enhanced ultrasound (CEUS) plays a substantial role in differentiating various liver pathologies due to its availability and specificity. Various contrast-enhanced substances used for CEUS assist mainly in detecting focal liver lesions and differentiating their malignant character. This review focuses on the main indications and limits of this novel investigation, considering that patients presenting with various liver pathologies are more challenging. We highlighted in our review the similarities with the CT/MRI imaging methods in reference to the specificity and sensitivity of the method, in its potential ability to detect various liver tumors. Moreover, the contrast agents used by CEUS are eliminated throughout the lungs, showing no evidence of hepatotoxic, nephrotoxic, or cardiotoxic events. In conclusion, the accessibility and safety of the procedure and the absence of the use of ionizing radiation point out that CEUS could be a stand-alone technique in the diagnosis and evaluation of complex liver pathologies.