Dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, called incretin modulators, are key drugs for managing type 2 diabetes that are widely recognized for their effectiveness. These drugs contribute to the regulation of glucose metabolism by mimicking or enhancing the function of a gastrointestinal hormone known as incretins, including GLP-1 and gastric inhibitory peptide (GIP). Incretins uniquely stimulate insulin secretion in a glucose concentration-dependent manner only when blood glucose is elevated. Among the incretin modulators, GLP-1 receptor agonists have shown multiple benefits: they delay gastric emptying, reduce glucagon secretion, enhance glycogen synthase in the liver, suppress appetite in the central nervous system, and decrease body weight. Additionally, they have been recently shown to protect cardiovascular and kidney functions. These findings have led to their recommendation for use in patients with type 2 diabetes mellitus complicated by chronic kidney disease or heart failure. Currently, these incretin modulators are prescribed only for type 2 diabetes; however, some GLP-1 receptor agonists are expected to be approved for obesity treatment soon in Japan. Their clinical use exemplified successful translational research.

The pathological condition of atopic dermatitis is formed by three factors: decreased skin barrier function, type 2 immune response, and itching. In recent years, elucidation of the pathological condition of atopic dermatitis has progressed from the immunological aspect. Type 2 cytokines, such as interleukin (IL) -4 and IL-13, produced from cells such as Th2 cells and type 2 innate lymphocytes, play a crucial role in the lesion areas of atopic dermatitis. These type 2 cytokines decrease the antibacterial peptide levels and the barrier of epidermal keratinocytes, and induce inflammation. Currently, antibody preparations that suppress targeted cytokines, Janus kinase (JAK) inhibitors that inhibit the JAK-signal transducer and activator of transcription (STAT) pathway and system, and anti-phosphodiesterase4 (PDE4) inhibitors, developed based on the pathological condition of atopic dermatitis, are on the market. The existing topical drug therapies are the anticipated treatment methods for refractory atopic dermatitis affecting children and adults.

ChatGPT, a large language model released in late 2022, shocked the world with its human-like response capabilities. ChatGPT can generate grammatically correct sentences and respond to prompts accurately; however, it sometimes provides incorrect information. The latest version of ChatGPT is also capable of recognizing and interpreting images and pointing out errors in table calculations. AI has demonstrated capabilities surpassing those of humans in various fields, such as Go and Shogi, autonomous driving taxis, and medical research, with medical diagnostics reaching levels comparable to those of specialists. Generative AI like ChatGPT is characterized by its ability to create not only text but also images and sounds, thus generating new original content. Doctors and medical professionals must understand its principles as much as possible for usage.

Information systems have evolved through a Tri-Core Information Model consisting of genes, brains, and AI. Each shares the structure of input, information processing, and output, functioning based on the principles of maximizing probability and incorporating randomness. However, there are differences among genes, brains, and AI in terms of parameter update intervals, number of parameters, and energy consumption. The brain's system has evolved to develop reasoning capabilities, language, and painting functions to maximize the probabilities of survival and reproduction. Generative AI features probability maximization and performs randomization based on this probability.

ChatGPT calculates the probability of the next word from past sentences and generates new sentences using optimized parameters. While AI's evolution could pose a threat to humanity, understanding the threat and preventing AI from running amok requires not only knowledge of AI's technology and performance but also an understanding of its principles and theoretical basis. In the medical field, as the application of AI advances, it is necessary to consider not only technical knowledge but also ethical, legal, and social issues.

With an aging population, there is a growing need for managing critically ill patients, presenting a significant challenge in maintaining an adequate supply of medical personnel. Japan is increasingly turning its attention to remote ICUs as a potential solution to this problem. Tele-ICU, an innovative model, brings together a team comprising intensive care specialists, nurses, and physician office assistants to offer continuous monitoring and support for critically ill patients in facilities without on-site intensive care specialists.

In traditional ICUs, healthcare professionals juggle the care of multiple patients simultaneously, manually gathering data and calculating scores. However, the future holds promise in the ability to harness technology and AI for efficient patient identification and proactive care, enabling early intervention. Tele-ICU represents a transformative approach to healthcare delivery, standardizing intensive care processes and ultimately improving post-discharge patient health. This improvement not only benefits patients but, healthcare providers, institutions, and insurance systems as well.

The future promises the widespread adoption of remote ICUs, thereby promoting collaboration among local medical facilities. This requires standardizing and using data, which is crucial for driving adoption. By utilizing new technology to work with local medical institutions and streamline data, we can improve healthcare quality and efficiency, benefiting all stakeholders.