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Participatory artificial intelligence in public social services : from bias to fairness in assessing beneficiaries
Get PDFThis open access edited volume focuses on fairness issues concerning the use of artificial intelligence (AI) for social service provision in national welfare systems. With this, it touches upon important questions in the innovation agenda of countries across continents about the ethics, justice, quality, responsibility, accountability, and transparency to use AI for state functions. The volume shows that in many countries, AI, or at least data analytics methods, are already in place to support the assessment of beneficiaries for deciding on the value criteria to distinguish between legal /fraudulent, deserving/non-deserving, or needy/non-needy recipients. The book provides a cross-cultural comparison of AI-based social assessment among national welfare systems of 9 countries across 4 continents: Spain, Estonia, Germany, Iran, India, Nigeria, Ukraine, China and USA. Based on participatory research results from multi-stakeholder inputs, especially those from vulnerable groups, the chapters in this volume show that value criteria for fairness and social justice are context-bound and vary across the globe. Furthermore, they are in constant flux, aligned to social change. Thus, the volume looks at pathways to developing culture-sensitive, responsive and participatory AI for social assessment in public service provision. The contributions are interdisciplinary and introduce perspectives from the fields of sociology, computational social science, computer science and public policy. This topical volume is of interest to a wide readership.306 Seite
Optimistisches vs. pessimistisches Framing bei der Übermittlung einer Prognose an Eltern sehr unreifer Frühgeborener – Die randomisierte klinische COPE-Studie
Get PDFHintergrund
Auf der Neugeborenen-Intensivstation herrscht Unklarheit darüber, welche Art der Rahmung einer einschränkenden Prognose Eltern Frühgeborener mit einer schweren Komplikation bevorzugen.
Zielsetzung
Untersuchung der elterlichen Präferenz für optimistisches vs. pessimistisches Framing und der Auswirkungen unterschiedlichen Framings bei der Übermittlung prognostischer Informationen nach einer schweren Komplikation bei einem Frühgeborenen.
Studiendesign, -setting und -teilnehmer
Die COPE-Studie wurde als randomisierte klinische Crossover-Studie zwischen Juni und Oktober 2021 im Rahmen einer Online-Befragung im Schwerpunktbereich Neonatologie der Universitätsmedizin der Johannes Gutenberg-Universität Mainz durchgeführt. Teilnahmeberechtigt waren Eltern ehemaliger Frühgeborener mit einem Geburtsgewicht unter 1500 g, die zwischen 2009 und 2019 an der o.g. Universitätsmedizin behandelt worden waren. Die Daten wurden zwischen Oktober 2021 und August 2022 analysiert.
Interventionen
Eingebettet in einen für beide Studiengruppen identischen Online-Fragebogen, wurden den teilnehmenden Eltern nacheinander zwei Videovignetten, in den beiden Studiengruppen dabei in unterschiedlicher Sequenz, gezeigt. In den Videovignetten wurde ein standardisiertes Gespräch zwischen einer Neonatologin und Eltern, dargestellt von professionellen Schauspielern, über die Prognose eines hypothetischen Frühgeborenen mit schwerer intraventrikulärer Blutung gezeigt. Die Videovignetten unterschieden sich dabei in der Formulierung numerischer Schätzwerte für das Überleben und die Entwicklung des betroffenen Frühgeborenen als entweder Überlebenswahrscheinlichkeit und Wahrscheinlichkeit einer Nichtbeeinträchtigung bei Überleben (optimistisches Framing) oder Sterberisiko und Risiko für Beeinträchtigung bei Überleben (pessimistisches Framing).
Hauptergebnisse und Messgrößen
Das primäre Ergebnis war die Präferenzquote, d.h. das Verhältnis der Präferenz für optimistisches gegenüber pessimistischem Framing. Zu den sekundären Ergebnissen gehörten emotionale Erregung, die Wahrnehmung der Kommunikation und die Erinnerung an numerische Schätzungen.
Ergebnisse
Von 220 teilnehmenden Eltern (142 [64,5 %] Mütter; mittleres [SD] Alter: Mütter, 39,1 [5,6] Jahre; Väter, 42,7 [6,9] Jahre) bevorzugten 196 (89,1 %) das optimistische und 24 (10,1 %) das pessimistische Framing (Preference Odds, 11,0; 95 % CI, 6,28-19,10; P < .001). Die Präferenz für optimistisches Framing war ausgeprägter, wenn dieses als zweite Variante gesehen wurde (Präferenz-Odds, 5,41; 95% CI, 1,77-16,48; P = .003). Die emotionale Erregung war bei Studienbeginn in beiden Gruppen ähnlich (mittlerer Unterschied, -0,34; -1,18 bis 0,49; P = .42) und nahm nach dem ersten Video gleichermaßen zu (mittlerer Unterschied, -0,55; 95% CI, -1,79 bis 0,69; P = .39). Nach dem zweiten Video verringerte sich die Erregung, wenn das optimistische Framing auf das pessimistische Framing folgte, blieb hingegen unverändert, wenn das pessimistische Framing auf das optimistische Framing folgte (mittlere Differenz, 2,15; 95% CI, 0,91 bis 3,39; P < .001). Bei optimistischem Framing erinnerten sich die Teilnehmer genauer an numerische Schätzungen für das Überleben (Odds Ratio, 4,00; 95% CI, 1,64-9,79; P = .002), nicht aber für die Beeinträchtigung (Odds Ratio, 1,50; 95% CI, 0,85-2,63; P = .16).
Schlussfolgerung
Wenn Eltern von sehr frühgeborenen Kindern prognostische Informationen über eine schwerwiegende Komplikation erhalten, bevorzugen sie möglicherweise ein optimistisches Framing. Ein optimistisches Framing kann zu realistischeren Erwartungen in Bezug auf das Überleben, nicht aber auf die Beeinträchtigung führen.54 Seiten ; Illustratione
Evaluation of inflammatory serum parameters as a diagnostic tool in patients with endometriosis : a case-control study
Get PDFEven though non-invasive prediction of endometriosis may seem technically feasible using sophisticated machine learning algorithms, a standard clinical use case for non-surgical diagnosis of endometriosis has not yet been established. In the present paper, we assess the potential of the inflammatory serum markers hepcidin, soluble urokinase-type plasminogen activator receptor (suPar), and interleukin-6 (IL-6) in a cohort of 87 patients. Hereby, 59 patients were histologically diagnosed with endometriosis, whereas other 28 patients served as our non-endometriosis control group. An initial exploratory univariate statistical analysis (Mann-Whitney test) revealed the diagnostic potential of different serum levels of suPar (p = 0.024) and IL-6 (p < 0.001) between both groups; the formation of a distinct training data set (n = 77) subsequently allowed to train a supervised machine learning analysis (tree classifier) employing serum levels of suPar, hepcidin, and IL-6 as predictor variables. Based on an internal 5-fold cross validation, the classifier performance was initially assessed using standard metrics such as sensitivity, positive predictive value, and AUROC curve. Additionally, the algorithm was tested on an external validation (holdout) data set (n = 10), showing sufficient overall accuracy of 80% without tendencies of overfitting. In conclusion, our data demonstrates the diagnostic potential of IL-6 and suPar as pro-inflammatory serum biomarkers in endometriosis. Using a decision tree-based supervised learning approach, we additionally present a straight-forward way of a potential clinical employment, aiming at less invasive (non-surgical) diagnosis
Raw data for "Efficient red light-driven singlet oxygen photocatalysis with an osmium-based Coulombic dyad"
No full textPhotoactive osmium complexes are widely used sensitizers for the generation of singlet oxygen, because they can be excited directly into their triplet states with low-energy red light. However, their short-lived excited states reduce quenching efficiencies and reaction quantum yields significantly. To elongate the excited state lifetime, osmium complexes have been linked to organic chromophores to form molecular dyads. This approach, while effective, is time- and resource-consuming, hampering larger-scale applications. Here, we demonstrate a straightforward approach by directly mixing a readily available cationic osmium complex and an anionic perylene derivative in solution. Strong Coulombic interactions facilitate rapid energy transfer (~100 ps) from the excited osmium complex to the perylene derivative, mimicking a dyad-like system. Detailed spectroscopic investigations revealed an increased singlet oxygen formation rate by over one order of magnitude at sub-millimolar perylene concentrations, attributed to (i) the three orders of magnitude longer lifetime of the perylene triplet state produced via intra-ion-pair energy transfer and (ii) an inherently high singlet oxygen quantum yield of that key species. The novel catalyst system enables highly productive photooxygenations in water and in a MeOH/H2O 10/1 mixture, highlighting the broad applicability and versatility of the Coulombic dyad approach for photocatalytic synthesis and wastewater treatment.Experiment
The effectiveness of digital vs. analogue teaching resources in a flipped classroom for undergraduate focus cardiac ultrasound training : a prospective, randomised, controlled single-centre study
Get PDFIntroduction: This study investigated the effectiveness of e-learning compared to traditional teaching methods in ultrasound education, centring on a focus cardiac ultrasound (FoCUS) course for third-year undergraduate medical students. With the rise of digital teaching methods, it is essential to evaluate their impact on the development of theoretical and practical skills in ultrasound training. Methods: A prospective, randomised, controlled trial was conducted involving two groups of students participating in a one-day FoCUS course delivered in a flipped classroom format. The study group used e-learning resources, while the control group used hard-copy lecture notes. Assessments were conducted at three stages: before the course, during the preparation phase, and after the course. Evaluations included self-assessment surveys, theory tests, and practical exams using direct observation of procedural skills (DOPS) tests. The study group had 15% less practice time compared to the control group. Results: A total of 109 complete datasets (study group, n = 52; control group, n = 57) were analysed. Both groups showed an equivalent initial level of and a continuous and significant (p < 0.01) increase in subjective and objective skills over the evaluated time frame. The study group achieved significantly (p = 0.03) higher results in DOPS (T2) than the control group. No significant differences were found in the total scores of the theory tests (T2 + T3) or DOPS (T3). Both groups rated their teaching materials, motivation, and the course concept in similarly high scale ranges. Conclusions: The findings suggest that e-learning is as effective as traditional methods in developing ultrasound skills and may serve as a viable alternative, even with reduced face-to-face interaction. These results indicate that accreditation processes could be applied similarly to those for traditional formats without requiring in-person training as a prerequisite for qualit
Micelle forming linear–dendritic block copolymers : a theoretical comparison between random hyperbranched and precise dendrimer polymer architectures
Get PDFHyperbranched block copolymers offer a simpler and more efficient synthesis route compared to more traditional dendritic systems while still providing exceptional control over surface functionality and self-assembly. This makes them ideal candidates for engineering nanoparticles with tailored properties for applications such as drug delivery and sensing. Here we use self-consistent field calculations to compare the micelle structures formed by copolymers with polydisperse hyperbranched (LHBC), monodisperse dendritic (LDBC), and linear solvophilic blocks. Representative LHBC structures were generated by molecular dynamics simulations mimicking the slow-monomer addition protocol. We find that LHBC micelles are more stable, have a lower critical micelle concentration, and are better at accommodating larger drug payloads than LDBC micelles, and these properties further improve with increasing polydispersity. LHBC micelles also offer more terminal ends for functionalization than LDBC micelles for LDBCs with up to four branching generations, with the number of terminal ends being surprisingly independent of the LHBC polydispersity. Our findings highlight the superiority of LHBC micelles in flexibility and performance over LDBC micelles
Differences in tooth development in patients with unilateral cleft lip and palate
Get PDFObjectives:
The aim of this study was to investigate tooth development in patients with unilateral cleft lip and palate (UCLP) and unilateral cleft lip and alveolus (UCLA).
Material and Methods:
A retrospective case–control study was carried out; 180 panoramic radiographs (OPGs) from non-syndromic patients (160 UCLP, 20 UCLA) treated at the University Medical Center Mainz (2019–2022) were analyzed. Patients were matched to a control group by calendar age, gender, and ethnicity. Inclusion criteria were verified through clinical data, photographs, and radiographs. No follow-up was conducted for this study.
Results:
The cleft group showed a significantly lower dental age compared to the control group (10.72 ± 2.65 vs. 11.41 ± 2.79; p = 0.017), with a mean difference of 0.69 years (95% CI: 0.13–1.25 years). Tooth development was slower on the cleft side (p = 0.001), and maxillary teeth lagged behind mandibular teeth (p < 0.001). The difference in the control group was somewhat smaller, with a mean difference of 0.11 degrees of mineralization in the control group compared to 0.25 degrees of mineralization in the cleft group. In UCLP patients, significant mineralization differences were noted for the lateral incisors (p = 0.004), the central incisor (p = 0.047), and canine (p = 0.030).
Conclusions:
Patients with unilateral clefts show delayed tooth development and dental age, particularly in the affected quadrant. In everyday treatment, attention should be paid to a later start of orthodontic tooth movement to avoid damaging the slower developing roots
Digitalizing informed consent in healthcare : a scoping review
Get PDFBackground
Traditional paper-based informed consent for medical procedures poses a number of challenges, such as low comprehensibility, lack of customization, and limited time for discussion with medical staff. Digitalization, especially in light of the rapid development of AI-based technologies, could provide a solution.
Methods
This scoping review explores the digitalization of the consent process, focusing on the types of technologies used, their role in the consent process, evaluation results, and success factors for implementation. Following the guidance of the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis for scoping reviews, we searched various databases and platforms (Web of Science, EBSCOHost, PubMed and PubPsych) for eligible articles published between January 2012 and June 2024.
Results
Title and abstract screening of 4287 records resulted in the inclusion of 27 studies for analysis. The findings suggest that digitalizing the consent process can enhance recipients' understanding of clinical procedures, potential risks and benefits, and alternative treatments. Mixed evidence exists on patient satisfaction, convenience, and perceived stress. The limited research on healthcare professionals indicates that time savings are the major benefit. AI-based technologies seem to be not yet suitable for use without medical oversight.
Conclusions
Overall, few interactive technologies have been evaluated in the patient consent process, and only recently have studies started to examine the use of AI technologies. This indicates an early stage of the digitalization of patient consent for medical diagnosis and treatment. However, there is great potential to optimize the consent process for both patients and healthcare professionals. Methodologically sound studies are needed to validate these findings.
Trial registration
The scoping review was initially preregistered with PROSPERO (CRD42023397681) as a systematic review. The reasons for the change to a scoping review are outlined in the registration, while the systematic approach to data extraction and analysis was maintained
Thermomechanical modeling of mantle dynamics and plate motion in the Mediterranean
Get PDFOver millions of years, the Mediterranean has been shaped by various geological pro
cesses. The region comprises several rollback subduction systems, some still actively
retreating, and is influenced by the convergence of the African plate in the south and
the Eurasian plate in the north. The dynamic behaviour is also reflected in the crust,
as the region is characterized by numerous orogens as well as a complex plate motion
pattern. The Adriatic microplate is located in the center of the Mediterranean and is
bounded by the African plate and the Eurasian plate. This configuration makes the
Mediterranean, and in particular the Adriatic microplate, an ideal setting to investi
gate the interplay between mantle dynamics and plate motion.
In this work, 3D thermomechanical modeling of the Mediterranean region is used
to investigate the complex geological history of this region over the last 35 Myr.
The results show that the subduction zones strongly interact with each other. The
retreat of both the Apennines-Calabrian subduction system to the west of Adria and
the Dinaric-Hellenic subduction system to the east of Adria leads to an increased
dynamic pressure under the Adriatic microplate. This results in mantle flow to the
north and south. In the north, the mantle flow is blocked by the Alpine slab, so that
mantle flow parallel to the Alpine trench emerges starting at 20 Ma. Another aspect
of the study is the plate motion of the Adriatic microplate. The results indicate that
this is primarily controlled by the convergence of the African and Eurasian plates, the
horizontal distance between the Calabrian and Hellenic trenches and the Alpine slab
retreat to the north of Adria.
The simulation results are used to calculate synthetic shear-wave splitting param
eters to quantify seismic anisotropy. The comparison with observations reproduces
f
irst-order features, such as the trench-parallel orientation of the fast polarization di
rection south of the Alpine slab. However, the comparison between the model and
observations is not perfect, as some regions, such as the Liguro-Provençal Basin, ex
hibit differences. These differences may stem from features absent in the model, such
as a slab gap of the Apennines slab or lower mantle structures. Overall, the compar
ison demonstrates the value of shear wave splitting observations as an observational
constraint and shows how the model results can help interpret observations.
Thermomechanical simulations typically involve a large number of material param
eters, and it is often difficult to quantify the individual influence of each parameter on
a specific output of interest, such as the velocity of a subduction plate. With the dis
crete adjoint method, it is possible to calculate sensitivities that show the influence of
material parameters on a specific output of interest. Here, we illustrate the implemen
tation of the discrete adjoint method with automatic differentiation. This approach
has the advantage that it allows functions from the Stokes solver to be reused, en
abling the design of a problem-agnostic adjoint solver. The resulting sensitivities are
scaled to allow a comparison between different parameters. Finally, this method is
applied to a 2D subduction zone with a nonlinear visco-elastic rheology, where the
effects of slab pull and ridge push on the plate motion are compared quantitatively.Über Millionen von Jahren hinweg wurde der Mittelmeerraum von verschiedenen geo
logischen Prozessen geformt. Die Region umfasst mehrere zurückweichende Subduk
tionszonen, von welchen heute noch einige aktiv sind. Außerdem steht die Region
im Einfluss der Konvergenz der Afrikanischen Platte im Süden und der Eurasischen
Platte im Norden. Das dynamische Verhalten zeigt sich auch in der Erdkruste, da die
Region von mehreren Gebirgen und einer komplexen Plattenbewegung gekennzeichnet
ist. Die Adriatische Platte befindet sich im Zentrum des Mittelmeerraums und ist von
der Afrikanischen und Eurasischen Platte begrenzt. Diese Zusammenstellung macht
den Mittelmeerraum und im Speziellen die Adriatische Platte zu einem idealen Ort,
um das Zusammenspiel aus Manteldynamik und Plattenbewegung zu untersuchen.
In dieser Arbeit wird thermomechanische 3D-Modellierung verwendet, um die
komplexe geologische Geschichte der Region über die letzten 35 Millionen Jahre besser
zu verstehen. Die Ergebnisse zeigen, dass sich die Subduktionszonen gegenseitig stark
beeinflussen. Das Zurückweichen des apenninisch-kalabrischen Subduktionssystems
westlich der Adriatischen Mikroplatte und des dinarisch-hellenischen Subduktions
systems östlich von Adria führt zu einem erhöhten dynamischen Druck im Erdmantel
unter der Adriatischen Platte. Dies resultiert in Mantelfluss nach Norden und nach
Süden. Im Norden wird der Mantelfluss durch die alpine Subduktionszone blockiert,
sodass sich seit 20 Millionen Jahren ein Mantelfluss parallel zur alpinen Subduktions
zone entwickelt hat. Ein anderer Aspekt der Studie befasst sich mit der Plattenbe
wegung der Adriatischen Platte. Die Ergebnisse zeigen, dass diese vor allem von der
Konvergenz der Eurasischen mit der Afrikanischen Platte, der horizontalen Distanz
der kalabrischen und der hellenischen Subduktionszone sowie dem Zurückweichen der
alpinen Subduktionszone abhängt.
Mit den Simulationsergebnissen werden synthetische Parameter für die seismische
Doppenelbrechung berechnet, um die seismische Anisotropie zu charakterisieren. Der
Vergleich mit Beobachtungen reproduziert Merkmale erster Ordnung, wie die paral
lele Orientierung der schnellen Polarisationsrichtung zur alpinen Subduktionszone im
Süden der Alpen. Der Vergleich zwischen Modellergebnissen und seismischen Beob
achtungen zeigt jedoch auch Unstimmigkeiten, wie zum Beispiel im Liguro-Provençal
Becken. Diese Unterschiede können auf Merkmale zurückzuführen sein, die im Modell
nicht auftreten, wie zum Beispiel eine Lücke in der apenninischen Subduktionsplat
te, oder auf Strukturen im unteren Mantel. Insgesamt zeigt der Vergleich, dass die
Analyse der seismischen Doppelbrechung eine zusätzliche Möglichkeit zur Verifizie
rung des numerischen Modells bietet und dass die Modellergebnisse helfen können,
die Beobachtungen besser zu interpretieren.
Thermomechanische Simulationen beinhalten typischerweise eine Vielzahl an Mo
dellparametern und es ist oft schwierig, den individuellen Einfluss einzelner Parameter
auf ein bestimmtes Resultat, wie z. B. die Geschwindigkeit einer Subduktionsplatte, zu
quantifizieren. Mit der diskreten Adjungierten Methode ist es möglich, Sensitivitäten
zu berechnen, die den Einfluss von Materialparametern auf ein bestimmtes Ergebnis
zeigen. In diesem Zusammenhang ist die Implementierung der diskreten Adjungierten
Methode mithilfe automatischer Differentiation beschrieben. Dieser Ansatz hat den
Vorteil, dass Funktionen aus dem Stokes-Löser wiederverwendet werden können, was
die Entwicklung von einem problemunabhängigen Adjungierten-Löser ermöglicht. Die
resultierenden Sensitivitäten werden skaliert, um einen Vergleich verschiedener Para
meter zu ermöglichen. Schließlich wird diese Methode auf eine 2D-Subduktionszone
mit einer nichtlinearen, visko-elastischen Rheologie angewendet. Dabei werden ver
schiedene Prozesse, die die Plattenbewegung beeinflussen, quantitativ miteinander
verglichen.xix, 114 Seiten ; Illustrationen, Diagramm
Simulating extractables and leachables in biopharmaceutical manufacturing to support safety assessment
Get PDFThe use of single-use systems in the manufacturing of biopharmaceuticals raises concerns about the accumulation of process equipment-related leachables in their production and purification processes. However, this risk is mitigated by effective sinks in the manufacturing processes and dilution of product flow, for example, in tangential-flow-filtration. This paper presents a modeling approach that combines the release and adsorption of compounds with dynamic process conditions of biopharmaceutical processes. These calculations help assess process criticality by identifying sources but also low-risk processes and components regarding extractables and leachables accumulation. This approach can significantly reduce the necessity for resource-intensive practical testing, such as leachable studies, which may be impractical from an analytical perspective due to the complex matrices in biopharmaceutical process streams