The Sociodemographic Biases in Machine Learning Algorithms: A Biomedical Informatics Perspective.

Artificial intelligence models represented in machine learning algorithms are promising tools for risk assessment used to guide clinical and other health care decisions. Machine learning algorithms, however, may house biases that propagate stereotypes, inequities, and discrimination that contribute to socioeconomic health care disparities. The biases include those related to some sociodemographic characteristics such as race, ethnicity, gender, age, insurance, and socioeconomic status from the use of erroneous electronic health record data. Additionally, there is concern that training data and algorithmic biases in large language models pose potential drawbacks. These biases affect the lives and livelihoods of a significant percentage of the population in the United States and globally. The social and economic consequences of the associated backlash cannot be underestimated. Here, we outline some of the sociodemographic, training data, and algorithmic biases that undermine sound health care risk assessment and medical decision-making that should be addressed in the health care system. We present a perspective and overview of these biases by gender, race, ethnicity, age, historically marginalized communities, algorithmic bias, biased evaluations, implicit bias, selection/sampling bias, socioeconomic status biases, biased data distributions, cultural biases and insurance status bias, conformation bias, information bias and anchoring biases and make recommendations to improve large language model training data, including de-biasing techniques such as counterfactual role-reversed sentences during knowledge distillation, fine-tuning, prefix attachment at training time, the use of toxicity classifiers, retrieval augmented generation and algorithmic modification to mitigate the biases moving forward.

The Effect of Antidepressants on Withdrawal in Patients with Alcohol Dependence: A Retrospective Study.

The use of electronic health records has expanded in the past decades, with healthcare entities storing terabytes of patient health data. In this study, we investigated how these databases can be utilized to generate clinically relevant information. We used the Office of Addiction Services and Supports Client Data Systems data merged with the NYS Medicaid Data Warehouse to study the relationship of certain antidepressants on alcohol withdrawal (AW) rates in patients with alcohol dependence (AD). We found that in patients with AD, bupropion was associated with a significantly reduced rate of AW compared to selective serotonin reuptake inhibitors (SSRIs). This may be due to the ability of bupropion to inhibit dopaminergic reuptake. This retrospective study provides the advantage of being faster and less expensive than randomized controlled trials (RCTs).

Arsenic fractionation and speciation in different textured soils supplied with farmyard manure and accumulation by sunflower under alkaline calcareous conditions.

Arsenic (As) is a naturally occurring element that is found in soil, water, and rocks. However, it can also be released into the environment through human activities. Arsenic is considered an environmental hazard because it is toxic to humans and animals and can cause serious health problems. Additionally, As-contaminated soil can limit plant growth and reduce crop yields, leading to economic losses for farmers. So, decreasing metal/metalloid solubility in soil by synthetic and organic amendments leads to better crop productivity on contaminated soils. The current study aimed to evaluate farmyard manure (FYM)-mediated changes in soil arsenic (As) behavior, and subsequent effects on achene yield of sunflower. Treatment plan comprised of two As levels, i.e., As-60 (60 mg kg-1) and As-120 (120 mg kg-1), four FYM levels (0, 20, 35, and 50 g kg-1), three textural types (sandy, loamy and clayey), and replicated thrice. Seven As fractions including water soluble-As (WS-As), labile-As (L-As), calcium-bound As (Ca-As), aluminum-bound As (Al-As), iron-bound As (Fe-As), organic-matter-bound As (OM-As), and residual-As (R-As) were determined which differed significantly (P ≤ 0.05) with FYM and soil texture. FYM supplementation decreased WS-As, L-As, Ca-As, and Al-As while increased Fe-As, OM-As, and R-As. The immobilizing effect of FYM increased with increasing its rate of application, and maximum effect was found in clayey soil. As speciation in soil also significantly (P ≤ 0.05) affected by FYM and soil texture, with a reduction in arsenate while increase in arsenite, mono-methyl arsenate, and di-methyl arsenate with increasing the rate of FYM supplementation. Bioaccumulation factor reduced with FYM addition, and highest reduction of 38.65 and 42.13% in sandy, 34.24 and 36.26% in loamy while 29.16 and 35.10% in clayey soils at As-60 and As-120, respectively, by 50 g kg-1 FYM compared with respective As treatments without FYM. As accumulation in plant parts was significantly (P ≤ 0.05) reduced by FYM with the subsequent improvement in achene yield.

Alteration in soil arsenic dynamics and toxicity to sunflower (Helianthus annuus L.) in response to phosphorus in different textured soils.

Being analogue to arsenic (As), phosphorus (P) may affect As dynamics in soil and toxicity to plants depending upon many soil and plant factors. Two sets of experiments were conducted to determine the effect of P on As fractionation in soils, its accumulation by plants and subsequent impact on growth, yield and physiological characteristics of sunflower (Helianthus annuus L.). Experimental plan comprised of two As levels (60 and 120 mg As kg-1 soil), four P (0-5-10-20 g phosphate rock kg-1 soil) and three textural types (sandy, loamy and clayey) with three replications. Among different As fractions determined, labile, calcium-bound, organic matter-bound and residual As increased while iron-bound and aluminum-bound As decreased with increasing P in all the three textural types. Labile-As percentage increased in the presence of P by 16.9-48.0% at As60 while 36.0-68.1% at As120 in sandy, 19.1-64.0% at As60 while 11.5-52.3% at As120 in loamy, and 21.8-58.2% at As60 while 22.3-70.0% at As120 in clayey soil compared to respective As treatment without P. Arsenic accumulation in plant tissues at both contamination levels declined with P addition as evidenced by lower bioconcentration factor. Phosphorus mitigated the As-induced oxidative stress expressed in term of reduced hydrogen peroxide, malondialdehyde while increased glutathione, and consequently improved the achene yield. Although, P increased As solubility in soil but restricted its translocation to plant, leading to reversal of oxidative damage, and improved sunflower growth and yield in all the three soil textural types, more profound effect at highest P level and in sandy texture.

Review Analysis on Thymectomy vs Conservative Medical Management in Myasthenia Gravis.

Myasthenia gravis (MG) is an acquired, rare autoimmune disease that occurs due to autoantibodies blocking neuromuscular transmission. Its pathophysiology involves production of antibodies against the nicotinic acetylcholine receptors. Patients with negative anti-acetylcholine receptors (AChR) antibodies results are recognized as seronegative myasthenia gravis. In this review we tried to compare surgical and medical management of MG with each other to find out which is more effective. Different clinical trials and retrospective cohorts comparing these two parameters statistically were searched and studied. Remission rates in both medical and surgical management were compared. We found out that rates of remission were better in post thymectomy patients than patients on various medical treatment options including corticosteroids, immunosuppressants, intravenous immunoglobulins and acetylcholinesterase inhibitors alone. Hence thymectomy is studied to be the superior treatment option than other conservative medical management options alone.

Arsenic fractionation and its impact on physiological behavior of sunflower (Helianthus annuus L.) in three texturally different soils under alkaline calcareous conditions.

Soil textural composition may be important to control arsenic (As) behavior in soil and movement to plant. Two independent parallel experiments comprising of five As levels (0, 50, 100, 150, and 200 mg As kg-1 soil) and three soil textural types (sandy, loamy, and clayey) were designed for determining As fractionation in soils and its consequential effects on growth, yield, and physiological characteristics of sunflower (Helianthus annuus L.). Six As fractions, i.e., NH4Cl-extractable, NH4F-extractable, NaOH-extractable, H2SO4-extractable, H2O2-extractable, and HNO3-extractable, were determined. On an average, NH4Cl-extractable As (the most phytoavailable among the extracted fractions) was 48.9, 19.8, and 6.6% of the total As while the bioaccumulation factor for root ranged between 1.9 and 9.5, 1.8 and 4.4, and 0.8 and 2.1 for sandy, loamy, and clayey textured soils, respectively. There was an increase of 8.3, 5.6, and 6.0 times in malondialdehyde with a subsequent reduction in photosynthetic rate by 53.3, 42.7, and 38.0% and achene yield 90.0, 87.1, and 85.5% in sandy, loamy, and clayey textured soils, respectively at 200 mg As kg-1 as compared with the control. Antioxidant enzyme activities were increased with increasing As addition, and maximum activities were found at 150 mg As kg-1, where catalase activities were 377.7, 341.6, and 292.0%; peroxidase 788.5, 758.6, and 737.0%; and superoxide dismutase 235.7, 191.8, and 177.2% higher in sandy, loamy, and clayey textured soils, respectively as compared with the control. In conclusion, As fractionation was markedly influenced by soil texture, and toxic effects of As on growth, yield and physiological characteristics of sunflower were maximum in sandy followed by loamy and clayey textured soils in descending order.

Primary embryonal rhabdomyosarcoma of the liver in a young male.

Rhabdomyosarcoma (RMS) occurs infrequently in the liver. Rhabdomyosarcomas are malignant tumours that display features of striated muscle differentiation. They are the most common soft-tissue sarcomas among children. In adults however, these are very rare. We report a case of a primary embryonal rhabdomyosarcoma of the liver in a 17 years old boy. This was confirmed by histological examination using immunohistochemical analysis (LCA negative, desmin positive, myogenin focally positive and cytokeratin negative) and site was confirmed by PET CT scan. He received multiple chemotherapies including (doxorubicin, ifosfamide, dacarbazine; gemcitabine, paclitaxel; vincristine, actinomycin D, cyclophosphamide) but longest sustained stable disease was seen with gemcitabine-paclitaxel regimen. The patient died 31 months after the first presentation, secondary to complicated abundant abdominal progressive disease. The poor prognosis and early death of most previously reported cases imply the need for investigation of a more effective treatment method of this uncommon tumour.