Overwintering ecology and movement of anadromous Arctic char (Salvelinus alpinus) in a large, ice-covered river in the Canadian Arctic.

Arctic char (Salvelinus alpinus) is a facultatively anadromous fish species that is critically important to many Inuit communities in the Canadian Arctic. Plasticity in life history has allowed the species to persist in a diversity of challenging Holarctic environments. Despite their ecological and cultural importance and their presence in aquatic ecosystems that are ice-covered for much of the year, few under-ice studies of Arctic char have been conducted. Most winter studies of adult Arctic char have focused on lakes, where they typically overwinter. Several populations of Arctic char, however, overwinter in large river systems, and subsistence fishers have reported that Arctic char overwinter in the lower reaches of the Coppermine River. The Coppermine River is a large Arctic river that flows into Coronation Gulf near Kugluktuk, Nunavut, Canada. The authors used acoustic telemetry to investigate the overwintering ecology of Arctic char in the region. Consistent with local knowledge, they detected Arctic char overwintering within the fluvial environment of the Coppermine River from 2018 to 2020. Unlike other fluvial environments known to be used by overwintering Arctic char, the lower reaches of the Coppermine River are completely ice-covered throughout the winter, are of moderate depths (3.8-14.1 m) and have no known groundwater inputs. Acoustic telemetry observations indicated long-distance movement (7-8 km) within the river in early winter (October) in response to dynamic ice formation. Under-ice movement generally declined 2 weeks after river freeze-up but continued throughout winter in the lower 5 km of the river, where there were fewer under-ice disturbances. Migration into the marine environment before river ice break-up (June), as well as winter (November-May) movements into and within the marine environment, was unexpectedly observed for some fish. Under-ice use of the marine environment is unusual for Arctic char at the distances observed (up to 18 km) and has not previously been documented at the temperatures (fish body temperatures from -0.76 to 1.90°C) observed. Results allow further understanding of the diverse life-history tactics employed by Arctic char and lay a foundation for future research into fluvial and other diverse overwintering tactics employed by the species.

Erroneous data: The Achilles' heel of AI and personalized medicine.

This paper reviews dilemmas and implications of erroneous data for clinical implementation of AI. It is well-known that if erroneous and biased data are used to train AI, there is a risk of systematic error. However, even perfectly trained AI applications can produce faulty outputs if fed with erroneous inputs. To counter such problems, we suggest 3 steps: (1) AI should focus on data of the highest quality, in essence paraclinical data and digital images, (2) patients should be granted simple access to the input data that feed the AI, and granted a right to request changes to erroneous data, and (3) automated high-throughput methods for error-correction should be implemented in domains with faulty data when possible. Also, we conclude that erroneous data is a reality even for highly reputable Danish data sources, and thus, legal framework for the correction of errors is universally needed.

Off-label and unlicensed prescribing in Europe: implications for patients' informed consent and liability.

This article reviews the implications of off-label (OL) and unlicensed (UL) medicine use with respect to the legal duty to inform patients and the liability for failure to provide the patient with adequate information on benefits and risks. Informed consent is a legal prerequisite to any medical treatment and requires the physician to inform the patient about benefits and risks important for the patient's decision. Since OL/UL medicine use is common in all fields of medical practice, physicians must be aware of the stricter requirements for information of the patient. The UK High Supreme Court ruled in the case Montgomery v. Lanarkshire Health Board that physicians' information duty is not limited to the level of information that the physician finds important, but to what the patient deems important. In general, violations of the rule of informed consent does not constitute a physical injury, and patients can only claim compensation for damages, if adequate disclosure had been given, and its likely, that patients would have either rejected or opted for an alternative treatment.