ABSTRACT
Consent bias is a type of selection bias in biomedical research where those consenting to the research differ systematically from those not consenting. It is particularly relevant in precision medicine research because the complexity of these studies prevents certain subgroups from understanding, trusting, and consenting to the research. Because consent bias distorts research findings and causes inequitable distribution of research benefits, scholars propose two types of schemes to reduce consent bias: reforming existing consent models and removing the consent requirement altogether. This study explores the possibility of waiving consent in observational studies using existing data, because they involve fewer risks to participants than clinical trials if privacy safeguards are strengthened. It suggests that data protection mechanisms such as security enhancement and data protection impact assessment should be conducted to protect data privacy of participants in observational studies without consent.
Subject(s)
Informed Consent , Precision Medicine , Humans , Informed Consent/standards , Biomedical Research/standards , Observational Studies as Topic , Bias , Selection BiasABSTRACT
Ethical safeguards such as debriefing are often recommended or required for research studies in which participants are deceived. However, existing guidance on these safeguards seems insufficiently coherent and precise, which may be associated with their suboptimal implementation in practice. This study aimed to contribute to a more coherent and precise framework of ethical safeguards in deceptive studies through semi-structured interviews with a diverse sample of 24 researchers who had significant experience with deception. Interviewees discussed which ethical safeguards they implemented and how, as well as their relation to the notion of truthfulness (i.e., the intentional communication of true information). Moreover, interviewees provided a variety of reasons for and against implementing these safeguards, as well as how these reasons varied with the particular context of a study. Overall, the current study contributes to a more coherent and precise understanding of ethical safeguards in deceptive research that could be useful for guiding researchers and ethics reviewers in their ethical decision-making, although certain imprecisions and incoherent aspects remain in need of further investigation and normative reflection.
ABSTRACT
Normothermic Regional Perfusion, or NRP, is a method of donated organ reperfusion using cardiopulmonary bypass or a modified extracorporeal membrane oxygenation (ECMO) circuit after circulatory death while leaving organs in the dead donor's corpse. Despite its potential, several key ethical issues remain unaddressed by this technology.
Subject(s)
Trust , Humans , Perfusion , Extracorporeal Membrane Oxygenation/ethics , Organ Preservation/methods , Organ Preservation/ethics , Cardiopulmonary Bypass/ethics , Tissue and Organ Procurement/ethicsABSTRACT
In this month's Policy column, Iwan Dowie discusses the 'deprivation of liberty' - which is used to safeguard patients who may be lacking sufficient mental capacity to manage their own safety. The author, through previous legal cases, shares how the Deprivation of Liberty Safeguards (DoLS)-an amendment to the Mental Capacity Act 2005-came into being, and the importance of community nurses in knowing the DoLS.
Subject(s)
Community Health Nursing , Mental Competency , Humans , Mental Competency/legislation & jurisprudence , United Kingdom , Freedom , Commitment of Mentally Ill/legislation & jurisprudence , Nurse's Role , State MedicineABSTRACT
This paper describes the methodology used to create a fuel data library comprising safeguards-relevant quantities that may be useful for verification of spent nuclear fuel (SNF) produced by simulating a concept Molten Salt Reactor (MSR). The Monte-Carlo particle transport code, Serpent2 and the calculation code SOURCES 4C were used to compile this fuel data library. The data library is based on the Compact Molten Salt Reactor (CMSR) concept being developed by Seaborg Technologies (based in Copenhagen, Denmark). The library includes data such as nuclide mass densities for a total of 1398 nuclides (in g/cm3), as well as total decay heat production (denoted by suffix the 'TOT_DH') in Watts, total gamma photon emission rates (denoted by the suffix 'TOT_GS') in photos per second, and the total activity (denoted by suffix 'TOT_A') in Becquerel. Lastly, the data also includes total neutron emission rates from 1) spontaneous fission (denoted by 'SF' and reported in neutrons per second per cm3), and 2) (É, n) reactions (denoted by 'AN' and reported in neutrons per second per cm3) for the fuel salt. These quantities are reported for a range of burnup-initial enrichment-cooling time (or collectively known as, BIC) parameters. The resulting fuel data library is an extension of a previously published data library for the same reactor concept but with one significant change. The current library is based on a more realistic model of the CMSR involving movement of gaseous and volatile fission products (GFP and VFP) from the core via an Off-Gas System (OGS). The dataset is made available for public use in a compressed binary format as an HDF5 (or Hierarchical Data Format) file that can be parsed using data analysis tools such as Pandas.
ABSTRACT
Applications for detention under civil sections of the England and Wales Mental Health Act 1983 require at least one recommendation from a registered medical practitioner who is approved under section 12 of the Act. The Mental Health Act 2007 introduced multi-professional approved clinicians who may act as a patient's responsible clinician with responsibilities that include renewal of detention for treatment. Approved clinicians who are medical practitioners are automatically approved for section 12 purposes, whereas other approved clinicians are not. It is argued in this paper that this inconsistency is illogical, has implications for patient care and needs to be remedied.
ABSTRACT
This paper describes the creation and description of a nuclear fuel isotopics dataset for irradiated fuel salt from a Molten Salt Reactor (MSR). The dataset has been created using simulations carried out using the Monte-Carlo particle transport code, Serpent 2.1.32 (released February 24, 2021) and the calculation code SOURCES 4C (released October 09, 2002) for computing properties of irradiated molten fuel salt. The dataset comprises isotopic mass densities of 1362 isotopes (including fission products and major and minor actinides) and their corresponding contributions to decay heat, gamma activity, and spontaneous fission rates computed by Serpent 2.1.32 as well as overall neutron emission rates from spontaneous fission and (É, n) reactions computed by SOURCES 4C. These quantities are computed for a model MSR core utilizing a full-core 3D model of the Seaborg Compact Molten Salt Reactor (CMSR). The dataset spans a wide range of values of burnup (BU), initial enrichment (IE) and cooling time (CT) over which the above-mentioned quantities are reported. The structure of the dataset includes isotopic mass densities (in g/cm3), followed by isotope-wise contributions to decay heat (denoted by suffix '_DH' and reported in Watts), gamma photon emission rates (denoted by suffix '_GS' and reported photons per second), and spontaneous fission rates (denoted by suffix '_SF' and reported in fissions per second). In addition to these columns, the data also includes total neutron emission rates from 1) spontaneous fission (denoted by 'SF' and reported in neutrons per second per cm3), and 2) (É, n) reactions (denoted by 'AN' and reported in neutrons per second per cm3). In total, the dataset has 310,575 rows of different combinations of fuel burnup, initial enrichment, and cooling time (BIC) values spanning the realistic possible range of these parameters. The dataset is made available for public use in a comma-separated value file that can be easily read using one of the numerous popular data analysis tools such as NumPy or Pandas.
ABSTRACT
Radioactive hot particle is the particulate form of nuclear material that exists in the environment. The U, Pu, Am, Cs, and other radionuclides isotope in the hot particle contain abundant and accurate fingerprint information, such as the origin and age of the nuclear material. The acquisition and analysis of the key information in the hot particle can be equivalent to the analysis of bulk nuclear material, which could directly reflect the real situation of nuclear activities. Therefore, the single particle analysis of hot particles has become an irreplaceable key technology in nuclear safeguards inspection. The rapid identification, screening, locating, and accurate isotope analysis of hot particles from a large number of particles dispersed in environmental media or on the surface of other materials are one of the most important research field in nuclear emergency. In this review, the research process of the analytical methods for hot particles in the last decade was summarized, including the physical character of hot particles, and the techniques of localization, screening, and extraction of hot particles. Furthermore, we also focused on the mass spectrometry technology for the analysis of hot particle. The advantages and disadvantages of the most used mass spectrometry were summarized. Finally, the research trend for hot particle analysis methods was proposed.
Subject(s)
Radiation Monitoring , Radioactivity , RadioisotopesABSTRACT
OBJECTIVE: To evaluate the potential impact of the recently announced 'Safeguards' initiative on mental health-related emergency department presentation rates for children and adolescents (0-17 years). This state-funded initiative aims to establish 25 Child and Adolescent Acute Response Teams across New South Wales. METHODS: We estimated the effects of the 'Safeguards' initiative using a state-level dynamic model of child and adolescent acute mental health care. Potential reductions in total numbers of mental health-related emergency department presentations and re-presentations (i.e. presentations within 3 months of an initial presentation) were assessed via a series of simulation experiments in which we systematically varied the total number of Child and Adolescent Acute Response Teams and the mean duration of care per patient. RESULTS: Assuming a mean treatment duration of 6 weeks per patient, 25 Child and Adolescent Acute Response Teams are projected to reduce total numbers of mental health-related emergency department presentations and re-presentations over the period 2022-2031 by 15.0% (95% interval, 12.0-18.2%) and 31.7% (26.2-37.8%), respectively. Increasing the total number of Child and Adolescent Acute Response Teams above 25 has minimal additional impact on projected reductions in numbers of emergency department presentations and re-presentations, provided the mean duration of care is no more than 8 weeks. However, where the mean duration of care is greater than 4 weeks, a decrease in the number of Child and Adolescent Acute Response Teams below 25 reduces the potential effectiveness of the 'Safeguards' initiative significantly. CONCLUSION: Our simulation results indicate that full and timely implementation will be critical if the potentially substantial impact of the 'Safeguards' initiative on demand for hospital-based emergency mental health care is to be realised.
Subject(s)
Community Health Services , Community Mental Health Services , Child , Humans , Adolescent , Mental Health , New South Wales , Emergency Service, HospitalABSTRACT
This database contains the isotopic mass density and the contribution to activity, decay heat, photon emission, spontaneous fission rate, (α,n) emission rates and radiotoxicity of 150 nuclides that are present in nuclear fuel irradiated in PWRs. These nuclides are of paramount importance for nuclear waste characterization and fuel cycle analysis. These values were obtained by depletion calculations based on a 3D pin-cell geometry model and performed with the Monte Carlo reactor physics burnup calculation code Serpent2, with state-of-the-art nuclear data libraries and relevant methods. The calculations cover a wide range of burnup levels for conventional PWRs and take into account both UOX and MOX fuel. A broad span for initial enrichment for UOX (from 1.5% to 6.0%), and for both the initial plutonium content (from 4.0% to 12.0% and the plutonium isotopic composition of MOX has been considered. This database has been made publicly available due to its relevance in the fields of waste and fuel characterization, nuclear safeguards and radiation protection, and it will allow other potential users to avoid the time-consuming calculations required to obtain the aforementioned data. Additionally, it constitutes an interesting dataset for model training in machine learning applications related to nuclear science and engineering.
ABSTRACT
On 25th February 2022, increased gamma radiation dose rates were reported within the Chornobyl Exclusion Zone (CEZ). This coincided with Russian military vehicles entering the Ukrainian part of the CEZ from neighbouring Belarus. It was speculated that contaminated soil resuspension by vehicle movements or a leak from the Chornobyl Nuclear Power Plant complex may explain these spikes in radiation dose rates. The gamma dose rate monitoring network in the CEZ provides a crucial early warning system for releases of radioactivity to the environment and is part of the international safeguards for nuclear facilities. With the potential for further military action in the CEZ and concerns over nuclear safety, it is essential that such anomalous readings are investigated. We evaluate the hypotheses suggested to explain the apparent gamma dose rate increases, demonstrating that neither military vehicle-induced soil resuspension nor a leak from the Chornobyl Nuclear Power Plant are plausible. However, disruption of the Chornobyl base-station's reception of wireless signals from the gamma dose rate monitoring network in the CEZ may potentially explain the dose rate increases recorded.
Subject(s)
Chernobyl Nuclear Accident , Military Personnel , Radiation Exposure , Radiation Monitoring , Humans , Soil , Environment , Ukraine , Radiation DosageABSTRACT
Infrastructure development is a major driver of biodiversity loss globally. With upward of US$2.5 trillion in annual investments in infrastructure, the financial sector indirectly drives this biodiversity loss. At the same time, biodiversity safeguards (project-level biodiversity impact mitigation requirements) of infrastructure financiers can help limit this damage. The coverage and harmonization of biodiversity safeguards are important factors in their effectiveness and therefore warrant scrutiny. It is equally important to examine the extent to which these safeguards align with best-practice principles for biodiversity impact mitigation outlined in international policies, such as that of the International Union for Conservation of Nature. We assessed the biodiversity safeguards of public development banks and development finance institutions for coverage, harmonization, and alignment with best practice. We used Institute of New Structural Economics and Agence Française de Développement's global database to identify development banks that invest in high-biodiversity-footprint infrastructure and have over US$500 million in assets. Of the 155 banks, 42% (n = 65) had biodiversity safeguards. Of the existing safeguards, 86% (56 of 65) were harmonized with International Finance Corporation (IFC) Performance Standard 6 (PS6). The IFC PS6 (and by extension the 56 safeguard policies harmonized with it) had high alignment with international best practice in biodiversity impact mitigation, whereas the remaining 8 exhibited partial alignment, incorporating few principles that clarify the conditions for effective biodiversity offsetting. Given their dual role in setting benchmarks and leveraging private finance, infrastructure financiers in development finance need to adopt best-practice biodiversity safeguards if the tide of global biodiversity loss is to be stemmed. The IFC PS6, if strengthened, can act as a useful template for other financier safeguards. The high degree of harmonization among safeguards is promising, pointing to a potential for diffusion of practices.
Evaluación mundial de las salvaguardas para la biodiversidad de los bancos del desarrollo que financian la infraestructura Resumen El desarrollo infraestructural es una de las causas principales de la pérdida mundial de biodiversidad. Con más de US$2.5 billones de inversión anual en la infraestructura, el sector financiero impulsa de forma indirecta esta pérdida. Al mismo tiempo, las salvaguardas para la biodiversidad (los requerimientos para la mitigación del impacto sobre la biodiversidad a nivel proyecto) de los financiadores de la infraestructura pueden ayudar a limitar este daño. La cobertura y armonización de estas salvaguardas son factores importantes en su efectividad y por lo tanto requieren de escrutinio. Es igual de importante examinar en qué medida se ajustan estas salvaguardas con los principios de mejores prácticas para mitigar el impacto sobre la biodiversidad esbozados en las políticas internacionales, como las de la UICN. Analizamos las salvaguardas para la biodiversidad de los bancos del desarrollo público y las instituciones de financiamiento para el desarrollo en cuanto a cobertura, armonización y ajuste con las mejores prácticas. Usamos las bases de datos mundiales del Institute of New Structural Economics y de la Agence Française de Développement para identificar los bancos del desarrollo que invierten en infraestructuras con una gran huella de biodiversidad y que tienen más de US$500 millones en activos. De los 155 bancos, el 42% % (n = 65) tenía salvaguardas para la biodiversidad. De éstas, el 86% (56 de 65) armonizaba con el Estándar de Desempeño 6 (PS6) de la Corporación Financiera Internacional (IFC). El PS6 de la IFC (y por extensión, las 56 salvaguardas que armonizan con él) tuvo un gran ajuste con las mejores prácticas internacionales para la mitigación del impacto sobre la biodiversidad, mientras que las ocho faltantes exhibieron un ajuste parcial, pues incorporaban pocos principios que clarificaban las condiciones de una compensación efectiva de biodiversidad. Ya que los financiadores de la infraestructura tienen un papel doble estableciendo referencias e impulsando el financiamiento privado, también necesitan adoptar las mejores prácticas para salvaguardar la biodiversidad si se desea detener la pérdida de biodiversidad mundial. El PS6 de la IFC, si se fortalece, puede fungir como una plantilla útil para los demás financiadores de las salvaguardas. La gran armonización entre las salvaguardas es prometedora y apunta hacia un potencial de difusión de las prácticas.
Subject(s)
Biodiversity , Conservation of Natural Resources , Public Policy , Databases, FactualABSTRACT
Synthetic biologists design and engineer organisms for a better and more sustainable future. While the manifold prospects are encouraging, concerns about the uncertain risks of genome editing affect public opinion as well as local regulations. As a consequence, biosafety and associated concepts, such as the Safe-by-design framework and genetic safeguard technologies, have gained notoriety and occupy a central position in the conversation about genetically modified organisms. Yet, as regulatory interest and academic research in genetic safeguard technologies advance, the implementation in industrial biotechnology, a sector that is already employing engineered microorganisms, lags behind. The main goal of this work is to explore the utilization of genetic safeguard technologies for designing biosafety in industrial biotechnology. Based on our results, we posit that biosafety is a case of a changing value, by means of further specification of how to realize biosafety. Our investigation is inspired by the Value Sensitive Design framework, to investigate scientific and technological choices in their appropriate social context. Our findings discuss stakeholder norms for biosafety, reasonings about genetic safeguards, and how these impact the practice of designing for biosafety. We show that tensions between stakeholders occur at the level of norms, and that prior stakeholder alignment is crucial for value specification to happen in practice. Finally, we elaborate in different reasonings about genetic safeguards for biosafety and conclude that, in absence of a common multi-stakeholder effort, the differences in informal biosafety norms and the disparity in biosafety thinking could end up leading to design requirements for compliance instead of for safety.
Subject(s)
Biotechnology , Containment of Biohazards , Humans , Communication , Engineering , FenbendazoleABSTRACT
BACKGROUND: No laws or official guidelines govern voluntary assisted dying (VAD) in Japan. A legislative bill on the termination of life-sustaining measures has yet to be sent to deliberations for legislation, due to strong opposition that has prevented it from being submitted to the Diet. However, Japan has recently witnessed several cases involving VAD. MAIN TEXT: Against this backdrop, we argue that Japan should begin discussion on VAD legislation, referring to the Voluntary Assisted Dying Act 2017 (VADA2017), which was established in 2017 in Victoria, Australia. VADA2017 puts in place a wide range of stringent safeguards and is considered worldwide to be the safest and most conservative policy on a physician offering assisted dying based on the patient's premeditated request. We consider what opposing opinions from society would arise in response to the VADA2017. Among these will include arguments against VAD itself, those against the validation of this act, and opinions that oppose even the initiation of the dialogue on VAD. CONCLUSIONS: We conclude that to protect the right to life among those placed in vulnerable positions and, at the same time, to respect decision-making of those who wish for immediate death due to unbearable suffering, the dialogue must immediately begin with that on introducing a policy more conservative than that of the VADA2017, which solidly considers arguments against VAD.
Subject(s)
Physicians , Suicide, Assisted , Humans , Japan , Victoria , Dissent and DisputesABSTRACT
Through a systematic scanning of 235U and 238U emission lines between 280 nm and 745 nm, the optimal emission line for direct gaseous uranium hexafluoride (UF6) enrichment assay using laser-induced breakdown spectroscopy (LIBS) was found. Screening for spectral features that are potentially useful for U isotopic analysis was gauged from the magnitude of the 235U-238U isotopic shift and the signal-to-background ratio of the emission line through a parameter termed ΔSBR 235U-238U. The ΔSBR spectrum shows peaks at wavelength positions where there are strong lines with significant 235U-238U shifts. The screening identified 13 spectral-window candidates, which were down selected based on their overall accuracy in predicting the 235U enrichment of three UF6 samples of natural (0.720 atom% 235U) and low-enriched (4.675 atom% and 9.157 atom% 235U) grades. The U(I) 646.498 nm emission line, with a determined 235U-238U isotopic shift of -17.7 pm, was found to be the optimal spectral window for direct UF6 enrichment assay. The root mean square error for enrichment assays on the three natural and low-enriched UF6 samples, with each sample measured in six replicates, was 0.31% in absolute 235U content. Each measurement comprised LIBS signals accumulated from 3000 laser shots. The analytical bias and precision were better than 0.5% and 0.3%, respectively, in absolute [235U/(235U + 238U)] ratios. Specific for the two low-enriched UF6 samples, the relative standard deviations from six replicated measurements were around 2%.
ABSTRACT
The monitoring of nuclear safeguards measurements consists of verifying the coherence between the operator declarations and the corresponding inspector measurements on the same nuclear items. Significant deviations may be present in the data, as consequence of problems with the operator and/or inspector measurement systems. However, they could also be the result of data falsification. In both cases, quantitative analysis and statistical outcomes may be negatively affected by their presence unless robust statistical methods are used. This article aims to investigate the benefits deriving from the introduction of robust procedures in the nuclear safeguards context. In particular, we will introduce a robust estimator for the estimation of the uncertainty components of the measurement error model. The analysis will prove the capacity of robust procedures to limit the bias in simulated and empirical contexts to provide more sounding statistical outcomes. For these reasons, the introduction of robust procedures may represent a step forward in the still ongoing development of reliable uncertainty quantification methods for error variance estimation.
ABSTRACT
The vitality of clinical research and the health of the public relies on continued efforts to engage children in clinical research in a fully protected and ethically robust manner. Parents serve as proxy decision-makers assessing the risks and benefits of any given study in order to do what is in the best interest of their child. This study investigated maternal perceptions of research safeguards and mothers' willingness to enroll their children in clinical research studies. We hypothesized that mothers' perceptions of the protectiveness of safeguard procedures utilized in clinical research would be associated with mothers' willingness to enroll their children in research studies with such safeguards. Through a survey conducted via Amazon Mechanical Turk, mothers were asked to rate the perceived protectiveness of four safeguard procedures (confidential data coding, data and safety monitoring boards (DSMBs), institutional review boards (IRBs), and informed consent) and the degree to which they were willing to have their child participate in research studies in the presence of each of the four safeguard procedures. Respondents generally perceived safeguard procedures to be protective. Mothers' trust in researchers' honesty positively impacted perceptions of the protectiveness of research safeguard procedures and willingness to enroll children in research. Mothers of only healthy children perceived research safeguards to be more protective than mothers with at least one child with at least one health issue. This study provides insight into whether maternal perceptions of the protectiveness of different safeguard procedures are associated with mothers' willingness to enroll their children in research.
ABSTRACT
BACKGROUND: A growing number of studies show the potential of loyalty card data for use in health research. However, research into public perceptions of using this data is limited. This study aimed to investigate public attitudes towards donating loyalty card data for academic health research, and the safeguards the public would want to see implemented. The way in which participant attitudes varied according to whether loyalty card data would be used for either cancer or COVID-19 research was also examined. METHODS: Participants (N = 40) were recruited via Prolific Academic to take part in semi-structured telephone interviews, with questions focused on data sharing related to either COVID-19 or ovarian/bowel cancer as the proposed health condition to be researched. Content analysis was used to identify sub-themes corresponding to the two a priori themes, attitudes and safeguards. RESULTS: Participant attitudes were found to fall into two categories, either rational or emotional. Under rational, most participants were in favour of sharing loyalty card data. Support of health research was seen as an important reason to donate such data, with loyalty card logs being considered as already within the public domain. With increased understanding of research purpose, participants expressed higher willingness to donate data. Within the emotional category, participants shared fears about revealing location information and of third parties obtaining their data. With regards to safeguards, participants described the importance of anonymisation and the level of data detail; the control, convenience and choice they desired in sharing data; and the need for transparency and data security. The change in hypothetical purpose of the data sharing, from Covid-19 to cancer research, had no impact on participants' decision to donate, although did affect their understanding of how loyalty card data could be used. CONCLUSIONS: Based on interviews with the public, this study contributes recommendations for those researchers and the wider policy community seeking to obtain loyalty card data for health research. Whilst participants were largely in favour of donating loyalty card data for academic health research, information, choice and appropriate safeguards are all exposed as prerequisites upon which decisions are made.
Subject(s)
COVID-19 , Public Opinion , Attitude , Humans , Information Dissemination , Qualitative ResearchABSTRACT
Covid-19 requires practitioners to reflect on how they deliver health services. Using technology, in particular video technology, has increased, especially in primary care. This article considers the implications of technology for assessments under the Mental Health Act 1983. NHS Covid-19 guidance anticipated its use in assessments, but this was held to be unlawful. Is this the right decision or is it too restrictive an interpretation of the 1983 Act? The article argues that consideration should be given to the potential role, if any, of video technology in assessments and identifies some issues that need to be addressed. Use of these technologies should be part of the current review of the 1983 legislation.
Subject(s)
COVID-19 , Mental Health , Humans , TechnologyABSTRACT
OBJECTIVES: Machine learning (ML) and natural language processing have great potential to improve efficiency and accuracy in diagnosis, treatment recommendations, predictive interventions, and scarce resource allocation within psychiatry. Researchers often conceptualize such an approach as operating in isolation without much need for human involvement, yet it remains crucial to harness human-in-the-loop practices when developing and implementing such techniques as their absence may be catastrophic. We advocate for building ML-based technologies that collaborate with experts within psychiatry in all stages of implementation and use to increase model performance while simultaneously increasing the practicality, robustness, and reliability of the process. METHODS: We showcase pitfalls of the traditional ML framework and explain how it can be improved with human-in-the-loop techniques. Specifically, we applied active learning strategies to the automatic scoring of a story recall task and compared the results to a traditional approach. RESULTS: Human-in-the-loop methodologies supplied a greater understanding of where the model was least confident or had knowledge gaps during training. As compared to the traditional framework, less than half of the training data were needed to reach a given accuracy. CONCLUSIONS: Human-in-the-loop ML is an approach to data collection and model creation that harnesses active learning to select the most critical data needed to increase a model's accuracy and generalizability more efficiently than classic random sampling would otherwise allow. Such techniques may additionally operate as safeguards from spurious predictions and can aid in decreasing disparities that artificial intelligence systems otherwise propagate.