Sustainable AI : An inventory of the state of knowledge of ethical, social, and legal challenges related to artificial intelligence

This report is an inventory of the state of knowledge of ethical, social, and legal challenges related to artificial intelligence conducted within the Swedish Vinnova-funded project “Hållbar AI – AI Ethics and Sustainability”, led by Anna Felländer. Based on a review and mapping of reports and studies, a quantitative and bibliometric analysis, and in-depth analyses of the healt- care sector, the telecom sector, and digital platforms, the report proposes three recommendations. Sustainable AI requires: 1. a broad focus on AI governance and regulation issues, 2. promoting multi-disciplinary collaboration, and 3. building trust in AI applications and applied machine-learning, which is a matter of key importance and requires further study of the relationship between transparency and accountability

Changes in rates of arthroscopy due to degenerative knee disease and traumatic meniscal tears in Finland and Sweden

Background and purpose — Knee arthroscopy is commonly performed to treat degenerative knee disease symptoms and traumatic meniscal tears. We evaluated whether the recent high-quality randomized control trials not favoring arthroscopic surgery for degenerative knee disease affected the procedure incidence and trends in Finland and Sweden. Patients and methods — We conducted a bi-national registry-based study including all adult (aged ≥18 years) inpatient and outpatient arthroscopic surgeries performed for degenerative knee disease (osteoarthritis (OA) and degenerative meniscal tears) and traumatic meniscal tears in Finland between 1997 and 2012, and in Sweden between 2001 and 2012. Results — In Finland, the annual number of operations was 16,389 in 1997, reached 20,432 in 2007, and declined to 15,018 in 2012. In Sweden, the number of operations was 9,944 in 2001, reached 11,711 in 2008, and declined to 8,114 in 2012. The knee arthroscopy incidence for OA was 124 per 105 person-years in 2012 in Finland and it was 51 in Sweden. The incidence of knee arthroscopies for meniscal tears coded as traumatic steadily increased in Finland from 64 per 105 person-years in 1997 to 97 per 105 person-years in 2012, but not in Sweden. Interpretation — The incidence of arthroscopies for degenerative knee disease declined after 2008 in both countries. Remarkably, the incidence of arthroscopy for degenerative knee disease and traumatic meniscal tears is 2 to 4 times higher in Finland than in Sweden. Efficient implementation of new high-quality evidence in clinical practice could reduce the number of ineffective surgeries

Incidence of femoral fractures in children and adolescents in Finland and Sweden between 1998 and 2016 : A binational population-based study

Background and objective: Femoral fractures in children have significant impact for patients, family, and trauma resources as they usually require hospitalization and surgical treatment. The aim of this study was to determine the incidence and trends of femoral fractures among children and adolescents hospitalized between 1998 and 2016 in Finland and Sweden. Methods: All patients younger than 17 years of age in Finland and Sweden with a femoral fracture treated surgically between 1998 and 2016 were included in the study. Data were collected from National Hospital Discharge Registries. Patients were classified by gender and age into four groups. The annual incidences per 100,000 were calculated using annual mid-year population census data obtained from the Official Statistics of Finland and Sweden. Results: In total, 6410 patients younger than 17 years of age diagnosed with femoral fracture were included in this study. The total incidence per 100,000 femoral fractures was 13.3 in Finland and 11.0 in Sweden. The incidence of femoral fractures decreased during the study period in all age groups, except for teenage Finnish girls. Most of the fractures were located in femoral shaft. Fractures of the upper and distal femur were rare. Male predominance was detected in all age groups older than 1 year. Conclusions: The incidence of femoral fractures decreased in all age groups except in teenage Finnish girls. Majority of femoral fractures were located in femoral shaft with male predominance. In children younger than 1 year of age, female predominance was found.publishedVersionPeer reviewe

\u3ci\u3eMedicine Meets Virtual Reality 21\u3c/i\u3e

Editors: James D. Westwood, Susan W. Westwood, Li Felländer-Tsai, Cali M. Fidopiastis, Randy S. Haluck, Richard A. Robb, Steven Senger, Kirby G. Vosburgh. Chapter, Varying the Speed of Perceived Self-Motion Affects Postural Control During Locomotion, co-authored by Joshua Pickhinke, Jung Hung Chien, Mukul Mukherjee, UNO faculty and staff members. Virtual reality environments have been used to show the importance of perception of self-motion in controlling posture and gait. In this study, the authors used a virtual reality environment to investigate whether varying optical flow speed had any effect on postural control during locomotion. Healthy young adult participants walked under two conditions, with optical flow matching their preferred walking speed, and with a randomly varying optic flow speed compared to their preferred walking speed. Exposure to the varying optic flow increased the variability in their postural control as measured by area of COP when compared with the matched speed condition. If perception of self-motion becomes less predictable, postural control during locomotion becomes more variable and possibly riskier.https://digitalcommons.unomaha.edu/facultybooks/1261/thumbnail.jp

TPM: Cloud-Based Tele PTSD Monitor Using Multi-Dimensional Information

An automated system that can remotely and non-intrusively screen individuals at high risk for Post-Traumatic Stress Disorder (PTSD) and monitor their progress during treatment would be desired by many Veterans Affairs (VAs) as well as other PTSD treatment and research organizations. In this paper, we present an automated, cloud-based Tele-PTSD Monitor (TPM) system based on the fusion of multiple sources of information. The TPM system can be hosted in a cloud environment and accessed through landline or cell phones, or on the Internet through a web portal or mobile application (app)

A Voice-Based Automated System for PTSD Screening and Monitoring

Comprehensive evaluation of PTSD includes diagnostic interviews, self-report testing, and physiological reactivity measures. It is often difficult and costly to diagnose PTSD due to patient access and the variability in symptoms presented. Additionally, potential patients are often reluctant to seek help due to the stigma associated with the disorder. A voice-based automated system that is able to remotely screen individuals at high risk for PTSD and monitor their symptoms during treatment has the potential to make great strides in alleviating the barriers to cost effective PTSD assessment and progress monitoring. In this paper we present a voice-based automated Tele-PTSD Monitor (TPM) system currently in development, designed to remotely screen, and provide assistance to clinicians in diagnosing PTSD. The TPM system can be accessed via a Public Switched Telephone Network (PSTN) or the Internet. The acquired voice data is then sent to a secure server to invoke the PTSD Scoring Engine (PTSD-SE) where a PTSD mental health score is computed. If the score exceeds a predefined threshold, the system will notify clinicians (via email or short message service) for confirmation and/or an appropriate follow-up assessment and intervention. The TPM system requires only voice input and performs computer-based automated PTSD scoring, resulting in low cost and easy field-deployment. The concept of the TPM system was supported using a limited dataset with an average detection accuracy of up to 95.88%

Mortality following proximal humerus fracture—a nationwide register study of 147,692 fracture patients in Sweden

Summary: Little is known about survival after proximal humerus fracture. In this manuscript, we found the mortality to be high (almost four times higher than in age- and sex-matched controls). While frailty hip fracture has gained attention, we hope our manuscript will shed light on frailty proximal humerus fracture patients. Introduction: Proximal humerus fractures (PHF) are common and occur mostly after the 6th decade of life. While mortality following PHF has been reported previously, mortality data after longer follow-up on a national level is lacking. Methods: We obtained data from the Swedish Hospital Discharge Register (SHDR), on all adult patients (≥ 18 years) with a diagnosis of PHF (S42.2, S42.20, or S42.21) for the period between 2001 and 2016. We used the Swedish Cause of Death Register (SCDR) to investigate mortality in the fracture cohort. We compared the mortality of fracture patients with age- and sex-matched population-based mortality data obtained from Statistics Sweden. Results: A total of 147 692 PHF patients were identified, with a male to female ratio of 1:3. The mean age was 69 years (range, 18 to 111). Most patients were treated non-surgically (n = 126,487, 86%). The crude mortality rate was 2.2% at 1 month, 4.1% at 3 months, 8.5% at 12 months, and 24% at 48 months after sustaining a PHF. Mortality increased with age; however, the standardized mortality rate (SMR) was highest among young patients. SMR was 5.4 in the 18- to 39-year age group, 3.9 in the 40- to 64-year age group, 1.8 in the 65–79-year age group, and 1.2 in the ≥ 80-year-old population. The age-adjusted SMR was 3.9 in the whole adult PHF population. Conclusion: The mortality rate and SMR suggest that PHF patients are heterogeneous. Some older PHF patients may benefit from specialized care (e.g., orthogeriatric), and this should be evaluated in future studies.publishedVersionPeer reviewe

Operative versus non-operative treatment for 2-part proximal humerus fracture: A multicenter randomized controlled trial

Background Although increasingly used, the benefit of surgical treatment of displaced 2-part proximal humerus fractures has not been proven. This trial evaluates the clinical effectiveness of surgery with locking plate compared with non-operative treatment for these fractures. Methods and findings The NITEP group conducted a superiority, assessor-blinded, multicenter randomized trial in 6 hospitals in Finland, Estonia, Sweden, and Denmark. Eighty-eight patients aged 60 years or older with displaced (more than 1 cm or 45 degrees) 2-part surgical or anatomical neck proximal humerus fracture were randomly assigned in a 1:1 ratio to undergo either operative treatment with a locking plate or non-operative treatment. The mean age of patients was 72 years in the non-operative group and 73 years in the operative group, with a female sex distribution of 95% and 87%, respectively. Patients were recruited between February 2011 and April 2016. The primary outcome measure was Disabilities of Arm, Shoulder, and Hand (DASH) score at 2-year follow-up. Secondary outcomes included Constant–Murley score, the visual analogue scale for pain, the quality of life questionnaire 15D, EuroQol Group’s 5- dimension self-reported questionnaire EQ-5D, the Oxford Shoulder Score, and complications. The mean DASH score (0 best, 100 worst) at 2 years was 18.5 points for the operative treatment group and 17.4 points for the non-operative group (mean difference 1.1 [95% CI −7.8 to 9.4], p = 0.81). At 2 years, there were no statistically or clinically significant between-group differences in any of the outcome measures. All 3 complications resulting in secondary surgery occurred in the operative group. The lack of blinding in patient-reported outcome assessment is a limitation of the study. Our assessor physiotherapists were, however, blinded. Conclusions This trial found no significant difference in clinical outcomes at 2 years between surgery and non-operative treatment in patients 60 years of age or older with displaced 2-part fractures of the proximal humerus. These results suggest that the current practice of performing surgery on the majority of displaced proximal 2-part fractures of the humerus in older adults may not be beneficial. Trial registration ClinicalTrials.gov NCT01246167.Peer reviewe