Unmasking Bias and Inequities: A Systematic Review of Bias Detection and Mitigation in Healthcare Artificial Intelligence Using Electronic Health Records

Objectives: Artificial intelligence (AI) applications utilizing electronic health records (EHRs) have gained popularity, but they also introduce various types of bias. This study aims to systematically review the literature that address bias in AI research utilizing EHR data. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. We retrieved articles published between January 1, 2010, and October 31, 2022, from PubMed, Web of Science, and the Institute of Electrical and Electronics Engineers. We defined six major types of bias and summarized the existing approaches in bias handling. Results: Out of the 252 retrieved articles, 20 met the inclusion criteria for the final review. Five out of six bias were covered in this review: eight studies analyzed selection bias; six on implicit bias; five on confounding bias; four on measurement bias; two on algorithmic bias. For bias handling approaches, ten studies identified bias during model development, while seventeen presented methods to mitigate the bias. Discussion: Bias may infiltrate the AI application development process at various stages. Although this review discusses methods for addressing bias at different development stages, there is room for implementing additional effective approaches. Conclusion: Despite growing attention to bias in healthcare AI, research using EHR data on this topic is still limited. Detecting and mitigating AI bias with EHR data continues to pose challenges. Further research is needed to raise a standardized method that is generalizable and interpretable to detect, mitigate and evaluate bias in medical AI.Comment: 29 pages, 2 figures, 2 tables, 2 supplementary files, 66 reference

Pseudogap behavior in charge density wave kagome material ScV6_6Sn6_6 revealed by magnetotransport measurements

Over the last few years, significant attention has been devoted to studying the kagome materials AV$_3$Sb$_5$ (A = K, Rb, Cs) due to their unconventional superconductivity and charge density wave (CDW) ordering. Recently ScV$_6$Sn$_6$ was found to host a CDW below $\approx$90K, and, like AV$_3$Sb$_5$, it contains a kagome lattice comprised only of V ions. Here we present a comprehensive magnetotransport study on ScV$_6$Sn$_6$. We discovered several anomalous transport phenomena above the CDW ordering temperature, including insulating behavior in interlayer resistivity, a strongly temperature-dependent Hall coefficient, and violation of Kohler's rule. All these anomalies can be consistently explained by a progressive decrease in carrier densities with decreasing temperature, suggesting the formation of a pseudogap. Our findings suggest that high-temperature CDW fluctuations play a significant role in determining the normal state electronic properties of ScV$_6$Sn$_6$

The Novel Monkeypox Outbreak: What Should We Know and Reflect On?

While the COVID-19 pandemic continues, the world is on high alert regarding the second public health threat of a global monkeypox outbreak. Monkeypox, a relative of smallpox, is a zoonotic disease that was initially restricted to Africa. However, a novel outbreak has occurred in Europe, a non-endemic region, starting in May 2022. In the face of this unprecedented event, people should be aware of several crucial facts regarding monkeypox to support global public health prevention and control of the outbreak, including pathogenetic epidemiological and diagnostic aspects. As the cases outside Africa rapidly increase, including in a large proportion of men who have sex with men, thinking about the potential effects on global public health, as well as the shifting epidemiological trends of monkeypox and the insights from this novel outbreak, will be crucial

Symmetry-protected higher-order exceptional points in staggered flatband rhombic lattices

Higher-order exceptional points (EPs), which appear as multifold degeneracies in the spectra of non-Hermitian systems, are garnering extensive attention in various multidisciplinary fields. However, constructing higher-order EPs still remains as a challenge due to the strict requirement of the system symmetries. Here we demonstrate that higher-order EPs can be judiciously fabricated in PT -symmetric staggered rhombic lattices by introducing not only on-site gain/loss but also nonHermitian couplings. Zero-energy flatbands persist and symmetry-protected third-order EPs (EP3) arise in these systems owing to the non-Hermitian chiral/sublattice symmetry, but distinct phase transitions and propagation dynamics occur. Specifically, the EP3 arises at the Brillouin zone (BZ) boundary in the presence of on-site gain/loss. The single-site excitations display an exponential power increase in the PT -broken phase. Meanwhile, a nearly flatband sustains when a small lattice perturbation is applied. For the lattices with non-Hermitian couplings, however, the EP3 appears at the BZ center. Quite remarkably, our analysis unveils a dynamical delocalization-localization transition for the excitation of the dispersive bands and a quartic power increase beyond the EP3. Our scheme provides a new platform towards the investigation of the higher-order EPs, and can be further extended to the study of topological phase transitions or nonlinear processes associated with higher-order EPs.Comment: 10 pages, 10 figure

Determination of the 95% effective dose of remimazolam tosylate in anesthesia induction inhibits endotracheal intubation response in senile patients

Background and Purpose: The prevalence of elderly patients prompts anesthesiologists to determine the optimal dose of medication due to the altered pharmacokinetics and pharmacodynamics of this population. The present study aimed to determine the 95% effective dose (ED95) of remimazolam tosylate in anesthesia induction to inhibit endotracheal intubation-related cardiovascular reaction in frail and non-frail senile patients.Methods: A prospective sequential allocation dose-finding study of remimazolam tosylate was conducted on 80 elderly patients who received general anesthesia between May and June 2022 at the First Affiliated Hospital of Nanchang University. The initial dose was 0.3 mg/kg. The blood pressure and heart rate fluctuations during intubation were either <20% (negative cardiovascular response) or ≥20% (positive cardiovascular response). If positive, the dose of the next patient was increased by 0.02 mg/kg, while if negative, it was reduced by 0.02 mg/kg according to the 95:5 biased coin design (BCD). The ED95 and 95% confidence intervals (CIs) were determined using R-Foundation isotonic regression and bootstrapping methods.Results: The ED95 of remimazolam tosylate to inhibit the response during tracheal intubation was 0.297 mg/kg (95% CI: 0.231–0.451 mg/kg) and 0.331 mg/kg (95% CI: 0.272–0.472 mg/kg) in frail and non-frail senile patients, respectively.Conculation and Implications: The CI of the two groups overlap, and no difference was detected in the ED95 of remimazolam tosylate in inhibiting endotracheal intubation-related cardiovascular response in frail and non-frail senile patients. These results suggested that remimazolam tosylate is an optimal anesthesia inducer for all elderly patients.Clinical Trial Registration:https://www.chictr.org.cn, identifier ChiCTR2200055709

Evolution of multiple cell clones over a 29-year period of a CLL patient

Chronic lymphocytic leukaemia (CLL) is a frequent B-cell malignancy, characterized by recurrent somatic chromosome alterations and a low level of point mutations. Here we present single-nucleotide polymorphism microarray analyses of a single CLL patient over 29 years of observation and treatment, and transcriptome and whole-genome sequencing at selected time points. We identify chromosome alterations 13q14−, 6q− and 12q+ in early cell clones, elimination of clonal populations following therapy, and subsequent appearance of a clone containing trisomy 12 and chromosome 10 copy-neutral loss of heterogeneity that marks a major population dominant at death. Serial single-cell RNA sequencing reveals an expression pattern with high FOS, JUN and KLF4 at disease acceleration, which resolves following therapy, but reoccurs following relapse and death. Transcriptome evolution indicates complex changes in expression occur over time. In conclusion, CLL can evolve gradually during indolent phases, and undergo rapid changes following therapy

Full-length single-cell RNA-seq applied to a viral human cancer:applications to HPV expression and splicing analysis in HeLa S3 cells

Background: Viral infection causes multiple forms of human cancer, and HPV infection is the primary factor in cervical carcinomas Recent single-cell RNA-seq studies highlight the tumor heterogeneity present in most cancers, but virally induced tumors have not been studied HeLa is a well characterized HPV+ cervical cancer cell line Result: We developed a new high throughput platform to prepare single-cell RNA on a nanoliter scale based on a customized microwell chip Using this method, we successfully amplified full-length transcripts of 669 single HeLa S3 cells and 40 of them were randomly selected to perform single-cell RNA sequencing Based on these data, we obtained a comprehensive understanding of the heterogeneity of HeLa S3 cells in gene expression, alternative splicing and fusions Furthermore, we identified a high diversity of HPV-18 expression and splicing at the single-cell level By co-expression analysis we identified 283 E6, E7 co-regulated genes, including CDC25, PCNA, PLK4, BUB1B and IRF1 known to interact with HPV viral proteins Conclusion: Our results reveal the heterogeneity of a virus-infected cell line It not only provides a transcriptome characterization of HeLa S3 cells at the single cell level, but is a demonstration of the power of single cell RNA-seq analysis of virally infected cells and cancers