Clicking Away Consent: Establishing Accountability and Liability Apportionment in Direct-to-Consumer Healthcare Artificial Intelligence

Artificial Intelligence (AI) and machine learning are making sweeping changes across all industries, and health care is no exception. AI promises to revolutionize patient treatment with the development of algorithm-driven tools to improve efficiency in clinical care. As alluring as machine-driven learning may be given its potentialities, however, the incorporation of AI into the healthcare field has also been received with trepidation. This fear is understandable given the lack of transparency to the public surrounding the exact mechanisms for creating algorithms and the reasoning followed by the software. Indeed, AI in the healthcare system is aptly known as “black-box medicine.” Liability apportionment for when AI malfunctions or errs is special cause for concern and an area of tort law that remains largely uncharted, controversial, and jurisdiction-dependent. This note sets out to provide solutions to the moral and legal concerns raised by AI developers’ use of liability waivers to escape culpability, specifically in the context of direct-to consumer health and medical mobile applications (apps). The seminal case of Tunkl v. Regents of University of California provides an excellent six-factor framework for the judicial interpretation necessary to ensure accountability and transparency in AI-based treatment. This note argues that the Tunkl factor of bargaining power dynamics should hold controlling weight as it deals with the essence of contract validity based on mutual understanding and voluntariness. Focusing on the power dynamic between AI developers and consumers is especially important in the healthcare app space because of the heavy influence of information asymmetry and heuristic biases, which are exacerbated by the black box nature of medicine. This framework should be applied in invalidating exculpatory clauses contrary to public policy and in finding all waivers of liability required to be signed by app users to be presumptively invalid, regardless of the categorization of the app (i.e., for both health apps and wellness apps). Centering concerns over bargaining power and voluntariness in judicial interpretation of exculpatory clauses, and thus upholding the principles of contractual freedom, is essential to establishing accountability and transparency in AI healthcare use

Post-fire successional effects on breeding grassland birds in mesquite savanna habitats of the Texas rolling plains

North American grasslands and grassland birds have declined drastically due to habitat degradation by fire suppression (i.e., woody encroachment), fragmentation, and conversion to croplands. A better understanding is needed of the relationships among disturbance regimes (e.g., fire), resultant vegetation changes, and grassland bird communities to effectively manage remaining grasslands and grassland birds. I assessed the relationship between post-fire succession, and mean relative abundance and nesting ecology of breeding grassland birds (i.e., nest-site selection and nest success) in mesquite-dominated rangeland of the Texas Rolling Plains, where prescribed fire is used as a tool to manage shrub encroachment. Brush cover, grass cover, and visual obstruction generally increased with post-fire succession, and bare ground decreased with post-fire succession. Species richness, grasshopper sparrows (Ammodramus savannarum), CassinâÂÂs sparrows (Aimophila cassinii), and dickcissels (Spiza americana) responded positively to post-fire succession, and lark sparrows (Chondestes grammacus) responded negatively to post-fire succession.; abundance of these avian groups was low on the control sites. During 2004âÂÂ2005, 90 grassland bird nests were monitored. I found conflicting results for vegetation parameters important to nest site selection and probability of nest success. For all species except lark sparrows, nest-site location was positively associated with visual obstruction and with grass or forb cover. However, the probability of nest success increased with lower visual obstruction, bare ground cover, or grass cover. Grassland bird abundance, nest-site location, and nest success had differing associations with vegetation variables. These results suggest that to effectively manage remaining grasslands for sustainable breeding grassland bird populations, managers should engage in practices that keep habitat in multiple vegetative successional stages

1991 Convocation

Opening Selections: George Bizet, Henry Mancini Processional: Jean Joseph Mouret Welcome: Dr. John Peoples, Director, Fermi National Accelerator Laboratory; Dr. Stephanie Pace Marshall, Executive Director; Walter Lee, Student Council President Introductions: Dr. Stephanie Pace Marshall Musical Selection: Lew Pallack Keynote Speaker: Dr. Donald L. Correll, Associate Program Leader, Laser Programs, Lawrence Livermore National Laboratory Recessional: Rimsky-Korsako

Determination of Cyanide Exposure by Gas Chromatography–mass Spectrometry Analysis of Cyanide-exposed Plasma Proteins

Exposure to cyanide can occur in a variety of ways, including exposure to smoke from cigarettes or fires, accidental exposure during industrial processes, and exposure from the use of cyanide as a poison or chemical warfare agent. Confirmation of cyanide exposure is difficult because, in vivo, cyanide quickly breaks down by a number of pathways, including the formation of both free and protein-bound thiocyanate. A simple method was developed to confirm cyanide exposure by extraction of protein-bound thiocyanate moieties from cyanide-exposed plasma proteins. Thiocyanate was successfully extracted and subsequently derivatized with pentafluorobenzyl bromide for GC–MS analysis. Thiocyanate levels as low as 2.5 ng mL−1 and cyanide exposure levels as low as 175 g kg−1 were detected. Samples analyzed from smokers and non-smokers using this method showed significantly different levels of protein-bound thiocyanate (p \u3c 0.01). These results demonstrate the potential of this method to positively confirm chronic cyanide exposure through the analysis of protein-bound cyanide in human plasma

A toolbox of nanobodies developed and validated for use as intrabodies and nanoscale immunolabels in mammalian brain neurons.

Nanobodies (nAbs) are small, minimal antibodies that have distinct attributes that make them uniquely suited for certain biomedical research, diagnostic and therapeutic applications. Prominent uses include as intracellular antibodies or intrabodies to bind and deliver cargo to specific proteins and/or subcellular sites within cells, and as nanoscale immunolabels for enhanced tissue penetration and improved spatial imaging resolution. Here, we report the generation and validation of nAbs against a set of proteins prominently expressed at specific subcellular sites in mammalian brain neurons. We describe a novel hierarchical validation pipeline to systematically evaluate nAbs isolated by phage display for effective and specific use as intrabodies and immunolabels in mammalian cells including brain neurons. These nAbs form part of a robust toolbox for targeting proteins with distinct and highly spatially-restricted subcellular localization in mammalian brain neurons, allowing for visualization and/or modulation of structure and function at those sites

Preferential tau aggregation in von Economo neurons and fork cells in frontotemporal lobar degeneration with specific MAPT variants.

Tau aggregation is a hallmark feature in a subset of patients with frontotemporal dementia (FTD). Early and selective loss of von Economo neurons (VENs) and fork cells within the frontoinsular (FI) and anterior cingulate cortices (ACC) is observed in patients with sporadic behavioral variant FTD (bvFTD) due to frontotemporal lobar degeneration (FTLD), including FTLD with tau inclusions (FTLD-tau). Recently, we further showed that these specialized neurons show preferential aggregation of TDP-43 in FTLD-TDP. Whether VENs and fork cells are prone to tau accumulation in FTLD-tau remains unclear, and no previous studies of these neurons have focused on patients with pathogenic variants in the gene encoding microtubule-associated protein tau (FTLD-tau/MAPT). Here, we examined regional profiles of tau aggregation and neurodegeneration in 40 brain regions in 8 patients with FTLD-tau/MAPT and 7 with Pick's disease (PiD), a sporadic form of FTLD-tau that often presents with bvFTD. We further qualitatively assessed the cellular patterns of frontoinsular tau aggregation in FTLD-tau/MAPT using antibodies specific for tau hyperphosphorylation, acetylation, or conformational change. ACC and mid-insula were among the regions most affected by neurodegeneration and tau aggregation in FTLD-tau/MAPT and PiD. In these two forms of FTLD-tau, severity of regional neurodegeneration and tau protein aggregation were highly correlated across regions. In FTLD-tau/MAPT, VENs and fork cells showed disproportionate tau protein aggregation in patients with V337 M, A152T, and IVS10 + 16 variants, but not in patients with the P301L variant. As seen in FTLD-TDP, our data suggest that VENs and fork cells represent preferentially vulnerable neuron types in most, but not all of the MAPT variants we studied