The ethical, legal and social implications of using artificial intelligence systems in breast cancer care

Breast cancer care is a leading area for development of artificial intelligence (AI), with applications including screening and diagnosis, risk calculation, prognostication and clinical decision-support, management planning, and precision medicine. We review the ethical, legal and social implications of these developments. We consider the values encoded in algorithms, the need to evaluate outcomes, and issues of bias and transferability, data ownership, confidentiality and consent, and legal, moral and professional responsibility. We consider potential effects for patients, including on trust in healthcare, and provide some social science explanations for the apparent rush to implement AI solutions. We conclude by anticipating future directions for AI in breast cancer care. Stakeholders in healthcare AI should acknowledge that their enterprise is an ethical, legal and social challenge, not just a technical challenge. Taking these challenges seriously will require broad engagement, imposition of conditions on implementation, and pre-emptive systems of oversight to ensure that development does not run ahead of evaluation and deliberation. Once artificial intelligence becomes institutionalised, it may be difficult to reverse: a proactive role for government, regulators and professional groups will help ensure introduction in robust research contexts, and the development of a sound evidence base regarding real-world effectiveness. Detailed public discussion is required to consider what kind of AI is acceptable rather than simply accepting what is offered, thus optimising outcomes for health systems, professionals, society and those receiving care

Plant species or flower colour diversity? Identifying the drivers of public and invertebrate response to designed annual meadows

© 2018 The Authors There is increasing evidence of the benefits of introducing urban meadows as an alternative to amenity mown grass in public greenspaces, both for biodiversity, and human wellbeing. Developing a better understanding of the meadow characteristics driving human and wildlife response is therefore critical. We addressed this by assessing public and invertebrate response to eight different annual meadow mixes defined by two levels of plant species diversity and two levels of colour diversity, sown in an urban park in Luton, UK, in April 2015. On-site questionnaires with the visiting public were conducted in July, August and September 2015. Invertebrate responses were assessed via contemporaneous visual surveys and one sweep net survey (August 2015). Flower colour diversity had effects on human aesthetic response and the response of pollinators such as bumblebees and hoverflies. Plant species diversity, however, was not a driver of human response with evidence that people used colour diversity as a cue to assessing species diversity. Plant species diversity did affect some invertebrates, with higher abundances of certain taxa in low species diversity meadows. Our findings indicate that if the priority for sown meadows is to maximise human aesthetic enjoyment and the abundance and diversity of observable invertebrates, particularly pollinators, managers of urban green infrastructure should prioritise high flower colour diversity mixes over those of high plant species diversity. Incorporating late-flowering non-native species such as Coreopsis tinctoria (plains coreopsis) can prolong the attractiveness of the meadows for people and availability of resources for pollinators and would therefore be beneficial

Diet quality in late midlife is associated with faster walking speed in later life in women, but not men

Healthy diet has been linked to better age-related physical functioning, but evidence on the relationship of overall diet quality in late midlife and clinically relevant measures of physical functioning in later life is limited. Research on potential sex differences in this relationship is scarce. The aim was to investigate the prospective association between overall diet quality, as assessed by the Healthy Eating Index-2015 at age 60-64y and measures of walking speed seven years later, among men and women from the Insight46, a neuroscience sub-study of the Medical Research Council National Survey of Health and Development. Diet was assessed at age 60-64y using five-day food diaries, from which total HEI-2015 was calculated. At age 69-71y, walking speed was estimated during four 10-meter walks at self-selected pace, using inertial measurement units. Multivariable linear regression models with sex as modifier, controlling for age, follow-up, lifestyle, health, social variables and physical performance were used. The final sample was 164 women and 167 men (n=331). Women had higher HEI-2015 scores and slower walking speed than men. A 10 point increase in HEI-2015 was associated with faster walking speed seven years later among women (B: 0.024, 95% CI: 0.006, 0.043), but not men. The association remained significant in the multivariable model (B: 0.021, 95% CI: 0.003, 0.040). In women in late midlife higher diet quality is associated with faster walking speed. A healthy diet in late midlife is likely to contribute towards better age-related physical capability and sex differences are likely to affect this relationship

Diminished Neural and Cognitive Responses to Facial Expressions of Disgust in Patients with Psoriasis: A Functional Magnetic Resonance Imaging Study

Psoriasis produces significant psychosocial disability; however, little is understood about the neurocognitive mechanisms that mediate the adverse consequences of the social stigma associated with visible skin lesions, such as disgusted facial expressions of others. Both the feeling of disgust and the observation of disgust in others are known to activate the insula cortex. We investigated whether the social impact of psoriasis is associated with altered cognitive processing of disgust using (i) a covert recognition of faces task conducted using functional magnetic resonance imaging (fMRI) and (ii) the facial expression recognition task (FERT), a decision-making task, conducted outside the scanner to assess the ability to recognize overtly different intensities of disgust. Thirteen right-handed male patients with psoriasis and 13 age-matched male controls were included. In the fMRI study, psoriasis patients had significantly (P<0.005) smaller signal responses to disgusted faces in the bilateral insular cortex compared with healthy controls. These data were corroborated by FERT, in that patients were less able than controls to identify all intensities of disgust tested. We hypothesize that patients with psoriasis, in this case male patients, develop a coping mechanism to protect them from stressful emotional responses by blocking the processing of disgusted facial expressions

A REPORT BY THE ALL - PARTY PARLIAMENTARY GROUP ON A FIT AND HEALTHY CHILDHOOD THE IMPACT OF SOCIAL AND ECONOMIC INEQUALITIES ON CHILDREN’S HEALTH

A child born into circumstances of social and economic inequality in the 21st century United Kingdom will start life with one hand tied behind their back. Nowhere is the disparity of experience more marked than in that of health and this, in turn, impacts the entire life course. In the same way that priority is given to securing the national infrastructure, prioritising the health of children from all areas and in all circumstances from the outset would therefore seem to be prudent rather than profligate. Yet as this Report demonstrates,successive Governments have skimped rather thansaved; failedto build upon existing policy and played a costly policy game of ‘catching up later’ instead of deploying the early ntervention me asures that are cheaper andmore effective in the long term

Neocortical inhibitory interneuron subtypes are differentially attuned to synchrony- and rate-coded information

Neurons can carry information with both the synchrony and rate of their spikes. However, it is unknown whether distinct subtypes of neurons are more sensitive to information carried by synchrony versus rate, or vice versa. Here, we address this question using patterned optical stimulation in slices of somatosensory cortex from mouse lines labelling fast-spiking (FS) and regular-spiking (RS) interneurons. We used optical stimulation in layer 2/3 to encode a 1-bit signal using either the synchrony or rate of activity. We then examined the mutual information between this signal and the interneuron responses. We found that for a synchrony encoding, FS interneurons carried more information in the first five milliseconds, while both interneuron subtypes carried more information than excitatory neurons in later responses. For a rate encoding, we found that RS interneurons carried more information after several milliseconds. These data demonstrate that distinct interneuron subtypes in the neocortex have distinct sensitivities to synchrony versus rate codes