This is a condensed summary of an international multisociety statement on ethics of artificial intelligence (AI) in radiology produced by the ACR, European Society of Radiology, RSNA, Society for ...Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine. AI has great potential to increase efficiency and accuracy throughout radiology, but it also carries inherent pitfalls and biases. Widespread use of AI-based intelligent and autonomous systems in radiology can increase the risk of systemic errors with high consequence and highlights complex ethical and societal issues. Currently, there is little experience using AI for patient care in diverse clinical settings. Extensive research is needed to understand how to best deploy AI in clinical practice. This statement highlights our consensus that ethical use of AI in radiology should promote well-being, minimize harm, and ensure that the benefits and harms are distributed among stakeholders in a just manner. We believe AI should respect human rights and freedoms, including dignity and privacy. It should be designed for maximum transparency and dependability. Ultimate responsibility and accountability for AI remains with its human designers and operators for the foreseeable future. The radiology community should start now to develop codes of ethics and practice for AI that promote any use that helps patients and the common good and should block use of radiology data and algorithms for financial gain without those two attributes. This article is a simultaneous joint publication in
,
,
, and
. Published under a CC BY-NC-ND 4.0 license.
Purpose
A new type of linear accelerator (linac) was recently introduced into the market by a major manufacturer. Our institution is one of the early users of this preassembled and preconfigured ...dual‐layer multileaf collimator (MLC), ring‐gantry linac — Halcyon™ (1st version). We performed a set of full acceptance testing and commissioning (ATC) measurements for three Halcyon machines and compared the measured data with the standard beam model provided by the manufacturer. The ATC measurements were performed following the guidelines given in different AAPM protocols as well as guidelines provided by the manufacturer. The purpose of the present work was to perform a risk assessment of the ATC process for this new type of linac and investigate whether the results obtained from this analysis could potentially be used as a guideline for improving the design features of this type of linac.
Methods
AAPM's TG100 risk assessment methodology was applied to the ATC process. The acceptance testing process relied heavily on the use of a manufacturer‐supplied phantom and the automated analysis of electronic portal imaging device (EPID) images. For the commissioning process, a conventional measurement setup and process (e.g., use of water tank for scanning) was largely used. ATC was performed using guidelines recommended in various AAPM protocols (e.g., TG‐106, TG‐51) as well as guidelines provided by the manufacturer. Six medical physicists were involved in this study. Process maps, process steps, and failure modes (FMs) were generated for the ATC procedures. Failure modes and effects analysis (FMEA) were performed following the guidelines given in AAPM TG‐100 protocol. The top 5 and top 10 highest‐ranked FMs were identified for the acceptance and commissioning procedures, respectively. Quality control measures were suggested to mitigate these FMs.
Results
A total of 38 steps and 88 FMs were identified for the entire ATC process. Fourteen steps and 34 FMs arose from acceptance testing. The top 5 FMs that were identified could potentially be mitigated by the manufacturer. For commissioning, a total of 24 steps and 54 potential FMs were identified. The use of separate measurement tools that are not machine‐integrated has been identified as a cause for the higher number of steps and FMs generated from the conventional ATC approach. More than half of the quality control measures recommended for both acceptance and commissioning could potentially be incorporated by the manufacturer in the design of the Halcyon machine.
Conclusion
This paper presents the results of FMEA and quality control measures to mitigate the FMs for the ATC process for Halcyon machine. Unique FMs that result from the differences in the ATC guidelines provided by the vendor and current conventional protocols, and the challenges of performing the ATC due to the new linac features and ring‐gantry design were highlighted for the first time. The FMs identified in the present work along with the suggested quality control measures, could potentially be used to improve the design features of future ring‐gantry type of linacs that are likely to be preassembled, preconfigured, and heavily reliant on automation and image guidance.
This is a condensed summary of an international multisociety statement on ethics of artificial intelligence (AI) in radiology produced by the ACR, European Society of Radiology, RSNA, Society for ...Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine.
AI has great potential to increase efficiency and accuracy throughout radiology, but also carries inherent pitfalls and biases. Widespread use of AI-based intelligent and autonomous systems in radiology can increase the risk of systemic errors with high consequence, and highlights complex ethical and societal issues. Currently, there is little experience using AI for patient care in diverse clinical settings. Extensive research is needed to understand how to best deploy AI in clinical practice.
This statement highlights our consensus that ethical use of AI in radiology should promote well-being, minimize harm, and ensure that the benefits and harms are distributed among stakeholders in a just manner. We believe AI should respect human rights and freedoms, including dignity and privacy. It should be designed for maximum transparency and dependability. Ultimate responsibility and accountability for AI remains with its human designers and operators for the foreseeable future.
The radiology community should start now to develop codes of ethics and practice for AI which promote any use that helps patients and the common good and should block use of radiology data and algorithms for financial gain without those two attributes.
This is a condensed summary of an international multisociety statement on ethics of artificial intelligence (AI) in radiology produced by the ACR, European Society of Radiology, RSNA, Society for ...Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine. AI has great potential to increase efficiency and accuracy throughout radiology, but it also carries inherent pitfalls and biases. Widespread use of AI-based intelligent and autonomous systems in radiology can increase the risk of systemic errors with high consequence and highlights complex ethical and societal issues. Currently, there is little experience using AI for patient care in diverse clinical settings. Extensive research is needed to understand how to best deploy AI in clinical practice. This statement highlights our consensus that ethical use of AI in radiology should promote well-being, minimize harm, and ensure that the benefits and harms are distributed among stakeholders in a just manner. We believe AI should respect human rights and freedoms, including dignity and privacy. It should be designed for maximum transparency and dependability. Ultimate responsibility and accountability for AI remains with its human designers and operators for the foreseeable future. The radiology community should start now to develop codes of ethics and practice for AI that promote any use that helps patients and the common good and should block use of radiology data and algorithms for financial gain without those two attributes.
The effects of weather on an individual can often alter the population dynamics of a species. Knowledge of how weather influences individual behavior is therefore essential in understanding its full ...impact in the context of population ecology. Snowy Owls (Bubo scandiacus) exhibit expensive long-distance migrations in winters following population irruptions. During irruptive movements, many owls migrate past the southernmost extent of their traditional wintering grounds, the mechanism for which is still debated. We propose and test the “milder climate” hypothesis; Snowy Owls wintering in lower latitudes are better able to meet their metabolic demands due to higher temperatures and lower snow cover. During the Snowy Owl irruption of 2014–2015, we examined this hypothesis by assessing the influence of local weather variables on foraging success, frequency of prey capture attempts, and overall activity budgets in a sample of wintering Snowy Owls in New York, USA. We used eBird, an online citizen science resource, to help locate Snowy Owls, which we observed from an automobile. We found that none of the weather variables tested affected foraging success. However, the lack of effect of snow depth on foraging success may suggest that hearing is more important for hunting in Snowy Owls than previously thought. Hunting frequency decreased with increasing temperatures, suggesting Snowy Owls were better able to meet their metabolic demands in higher temperatures. We thus offer support for the milder climate hypothesis; Snowy Owls wintering in lower latitudes may be able to offset the energetic expenses of long-distance movements.
This study characterizes Blastocystis species infections in humans and mantled howler monkeys, Alouatta palliata aequatorialis, living in close proximity to one another in northwestern Ecuador. ...Blastocystis species were identified from 58 of 96 (60.4 %) mantled howler monkey fecal samples, and 44 of 55 human fecal samples (81.5 %) by polymerase chain reaction. Using single-stranded conformation polymorphism, we were able to efficiently separate and sequence subtypes (STs) within mixed samples without the need for cloning. Blastocystis ST1, ST2, and ST3 were found in people, and two individuals were infected with more than one subtype. All monkey samples were ST8. The lack of shared subtypes between humans and monkeys suggests that no Blastocystis transmission occurs between these species in spite of close proximity in some instances. Based on analysis of demographic data from a questionnaire given to human participants, individuals who boiled their water before consumption were significantly less likely to be infected with Blastocystis (44.4 %) compared to those who did not (93.8 %) (p = 0.002). No other risk factors were significant, although hunters, females, individuals living in large families, and those living closer to forested habitat tended to have a higher proportion of Blastocystis infections.
To describe and illustrate a novel technique of uretero-ileal anastomosis for use in urinary diversion – the Pull-through Anastomosis of Ureter To Enteric Conduit (PAUTEC). A second objective was to ...evaluate the surgical outcomes of the PAUTEC anastomosis.
Our novel anastomotic technique was described step-by-step and visually depicted with illustrations and the accompanying narrated video. Additionally, to evaluate safety and efficacy, a retrospective review of a prospectively maintained database was performed. Patients who underwent radical cystectomy alone or during pelvic exenteration, with ileal conduit diversion incorporating PAUTEC, 2016-2020 with ≥6 months follow-up were included. Surgical outcomes and renal function were analysed.
PAUTEC anastomosis was performed on 43 ureters in 23 patients. Mean age was 66 years 50-80 and 21 of 23 patients were male. One patient had a conservatively-managed small urine leak. No ureteric strictures have been identified to date. Mean serum creatinine was 1.15 mg/dL 0.69-2.08 (102umol/L, range 61-184 umol/L) preoperatively, and 1.09 mg/dL 0.61-2.59 (96.3 umol/L, range 54-229 umol/L) at follow-up, demonstrating no significant change (P= .26, paired t-test). Mean follow-up was 15 months 6-44.
A PAUTEC technique of uretero-ileal anastomosis is feasible and technically straightforward, with satisfactory outcomes observed to date.
This is a condensed summary of an international multisociety statement on ethics of artificial intelligence (AI) in radiology produced by the ACR, European Society of Radiology, RSNA, Society for ...Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine. AI has great potential to increase efficiency and accuracy throughout radiology, but it also carries inherent pitfalls and biases. Widespread use of AI-based intelligent and autonomous systems in radiology can increase the risk of systemic errors with high consequence and highlights complex ethical and societal issues. Currently, there is little experience using AI for patient care in diverse clinical settings. Extensive research is needed to understand how to best deploy AI in clinical practice. This statement highlights our consensus that ethical use of AI in radiology should promote well-being, minimize harm, and ensure that the benefits and harms are distributed among stakeholders in a just manner. We believe AI should respect human rights and freedoms, including dignity and privacy. It should be designed for maximum transparency and dependability. Ultimate responsibility and accountability for AI remains with its human designers and operators for the foreseeable future. The radiology community should start now to develop codes of ethics and practice for AI that promote any use that helps patients and the common good and should block use of radiology data and algorithms for financial gain without those two attributes.
An analysis of gastrointestinal parasites of Ecuadorian mantled howler monkeys, Alouatta palliata aequatorialis, was conducted based on examination of fecal smears, flotations, and sedimentations. At ...least 1 type of parasite was detected in 97% of the 96 fecal samples screened across 19 howler monkey groups using these techniques. Samples averaged 3.6 parasite species per individual (±1.4 SD). Parasites included species representing genera of 2 apicomplexans: Cyclospora sp. (18% of individual samples) and Isospora sp. (3%); 6 other protozoa: Balantidium sp. (9%), Blastocystis sp. (60%), Chilomastix sp. (4%), Dientamoeba sp. (3%), Entamoeba species (56%), Iodamoeba sp. (5%); 4 nematodes: Enterobius sp. (3%), Capillaria sp. (78%), Strongyloides spp. (88%) which included 2 morphotypes, Trypanoxyuris sp. (12%); and the platyhelminth Controrchis sp. (15%). A statistically significant positive correlation was found between group size and each of 3 different estimators of parasite species richness adjusted for sampling effort (ICE: r² = 0.24, P = 0.05; Chao2: r² = 0.25, P = 0.05, and Jackknife: r² = 0.31, P = 0.03). Two significant associations between co-infecting parasites were identified. Based on the prevalence data, individuals infected with Balantidium sp. were more likely to also be infected with Isospora sp. (χ² = 6.02, P = 0.01), while individuals harboring Chilomastix sp. were less likely to have Capillaria sp. present (χ² = 4.03, P = 0.04).
The Anatomy of the Acetabulum: What is Normal? Krebs, Viktor; Incavo, Stephen J.; Shields, William H.
Clinical orthopaedics and related research,
04/2009, Volume:
467, Issue:
4
Journal Article
Peer reviewed
Open access
Published studies of the human hip make frequent reference to the normal pelvis and acetabulum. However, other than qualitative descriptions we found no clinically applicable published references ...describing a normal pelvis and acetabulum; such information is important for designing certain kinds of implants (eg, reconstruction cages). We describe a method to quantify, average, and apply data gathered from normal human specimens to create a standard representation of the ilium and ischium. One hundred healthy hemipelves from 50 human skeletons were evaluated. We measured angles and distances between major anatomic landmarks in the pelvis. The data collected were analyzed for variance and averaged to create a normal topographic map. Finally, we examined several commercially available acetabular reconstruction cages to determine the fit to the anatomically determined normal pelvis. These results provide a representation of true acetabular geometry and may serve as the basis for future acetabular reconstruction cage design.
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