The availability of large, deidentified health datasets has enabled significant innovation in using machine learning (ML) to better understand patients and their diseases. However, questions remain regarding the true privacy of this data, patient control over their data, and how we regulate data sharing in a way that that does not encumber progress or further potentiate biases for underrepresented populations. After reviewing the literature on potential reidentifications of patients in publicly available datasets, we argue that the cost—measured in terms of access to future medical innovations and clinical software—of slowing ML progress is too great to limit sharing data through large publicly available databases for concerns of imperfect data anonymization. This cost is especially great for developing countries where the barriers preventing inclusion in such databases will continue to rise, further excluding these populations and increasing existing biases that favor high-income countries. Preventing artificial intelligence’s progress towards precision medicine and sliding back to clinical practice dogma may pose a larger threat than concerns ofpotentialpatient reidentification within publicly available datasets. While the risk to patient privacy should be minimized, we believe this risk will never be zero, and society has to determine an acceptable risk threshold below which data sharing can occur—for the benefit of a global medical knowledge system.

Current methods to evaluate a journal’s impact rely on the downstream citation mapping used to generate the Impact Factor. This approach is a fragile metric prone to being skewed by outlier values and does not speak to a researcher’s contribution to furthering health outcomes for all populations. Therefore, we propose the implementation of a Diversity Factor to fulfill this need and supplement the current metrics. It is composed of four key elements: dataset properties, author country, author gender and departmental affiliation. Due to the significance of each individual element, they should be assessed independently of each other as opposed to being combined into a simplified score to be optimized. Herein, we discuss the necessity of such metrics, provide a framework to build upon, evaluate the current landscape through the lens of each key element and publish the findings on a freely available website that enables further evaluation. The OpenAlex database was used to extract the metadata of all papers published from 2000 until August 2022, and Natural language processing was used to identify individual elements. Features were then displayed individually on a static dashboard developed using TableauPublic, which is available at www.equitablescience.com. In total, 130,721 papers were identified from 7,462 journals where significant underrepresentation of LMIC and Female authors was demonstrated. These findings are pervasive and show no positive correlation with the Journal’s Impact Factor. The systematic collection of the Diversity Factor concept would allow for more detailed analysis, highlight gaps in knowledge, and reflect confidence in the translation of related research. Conversion of this metric to an active pipeline would account for the fact that how we define those most at risk will change over time and quantify responses to particular initiatives. Therefore, continuous measurement of outcomes across groups and those investigating those outcomes will never lose importance. Moving forward, we encourage further revision and improvement by diverse author groups in order to better refine this concept.

Public health campaigns broadcast the link between heavy alcohol consumption during pregnancy and physical, cognitive, and behavioral birth defects; however, they appear less effective in deterring moderate consumption prevalent in women who are pregnant or of childbearing age. The incidence of mild Fetal Alcohol Spectrum Disorders (FASD) is likely underestimated because the affected individuals lack physical signs such as retarded growth and facial dysmorphology and cognitive/behavioral deficits are not commonly detected until late childhood. Sensory information processing is distorted in FASD, but alcohol's effects on the development of axons that mediate these functions are not widely investigated. We hypothesize that alcohol exposure alters axon growth and guidance contributing to the aberrant connectivity that is a hallmark of FASD. To test this, we administered alcohol to pregnant dams from embryonic day (E) 7.5 to 14.5, during the time that axons which form the major forebrain tracts are growing. We found that moderate alcohol exposure had no effect on body weight of E15.5 embryos, but significantly increased the length of L1+ axons. To investigate a possible cause of increased L1+ axon length, we investigated the number and distribution of corridor cells, one of multiple guidance cues for thalamocortical axons which are involved in sensory processing. Alcohol did not affect corridor cell number or distribution at the time when thalamocortical axons are migrating. Future studies will investigate the function of other guidance cues for thalamocortical axons, as well as lasting consequences of axon misguidance with prenatal alcohol exposure.

Se demuestra como la gestión de los eventos adversos en los establecimientos de atención de la salud puede mejorarse con el entrenamiento de los equipos de trabajo en metodologías y herramientas de calidad propias del Kaizen, que ayudan a desarrollar microproyectos enfocados a mejorar los resultados de procesos específicos. Finalmente, esto fortalece la cultura de calidad de las instituciones y la seguridad de los pacientes

Introduction: Ocular trauma is a significant cause of preventable monocular blindness among young adults in Latin America, frequently linked to assaults and high-energy projectiles. Case description: A 35-year-old male presented to the emergency department after being struck in the right eye by a compressed-air rubber projectile. Clinical findings: Examination revealed no light perception, enophthalmos, a 1 cm scleral laceration, extensive corneal perforation, intraocular tissue loss, and a central rubber foreign body (OTS category 1; IGATES: penetrating trauma with foreign body). Patient evaluation: Ultrasound and CT scans confirmed intraocular hemorrhage, globe deformity, and periorbital emphysema without bone fracture. Intervention: Urgent primary evisceration was performed under general anesthesia and loco-regional block, involving thorough uveal curettage and hydrogen peroxide irrigation to prevent sympathetic ophthalmia; an orbital conformer was not implanted due to a lack of hospital supplies. The postoperative course was free of pain or infection, and the patient was referred for disability and mental health assessment. Conclusions: Timely primary evisceration under general anesthesia and loco-regional block is an effective approach for non-reconstructible open-globe injuries with irreversible vision loss, mitigating severe immunological complications. Furthermore, this case highlights the critical need to ensure the availability of prosthetic supplies in public facilities and to provide comprehensive psychological and vocational support, given the severe socioeconomic and self-image impact on productive adults.