Gender Bias in Artificial Intelligence: Severity Prediction at an Early Stage of COVID-19

Artificial intelligence (AI) technologies have been applied in various medical domains to predict patient outcomes with high accuracy. As AI becomes more widely adopted, the problem of model bias is increasingly apparent. In this study, we investigate the model bias that can occur when training a model using datasets for only one particular gender and aim to present new insights into the bias issue. For the investigation, we considered an AI model that predicts severity at an early stage based on the medical records of coronavirus disease (COVID-19) patients. For 5,601 confirmed COVID-19 patients, we used 37 medical records, namely, basic patient information, physical index, initial examination findings, clinical findings, comorbidity diseases, and general blood test results at an early stage. To investigate the gender-based AI model bias, we trained and evaluated two separate models—one that was trained using only the male group, and the other using only the female group. When the model trained by the male-group data was applied to the female testing data, the overall accuracy decreased—sensitivity from 0.93 to 0.86, specificity from 0.92 to 0.86, accuracy from 0.92 to 0.86, balanced accuracy from 0.93 to 0.86, and area under the curve (AUC) from 0.97 to 0.94. Similarly, when the model trained by the female-group data was applied to the male testing data, once again, the overall accuracy decreased—sensitivity from 0.97 to 0.90, specificity from 0.96 to 0.91, accuracy from 0.96 to 0.91, balanced accuracy from 0.96 to 0.90, and AUC from 0.97 to 0.95. Furthermore, when we evaluated each gender-dependent model with the test data from the same gender used for training, the resultant accuracy was also lower than that from the unbiased model.

Nonarthritic Hip Pathology Patterns According to Sex, Femoroacetabular Impingement Morphology, and Generalized Ligamentous Laxity

Background: Sex differences are frequently encountered when diagnosing orthopaedic problems. Current literature suggests specific sex differences, such as a higher prevalence of cam-type femoroacetabular impingement syndrome in male patients and features of hip instability in female patients. Purpose: To identify hip pathology patterns according to sex, alpha angle deformity, and generalized ligamentous laxity (GLL) in a nonarthritic patient population that underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome and labral tears. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients who underwent primary hip arthroscopy between February 2008 and February 2017 were included and separated into male and female groups for initial analysis. Patients were excluded if they had Tönnis osteoarthritis grade >1, previous ipsilateral hip surgery, or previous hip conditions. The demographics, radiographic findings, intraoperative findings, and surgical procedures were then analyzed and compared. Subanalyses were performed for both groups. A threshold of 1 SD above the mean alpha angle in the male group was used to create 2 subgroups. For female patients, GLL based on a Beighton score ≥4 was used to divide the group. Intraoperative findings were compared for both subanalyses. Results: A total of 2701 hips met all inclusion and exclusion criteria. Of those, 994 hips were in the male group and 1707 in the female group. The mean ± SD age was 36.6 ± 13.8 and 37.1 ± 15.0 years for the male and female groups, respectively( P = .6288). The average body mass index was significantly higher in the male group ( P < .0001). GLL was more common in women (38.6%) than men (13.6%) ( P < .001). The male group had a higher proportion of acetabular Outerbridge grade 3 (21.8%) and 4 (19.2%) lesions when compared with the female group (9.3% and 6.3%, respectively) ( P < .0001). Men in the subgroup with an alpha angle ≥78° reported higher rates of acetabular Outerbridge grade 4 damage than men with an alpha angle <78° ( P < .001). Mean lateral center-edge angle was lower in the female subgroup with Beighton score ≥4 vs <4 (23.7°± 4.2° vs 31.3°± 5.8°; P < .0001). Conclusion: In this analysis of a large cohort of patients who underwent hip arthroscopy, 2 patterns of hip pathologies were related to sex. On average, male patients had larger alpha angles and increased acetabular chondral damage when compared with their female counterparts. Furthermore, a larger cam-type anatomy was associated with more severe acetabular chondral damage in men. In the female group, the incidence of features of hip instability such as GLL were significantly higher than in the male group.

Sex-related differences regarding cephalic vein lead access for CIEDs implantation

Background Minimally invasive and safe central venous access is imperative for lead insertion of cardiac implantable electronic devices (CIEDs). The purpose of this trial was to explore and compare the usability of the cephalic vein (CV) between both sexes. Methods and results This single-center prospective study included 102 consecutive patients in a period of six months. Pre-procedural contrast-enhanced venographic images of the upper arm were performed in all included patients. Our attention was focused on comparing several morpho-anatomical CV characteristics such as venous diameter, presence of valves and angle of entrance of the CV into the subclavian vein (SV). Study results concerning the CV morpho-anatomical differences were more favorable regarding the female patient group, with significant differences in CV diameter (p-0.030). There was also a difference in favor of the female group regarding the favorable CV angle of entrance into the SV, found in the 61.7% versus 54.4% in the male patient group. The comparison of usability of the CV and CVC technique was explored by comparing the number of leads inserted through the CV in both sexes. Two leads were implanted in 11.7% in the female group versus 5.8% in the male group, and 0 leads through the CV in 38.2% of the female patients versus 50% of male group. Conclusion Female patients have more favorable cephalic vein morpho-anatomical futures and better usability for lead placement than male patients.

Growth Performance, Carcass Characteristics and Meat Quality of Organically Reared Broiler Chickens Depending on Sex

Given the growing interest of consumers in naturally produced meat, we decided to examine the muscles of Ross 308 broiler chickens kept in an ecological system, with the division into two research groups depending on sex. All the analyses were carried out using the appropriate methods recommended by the AOAC and in accordance with the Polish standards (PN), which are described in detail in the relevant section of the publication. The aim of the experiment was to investigate the effect of sex on the growth performance, carcass traits and meat quality, as well as the fatty acid profile and histological parameters, of the pectoral muscles from organic broiler chickens. A total of 60 one-day-old Ross 308 chickens (half males and half females) were divided into two groups, according to the sex, and reared under organic conditions (Org.) until 82 days of age (ten birds, i.e., five males and five females in each of three pens; replications for experimental groups). Compared with the female group, the male group had a higher final BW and carcass weight (p < 0.05). The males had a better growth and slaughter performance than the females. The meat quality traits and fatty acids content were also affected by sex. The meat from females showed a significantly higher (p < 0.05) protein, dry matter, fiber diameter and shear force and a significantly lower (p < 0.05) fat level than the male group. In this research, the suitability of these fast-growing broilers for natural and organic production systems has been researched with regard to the performance, meat quality and histological characteristics of the muscles.

“Perrotta Psychotherapeutic Protocol for Disorders of the Neurotic Area” (PPP-DNA): Proposal of protocol, profiles and clinical applications. Research

Purpose: This research addresses the topic of anxiety, phobic and obsessive disorders. In this research, the theme is addressed to the psychopathological investigation of personalities, according to the PICI-2TA model (Perrotta Integrative Clinical Interviews, version 2-TA), the PAD-Q (Perrotta Affective Dependency Questionnaire), the PSM (Perrotta Sexual Matrix), the PDM-Q (Perrotta Defence Mechanisms Questionnaire) and the PHEM model (Perrotta Human Emotions Model), in order to design a direct and functional psychotherapeutic protocol to manage the psychopathological process in the shortest time possible, according to the principles of efficiency, effectiveness and economy, trying to reduce the symptomatology until the total regression by the fifth-tenth session. Methods: Clinical interview and administration of the PICI-2, the PAD-Q, the PSM, and the PDM-Q. Results: In the male group, aged 18-36 years, there were 8 people, of whom 6 (75%) reacted to the total resolution of the neurotic symptomatology described between the fifth and ninth sessions, while only 2 (25%) said they felt their neurotic symptoms had subsided. In the male group, aged 37-54 years, there are 5 people, of whom 4 (80%) reacted to the total resolution of neurotic symptomatology described between the fifth and ninth sessions. In the male group, aged 55-72 years, there were 6 people, of whom 4 (66.6%) reacted to the total resolution of neurotic symptoms described between the ninth and tenth sessions. In the female group, aged 18-36 years, there were 22 people, of whom 18 (82%) reacted to the total resolution of neurotic symptoms described between the fifth and ninth sessions. In the female group, aged 37-54 years, there were 13 people, of whom 9 (69.2%) reacted to the total resolution of neurotic symptoms described between the fifth and ninth session. In the female group, aged 55-72 years, there were 11 people, of whom 8 (72.7%) reacted to the total resolution of neurotic symptoms described between the fifth and ninth sessions. Conclusions: The research showed that the PPP-DNA protocol, for neurotic disorders, was effective in the total population sample for 74.36%, for the fractionated male population sample for 73.86% and for the fractionated female population sample for 74.86%, with resistance to change identified in adverse conditions of family, environmental, socio-cultural and temporal type (of duration of neurotic symptomatology), however able to promote an attenuation of the symptomatology suffered by at least 50%.

Sex differences in transradial access site characteristics and crossover in STEMI

Objective To assess the differences according to sex in radial artery access site characteristics and crossover and it's influence on the success of ST segment elevation myocardial infarction (STEMI) procedures with primary chosen transradial access site in a large series of patients. Background Transradial angiography (TRA) is now the default access site for PPCI, but technically is a more challenging approach mostly due to anatomic challenges connected to the radial artery. Methods All 5092 consecutive STEMI patients from our center, in the period from March 2011 until December 2017 were examined. Patient were divided in two groups according to sex. Preprocedural radial artery angiography was performed in all patients. Clinical and procedure characteristics, type of radial anatomy variants, transfer to other access sites, transfer direction and procedure time were analyzed. Access site bleeding complications and in-hospital mortality were also recorded. Primary end-point of the study was the occurrence of TRA failure and need to crossover to another access site to finish the procedure. Results From the STEMI population in this period the female group had 1326 PPCI treated patients and the male group 3766 patients. The female group of patients was older 65±11 than the male group 59±11 (p&lt;0,0001). BMI was 27 vs. 30 in the male group (p=0.0003). Most common risk factors in both groups were hypertension, smoking and diabetes, with the latter being more frequent in the female group p&lt;0,0001. Radial artery anomalies were more frequent in the female group 8,8% vs 6,5% (p&lt;0,0001), with complex RA loop and tortuous RA having double percentage than in their male counterparts. Primary chosen TRA access site failure occurred in 4.6% (61) vs. 3.5% (97) of STEMI patients (p&lt;0.0001). Most common access site crossover site was right ulnar access in both groups with 57 and 61% accordingly. Access site bleeding complications, were more common in the female group with 4.4% vs. 3.2%, also this difference persisted in EASY score hematoma 3 to 5. Clinical radial artery spasm was significantly more frequent in female patients 5,7% vs. 2.2% (p&lt;0.0001). In-hospital mortality rate was similar in the two group of patients. Conclusion Female sex is a significant risk factor for TRA failure in STEMI usually connected to smaller size of RA and the more common finding of radial artery anomalies and spasm. FUNDunding Acknowledgement Type of funding sources: None.

Platelet polyphosphate and SARS-Cov-2 mRNA-vaccine-induced inflammatory side-effects: a pilot study

Background: Platelets have recently been recognized as immune cells. Platelets first contact invading pathogens and then induce immune reactions in cooperation with white blood cells. Platelet polyphosphate (polyP), which is classically recognized as a thrombotic and hemostatic biomolecule, has recently attracted attention as a cytokine that modulates inflammation and is involved in intercellular communication between platelets and major immune cells. Objective: To determine the involvement of polyP in SARS-Cov-2-mRNA vaccine-induced immune responses, this pilot study examined the effects of mRNA vaccines on platelet polyP levels. Methods: Before and after vaccination (BNT162b2), blood samples were obtained from healthy, non-smoking individuals (relatively older male group, n=6 vs. younger female group, n=23), who did not have systemic diseases that required continuous treatment. Washed platelets were prepared and subjected to a fluorometric determination of platelet polyP levels using 4',6-diamidino-2-phenylindole. The side effects of vaccination were recorded as scores. Results: Compared with the male group, platelet polyP levels decreased in the relatively younger female group after the initial dose, while the side effect score increased in the female group after the second dose. Moderate correlation coefficients were observed between the reduction in polyP levels and the side effect scores or the original polyP levels. Conclusions: Despite being a pilot study using a small sample size, this study suggests the possibility that platelet polyP may suppress the side effects induced by the mRNA vaccines after the initial dose, but not the second dose, in relatively young female subjects who generally have high immune responsiveness.

A Study on the Factors of Cosmetics Purchasing Behavior for Adolescents

The purpose of this study is to examine the factors of cosmetics purchasing behavior of cosmetics for adolescents. This study was conducted through a survey of 278 people, and the IBM SPSS 26.0 was used for statistical processing. The results of this study are as follows. First, adolescents tend to collect information necessary for purchasing cosmetics through the Internet, and purchase cosmetics directly by visiting cosmetics stores. Second, adolescents usually purchase cosmetics once or twice a month, and prefer products in the range of 10,000 to 20,000 won. The most important thing to consider when purchasing cosmetics is skin condition. Third, regarding the purchase of cosmetics, adolescents have a greater influence on their peer group. And the female group is more affected by the appearance and skin factors than the male group. The higher the cost of spending a month in cosmetic products and their interest in peer groups they are, the greater the number of purchases of cosmetics Adolescents tend to increas. Fifth, the higher the price of the cosmetics and the appearance factor they are, The higher the cost of purchasing cosmetics per month adolescents tend to spend. The results of this study can be used as basic data to understand cosmetics purchasing behavior and planning cosmetic sales strategies for adolescents.

The relationship between smoking cigarettes and metabolic syndrome: A cross-sectional study with non-single residents of Seoul under 40 years old

Introduction Young adults receive health screenings at lower rates than other age groups, and it may be difficult to detect diseases in the early stages for this group. We examined differences in health status relative to smoking in a young age group using the results of health screenings conducted in engaged and newly married couples in a cross-sectional database. Methods The participants in this study were 808 young adults who visited a municipal hospital health screening center from July 2017 to March 2019. They completed a self-administered questionnaire, and physical measurements and a blood test were taken. They were classified into non-cigarette smokers, past cigarette smokers, and current cigarette smokers according to smoking behavior. In this study, we compared metabolic syndrome, the main components of which include obesity, high blood pressure, high blood triglycerides, low levels of HDL cholesterol and insulin resistance, with smoking behavior. Results The mean age of the participants was 30.9±3.3 years (males 32.0±3.2, females 29.8±3.1), and 13.9% were current cigarette smokers (males 22.8%, females 5.1%). The proportion of men in their 30s was 76.6% for male group and 50.0% for female group, indicating that the male group had a relatively higher proportion of older and current smokers. Significant differences were found in age, sex, blood pressure, metabolic abnormalities, and drinking status according to smoking status. Cigarette smokers had a 2.4-fold greater risk of metabolic syndrome (95% confidence interval [CI], 1.43–3.96) than non-cigarette smokers; in particular, they had a 2.6-fold (95% CI, 1.44–4.55) greater risk of hypertriglyceridemia and a three-fold (95% CI, 1.45–6.35) greater risk of low HDL cholesterol. Conclusions In comparison with non-single, young and generally healthy city dwellers, the risk of metabolic syndrome was significantly higher in smokers than in non-smokers, and in particular, it was confirmed that the risk of hypertriglyceridemia and low HDL cholesterolemia was higher. Smoking cessation is necessary, even for the young, because smoking may cause changes in blood lipids even if the smoking duration is short.