Auditing Risk Prediction of Long-Term Unemployment

As more and more governments adopt algorithms to support bureaucratic decision-making processes, it becomes urgent to address issues of responsible use and accountability. We examine a contested public service algorithm used in Danish job placement for assessing an individual's risk of long-term unemployment. The study takes inspiration from cooperative audits and was carried out in dialogue with the Danish unemployment services agency. Our audit investigated the practical implementation of algorithms. We find (1) a divergence between the formal documentation and the model tuning code, (2) that the algorithmic model relies on subjectivity, namely the variable which focus on the individual's self-assessment of how long it will take before they get a job, (3) that the algorithm uses the variable "origin" to determine its predictions, and (4) that the documentation neglects to consider the implications of using variables indicating personal characteristics when predicting employment outcomes. We discuss the benefits and limitations of cooperative audits in a public sector context. We specifically focus on the importance of collaboration across different public actors when investigating the use of algorithms in the algorithmic society.

Toxicity and Tolerability of 177Lu-DOTA-TATE PRRT with a Modified Administered Activity Protocol in NETs of Variable Origin – A Phase 2 Registry Study

Background: Peptide receptor radionuclide therapy (PRRT) has been recently approved for advanced, metastatic, or progressive neuroendocrine tumors (NETs). Objectives: This study reports the adverse events (AEs) observed with patient-tailored administered activity. Methods: Fifty-two PRRT naive patients were treated with 177Lu-DOTATATE. The administered activity ranges between 2.78 and 5.55 GBq/cycle using the patient's unique characteristics (age, symptoms, blood work, and biomarkers). Results: The protocol was well tolerated with the overwhelming majority of participants being forty-six (88%), completing all 4 induction therapy cycles. The median cumulative administered activity was 19.6 GBq (ranged 3.8-22.3 GBq). A total of 42/52 (81%) reported at least one symptom, and 43/52 (83%) had evidence of biochemical abnormality at enrollment that would meet grade 1 or 2 criteria for AEs. These symptoms only slightly increase with treatment to 50/52 (96%) and 51/52 (98%), respectively. The most common symptoms were mild fatigue (62%), shortness of breath (50%), nausea (44%), abdominal pain (38%), and musculoskeletal pain (37%). The most common biomarker abnormalities were mild anemia (81%), reduced estimated glomerular filtration rate (eGFR) (58%), increased alkaline phosphatase (ALP) (50%), and leukopenia (37%). Of critical importance, no 177Lu-DOTATATE related grade 3 or 4 AEs were observed. Conclusion: Tailoring the administered activity of 177Lu-DOTATATE to the individual patient with a variety of NETs is both safe and well-tolerated. No patient developed severe grade 3 or 4 AEs. Most patients exhibit symptoms or biochemical abnormality before treatment and this only slightly worsens following induction therapy.

Variable origin of vertebral artery : A Cadaveric and Multidetector computed tomographic study on Indian population

Background: The knowledge of normal and variant anatomy of vertebral artery is important for the interpretation of vascular radiology and in performing safe vascular procedures like repair of aneurysms, excision of craniocervical junction masses & vertebral endarterectomy. Aim: To find out incidence of left vertebral artery of aortic origin in North Indian population. Materials & Method: During routine dissection of thoracic region, an anatomical variation of origin of left vertebral artery of aortic origin was observed in adult male cadaver. To find out incidence of left vertebral artery of aortic origin in North Indian population, Radiological study was done on 100 patients [34 female + 66 males] who were advised computed tomography of neck & thorax for various indication. Diameter of left vertebral artery at origin from arch of aorta and where it entered foramen transversarium was measured. Length of VI segment i.e. from its origin to where it entered foramen transversarium was also measured. Result: Out of 100 patients, left vertebral artery of aortic origin was observed in 4 patients. Conclusion: Aortic origin of vertebral artery is of diagnostic importance prior to surgery in neck & chest regions. Cadaveric metrological studies are also helpful to design aortic stent