Maximizing biomedical research impacts through bioethical considerations.

Bioethics is the formal study of ethical judgments concerning the advances and applications of biology, medicine and related technologies. In a time of unprecedented biomedical advances, it is critical to integrate bioethical frameworks more fully into biomedical research to align these scientific advances with their intended societal needs. In this Perspective, we describe some motivations and frameworks for cross-disciplinary bioethical training for biomedical researchers, and discuss how actively considering bioethics in research and study design could maximize biomedical researchers' intended impacts in society.

New Findings on Unconsented Intimate Exams Suggest Racial Bias and Gender Parity.

Testimony from hundreds of medical students and numerous physicians and scholars suggests that unconsented intimate exams (UIEs) are unlikely to be rare, isolated incidents. However, much is unknown about the frequency of these exams and the circumstances in which they take place. The Community Bioethics Forum, founded and chaired by one of the authors of this commentary, is a consultative group of diverse community members who provide insights on law and policy to policy-makers and medical associations.

Reflections on New Evidence on Crisis Standards of Care in the COVID-19 Pandemic.

Crisis standards of care have been widely developed by healthcare systems and states in the United States during the COVID-19 pandemic, and in some rare cases have actually been used to allocate medical resources. All publicly available U.S.

Promoting racial equity in COVID-19 resource allocation.

Due to COVID-19's strain on health systems across the globe, triage protocols determine how to allocate scarce medical resources with the worthy goal of maximising the number of lives saved. However, due to racial biases and long-standing health inequities, the common method of ranking patients based on impersonal numeric representations of their morbidity is associated with disproportionately pronounced racial disparities. In response, policymakers have issued statements of solidarity.

Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency.

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the triage protocol, summarize the protocol itself, and discuss the major ethical challenges encountered, along with our answers to these challenges.

A Pot Ignored Boils On: Sustained Calls for Explicit Consent of Intimate Medical Exams.

Unconsented intimate exams (UIEs) on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties-both within and external to medicine-have increasingly voiced opposition to these exams.

Unmet Needs, Unwanted Persons: A Call for Expansion of Safe Haven Laws.

Legislative strategies for reducing infant abandonment and neonaticide developed in response to a series of sensational cases that occurred in Texas in 1999. The media coverage of these cases implied that the incidence of the crime was increasing, and Texas legislators responded with a law permitting parents to anonymously surrender their newborn at designated locations such as hospitals. This was the first "safe haven" law.

Distinct associations of insula and cingulate volume with the cognitive and affective dimensions of alexithymia.

Alexithymia ("no words for feelings") is a major risk factor for psychosomatic and psychiatric conditions characterized by affect dysregulation. The alexithymia personality construct comprises an affective dimension, the level of subjective emotional experience (emotionalizing and fantasizing), and a cognitive dimension, referring to the cognitive control of emotions (identifying, analyzing, and verbalizing feelings). These two dimensions may differentially put individuals at risk for psychopathology, but their specific neural bases have rarely been investigated.

The influence of combined cognitive plus social-cognitive training on amygdala response during face emotion recognition in schizophrenia.

Both cognitive and social-cognitive deficits impact functional outcome in schizophrenia. Cognitive remediation studies indicate that targeted cognitive and/or social-cognitive training improves behavioral performance on trained skills. However, the neural effects of training in schizophrenia and their relation to behavioral gains are largely unknown.

Neural activity during emotion recognition after combined cognitive plus social cognitive training in schizophrenia.

Cognitive remediation training has been shown to improve both cognitive and social cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training.

Theory of mind skills are related to gray matter volume in the ventromedial prefrontal cortex in schizophrenia.

Background: Among individuals with schizophrenia, deficits in theory of mind (ToM) skills predict poor social functioning. Therefore, identifying the neural basis of ToM may assist the development of treatments that improve social outcomes. Despite growing evidence that the ventromedial prefrontal cortex (VMPFC) facilitates ToM skills among healthy individuals, methodological challenges, such as the influence of general cognitive deficits, have made it difficult to identify the relationship between ToM processing and VMPFC function in schizophrenia.

Social anhedonia is associated with neural abnormalities during face emotion processing.

Human beings are social organisms with an intrinsic desire to seek and participate in social interactions. Social anhedonia is a personality trait characterized by a reduced desire for social affiliation and reduced pleasure derived from interpersonal interactions. Abnormally high levels of social anhedonia prospectively predict the development of schizophrenia and contribute to poorer outcomes for schizophrenia patients.

A multi-classifier and decision fusion framework for robust classification of mammographic masses.

Most end-to-end Computer Aided Diagnosis (CAD) systems follow a three step approach - (1) Image enhancement and segmentation, (2) Feature extraction, and, (3) Classification. While the state of the art in image enhancement and segmentation can now very accurately identify regions of interest for feature extraction, they typically result in very high dimensional feature spaces. This adversely affects the performance of classification systems because a large feature space dimensionality necessitates a large training database to accurately model the statistics of class features (e.

Digital mammogram spiculated mass detection and spicule segmentation using level sets.

This letter presents an automated mammographic computer aided diagnosis (CAD) system to detect and segment spicules in digital mammograms, termed spiculation segmentation with level sets (SSLS). SSLS begins with a segmentation of the suspicious mass periphery, which is created using a previously developed adaptive level set segmentation algorithm (ALSSM) by the authors. The mammogram is then analyzed using features derived from the Dixon and Taylor Line Operator (DTLO), which is a method of linear structure enhancement.

Digital mammographic computer aided diagnosis (CAD) using adaptive level set segmentation.

We present a mammographic computer aided diagnosis (CAD) system, which uses an adaptive level set segmentation method (ALSSM), which segments suspicious masses in the polar domain and adaptively adjusts the border threshold at each angle to provide high-quality segmentation results. The primary contribution of this paper is the adaptive speed function for controlling level set segmentation. To assess the efficacy of the system, 60 relatively difficult cases (30 benign, 30 malignant) from the Digital Database of Screening Mammography (DDSM) are analyzed.

Level set-based core segmentation of mammographic masses facilitating three stage (core, periphery, spiculation) analysis.

We present mammographic mass core segmentation, based on the Chan-Vese level set method. The proposed method is analyzed via resulting feature efficacies. Additionally, the core segmentation method is used to investigate the idea of a three stage segmentation approach, i.