Artificial intelligence in health and bioethical implications: a systematic review / Inteligencia artificial en salud y sus implicaciones bioéticas: una revisión sistemática / Inteligência artificial em saúde e implicações bioéticas: uma revisão sistemática

Abstract The presence of artificial intelligence in healthcare is growing, helping in diagnosis and decision making. However, its application raises doubts, mostly related to ethics. This study aimed to identify its uses in health and its bioethical implications from a systematic literature review using the PRISMA guidelines. The ScienceDirect and Scopus databases were searched, using the descriptors "artificial intelligence," "bioethics" and "health." Works in English, published between 2017 and 2021 were considered, resulting in 102 articles found and, after applying the established criteria, 11 were selected. The studies reported on the bioethical principles of beneficence, non-maleficence, autonomy and justice, adding an element, explainability. Relationships were found between artificial intelligence in health and unpredictability, predictability, trust, physicians' role, systems development, privacy, data security, financial and social aspects. Developers, healthcare professionals and patients must maximize the benefits and limit the risks of tools that use this technology.

Resumen El uso de la inteligencia artificial en salud va en aumento por facilitar el diagnóstico y la toma de decisiones, pero sus implicaciones plantean dudas relacionadas con la ética. Esta revisión sistemática desde las directrices Prisma identificó los usos de la inteligencia artificial en salud y sus implicaciones bioéticas. Las búsquedas se realizaron en Science Direct y Scopus utilizando los descriptores "artificial intelligence", "bioethics" y "health". De los trabajos en inglés publicados entre 2017 y 2021, se obtuvo 102 artículos. Aplicados los criterios, quedaron 11. Los estudios abordaron los principios bioéticos de beneficencia, no maleficencia, autonomía y justicia, añadiendo el elemento explicabilidad. La inteligencia artificial se correlacionó con la imprevisibilidad, previsibilidad, confianza, papel de los médicos, desarrollo de sistemas, privacidad, seguridad de los datos y aspectos financieros y sociales. Los desarrolladores, los profesionales sanitarios y los pacientes deben maximizar los beneficios y limitar los riesgos que involucra esta tecnología.

Resumo A presença de inteligência artificial na saúde vem crescendo, ajudando em diagnósticos e tomadas de decisão, mas suas implicações geram dúvidas relacionadas à ética. Esta revisão sistemática, baseada nas diretrizes Prisma, identificou os usos de inteligência artificial na saúde e suas implicações bioéticas. Foi realizada busca nas bases de dados Science Direct e Scopus usando os descritores "artificial intelligence", "bioethics" e "health". Trabalhos em inglês, publicados entre 2017 e 2021 foram considerados, resultando em 102 artigos. Após aplicação dos critérios estabelecidos, 11 foram selecionados. Os estudos discutiram os princípios bioéticos da beneficência, não maleficência, autonomia e justiça, adicionando o elemento explicabilidade. Inteligência artificial mostrou correlação com imprevisibilidade, previsibilidade, confiança, papel do médico, desenvolvimento de sistemas, privacidade, segurança de dados, e aspectos sociais e financeiros. Desenvolvedores, profissionais da saúde e pacientes devem maximizar os benefícios e limitar os riscos das ferramentas que usam essa tecnologia.

Biochemical and histopathological responses in Nile tilapia exposed to a commercial insecticide mixture containing dinotefuran and lambda-cyhalothrin.

The indiscriminate use of pesticides has led to an increased risk of environmental contamination and pest resistance worldwide, favoring the development of less hazardous formulations. The commercial insecticide ZEUS® (Ihara, Brazil) combining dinotefuran and lambda-cyhalothrin was recently formulated in order to meet the environmental sustainability and food security. However, little is known about the potential toxic effects of ZEUS® to aquatic species. Thus, we report, for the first time, the biochemical and histological responses in tilapia (Oreochromis niloticus) following 96 h exposure to 0.01 mg/L, 0.05 mg/L and 0.1 mg/L ZEUS®. Different biochemical endpoints, including acetylcholinesterase (AChE), gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP), were assessed as potential biomarkers of insecticide effects. Glutathione S-transferase (GST) was evaluated as a marker of phase II biotransformation, and histopathological changes were measured to indicate gill alterations following ZEUS® exposure. After 96 h exposure, ZEUS® treatment increased GST activity in the liver of fish exposed to the highest concentration, while the intermediate dose increased both renal GGT and hepatic ALP activities. These findings reflect the importance of the liver and kidneys in the detoxification of ZEUS® and highlight the need to understand further toxicity effects. Likewise, the histopathological analysis of gills provided evidence that ZEUS® caused moderate damages. Despite biomarkers alterations reported for O. niloticus following ZEUS® exposure, by comparing our findings with data on toxicity of individual compounds, the commercial ZEUS® mixture seems to present similar or even lower adverse effects on freshwater fish.

Freshwater catfish jundiá (Rhamdia quelen) larvae are prepared to digest inert feed at the exogenous feeding onset: physiological and histological assessments.

This study assessed the morphological development of jundiá larvae's digestive system and digestive proteolytic activity. Specific serine proteinases activities varied over time, with the highest peak at 12 h after hatching (AH), which corresponded to 296.38 ± 84.20 mU mg⁻¹ for trypsin and 315.45 ± 42.16 mU mg⁻¹ for chymotrypsin. Specific aspartic proteinases activities increased up to the start of weaning, oscillated during that phase, but showed a consistent increase after that, resulting in the highest specific activity at 252 h AH (7.88 ± 0.68 mU mg⁻¹). Gel assays showed different molecular forms, especially of serine proteinases. Histology showed the gastrointestinal tract development onset at 0 h AH and open mouth at 4 h AH. At 16 h AH, the following differentiation of the digestive tract was evident: oropharyngeal cavity, esophagus, liver, pancreas, stomach, and intestine. At 40 h AH, zymogen granules in the pancreas were observed, and at 48 h AH, mucus in the digestive tract and gastric glands in the stomach. Findings indicate that jundiá has a functional stomach before the end of vitelline reserves. Therefore, jundiá larvae are probably capable to digest inert feed at the exogenous feeding onset.