Open Access

Artificial intelligence is steadily being integrated into all areas of medicine. In reproductive medicine, artificial intelligence methods can be utilized to improve the selection and prediction of sperm cells, oocytes, and embryos and to generate better predictive models for in vitro fertilization. The use of artificial intelligence in this field is justified by the suffering of persons or couples who wish to have children but are unable to conceive. However, research into the use of artificial intelligence in reproductive medicine is still in the early experimental stage and furthermore raises complex normative questions. There are ethical research challenges because evidence of the efficacy of certain pertinent systems is often lacking and because of the increased difficulty of ensuring informed consent on the part of the affected persons. Other ethically relevant issues include the potential risks for offspring and the difficulty of providing sufficient information. The opportunity to fulfill the desire to have children affects the welfare of patients and their reproductive autonomy. Ultimately, ensuring more accurate predictions and allowing physicians to devote more time to their patients will have a positive effect. Nevertheless, clinicians must be able to process patient data conscientiously. When using artificial intelligence, numerous actors are involved in making the diagnosis and deciding on the appropriate therapy, raising questions about who is ultimately responsible when mistakes occur. Questions of fairness arise with regard to resource allocation and cost reimbursement. Thus, before implementing artificial intelligence in clinical practice, it is necessary to critically examine the quantity and quality of the data used and to address issues of transparency. In the medium and long term, it would be necessary to confront the undesirable impact and social dynamics that may accompany the use of artificial intelligence in reproductive medicine.

BACKGROUND Aphasia after acute stroke is a frequent and disabling condition, impairing communication and quality of life. We investigated whether tablet-assisted Speech and Language Therapy (SLT) using the Neolexon application is superior to standard SLT in acute stroke patients. METHODS In this prospective, open-label, randomized, controlled clinical trial, patients with acute post-stroke aphasia were recruited from one stroke center and two neurorehabilitation clinics in Germany. Participants were stratified by aphasia severity and randomized to tablet-assisted SLT (n = 53) or standard SLT (n = 51), initiated during inpatient care and continued in rehabilitation (30 min/Day). The primary outcome was the change in the Bielefelder Aphasia Screening (BIAS) percentile rank from baseline to 90 days. Secondary outcomes included frequency and duration of self-training. RESULTS From 07/2021 to 09/2024, 4097 patients were screened and 104 randomized (mean age 74.4 ± 11.2 years; 51.9% female). No significant difference in BIAS change was found at 90 days (18 vs. 14). The trial was stopped early for futility. The intervention group engaged in self-directed training more frequently (37.7% vs. 21.6%) and trained longer (10 vs. 4 h). Subgroup analyses showed benefits of tablet-assisted SLT in patients with mild (β = 15.51; 95% CI -1.67 to 32.69) and moderate aphasia (β = 23.58; 95% CI -4.48 to 51.65), and those with a National Institutes of Health Stroke Scale of less than 5 (β = 21.69; 95% CI 5.54-37.84). CONCLUSIONS Although underpowered to demonstrate overall superiority, tablet-assisted SLT showed potential benefits in patients with mild to moderate aphasia and less severe strokes in the acute setting. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04080817.

Der Förderung beruflich Begabter ist in Deutschland bisher ungleich weniger Beachtung geschenkt worden als etwa der Begabtenförderung im akademischen Bereich. Diesem Mangel will das Bundesinstitut für Berufsbildung mit seinem Modellversuch „Leistungsstarke Auszubildende nachhaltig fördern“ Abhilfe schaffen. Ziel des Modellversuchs ist es, beruflich besonders begabten Auszubildenden mit Hauptschul- oder Realschulabschluss bereits während ihrer Ausbildung Zusatzqualifikationen zu vermitteln.