Digital health fiduciaries:protecting user privacy when sharing health data

Wearable self-tracking devices capture multidimensional health data and offer several advantages including new ways of facilitating research. However, they also create a conflict between individual interests of avoiding privacy harms, and collective interests of assembling and using large health data sets for public benefits. While some scholars argue for transparency and accountability mechanisms to resolve this conflict, an average user is not adequately equipped to access and process information relating to the consequences of consenting to further uses of her data. As an alternative, this paper argues for fiduciary relationships, which put deliberative demands on digital health data controllers to keep the interests of their data subjects at the forefront as well as cater to the contextual nature of privacy. These deliberative requirements ensure that users can engage in collective participation and share their health data at a lower risk of privacy harms. This paper also proposes a way to balance the flexible and open-ended nature of fiduciary law with the specific nature and scope of fiduciary duties that digital health data controllers should owe to their data subjects.</p

Proxy Assertions and Agency:The Case of Machine-Assertions

The world is witnessing a rise in speech-enabled devices serving as epistemic informants to their users. Some philosophers take the view that because the utterances produced by such machines can be phenomenologically similar to an equivalent human speech, and they may deliver the same function in terms of delivering content to their audience, such machine utterances should be conceptualized as “assertions”. This paper argues against this view and highlights the theoretical and pragmatic challenges faced by such a conceptualization which seems to be based on a “functionalist” account of assertion. Instead, the paper argues that the view that some such machine utterances can be “proxy assertions”, made on behalf of the designers and/or deployers of such machines is more tenable. Existing accounts of such a view, however, need further refinement, which is provided here. The paper then discusses implications of this view for design of such machines, particularly those enabled and equipped with machine learning capabilities.</p

Contextual Multilingual Spellchecker for User Queries

Spellchecking is one of the most fundamental and widely used search features. Correcting incorrectly spelled user queries not only enhances the user experience but is expected by the user. However, most widely available spellchecking solutions are either lower accuracy than state-of-the-art solutions or too slow to be used for search use cases where latency is a key requirement. Furthermore, most innovative recent architectures focus on English and are not trained in a multilingual fashion and are trained for spell correction in longer text, which is a different paradigm from spell correction for user queries, where context is sparse (most queries are 1-2 words long). Finally, since most enterprises have unique vocabularies such as product names, off-the-shelf spelling solutions fall short of users' needs. In this work, we build a multilingual spellchecker that is extremely fast and scalable and that adapts its vocabulary and hence speller output based on a specific product's needs. Furthermore, our speller out-performs general purpose spellers by a wide margin on in-domain datasets. Our multilingual speller is used in search in Adobe products, powering autocomplete in various applications

A Scoping Review and Preliminary Illustrative Analysis of Biomarkers in Stress-Related Psychiatric Illness: Diagnostic and Prognostic Implications

Stress is the body's response to any changes that might place it under mental, emotional, or physical strain and could either demand attention or prompt action. A stress reaction can be brought on by both internal and external factors. The conditions, demands, issues, and expectations you deal with every day are all regarded as external influences, as are your physical surroundings, your job, your contacts with others, your family, and all other related factors. The ability of your body to respond to and handle external stimuli depends on internal factors. Your ability to handle stress is influenced internally by your food habits, level of general health and fitness, mental health, and the amount of sleep and rest you get. Such demanding conditions could affect how certain stress hormone levels are regulated. Biomarkers such as mGlu2/3, 5-hydroxyindoleacetic acid (5-HIAA), serum alpha-amylase, amygdala reactivity, neuropeptide Y (NPY), heat shock proteins, cortisol, and catecholamines are used to assess the hormone imbalance. Disease prevention, early detection, and therapy are all possible uses for biomarkers. In this review, we looked at a wide range of stress-related biomarkers that might cause different psychiatric illnesses and how those conditions can, over time, alter a person's lifestyle

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701