National expenditure on health research in South Africa : What is the benchmark ?

PKThe Mexico (2004), Bamako (2008) and Algiers (2008) declarations committed the South African (SA) Ministry of Health to allocate 2% of the national health budget to research, while the National Health Research Policy (2001) proposed that the country budget for health research should be 2% of total public sector health expenditure. The National Health Research Committee has performed an audit to determine whether these goals have been met, judged by: (i) health research expenditure as proportions of gross expenditure on research and development (GERD) and the gross domestic product (GDP); and (ii) the proportion of the national health and Department of Health budgets apportioned to research. We found that total expenditure on health research in SA, aggregated across the public and private sectors,was R3.5 billion in 2009/10, equating to 16.7% of GERD. However, the total government plus science council spend on health research that year was only R729 million, equating to 3.5% of GERD (0.03% of the GDP) or 0.80% of the R91.4 billion consolidated government expenditure on health. We further found that R418 million was spent through the 2009/2010 Health Vote on health research, equating to 0.46% of the consolidated government expenditure on health or 0.9% of the R45.2 billion Health Vote. Data from other recent years were similar. Current SA public sector health research allocations therefore remain well below the aspirational goal of 2% of the national health budget. We recommend that new, realistic, clearly defined targets be adopted and an efficient monitoring mechanism be developed to track future health research expenditure

Oncolytic HSV-1 G207 immunovirotherapy for pediatric high-grade gliomas

BACKGROUND: Outcomes in children and adolescents with recurrent or progressive high-grade glioma are poor, with a historical median overall survival of 5.6 months. Pediatric high-grade gliomas are largely immunologically silent or cold, with few tumor-infiltrating lymphocytes. Preclinically, pediatric brain tumors are highly sensitive to oncolytic virotherapy with genetically engineered herpes simplex virus type 1 (HSV-1) G207, which lacks genes essential for replication in normal brain tissue. METHODS: We conducted a phase 1 trial of G207, which used a 3+3 design with four dose cohorts of children and adolescents with biopsy-confirmed recurrent or progressive supratentorial brain tumors. Patients underwent stereotactic placement of up to four intratumoral catheters. The following day, they received G207 (10 RESULTS: Twelve patients 7 to 18 years of age with high-grade glioma received G207. No dose-limiting toxic effects or serious adverse events were attributed to G207 by the investigators. Twenty grade 1 adverse events were possibly related to G207. No virus shedding was detected. Radiographic, neuropathological, or clinical responses were seen in 11 patients. The median overall survival was 12.2 months (95% confidence interval, 8.0 to 16.4); as of June 5, 2020, a total of 4 of 11 patients were still alive 18 months after G207 treatment. G207 markedly increased the number of tumor-infiltrating lymphocytes. CONCLUSIONS: Intratumoral G207 alone and with radiation had an acceptable adverse-event profile with evidence of responses in patients with recurrent or progressive pediatric high-grade glioma. G207 converted immunologically cold tumors to hot. (Supported by the Food and Drug Administration and others; ClinicalTrials.gov number, NCT02457845.)

Asteroid Retrieval Feasibility Study

This report describes the results of a study sponsored by the Keck Institute for Space Studies (KISS) to investigate the feasibility of identifying, robotically capturing, and returning an entire Near-Earth Asteroid (NEA) to the vicinity of the Earth by the middle of the next decade. The KISS study was performed by people from Ames Research Center, Glenn Research Center, Goddard Space Flight Center, Jet Propulsion Laboratory, Johnson Space Center, Langley Research Center, the California Institute of Technology, Carnegie Mellon, Harvard University, the Naval Postgraduate School, University of California at Los Angeles, University of California at Santa Cruz, University of Southern California, Arkyd Astronautics, Inc., The Planetary Society, the B612 Foundation, and the Florida Institute for Human and Machine Cognition

Prospectives

Tiré de: Prospectives, vol. 8, no 2, mars 1972Titre de l'écran-titre (visionné le 24 janv. 2013

Perspectives and Best Practices for Artificial Intelligence and Continuously Learning Systems in Healthcare

Goals of this paper Healthcare is often a late adopter when it comes to new techniques and technologies; this works to our advantage in the development of this paper as we relied on lessons learned from CLS in other industries to help guide the content of this paper. Appendix V includes a number of example use cases of AI in Healthcare and other industries. This paper focuses on identifying unique attributes, constraints and potential best practices towards what might represent “good” development for Continuously Learning Systems (CLS) AI systems with applications ranging from pharmaceutical applications for new drug development and research to AI enabled smart medical devices. It should be noted that although the emphasis of this paper is on CLS, some of these issues are common to all AI products in healthcare. Additionally, there are certain topics that should be considered when developing CLS for healthcare, but they are outside of the scope of this paper. These topics will be briefly touched upon, but will not be explored in depth. Some examples include: Human Factors – this is a concern in the development of any product – what are the unique usability challenges that arise when collecting data and presenting the results? Previous efforts at generating automated alerts have often created problems (e.g. alert fatigue.) CyberSecurity and Privacy – holding a massive amount of patient data is an attractive target for hackers, what steps should be taken to protect data from misuse? How does the European Union’s General Data Protection Regulation (GDPR) impact the use of patient data? Legal liability – if a CLS system recommends action that is then reviewed and approved by a doctor, where does the liability lie if the patient is negatively affected? Regulatory considerations – medical devices are subject to regulatory oversight around the world; in fact, if a product is considered a medical device depends on what country you are in. AI provides an interesting challenge to traditional regulatory models. Additionally, some organizations like the FTC regulate non-medical devices. This paper is not intended to be a standard, nor is this paper trying to advocate for one and only one method of developing, verifying, and validating CLS systems – this paper highlights best practices from other industries and suggests adaptation of those processes for healthcare. This paper is also not intended to evaluate existing or developing regulatory, legal, ethical, or social consequences of CLS systems. This is a rapidly evolving subject with many companies, and now some countries, establishing their own AI Principles or Code of Conduct which emphasize legal and ethical considerations including goals and principles of fairness, reliability and safety, transparency around how the results of these learning systems are explained to the people using those systems5 . The intended audience of this paper are Developers, Researchers, Quality Assurance and Validation personnel, Business Managers and Regulators across both Medical Device and Pharmaceutical industries that would like to learn more about CLS best practices, and CLS practitioners wanting to learn more about medical device software development

(Un)informed Consent: Studying GDPR Consent Notices in the Field

Since the adoption of the General Data Protection Regulation (GDPR) in May 2018 more than 60 % of popular websites in Europe display cookie consent notices to their visitors. This has quickly led to users becoming fatigued with privacy notifications and contributed to the rise of both browser extensions that block these banners and demands for a solution that bundles consent across multiple websites or in the browser. In this work, we identify common properties of the graphical user interface of consent notices and conduct three experiments with more than 80,000 unique users on a German website to investigate the influence of notice position, type of choice, and content framing on consent. We find that users are more likely to interact with a notice shown in the lower (left) part of the screen. Given a binary choice, more users are willing to accept tracking compared to mechanisms that require them to allow cookie use for each category or company individually. We also show that the wide-spread practice of nudging has a large effect on the choices users make. Our experiments show that seemingly small implementation decisions can substantially impact whether and how people interact with consent notices. Our findings demonstrate the importance for regulation to not just require consent, but also provide clear requirements or guidance for how this consent has to be obtained in order to ensure that users can make free and informed choices.Comment: 18 pages, 6 figures, 2019 ACM SIGSAC Conference on Computer and Communications Security (CCS '19), November 11-15, 2019, London, United Kingdo

Oxidised cosmic acceleration

We give detailed proofs of several new no-go theorems for constructing flat four-dimensional accelerating universes from warped dimensional reduction. These new theorems improve upon previous ones by weakening the energy conditions, by including time-dependent compactifications, and by treating accelerated expansion that is not precisely de Sitter. We show that de Sitter expansion violates the higher-dimensional null energy condition (NEC) if the compactification manifold M is one-dimensional, if its intrinsic Ricci scalar R vanishes everywhere, or if R and the warp function satisfy a simple limit condition. If expansion is not de Sitter, we establish threshold equation-of-state parameters w below which accelerated expansion must be transient. Below the threshold w there are bounds on the number of e-foldings of expansion. If M is one-dimensional or R everywhere vanishing, exceeding the bound implies the NEC is violated. If R does not vanish everywhere on M, exceeding the bound implies the strong energy condition (SEC) is violated. Observationally, the w thresholds indicate that experiments with finite resolution in w can cleanly discriminate between different models which satisfy or violate the relevant energy conditions.Comment: v2: corrections, references adde

Glucocorticoid Receptor-Dependent Gene Regulatory Networks

While the molecular mechanisms of glucocorticoid regulation of transcription have been studied in detail, the global networks regulated by the glucocorticoid receptor (GR) remain unknown. To address this question, we performed an orthogonal analysis to identify direct targets of the GR. First, we analyzed the expression profile of mouse livers in the presence or absence of exogenous glucocorticoid, resulting in over 1,300 differentially expressed genes. We then executed genome-wide location analysis on chromatin from the same livers, identifying more than 300 promoters that are bound by the GR. Intersecting the two lists yielded 53 genes whose expression is functionally dependent upon the ligand-bound GR. Further network and sequence analysis of the functional targets enabled us to suggest interactions between the GR and other transcription factors at specific target genes. Together, our results further our understanding of the GR and its targets, and provide the basis for more targeted glucocorticoid therapies