Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application : a cross sectional exploratory study

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting. Objective To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care. Method Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed. Results There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice. Conclusions Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions

British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings

The full Guideline for oxygen use in adults in healthcare and emergency settings, published in Thorax1 provides an update to the 2008 BTS Emergency oxygen guideline.2 The following is a summary of the recommendations and good practice points. The sections noted to within this summary refer to the full guideline sections

Rahapeliriippuvuus hallintaan -menetelmäkoulutus

This paper proposes an efficient algorithm to compress the cubes in the progress of the parallel data cube generation. This low overhead compression mechanism provides block-by-block and record-by-record compression by using tuple difference coding techniques, thereby maximizing the compression ratio and minimizing the decompression penalty at run-time. The experimental results demonstrate that the typical compression ratio is about 30:1 without sacrificing running time. This paper also demonstrates that the compression method is suitable for Hilbert Space Filling Curve, a mechanism widely used in multi-dimensional indexing

Reordering Columns for Smaller Indexes

Column-oriented indexes-such as projection or bitmap indexes-are compressed by run-length encoding to reduce storage and increase speed. Sorting the tables improves compression. On realistic data sets, permuting the columns in the right order before sorting can reduce the number of runs by a factor of two or more. Unfortunately, determining the best column order is NP-hard. For many cases, we prove that the number of runs in table columns is minimized if we sort columns by increasing cardinality. Experimentally, sorting based on Hilbert space-filling curves is poor at minimizing the number of runs.Comment: to appear in Information Science

Pervasive speleogenetic modification of cave passages by nitrification of biogenic ammonia

It has long been known that guano deposits from animals in caves can cause localised biogenic modification through a combination of acidity and altered environmental conditions, such as increased humidity and CO2. Geomorphological and geochemical evidence from the caves in the Gunung Mulu National Park, Sarawak, suggest this biogenic overprint may be far more widespread than previously thought due to microbial metabolic activity. Based on our observations, we propose a novel method of secondary cave enlargement by the conversion of highly soluble ammonia gas released by bat and swiftlet guano to NOx on surfaces by microbial ammonia oxidation. Our data suggest this activity produces aggressive nitric acid solutions on moist cave walls, accelerating limestone dissolution. This previously undescribed cave enlargement process has potentially profound geomorphological implications, as the original passage morphologies (which are used to interpret speleogenesis and landscape evolution) are erased and replaced with a distinctive suite of biogenic corrosion features. Such findings significantly alter our understanding of post-speleogenetic modification and secondary enlargement of caves in tropic environments

Dethroning historical reputations: Universities, museums and the commemoration of benefactors

The campaigns in universities across the world to reject, rename and remove historic benefactions have brought the present into collision with the past. In Britain the attempt to remove a statue of one of Oxford’s most famous benefactors, the imperialist Cecil Rhodes, has spread to other universities and their benefactors, and now also affects civic monuments and statues in towns and cities across the country. In the United States, memorials to leaders of the Confederacy in the American Civil War and to other slaveholders have been the subject of intense dispute. Should we continue to honour benefactors and historic figures whose actions are now deemed ethically unacceptable? How can we reconcile the views held by our ancestors with those we now hold today? Should we even try, acknowledging, in the words of the novelist L. P. Hartley, that ‘the past is another country; they do things differently there’? The essays in this interdisciplinary collection are drawn from a conference at the Institute of Historical Research in the University of London. Historians, fundraisers, a sociologist and a museum director examine these current issues from different perspectives, with an introductory essay by Sir David Cannadine, president of the British Academy. Together they explore an emerging conflict between the past and present, history and ideology, and benefactors and their critics

The Oxford Royal College of General Practitioners Clinical Informatics Digital Hub: Protocol to Develop Extended COVID-19 Surveillance and Trial Platforms

Background Routinely recorded primary care data have been used for many years by sentinel networks for surveillance. More recently, real world data have been used for a wider range of research projects to support rapid, inexpensive clinical trials. Because the partial national lockdown in the United Kingdom due to the coronavirus disease (COVID-19) pandemic has resulted in decreasing community disease incidence, much larger numbers of general practices are needed to deliver effective COVID-19 surveillance and contribute to in-pandemic clinical trials. Objective The aim of this protocol is to describe the rapid design and development of the Oxford Royal College of General Practitioners Clinical Informatics Digital Hub (ORCHID) and its first two platforms. The Surveillance Platform will provide extended primary care surveillance, while the Trials Platform is a streamlined clinical trials platform that will be integrated into routine primary care practice. Methods We will apply the FAIR (Findable, Accessible, Interoperable, and Reusable) metadata principles to a new, integrated digital health hub that will extract routinely collected general practice electronic health data for use in clinical trials and provide enhanced communicable disease surveillance. The hub will be findable through membership in Health Data Research UK and European metadata repositories. Accessibility through an online application system will provide access to study-ready data sets or developed custom data sets. Interoperability will be facilitated by fixed linkage to other key sources such as Hospital Episodes Statistics and the Office of National Statistics using pseudonymized data. All semantic descriptors (ie, ontologies) and code used for analysis will be made available to accelerate analyses. We will also make data available using common data models, starting with the US Food and Drug Administration Sentinel and Observational Medical Outcomes Partnership approaches, to facilitate international studies. The Surveillance Platform will provide access to data for health protection and promotion work as authorized through agreements between Oxford, the Royal College of General Practitioners, and Public Health England. All studies using the Trials Platform will go through appropriate ethical and other regulatory approval processes. Results The hub will be a bottom-up, professionally led network that will provide benefits for member practices, our health service, and the population served. Data will only be used for SQUIRE (surveillance, quality improvement, research, and education) purposes. We have already received positive responses from practices, and the number of practices in the network has doubled to over 1150 since February 2020. COVID-19 surveillance has resulted in tripling of the number of virology sites to 293 (target 300), which has aided the collection of the largest ever weekly total of surveillance swabs in the United Kingdom as well as over 3000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology samples. Practices are recruiting to the PRINCIPLE (Platform Randomised trial of INterventions against COVID-19 In older PeopLE) trial, and these participants will be followed up through ORCHID. These initial outputs demonstrate the feasibility of ORCHID to provide an extended national digital health hub. Conclusions ORCHID will provide equitable and innovative use of big data through a professionally led national primary care network and the application of FAIR principles. The secure data hub will host routinely collected general practice data linked to other key health care repositories for clinical trials and support enhanced in situ surveillance without always requiring large volume data extracts. ORCHID will support rapid data extraction, analysis, and dissemination with the aim of improving future research and development in general practice to positively impact patient care. International Registered Report Identifier (IRRID) DERR1-10.2196/19773 </jats:sec

Drug resistance-associated mutations in Plasmodium UBP-1 disrupt its essential deubiquitinating activity.

Deubiquitinating enzymes function to cleave ubiquitin moieties from modified proteins, serving to maintain the pool of free ubiquitin in the cell while simultaneously impacting the fate and function of a target protein. Like all eukaryotes, Plasmodium parasites rely on the dynamic addition and removal of ubiquitin for their own growth and survival. While humans possess around 100 DUBs, Plasmodium contains ∼20 putative ubiquitin hydrolases, many of which bear little to no resemblance to those of other organisms. In this study, we characterize PfUBP-1, a large ubiquitin hydrolase unique to Plasmodium spp that has been linked to endocytosis and drug resistance. We demonstrate its ubiquitin activity, linkage specificity and assess the repercussions of point mutations associated with drug resistance on catalytic activity and parasite fitness. We confirm that the deubiquitinating activity of UBP-1 is essential for parasite survival, implicating an important role for ubiquitin signaling in endocytosis