Adapting the System to Users Based on Implicit Data: Ethical Risks and Possible Solutions

Symbiotic systems are systems that gather personal data implicitly provided by the user, derive a profile/model of the user from such data and adjust their output/service according to their notion of what would be desirable to the user thus modeled. Because of these three characteristics, symbiotic systems represent a step forward towards facilitated, simplified, user-friendly digital devices, or do they? Here we propose three cases describing realistic applications of symbiotic systems that potentially encapsulate some serious risk to their users. Experts of five different domains (i.e., ethics, security, law, human-computer interaction and psychology) dissect each case to identify the risks to the users and derive some possible minimization strategies. This panel aims at contributing to a beneficial development of symbiotic systems as it can be achieved by increasing users' discernment and awareness of their consequences for society and everyday life

Providing modeling tools on extreme events of climate change to Puget Sound managers

As climate change becomes a reality for the management of Puget Sound, water resource and fisheries managers should consider incorporating predictions and outcomes of future climate drivers into their long-range plans and daily operations. Modeling tools that focus on climate impacts and predictions show that extreme events are more often responsible for large impacts than the long-term press of climate change. Working with water resource and fisheries managers in the Dungeness and Skagit watersheds, this project uses outputs of existing climate and estuarine models to define thresholds and metrics associated with extreme climate-driven events that are of importance to the resource managers. Managers from the Dungeness and Skagit basins were brought together to assist with defining information needs for sustainable fish habitat and human water uses. The resource managers participating in the project include municipal waste water treatment operators and planners, fisheries managers, agricultural practitioners and conservation district staff, flood control specialists, and others. The information needs identified by the planners, based on the climate model outputs, include better predictions for low stream flows, stream temperature, extent of salinity intrusion into tidal rivers, and timing of extreme events that fall outside the historical norm. The project is developing a decision-support system to meet these needs. The metrics used to drive the decision-support system are derived from model outputs, driven by resource management needs. The information needs, metrics derived from existing models, and the draft decision-support system will be presented. The research team also seeks to use the project to define improved communication pathways between the scientific community and local managers

Posttransplant MRD and T-cell chimerism status predict outcomes in patients who received allografts for AML/MDS

Allogeneic stem-cell transplant allows for the delivery of curative graft-versus-leukemia (GVL) in patients with acute myeloid leukemia/myelodysplasia (AML/MDS). Surveillance of T-cell chimerism, measurable residual disease (MRD) and blast HLA-DR expression may inform whether GVL effectiveness is reduced. We report here the prognostic impact of these biomarkers in patients allografted for AML/MDS. One hundred eighty-seven patients from FIGARO, a randomized trial of reduced-intensity conditioning regimens in AML/MDS, were alive and relapse-free at the first MRD time-point and provided monitoring samples for flow cytometric MRD and T-cell chimerism, requested to month+12. Twenty-nine (15.5%) patients had at least 1 MRD-positive result posttransplant. MRD-positivity was associated with reduced overall survival (OS) (hazard ratio [HR], 2.18; P = .0028) as a time-varying Cox variable and remained significant irrespective of pretransplant MRD status in multivariate analyses (P < .001). Ninety-four patients had sequential MRD with T-cell chimerism results at months+3/+6. Patients with full donor T-cell chimerism (FDTC) had an improved OS as compared with patients with mixed donor T-cell chimerism (MDTC) (adjusted HR=0.4; P = .0019). In patients with MDTC (month+3 or +6), MRD-positivity was associated with a decreased 2-year OS (34.3%) vs MRD-negativity (71.4%) (P = .001). In contrast, in the group with FDTC, MRD was infrequent and did not affect the outcome. Among patients with posttransplant MRD-positivity, decreased HLA-DR expression on blasts significantly reduced OS, supporting this as a mechanism for GVL escape. In conclusion, posttransplant MRD is an important predictor of the outcome in patients allografted for AML/MDS and is most informative when combined with T-cell chimerism results, underlining the importance of a GVL effect in AML/MDS

Service delivery challenges in HIV care during the first year of the COVID-19 pandemic: results from a site assessment survey across the global IeDEA consortium.

INTRODUCTION Interruptions in treatment pose risks for people with HIV (PWH) and threaten progress in ending the HIV epidemic; however, the COVID-19 pandemic's impact on HIV service delivery across diverse settings is not broadly documented. METHODS From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. Descriptive statistics were stratified by national HIV prevalence (<1%, 1-4.9% and ≥5%) and country income levels. RESULTS Questions about pandemic-related consequences for HIV care were completed by 225 (95%) sites in 42 countries with low (n = 82), medium (n = 86) and high (n = 57) HIV prevalence, including low- (n = 57), lower-middle (n = 79), upper-middle (n = 39) and high- (n = 50) income countries. Most sites reported being subject to pandemic-related restrictions on travel, service provision or other operations (75%), and experiencing negative impacts (76%) on clinic operations, including decreased hours/days, reduced provider availability, clinic reconfiguration for COVID-19 services, record-keeping interruptions and suspension of partner support. Almost all sites in low-prevalence and high-income countries reported increased use of telemedicine (85% and 100%, respectively), compared with less than half of sites in high-prevalence and lower-income settings. Few sites in high-prevalence settings (2%) reported suspending antiretroviral therapy (ART) clinic services, and many reported adopting mitigation strategies to support adherence, including multi-month dispensing of ART (95%) and designating community ART pick-up points (44%). While few sites (5%) reported stockouts of first-line ART regimens, 10-11% reported stockouts of second- and third-line regimens, respectively, primarily in high-prevalence and lower-income settings. Interruptions in HIV viral load (VL) testing included suspension of testing (22%), longer turnaround times (41%) and supply/reagent stockouts (22%), but did not differ across settings. CONCLUSIONS While many sites in high HIV prevalence settings and lower-income countries reported introducing or expanding measures to support treatment adherence and continuity of care, the COVID-19 pandemic resulted in disruptions to VL testing and ART supply chains that may negatively affect the quality of HIV care in these settings

Family physician leadership during the COVID-19 pandemic: roles, functions and key supports.

PURPOSE: Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of leadership roles for family physicians are absent from previous pandemic plans. This study aims to describe the leadership roles and functions family physicians played during the COVID-19 pandemic in Canada and identify supports and barriers to formalizing these roles in future pandemic plans. DESIGN/METHODOLOGY/APPROACH: This study conducted semi-structured qualitative interviews with family physicians across four regions in Canada as part of a multiple case study. During the interviews, participants were asked about their roles during each pandemic stage and the facilitators and barriers they experienced. Interviews were transcribed and a thematic analysis approach was used to identify recurring themes. FINDINGS: Sixty-eight family physicians completed interviews. Three key functions of family physician leadership during the pandemic were identified: conveying knowledge, developing and adapting protocols for primary care practices and advocacy. Each function involved curating and synthesizing information, tailoring communications based on individual needs and building upon established relationships. PRACTICAL IMPLICATIONS: Findings demonstrate the need for future pandemic plans to incorporate formal family physician leadership appointments, as well as supports such as training, communication aides and compensation to allow family physicians to enact these key roles. ORIGINALITY/VALUE: The COVID-19 pandemic presents a unique opportunity to examine the leadership roles of family physicians, which have been largely overlooked in past pandemic plans. This study\u27s findings highlight the importance of these roles toward delivering an effective and coordinated pandemic response with uninterrupted and safe access to primary care

Astonish Me! Recalling the Cabaret Spirit

Program for the 1999 RISD Wintersessoin Cabaret intiated by the Image and Word class in collaboration with students of RISD Cabaret 1998 and held at AS220. The presentation was conceived and performed in homage and celebration of past RISD Cabaret shows 1987-1998. Graphic Design: Ron Winter, Ji-Ho Sohn and Eric Urban.https://digitalcommons.risd.edu/liberalarts_cabaret_programs/1010/thumbnail.jp

Dedicated JPSS VIIRS Ocean Color Calibration/Validation Cruise

The NOAA/STAR ocean color team is focused on “end-to-end” production of high quality satellite ocean color products. In situ validation of satellite data is essential to produce the high quality, “fit for purpose” remotely sensed ocean color products that are required and expected by all NOAA line offices, as well as by external (both applied and research) users. In addition to serving the needs of its diverse users within the U.S., NOAA has an ever increasing role in supporting the international ocean color community and is actively engaged in the International Ocean-Colour Coordinating Group (IOCCG). The IOCCG, along with the Committee on Earth Observation Satellites (CEOS) Ocean Colour Radiometry Virtual Constellation (OCR-VC), is developing the International Network for Sensor Inter-comparison and Uncertainty assessment for Ocean Color Radiometry (INSITU-OCR). The INSITU-OCR has identified, amongst other issues, the crucial need for sustained in situ observations for product validation, with longterm measurement programs established and maintained beyond any individual mission. Recently, the NOAA/STAR Ocean Color Team has been making in situ validation measurements continually since the launch in fall 2011 of the Visible Infrared Imaging Radiometer Suite (VIIRS) aboard the Suomi National Polar-orbiting Partnership (SNPP) platform, part of the U.S. Joint Polar Satellite System (JPSS) program. NOAA ship time for the purpose of ocean color validation, however, had never been allocated until the cruise described herein. As the institutional lead for this cruise, NOAA/STAR invited external collaborators based on scientific objectives and existing institutional collaborations. The invited collaborators are all acknowledged professionals in the ocean color remote sensing community. Most of the cruise principal investigators (PIs) are also PIs of the VIIRS Ocean Color Calibration and Validation (Cal/Val) team, including groups from Stennis Space Center/Naval Research Laboratory (SSC/NRL) and the University of Southern Mississippi (USM); City College of New York (CCNY); University of Massachusetts Boston (UMB); University of South Florida (USF); University of Miami (U. Miami); and, the National Institute of Standards and Technology (NIST). These Cal/Val PIs participated directly, sent qualified researchers from their labs/groups, or else contributed specific instruments or equipment. Some of the cruise PIs are not part of the NOAA VIIRS Ocean Color Cal/Val team but were chosen to complement and augment the strengths of the Cal/Val team participants. Outside investigator groups included NASA Goddard Space Flight Center (NASA/GSFC), Lamont-Doherty Earth Observatory at Columbia University (LDEO), and the Joint Research Centre of the European Commission (JRC). This report documents the November 2014 cruise off the U.S. East Coast aboard the NOAA Ship Nancy Foster. This cruise was the first dedicated ocean color validation cruise to be supported by the NOAA Office of Marine and Air Operations (OMAO). A second OMAO-supported cruise aboard the Nancy Foster is being planned for late 2015. We at NOAA/STAR are looking forward to continuing dedicated ocean color validation cruises, supported by OMAO on NOAA vessels, on an annual basis in support of JPSS VIIRS on SNPP, J-1, J-2 and other forthcoming satellite ocean color missions from the U.S as well as other countries. We also look forward to working with the U.S. and the international ocean community for improving our understanding of global ocean optical, biological, and biogeochemical properties.JRC.H.1-Water Resource

Venetoclax combined with low dose cytarabine compared to standard of care intensive chemotherapy for the treatment of favourable risk adult acute myeloid leukaemia (VICTOR): Study protocol for an international, open-label, multicentre, molecularly-guided randomised, phase II trial

Background: For patients with acute myeloid leukaemia (AML), the only potentially curative treatment is intensive chemotherapy (IC). This is highly toxic, particularly for patients > 60 years, potentially leading to prolonged hospitalisations requiring intensive supportive care, and sometimes treatment-related death. This also results in extensive healthcare costs and negatively impacts quality of life (QoL). Venetoclax with low-dose cytarabine (VEN + LDAC) is a novel, low-intensity treatment for AML patients who cannot receive IC. VEN + LDAC is given as an outpatient and toxicity appears significantly lower than with IC. Analysis of clinical trials performed to date are promising for patients with the genotype NPM1mutFLT3 ITDneg, where remission and survival rates appear comparable to those achieved with IC. Methods: VICTOR is an international, two-arm, open-label, multi-centre, non-inferiority, randomised-controlled phase II trial to assess VEN + LDAC compared to standard of care (IC) as first-line treatment in older patients (initially aged ≥ 60 years) with newly diagnosed AML. The trial will recruit patients with a NPM1mutFLT3 ITDneg genotype; those with a favourable risk in relation to the experimental treatment. University of Birmingham is the UK co-ordinating centre, with national hubs in Aarhus University Hospital, Denmark, and Auckland District Health Board, New Zealand. The primary outcome is molecular event-free survival time where an event is defined as failure to achieve morphological complete response (CR) or CR with incomplete blood count recovery after two cycles of therapy; molecular persistence, progression or relapse requiring treatment change; morphological relapse, or; death. Secondary outcomes include cumulative resource use at 12- and 24-months, and QoL as assessed by EORTCQLQ-C30 and EQ-5D-3L at 3-, 6-, 12-, 18- and 24-months. The trial employs an innovative Bayesian design with target sample size of 156 patients aged > 60 years. Discussion: The principle underpinning the VICTOR trial is that the chance of cure for patients in the experimental arm should not be compromised, therefore, an adaptive design with regular checks on accumulating data has been employed, which will allow for a staged expansion of the trial population to include younger patients if, and when, there is sufficient evidence of non-inferiority in older patients. Trial registration: EudraCT: 2020–000,273-24; 21-Aug-2020. ISRCTN: 15,567,173; 08-Dec-2020