Who Owns the Data? Open Data for Healthcare.

Research on large shared medical datasets and data-driven research are gaining fast momentum and provide major opportunities for improving health systems as well as individual care. Such open data can shed light on the causes of disease and effects of treatment, including adverse reactions side-effects of treatments, while also facilitating analyses tailored to an individual's characteristics, known as personalized or "stratified medicine." Developments, such as crowdsourcing, participatory surveillance, and individuals pledging to become "data donors" and the "quantified self" movement (where citizens share data through mobile device-connected technologies), have great potential to contribute to our knowledge of disease, improving diagnostics, and delivery of -healthcare and treatment. There is not only a great potential but also major concerns over privacy, confidentiality, and control of data about individuals once it is shared. Issues, such as user trust, data privacy, transparency over the control of data ownership, and the implications of data analytics for personal privacy with potentially intrusive inferences, are becoming increasingly scrutinized at national and international levels. This can be seen in the recent backlash over the proposed implementation of care.data, which enables individuals' NHS data to be linked, retained, and shared for other uses, such as research and, more controversially, with businesses for commercial exploitation. By way of contrast, through increasing popularity of social media, GPS-enabled mobile apps and tracking/wearable devices, the IT industry and MedTech giants are pursuing new projects without clear public and policy discussion about ownership and responsibility for user-generated data. In the absence of transparent regulation, this paper addresses the opportunities of Big Data in healthcare together with issues of responsibility and accountability. It also aims to pave the way for public policy to support a balanced agenda that safeguards personal information while enabling the use of data to improve public health

Developing UAV monitoring of South Georgia and the South Sandwich Islands’ iconic land-based marine predators

Many remote islands present barriers to effective wildlife monitoring in terms of challenging terrain and frequency of visits. The sub-Antarctic islands of South Georgia and the South Sandwich Islands are home to globally significant populations of seabirds and marine mammals. South Georgia hosts the largest breeding populations of Antarctic fur seals, southern elephant seals and king penguins as well as significant populations of wandering, black-browed and grey-headed albatross. The island also holds important populations of macaroni and gentoo penguins. The South Sandwich Islands host the world’s largest colony of chinstrap penguins in addition to major populations of Adélie and macaroni penguins. A marine protected area was created around these islands in 2012 but monitoring populations of marine predators remains a challenge, particularly as these species breed over large areas in remote and often inaccessible locations. During the 2019/20 austral summer, we trialed the use of an unoccupied aerial vehicle (UAV; drone) to monitor populations of seals, penguins and albatross and here we report our initial findings, including considerations about the advantages and limitations of the methodology. Three extensive southern elephant seal breeding sites were surveyed with complete counts made around the peak pupping date, two of these sites were last surveyed 24 years ago. A total of nine islands, historically recorded as breeding sites for wandering albatross, were surveyed with 144 fledglings and 48 adults identified from the aerial imagery. The UAV was effective at surveying populations of penguins that nest on flat, open terrain, such as Adélie and chinstrap penguin colonies at the South Sandwich Islands, and an extensive king penguin colony on South Georgia, but proved ineffective for monitoring macaroni penguins nesting in tussock habitat on South Georgia as individuals were obscured or hidden by vegetation. Overall, we show that UAV surveys can allow regular and accurate monitoring of these important wildlife populations

Mid-Infrared Imaging of the Post-AGB Star AC Herculis with the MMT Adaptive Optics System

We utilized the MMT's unique deformable secondary adaptive optics system to produce high-resolution (FWHM=0.3"), very high Strehl mid-infrared (9.8, 11.7 & 18 micron) images of the post-AGB star AC Her. The very high (98+/-2%) Strehls achieved with Mid-IR AO led naturally to an ultra-stable PSF independent of airmass, seeing, or location on the sky. We find no significant difference between AC Her's morphology and our unresolved PSF calibration stars (mu UMa & alpha Her) at 9.8, 11.7, & 18 microns. Our current observations do not confirm any extended Mid-IR structure around AC Her. These observations are in conflict with previously reported Keck (seeing-limited) 11.7 and 18 micron images which suggested the presence of a resolved ~0.6" edge-on circumbinary disk. We conclude that AC Her has no extended Mid-IR structure on scales greater than 0.2" (R<75 AU). These first results of Mid-IR AO science are very encouraging for future high accuracy Mid-IR imaging with this technique.Comment: To appear in the November 20, 2003 issue of the Astrophysical Journal Letters. The preprint has 7 pages and 3 figures (one in color; but prints OK in B&W

Diabetes Mellitus and Obesity as Risk Factors for Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) is among the deadliest types of cancer. The worldwide estimates of its incidence and mortality in the general population are eight cases per 100,000 person-years and seven deaths per 100,000 person-years, and they are significantly higher in the United States than in the rest of the world. The incidence of this disease in the United States is more than 50,000 new cases in 2017. Indeed, total deaths due to PDAC are projected to increase dramatically to become the second leading cause of cancer-related deaths before 2030. Considering the failure to date to efficiently treat existing PDAC, increased effort should be undertaken to prevent this disease. A better understanding of the risk factors leading to PDAC development is of utmost importance to identify and formulate preventive strategies. Large epidemiologic and cohort studies have identified risk factors for the development of PDAC, including obesity and type 2 diabetes mellitus. This review highlights the current knowledge of obesity and type 2 diabetes as risk factors for PDAC development and progression, their interplay and underlying mechanisms, and the relation to diet. Research gaps and opportunities to address this deadly disease are also outlined

TESS Discovery of an ultra-short-period planet around the nearby M dwarf LHS 3844

Data from the newly-commissioned \textit{Transiting Exoplanet Survey Satellite} (TESS) has revealed a "hot Earth" around LHS 3844, an M dwarf located 15 pc away. The planet has a radius of $1.32\pm 0.02$ $R_\oplus$ and orbits the star every 11 hours. Although the existence of an atmosphere around such a strongly irradiated planet is questionable, the star is bright enough ($I=11.9$, $K=9.1$) for this possibility to be investigated with transit and occultation spectroscopy. The star's brightness and the planet's short period will also facilitate the measurement of the planet's mass through Doppler spectroscopy.Comment: 10 pages, 4 figures. Submitted to ApJ Letters. This letter makes use of the TESS Alert data, which is currently in a beta test phase, using data from the pipelines at the TESS Science Office and at the TESS Science Processing Operations Cente

A Prospective Study to Establish a New-Onset Diabetes Cohort: From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer

The National Cancer Institute and the National Institute for Diabetes and Digestive and Kidney Diseases initiated the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC) in 2015 (the CPDPC's origin, structure, governance, and research objectives are described in another article in this journal). One of the key objectives of CPDPC is to assemble a cohort of 10,000 subjects 50 years or older with new-onset diabetes, called the NOD cohort. Using a define, enrich, and find early detection approach, the aims of the NOD study are to (a) estimate the 3-year probability of pancreatic ductal adenocarcinoma (PDAC) in NOD (define), (b) establish a biobank of clinically annotated biospecimens from presymptomatic PDAC and control new-onset type 2 diabetes mellitus subjects, (c) conduct phase 3 validation studies of promising biomarkers for identification of incident PDAC in NOD patients (enrich), and (d) provide a platform for development of a future interventional screening protocol for early detection of PDAC in patients with NOD that incorporates imaging studies and/or clinical algorithms (find). It is expected that 85 to 100 incidences of PDAC will be diagnosed during the study period in this cohort of 10,000 patients

Conditional Myh9 and Myh10 inactivation in adult mouse renal epithelium results in progressive kidney disease

Actin-associated nonmuscle myosin II (NM2) motor proteins play critical roles in a myriad of cellular functions, including endocytosis and organelle transport pathways. Cell type–specific expression and unique subcellular localization of the NM2 proteins, encoded by the Myh9 and Myh10 genes, in the mouse kidney tubules led us to hypothesize that these proteins have specialized functional roles within the renal epithelium. Inducible conditional knockout (cKO) of Myh9 and Myh10 in the renal tubules of adult mice resulted in progressive kidney disease. Prior to overt renal tubular injury, we observed intracellular accumulation of the glycosylphosphatidylinositol-anchored protein uromodulin (UMOD) and gradual loss of Na+ K+ 2Cl– cotransporter from the apical membrane of the thick ascending limb epithelia. The UMOD accumulation coincided with expansion of endoplasmic reticulum (ER) tubules and activation of ER stress and unfolded protein response pathways in Myh9&10-cKO kidneys. We conclude that NM2 proteins are required for localization and transport of UMOD and loss of function results in accumulation of UMOD and ER stress–mediated progressive renal tubulointerstitial disease. These observations establish cell type–specific role(s) for NM2 proteins in regulation of specialized renal epithelial transport pathways and reveal the possibility that human kidney disease associated with MYH9 mutations could be of renal epithelial origin

Evaluation of a Mixed Meal Test for Diagnosis and Characterization of PancrEaTogEniC DiabeTes Secondary to Pancreatic Cancer and Chronic Pancreatitis: Rationale and Methodology for the DETECT Study From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer

Pancreatogenic diabetes mellitus is most commonly the result of chronic pancreatitis but can also occur secondary to pancreatic cancer. The early identification of pancreatogenic diabetes and distinction from the more prevalent type 2 diabetes are clinically significant; however, currently, there is no validated method to differentiate these diabetes subtypes. We describe a study, "Evaluation of a Mixed Meal Test for Diagnosis and Characterization of PancrEaTogEniC DiabeTes Secondary to Pancreatic Cancer and Chronic Pancreatitis: the DETECT study," that seeks to address this knowledge gap. The DETECT study is a multicenter study that will examine differences in hormone and glucose excursions after a mixed meal test. The study will also create a biorepository that will be used to evaluate novel diagnostic biomarkers for differentiating these diabetes subtypes

Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer

Diabetes mellitus is a group of diseases defined by persistent hyperglycaemia. Type 2 diabetes, the most prevalent form, is characterised initially by impaired insulin sensitivity and subsequently by an inadequate compensatory insulin response. Diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. Historically, diabetes due to diseases of the exocrine pancreas was described as pancreatogenic or pancreatogenous diabetes mellitus, but recent literature refers to it as type 3c diabetes. It is important to note that type 3c diabetes is not a single entity; it occurs because of a variety of exocrine pancreatic diseases with varying mechanisms of hyperglycaemia. The most commonly identified causes of type 3c diabetes are chronic pancreatitis, pancreatic ductal adenocarcinoma, haemochromatosis, cystic fibrosis, and previous pancreatic surgery. In this Review, we discuss the epidemiology, pathogenesis, and clinical relevance of type 3c diabetes secondary to chronic pancreatitis and pancreatic ductal adenocarcinoma, and highlight several important knowledge gaps

Bringing the Street Back In:Considering Strategy, Contingency and Relative Good Fortune in Street Children’s Access to Paid Work in Accra

A sociology of street children has emerged defined by its rejection of the dominant narratives of child welfare organisations that identify the street as the root cause of children’s immiseration and improper socialisation. In its place, sociological analysis has undermined the value of conceptualising street children as a coherent group on the street and in a parallel move has looked to conceptually reposition street children away from assumptions of passivity and neglect, towards a foundational insistence that the starting place for analysis is the positioning of street children as active and strategic social agents. It is the adequacy of this latter concern that is the focus of this article. By reintroducing the location of children within the social relations of the informal street economy, this article draws upon extensive and long-term qualitative research examining the lives of street children in Accra, Ghana. The argument here is that sociological notions of strategic action and efficacious agency seem ill-suited to accounting for the dilemmas and difficulties that street children’s quests for paid work inevitably involve. Rather, it is relative good fortune within the radical uncertainty of the social relations of the informal street economy that seems much more appropriate to accounting for how these children are integrated into wor