Data Privacy in the Time of Plague

Data privacy is a life-or-death matter for public health. Beginning in late fall 2019, two series of events unfolded, one everyone talked about and one hardly anyone noticed: The greatest world-health crisis in at least 100 years, the COVID-19 pandemic; and the development of the Personal Data Protection Act Committee by the Uniform Law Commissioners (ULC) in the United States. By July 2021, each of these stories had reached a turning point. In the developed, Western world, most people who wanted to receive the vaccine against COVID- 19 could do so. Meanwhile, the ULC adopted the Uniform Personal Data Protection Act (UPDPA) at its annual meeting, paving the way for state legislatures to adopt it beginning in 2022. It has so far been introduced in three jurisdictions. These stories intersect in public health. Public health researchers struggled with COVID-19 in the United States because they lacked information about individuals who were exposed, among other matters. Understanding other public health threats (e.g., obesity, opioid abuse, racism) also requires linking diverse data on contributing social, environmental, and economic factors. The UPDPA removes some barriers to public health practice and research resulting from the lack of comprehensive federal privacy laws. Its full potential, however, can be achieved only with involvement of public health researchers and professionals. This article analyzes the UPDPA and other comprehensive state privacy statutes, noting the ways that they could promote—and hinder—public health. It concludes with recommendations for public health researchers and professionals to get involved in upcoming legislative debates on data privacy. Lives will depend on the outcomes

Privacy preserving interactive record linkage (PPIRL)

Record linkage to integrate uncoordinated databases is critical in biomedical research using Big Data. Balancing privacy protection against the need for high quality record linkage requires a human–machine hybrid system to safely manage uncertainty in the ever changing streams of chaotic Big Data

Root canals shaped by nickel-titanium instrumentation with automated computerized numerical control systems

Background: To investigate the efficacy of a nickel-titanium (NiTi) file with an automated computerized numerical control (CNC) system for root canal shaping. Methods: The movement of the automated device and the insertion angle were investigated. In Experiment 1, simulated resin root canals were randomly divided into four groups (n = 20): manual downward movement using a handpiece (Group 1), vertical downward movement by CNC (Group 2), reciprocating up and down movement by CNC (Group 3), and spiral up and down movement by CNC (Group 4). In Experiment 2, five different insertion angles of the NiTi file were evaluated (n = 20). Four parameters were used to evaluate the shaping ability: change in the working length, central axis offset, curvature variation, and preparation time. Groups were compared using one-way analysis of variance (ANOVA) with significance was set at P \u3c 0.05. Results: The change in central axis position in the curved part of the root canal was found to be smaller in Group 4 than in other groups (P \u3c 0.05). The curvature changes and preparation time of Groups 1 and 4 were significantly reduced compared with Groups 2 and 3 (P \u3c 0.05). The variation in working length and curvature in the 5° insertion angle group was significantly smaller than in the other groups (P \u3c 0.05). Conclusions: A spiral up and down movement, controlled by the CNC machine, and 5° insertion angle, maintained original root canal shape more precisely than other methods

Establishing an International Data Linkage Repository Workgroup Toward a Benchmarking Repository

Introduction Access to real data with diverse attributes is critical for effective development of any data analytic algorithm. Benchmarking data repositories have all been vital to the development of research communities focused on algorithm development. This work reports on the development of such a data repository for record linkage. Objectives and Approach Establishing a common benchmarking repository of real data can propel a field to the next level of rigor by facilitating comparison of different algorithms, understanding what type of algorithms work best under certain real data conditions and problem domains, promoting transparency and replicability of research, and creating incentives for proper citations for contributions. In addition, benchmarking repositories can bring together the diverse stakeholders (e.g., computer scientists, statisticians, data custodians, data users including social, behaviour, economic, and health (SBEH) scientists) that can advance the field more effectively than could researchers from any single discipline. Results In Fall 2016, international leaders in record linkage formed a Data Linkage Repository workgroup (DLRep) to establish a benchmarking data repository for record linkage. The workgroup is working in collaboration with The Inter-university Consortium for Political and Social Research (ICPSR) to host the site data repository planned for release in Summer 2018. The repository for record linkage research will house various types of real data that require linking with metadata, unique handles for citations, proposed algorithms for evaluation criteria, and a platform for posting, sharing, and comparing results as well as citations of relevant papers. Some datasets will have the gold standard published that researchers can evaluate their results against. Other datasets will gather results to build the gold standard as a community. Conclusion/Implications Record linkage methodology is important to domains where data needs to be integrated from multiple sources, including diverse disciplines. Establishing an international interdisciplinary research community around a benchmark data linkage repository to validate and compare linkage algorithms is crucial to fully realizing the social benefits of data about people

Effects of Maternity Care Coordination on Pregnancy Outcomes: Propensity-Weighted Analyses

Care coordination services that link pregnant women to health-promoting resources, avoid duplication of effort, and improve communication between families and providers have been endorsed as a strategy for reducing disparities in adverse pregnancy outcomes, however empirical evidence regarding the effects of these services is contradictory and incomplete. This study investigates the effects of maternity care coordination on pregnancy outcomes in North Carolina

Factors associated with unrecognized cirrhosis in patients with hepatocellular carcinoma

Background/Aims Cirrhosis is the most important risk factor of hepatocellular carcinoma (HCC), and patients with cirrhosis are recommended to receive semiannual surveillance for early HCC detection. However, early cirrhosis is often asymptomatic and can go undiagnosed for years, leading to underuse of HCC surveillance in clinical practice. We characterized the frequency and associated factors of unrecognized cirrhosis in a national sample of patients with HCC from the United States. Methods HCC patients aged 68 years and older, diagnosed during 2011 to 2015 were included from the SEER-Medicare Linked Database. If cirrhosis was diagnosed within 6 months immediately preceding HCC diagnosis or after HCC diagnosis, cases were categorized as unrecognized cirrhosis. Factors associated with unrecognized cirrhosis were identified using logistic regression analyses. Factors associated with overall survival were evaluated using Cox regression analyses. Results Among 5,098 HCC patients, 74.8% patients had cirrhosis. Among those with cirrhosis, 57.4% had unrecognized cirrhosis, with the highest proportion (76.3%) among those with NAFLD-related HCC. Male sex (aOR: 2.12, 95% CI: 1.83–2.46), non-Hispanic Black race (aOR: 1.93, 95% CI: 1.45–2.57), and NAFLD etiology (aOR: 4.46, 95% CI: 3.68–5.41) were associated with having unrecognized cirrhosis. Among NAFLD-related HCC patients, male sex (aOR: 2.32, 95% CI: 1.71–3.14) was associated with unrecognized cirrhosis. Unrecognized cirrhosis was independently associated with worse overall survival (aHR: 1.17, 95% CI: 1.08–1.27) compared to recognized cirrhosis. Conclusions Unrecognized cirrhosis is common in NAFLD-related HCC, particularly among male and Black patients, highlighting these groups as important intervention targets to improve HCC surveillance uptake and outcomes

Emerging Need for Vaccination against Hepatitis A Virus in Patients with Chronic Liver Disease in Korea

Vaccination against hepatitis A virus (HAV) is recommended for patients with chronic liver disease (CLD), but this has been deemed unnecessary in Korea since the immunity against HAV was almost universal in adults. However, this practice has never been reevaluated with respect to the changing incidence of adult acute hepatitis A. We retrospectively reviewed the medical records of 278 patients with acute hepatitis A diagnosed from January 1995 to November 2005 and prospectively tested 419 consecutive CLD patients from July to December 2005 for the presence of IgG anti-HAV. The number of patients with acute hepatitis A has markedly increased recently, and the proportion of adult patients older than 30 yr has been growing from 15.2% during 1995-1999, to 28.4% during 2000-2005 (p=0.019). Among 419 CLD patients, the seroprevalences of IgG anti-HAV were 23.1% for those between 26 and 30 yr, 64% between 31 and 35 yr, and 85.0% between 36 and 40 yr. These data demonstrate that immunity against HAV is no more universal in adult and substantial proportion of adult CLD patients are now at risk of HAV infection in Korea. Therefore, further study on seeking proper strategy of active immunization against HAV is warranted in these populations