Catching the flu: Syndromic surveillance, algorithmic governmentality and global health security

How do algorithms shape the imaginary and practice of security? Does their proliferation point to a shift in the political rationality of security? If so, what is the nature and extent of that shift? This article explores these questions in relation to global health security. Prompted by an epidemic of new infectious disease outbreaks – from HIV, SARS and pandemic flu, through to MERS and Ebola – many governments are making health security an integral part of their national security strategies. Algorithms are central to these developments because they underpin a number of nextgeneration syndromic surveillance systems now routinely used by governments and international organizations to rapidly detect new outbreaks globally. This article traces the origins, design and evolution of three such internet-based surveillance systems: 1) the Program for Monitoring Emerging Diseases, 2) the Global Public Health Intelligence Network, and 3) HealthMap. The article shows how the successive introduction of those three syndromic surveillance systems has propelled algorithmic technologies into the heart of global outbreak detection. This growing recourse to algorithms for the purposes of strengthening global health security, the article argues, signals a significant shift in the underlying problem, nature, and role of knowledge in contemporary security practices

Current approaches and future perspectives on strategies for the development of personalized tissue engineering therapies

Personalized tissue engineering and regenerative medicine (TERM) therapies propose patient-oriented effective solutions, considering individual needs. Cell-based therapies, for example, may benefit from cell sources that enable easier autologous set-ups or from recent developments on IPS cells technologies towards effective personalized therapeutics. Furthermore, the customization of scaffold materials to perfectly fit a patientâ s tissue defect through rapid prototyping technologies, also known as 3D printing, is now a reality. Nevertheless, the timing to expand cells or to obtain functional in vitrotissue substitutes prior to implantation prevents advancements towards routine use upon patient´s needs. Thus, personalized therapies also anticipate the importance of creating off-the-shelf solutions to enable immediately available tissue engineered products. This paper reviews the main recent developments and future challenges to enable personalized TERM approaches and to bring these technologies closer to clinical applications.The authors wish to acknowledge the financial support of the Portuguese Foundation for Science and Technology for the post-doctoral grant (SFRH/BPD/111729/2015) and Recognize (UTAP-ICDT/CTM-BIO/0023/2014), and the project RL3 -TECT -NORTE-07-0124-FEDER-000020 co-financed by ON.2 (NSRF), through ERDF

The golden circle: A way of arguing and acting about technology in the London ambulance service

This paper analyses the way in which the London Ambulance Service recovered from the events of October 1992, when it implemented a computer-aided despatch system (LASCAD) that remained in service for less than two weeks. It examines the enactment of a programme of long-term organizational change, focusing on the implementation of an alternative computer system in 1996. The analysis in this paper is informed by actor-network theory, both by an early statement of this approach developed by Callon in the sociology of translation, and also by concepts and ideas from Latour’s more recent restatement of his own position. The paper examines how alternative interests emerged and were stabilized over time, in a way of arguing and acting among key players in the change programme, christened the Golden Circle. The story traces four years in the history of the London Ambulance Service, from the aftermath of October 1992 through the birth of the Golden Circle to the achievement of National Health Service (NHS) trust status. LASCAD was the beginning of the story, this is the middle, an end lies in the future, when the remaining elements of the change programme are enacted beyond the Golden Circle

The polo-like kinase 1 (PLK1) inhibitor NMS-P937 is effective in a new model of disseminated primary CD56+ acute monoblastic leukaemia

CD56 is expressed in 15–20% of acute myeloid leukaemias (AML) and is associated with extramedullary diffusion, multidrug resistance and poor prognosis. We describe the establishment and characterisation of a novel disseminated model of AML (AML-NS8), generated by injection into mice of leukaemic blasts freshly isolated from a patient with an aggressive CD56+ monoblastic AML (M5a). The model reproduced typical manifestations of this leukaemia, including presence of extramedullary masses and central nervous system involvement, and the original phenotype, karyotype and genotype of leukaemic cells were retained in vivo. Recently Polo-Like Kinase 1 (PLK1) has emerged as a new candidate drug target in AML. We therefore tested our PLK1 inhibitor NMS-P937 in this model either in the engraftment or in the established disease settings. Both schedules showed good efficacy compared to standard therapies, with a significant increase in median survival time (MST) expecially in the established disease setting (MST = 28, 36, 62 days for vehicle, cytarabine and NMS-P937, respectively). Importantly, we could also demonstrate that NMS-P937 induced specific biomarker modulation in extramedullary tissues. This new in vivo model of CD56+ AML that recapitulates the human tumour lends support for the therapeutic use of PLK1 inhibitors in AML

Decarbonization of heat through low-temperature waste heat recovery: proposal of a tool for the preliminary evaluation of technologies in the industrial sector

In an industrial energy scenario increasingly focused on decarbonization and energy cost containment, waste heat is a resource that is no longer negligible. Despite the great abundance of waste heat, its recognized potential, and numerous technologies available for its use, the rate of waste heat recovery (WHR) is still low, especially at low temperatures (<230 degrees C). Non-technological barriers, such as the lack of knowledge and support tools, strongly limit the diffusion of WHR technologies. The work presented in this paper aims to overcome non-technological gaps by developing a simple and operational tool that can support companies in the preliminary stages of evaluating a WHR application. The methodology followed involved the development of specific data-based models for WHR technology sizing by correlating waste heat input characteristics with dimensional and economic parameters of the technologies evaluated. We considered the most representative technologies in the WHR scenario: organic Rankine cycles for electric power generation, heat pumps for thermal power generation, absorption chillers for cooling generation, and plate heat exchangers for low-temperature heat exchange applications. One of the significant strengths of the tool is that it was developed using real and hard-to-find technologies performance and cost data mainly collected through continuous interactions with WHR technology providers. Moreover, the interaction with the technology providers allowed contextualization and validation of the tool in the field. In addition, the tool was applied to three large companies operating in the Italian industrial sector to test its effectiveness. The tool applications made it possible to propose cost-effective solutions that the companies had not considered before, despite the high level of attention with which they were already approaching energy efficiency improvements. The result obtained demonstrates the applicability and innovativeness of the tool

Endothelial cell regulation of leukocyte infiltration in inflammatory tissues

Endothelial cells play an important, active role in the onset and regulation of inflammatory and immune reactions. Through the production of chemokines they attract leukocytes and activate their adhesive receptors. This leads to the anchorage of leukocytes to the adhesive molecules expressed on the endothelial surface. Leukocyte adhesion to endothelial cells is frequently followed by their extravasation. The mechanisms which regulate the passage of leukocytes through endothelial clefts remain to be clarified. Many indirect data suggest that leukocytes might transfer signals to endothelial cells both through the release of active agents and adhesion to the endothelial cell surface. Adhesive molecules (such as PECAM) on the endothelial cell surface might also ‘direct’ leukocytes through the intercellular junction by haptotaxis. The information available on the molecular structure and functional properties of endothelial chemokines, adhesive molecules or junction organization is still fragmentary. Further work is needed to clarify how they interplay in regulating leukocyte infiltration into tissues

Low-fiber alfalfa (Medicago sativa L.) meal in the laying hen diet: Effects on productive traits and egg quality

Abstract This study was designed to determine the effects on laying performance and egg quality resulting from partial substitution of soybean meal (SBM) with low-fiber alfalfa (LFA; Medicago sativa L.) meal in the diet of early-phase laying hens. ISA Brown layers, 18 wk of age, were randomly allocated to 2 dietary treatments and fed for 10 wk. The hens were fed 2 wheat middling–based diets: a control diet, which contained SBM (15% of diet), and a test diet containing LFA (15% of diet) as the main protein source. Low-fiber alfalfa meal was obtained by a combination of sieving and air-classification processes. Feed intake was recorded daily, and egg production was calculated on a hen-day basis; eggs from each group were weekly collected to evaluate egg components and quality. The partial substitution of SBM with LFA had no adverse effect on growth performance of early-phase laying hens. Egg production and none of the egg-quality traits examined were influenced by dietary treatment, except for yolk color (

Design of a Database of Case Studies and Technologies to Increase the Diffusion of Low-Temperature Waste Heat Recovery in the Industrial Sector

The recovery of waste heat is a fundamental means of achieving the ambitious medium- and long-term targets set by European and international directives. Despite the large availability of waste heat, especially at low temperatures (<250 degrees C), the implementation rate of heat recovery interventions is still low, mainly due to non-technical barriers. To overcome this limitation, this work aims to develop two distinct databases containing waste heat recovery case studies and technologies as a novel tool to enhance knowledge transfer in the industrial sector. Through an in-depth analysis of the scientific literature, the two databases' structures were developed, defining fields and information to collect, and then a preliminary population was performed. Both databases were validated by interacting with companies which operate in the heat recovery technology market and which are possible users of the tools. Those proposed are the first example in the literature of databases completely focused on low-temperature waste heat recovery in the industrial sector and able to provide detailed information on heat exchange and the technologies used. The tools proposed are two key elements in supporting companies in all the phases of a heat recovery intervention: from identifying waste heat to choosing the best technology to be adopted

Private Hospital Energy Performance Benchmarking Using Energy Audit Data: An Italian Case Study

The increased focus on energy efficiency, both at the national and international levels, has fostered the diffusion and development of specific energy consumption benchmarks for most relevant economic sectors. In this context, energy-intensive facilities, such as hospitals and health structures, represent a unique case. Indeed, despite the high energy consumption of these structures, scientific literature lacks the presence of adequate energy performance benchmarks, especially in regard to the European context. Thus, this study aimed at defining energy benchmark indicators for the Italian private healthcare sector using data collected from the Italian mandatory energy audits according to Art.8 EU Directive 27/2012. The benchmark indicators’ definition was made using a methodology proposed by the Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA). This methodology provided the calculation of specific energy performance indicators (EnPIs) by considering the global energy consumption of the different sites and the sector’s relevant variables. The results obtained were compared with those obtained from a consolidated but more complex methodology: the one envisaged by the Environmental Protection Agency. The results obtained allowed us to validate the reliability of the proposed methodology, as well as the validity and future usability of the calculated indicators. Relying on a significant database containing actual data from recent energy audits, this study was thus able to provide an up-to-date and reliable benchmark for the private healthcare sector

Private hospital energy performance benchmarking using energy audit data: an Italian case study

The increased focus on energy efficiency, both at the national and international levels, has fostered the diffusion and development of specific energy consumption benchmarks for most relevant economic sectors. In this context, energy-intensive facilities, such as hospitals and health structures, represent a unique case. Indeed, despite the high energy consumption of these structures, scientific literature lacks the presence of adequate energy performance benchmarks, especially in regard to the European context. Thus, this study aimed at defining energy benchmark indicators for the Italian private healthcare sector using data collected from the Italian mandatory energy audits according to Art.8 EU Directive 27/2012. The benchmark indicators’ definition was made using a methodology proposed by the Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA). This methodology provided the calculation of specific energy performance indicators (EnPIs) by considering the global energy consumption of the different sites and the sector’s relevant variables. The results obtained were compared with those obtained from a consolidated but more complex methodology: the one envisaged by the Environmental Protection Agency. The results obtained allowed us to validate the reliability of the proposed methodology, as well as the validity and future usability of the calculated indicators. Relying on a significant database containing actual data from recent energy audits, this study was thus able to provide an up-to-date and reliable benchmark for the private healthcare sector