Easing the Burdens of a Patchwork Approach to Data Privacy Regulation in Favor of a Singular Comprehensive International Solution—The International Data Privacy Agreement

Data privacy has become one of the premier hot-button issues in today’s increasingly digital human experience. Legislatures around the globe have attempted to act swiftly in an effort to safeguard the highly coveted personal information of their citizens and combat misuse at the hands of international businesses operating with an online presence. Since the European Union’s enactment of the General Data Protection Regulation (GDPR) in 2018, countries around the globe have been grappling with how best to replicate the EU’s leading data privacy regulation while providing the same or greater level of transparency into data collection practices. While a mere handful of countries have legislated a singular federal data privacy regulation, the United States – the birthplace of the “dot com bubble” – has largely lagged behind in its’ response. With California’s enactment of the California Consumer Privacy Act (CCPA) in 2020, combined with the absence of federal regulation on the horizon, the United States has signaled that the country’s approach to data privacy regulation will be centered on a state-by-state strategy. It has become apparent that the burdens on international businesses operating with an online presence will be proliferated through this approach when taking into account the various country-wide frameworks being implemented in other parts of the globe. This note offers a view of those arduous burdens through the lens of businesses who have already revamped their processes for the handling of consumer data in response to the GDPR and must now integrate a new approach in light of the CCPA. In doing so, the dissimilarities between the two regulations will be highlighted and analyzed, as well as the regulatory impacts that the two premier regulations have on the larger digital marketing ecosystem as a whole. Ultimately, this note argues that when taking into account the imminent passage of new regulations both within the United States as well as around the globe, the most comprehensive solution proves to be the development of a uniform international framework – the International Data Privacy Agreement (IDPA)

Movement kinematics and proprioception in post-stroke spasticity: assessment using the Kinarm robotic exoskeleton

Background Motor impairment after stroke interferes with performance of everyday activities. Upper limb spasticity may further disrupt the movement patterns that enable optimal function; however, the specific features of these altered movement patterns, which differentiate individuals with and without spasticity, have not been fully identified. This study aimed to characterize the kinematic and proprioceptive deficits of individuals with upper limb spasticity after stroke using the Kinarm robotic exoskeleton. Methods Upper limb function was characterized using two tasks: Visually Guided Reaching, in which participants moved the limb from a central target to 1 of 4 or 1 of 8 outer targets when cued (measuring reaching function) and Arm Position Matching, in which participants moved the less-affected arm to mirror match the position of the affected arm (measuring proprioception), which was passively moved to 1 of 4 or 1 of 9 different positions. Comparisons were made between individuals with (n = 35) and without (n = 35) upper limb post-stroke spasticity. Results Statistically significant differences in affected limb performance between groups were observed in reaching-specific measures characterizing movement time and movement speed, as well as an overall metric for the Visually Guided Reaching task. While both groups demonstrated deficits in proprioception compared to normative values, no differences were observed between groups. Modified Ashworth Scale score was significantly correlated with these same measures. Conclusions The findings indicate that individuals with spasticity experience greater deficits in temporal features of movement while reaching, but not in proprioception in comparison to individuals with post-stroke motor impairment without spasticity. Temporal features of movement can be potential targets for rehabilitation in individuals with upper limb spasticity after stroke.York University Librarie

A curious case of forceps delivery in IR

Self-expanding nitinol stents are routinely used to treat left common iliac vein compression in patients with May-Thurner syndrome. On occasion these stents do not provide adequate radial force to achieve a sufficient iliac lumen. If symptoms persist and persistent iliac vein compression is noted then balloon-expandable stents may be used to provide buttressing support at the compression site. We present a case where the buttressing balloon-expandable stent is crushed and subsequently removed percutaneously prior to placement of a high radial force self-expanding stent at the compressive site

Direct aneurysm sac catheterization and embolization of an enlarging internal iliac aneurysm using cone-beam CT

Since cone-beam computed tomography (CT) has been adapted for use with a C-arm system it has brought volumetric CT capabilities in the interventional suite. Although cone-beam CT image resolution is far inferior to that generated by traditional CT scanners, the system offers the ability to place an access needle into position under tomographic guidance and use the access to immediately begin a fluoroscopic procedure without moving the patient. We describe a case of a “jailed” enlarging internal iliac artery aneurysm secondary to abdominal aortic aneurysm repair, in which direct percutaneous puncture of the internal iliac artery aneurysm sac was performed under cone-beam CT guidance

Percutaneous retrieval of a Mobin-Uddin inferior vena cava filter 42 years following implantation

Inferior vena cava filters (IVCFs) are an established alternative for protection from thromboembolism when anticoagulation fails or is contraindicated. Before the creation of retrievable IVCFs, patients received filters that were permanent or designed without standardized retrieval options. Although these filters were implanted for prolonged protection, chronic vena caval occlusion and post-thrombotic syndrome are potential sequelae. We present a 53-year-old patient with a Mobin-Uddin permanent IVCF placed 42 years prior complicated by acute iliocaval thrombosis following more than 40 years of filter dwell time. She was successfully treated with thrombolysis, thrombectomy, endobronchial forceps assisted IVCF removal, and iliocaval stent reconstruction

Expression of the intestinal biomarkers Guanylyl cyclase C and CDX2 in poorly differentiated colorectal carcinomas.

Guanylyl cyclase C, a receptor for bacterial diarrheagenic enterotoxins, is expressed selectively by intestinal epithelium and is an endogenous downstream target of CDX2. The expression of Guanylyl cyclase C is preserved throughout the adenoma/carcinoma sequence in the colorectum. Detection of Guanylyl cyclase C expression by reverse transcriptase-polymerase chain reaction is currently being validated as a technique to identify occult lymph node metastases in patients with colorectal cancer and for circulating cells in the blood for postoperative surveillance. Although Guanylyl cyclase C is widely expressed by well-differentiated colorectal cancer, its expression in poorly differentiated colorectal cancer has not been evaluated. A tissue microarray was created from 69 archival specimens including 44 poorly differentiated, 15 undifferentiated or medullary, and 10 signet ring cell colorectal carcinomas. Matched normal colonic mucosa was used as a positive control. Immunohistochemical staining for Guanylyl cyclase C and CDX2 was evaluated as positive or negative based on at least a 10% extent of staining. Of the 69 tumor samples, 75%, 47%, and 90% of the poorly differentiated, medullary, and signet ring cell tumors were positive for Guanylyl cyclase C and 75%, 40% and 90% of these subsets were positive for CDX2, respectively. There was excellent correlation between Guanylyl cyclase C and CDX2 expression on a case-per-case basis (P \u3c .0001). There was also a statistically significant difference in the Guanylyl cyclase C staining pattern between medullary carcinomas and poorly differentiated, not otherwise specified (P = .05). Immunopositivity for Guanylyl cyclase C was greater than 95% in a separately stained microarray series of well/moderately differentiated colorectal carcinomas. In conclusion, Guanylyl cyclase C expression is lost in a quarter of poorly differentiated and half of undifferentiated colorectal carcinomas. Therefore, the utility of Guanylyl cyclase C expression as a diagnostic marker for colorectal carcinoma may be questionable in poorly differentiated colorectal neoplasms

Quality of linked data: Linking the National Hospital Care Survey Data to the National Death Index

Introduction Data linkages can produce rich data resources to address a variety of research topics. However, assessing linkage quality can be challenging given that there are many approaches and no clear best practices. Objectives and Approach Through its Data Linkage Program, the National Center for Health Statistics (NCHS) links national survey data with vital and administrative records. A recent linkage of the National Hospital Care Survey data with the National Death Index employed a new linkage methodology, which included a first time approach for validating the results within the linkage algorithm. Results The new methodology includes two passes: a deterministic linkage, followed by a probabilistic approach based on the Fellegi-Sunter methodology. In the second pass, a key identifier, Social Security Number (SSN), was not used as a linkage variable but instead to determine link accuracy, when available on the patient record. A model was then built to predict link accuracy status according to the computed Fellegi-Sunter total pair weight and then used to estimate it for those patient records without an SSN. Results from this new approach were compared with results from prior linkage methodologies and generated higher match rates and lower error rates. The linkage methodology designed for this study is now being tested on other types of input data such as data from household surveys. Conclusion/Implications The linkage approach may be incorporated into additional linkages conducted by NCHS. This talk will describe the input sources for this linkage, the methodology used, the error rate assessment and then discuss conclusions and implications for precision and efficiency

AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus

Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy

HACA3: A Unified Approach for Multi-site MR Image Harmonization

The lack of standardization is a prominent issue in magnetic resonance (MR) imaging. This often causes undesired contrast variations due to differences in hardware and acquisition parameters. In recent years, MR harmonization using image synthesis with disentanglement has been proposed to compensate for the undesired contrast variations. Despite the success of existing methods, we argue that three major improvements can be made. First, most existing methods are built upon the assumption that multi-contrast MR images of the same subject share the same anatomy. This assumption is questionable since different MR contrasts are specialized to highlight different anatomical features. Second, these methods often require a fixed set of MR contrasts for training (e.g., both Tw-weighted and T2-weighted images must be available), which limits their applicability. Third, existing methods generally are sensitive to imaging artifacts. In this paper, we present a novel approach, Harmonization with Attention-based Contrast, Anatomy, and Artifact Awareness (HACA3), to address these three issues. We first propose an anatomy fusion module that enables HACA3 to respect the anatomical differences between MR contrasts. HACA3 is also robust to imaging artifacts and can be trained and applied to any set of MR contrasts. Experiments show that HACA3 achieves state-of-the-art performance under multiple image quality metrics. We also demonstrate the applicability of HACA3 on downstream tasks with diverse MR datasets acquired from 21 sites with different field strengths, scanner platforms, and acquisition protocols