Privacy in the Cloud: The Fourth Amendment Fog

The Cloud has changed how individuals record, store, and aggregate their personal information. As technology’s capacity for holding an individual’s most intimate details and recording day-to-day experiences increases, Fourth Amendment privacy protections become less equipped to respond to technological advances. These advances allow private companies to store an immense amount of their consumers’ personal information, and government entities to obtain that information. In response, tech companies have begun refusing to comply with government demands for information collected and stored in their devices and in the Cloud, and are increasingly ending up in court, fighting orders to disclose consumer information. A dynamic tension has developed between the United States government’s desire and increased capacity to obtain information about consumers, and tech companies wanting to keep their consumers’ information private. The relevant statute, the Electronic Communications Privacy Act (ECPA), is not equipped to address these technological advances. The Supreme Court’s extensive Fourth Amendment jurisprudence and guidelines for addressing Fourth Amendment issues are similarly ill-suited to answer the novel and unique issues that accompany digital, remote storage of personal information. This Comment identifies the inadequacies of ECPA and the Fourth Amendment jurisprudence as they each apply to technological advances and the potential of Cloud data. It argues that Congress must revise the legislative scheme to adequately protect information stored in the Cloud, particularly addressing whether consumers have a right to know when their information is being accessed by the United States government. Further, it argues courts lack the tools to adequately amend, reframe, repeal, or apply ECPA, and thus should not be the primary body making decisions about the bounds of technologically based government collection under the Fourth Amendment. Alternatively, if the legislature does not act, courts will remain required to make findings related to whether the collection of information is a violation of the Fourth Amendment. Courts should, then, recognize that digital data deserves a fundamentally distinct analysis and discontinue the trend of finding attenuated connections between classic surveillance techniques and government surveillance using advanced technology

Institute of Education Archives: Papers of Arabella Kurdi

Catalogue of the papers of Arabella Kurdi held by the Institute of Education Archives.Kurdi worked as School Meals and Domestic Science Organiser from The British Families Education Service (BFES) in post-war Germany. Her papers relate to her work, 1947-[1971], including album of photographs of conditions in Germany, friends and colleagues and BFES schools; correspondence, including letters describing her experiences; material relating to the school meals service; and printed material

Institute of Education Archives: Papers of Mimi Hatton

Catalogue of the papers of Mimi Hatton held by the Institute of Education Archives. Hatton was a primary teacher with the British Families Education Service (BFES) in post-war Germany. Her papers, 1946-1952, relate to her work with the BFES, including an account of her service in Germany; photographs; and memorabilia

Implementing pelvic floor muscle training for women with pelvic organ prolapse: a realist evaluation of different delivery models.

Background Pelvic Floor Muscle Training (PFMT) has been shown to be effective for pelvic organ prolapse in women, but its implementation in routine practice is challenging due to lack of adequate specialist staff. It is important to know if PFMT can be delivered by different staff skill mixes, what barriers and facilitators operate in different contexts, what strategies enable successful implementation and what are the underlying mechanisms of their action. PROPEL intervention was designed to maximise the delivery of effective PFMT in the UK NHS using different staff skill mixes. We conducted a realist evaluation (RE) of this implementation to understand what works, for whom, in what circumstances and why. Methods Informed by the Realist and RE-AIM frameworks, the study used a longitudinal, qualitative, multiple case study design. The study took place in five, purposively selected, diverse NHS sites across the UK and proceeded in three phases to identify, test and refine a theory of change. Data collection took place at 4 time points over an 18 month implementation period using focus groups and semi-structured interviews with a range of stakeholders including service leads/managers, senior practitioners, newly trained staff and women receiving care in the new service models. Data were analysed using thematic framework approach adapted to identify Context, Mechanism and Outcome (CMO) configurations of the RE. Results A heightened awareness of the service need among staff and management was a mechanism for change, particularly in areas where there was a shortage of skilled staff. In contrast, the most established specialist physiotherapist-delivered PFMT service activated feelings of role protection and compromised quality, which restricted the reach of PFMT through alternative models. Staff with some level of prior knowledge in women’s health and adequate organisational support were more comfortable and confident in new role. Implementation was seamless when PFMT delivery was incorporated in newly trained staff’s role and core work. Conclusion Roll-out of PFMT delivery through different staff skill mixes is possible when it is undertaken by clinicians with an interest in women’s health, and carefully implemented ensuring adequate levels of training and ongoing support from specialists, multi-disciplinary teams and management

Abolishing The Police

“This is the first time we are seeing… a conversation about defunding, and some people having a conversation about abolishing the police and prison state. This must be what it felt like when people were talking about abolishing slavery.” – Patrisse Cullors, Black Lives Matter. Abolishing the Police (An Illustrated Introduction) is both a contribution to this conversation and an invitation to join it. It provides rigorous and accessible analyses of why we might want to abolish the police, what abolishing them would involve, and how it might be achieved, introducing readers to the rich existing traditions of anti-police theory and practice. Its authors draw on their diverse on-the-ground experiences of political organising, protest, and resistance to policing in the UK, France, Germany, and the United States, as well as their original research in academic fields ranging from law to security studies, political theory to sociology to public health

Empirical constraints on extrusion mechanisms from the upper margin of an exhumed high-grade orogenic core, Sutlej valley, NW India

The Early–Middle Miocene exhumation of the crystalline core of the Himalaya is a relatively well-understood process compared to the preceding phase of burial and prograde metamorphism in the Eocene–Oligocene. Highly deformed rocks of the Greater Himalayan Sequence (GHS) dominate the crystalline core, and feature a strong metamorphic and structural overprint related to the younger exhumation. The Tethyan Sedimentary Series was tectonically separated from the underlying GHS during the Miocene by the South Tibetan Detachment, and records a protracted and complex history of Cenozoic deformation. Unfortunately these typically low-grade or unmetamorphosed rocks generally yield little quantitative pressure–temperature�time information to accompany this deformation history. In parts of the western Himalaya, however, the basal unit of the Tethyan Sedimentary Series (the Haimanta Group) includes pelites metamorphosed to amphibolite facies. This presents a unique opportunity to explore the tectono-thermal evolution of crystalline rocks which record the early history of the orogen. Pressure–temperature�time–deformation (P–T�t–d) paths modelled for two Haimanta Group pelitic rocks reveal three distinct stages of metamorphism: (1) prograde Barrovian metamorphism to 610–620 °C at c. 7–8 kbars, with garnet growing over an early tectonic fabric (S1); (2) initial decompression during heating to 640–660 °C at c. 6–7 kbars, with development of a pervasive crenulation cleavage (S2) and staurolite and kyanite porphyroblast growth; (3) further exhumation during cooling, with minor retrograde metamorphism and modification of the pervasive S2 fabric. Monazite growth ages constrain the timing of initial garnet growth (> 34 Ma), the start of D2 and maximum burial (c. 30 Ma), and the termination of garnet growth (c. 28 Ma). Muscovite Ar/Ar ages indicate cooling through c. 300 °C at c. 13 Ma, from which we derive an initial exhumation rate of c. 1.3 mm year? 1 for the Haimanta Group. The underlying GHS was exhumed at a rate of 2.2 to 3 mm year? 1 during this time. The difference in exhumation rate between these two units is considered to reflect Early Miocene displacement on the intervening South Tibetan Detachment. Slower exhumation (c. 0.6 mm year? 1) of both units after c. 13 Ma followed the cessation of major displacement on this structure, after which time the Haimanta Group and the GHS were exhumed as one relatively coherent tectonic block

Genomewide Association Scan of Suicidal Thoughts and Behaviour in Major Depression

Background Suicidal behaviour can be conceptualised as a continuum from suicidal ideation, to suicidal attempts to completed suicide. In this study we identify genes contributing to suicidal behaviour in the depression study RADIANT. Methodology/Principal Findings A quantitative suicidality score was composed of two items from the SCAN interview. In addition, the 251 depression cases with a history of serious suicide attempts were classified to form a discrete trait. The quantitative trait was correlated with younger onset of depression and number of episodes of depression, but not with gender. A genome-wide association study of 2,023 depression cases was performed to identify genes that may contribute to suicidal behaviour. Two Munich depression studies were used as replication cohorts to test the most strongly associated SNPs. No SNP was associated at genome-wide significance level. For the quantitative trait, evidence of association was detected at GFRA1, a receptor for the neurotrophin GDRA (p = 2e-06). For the discrete trait of suicide attempt, SNPs in KIAA1244 and RGS18 attained p-values of <5e-6. None of these SNPs showed evidence for replication in the additional cohorts tested. Candidate gene analysis provided some support for a polymorphism in NTRK2, which was previously associated with suicidality. Conclusions/Significance This study provides a genome-wide assessment of possible genetic contribution to suicidal behaviour in depression but indicates a genetic architecture of multiple genes with small effects. Large cohorts will be required to dissect this further

Fc Effector Function Contributes to the Activity of Human Anti-CTLA-4 Antibodies.

With the use of a mouse model expressing human Fc-gamma receptors (FcγRs), we demonstrated that antibodies with isotypes equivalent to ipilimumab and tremelimumab mediate intra-tumoral regulatory T (Treg) cell depletion in vivo, increasing the CD8+ to Treg cell ratio and promoting tumor rejection. Antibodies with improved FcγR binding profiles drove superior anti-tumor responses and survival. In patients with advanced melanoma, response to ipilimumab was associated with the CD16a-V158F high affinity polymorphism. Such activity only appeared relevant in the context of inflamed tumors, explaining the modest response rates observed in the clinical setting. Our data suggest that the activity of anti-CTLA-4 in inflamed tumors may be improved through enhancement of FcγR binding, whereas poorly infiltrated tumors will likely require combination approaches

Carbonic Anhydrase 9 Expression Increases with Vascular Endothelial Growth Factor-Targeted Therapy and Is Predictive of Outcome in Metastatic Clear Cell Renal Cancer

AbstractBackgroundThere is a lack of biomarkers to predict outcome with targeted therapy in metastatic clear cell renal cancer (mccRCC). This may be because dynamic molecular changes occur with therapy.ObjectiveTo explore if dynamic, targeted-therapy-driven molecular changes correlate with mccRCC outcome.Design, setting, and participantsMultiple frozen samples from primary tumours were taken from sunitinib-naïve (n=22) and sunitinib-treated mccRCC patients (n=23) for protein analysis. A cohort (n=86) of paired, untreated and sunitinib/pazopanib-treated mccRCC samples was used for validation. Array comparative genomic hybridisation (CGH) analysis and RNA interference (RNAi) was used to support the findings.InterventionThree cycles of sunitinib 50mg (4 wk on, 2 wk off).Outcome measurements and statistical analysisReverse phase protein arrays (training set) and immunofluorescence automated quantitative analysis (validation set) assessed protein expression.Results and limitationsDifferential expression between sunitinib-naïve and treated samples was seen in 30 of 55 proteins (p<0.05 for each). The proteins B-cell CLL/lymphoma 2 (BCL2), mutL homolog 1 (MLH1), carbonic anhydrase 9 (CA9), and mechanistic target of rapamycin (mTOR) (serine/threonine kinase) had both increased intratumoural variance and significant differential expression with therapy. The validation cohort confirmed increased CA9 expression with therapy. Multivariate analysis showed high CA9 expression after treatment was associated with longer survival (hazard ratio: 0.48; 95% confidence interval, 0.26–0.87; p=0.02). Array CGH profiles revealed sunitinib was associated with significant CA9 region loss. RNAi CA9 silencing in two cell lines inhibited the antiproliferative effects of sunitinib. Shortcomings of the study include selection of a specific protein for analysis, and the specific time points at which the treated tissue was analysed.ConclusionsCA9 levels increase with targeted therapy in mccRCC. Lower CA9 levels are associated with a poor prognosis and possible resistance, as indicated by the validation cohort.Patient summaryDrug treatment of advanced kidney cancer alters molecular markers of treatment resistance. Measuring carbonic anhydrase 9 levels may be helpful in determining which patients benefit from therapy

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely