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Artificial Intelligence in Health Care: the Hope, the Hype, the Promise, the Peril
Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril Michael Matheny, Sonoo Thadaney Israni, Mahnoor Ahmed, and Danielle Whicher, Editors WASHINGTON, DC NAM.EDU PREPUBLICATION COPY - Uncorrected Proofs NATIONAL ACADEMY OF MEDICINE • 500 Fifth Street, NW • WASHINGTON, DC 20001 NOTICE: This publication has undergone peer review according to procedures established by the National Academy of Medicine (NAM). Publication by the NAM worthy of public attention, but does not constitute endorsement of conclusions and recommendationssignifies that it is the by productthe NAM. of The a carefully views presented considered in processthis publication and is a contributionare those of individual contributors and do not represent formal consensus positions of the authors’ organizations; the NAM; or the National Academies of Sciences, Engineering, and Medicine. Library of Congress Cataloging-in-Publication Data to Come Copyright 2019 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. Suggested citation: Matheny, M., S. Thadaney Israni, M. Ahmed, and D. Whicher, Editors. 2019. Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. NAM Special Publication. Washington, DC: National Academy of Medicine. PREPUBLICATION COPY - Uncorrected Proofs “Knowing is not enough; we must apply. Willing is not enough; we must do.” --GOETHE PREPUBLICATION COPY - Uncorrected Proofs ABOUT THE NATIONAL ACADEMY OF MEDICINE The National Academy of Medicine is one of three Academies constituting the Nation- al Academies of Sciences, Engineering, and Medicine (the National Academies). The Na- tional Academies provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. -
Binnenwerk Cindy Postma.Indd
CHAPTER 6 Multiple putative oncogenes at the chromosome 20q amplicon contribute to colorectal adenoma to carcinoma progression Gut 2009, 58: 79-89 Beatriz Carvalho Cindy Postma Sandra Mongera Erik Hopmans Sharon Diskin Mark A. van de Wiel Wim van Criekinge Olivier Thas Anja Matthäi Miguel A. Cuesta Jochim S. Terhaar sive Droste Mike Craanen Evelin Schröck Bauke Ylstra Gerrit A. Meijer 104 | Chapter 6 Abstract Objective: This study aimed to identify the oncogenes at 20q involved in colorectal adenoma to carcinoma progression by measuring the effect of 20q gain on mRNA expression of genes in this amplicon. Methods: Segmentation of DNA copy number changes on 20q was performed by array CGH in 34 non-progressed colorectal adenomas, 41 progressed adenomas (i.e. adenomas that present a focus of cancer) and 33 adenocarcinomas. Moreover, a robust analysis of altered expression of genes in these segments was performed by microarray analysis in 37 adenomas and 31 adenocarcinomas. Protein expression was evaluated by immunohistochemistry on tissue microarrays. Results: The genes C20orf24, AURKA, RNPC1, TH1L, ADRM1, C20orf20 and TCFL5, mapping at 20q were signifi cantly overexpressed in carcinomas compared to adenomas as consequence of copy number gain of 20q. Conclusion: This approach revealed C20orf24, AURKA, RNPC1, TH1L, ADRM1, C20orf20 and TCFL5 genes to be important in chromosomal instability-related adenoma to carcinoma progression. These genes therefore may serve as highly specifi c biomarkers for colorectal cancer with potential clinical applications. Putative oncogenes at chromosome 20q in colorectal carcinogenesis | 105 Introduction The majority of cancers are epithelial in origin and arise through a stepwise progression from normal cells, through dysplasia, into malignant cells that invade surrounding tissues and have metastatic potential. -
NHS England Briefed Against Gps
this week NHS RESERVES page 381 • MESH CLINICS page 382 • LIVERPOOL TESTING page 384 LMCs: NHS England briefed against GPs GP leaders have demanded that NHS chair of the BMA’s General Practitioners The BMA’s Richard Vautrey England and NHS Improvement apologise Committee, writing to the NHS chief said it seemed NHS England and retract any communications that may executive, Simon Stevens, asking for had “intentionally sought have harmed their reputation or incited NHSE/I to “apologise to the profession and to create negative media coverage of primary care” complaints by implying that practices had correct damage that has been done.” not been fully involved in care of patients Vautrey wrote, “Implying within the throughout the covid-19 pandemic. press release that GPs are not providing A motion passed at the annual patients with the appointments they conference of England’s local medical need and ‘reminding’ them that they face committees on 27 November said that ‘enforcement action’ if they do not has much of NHSE/I’s communications with presented NHSE/I as antagonistic and GPs, the press, and the public had been completely out of touch with the profession. “abhorrent and insulting.” The conference It also seems to many GPs that NHSE/I has, called for NHSE/I to recognise general by using this tactic, intentionally sought to LATEST ONLINE practice’s contribution to the management create negative media coverage of primary of the pandemic and the continuation of care services. Test for HIV normal service, “particularly given the “The BMA is now hearing large numbers wherever blood is general practitioners who have died in the of reports from practices receiving taken, recommends course of their duties to the public.” complaints and many staff members being UK independent The motion added that it “deplores verbally abused by the public based on commission the habit” of briefi ng journalists before these unsupported and ill-informed media Declarations of communicating with the profession and its articles. -
Multi‑Resolution Functional Summarization and Alignment of Biological Network Models
This document is downloaded from DR‑NTU (https://dr.ntu.edu.sg) Nanyang Technological University, Singapore. Multi‑resolution functional summarization and alignment of biological network models Seah, Boon Siew 2014 Seah, B. S. (2014). Multi‑resolution functional summarization and alignment of biological network models. Doctoral thesis, Nanyang Technological University, Singapore. https://hdl.handle.net/10356/60641 https://doi.org/10.32657/10356/60641 Downloaded on 07 Oct 2021 12:44:34 SGT ATTENTION: The Singapore Copyright Act applies to the use of this document. Nanyang Technological University Library Multi-resolution Functional Summarization and Alignment of Biological Network Models Seah Boon Siew A THESIS SUBMITTED FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN COMPUTATION AND SYSTEMS BIOLOGY (CSB) SINGAPORE-MIT ALLIANCE NANYANG TECHNOLOGICAL UNIVERSITY Feb 17, 2014 ATTENTION: The Singapore Copyright Act applies to the use of this document. Nanyang Technological University Library ATTENTION: The Singapore Copyright Act applies to the use of this document. Nanyang Technological University Library DECLARATION I hereby declare that this thesis is my original work and it has been written by me in its entirety. I have duly acknowledged all the sources of information which have been used in the thesis. This thesis has also not been submitted for any degree in any university previously. Seah Boon Siew Feb 17, 2014 ii ATTENTION: The Singapore Copyright Act applies to the use of this document. Nanyang Technological University Library Acknowledgments I would like to thank my supervisor Assoc. Prof. Sourav S. Bhowmick (NTU) and my co-supervisor Prof. C. Forbes Dewey, Jr. (MIT) for their guidance and support. -
Patients First
04 Patients First PATIENTS FIRST THE CLEVELAND CLINIC 2004 ANNUAL REPORT 1 “Patients First” > On Oct. 1, 2004, The Cleveland Clinic welcomed Delos M. Cosgrove, M.D., as its new Chief Executive Offi cer and President. With the inauguration of Dr. Cosgrove, The Cleveland Clinic has rededicated itself to one of the most sacred principles of medicine: “Patients First.” This prin- ciple declares the primacy of patient care, patient comfort and patient communication in every activity undertaken by The Cleveland Clinic. It affi rms the importance of research and education for their contributions to clinical medicine and the improvement of patient care. At the same time, “Patients First” demands a relentless focus on measurable quality. By setting standards, collecting data and analyzing results, The Cleveland Clinic puts patients fi rst through improved outcomes, better service and by providing a healthier future for all. PATIENTS FIRST THE CLEVELAND CLINIC 2004 ANNUAL REPORT 2 Dear Friends: In 2004, The Cleveland Clinic enjoyed the best year in its and visitor spending. We are currently the largest employer history. We helped more patients and contributed more in Northeast Ohio, and the third largest non-governmental to our local and regional economies than ever before. The employer in the state. Our economic activities create ad- number of patient visits, surgeries and hospital admis- ditional jobs in the community, for a total of 65,000 jobs sions at The Cleveland Clinic and Cleveland Clinic Health overall. We are responsible for direct and indirect state System have surpassed all previous years. Working as a and local taxes totaling $300 million – including one out team, we are building, educating and innovating for the of every 10 tax dollars collected in the city of Cleveland. -
Microkernel Construction Introduction
Microkernel Construction Introduction Nils Asmussen 04/09/2020 1 / 32 Normal Organization Thursday, 4th DS, 2 SWS Slides: www.tudos.org ! Studies ! Lectures ! MKC Subscribe to our mailing list: www.tudos.org/mailman/listinfo/mkc2020 In winter term: Microkernel-based operating systems (MOS) Various labs 2 / 32 Organization due to COVID-19 Slides and video recordings of lectures will be published Questions can be asked on the mailing list Subscribe to the mailing list! Practical exercises are planed for the end of the semester Depending on how COVID-19 continues, exercises are in person or we use some video-conferencing tool 3 / 32 Goals 1 Provide deeper understanding of OS mechanisms 2 Look at the implementation details of microkernels 3 Make you become enthusiastic microkernel hackers 4 Propaganda for OS research done at TU Dresden and Barkhausen Institut 4 / 32 Outline Organization Monolithic vs. Microkernel Kernel design comparison Examples for microkernel-based systems Vision vs. Reality Challenges Overview About L4/NOVA 5 / 32 Monolithic Kernel System Design u s Application Application Application e r k Kernel e r File Network n e Systems Stacks l m Memory Process o Drivers Management Management d e Hardware 6 / 32 Monolithic Kernel OS (Propaganda) System components run in privileged mode No protection between system components Faulty driver can crash the whole system Malicious app could exploit bug in faulty driver More than 2=3 of today's OS code are drivers No need for good system design Direct access to data structures Undocumented -
Can Microkernels Mitigate Microarchitectural Attacks?⋆
Can Microkernels Mitigate Microarchitectural Attacks?? Gunnar Grimsdal1, Patrik Lundgren2, Christian Vestlund3, Felipe Boeira1, and Mikael Asplund1[0000−0003−1916−3398] 1 Department of Computer and Information Science, Link¨oping University, Sweden ffelipe.boeira,[email protected] 2 Westermo Network Technologies [email protected] 3 Sectra AB, Link¨oping,Sweden Abstract. Microarchitectural attacks such as Meltdown and Spectre have attracted much attention recently. In this paper we study how effec- tive these attacks are on the Genode microkernel framework using three different kernels, Okl4, Nova, and Linux. We try to answer the question whether the strict process separation provided by Genode combined with security-oriented kernels such as Okl4 and Nova can mitigate microar- chitectural attacks. We evaluate the attack effectiveness by measuring the throughput of data transfer that violates the security properties of the system. Our results show that the underlying side-channel attack Flush+Reload used in both Meltdown and Spectre, is effective on all in- vestigated platforms. We were also able to achieve high throughput using the Spectre attack, but we were not able to show any effective Meltdown attack on Okl4 or Nova. Keywords: Genode, Meltdown, Spectre, Flush+Reload, Okl4, Nova 1 Introduction It used to be the case that general-purpose operating systems were mostly found in desktop computers and servers. However, as IoT devices are becoming in- creasingly more sophisticated, they tend more and more to require a powerful operating system such as Linux, since otherwise all basic services must be im- plemented and maintained by the device developers. At the same time, security has become a prime concern both in IoT and in the cloud domain. -
Anatomy and Atrophy of Medical Paternalism Robert F
Anatomy and Atrophy of Medical Paternalism Robert F. Graboyes and Eric Topol MERCATUS RESEARCH Robert F. Graboyes and Eric Topol, “Anatomy and Atrophy of Medical Paternalism” (Mercatus Research, Mercatus Center at George Mason University, Arlington, VA, 2017). ABSTRACT Since Ancient Greece, a guiding principle of Western medicine has been pater- nalism—the idea that doctors have intrinsically superior insights, patients should defer to their edicts, and this asymmetry is a desirable state of affairs. In the 20th century, new medical knowledge and technologies accumulated at an unprecedented rate, and medical paternalism arguably reached its zenith. Now, however, new technologies are eroding the doctor’s privileged role by deconstructing, digitizing, and democratizing medical knowledge. Digital technologies and other breakthroughs offer unprecedented opportunities to save lives and cut costs. Along with self-interest, however, selective strains of risk aversion, technophobia, and egalitarianism among physicians are gener- ating resistance to the new reality. This article catalogs the motives for and impact of medical paternalism, the reasons for its decline, and potential policy responses that would ease the transition. JEL codes: I11, I13, I18, K2 Keywords: health care, healthcare, medicine, physician, doctors, consumer sov- ereignty, licensure, certification, regulation, prices, technology, digital health The Mercatus Center gratefully acknowledges the financial support of the John Templeton Foundation for research on healthcare policy in the United States. Copyright © 2017 by Robert F. Graboyes, Eric Topol, and the Mercatus Center at George Mason University The views expressed in Mercatus Research are the authors’ and do not represent official positions of the Mercatus Center or George Mason University. Patients . -
Operating System Support for Run-Time Security with a Trusted Execution Environment
Operating System Support for Run-Time Security with a Trusted Execution Environment - Usage Control and Trusted Storage for Linux-based Systems - by Javier Gonz´alez Ph.D Thesis IT University of Copenhagen Advisor: Philippe Bonnet Submitted: January 31, 2015 Last Revision: May 30, 2015 ITU DS-nummer: D-2015-107 ISSN: 1602-3536 ISBN: 978-87-7949-302-5 1 Contents Preface8 1 Introduction 10 1.1 Context....................................... 10 1.2 Problem....................................... 12 1.3 Approach...................................... 14 1.4 Contribution.................................... 15 1.5 Thesis Structure.................................. 16 I State of the Art 18 2 Trusted Execution Environments 20 2.1 Smart Cards.................................... 21 2.1.1 Secure Element............................... 23 2.2 Trusted Platform Module (TPM)......................... 23 2.3 Intel Security Extensions.............................. 26 2.3.1 Intel TXT.................................. 26 2.3.2 Intel SGX.................................. 27 2.4 ARM TrustZone.................................. 29 2.5 Other Techniques.................................. 32 2.5.1 Hardware Replication........................... 32 2.5.2 Hardware Virtualization.......................... 33 2.5.3 Only Software............................... 33 2.6 Discussion...................................... 33 3 Run-Time Security 36 3.1 Access and Usage Control............................. 36 3.2 Data Protection................................... 39 3.3 Reference -
Commencement
UN IVERS IT Y 0 F R 0 CHESTER 0 N E HUN 0 R E 0 SIXTY~ FIRST COMMENCEMENT MAY 2011 Introduction, 4 Honorary Awards, 5 Honor Societies and Awards, 1 0 Doctoral Degree Candidates, 14 Doctor of Philosophy, 14 School of Nursing, 15 Doctor of Nursing Practice, 15 Eastman School of Music_, 16 Doctor of Musical Arts, 16 Doctor of Education, 16 Degree Candidates, 17 School of Arts and Sciences, 1 7 Bachelor of Arts, 17 Bachelor of Science, 22 Master of Arts, 25 Master of Science, 26 Bachelor of Arts, 2 7 Bachelor of Science, 27 Master of Science, 28 Eastman School of Music, 30 Bachelor of Music, 30 Master of Arts, 31 Master of Music, 31 School of Medicine and Dentistry, 32 Master of Arts, 32 M aster of Science, 32 M aster of Public Health, 32 Doctor of M edicine and Doctor of Philosophy, 33 Doctor of M edicine and Doctor of Philosophy with Distinction in Research, 33 Doctor of M edicine with Distinction in Research and with Distinction in Community Service, 33 Doctor of Medicine with Distinction in Research, 33 Doctor of M edicine with Distinction in Community Service, 33 Doctor of M edicine, 33 William E. Simon <L;raduate School of Business Administration, 34 School of Nursing, 35 Bachelor of Science, 35 M aster of Science, 36 M argaret Warner Graduate School of Education and Human Development, 37 M aster of Science, 37 The Genesee, 39 Campus M ap, 40 Jntrodu( lion ARich Tradition at Rochester The commencement season has always stnod out as the of the l:n iversity, and two silver bands are engraved with the "supreme festival" on Rochester 's academic calendar, Arthur names ' >f the Cniversity's presidents. -
Dr Eric Topol ******@***Scripps.Edu Cardiologist and Geneticist, Directs
Zoom On: Dr. Eric Topol, Translational Science Leader Dr Eric Topol ******@***scripps.edu Cardiologist and Geneticist, Directs - Scripps Translational Science Institute, La Jolla, CA, USA Chief Academic Officer - Scripps Health Eric Topol, MD is a cardiologist and geneticist who directs the Scripps Translational Science Institute (La Jolla, CA, USA). He is also the Chief Academic Officer at Scripps Health, and a senior consultant at the Scripps Clinic’s Division of Cardiovascular Diseases. He is a professor of genomics in the Department of Molecular and Experimental Medicine, where his research focuses on individualised medicine and the interface of genomics and technology. In 2012, Dr. Topol was named the Most Influential Physician Executive in Healthcare by Modern Healthcare for taking on the topic of how big data will revolutionise hospitals and healthcare in general. In his 2012 book The Creative Destruction of Medicine, Dr. Topol addresses the topic of how healthcare stands to benefit from technology and the wireless age. The tools which are increasingly used by physicians and patients alike, such as mobile phones and pocket computers, are not only useful for their ability to connect doctors and patients. The greatest potential exists in their generation of health information that will serve researchers in ways that data from clinical trials cannot. Population-based studies are limited in the ways they can predict how patients respond to disease therapies, but personalised medicine that ultimately includes genomic sequencing and printing technology will change the way patients are diagnosed and treated. Dr. Topol has been elected to the National Academy of Sciences’ Institute of Medicine, and has received numerous awards including the European Society of Cardiology’s Andreas Gruntzig Award and the Thompson Scientific Award “Doctor of the Decade”. -
D I V I S I O Ns, D E Pa R T M E N T S, I N S T I T U T Es, and Centers
section four D I V I S I O N S, D E PA R T M E N T S, I N S T I T U T E S, AND CENTERS 1 5 5 11. DIVISION OF MEDICINE BY MUZAFFAR AHMAD, CLAUDIA D’ARCANGELO, AND JOHN CLOUGH A good physician knows his patient through and through, and his knowledge is bought dearly. Time, sympathy, and understanding must be lavishly dispensed, but the reward is to be found in that personal bond, which forms the greatest satisfaction of medical practice. —A.C. Ernstene B E G I N N I N G S THE DIV I S I O N OF MED I C I N E HA S PL AY E D AN IM P O R TAN T RO L E IN TH E development of medical practice at The Cleveland Clinic since its opening in 1921. Dr. John Phillips, the only internist among the four founders, was the first chief of the Division of Medicine, then called the Medical Department. He was a true family physician who saw medicine begin to move away from house calls and toward an of fice-based practice during the eight years between 1921 and his untimely death in 1929 at age 50. Nevertheless, he continued to tr eat patients with diverse disorders and make house calls, often spending his entire weekend visiting patients in their homes. Despite his own inclination and experience, Phillips rec o g n i z e d the value of specialization. In 1921, he assigned Henry J.