Examining public views on decentralised health data sharing.

In recent years, researchers have begun to explore the use of Distributed Ledger Technologies (DLT), also known as blockchain, in health data sharing contexts. However, there is a significant lack of research that examines public attitudes towards the use of this technology. In this paper, we begin to address this issue and present results from a series of focus groups which explored public views and concerns about engaging with new models of personal health data sharing in the UK. We found that participants were broadly in favour of a shift towards new decentralised models of data sharing. Retaining 'proof' of health information stored about patients and the capacity to provide permanent audit trails, enabled by immutable and transparent properties of DLT, were regarded as particularly valuable for our participants and prospective data custodians. Participants also identified other potential benefits such as supporting people to become more health data literate and enabling patients to make informed decisions about how their data was shared and with whom. However, participants also voiced concerns about the potential to further exacerbate existing health and digital inequalities. Participants were also apprehensive about the removal of intermediaries in the design of personal health informatics systems.

Non-Fungible Tokens as a Mechanism for Representing Patient Consent.

In recent years we have seen the adoption of distributed ledger technology (DLT), originally the mechanism underpinning the operation of the Bitcoin crypto currency, across a wider range of technology sectors including healthcare. DLT allows for the design of informatics systems with the properties of immutability, security, and decentralization. One recent innovation in the space has been the specification and development of Non-Fungible Tokens (NFTs). NFTs are decentralized DLT-based records that represent ownership of a unique digital asset. The predominant current use case for NFTs has been in the representation and sale of digital artwork, however the features offered by NFTs, unique-ness, immutability, transferability, and verifiability, are directly applicable to the design of health informatics systems. In this paper we explore these properties and describe a reference architecture for using NFTs as a means of representing and transferring records of patient's consent for medical data use.

Stoichiometry of Rtt109 complexes with Vps75 and histones H3-H4.

Histone acetylation is one of many posttranslational modifications that affect nucleosome accessibility. Vps75 is a histone chaperone that stimulates Rtt109 acetyltransferase activity toward histones H3-H4 in yeast. In this study, we use sedimentation velocity and light scattering to characterize various Vps75-Rtt109 complexes, both with and without H3-H4. These complexes were previously ill-defined because of protein multivalency and oligomerization. We determine both relative and absolute stoichiometry and define the most pertinent and homogeneous complexes. We show that the Vps75 dimer contains two unequal binding sites for Rtt109, with the weaker binding site being dispensable for H3-H4 acetylation. We further show that the Vps75-Rtt109-(H3-H4) complex is in equilibrium between a 2:1:1 species and a 4:2:2 species. Using a dimerization mutant of H3, we show that this equilibrium is mediated by the four-helix bundle between the two copies of H3. We optimize the purity, yield, and homogeneity of Vps75-Rtt109 complexes and determine optimal conditions for solubility when H3-H4 is added. Our comprehensive biochemical and biophysical approach ultimately defines the large-scale preparation of Vps75-Rtt109-(H3-H4) complexes with precise stoichiometry. This is an essential prerequisite for ongoing high-resolution structural and functional analysis of this important multi-subunit complex.

Aplicativo móvel para a escolha do banho do paciente em uma unidade coronariana / Mobile app for choosing a patient's bath in a coronary unit

Introdução: As doenças cardiovasculares são uma das principais causas de mortalidade no mundo. A forma aguda desta situação é denominada Síndrome Coronariana Aguda (SCA) que pode ser classificada como: angina instável e infarto agudo do miocárdio. Após o diagnóstico médico definido como SCA, o paciente necessita de internação em uma Unidade Coronariana. Neste ambiente é oferecida uma assistência guiada por protocolos clínicos e diretrizes de forma a contribuir na sua recuperação, minimizar o risco de complicações e prevenir os danos. Entre os protocolos que envolvem esse cuidado destaca-se o banho, que pode ser classificado como no leito ou de aspersão. Para a tomada de decisão do do enfermeiro quanto a indicação ao banho do paciente coronariopata são necessárias informações clinicas, e da hemodinâmica atual do paciente. Pontua-se como problema "A ausência de sistematização para tomada de decisão quanto a escolha banho do paciente coronariopata em uma Unidade Coronariana". Objetivo: Elaborar um algoritmo no formato de aplicativo móvel para auxiliar a tomada de decisão do enfermeiro quanto ao banho do paciente coronariopata em uma Unidade Coronariana. Método: Trata-se de estudo exploratório, metodológico e abordagem quantitativa para a elaboração de um algoritmo no formato de aplicativo móvel. O estudo foi realizado em duas etapas: 1ªetapa: elaborou-se um intrumento a partir de uma revisão de literatura abordando as temáticas reabilitação cardíaca e banho. Este instrumento foi submetido a validação de seus critérios por enfermeiros. A abordagem dos dados, foi realizada por estatística descritriva como cálculo do Coeficiente de Alfa de Cronbach. 2ªetapa: Elaboração do algoritmo baseado nos achados do instrumento aplicado, em formato de aplicativo móvel para auxiliar na tomada de decisão quanto ao banho do paciente coronariopata na UTI. Resultados: Avaliaram o instrumento um total de 29 enfermeiros, em um período de 03 meses. Dentre estes 26 (89%) eram do sexo feminino, com idade na faixa de 23 à 58 anos e todos os enfermeiros possuíam algum tipo de pós-graduação em seu currículo. Foram 22 critérios submetidos à validação por 29 especialistas, totalizando 638 avaliações. Dentre estes, 63% (401) foi classificada como Concordância. O valor encontrado para o coeficiente α foi de aproximadamente 0,9536. Foram 19 itens validados, através do coeficiente α, e 19 itens sugeridos e utilizados pelos especialistas. Após categorização, foram selecionados 19 itens, organizados em formato de algoritmo, com respostas dicotômicas (sim ou não) o que sugere a cada final de fluxo o tipo do banho (não banho, banho no leito ou banho de aspersão) indicado ao paciente, devido suas condições clínicas. Conclusão: O aplicativo móvel, produto desta pesquisa, foi elaborado por um colaborador que o utilizou a interface de desenvolvimento Android Studio® com a linguagem Java® a partir do algoritmo estruturado baseado nos achados do julgamento prévio dos especialistas para auxiliar na tomada de decisão quanto ao banho do paciente em uma Unidade Coronariana, para sua disponibilização para download, sugere-se a validação através de um estudo piloto, para garantir a segurança ao paciente

Introduction: Cardiovascular diseases are one of the leading causes of mortality in the world. The acute form of this condition is called Acute Coronary Syndrome (ACS), which can be classified as unstable angina and acute myocardial infarction. After the medical diagnosis defined as SCA, the patient needs hospitalization in a Coronary Unit. In this environment, it is offered assistance guided by clinical protocols and guidelines in order to contribute to its recovery, to minimize the risk of complications and to prevent damages. Among the protocols that involve this care is the bath, which can be classified as bedding or spraying. The clinician's clinical information and the patient's current hemodynamics are necessary for the decision-making of the nurse regarding the indication to the coronary patient's bath. The problem "The absence of systematization for decision making regarding the choice of bath of the coronariopata patient in a Coronary Unit" is a problem. Objective: To elaborate an algorithm in the format of a mobile application to aid the decision making of the nurse regarding the bath of the coronariopata patient in a Coronary Unit. Method: This is an exploratory, methodological and quantitative approach to the elaboration of an algorithm in the mobile application format. The study was carried out in two stages: 1st stage: an instrument was elaborated from a literature review addressing the themes of cardiac and bath rehabilitation. This instrument was submitted to validation of its criteria by nurses. The data approach was carried out by a statistic described as the calculation of Cronbach's Alpha Coefficient. 2nd stage: Elaboration of the algorithm based on the findings of the applied instrument, in a mobile application format to aid in decision making regarding the coronary patient's ICU bath. Results: A total of 29 nurses were evaluated in a period of 03 months. Of these, 26 (89%) were female, ranging in age from 23 to 58 years old and all nurses had some type of postgraduate degree in their curriculum. There were 22 criteria submitted to validation by 29 specialists, totaling 638 evaluations. Of these, 63% (401) was classified as Concordance. The value found for the coefficient α was approximately 0.9536. There were 19 items validated through the α coefficient and 19 items suggested and used by the specialists. After categorization, we selected 19 items, organized in an algorithm format, with dichotomic responses (yes or no), which suggests to each end of the flow the type of bath (not bath, bath in the bed or bath of sprinkling) due to its clinical conditions. Conclusion: The mobile application, the product of this research, was developed by a developer who used the Android Studio® development interface with the Java® language from a structured algorithm based on the findings of the expert's prior judgment to assist in decision making to the patient's bath in a Coronary Unit, for its availability for download, validation is suggested through a pilot study, to guarantee patient safety