Barts Health NHS Trust
Barts Health NHS Trust
News Article | April 26, 2017
NHS organisations are obliged by law to report people it fears at risk of becoming terrorists under the Prevent strategy - part of the UK government's counterterrorism plan aimed at stopping people becoming terrorists. But new data collected by The BMJ has uncovered low levels of referrals to Prevent since the duty took hold, suggesting that it is having little impact in the NHS. Figures obtained by freedom of information requests from 59 acute trusts in England found just 75 referrals to the programme between 2015-16. A further 74 trusts replied, but withheld information on referrals; some because the actual number of referrals was so small, others on security grounds. Mental health trusts in England recorded a much higher level of referrals: 23 of these trusts (40%) were willing to provide data, showing a total of 254 referrals. This higher number is not surprising given that psychiatric patients are more likely to discuss such issues with their doctor. The data also shows how many NHS staff have been left ill-prepared to deal with the Prevent programme. The BMJ asked trusts whether staff receive training, and responses from 134 acute trusts (81%) and 57 mental health trusts (95%) reveal a mixed picture. For example, at St George's University Hospitals NHS Foundation Trust, south west London, just 4.5% have been trained, but at Barts Health NHS Trust, east London, 94% staff have undergone the Home Office-approved training. A recent report by the US Open Society Justice Initiative warns of the threat the duty poses to the doctor-patient relationship and calls for its repeal in both the health and education sectors. However, the GMC's updated confidentiality guidance makes it clear that in certain circumstances such as assisting in the prevention, detection or prosecution of serious crime, doctors would be "justified in disclosing information about patients in the public interest." Other criticisms of Prevent is the lack of transparency about patients who have been referred and that the training offered to doctors and healthcare staff is limited. The Royal College of Psychiatrists has also questioned the "variable quality of the evidence" underpinning the Prevent strategy and has called for it to be published in full. In an exclusive interview, Metropolitan Police assistant commissioner Mark Rowley, the national lead for counterterrorism policing, tells The BMJ that the involvement of the NHS in Prevent is "massively important, more important than it's ever been." Rowley claims that out of 13 attacks which the security services say they have foiled since 2013, "a disproportionate number of them do have mental health issues." He would not specify a number. But he stresses that any suggestion mental illness causes terrorism is "complete nonsense" - and is adamant that collaboration between the NHS and the police is about safeguarding vulnerable people, not surveillance to identify criminals. Rowley admits there needs to be more transparency around the strategy to win over sceptical clinicians - and acknowledges that research is racing to catch up with the change in terrorist tactics from networks to inciting lone attacks. However, he points to two ongoing projects that aim to improve understanding of connections between mental health and vulnerability to radicalisation, and identify how specialist mental health teams should work with the police to reduce risk to the public and keep vulnerable people out of the criminal justice system. "This is new and dynamic and we are going to have to learn together," he concludes.
News Article | May 15, 2017
A "second spike" in cyber-attacks has not hit the NHS but some hospital trusts are suffering ongoing disruption due to Friday's ransomware attack. Routine surgery and GP appointments have been cancelled across the NHS as it recovers from the global outbreak. But the number of hospitals diverting patients from A&E has decreased from seven on Sunday to two. They are the Lister Hospital in Hertfordshire and the Broomfield Hospital in Essex. Health Secretary Jeremy Hunt, who attended a Cobra committee meeting on cyber-security on Monday, said it was "encouraging" that there has not been any fresh attacks, although the National Crime Agency said this did not mean there would not be one in the future. "We've not seen a second wave of attacks and the level of criminal activity is at the lower end of the range that we had anticipated," he said. At least 16 trusts out of 47 that were hit are still facing issues, leading to further cancellations and delays to services, BBC research suggests. Patients have been told to turn up for appointments, unless advised otherwise, although some GPs are asking people to consider whether they really need to attend the surgery imminently. But Dr Anne Rainsberry, national incident director at NHS England, said there were "encouraging signs" the situation was improving. "The message to patients is clear: the NHS is open for business. Staff are working hard to ensure that the small number of organisations still affected return to normal shortly." With the NHS slowly getting on top of the disruption caused by the cyber attack, attention, naturally, starts to turn to who is to blame for the fact it seems to have been so vulnerable. Some hospitals appear not to have installed patches sent out in April that were designed to deal with the vulnerability which this attack appears to have exploited. But there could be good reason for this - checking that they were compatible with the rest of the IT system is certainly one. And, as yet, it is not clear if the trusts affected are the ones which had not used the patch. So what about ministers? We know there have been warnings before about IT security in the NHS - last summer a review said it needed looking at. But the problem is that over the last three years the capital budget - which is a ring-fenced fund used to pay for buildings and equipment - has been raided by the government to bail out day-to-day services, such as A&E. Last year a fifth of the capital budget was diverted. That, of course, makes it more difficult for trusts to keep their systems up to date. The ransomware that hit the NHS in England and Scotland, known as Wanna Decryptor or WannaCry, has infected 200,000 machines in 150 countries since Friday. Europol, the EU's law enforcement agency, has called the cyber-attack the "largest ransomware attack observed in history". Home Secretary Amber Rudd, who chaired the Cobra meeting on cyber security, said the UK was working with international partners in the global manhunt to find the ransomware's creators. "The National Cyber Security Centre and the NCA are working with Europol and other international partners to make sure that we all collect the right evidence, which we need to do, to make sure we have the right material to find out who has done this and go after them, which we will," she said. Barts Health NHS Trust, which runs five hospitals in east London, says it continues to experience some "delays and disruption" to services. It says it has "reduced the volume" of planned services for Monday and Tuesday, which means some surgery and outpatient appointments will be cancelled. However, its hospitals remain open for emergency care and it is no longer diverting ambulances from its sites. The trust said its trauma and stroke care services are now fully operational, as are renal dialysis services. More on the latest NHS disruptions The ransomware, which locks users' files and demands a $300 (£230) payment to allow access, spread to organisations including FedEx, Renault and the Russian interior ministry. In England, 47 NHS trusts reported problems at hospitals and 13 NHS organisations in Scotland were affected. NHS Wales said none of its computer systems was affected and no patient data compromised, while police in Northern Ireland said no incidents had been reported. Responding to suggestions that the NHS had left itself open to an attack of this nature, Mr Hunt told the BBC it had "massively" upgraded its security before the incident. This included reducing the number of computers that were using an older Microsoft operating system and were therefore vulnerable to attack, and setting up a security centre. Pressed that the NHS was affected by the ransomware attack because its systems were vulnerable, Mr Hunt said the NHS was a "huge network" and more than 80% of it was unaffected. Prime Minister Theresa May has denied suggestions that the government ignored warnings that NHS systems were vulnerable to cyber-attacks. "It was clear warnings were given to hospital trusts, but this is not something that focused on attacking the NHS here in the UK," she said. In July last year, the Care Quality Commission and National Data Guardian, Dame Fiona Caldicott, wrote to Mr Hunt warning that an "external cyber threat is becoming a bigger consideration" within the NHS. It said a data security review of 60 hospitals, GP surgeries and dental practices found there was a "lack of understanding of security issues" and data breaches were caused by time-pressed staff often working "with ineffective processes and technology". Meanwhile, Security Minister Ben Wallace has insisted NHS trusts have enough money to protect themselves against cyber-attacks. The "real key" was whether trusts had regularly backed up data and whether they were installing security patches, he said. Chris Hopson, chief executive of NHS Providers, told Radio 4's Today programme many hospitals use sophisticated technology such as MRI and CT scanners which are "bound to be using old software" because they have a ten-year life expectancy, so are often linked to older operating systems. He said he was "disappointed" at the suggestion by some that the cyber-attack problem was down to "NHS manager incompetence". The government is insisting that the NHS had been repeatedly warned about the cyber-threat to its IT systems, with Defence Secretary Michael Fallon stating £50m was being spent on NHS systems to improve their security. But Labour criticised the Conservatives, saying they had cut funding to the NHS's IT budget and a contract to protect computer systems was not renewed after 2015. Shadow health secretary Jonathan Ashworth pointed to a report from the National Audit Office six months ago. It highlighted how, in February 2016, the Department of Health had "transferred £950m of its £4.6bn budget for capital projects, such as building works and IT, to revenue budgets to fund the day-to-day activities of NHS bodies". The WannaCry ransomware exploits a flaw in Microsoft Windows first identified by US intelligence. Microsoft, who released a security update in March to protect computers from it, described Friday's incident as a "wake-up call". Get news from the BBC in your inbox, each weekday morning
News Article | May 15, 2017
“It was chaos,” a receptionist working the night shift at Jakarta’s Dharmais Hospital, Indonesia’s biggest cancer center, tells Fast Company. “There were 150-200 people waiting for hours and getting more impatient, waiting for their appointments. Some of them were crying.” He was just one of hundreds of thousands of people around the world at hospitals, universities, and businesses large and small who were affected by the global ransomware attack that struck computers in at least 150 countries and at its peak even forced hospitals to turn away ambulances. “Our focus is getting our systems back up and making sure our patients don’t lose out,” says Peter Gibson, a spokesperson for the East and North Hertfordshire National Health Service Trust in the U.K., which on Monday told patients to only visit its Lister Hospital emergency unit “if it is absolutely essential or you are concerned.” The trust was one of at least 48 regional public medical groups in the U.K. affected by malware that has struck more than 200,000 victims around the globe since Friday, spreading rapidly through a security hole in Microsoft operating systems that was revealed in a set of NSA files. The cyber attack, known as “WannaCrypt” or “WannaCry,” encrypted files on affected computers and demanded a ransom of at least $300 be paid in bitcoin in order to access their contents, disrupting services everywhere from Chinese gas stations to Indian police departments. There’s no sign that the malware copied any data, and U.K. health systems and other affected organizations say that customer data wasn’t stolen. Computers in Europe and Asia were particularly hard hit by the malware, which saw its spread disrupted when a security researcher registered an internet domain that acted as a “kill switch” to disable the attack code. But that didn’t help organizations that had already been struck by the malware, which led U.K. hospital operators including London’s Barts Health NHS Trust to redirect ambulances to other hospitals throughout the weekend. “We are no longer diverting ambulances from any of our hospitals,” the trust said in a Monday statement. “Trauma and stroke care is also now fully operational. However, we continue to experience IT disruption and we are very sorry for any delays and cancellations that patients have experienced.” Anthony Brett, a 50-year-old from east London, was scheduled to have surgery to insert a stent into his liver, but he was told that the procedure would have to be postponed. “To do it to the NHS that does so much good for people, it’s just disgusting,” he told the Telegraph about the unknown hackers. “They should be hung, drawn, and quartered.” Even some U.K. medical providers that weren’t direct victims of the attack still cut back services after shutting down equipment to avoid the risk of infection. “We’re not infected, but we are affected, because we’ve had to turn our computers off as a precautionary measure,” says Danny Hudson, a spokesman for the Sherwood Forest Hospitals NHS Foundation Trust. The move led to four operations being cancelled, and three outpatient clinics closed over the weekend, though services were restored by Monday, according to the hospital system. The attack forced shutdowns at other types of businesses as well, including at European auto manufacturing plants run by carmakers Nissan and Renault. “We took protective measures to immediately stop the spread of the virus and protect the [company],” says a spokesperson for Renault. “It included temporary suspension of industrial activities on some of our sites, depending on situations.” The spokesperson didn’t have a full count of the number of sites affected, and the company had not yet computed the cost of the downtime or restoration efforts Monday. All but one plant had been restarted Monday, with the holdout in the French town of Douai set to resume operations Tuesday. “We had some production impact, but we will make things happen in order to deliver [to] our customers on time,” the spokesperson said. The attack also visibly struck the German railroad Deutsche Bahn, Europe’s largest train operator. While company spokesperson Lutz Müller emphasized in an email to Fast Company that train services weren’t affected and “there have not been any security risks for both our passengers and our staff,” the malware did disable some ticket machines and digital schedule boards at German rail stations. Photos of railroad monitors displaying digital ransom notes atop arrivals and departures were shared on social media over the weekend, and Müller says Deutsche Bahn deployed additional personnel to assist passengers while the systems were down. “We are currently working hard to get all our displays running again, but this will take a few days,” he writes, adding that the railroad’s apps, website, and phone lines are working normally. Fewer systems in the Americas appeared to be affected, though delivery giant FedEx was notably impacted, leading it to suspend money-back guarantees for FedEx Express packages slated for Saturday delivery. “FedEx experienced interference with some of our systems which caused disruptions to the FedEx Express Memphis Hub sort operations,” the company said Saturday. “We immediately implemented contingency plans to minimize the impact to our customers. We regret any inconvenience this has caused.” The Memphis Commercial Appeal, the company’s hometown newspaper, reported that more than 100 FedEx flights appeared to be delayed during the busy Mother’s Day weekend, but by Monday the company said systems had returned to normal. “FedEx has resumed normal operations and systems are performing as designed,” a spokesperson said via email on Monday, declining to comment on the extent of the weekend disruption. The Canadian Broadcasting Corporation also reported that Lakeridge Health, a large Ontario hospital, was struck by the malware. The hospital didn’t respond to multiple requests for comment from Fast Company Monday, and the CBC reported that the hospital was able to restore affected computers without an impact to patient treatment. Universities across the globe were also affected by the attack, including China’s flagship Peking and Tsinghua universities. The Massachusetts Institute of Technology’s IT department warned in a Friday tweet that the ransomware was “affecting MIT folks,” though MIT officials didn’t respond to multiple requests Monday for further details. And Britain’s University of Cambridge also shut down some systems after detecting attempted attacks from the malware, according to a student newspaper, though the university said Monday no systems were ultimately infected. “The University will continue to monitor developments closely,” a spokesperson said. A ransomware spreading in the lab at the university pic.twitter.com/8dROVXXkQv The University of Milano-Bicacco also saw four computers in a student computer lab infected with the malware, and a photo of the machines was widely circulated on social media. But the ransomware was removed without any lasting damage, and the rest of the 120 computers in the lab were unaffected, wrote associate professor Claudio Ferretti in an email to Fast Company. “All the machines in the didactic laboratories normally are replicas of a single image, with no personal/single student data, and therefore no data was lost and the infected machines where immediately restored from the common clean image,” he wrote. Cybersecurity experts also continued to warn Monday that computers running versions of Windows prior to Windows 10 that haven’t been updated to fix the vulnerability could still fall victim to copycat attacks. Experts urged anyone who had not yet installed Microsoft’s security fixes, issued in March, to do so immediately. Microsoft released patches over the weekend for older, unsupported versions of Windows, including Windows XP, in an unusual move for the company. And Microsoft president Brad Smith critiqued the NSA and other spy agencies for “stockpiling” vulnerabilities that can be leaked to do damage. The identity of who was behind the malware apparently still remained unknown on Monday. Russia, widely blamed for recent hacks on government agencies and political parties around the world, denied responsibility, reporting that about 1,000 computers in the country’s Interior Ministry were struck by the attack. About $56,000 in ransom was sent to bitcoin addresses associated with the malware, a number that trickled upward throughout Monday, according to bitcoin security firm Elliptic. It was unclear, though, whether the software’s creators would be able to claim the bounty without identifying themselves. Experts still warned that creators of the original malware, or independent hackers, could tweak the code to allow the attack to continue despite the “kill switch” domain. “Companies should issue a special alert to employees today to be especially careful with opening emails and attachments even if they know the person sending the email,” said Michael Patterson, CEO of security firm Plixer, in a Monday statement. “This ransomware is evolving and there may be more to this as the week continues.” Additional reporting by Marcus Baram This story has been updated
News Article | May 12, 2017
Britain's National Health Service reported a cyber attack on a number of hospitals on May 12, 2017 (AFP Photo/Isabel INFANTES) London (AFP) - A fast-moving wave of cyberattacks swept the globe Friday, apparently exploiting a flaw exposed in documents leaked from the US National Security Agency. The attacks came in the form of ransomware, a technique used by hackers that locks users' files unless they pay the attackers a designated sum in the virtual currency Bitcoin. The scope of the attacks was not immediately clear, but some analysts reported that dozens of countries had been affected, with the malware linked to attacks on hospitals in Britain as well as the Spanish telecom giant Telefonica and the US delivery firm FedEx. The US Department of Homeland Security's computer emergency response team said it was aware of ransomware infections "in several countries around the world." "We are now seeing more than 75,000 detections... in 99 countries," Jakub Kroustek of the security firm Avast said in a blog post around 2000 GMT. Earlier, Kaspersky researcher Costin Raiu cited 45,000 attacks in 74 countries, saying that the malware, a self-replicating "worm," was spreading quickly. Forcepoint Security Labs said that "a major malicious email campaign" consisting of nearly five million emails per hour was spreading the new ransomware. The malware's name is WCry, but analysts were also using variants such as WannaCry. Forcepoint said in a statement that the attack had "global scope", affecting organisations in Australia, Belgium, France, Germany, Italy and Mexico. In the United States, FedEx acknowledged it had been hit by malware and was "implementing remediation steps as quickly as possible." The UK's state-run National Health Service declared a "major incident" after the attack, which forced some hospitals to divert ambulances and scrap operations. In Spain, major firms including Telefonica were hit, with employees told to shut down workstations immediately through megaphone announcements. At least 16 organisations within the NHS, some of them responsible for several hospitals each, reported being targeted. "We are aware that a number of NHS organisations have reported that they have suffered from a ransomware attack. This is not targeted at the NHS, it's an international attack and a number of countries and organisations have been affected," said Prime Minister Theresa May. Britain's National Cyber Security Centre and its National Crime Agency were looking into the UK incidents. Pictures posted on social media showed screens of NHS computers with images demanding payment of $300 (275 euros) in Bitcoin, saying: "Ooops, your files have been encrypted!" It demands payment in three days or the price is doubled, and if none is received in seven days, the files will be deleted, according to the screen message. A hacking group called Shadow Brokers released the malware in April claiming to have discovered the flaw from the NSA, Kaspersky said. Although Microsoft released a security patch for the flaw earlier this year, many systems have yet to be updated, researchers said. "Unlike most other attacks, this malware is spreading primarily by direct infection from machine to machine on local networks, rather than purely by email," Lance Cottrell, chief scientist at the US technology group Ntrepid. "The ransomware can spread without anyone opening an email or clicking on a link." NHS Incident Director Anne Rainsberry urged the British public to "use the NHS wisely while we deal with this major incident which is still ongoing". The sort of ransom demands seen on the NHS screens are not without precedent at medical facilities. In February 2016, a Los Angeles hospital, the Hollywood Presbyterian Medical Center, paid $17,000 in Bitcoin to hackers who took control of its computers for more than a week. "Ransomware becomes particularly nasty when it infects institutions like hospitals, where it can put people's lives in danger," said Kroustek, the Avast analyst. A spokesman for Barts Health NHS Trust in London said it was experiencing "major IT disruption" and delays at all four of its hospitals. "We have activated our major incident plan to make sure we can maintain the safety and welfare of patients," the spokesman said. "Ambulances are being diverted to neighbouring hospitals." Two employees at St Bartholomew's Hospital, which is part of Barts Health, told AFP that all the computers in the hospital had been turned off. Caroline Brennan, 41, went to the hospital to see her brother, who had open heart surgery. "They told us there was a problem. They said the system was down and that they cannot transfer anyone till the computer system was back up so he is still in the theatre."
News Article | May 12, 2017
The attacks—which experts said affected dozens of countries—used a technique known as ransomware that locks users' files unless they pay the attackers a designated sum in the virtual currency Bitcoin. Affected by the onslaught were computer networks at hospitals in Britain, Russia's interior ministry, the Spanish telecom giant Telefonica and the US delivery firm FedEx and many other organizations. Britain's National Cyber Security Centre and its National Crime Agency were looking into the UK incidents, which disrupted care at National Health Service facilities. "This is not targeted at the NHS, it's an international attack and a number of countries and organizations have been affected," British Prime Minister Theresa May said. Russia's interior ministry said that some of its computers had been hit by a "virus attack" and that efforts were underway to destroy it. The US Department of Homeland Security's computer emergency response team said it was aware of ransomware infections "in several countries around the world." Jakub Kroustek of the security firm Avast said in a blog post update around 2000 GMT, "We are now seeing more than 75,000 detections... in 99 countries." Kaspersky researcher Costin Raiu cited 45,000 attacks in 74 countries, saying that the malware, a self-replicating "worm," was spreading quickly. In a statement, Kaspersky Labs said it was "trying to determine whether it is possible to decrypt data locked in the attack—with the aim of developing a decryption tool as soon as possible." "It's unequivocally scary," said John Dickson of the Denim Group, a US security consultancy. Dickson said the malware itself, which exploits a flaw in Windows, was not new but that adding the ransomware "payload" made it especially dangerous. "I'm watching how far this propagates and when governments get involved," he said. The malware's name is WCry, but analysts were also using variants such as WannaCry. Forcepoint Security Labs said in a statement that the attack had "global scope" and was affecting networks in Australia, Belgium, France, Germany, Italy and Mexico. In the United States, FedEx acknowledged it had been hit by malware and was "implementing remediation steps as quickly as possible." Britain's National Health Service declared a "major incident" after the attack, which forced some hospitals to divert ambulances and scrap operations. Pictures posted on social media showed screens of NHS computers with images demanding payment of $300 (275 euros) in Bitcoin, saying: "Ooops, your files have been encrypted!" It demands payment in three days or the price is doubled, and if none is received in seven days, the files will be deleted, according to the screen message. A hacking group called Shadow Brokers released the malware in April claiming to have discovered the flaw from the NSA, Kaspersky said. Although Microsoft released a security patch for the flaw earlier this year, many systems have yet to be updated, researchers said. "Unlike most other attacks, this malware is spreading primarily by direct infection from machine to machine on local networks, rather than purely by email," Lance Cottrell, chief scientist at the US technology group Ntrepid. "The ransomware can spread without anyone opening an email or clicking on a link." The sort of ransom demands have been growing precedent at medical facilities. In February 2016, a Los Angeles hospital, the Hollywood Presbyterian Medical Center, paid $17,000 in Bitcoin to hackers who took control of its computers for more than a week. "Ransomware becomes particularly nasty when it infects institutions like hospitals, where it can put people's lives in danger," said Kroustek, the Avast analyst. A spokesman for Barts Health NHS Trust in London said it was experiencing "major IT disruption" and delays at all four of its hospitals. "We have activated our major incident plan to make sure we can maintain the safety and welfare of patients," the spokesman said. "Ambulances are being diverted to neighboring hospitals." Two employees at St Bartholomew's Hospital, which is part of Barts Health, told AFP that all the computers in the hospital had been turned off. Caroline Brennan, 41, went to the hospital to see her brother, who had open heart surgery. "They told us there was a problem. They said the system was down and that they cannot transfer anyone till the computer system was back up," Brennan said. Some said the attacks highlighted the need for agencies like the NSA to disclose security flaws so they can be patched. "These attacks underscore the fact that vulnerabilities will be exploited not just by our security agencies, but by hackers and criminals around the world," said Patrick Toomey of the American Civil Liberties Union. Explore further: Cyber strike on UK hospitals is 'international attack': PM
News Article | May 29, 2017
EDINBURGH, Scotland (May 29, 2017) - The International Neuromodulation Society (INS) has selected six best scientific abstracts that represent insights that may facilitate expanded, increasingly tailored care. The winners are being announced May 29 at the INS 13th World Congress in Edinburgh, Scotland. "These accomplishments represent rapid progress in our field, and offer potential to expand and improve patient care," commented INS President Timothy Deer, M.D. "We are proud to acknowledge such stellar and promising research." Neuromodulation entered use in the 1980s to manage chronic pain, treat bladder dysfunction, improve sensory deficits, and limit motor symptoms of movement disorder. The techniques and targets continue to evolve with potential to treat an expanding array of health conditions. The scientific abstracts being recognized reflect the field's overall trends toward personalized care that tailors therapy to address underlying conditions. The abstracts were selected for quality, originality, and ingenuity from among more than 470 accepted abstracts. The abstract competition began in 2015. The six winning research projects represent innovative therapy approaches or basic research, providing knowledge that can improve treatment or help clarify mode of action. New functional treatment for chronic low back pain - Vivek Mehta, MD, FRCA, FFPMRCA, a consultant in Pain Medicine and Neuromodulation; and director, Pain and Anaesthesia Research Centre at St. Bartholomew's Hospital, Barts Health NHS Trust, London, is presenting on behalf of collaborators an innovative neuromodulation treatment option that was demonstrated in 53 patients who have disabling localized chronic lower back pain. These patients had undergone medication and pain interventions without any demonstrable benefit and were not found suitable for spinal surgery. This new treatment stimulates the multifidus muscle, a core muscle group, which causes it to contract, thereby strengthening it and stabilizing the lower back. The method targets functional stability as well as pain. After 90 days of treatment, most participants improved in at least one of three measures - pain, disability, or quality of life. At one year, more than 80 percent of patients expressed satisfaction with the treatment. The study indicated this innovative therapy could be safe and effective option for patients with chronic disabling low back pain who are not suitable candidates for surgery. Earlier in its development, the method was featured four years ago in an Innovations Day panel at the INS 11th World Congress. Stimulation effects on postural instability in Parkinson's disease - Stephanie Tran, a neuroscience master's candidate at the University of British Columbia, submitted results of a study that showed non-invasive galvanic vestibular stimulation improved postural stability in 13 patients with Parkinson's disease, a movement disorder marked by postural instability. The vestibular system is part of the inner ear involved in maintaining balance. Its stimulation had been shown to affect motor responsiveness in individuals with neurodegenerative disease. She tracked patients' degree of sway as they stood with their eyes closed, taking measurements while they were on their normal medication to target treatment-resistant symptoms. She compared two stimulation directions and found stimulation from the middle to side was particularly helpful in the patients. By contrast, the stimulation did not change measurements nine healthy control subjects. She also was a winner in the INS 12th World Congress abstract competition in 2015 for related research. Combined stimulation method for pain control - Eugene Mironer, M.D., managing partner of the Carolinas Center for Advanced Management of Pain in North Carolina and South Carolina, will present results of a comparative prospective study in 40 patients who have lower back or leg pain and received a combination of spinal and peripheral nerve stimulation. Patients were randomly administered three different stimulation interaction patterns for two weeks apiece. He found 82 percent of the patients preferred an interaction in which the spinal cord stimulator had a positive charge and, across the lower back, a peripheral nerve stimulator had a negative charge. The remainder of the patients preferred the reverse polarity. No patients chose the third option, in which the leads were used independently. The patients' preferred spinal-peripheral stimulation supports findings in an earlier study from Neuromodulation: Technology at the Neural Interface that evaluated that configuration. High-frequency spinal cord stimulation for intractable leg pain - Jan Willem Kallewaard, M.D. of Rijnstate Hospital, Arnhem, the Netherlands, is presenting interim results from a prospective multicenter study in 42 pain patients whose intractable leg pain was treated with high-frequency spinal cord stimulation. This method does not produce tingling sensations of paresthesia like conventional spinal cord stimulation. Data are being collected on pain intensity and quality, functionality, quality of life, psychological assessments, opioid usage and return to work. In six-month results, the study showed clinically meaningful improvements in pain scores, disability and catastrophizing. High-frequency stimulation capabilities were the subject of an Innovations Day presentation at the INS 10th World Congress. Preliminary results from a prospective, multicenter study of high-frequency spinal cord stimulation in intractable, painful peripheral polyneuropathy - Sean Li, M.D. will present preliminary results from the first prospective, multicenter clinical study to use high-frequency spinal cord stimulation in patients with painful peripheral polyneuropathy of the arms or legs. At one month, the 16 participants experienced 70.5 percent pain relief overall. Six of the patients had painful diabetic neuropathy, a relatively common complication that is hard to treat. This subgroup experienced 67.5 percent pain relief. Pain-relieving spinal cord stimulation is associated with the activation of progenitor nerve cells - A scientific study by Clinical Associate Professor Chi Wai Cheung, M.D., director of Hong Kong University's Laboratory and Clinical Research Institute for Pain, and his research team provide rare cellular evidence of spinal cord stimulation effects. The study in laboratory rats showed spinal cord stimulation that relieves pain from spinal injury is associated with an increase in neural progenitor cells. About half the progenitor cells carried a marker for GABA-expressing neurons. GABA is a neurotransmitter associated with inhibition of pain signals. Repetitive spinal cord stimulation provided a long-lasting and incremental analgesic effect, based on hypersensitivity results from touching the hind paw with a microfilament. The pain-relieving effect might be associated with increased progenitor cells since many showed characteristics of GABA neurons. This study provides evidence for a central mechanism of pain relief from spinal cord stimulation. All abstracts submissions accepted for presentation at the congress will be published online in the INS journal Neuromodulation: Technology at the Neural Interface. The nonprofit International Neuromodulation Society presents up-to-date information about the full breadth of neuromodulation therapies through an interactive website, its journal Neuromodulation: Technology at the Neural Interface, annual regional meetings, and its biennial world congress. Neuromodulation therapy, sometimes referred to as bioelectric medicine or electroceuticals, is one of medicine's fastest-growing fields, driven by rising neurological disease in an aging population, and the need for non-pharmacological approaches to manage symptoms. The first use of spinal cord stimulation (SCS) to treat chronic pain of neuropathic origin was reported in 1967 by C. Norman Shealy, M.D., Ph.D. Neuromodulation devices, such as SCS and deep brain stimulation systems, leverage technology developed for cardiac pacemakers and cochlear implants to re-balance neural activity. Neuromodulation therapies help relieve chronic pain or restore function. Existing and emerging devices operate through targeted application of electrical, magnetic, chemical, or optical stimulation. Current or emerging neuromodulation therapies address deficits in vision, hearing, breathing, mobility, grasp or gait, motor function, mood, memory, and digestion.
Regenerate, Barts Health Nhs Trust and Queen Mary, University of London | Date: 2017-04-19
The present invention provides a composition comprising cells obtainable by bone marrow aspiration, or multipotent or pluripotent progenitor cells,and granulocyte-colony stimulating factor (G-CSF), as a combined preparation for simultaneous, separate or sequential use in the therapy of cardiomyopathy in a subject, wherein the cells are administered directly to the myocardium of the subject.
News Article | May 13, 2017
Last October the Northern Lincolnshire and Goole NHS Foundation Trust was subject to a cyber-attack that saw it forced to shut down its IT systems, resulting in the cancellation of almost 3,000 patient appointments. Until last Friday the incident was one of the few known examples of an attack on the NHS using ransomware, a type of software that encrypts a computer system’s files and refuses to unlock them until a payment is made. Once an obscure form of computer hacking, ransomware attacks are now ubiquitous. More than 600 million such attacks were carried out last year alone. Those demanding the ransoms often insist on being paid in bitcoins – the virtual currency that allows its owners to hide their identity. But what was unusual about Friday’s attack was its reach – 99 countries were hit. High-profile victims include French car manufacturer Renault, Germany’s rail service Deutsche Bahn and Spain’s Telefonica. Almost three-quarters of the victims were in Russia. In the UK, 48 NHS trusts and scores more GP practices were affected. Many others closed their IT systems down as a precautionary measure. As the crisis escalated yesterday into a full-blooded election issue, the home secretary, Amber Rudd, promised that “lessons would be learned” from what experts describe as one of the biggest cyber-attacks since the infamous Love Bug virus in May 2000 which largely infected personal computers rather than critical, corporate IT systems. But many experts believes lessons should have been learned long ago. “It’s not as though this has come as a shock to anybody,” said Paul Vlissidis, technical director at NCC Group, a cybersecurity firm. “For anyone who works in the NHS or the security industry, a lot of people have been saying for a long time that there’s going to be a big one that gets through.” Of the 29 NHS trusts that answered a freedom of information request from NCC, 28 revealed that they had been a victim of ransomware in 2016. Papworth heart and lung hospital in Cambridgeshire was subject to one such attack, according to its ICT director, Jane Berezynskyj, who told a conference last year the malware had started encrypting the hospital’s files just after its daily backup had been completed. “We were very, very lucky,” she acknowledged. NHS trusts have been warned to back up their computer systems regularly but it is unclear how many follow the guidance. NHS staff have told the Observer that hospital IT teams were scrambling to fix their systems several weeks ago – ever since Microsoft alerted the world to the vulnerability of its operating system back in March. The system’s vulnerability was exploited by a hacking collective called Shadow Brokers which released a hacking tool – thought to have been developed by the US military security organisation, the National Security Agency – on to the internet, allowing others to launch ransomware attack weeks later. By yesterday afternoon it was estimated that around 120,000 systems around the world were infected. It is common practice for security agencies like the NSA to develop tools to exploit computer systems. But these tools can then end up being acquired by criminal gangs and state actors, according to experts. “It’s our governments, via the intelligence agencies, that share a responsibility for creating vulnerabilities in our communication networks, surveilling our smart phones and televisions and exploiting loopholes in our operating systems,” said Dr Simon Moores, chair of the International eCrime Congress. One theory suggests an NSA contractor left the hacking tools on an unsecured computer from where they were stolen by the Shadowbrokers collective, about whom little is known. “They are very good hackers with experience in operational security,” said Costin Raiu, director of Kaspersky Lab’s Global Research and Analysis Team. “You see it in all the choices they make,” Raiu added, pointing out that they used specialist encryption tools and hardware to protect their identities. “They’re not amateurs, they’re very highly skilled which makes it very hard to catch them.” But even if they were apprehended others would take their place. According to Moores, malware programs are sold on darknet markets “for the price of a good curry”. This is a concern for the managers of archaic NHS IT systems. “The problem is that the old IT systems were never designed to withstand the forces now ranged against them,” Moores said. “You may note that US hospitals haven’t been so badly hurt if only because they have the money to use more up-to-date systems rather than coax older systems to keep going.” Cash-strapped NHS hospitals have been reluctant to spend money to upgrade their IT systems. Those in special measures complain that they have been prevented from allocating resources to tackle the problem. As a result, many NHS IT systems have been cobbled together down the years by piling new software on old software, creating an unwieldy and complex infrastructure that is not fit for purpose. An article in the British Medical Journal noted: “Many hospitals use proprietary software that runs on ancient operating systems. Barts Health NHS Trust’s computers, attacked by ransomware in January, ran Windows XP. Released in 2001, it is now obsolete, yet 90% of NHS trusts run this version of Windows.” Overhauling these systems requires skilled IT professionals. But a report by MPs on the Public Accounts Committee noted in February that “the government faces a real struggle to find enough public sector employees with the skills to match the pace of change”. Until that skills gap is closed, the UK’s public sector will always be one step behind the hackers, a concern for security experts who question whether other critical IT systems such as those in the nuclear power and energy transmission sectors may be equally vulnerable. Raiu predicted that Friday’s attack would force governments to take action against crypto-currencies. “I wouldn’t be surprised if in the near future governments ban the use of bitcoins.” Kaspersky Lab’s analysis suggested that as of yesterday afternoon only around 60 people had paid the $300 bitcoin ransom demanded to unlock their computers. He suggested that the number would grow in the coming days as companies and individuals researched how to purchase bitcoins. “We don’t recommend that you pay the ransom,” Raui said. “Make a backup and maybe a solution to decrypt the data will become available in the near future.” The one crumb of comfort from the chaos unleashed on the world’s IT systems is that it could have been worse. The ransomware’s global spread was embedded with a “kill switch”. This compelled the ransomware to search the web for an address that, having been found and activated, stopped it from spreading. Fortunately for the world’s systems, a UK security expert stumbled across the address and activated it. It suggests the hackers had appreciated the attack’s devastating potential and gave themselves an insurance policy to bring the hack to an end. Their successors may not be so risk averse.