From Clinical Information Systems toward HealthGrid Yannick Legré, maatG President of the International HealthGrid Associa...
Content <ul><li>A glance to the future </li></ul><ul><li>Once upon a time… HealthGrid </li></ul><ul><li>Life Sciences and ...
A glance to the future…
Trends <ul><li>Rising Asia  </li></ul><ul><ul><li>8 billion people by 2025; 2/3 in Asia, 7% in EU (decrease in EU populati...
Tensions, a socio-ecological transition <ul><li>Increasing scarcity of natural resources (potential “oil peak”, 3 billion ...
Vision: Science in 2030 Source: Prof. John Wood (“Science in 2030”) <ul><li>Multi-disciplinarity; no longer one technique ...
 
 
 
<ul><li>&quot; We can't solve problems by using the same kind of thinking we used when we created them. &quot;  </li></ul>...
Roles of e-Infrastructures (1/2) <ul><li>Linking institutions (enabling the sharing of resources, data and knowledge) </li...
Roles of e-Infrastructures (2/2) <ul><li>Reducing the Energy Consomption </li></ul><ul><ul><li>ICT represents 30% of energ...
Once upon a time… HealthGrid
Areas identified in the White Paper <ul><li>Medical Imaging and Medical Image Processing </li></ul><ul><li>Computational M...
<ul><li>Second Opinion </li></ul><ul><li>Cancer Screening </li></ul><ul><li>Education and Training </li></ul><ul><li>Refer...
<ul><li>Early diagnosis and development of effective disease-modifying drugs would be greatly facilitated by the availabil...
Virtual Physiological Human Network of Excellence <ul><li>NoE: team of organisations working in  key focus areas  to suppo...
 
Multiple Components    Endocardium (LV) Mitral valve Epicardium (LV) Aortic Valve, Root Right Ventricle Left Atrium Right ...
<ul><ul><li>Developing new drugs for neglected and emerging diseases with a particular focus on malaria and H5N1. </li></u...
ACGT Screenshot of the Newsletter Winter 2009 (page 1 and page 2)  3 – Grid enabled Pharmaceutical R&D: PharmaGrids (2/2) ...
4 – Grids for Epidemiological Studies & Public Health Surveillance (1/2) http://g-info.healthgrid.org g-INFO
Sentinelle / Ginseng Improve and facilitate systematic screening, such as cancer screening Easy and secure sharing of info...
Innovative Medicine Initiative 5 – Genomic Medicine Grid (1/2)  http://www.imi.europa.eu
<ul><li>Genomic (molecular, personalised)   medicine </li></ul><ul><li>Regenerative  medicine/tissue engineering seeks to ...
Life Sciences and Biomedical Research:  adoption and requirements
Life sciences & Biomedical Research <ul><li>Life Sciences covers a broad range of activities, ranging from biology to pati...
Grid adoption in Life Sciences <ul><li>Very large potential </li></ul><ul><ul><li>Genome sequencing projects and databanks...
Toward a roadmap Reference distribution of grid services Courtesy of the SHARE project – www.eu-share.org  http://roadmap....
HealthGrid Roadmap: Challenges & complexity Courtesy of the SHARE project – www.eu-share.org  http://roadmap.healthgrid.org
HealthGrid Roadmap: Another look Workflow tools http://roadmap.healthgrid.org Courtesy of the SHARE project – www.eu-share...
Grid adoption in Life Sciences <ul><li>The first critical requirement is a transparent grid/cloud infrastructure </li></ul...
Critical requirements <ul><li>Reliable </li></ul><ul><ul><li>Concerns ALL services </li></ul></ul><ul><ul><li>Infrastructu...
ELSE Requirements <ul><li>Legal and Ethical </li></ul><ul><ul><li>Patient consent </li></ul></ul><ul><ul><li>Data Security...
From Research Infrastructures towards sustainable Infrastructures:  the EGI example
<ul><li>European: </li></ul><ul><ul><li>Focus on meeting the needs of European Researchers </li></ul></ul><ul><ul><li>Thei...
<ul><li>In tegrated  S ustainable  P an-European  I nfrastructure for  R esearchers in  E urope </li></ul><ul><li>A 4 year...
A Virtuous User Cycle <ul><li>Integrated Services </li></ul><ul><li>Human </li></ul><ul><li>Technical </li></ul><ul><li>In...
The LSVRC Support Centre <ul><li>International Support Centre for Life Science grid/cloud users </li></ul><ul><ul><li>To a...
Governance model <ul><li>One coordinator (renewed every 6 months) </li></ul><ul><ul><li>Current: CNRS (French National Sci...
Conclusions <ul><li>The more complex and long term issues are not technical but rather Ethical, Legal and Socio-Economic <...
<ul><li>Call for papers opens October 2010 </li></ul><ul><li>See www.egi.eu/EGIUF2011 for more details </li></ul><ul><li>C...
HealthGrid 2011 June 29 th  – July 2 nd  2011 Bristol, UK  http://bristol2011.healthgrid.org  (soon available)
<ul><li>Thank you! </li></ul>French Rugby Federation &quot; It is a mistake to think you can solve any major problems just...
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From Clinical Information Systems toward HealthGrid

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Yannick Legré, maatG
President, International HealthGrid Association
(3/11/10, Illott, 11.00)

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  • Collect all clinically relevant data for a patient to obtain full set of info of patient’s health Understand individual health ICT can contribute the following: collect and store data in a structured manner visualise representations of data build tools for making use of the data
  • 1 – MEDICAL IMAGING AND MEDICAL IMAGE PROCESSING 2 – COMPUTATIONAL MODELS OF THE HUMAN BODY ( Therapy Planning and Computer-Assisted Intervention – Atlases – Numerical Simulations of the Human Body – … ) 3 – GRID ENABLED PHARMACEUTICAL R&amp;D: PHARMAGRIDS 4 – GRIDS FOR EPIDEMIOLOGICAL STUDIES 5 – GENOMIC MEDICINE GRID
  • - I will explain the road map we have devised in stages. A useful first stage is to consider our first attempt at a set of major milestones which lead to the major goal of knowledge healthgrids in widespread use. - We divide the milestones into two kinds -- technological (in purple), and -- deployment (in green). - We also distinguish those within relatively easy reach, in Phase 1, and those that we consider somewhat more remote, in Phase 2.
  • - We also have this model from the world of innovation studies , which distinguishes between -- ‘visionaries’ – the pioneers in research and application; -- ‘early adopters’ (also known as ‘fast followers’) – who recognise the potential for rapid benefits and take up the technology quickly; -- ‘early majority’ (sometimes called ‘mature adopters’) – these take relatively little risk in adopting the technology; and -- ‘late majority’, those who finally adopt a technology because there is virtually no other option.
  • - We also have this model from the world of innovation studies , which distinguishes between -- ‘visionaries’ – the pioneers in research and application; -- ‘early adopters’ (also known as ‘fast followers’) – who recognise the potential for rapid benefits and take up the technology quickly; -- ‘early majority’ (sometimes called ‘mature adopters’) – these take relatively little risk in adopting the technology; and -- ‘late majority’, those who finally adopt a technology because there is virtually no other option. - Even for early adopters, infrastructure interoperability and distributed data management are already necessary. - On demand access, ‘user friendliness’ and quality of service are at the first point of inflection, before rapid expansion. - With sophisticated AI tools in the later stages, a second inflection occurs and the technologies become routinely accepted.
  • From Clinical Information Systems toward HealthGrid

    1. 1. From Clinical Information Systems toward HealthGrid Yannick Legré, maatG President of the International HealthGrid Association (yannick.legre@healthgrid.org) HINZ 2010 Conference – November 3 rd 2010 – Wellington (New Zealand) www.healthgrid.org
    2. 2. Content <ul><li>A glance to the future </li></ul><ul><li>Once upon a time… HealthGrid </li></ul><ul><li>Life Sciences and Biomedical Research: adoption and requirements </li></ul><ul><li>From Research Infrastructure towards sustainable Infrastructure: the EGI example </li></ul><ul><li>To serve and support…: the LSVRC Support Centre </li></ul><ul><li>Conclusion </li></ul>
    3. 3. A glance to the future…
    4. 4. Trends <ul><li>Rising Asia </li></ul><ul><ul><li>8 billion people by 2025; 2/3 in Asia, 7% in EU (decrease in EU population as of 2012) </li></ul></ul><ul><ul><li>Centre of gravity of world production will move to Asia (35% vs 32% of EU) </li></ul></ul><ul><ul><li>By 2025 India & China could account for 20% of world’s R&D; Asia main destination for location of business R&D) </li></ul></ul><ul><li>In crucial areas to every nation’s welfare (energy, sustainable development & climate change, health, food safety...) at stake in the future will be access to global knowledge, development of global standards, diffusion of new technology… </li></ul><ul><li>Move from “brain drain” to “brain circulation” </li></ul>Courtesy K. Baxevanidis – EC DG INFSO – Géant & e-Infrastructures Unit
    5. 5. Tensions, a socio-ecological transition <ul><li>Increasing scarcity of natural resources (potential “oil peak”, 3 billion people missing water by 2025) </li></ul><ul><li>Vulnerability of planet (cf. potential Climate Change impacts, epidemics) </li></ul><ul><li>Demographic challenges </li></ul><ul><li>Will probably lead to: </li></ul><ul><ul><li>Tensions between Production and Consumption patterns, emergence of new “socio-ecological” production &consumption models (renewable energy, nuclear power & hydrogen & fuel cells </li></ul></ul><ul><ul><li>Changes in social behaviour supported by economic incentives for drastic reduction in energy consumption </li></ul></ul><ul><li>Are current national and international policies up to the challenge? </li></ul>Courtesy K. Baxevanidis – EC DG INFSO – Géant & e-Infrastructures Unit
    6. 6. Vision: Science in 2030 Source: Prof. John Wood (“Science in 2030”) <ul><li>Multi-disciplinarity; no longer one technique in one place; </li></ul><ul><li>Emerging role of informal scientific collaborations in a networked world (vs established bureaucracies of research); citizen-science </li></ul><ul><li>Open Access to data </li></ul><ul><li>New emphasis on research process itself rather than single, perfect new innovation (as innovations come in unpredictable ways through continuous interactions) </li></ul><ul><li>towards “science as a service mentality” </li></ul>Courtesy K. Baxevanidis – EC DG INFSO – Géant & e-Infrastructures Unit
    7. 10. <ul><li>&quot; We can't solve problems by using the same kind of thinking we used when we created them. &quot; </li></ul><ul><li>Albert Einstein </li></ul>
    8. 11. Roles of e-Infrastructures (1/2) <ul><li>Linking institutions (enabling the sharing of resources, data and knowledge) </li></ul><ul><li>Enabling Virtual Collaborations (as if all experts were in the same lab...) </li></ul><ul><li>Emphasis on sustainability in service provision (believed that this also creates better employment conditions and so attraction of skills) </li></ul><ul><li>Fighting digital divide by enabling collaborations from a distance (virtual research communities..) </li></ul>
    9. 12. Roles of e-Infrastructures (2/2) <ul><li>Reducing the Energy Consomption </li></ul><ul><ul><li>ICT represents 30% of energy consumption in modern organizations (even 50% within certain sectors like telecoms, IT companies, universities..) </li></ul></ul><ul><ul><li>The consomption of electricity for servers has doubled between 2000 and 2005 </li></ul></ul>
    10. 13. Once upon a time… HealthGrid
    11. 14. Areas identified in the White Paper <ul><li>Medical Imaging and Medical Image Processing </li></ul><ul><li>Computational Models of the Human Body ( Therapy Planning and Computer-Assisted Intervention – Atlases – Numerical Simulations of the Human Body – … ) </li></ul><ul><li>Grid-enabled Pharmaceutical R&D: PharmaGrids </li></ul><ul><li>Grids for Epidemiological Studies & Public Health Surveillance </li></ul><ul><li>Genomic Medicine Grid </li></ul>
    12. 15. <ul><li>Second Opinion </li></ul><ul><li>Cancer Screening </li></ul><ul><li>Education and Training </li></ul><ul><li>Reference Database / Repository </li></ul>MammoGrid & MammoGrid+ 1 – Medical Imaging and Medical Image Processing (1/2)
    13. 16. <ul><li>Early diagnosis and development of effective disease-modifying drugs would be greatly facilitated by the availability of an accurate (sensitive and specific cross sectionally and prospectively) disease marker. </li></ul>neuGRID / outGRID 1 – Medical Imaging and Medical Image Processing (2/2) http://www.neugrid.eu
    14. 17. Virtual Physiological Human Network of Excellence <ul><li>NoE: team of organisations working in key focus areas to support and enable VPH research, within and beyond the VPH Initiative </li></ul><ul><ul><li>- Identification of user needs, standards, ontologies, applications and development of VPH ToolKit </li></ul></ul><ul><ul><li>- VPH training activities and materials - MSc, interdisciplinary study groups, focused journal issues, textbook </li></ul></ul><ul><ul><li>- Research/news dissemination and international networking </li></ul></ul>2 – Computational Models of the Human Body – the Virtual Physiological Human (1/3) The VPH Institute got funding and is being created.
    15. 19. Multiple Components Endocardium (LV) Mitral valve Epicardium (LV) Aortic Valve, Root Right Ventricle Left Atrium Right Atrium Aorta Pulmonary trunk Sim-e-Child 2 – Computational Models of the Human Body – the Virtual Physiological Human (3/3) http://sim-e-child.org
    16. 20. <ul><ul><li>Developing new drugs for neglected and emerging diseases with a particular focus on malaria and H5N1. </li></ul></ul><ul><ul><li>Reduced R&D costs for neglected diseases </li></ul></ul><ul><ul><li>Accelerated R&D for emerging diseases </li></ul></ul>Wisdom ••• 3 – Grid enabled Pharmaceutical R&D: PharmaGrids (1/2) http://wisdom.healthgrid.org
    17. 21. ACGT Screenshot of the Newsletter Winter 2009 (page 1 and page 2) 3 – Grid enabled Pharmaceutical R&D: PharmaGrids (2/2) http://eu-acgt.org
    18. 22. 4 – Grids for Epidemiological Studies & Public Health Surveillance (1/2) http://g-info.healthgrid.org g-INFO
    19. 23. Sentinelle / Ginseng Improve and facilitate systematic screening, such as cancer screening Easy and secure sharing of information between all concerned partners Allow anonymized access to data for epidemiological surveys Provide support to research and facilitate feedback to improve clinical practices Can be easily customized to fit the requirements of a city, a region, a country… Sanitary Surveillance System 4 – Grids for Epidemiological Studies & Public Health Surveillance (2/2) http://www.e-sentinelle.org
    20. 24. Innovative Medicine Initiative 5 – Genomic Medicine Grid (1/2) http://www.imi.europa.eu
    21. 25. <ul><li>Genomic (molecular, personalised) medicine </li></ul><ul><li>Regenerative medicine/tissue engineering seeks to develop functional cell, tissue, and organ substitutes to repair, replace or enhance biological function that has been lost due to congenital abnormalities, injury, disease, or aging. </li></ul><ul><li>NanoMedicine – Use of nanoscale tools and components for the diagnosis, prevention and treatment of diseases and for understanding their pathophysiology . </li></ul>European Science Foundation, Nov. 2005 NIH Definition, NIBIB, June 2004 ActionGrid 5 – Genomic Medicine Grid (2/2) http://www.action-grid.eu/
    22. 26. Life Sciences and Biomedical Research: adoption and requirements
    23. 27. Life sciences & Biomedical Research <ul><li>Life Sciences covers a broad range of activities, ranging from biology to patient healthcare </li></ul><ul><ul><li>The multi-scales view (HealthGrid'03) </li></ul></ul><ul><li>Grid-empowered Life Sciences activity focuses on computational Life Sciences and distributed healthcare-related information systems and databanks </li></ul><ul><ul><li>LS data is distributed, and highly sensitive </li></ul></ul><ul><ul><li>LS community is widely spread (both geographically and in terms of research themes) </li></ul></ul>
    24. 28. Grid adoption in Life Sciences <ul><li>Very large potential </li></ul><ul><ul><li>Genome sequencing projects and databanks </li></ul></ul><ul><ul><li>Distributed populations data sets involved in epidemiology </li></ul></ul><ul><ul><li>Computational neurosciences </li></ul></ul><ul><ul><li>… </li></ul></ul><ul><li>Grid adoption visible world-wide. Still a slow take up </li></ul><ul><ul><li>Real communities scattered and “not” used to real collaborations </li></ul></ul><ul><ul><li>Medical data is sensitive </li></ul></ul><ul><ul><li>Healthcare is a business </li></ul></ul><ul><ul><li>Grids are (still) difficult to use </li></ul></ul>
    25. 29. Toward a roadmap Reference distribution of grid services Courtesy of the SHARE project – www.eu-share.org http://roadmap.healthgrid.org phase 1 phase 2 Sustainable computing grid Reference implementation of grid services Sustainable data grid Agreed medical informatics & grid standards Sustainable knowledge grid Agreed open source medical ontologies Generalized use of knowledge grids
    26. 30. HealthGrid Roadmap: Challenges & complexity Courtesy of the SHARE project – www.eu-share.org http://roadmap.healthgrid.org
    27. 31. HealthGrid Roadmap: Another look Workflow tools http://roadmap.healthgrid.org Courtesy of the SHARE project – www.eu-share.org Visionaries Early Adopters Early Majority Late Majority 2007 2009 2011 2014 2016 Infrastructure Interoperability Models Time Complexity Visionaries Early Adopters Early Majority Late Majority 2007 2009 2011 2014 2016 Visionaries Early Adopters Early Majority Late Majority 2007 2009 2011 2014 2016 Infrastructure Interoperability Quality of Service Quality of Service On Demand Access On Demand Access User Friendliness Usability Improved Distributed Data Management Improved Distributed Data Management Distributed Data Models Data Integration Tools and Standards Knowledge Management Tools and standards Domain Specific Knowledge Management and Ontologies Domain Specific Knowledge Management and Ontologies Time Complexity Collaboration
    28. 32. Grid adoption in Life Sciences <ul><li>The first critical requirement is a transparent grid/cloud infrastructure </li></ul><ul><ul><li>Reliable </li></ul></ul><ul><ul><li>Usable by non-expert end users </li></ul></ul><ul><ul><li>With simplified access procedures </li></ul></ul>
    29. 33. Critical requirements <ul><li>Reliable </li></ul><ul><ul><li>Concerns ALL services </li></ul></ul><ul><ul><li>Infrastructure monitoring to anticipate difficulties </li></ul></ul><ul><ul><li>End-to-end (across services): a job is not done as long as the result is not accessible to the user client </li></ul></ul><ul><li>Usable by non-expert end users </li></ul><ul><ul><li>Adapted interfaces </li></ul></ul><ul><ul><li>Reuse of generic tools </li></ul></ul><ul><li>With simplified access procedures </li></ul><ul><ul><li>Lightweight governance model </li></ul></ul><ul><ul><li>Lightened tooling </li></ul></ul><ul><ul><li>Accompanying new users (self-adoption is rare) </li></ul></ul>
    30. 34. ELSE Requirements <ul><li>Legal and Ethical </li></ul><ul><ul><li>Patient consent </li></ul></ul><ul><ul><li>Data Security harmonization measures </li></ul></ul><ul><ul><li>Liability for products and Services </li></ul></ul><ul><ul><li>Intellectual Property </li></ul></ul><ul><ul><li>New Policies and codes of Conduct </li></ul></ul><ul><ul><li>Predefined processing purposes </li></ul></ul><ul><li>Socio-Economic </li></ul><ul><ul><li>Trust & Acceptance Assurance </li></ul></ul><ul><ul><li>Cost-Benefit Estimation </li></ul></ul><ul><ul><li>Sustainability guarantees </li></ul></ul><ul><ul><li>Dissemination programmes </li></ul></ul>
    31. 35. From Research Infrastructures towards sustainable Infrastructures: the EGI example
    32. 36. <ul><li>European: </li></ul><ul><ul><li>Focus on meeting the needs of European Researchers </li></ul></ul><ul><ul><li>Their key need is to collaborate internationally </li></ul></ul><ul><li>Grid: </li></ul><ul><ul><li>Federation of shared resources, not a single technology </li></ul></ul><ul><ul><li>Supports a collaborative social network </li></ul></ul><ul><li>Infrastructure: </li></ul><ul><ul><li>Established physical and organisational structures </li></ul></ul><ul><ul><li>Services and facilities for an economy to function </li></ul></ul>What is EGI?
    33. 37. <ul><li>In tegrated S ustainable P an-European I nfrastructure for R esearchers in E urope </li></ul><ul><li>A 4 year project with €25M EC contribution </li></ul><ul><ul><li>Project cost €72M </li></ul></ul><ul><ul><li>Total Effort ~€330M </li></ul></ul><ul><ul><li>Effort: 9261PMs </li></ul></ul>The EGI-InSPIRE Project <ul><li>Project Partners (50) </li></ul><ul><li>EGI.eu, 40 NGIs, 2 EIROs </li></ul><ul><li>Asia Pacific (8 partners) </li></ul>Funded Un-Funded
    34. 38. A Virtuous User Cycle <ul><li>Integrated Services </li></ul><ul><li>Human </li></ul><ul><li>Technical </li></ul><ul><li>Infrastructure </li></ul>Feedback through VRCs in the User Community Board User Services Advisory Group to drive detailed design Where is the community? How can I contribute? How do I use these resources? <ul><li>- VRCs </li></ul><ul><li>Mailing lists </li></ul><ul><li>Workshops </li></ul><ul><li>Forums </li></ul><ul><li>Blogs </li></ul><ul><li>Projects </li></ul><ul><li>Sharing stories </li></ul><ul><li>Collaborating </li></ul><ul><li>Applications </li></ul><ul><li>Data collections </li></ul><ul><li>Requirements </li></ul><ul><li>Proposals </li></ul><ul><li>Projects </li></ul><ul><li>Success stories </li></ul><ul><li>Attend training courses </li></ul><ul><li>Utilise training material </li></ul><ul><li>Access data </li></ul><ul><li>Run applications on the grid </li></ul>Aka: “the chicken and egg conundrum...
    35. 39. The LSVRC Support Centre <ul><li>International Support Centre for Life Science grid/cloud users </li></ul><ul><ul><li>To act as a single, representative contact point for International Infrastructures Worldwide (such as EGI </li></ul></ul><ul><ul><li>To act as a single, representative contact point for the Funding Agencies (such as European Commission) and other Stakeholders in order to promote the requirements and needs of the community </li></ul></ul><ul><ul><li>To accompany users and deliver best experience </li></ul></ul><ul><ul><li>At the interface between VOs and operations </li></ul></ul><ul><li>Other benefits </li></ul><ul><ul><li>Reduce operational burden </li></ul></ul><ul><ul><li>Prevents community scattering in a decentralized EGI nebula </li></ul></ul><ul><li>Grouping several VOs </li></ul><ul><ul><li>biomed, enmr, lsgrid, vlemed </li></ul></ul><ul><ul><li>including the generic “biomed” VO that enables international collaboration and large-scale computations </li></ul></ul><ul><li>Supported by several NGIs and projects </li></ul><ul><ul><li>Dutch, French, German, Italian, Spanish, Swiss </li></ul></ul><ul><ul><li>EGI-Inspire, Lifewatch ESFRI </li></ul></ul><ul><li>See https://dav.healthgrid.org/lsvrc/LSVRC_proposition_09-08-2010-final.pdf </li></ul>
    36. 40. Governance model <ul><li>One coordinator (renewed every 6 months) </li></ul><ul><ul><li>Current: CNRS (French National Scientific Research Institute) </li></ul></ul><ul><li>Sub-domain scientific leaders </li></ul><ul><ul><li>Sub-groups defined in biomed VO (as VOMS groups) </li></ul></ul><ul><ul><li>Sub-groups may require specific resources (e.g. data access control) </li></ul></ul><ul><li>Open to new users </li></ul><ul><ul><li>Registration into groups (scientific sub-domain, projects, country) </li></ul></ul><ul><li>Model to be refined </li></ul><ul><ul><li>Depending on Organisational Level Agreements (OLA) </li></ul></ul><ul><ul><ul><li>OLAs between NGIs and VRCs should ensure adherence from NGIs with dedicated infrastructure and support for VRCs </li></ul></ul></ul><ul><ul><li>MoUs to be made with major grid infrastructures (EGI) and ESFRIs </li></ul></ul>
    37. 41. Conclusions <ul><li>The more complex and long term issues are not technical but rather Ethical, Legal and Socio-Economic </li></ul><ul><li>The more difficult will be to change our mindset and to accept to collaborate all together at a worldwide level </li></ul><ul><li>You are warmly invited to join and commit yourself and your organisation to contribute to the whole effort! </li></ul>
    38. 42. <ul><li>Call for papers opens October 2010 </li></ul><ul><li>See www.egi.eu/EGIUF2011 for more details </li></ul><ul><li>Contact: </li></ul><ul><ul><li>Steven Newhouse </li></ul></ul><ul><ul><ul><li>[email_address] </li></ul></ul></ul>
    39. 43. HealthGrid 2011 June 29 th – July 2 nd 2011 Bristol, UK http://bristol2011.healthgrid.org (soon available)
    40. 44. <ul><li>Thank you! </li></ul>French Rugby Federation &quot; It is a mistake to think you can solve any major problems just with potatoes. &quot; Douglas Adams The Hitchhikker's guide to the Galaxy

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