The concept of digital twins has great potential for transforming the existing health care system by making it more personalized. As a convergence of health care, artificial intelligence, and ...information and communication technologies, personalized health care services that are developed under the concept of digital twins raise a myriad of ethical issues. Although some of the ethical issues are known to researchers working on digital health and personalized medicine, currently, there is no comprehensive review that maps the major ethical risks of digital twins for personalized health care services.
This study aims to fill the research gap by identifying the major ethical risks of digital twins for personalized health care services. We first propose a working definition for digital twins for personalized health care services to facilitate future discussions on the ethical issues related to these emerging digital health services. We then develop a process-oriented ethical map to identify the major ethical risks in each of the different data processing phases.
We resorted to the literature on eHealth, personalized medicine, precision medicine, and information engineering to identify potential issues and developed a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. Developers of a digital twin for personalized health care service may use this map to identify ethical risks during the development stage in a more systematic way and can proactively address them.
This paper provides a working definition of digital twins for personalized health care services by identifying 3 features that distinguish the new application from other eHealth services. On the basis of the working definition, this paper further layouts 10 major operational problems and the corresponding ethical risks.
It is challenging to address all the major ethical risks that a digital twin for a personalized health care service might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist the developers of digital twins for personalized health care services in analyzing ethical risks in a more systematic manner.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The quantitative label-free detection of neurotransmitters provides critical clues in understanding neurological functions or disorders. However, the identification of neurotransmitters remains ...challenging for surface-enhanced Raman spectroscopy (SERS) due to the presence of noise. Here, we report spread spectrum SERS (ss-SERS) detection for the rapid quantification of neurotransmitters at the attomolar level by encoding excited light and decoding SERS signals with peak autocorrelation and near-zero cross-correlation. Compared to conventional SERS measurements, the experimental result of ss-SERS shows an exceptional improvement in the signal-to-noise ratio of more than three orders of magnitude, thus achieving a high temporal resolution of over one hundred times. The ss-SERS measurement further allows the attomolar SERS detection of dopamine, serotonin, acetylcholine, γ-aminobutyric acid, and glutamate without Raman reporters. This approach opens up opportunities not only for investigating the early diagnostics of neurological disorders or highly sensitive biomedical SERS applications but also for developing low-cost spectroscopic biosensing applications.
•Nine factors that characterize data-based value creation were identified.•The nine factors were identified and defined based on six action research projects.•The projects used specific datasets to ...design new information-intensive services.•Data usage in 149 information-intensive services was also analyzed.•The nine factors are useful in analyzing and designing data-based value creation.
Service is a key context for the application of IT, as IT digitizes information interactions in service and facilitates value creation, thereby contributing to service innovation. The recent proliferation of big data provides numerous opportunities for information-intensive services (IISs), in which information interactions exert the greatest effect on value creation. In the modern data-rich economy, understanding mechanisms and related factors of data-based value creation in IISs is essential for using IT to improve such services. This study identified nine key factors that characterize this data-based value creation: (1) data source, (2) data collection, (3) data, (4) data analysis, (5) information on the data source, (6) information delivery, (7) customer (information user), (8) value in information use, and (9) provider network. These factors were identified and defined through six action research projects with industry and government that used specific datasets to design new IISs and by analyzing data usage in 149 IIS cases. This paper demonstrates the usefulness of these factors for describing, analyzing, and designing the entire value creation chain, from data collection to value creation, in IISs. The main contribution of this study is to provide a simple yet comprehensive and empirically tested basis for the use and management of data to facilitate service value creation.
Domino liver transplantation (DLT) utilizes otherwise discarded livers as donor grafts for another recipients. It is unclear whether DLT has less favorable outcomes compared to deceased donor liver ...transplantation (DDLT). We aimed to assess the outcomes of DLT compared to DDLT.
MEDLINE, Embase, and Web of Science database were searched to identify studies comparing outcomes after DLT with DDLT. Data were pooled using random-effects modeling, evaluating odds ratios (OR) or mean difference (MD) for outcomes including waiting list time, severe hemorrhage, intensive care unit (ICU), length hospital stay (LOS), rejection, renal, vascular, and biliary events, and recipient survival at 1, 3, 5, and 10 years.
Five studies were identified including 945 patients (DLT = 409, DDLT = 536). The DLT recipients were older compared to the DDLT group (P = 0.04), and both cohorts were comparable regarding lab MELD, hepatocellular carcinoma, and waitlist time. There were no differences in vascular (OR: 1.60, P = 0.39), renal (OR: 0.62, P = 0.24), biliary (OR: 1.51, P = 0.21), severe hemorrhage (OR: 1.09, P = 0.86), rejection (OR: 0.78, P = 0.51), ICU stay (MD: 0.50, P = 0.21), or LOS (MD: 1.68, P = 0.46) between DLT and DDLT. DLT and DDLT were associated with comparable 1-year (78.9% vs 80.4%; OR: 1.03, P = 0.89), 3-year (56.2% vs 54.1%; OR: 1.35, P = 0.07), and 10-year survival (6.5% vs 8.5%; OR: 0.8, P = 0.67) rates. DLT was associated with higher 5-year survival (41.6% vs 36.4%; OR: 1.70; P = 0.003) compared to DDLT, which was not confirmed at sensitivity analysis.
This meta-analysis of the best available evidence (Level 2a) demonstrated that DLT and DDLT have comparable outcomes. As indications for liver transplantation expand, future high-quality research is encouraged to increase the DLT numbers in clinical practice, serving the growing waiting list candidates, with the caveat of uncertain de novo disease transmission risks.
The papain-like protease (PLpro), which controls replication of the severe acute respiratory syndrome coronavirus (SARS-CoV), has been identified as a potential drug target for the treatment of SARS. ...An intensive hunt for effective anti-SARS drugs has been undertaken by screening for natural product inhibitors that target SARS-CoV PLpro. In this study, diarylheptanoids 1-9 were isolated from Alnus japonica, and the inhibitory activities of these compounds against PLpro were determined. Of the isolated diarylheptanoids, hirsutenone (2) showed the most potent PLpro inhibitory activity, with an inhibitory concentration (IC50) value of 4.1 µM. Structure-activity analysis showed that catechol and α,β-unsaturated carbonyl moiety in the molecule were the key requirement for SARS-CoV cysteine protease inhibition.
Although minor laparoscopic liver resections (LLRs) appear as standardized procedures, major LLRs are still limited to few expert teams. The aim of this study was to report the combined data of 18 ...international centers performing major LLR. Variables evaluated were number and type of LLR, surgical indications, number of synchronous colorectal resections, details on technical points, conversion rates, operative time, blood loss and surgical margins. From 1996 to 2014, a total of 5388 LLR were carried out including 1184 major LLRs. The most frequent indication for laparoscopic right hepatectomy (LRH) was colorectal liver metastases (37.0%). Seven centers used hand assistance or hybrid approach selectively for LRH mostly at the beginning of their experience. Seven centers apply Pringle's maneuver routinely. The conversion rate for all major LLRs was 10% and mean operative time was 291 min. Mean estimated blood loss for all major LLR was 327 ml and negative surgical margin rate was 96.5%. Major LLRs still remain challenging procedures requiring important experience in both laparoscopy and liver surgery. Stimulating the younger generation to learn and accomplish these techniques is the better way to guarantee further development of this surgical field.
A smooth, ultra-flexible, and transparent electrode was developed from silver nanowires (AgNWs) embedded in a colorless polyimide (cPI) by utilizing an inverted film-processing method. The resulting ...AgNW-cPI composite electrode had a transparency of >80%, a low sheet resistance of 8 Ω/□, and ultra-smooth surfaces comparable to glass. Leveraging the robust mechanical properties and flexibility of cPI, the thickness of the composite film was reduced to less than 10 μm, which is conducive to extreme flexibility. This film exhibited mechanical durability, for both outward and inward bending tests, up to a bending radius of 30 μm, while maintaining its electrical performance under cyclic bending (bending radius: 500 μm) for 100,000 iterations. Phosphorescent, blue organic light-emitting diodes (OLEDs) were fabricated using these composites as bottom electrodes (anodes). Hole-injection was poor, because AgNWs were largely buried beneath the composite's surface. Thus, we used a simple plasma treatment to remove the thin cPI layer overlaying the nanowires without introducing other conductive materials. As a result, we were able to finely control the flexible OLEDs' electroluminescent properties using the enlarged conductive pathways. The fabricated flexible devices showed only slight performance reductions of <3% even after repeated foldings with a 30 μm bending radius.
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This study investigated the characteristics of biochars derived using various pine tree residues and pyrolysis temperatures and evaluated their Cd adsorption behaviors. The ...characteristics of pine tree residue biochars (PRBs) were dominantly affected by the pyrolysis temperature, and the optimum pyrolysis temperature for Cd adsorption was 600 °C. The adsorption of Cd by PRBs was divided into two stages: rapid adsorption on the initial boundary layer and slow adsorption by intraparticle diffusion. The Cd adsorption characteristics of all the PRBs were well described by pseudo-second-order and Langmuir isotherm models, and the maximum adsorption capacity was the highest in pine bark biochar (85.8 mg/g). The amounts of the cations released from the mixed pine tree residue biochars (M-PRBs) during Cd adsorption were increased, while the amount of phosphate released was decreased, indicating that exchangeable cations and phosphate on the biochar affected the Cd adsorption. In particular, the amount of Cd removed by the exchangeable cations corresponds to 23.6% of the total adsorption amount. Spectroscopic analyses using FTIR showed that the Cd adsorption on M-PRB was associated with functional groups such as CC, COH and COOH. Overall, the use of biochars derived from pine tree residue as an adsorbent is considered to be effective for both the treatment of wastewater containing heavy metals and the recycling of forest residues.
As a strategy to coordinate inter-cell interference in cellular networks, a fractional frequency reuse (FFR) system is proposed, in which the frequency bandwidth is split into two orthogonal bands; ...users staying near the center of a FFR cell use the band with a frequency reuse (FR) factor of one (i.e., full FR), and users located close to the cell edge utilize the band with a FR factor greater than one (i.e., partial FR). Full FR coverage, which identifies full FR and partial FR regions (that is, near-center and near-edge regions) within a FFR cell, has a crucial effect on system performance. Some of the authors of this paper recently investigated the optimization of full FR coverage to maximize system throughput. They analytically showed that under the constraint of satisfying a specified target outage probability, the optimal full FR coverage is a non-increasing function of base station power when all base station powers in the cellular network are scaled at an equal rate. Interestingly, in this paper, it is proven that as the power of a single base station is scaled, the optimal full FR coverage in that cell is a non-decreasing function of base station power. Our results provide useful insight into the design of full FR coverage in relation to the transmit power of a base station. It gives a deeper understanding of the intricate relationship between important FFR system parameters of base station power and full FR coverage.
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