The Ethical Implications of Telemedicine and the Internet for Home Healthcare

Information and communication technologies, such as the Internet, are transforming our business, education, and leisure practices. The healthcare industry is no exception to this trend and the burgeoning field of home-based telemedicine is evidence of this. As with many technological innovations in healthcare, assessments of homebased telemedicine and correlative policies are being driven by economic and technological criteria that emphasize cost reduction and technologic efficiency. These are important considerations, but these assessments neither identify the ethical values involved in home-based telemedicine nor address its possible ethical implications. Since the economic and technologic viability of home-based telemedicine is not identical with its ethical appropriateness and justification, this is a serious oversight. Hence, the use of telemedicine and the Internet in home healthcare invite a discussion about their ethical implications for the traditional goals and moral ideals of healthcare practice. The purpose of this study is to argue that the ethical implications of telemedicine and the Internet for home healthcare should be better understood and incorporated into future home-based telemedicine research and policy development. To this end, this study reviews the home-based telemedicine literature and examines the normative connections between home-based telemedicine and the following: (1) provider-patient relationships, (2) healthcare privacy and confidentiality, (3) distributive and family justice, and (4) informed consent. This study concludes that given the traditional values and goals of healthcare, information and communication technologies present both possible harms and benefits for home healthcare recipients and providers, but that on balance the benefits are more likely to outweigh the harms. However, because the exact benefits and harms of homebased telemedicine are unknown at this time, additional empirical research and outcome studies are needed. Finally, as part of a general technology assessment of home-based telemedicine, future research should include an ethical evaluation of all information and communication technologies that will be employed. If this is not done, home-based telemedicine policies will be inadequately informed and many of the possible harms of home-based telemedicine that could be prevented will not be prevented

Inhibition of EGFR-AKT axis results in the suppression of ovarian tumors in vitro and in preclinical mouse model

Ovarian cancer is the leading cause of cancer related deaths in women. Genetic alterations including overexpression of EGFR play a crucial role in ovarian carcinogenesis. Here we evaluated the effect of phenethyl isothiocyanate (PEITC) in ovarian tumor cells in vitro and in vivo. Oral administration of 12 μmol PEITC resulted in drastically suppressing ovarian tumor growth in a preclinical mouse model. Our in vitro studies demonstrated that PEITC suppress the growth of SKOV-3, OVCAR-3 and TOV-21G human ovarian cancer cells by inducing apoptosis in a concentration-dependent manner. Growth inhibitory effects of PEITC were mediated by inhibition of EGFR and AKT, which are known to be overexpressed in ovarian tumors. PEITC treatment caused significant down regulation of constitutive protein levels as well as phosphorylation of EGFR at Tyr1068 in various ovarian cancer cells. In addition, PEITC treatment drastically reduced the phosphorylation of AKT which is downstream to EGFR and disrupted mTOR signaling. PEITC treatment also inhibited the kinase activity of AKT as observed by the down regulation of p-GSK in OVCAR-3 and TOV-21G cells. AKT overexpression or TGF treatment blocked PEITC induced apoptosis in ovarian cancer cells. These results suggest that PEITC targets EGFR/AKT pathway in our model. In conclusion, our study suggests that PEITC could be used alone or in combination with other therapeutic agents to treat ovarian cancer. © 2012 Loganathan et al

PSS Characterisation of Telecom Offerings

International audienceThe global telecommunication network provides a powerful infrastructure supporting a multitude of offerings. As early as the 1980’s the telecom industry had moved to services using telecom products that could be provided within the offers (a gateway included in the offer) or by the customers themselves (a computer to access the web). However, although modern telecommunication systems are often considered as good support for Product Service Systems (PSS), telecom carriers hardly refer to PSS when establishing their own offers. Indeed it is not always easy to understand how modern telecom services, using personal mobile phones and other objects, really fit with PSS philosophy. This paper evaluates telecom offerings from a PSS standpoint. Current telecom offerings are compared with PSS characteristics found in literature. The results clarify the potentials of current telecom offerings in the PSS paradigm

Comparing Three Telecom Offers and PSS

International audienceThe increasing presence of telecommunication offerings on the market poses the question of material and energy consumption. One way to reduce these impacts would be to shift their business model to Product-Service Systems (PSS). To study this prospective, the paper focuses on three telecom offerings provided by a French telecom carrier and analyses how close they are to PSS. The first is a classical telecom business offering dedicated to small and medium sized enterprises. The second is dedicated to the school market, providing a dematerialized solution to help the different actors to interact and share information. The third concerns retirement homes and medical establishments. It helps the medical staff to improve the safety of disabled persons. Evaluation of the cases highlights the key parameters that guide transition to PSS. The paper shows how the method can be used to understand each offer individually and also to establish priorities between the offers for introducing PSS

Q-switched tunable solid-state laser using a MOEMS mirror

Simultaneous wavelength tuning and Q-switching of a Yb:KGW laser using a single, electrothermally actuated MOEMS mirror is reported for the first time. A 15.4 nm tuning range is achieved at 2.06 kHz pulse repetition frequency

Tunable Yb:KGW laser, CW or Q-switched, enabled by dual-axis tilt of a MOEMS mirror : KGW laser, CW or Q-switched, enabled by dual-axis tilt of a MOEMS mirror

The experimental proof-of-concept demonstration of an end-pumped Yb:KGW laser with tunable spectral and temporal output characteristics is reported. For the first time, tuning of both of these characteristics in a solid-state laser is achieved simultaneously using a single electrothermally-actuated MOEMS micromirror with controllable tilt angle in two dimensions. In continuous-wave mode, a wavelength tuning range of 22 nm with < 0.3 nm linewidth was achieved by using static MOEMS mirror tilt about one axis to select the intracavity wavelength dispersed by a prism. A wavelength tuning range of 15.3 nm with < 1.1 nm linewidth was achieved in Q-switched operation, by using simultaneous static tilt and resonant scanning of the MOEMS mirror about orthogonal axes. In this operational mode, a pulse repetition rate of 2.06 kHz was obtained with pulse durations varying from 460 ns to 740 ns over the addressable range of laser wavelengths

Prevention and treatment of venous thromboembolism in pregnancy in patients with hereditary antithrombin deficiency

Objective: The aims of the study reported here were to provide data from six pregnant subjects who were enrolled in a clinical trial of antithrombin (AT) concentrate, discuss other published case series and case reports, and provide general guidance for the use of AT concentrate for inherited AT deficiency in pregnancy. Methods: In the late 1980s, 31 AT-deficient subjects were enrolled in a prospective treatment trial of the plasma-derived AT concentrate Thrombate III®. Herein, newly available treatment data about the six pregnant subjects in the trial is tabulated and summarized. Results: All six experienced venous thromboembolism (VTE) during pregnancy, were dosed according to a weight-based protocol, and were treated concomitantly with anticoagulation. Loading doses of AT concentrate of 54–62 units/kg were followed by maintenance doses of 50%–100% of the loading dose for 3–10 days. At the time of labor, loading doses of 46–50 units/kg were followed by maintenance doses of 50%–75% of the loading dose for 5–7 days. None of the six experienced recurrent thrombosis while receiving treatment with AT concentrate. Conclusion: Currently we suggest that women with AT deficiency who are pregnant or postpartum and have a personal history of VTE or current VTE receive AT concentrates

Wavelength tuning of a solid-state laser with a tilting mems micromirror

Wavelength tuning of a Yb:KGW solid-state laser is presented using an electrothermally actuated micromirror and a diffraction grating or dispersing prism. 27 nm and 7.5 nm tuning ranges are achieved using extracavity and intracavity configurations respectively

The adhesion molecule Necl-3/SynCAM-2 localizes to myelinated axons, binds to oligodendrocytes and promotes cell adhesion

Background: Cell adhesion molecules are plasma membrane proteins specialized in cell-cell recognition and adhesion. Two related adhesion molecules, Necl-1 and Necl-2/SynCAM, were recently described and shown to fulfill important functions in the central nervous system. The purpose of the work was to investigate the distribution, and the properties of Necl-3/SynCAM-2, a previously uncharacterized member of the Necl family with which it shares a conserved modular organization and extensive sequence homology. Results: We show that Necl-3/SynCAM-2 is a plasma membrane protein that accumulates in several tissues, including those of the central and peripheral nervous system. There, Necl-3/SynCAM-2 is expressed in ependymal cells and in myelinated axons, and sits at the interface between the axon shaft and the myelin sheath. Several independent assays demonstrate that Necl-3/SynCAM-2 functionally and selectively interacts with oligodendrocytes. We finally prove that Necl-3/SynCAM-2 is a bona fide adhesion molecule that engages in homo- and heterophilic interactions with the other Necl family members, leading to cell aggregation. Conclusion: Collectively, our manuscripts and the works onNecl-1 and SynCAM/Necl-2 reveal a complex set of interactions engaged in by the Necl proteins in the nervous system. Our work also support the notion that the family of Necl proteins fulfils key adhesion and recognition functions in the nervous system, in particular between different cell types