589 research outputs found
Anticipatory governance and moral imagination : methodological insights from a scenario-based public deliberation study
The fields of Responsible Research and Innovation (RRI) and participatory foresight seek to establish, and toinclude publics within, anticipatory governance mechanisms. While scenario-based methods can bring to thepublics’ attention the ethical challenges associated to existing technologies, there has been little empirical re-search examining how, in practice, prospective public deliberative processes should be organized to informanticipatory governance. The goal of this article is to generate methodological insights into the way suchmethods can stimulate the public's moral imagination regarding what may (or may not) happen in the future andwhat should (or should not) happen in the future. Our qualitative analyses draw on a public deliberation studythat included videos and online scenarios to support participants’ (n= 57) deliberations about fictional inter-ventions for genetically at-risk individuals. Our findings clarify how participants: (1) challenged key elements ofour scenarios; (2) extended several of their technical and moral prospects; (3) engaged personally with others,including our scenarios’ characters; and (4) mobilized the past creatively to reason about the future. Ourmethodology enabled participants to creatively and empathetically envision complex sociotechnical futures. Yet,important methodological limits should be acknowledged by those who design, implement and use public en-gagement methods to inform anticipatory governance
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Dangerous diagnostics? Regulatory reform in the genomic era
Molecular diagnostics are expanding rapidly yet many have not been externally evaluated. Kelly Holloway and colleagues identify failings in the regulatory system and report on recent efforts at refor
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Health Canada needs to act on laboratory-developed diagnostics
An international exposé of flawed regulations for medical implants prompted Canada’s health minister to announce sweeping changes to the regulation of medical devices.1 Yet an important subset of medical devices remains outside the purview of this regulatory overhaul: laboratory-developed tests
Spectral and Timing Properties of IGR J17091-3624 in the Rising Hard State During its 2016 Outburst
We present a spectral and timing study of the NuSTAR and Swift observations
of the black hole candidate IGR J17091-3624 in the hard state during its
outburst in 2016. Disk reflection is detected in each of the NuSTAR spectra
taken in three epochs. Fitting with relativistic reflection models reveals that
the accretion disk is truncated during all epochs with , with the data favoring a low disk inclination of . The steepening of the continuum spectra between epochs
is accompanied by a decrease in the high energy cut-off: the electron
temperature drops from keV to keV, changing
systematically with the source flux. We detect type-C QPOs in the power spectra
with frequency varying between 0.131 Hz and 0.327 Hz. In addition, a secondary
peak is found in the power spectra centered at about 2.3 times the QPO
frequency during all three epochs. The nature of this secondary frequency is
uncertain, however a non-harmonic origin is favored. We investigate the
evolution of the timing and spectral properties during the rising phase of the
outburst and discuss their physical implications.Comment: 11 pages, 9 figures, accepted by Ap
Examining the ethical and social issues of health technology design through the public appraisal of prospective scenarios : a study protocol describing a multimedia-based deliberative method
Background: The design of health technologies relies on assumptions that affect how they will be implemented,
such as intended use, complexity, impact on user autonomy, and appropriateness. Those who design and
implement technologies make several ethical and social assumptions on behalf of users and society more broadly,
but there are very few tools to examine prospectively whether such assumptions are warranted and how the public
define and appraise the desirability of health innovations. This study protocol describes a three-year study that relies
on a multimedia-based prospective method to support public deliberations that will enable a critical examination
of the social and ethical issues of health technology design.
Methods: The first two steps of our mixed-method study were completed: relying on a literature review and the
support of our multidisciplinary expert committee, we developed scenarios depicting social and technical changes
that could unfold in three thematic areas within a 25-year timeframe; and for each thematic area, we created video
clips to illustrate prospective technologies and short stories to describe their associated dilemmas. Using this
multimedia material, we will: conduct four face-to-face deliberative workshops with members of the public (n = 40)
who will later join additional participants (n = 25) through an asynchronous online forum; and analyze and integrate
three data sources: observation, group deliberations, and a self-administered participant survey.
Discussion: This study protocol will be of interest to those who design and assess public involvement initiatives
and to those who examine the implementation of health innovations. Our premise is that using user-friendly tools
in a deliberative context that foster participants’ creativity and reflexivity in pondering potential technoscientific
futures will enable our team to analyze a range of normative claims, including some that may prove problematic
and others that may shed light over potentially more valuable design options. This research will help fill an
important knowledge gap; intervening earlier in technological development could help reduce undesirable effects
and inform the design and implementation of more appropriate innovations
A NuSTAR observation of the reflection spectrum of the low mass X-ray binary 4U 1728-34
We report on a simultaneous NuSTAR and Swift observation of the neutron star
low-mass X-ray binary 4U 1728-34. We identified and removed four Type I X-ray
bursts during the observation in order to study the persistent emission. The
continuum spectrum is hard and well described by a black body with 1.5
keV and a cutoff power law with 1.5 and a cutoff temperature of 25
keV. Residuals between 6 and 8 keV provide strong evidence of a broad Fe
K line. By modeling the spectrum with a relativistically blurred
reflection model, we find an upper limit for the inner disk radius of . Consequently we find that km,
assuming M=1.4{\mbox{\rm\,M_{\mathord\odot}}} and . We also find an
upper limit on the magnetic field of G.Comment: 9 pages, 8 figure
NuSTAR and Swift observations of the black hole candidate XTE J1908+094 during its 2013 outburst
The black hole candidate XTE J1908+094 went into outburst for the first time
since 2003 in October 2013. We report on an observation with the Nuclear
Spectroscopic Telescope Array (NuSTAR) and monitoring observations with Swift
during the outburst. NuSTAR caught the source in the soft state: the spectra
show a broad relativistic iron line, and the light curves reveal a ~40 ks flare
with the count rate peaking about 40% above the non-flare level and with
significant spectral variation. A model combining a multi-temperature thermal
component, a power-law, and a reflection component with an iron line provides a
good description of the NuSTAR spectrum. Although relativistic broadening of
the iron line is observed, it is not possible to constrain the black hole spin
with these data. The variability of the power-law component, which can also be
modeled as a Comptonization component, is responsible for the flux and spectral
change during the flare, suggesting that changes in the corona (or possibly
continued jet activity) are the likely cause of the flare.Comment: 9 pages, 6 figures, 3 tables, accepted for publication in Ap
The Broadband XMM-Newton and NuSTAR X-ray Spectra of Two Ultraluminous X-ray Sources in the Galaxy IC 342
We present results for two Ultraluminous X-ray Sources (ULXs), IC 342 X-1 and
IC 342 X-2, using two epochs of XMM-Newton and NuSTAR observations separated by
7 days. We observe little spectral or flux variability above 1 keV
between epochs, with unabsorbed 0.3--30 keV luminosities being
erg s for IC 342 X-1 and
erg s for IC 342 X-2, so that both were
observed in a similar, luminous state. Both sources have a high absorbing
column in excess of the Galactic value. Neither source has a spectrum
consistent with a black hole binary in low/hard state, and both ULXs exhibit
strong curvature in their broadband X-ray spectra. This curvature rules out
models that invoke a simple reflection-dominated spectrum with a broadened iron
line and no cutoff in the illuminating power-law continuum. X-ray spectrum of
IC 342 X-1 can be characterized by a soft disk-like black body component at low
energies and a cool, optically thick Comptonization continuum at high energies,
but unique physical interpretation of the spectral components remains
challenging. The broadband spectrum of IC 342 X-2 can be fit by either a hot
(3.8 keV) accretion disk, or a Comptonized continuum with no indication of a
seed photon population. Although the seed photon component may be masked by
soft excess emission unlikely to be associated with the binary system, combined
with the high absorption column, it is more plausible that the broadband X-ray
emission arises from a simple thin blackbody disk component. Secure
identification of the origin of the spectral components in these sources will
likely require broadband spectral variability studies.Comment: 12 pages, 11 figures, 5 Tables, Accepted for publication in The
Astrophysical Journa
Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies
Background: New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to
their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how
entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies.
Methods: Our 5-year qualitative research program examined the processes through which new health technologies
were envisioned, financed, developed and commercialized by entrepreneurial clinical teams operating in Quebec’s
(Canada) publicly funded healthcare system.
Results: Entrepreneurs have a direct influence over a new technology’s value proposition, but investors actively
transform this value. Investors support a technology that can find a market, no matter its intrinsic value for clinical
practice or healthcare systems. Regulatory agencies reinforce the “double” value of a new technology—as a health
intervention and as an economic commodity—and provide economic worth to the venture that is bringing the
technology to market.
Conclusion: Policy-oriented initiatives such as early health technology assessment (HTA) and coverage with evidence
may provide technology developers with useful input regarding the decisions they make at an early stage. But to foster
technologies that bring more value to healthcare systems, policy-makers must actively support the consideration of
health policy issues in innovation polic
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