The Three Generations of Electronic Government: From Service Provision to Open Data and to Policy Analytics

Part 1: E-Government FoundationsInternational audienceFor long time research and practice in the area of Electronic Government (e-government) has been focusing on the use of information and communication technologies (ICT) for improving the efficiency government agencies’ internal operations, as well as transactions with citizens and firms. However, the increased needs and expectations of citizens, and the proliferation of ‘participatory democracy’ ideas, gave rise to a new generation of ICT exploitation by government for increasing and enhancing citizens’ participation. Furthermore, the increasing social problems and challenges that had to be addressed by government through appropriate public policies, such as the increasing inequalities and poverty, the aging society, the environmental degradation, and the rising number of ‘unpredictable’ events, such as the financial and economic crisis, give rise to the development of a new wave of e-government focusing on policy analytics for supporting the design of effective responses - public policies for these challenges. Therefore, evolutions in the needs of modern societies, in combination with technological evolutions, give rise to evolutions in e-government, and the emergence of new generations of it. This paper aims at the identification and better understanding of the main characteristics of the different e-Government generations, using an analytical framework based on two rounds of literature review. The results of the study provide insights on the main features of the three main e-government generations, regarding their main goals, obstacles, key methods and tools, and reveal the new emerging generation of e-Government 3.0 and its basic characteristics. Furthermore, within the first and to some extent the second e-Government generation there have been substantial advancements, which have created distinct sub-generations of them, revealed and analysed through extensive relevant growth/maturity stages research

Personalizing health care: feasibility and future implications

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients

Current state of immunotherapy for glioblastoma

Glioma is the most common primary cancer of the central nervous system, and around 50% of patients present with the most aggressive form of the disease, glioblastoma. Conventional therapies, including surgery, radiotherapy, and pharmacotherapy (typically chemotherapy with temozolomide), have not resulted in major improvements in the survival outcomes of patients with glioblastoma. Reasons for this lack of progress include invasive tumour growth in an essential organ, which limits the utility of local therapy, as well as the protection of tumour cells by the blood-brain barrier, their intrinsic resistance to the induction of cell death, and lack of dependence on single, targetable oncogenic pathways, all of which impose challenges for systemic therapy. Furthermore, the unique immune environment of the central nervous system needs to be considered when pursuing immune-based therapeutic approaches for glioblastoma. Nevertheless, a range of different immunotherapies are currently being actively investigated in patients with this disease, spurred on by advances in immuno-oncology for other tumour types. Herein, we examine the current state of immunotherapy for gliomas, notably glioblastoma, the implications for combining the current standard-of-care treatment modalities with immunotherapies, potential biomarkers of response, and future directions for glioblastoma immuno-oncology