eHealth implementation in Europe: a scoping review on legal, ethical, financial, and technological aspects

Background: The evolution of eHealth development has shifted from standalone tools to comprehensive digital health environments, fostering data exchange among diverse stakeholders and systems. Nevertheless, existing research and implementation frameworks have primarily emphasized technological and organizational aspects of eHealth implementation, overlooking the intricate legal, ethical, and financial considerations. It is essential to discover what legal, ethical, financial, and technological challenges should be considered to ensure successful and sustainable implementation of eHealth.Objective: This review aims to provide insights into barriers and facilitators of legal, ethical, financial, and technological aspects for successful implementation of complex eHealth technologies, which impacts multiple levels and multiple stakeholders.Methods: A scoping review was conducted by querying PubMed, Scopus, Web of Science, and ACM Digital Library (2018–2023) for studies describing the implementation process of eHealth technologies that facilitate data exchange. Studies solely reporting clinical outcomes or conducted outside Europe were excluded. Two independent reviewers selected the studies. A conceptual framework was constructed through axial and inductive coding, extracting data from literature on legal, ethical, financial, and technological aspects of eHealth implementation. This framework guided systematic extraction and interpretation.Results: The search resulted in 7.308 studies that were screened for eligibility, of which 35 (0.48%) were included. Legal barriers revolve around data confidentiality and security, necessitating clear regulatory guidelines. Ethical barriers span consent, responsibility, liability, and validation complexities, necessitating robust frameworks. Financial barriers stem from inadequate funding, requiring (commercial) partnerships and business models. Technological issues include interoperability, integration, and malfunctioning, necessitating strategies for enhancing data reliability, improving accessibility, and aligning eHealth technology with existing systems for smoother integration.Conclusions: This research highlights the multifaceted nature of eHealth implementation, encompassing legal, ethical, financial, and technological considerations. Collaborative stakeholder engagement is paramount for effective decision-making and aligns with the transition from standalone eHealth tools to integrated digital health environments. Identifying suitable stakeholders and recognizing their stakes and values enriches implementation strategies with expertise and guidance across all aspects. Future research should explore the timing of these considerations and practical solutions for regulatory compliance, funding, navigation of responsibility and liability, and business models for reimbursement strategies

Geochronology of volcanically associated hydrocarbon charge in the pre-salt carbonates of the Namibe Basin, Angola

In volcanic rifted margins, the timing of hydrocarbon charge is difficult to predict, but is important in understanding fluid genesis. We investigated whether igneous activity was linked to hydrocarbon charge in the prolific South Atlantic pre-salt petroleum system. To do this, we applied in situ carbonate U-Pb geochronology, a relatively novel tool for dating hydrocarbon migration, to bituminous veins in pre-salt travertines from the rifted onshore Namibe Basin (Angola). To test if fluid flow was synchronous with known volcanic pulses, we also obtained new 40Ar/39/Ar geochronology from a nearby volcanic complex. Bitumen is associated with calcite in a first generation of veins and vugs, and with dolomite in younger veins. The dated calcite veins yielded a pooled U-Pb age of 86.2 ± 2.4 Ma, which overlaps the volcanism 40Ar/39/Ar age of 89.9 ± 1.8 Ma. The overlapping dates and the localized bitumen occurrence around the dated volcanic center show a clear genetic relationship between Late Cretaceous igneous activity and hydrocarbon charge. The dolomite was dated at 56.8 ± 4.8 Ma, revealing a previously unknown Paleocene/Eocene fluid-flow phase in the basin

Recovery and prognostic value of myocardial strain in ST-segment elevation myocardial infarction patients with a concurrent chronic total occlusion

Objectives: Global left ventricular (LV) function is routinely used to assess cardiac function; however, myocardial strain is able to identify more subtle dysfunction. We aimed to determine the recovery and prognostic value of featuring tracking (FT) cardiovascular magnetic resonance (CMR) strain in ST-segment elevation myocardial infarction (STEMI) patients with a concurrent chronic total occlusion (CTO). Methods: In the randomized EXPLORE trial, there was no significant difference in global LV functio

An interlaboratory study of TEX86 and BIT analysis of sediments, extracts and standard mixtures.

Two commonly used proxies based on the distribution of glycerol dialkyl glycerol tetraethers (GDGTs) are the TEX86 (TetraEther indeX of 86 carbon atoms) paleothermometer for sea surface temperature reconstructions and the BIT (Branched Isoprenoid Tetraether) index for reconstructing soil organic matter input to the ocean. An initial round-robin study of two sediment extracts, in which 15 laboratories participated, showed relatively consistent TEX86 values (reproducibility ±3-4°C when translated to temperature) but a large spread in BIT measurements (reproducibility ±0.41 on a scale of 0-1). Here we report results of a second round-robin study with 35 laboratories in which three sediments, one sediment extract, and two mixtures of pure, isolated GDGTs were analyzed. The results for TEX86 and BIT index showed improvement compared to the previous round-robin study. The reproducibility, indicating interlaboratory variation, of TEX86 values ranged from 1.3 to 3.0°C when translated to temperature. These results are similar to those of other temperature proxies used in paleoceanography. Comparison of the results obtained from one of the three sediments showed that TEX86 and BIT indices are not significantly affected by interlaboratory differences in sediment extraction techniques. BIT values of the sediments and extracts were at the extremes of the index with values close to 0 or 1, and showed good reproducibility (ranging from 0.013 to 0.042). However, the measured BIT values for the two GDGT mixtures, with known molar ratios of crenarchaeol and branched GDGTs, had intermediate BIT values and showed poor reproducibility and a large overestimation of the "true" (i.e., molar-based) BIT index. The latter is likely due to, among other factors, the higher mass spectrometric response of branched GDGTs compared to crenarchaeol, which also varies among mass spectrometers. Correction for this different mass spectrometric response showed a considerable improvement in the reproducibility of BIT index measurements among laboratories, as well as a substantially improved estimation of molar-based BIT values. This suggests that standard mixtures should be used in order to obtain consistent, and molar-based, BIT values

Open data from the third observing run of LIGO, Virgo, KAGRA, and GEO

The global network of gravitational-wave observatories now includes five detectors, namely LIGO Hanford, LIGO Livingston, Virgo, KAGRA, and GEO 600. These detectors collected data during their third observing run, O3, composed of three phases: O3a starting in 2019 April and lasting six months, O3b starting in 2019 November and lasting five months, and O3GK starting in 2020 April and lasting two weeks. In this paper we describe these data and various other science products that can be freely accessed through the Gravitational Wave Open Science Center at https://gwosc.org. The main data set, consisting of the gravitational-wave strain time series that contains the astrophysical signals, is released together with supporting data useful for their analysis and documentation, tutorials, as well as analysis software packages

Lithological control on soil chemistry and microbial diversity

The geological diversity of Northern Ireland provides a unique opportunity to investigate the effects of differing lithologies on the geochemistry of overlying soils. This will increase our understanding of how lithology influences the microbial populations within the soil and their role in biochemical cycling. Whilst several factors contribute to the properties of developing soils, source rock is one of the major controls in determining chemistry and formation rate. The array of geological ages and formations within Northern Ireland occurs over a relatively small area. When this is combined with the glacial history of the British-Irish ice sheet during the last glacial maximum, any soils present now will all be of the same age and have undergone the same climatic conditions. The Tellus project, an intense high resolution geochemical mapping study which analysed soil samples across Northern Ireland, has been utilised to select sites of potential interest where specific elements occur in high concentrations and evidence of anthropogenic activity is limited. There are several components to this interdisciplinary study; one of which is the chemical analysis, of inorganic and organic constituents throughout the depth profile. This has been undertaken upon soils from varying lithologies (Paleogene basalts, Devonian sandstones and Carboniferous limestones). The study also includes biological assessment in the form of various DNA profiling techniques and lab based microcosm experiments using soils obtained from the field. This will enable a thorough investigation of the microbial communities present which will identify microbial diversity arising from differences in lithology through the soil profile

Natural sulfurization of carbohydrates in marine sediments : consequences for the chemical and carbon isotopic composition of sedimentary organic matter

Carbohydrates make up the largest part of the organic matter in the biosphere and are used by living organism for many different reasons. They serve, among others, as carbon and energy source as well as metabolic intermediates. Carbohydrates are generally thought to be remineralized during early diagenesis in the water column and in the sediment and thus not preserved in substantial amounts. However, earlier studies have suggested that preservation of carbohydrates through sulfurization could be possible and may be an important pathway for the preservation of sedimentary organic matter. In theory, preservation of carbohydrates through sulfurization would have a significant impact on total organic carbon (TOC) as well as the carbon isotopic composition of the TOC (8 13CTOc) records and could, for example, explain the large variations in both records observed in the Upper Jurassic Kimmeridge Clay Formation (KCF). However, it is still unclear to what extent carbohydrates can be preserved in sedimentary organic material and what the consequence of a substantial preservation of carbohydrates is for the chemical composition of the TOC. Its consequences for the 8l3CTOC record are also unclear since hardly anything is known about the variation in isotopic compositions of carbohydrates in natural systems. The primary goal of the work described in this thesis is to test the hypothesis that preservation of carbohydrates through sulfurization may be an important pathway for the preservation of organic matter and, if so, to determine what the consequences for the TOC and 813CTOC record will be