Blockchain for digital government

In less than ten years from its advent in 2008, the concept of distributed ledgers has entered into mainstream research and policy agendas. Enthusiastic reception, fuelled by the success of Bitcoin and the explosion of potential use cases created high, if not hyped, expectations with respect to the transformative role of blockchain for the industry and the public sector. Growing experimentation with distributed ledgers and the emergence of the first operational implementations provide an opportunity to go beyond hype and speculation based on theoretical use cases. This report looks at the ongoing exploration of blockchain technology by governments. The analysis of a group of pioneering developments of public services shows that blockchain technology can reduce bureaucracy, increase the efficiency of administrative processes and increase the level of trust in public record keeping. Based on the state-of-art developments, blockchain has not yet demonstrated to be either transformative or even disruptive innovation for governments as it is sometimes portrayed. Ongoing projects bring incremental rather than fundamental changes to the operational capacities of governments. Nevertheless some of them propose clear value for citizens. Technological and ecosystem maturity of distributed ledgers have to increase in order to unlock the transformative power of blockchain. Policy agenda should focus on non-technological barriers, such as incompatibility between blockchain-based solutions and existing legal and organizational frameworks. This principal policy goal cannot be achieved by adapting technology to legacy systems. It requires using the transformative power of blockchain to be used to create new processes, organizations, structures and standards. Hence, policy support should stimulate more experimentation with both the technology and new administrative processes that can be re-engineered for blockchain.JRC.B.6-Digital Econom

Applying Harmonic Optical Microscopy for Spatial Alignment of Atrial Collagen Fibers

BACKGROUND: Atrial fibrosis creates a vulnerable tissue for atrial fibrillation (AF), but the spatial disarray of collagen fibers underlying atrial fibrosis is not fully elucidated. OBJECTIVE: This study hypothesizes that harmonics optical microscopy can illuminate the spatial mal-alignment of collagen fibers in AF via a layer-by-layer approach. PATIENTS AND METHODS: Atrial tissues taken from patients who underwent open-heart surgery were examined by harmonics optical microscopy. Using the two-dimensional Fourier transformation method, a spectral-energy description of image texture was constituted and its entropy was used to quantify the mal-alignment of collagen fibers. The amount of collagen fiber was derived from its area ratio to total atrial tissue in each image. Serum C-terminal pro-collagen pro-peptide (CICP), pro-matrix metalloproteinase-1 (pro-MMP-1), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were also evaluated. RESULTS: 46 patients were evaluated, including 20 with normal sinus rhythm and 26 with AF. The entropy of spectral-energy distribution of collagen alignment was significantly higher in AF than that in sinus rhythm (3.97 ± 0.33 vs. 2.80 ± 0.18, p<0.005). This difference was more significant in the permanent AF group. The amount of collagen was also significantly higher in AF patients (0.39 ± 0.13 vs. 0.18 ± 0.06, p<0.005) but serum markers of cardiac fibrosis were not significantly different between the two groups. CONCLUSIONS: Harmonics optical microscopy can quantify the spatial mal-alignment of collagen fibers in AF. The entropy of spectral-energy distribution of collagen alignment is a potential tool for research in atrial remodeling

Effects of Electrical and Structural Remodeling on Atrial Fibrillation Maintenance: A Simulation Study

Atrial fibrillation, a common cardiac arrhythmia, often progresses unfavourably: in patients with long-term atrial fibrillation, fibrillatory episodes are typically of increased duration and frequency of occurrence relative to healthy controls. This is due to electrical, structural, and contractile remodeling processes. We investigated mechanisms of how electrical and structural remodeling contribute to perpetuation of simulated atrial fibrillation, using a mathematical model of the human atrial action potential incorporated into an anatomically realistic three-dimensional structural model of the human atria. Electrical and structural remodeling both shortened the atrial wavelength - electrical remodeling primarily through a decrease in action potential duration, while structural remodeling primarily slowed conduction. The decrease in wavelength correlates with an increase in the average duration of atrial fibrillation/flutter episodes. The dependence of reentry duration on wavelength was the same for electrical vs. structural remodeling. However, the dynamics during atrial reentry varied between electrical, structural, and combined electrical and structural remodeling in several ways, including: (i) with structural remodeling there were more occurrences of fragmented wavefronts and hence more filaments than during electrical remodeling; (ii) dominant waves anchored around different anatomical obstacles in electrical vs. structural remodeling; (iii) dominant waves were often not anchored in combined electrical and structural remodeling. We conclude that, in simulated atrial fibrillation, the wavelength dependence of reentry duration is similar for electrical and structural remodeling, despite major differences in overall dynamics, including maximal number of filaments, wave fragmentation, restitution properties, and whether dominant waves are anchored to anatomical obstacles or spiralling freely

Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation

Purpose of Review: Atrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management of AF patients. Recent Findings: Novel echocardiographic biomarkers and their clinical application related to the management of AF have been taken into consideration. Both standard parameters such as atrial size and volume but also novels like atrial strain and tissue Doppler techniques have been analyzed. Summary: A number of novel echocardiographic parameters have been proven to enable early detection of left atrial dysfunction along with increased diagnosis accuracy. This concerns particularly experienced echocardiographers. Hence, these techniques might improve the prediction of stroke and thromboembolic events among AF patients and need to be further developed and disseminated. Nonetheless, even the standard imaging parameters could be of significant value and should not be discontinued in everyday clinical practice. © 2019, The Author(s)

withdrawn 2017 hrs ehra ecas aphrs solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation

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Blockchain Technology for Governmental Processes: The Design of a Blockchain Assessment Tool: a Design Science Approach

The European Union is exploring the possibilities of blockchain for their services and processes as a bottom-up approach to the coordination of citizens and economic administrators. However, the multi-actor complexity and the systems complexity of blockchain technology makes decision-making in this subject a difficult task, resulting in a proliferation of blockchain experiments that do not provide significant value. To capture the benefits of blockchain in processes where this technology is applicable in the EU, a blockchain assessment tool is needed that allows for the structural assessment of the fit with blockchain for an information exchange or registration process. This thesis uses a Design Science to design this blockchain assessment tool.Six elements were found to be of importance for blockchain experimentation in EU Institutions and Bodies: Complexities, Process Factors, Ripple Effects, Organizational Factors, Decision-making Process and Design Features. It is critical to take the complexities involved in implementing blockchain in public administrations into account. Also, the factors that define the fit between the process and blockchain technology need to be considered as insight in this fit can enhance decision-making regarding blockchain experimentation in EU Institutions and Bodies. In addition, there are a number of organizational factors that determine the ability of a governmental organization to adopt blockchain technology. Given the institutional change that blockchains might present, it is critical to take into account the ripple effects of blockchains when deciding to experiment with blockchain technology as an EU Institution or Body. As there is not merely one decision-making process for IT innovation adoption, the process of how a decision on blockchain experimentation is reached needs to be considered as well. Lastly, as blockchain technology compromises of various types and design features, it is important to reflect on the impact of these features on the process criteria.Using explorative expert interviews combined with Qualitative Data and Matrix Prioritization Analysis, the elements are concretized and translated into requirements for the blockchain assessment tool. Based on these requirements, the blockchain assessment tool is designed using a Morphological Chart to structure the design process. The blockchain assessment tool consists of three steps that allow a user to assess the blockchain fit, create a high-level blockchain design and to map the ripple effects. The blockchain assessment tool was demonstrated in two case studies exploring the possibilities of blockchain for an EU registration or information exchange system, for which the tool proved to provide key insights. Also, experts were interviewed to evaluate the tool, which demonstrated the need for this blockchain assessment tool for the public sector.Future research is suggested to focus on the trade-offs between the design features to provide a better view on the possible blockchain architectures. Also, more research into the openness and interoperability of blockchain systems could create more depth in the debate of permissionless versus permissioned blockchains in governments. Lastly, research into applying Value Sensitive Design for blockchains could enable the design of permissionless blockchain systems where authorities can be supervisors to protect public values in permissionless blockchains.Systems Engineering, Policy Analysis and Management (SEPAM

The consequences of blockchain architectures for the governance of public services: A case study of the movement of excise goods under duty exemptions

Blockchain technology has the potential to provide public services directly to the public. This challenges the need for public organizations, who traditionally provided these services. Much of the current work is focused on the technology, whereas the influence on public administration structure has gained less attention. The goal of this paper is to investigate the impact of blockchain technology on the governance of public service provision. For this, we performed a case study of an EU-wide system that monitors the movement of excise goods under duty suspension. We developed two scenarios for blockchain technology’s use based on a permissionless blockchain architecture on the one hand and a permissioned one on the other. The scenarios were evaluated based on their impact on transaction validation, data quality and governance. The findings show that blockchain technology alone cannot be an alternative for the current data quality controls, equal access assurances and adaptations to legislation conducted by public administrations. As such, governments will remain playing a key role in registration of documents and assets, however, the governance will likely change depending on the type of blockchain architecture.Information and Communication TechnologyPolicy Analysi