Democratization of quantum technologies

As quantum technologies (QT) advance, their potential impact on and relation with society has been developing into an important issue for exploration. In this paper, we investigate the topic of democratization in the context of QT, particularly quantum computing. The paper contains three main sections. First, we briefly introduce different theories of democracy (participatory, representative, and deliberative) and how the concept of democratization can be formulated with respect to whether democracy is taken as an intrinsic or instrumental value. Second, we give an overview of how the concept of democratization is used in the QT field. Democratization is mainly adopted by companies working on quantum computing and used in a very narrow understanding of the concept. Third, we explore various narratives and counter-narratives concerning democratization in QT. Finally, we explore the general efforts of democratization in QT such as different forms of access, formation of grassroot communities and special interest groups, the emerging culture of manifesto writing, and how these can be located within the different theories of democracy. In conclusion, we argue that although the ongoing efforts in the democratization of QT are necessary steps towards the democratization of this set of emerging technologies, they should not be accepted as sufficient to argue that QT is a democratized field. We argue that more reflexivity and responsiveness regarding the narratives and actions adopted by the actors in the QT field and making the underlying assumptions of ongoing efforts on democratization of QT explicit, can result in a better technology for society

From speculation to reality: Enhancing anticipatory ethics for emerging technologies (ATE) in practice

Various approaches have emerged over the last several decades to meet the challenges and complexities of anticipating and responding to the potential impacts of emerging technologies. Although many of the existing approaches share similarities, they each have shortfalls. This paper takes as the object of its study Anticipatory Ethics for Emerging Technologies (ATE) to technology assessment, given that it was formatted to address many of the privations characterising parallel approaches. The ATE approach, also in practice, presents certain areas for retooling, such as how it characterises levels and objects of analysis. This paper results from the work done with the TechEthos Horizon 2020 project in evaluating the ethical, legal, and social impacts of climate engineering, digital extended reality, and neurotechnologies. To meet the challenges these technology families present, this paper aims to enhance the ATE framework to encompass the variety of human processes and material forms, functions, and applications that comprise the socio-technical systems in which these technologies are embedded

From speculation to reality: enhancing anticipatory ethics for emerging technologies (ATE) in practice

Various approaches have emerged over the last several decades to meet the challenges and complexities of anticipating and responding to the potential impacts of emerging technologies. Although many of the existing approaches share similarities, they each have shortfalls. This paper takes as the object of its study Anticipatory Ethics for Emerging Technologies (ATE) to technology assessment, given that it was formatted to address many of the privations characterising parallel approaches. The ATE approach, also in practice, presents certain areas for retooling, such as how it characterises levels and objects of analysis. This paper results from the work done with the TechEthos Horizon 2020 project in evaluating the ethical, legal, and social impacts of climate engineering, digital extended reality, and neurotechnologies. To meet the challenges these technology families present, this paper aims to enhance the ATE framework to encompass the variety of human processes and material forms, functions, and applications that comprise the socio-technical systems in which these technologies are embedde

Evaluation of National Surgical Practice for Lateral Lymph Nodes in Rectal Cancer in an Untrained Setting

Background: Involved lateral lymph nodes (LLNs) have been associated with increased local recurrence (LR) and ipsi-lateral LR (LLR) rates. However, consensus regarding the indication and type of surgical treatment for suspicious LLNs is lacking. This study evaluated the surgical treatment of LLNs in an untrained setting at a national level. Methods: Patients who underwent additional LLN surgery were selected from a national cross-sectional cohort study regarding patients undergoing rectal cancer surgery in 69 Dutch hospitals in 2016. LLN surgery consisted of either ‘node-picking’ (the removal of an individual LLN) or ‘partial regional node dissection’ (PRND; an incomplete resection of the LLN area). For all patients with primarily enlarged (≥7 mm) LLNs, those undergoing rectal surgery with an additional LLN procedure were compared to those undergoing only rectal resection. Results: Out of 3057 patients, 64 underwent additional LLN surgery, with 4-year LR and LLR rates of 26% and 15%, respectively. Forty-eight patients (75%) had enlarged LLNs, with corresponding recurrence rates of 26% and 19%, respectively. Node-picking (n = 40) resulted in a 20% 4-year LLR, and a 14% LLR after PRND (n = 8; p = 0.677). Multivariable analysis of 158 patients with enlarged LLNs undergoing additional LLN surgery (n = 48) or rectal resection alone (n = 110) showed no significant association of LLN surgery with 4-year LR or LLR, but suggested higher recurrence risks after LLN surgery (LR: hazard ratio [HR] 1.5, 95% confidence interval [CI] 0.7–3.2, p = 0.264; LLR: HR 1.9, 95% CI 0.2–2.5, p = 0.874). Conclusion: Evaluation of Dutch practice in 2016 revealed that approximately one-third of patients with primarily enlarged LLNs underwent surgical treatment, mostly consisting of node-picking. Recurrence rates were not significantly affected by LLN surgery, but did suggest worse outcomes. Outcomes of LLN surgery after adequate training requires further research.</p

Prognostic Implications of Lateral Lymph Nodes in Rectal Cancer:A Population-Based Cross-sectional Study with Standardized Radiological Evaluation after Dedicated Training

BACKGROUND: There is an ongoing discussion regarding the prognostic implications of the presence, short-axis diameter, and location of lateral lymph nodes. OBJECTIVE: To analyze lateral lymph node characteristics, the role of downsizing on restaging MRI, and associated local recurrence rates for patients with cT3-4 rectal cancer after MRI re-review and training. DESIGN: Retrospective population-based cross-sectional study. SETTINGS: This collaborative project was led by local investigators from surgery and radiology departments in 60 Dutch hospitals. PATIENTS: A total of 3057 patients underwent rectal cancer surgery in 2016: 1109 had a cT3-4 tumor located ≤8 cm from the anorectal junction, of whom 891 received neoadjuvant therapy. MAIN OUTCOME MEASURES: Local recurrence and (ipsi) lateral local recurrence rates. RESULTS: Re-review identified 314 patients (35%) with visible lateral lymph nodes. Of these, 30 patients had either only long-stretched obturator (n = 13) or external iliac (n = 17) nodes, and both did not lead to any lateral local recurrences. The presence of internal iliac/obturator lateral lymph nodes (n = 284) resulted in 4-year local recurrence and lateral local recurrence rates of 16.4% and 8.8%, respectively. Enlarged (≥7 mm) lateral lymph nodes (n = 122) resulted in higher 4-year local recurrence (20.8%, 13.1%, 0%; p &lt;.001) and lateral local recurrence (14.7%, 4.4%, 0%; p &lt; 0.001) rates compared to smaller and no lateral lymph nodes, respectively. Visible lateral lymph nodes (HR 1.8 [1.1-2.8]) and enlarged lateral lymph nodes (HR 1.9 [1.1-3.5]) were independently associated with local recurrence in multivariable analysis. Enlarged lateral lymph nodes with malignant features had higher 4-year lateral local recurrence rates of 17.0%. Downsizing had no impact on lateral local recurrence rates. Enlarged lateral lymph nodes were found to be associated with higher univariate 4-year distant metastasis rates (36.4% vs 24.4%; p = 0.021), but this was not significant in multivariable analyses (HR 1.3 [0.9-1.]) and did not worsen overall survival. LIMITATIONS: This study was limited by the retrospective design and total number of patients with lateral lymph nodes. CONCLUSIONS: The risk of lateral local recurrence due to (enlarged) lateral lymph nodes was confirmed, but without the prognostic impact of downsizing after neoadjuvant therapy. These results point toward the incorporation of primary lateral lymph node size into treatment planning. See Video Abstract.</p

DETC2008-49342 ON ENGINEERING MEANINGS AND REPRESENTATIONS OF TECHNICAL FUNCTIONS

ABSTRACT In this paper I consider the relations between the different meanings and representations of the concept of technical function that are in use in engineering design methodology. I focus on two representation schemes -the verb-noun and the operation-on-flows representations -and analyse whether representations of technical functions created with the one scheme can be transposed into representations of the same functions with the other scheme. I argue that the answer depends on the particular meaning of function that one adopts. When functions of technical systems refer to behaviours of those systems, then the two representations can be reciprocally transposed following the rule that the verbs in the verb-noun representations correspond to the operations in the operationon-flows representations, and the nouns to the (main) flows. When, however, technical functions refer to the purposes for which systems are designed, it can be argued that these representations cannot be transposed using this rule. The reason for this result is that operation-on-flows combinations, where the flows are flows through technical systems, are, in general, not suited to represent purposive technical functions of the systems. In a subsidiary and more explorative discussion I focus on the transposition of verb-noun representations of purposive functions into operation-on-flows representations of behavioural functions in design methodologies such as the Functional Basis account of Robert Stone and Kristin Wood