Outcomes of a population-based series of early breast cancer patients with micrometastases and isolated tumour cells in axillary lymph nodes - Heiden-van der Loo, M.; Schaapveld, M.; Ho, V.K.Y.; Siesling, S.; Rutgers, E.J.T.; Peeters, P.H.M.
Background Axillary lymph node staging is traditionally important to provide prognostic information to guide further treatment. However, the relevance of isolated tumour cells (ITC) or micrometastases in axillary nodes and the need for adjuvant treatment remain uncertain.
Patients and methods Data from 18 370 patients with pT1–2 breast cancer with pN0, pN0i+ or pN1mi were analysed. The primary end point was 5-year disease-free survival (locoregional recurrence, distant metastases or contralateral breast cancer).
Results Five-year disease-free survival was 89.9% [95% confidence interval 89.5% to 90.4%]; and did not differ significantly between groups. After adjusting for prognostic factors (including treatment), patients with...
Ethicist as Designer: A Pragmatic Approach to Ethics in the Lab - Wynsberghe, Aimee van; Robbins, Scott
Contemporary literature investigating the significant impact of technology on our lives leads many to conclude that ethics must be a part of the discussion at an earlier stage in the design process i.e., before a commercial product is developed and introduced. The problem, however, is the question regarding how ethics can be incorporated into an earlier stage of technological development and it is this question that we argue has not yet been answered adequately. There is no consensus amongst scholars as to the kind of ethics that should be practiced, nor the individual selected to perform this ethical analysis. One...
A method for integrating ethics into the design of robots - Wynsberghe, Aimee van
Purpose – With the rapid and pervasive introduction of robots into human environments, ethics scholars along with roboticists are asking how ethics can be applied to the discipline of robotics. The purpose of this paper is to provide a concrete example of incorporating ethics into the design process of a robot in healthcare.
Design/methodology/approach – The approach for including ethics in the design process of care robots used in this paper is called the Care-Centered Value Sensitive Design (CCVSD) approach. The CCVSD approach presented here provides both an outline of the components demanding ethical attention as well as a step-by-step...
Vakmanschap in onze high tech gezondheidszorg? Over de kunst van het "elektronische" zorgen - Coeckelbergh, Mark
De hedendaagse gezondheidszorg steunt op elektronische informatie- en communicatietechnologie. Denk maar aan de computers die overal gebruikt worden en het gebruik van internet bij het zoeken naar informatie over gezondheid, elektronische voorschriften, medische expertsystemen, chip implantaten, zorgrobots, gezondheidsd|>|>s op mobiele telefoons, elektronische patiëntendossiers, enzovoort. Soms worden deze elektronische technologieën ook gebruikt om zorg op afstand te verlenen, bijvoorbeeld om de medische toestand van ouderen en chronisch zieken in de gaten te houden. Het gebruik van elektronische technologie-en in de gezondheidszorg roept echter ook ethische vragen op. Is het wel veilig om met een zorgrobot om te gaan? Respecteert een elektronisch...
The Moral Standing of Machines: Towards a Relational and Non-Cartesian Moral Hermeneutics - Coeckelbergh, Mark
Should we give moral standing to machines? In this paper, I explore the implications of a relational approach to moral standing for thinking about machines, in particular autonomous, intelligent robots. I show how my version of this approach, which focuses on moral relations and on the conditions of possibility of moral status ascription, provides a way to take critical distance from what I call the “standard” approach to thinking about moral status and moral standing, which is based on properties. It does not only overcome epistemological problems with the standard approach, but can also explain how we think about, experience,...
Performance optimization of large stroke flexure hinges for high stiffness and eigenfrequency - Gunnink, K.; Aarts, R.G.K.M.; Brouwer, D.M.
Two flexure hinge types are optimized for high support stiffness and high first unwanted eigenfrequency for two different working ranges, ±5.7° and ±20°. We show how multiple performance specifications lead to different designs with different performance. The optimization uses efficient parameterized non-linear beam-based models. The constraints and load case are taken from an electron microscopy use case.
Optimization results show that the Three Flexure Cross Hinge has the highest first unwanted eigenfrequencies, while the new Infinity Flexure Hinge shows highest support stiffnesses. The design of the optimal geometry is detailed such that a prototype mechanism is manufactured and tested. Experiments show...