Economic Considerations in Access to Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, with the number of procedures and sites offering the procedure steadily rising over the past decade in the United States. Despite this, growth into certain markets has been limited as hospitals have to balance high TAVR costs with the ability to offer a complete array of state-of-the-art therapies for aortic stenosis. This trade-off often results in decreased access to TAVR services by patients cared for in hospitals that cannot afford these services or have difficulty meeting procedural requirements, recruiting skilled physicians, and initiating and then maintaining a functioning TAVR program. The lack of access is more common among patients of color or those who are socioeconomically disadvantaged. The purpose of this review is to describe the hospital-level economic considerations of TAVR in the United States and the resulting effects on geographic, racial, ethnic, and socioeconomic access for Americans.

Neuromodulation in 2035

Neuromodulation devices are approved in the United States for the treatment of movement disorders, epilepsy, pain, and depression, and are used off-label for other neurologic indications. By 2035, advances in our understanding of neuroanatomical networks and in the mechanism of action of stimulation, coupled with developments in material science, miniaturization, energy storage, and delivery, will expand the use of neuromodulation devices. Neuromodulation approaches are flexible and modifiable. Stimulation can be targeted to a dysfunctional brain focus, region, or network, and can be delivered as a single treatment, continuously, according to a duty cycle, or in response to physiologic changes. Programming can be titrated and modified based on the clinical response or a physiologic biomarker. In addition to keeping pace with clinical and technological developments, neurologists in 2035 will need to navigate complex ethical and economic considerations to ensure access to neuromodulation technology for a rapidly expanding population of patients. This article provides an overview of systems in use today and those that are anticipated and highlights the opportunities and challenges for the future, some of which are technical, but most of which will be addressed by learning about brain networks, and from rapidly growing experience with neuromodulation devices.

The Demand Side of Democratic Backsliding: How Divergent Understandings of Democracy Shape Political Choice

Why do citizens in democracies fail to punish political candidates who openly violate democratic standards at the ballot box? The bulk of existing research assumes that a common understanding of democracy underpins citizens’ evaluations of different candidates, resulting in a trade-off between undemocratic practices and partisan or economic considerations. We shed doubt on this assumption by showing that divergent understandings of democracy coexist among citizens and affect vote choice. We leverage a novel approach to estimate individual-level citizen commitment to democracy by means of a candidate choice conjoint experiment in Poland, a country experiencing democratic backsliding in a context of deep polarization. We find support for our claim that respondents with less clear-cut liberal democratic attitudes not only tolerate democratic violations more readily, but do so irrespective of a given candidate’s partisan affiliation. Thus, we contend that a lack of attitudinal consolidation around liberal democratic norms explains continued voter support for authoritarian-leaning leaders.

An Approach to Integrate a Blockchain-Based Payment Model and Independent Secure Documentation for a Robot as a Service

Robots for hire instead of purchase are developing an increasing interest among customers. This article will present a concept developed at ZeMA for the integration of a blockchain-based payment module and manipulation-proof documentation of process-specific data. This should improve the business model of hiring robots not only in terms of technical components but also in terms of economic considerations. In this way, the billing process can be automated to a certain extent, and a legally secure basis with the manipulation-proof storage of process-specific data can be created. The advantages and disadvantages of blockchain, in relation to Robot as a Service, will be highlighted and it will be shown how the disadvantages can be negated. The current limits of blockchain will also be shown. The blockchain technology IOTA is used.

Speculations on the Future of Economic Models in the Wake of Trans/Posthuman Sentient Evolution in Charles Stross’s SF Novel “Accelerando”

Economy, understood as a domain of production, distribution and consumption of goods and services, has been unquestionably comprehended as a social activity, the purpose of which is to satisfy first of all vital material, but also immaterial, needs of the biological natural human being. Whatever the underlying ideology—whether protectionist mercantilism, the physiocrats’ laissez-faire policy, Adam Smith’s free-market capitalism, Karl Marx’s socialist economics, Keynesian state interventionism, or present day neoliberalism—economic considerations have been invariably driven by the fundamental problem of scarcity. The objective of the proposed paper is to present Charles Stross’s speculative predictions, made in his SF novel Accelerando, about the future of economic models in light of trans/posthuman evolution hailed by, among others, Ray Kurzweil, Max More, and Hans Moravec.

Values as Timeless Foundations of Today’s Economy – A Remedy for a Crisis in Economic Sciences

The presented paper refers to values as the timeless foundations of modern economics, and also to ethical limitations in the sphere of economic research, especially in the mainstream. The character of the paper is a review. The aim of the research is an attempt to show the fundamental importance of values, often rooted in history, for the development of modern economics and to present a remedy for the current analytical problems of economic sciences – considering the importance of axiology in economic research. The paper is divided into three main parts: introduction – theoretical considerations on the basis of the humanistic perspective of economics; first chapter – the place of values in philosophical and economic considerations, and second chapter – axiology as a complement to the gap in economic research (response to the crisis in the field of economic research). The authors proved that in the face of great crises, including the last one, which is the coronavirus crisis, there is an urgent need to extend economic analysis with values, which would make the science of economics more mature, perceiving an individual as an entity guided by a whole spectrum of principles. It is therefore necessary to go beyond the canon of rigid thinking, because otherwise we are threatened not only with the collapse of the economy, but the entire civilisation of the West. In this regard, let us provide a wider field for ethical analysis!