Digital sufficiency: conceptual considerations for ICTs on a finite planet.

ICT hold significant potential to increase resource and energy efficiencies and contribute to a circular economy. Yet unresolved is whether the aggregated net effect of ICT overall mitigates or aggravates environmental burdens. While the savings potentials have been explored, drivers that prevent these and possible counter measures have not been researched thoroughly. The concept digital sufficiency constitutes a basis to understand how ICT can become part of the essential environmental transformation. Digital sufficiency consists of four dimensions, each suggesting a set of strategies and policy proposals: (a) hardware sufficiency, which aims for fewer devices needing to be produced and their absolute energy demand being kept to the lowest level possible to perform the desired tasks; (b) software sufficiency, which covers ensuring that data traffic and hardware utilization during application are kept as low as possible; (c) user sufficiency, which strives for users applying digital devices frugally and using ICT in a way that promotes sustainable lifestyles; and (d) economic sufficiency, which aspires to digitalization supporting a transition to an economy characterized not by economic growth as the primary goal but by sufficient production and consumption within planetary boundaries. The policies for hardware and software sufficiency are relatively easily conceivable and executable. Policies for user and economic sufficiency are politically more difficult to implement and relate strongly to policies for environmental transformation in general. This article argues for comprehensive policies for digital sufficiency, which are indispensible if ICT are to play a beneficial role in overall environmental transformation.

Information and communication technology in emergency organizations: Applications, opportunities, and challenges.

The increasing complexity of the globally connected world in the twenty-first century leads to an expansion of the area of operations of so-called emergency organizations* with regard to their aims, tasks, and exposure to risks by fulfilling their intended mission. On the other side, the process of globalization is accompanied by continuous further development of existing information technologies (ICTs) as well as exploration of new forms of ICT. These technologies provide the chance for emergency organizations to gain the ability to act more flexible and effective within their prescribed tasks. As aspects of digitization could have a great impact on many parts of the processes and domains in emergency organizations, a broad view on the topic area is needed. To that end, this article at hand deals with the development of a systematic approach to structure ICT technologies and further approaches and corresponding elements of emergency organizations to find connecting links between both areas. For this purpose, a literature review was conducted. It takes up exemplary sources from literature and describes them along a standardized emergency process. The results of this review led to the development of an ad hoc classification system, which structures and clusters relevant information technologies for emergency organizations. It builds upon the standardized emergency process and could provide a foundation for emergency organizations as well as academic scholars for further information gathering and research. Furthermore, exemplary challenges and opportunities-based on the findings of the review-are provided.

Safety analysis of vagal nerve stimulation for continuous nerve monitoring during thyroid surgery.

OBJECTIVES/HYPOTHESIS: Intraoperative neuromonitoring (IONM) facilitates recurrent laryngeal nerve (RLN) identification, but various studies affirm virtually unchanged postoperative RLN palsy rates. Several authors meanwhile suggest continuous intraoperative neuromonitoring (CIONM) via vagal nerve stimulation (VNS) to improve RLN protection. However, knowledge of side effects of electrical VNS derives mainly from its therapeutic applications in the fields of neurology and psychiatry. The presented study was conducted to further evaluate the safety of CIONM and identify possible VNS related side effects. STUDY DESIGN: Prospective nonrandomized controlled trail. METHODS: Forty patients scheduled for thyroid or parathyroid surgery were enrolled in the trail. The intervention group consisted of 22 patients receiving VNS for CIONM. Eighteen patients were operated on with routine IONM. To assess VNS-induced effects on the autonomic nervous system (ANS), heart rate variability analysis (HRVA) was applied. Serum cytokine levels of tumor necrosis factor (TNF)-α were monitored to evaluate immunomodulatory effects of VNS. RESULTS: HRVA revealed significantly increased vagal activity during CIONM. This parasympathetic predominance was not countered by the sympathetic nervous system. Despite a significant increase of vagal tone, no hemodynamic events occurred; in fact, no significant changes in median heart rate or in median arterial blood pressure were detected. Even though anti-inflammatory effects of VNS have been reported, no attenuation of cytokine release of TNF-α was measured. CONCLUSIONS: VNS for CIONM resulted in increased vagal activity assessable via HRVA. The increased parasympathetic tone affected neither hemodynamics nor levels of the proinflammatory cytokine TNF-α. VNS for CIONM appears safe with the applied settings.