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Kidneys from nondirected donors (NDDs) have historically been allocated directly to the deceased donor wait list (DDWL). Recently, however, NDDs have participated in kidney exchange (KE) procedures, including KE ‘chains’, which have received considerable media attention. This increasing application of KE chains with NDD participation has occurred with limited ethical analysis and without ethical guidelines. This article aims to provide a rigorous ethical evaluation of NDDs and chain KEs. NDDs and bridge donors (BDs) (i.e. living donors who link KE procedures within KE chains) raise several ethical concerns including coercion, privacy, confidentiality, exploitation and commercialization. In addition, although NDD participation in KE procedures may increase transplant numbers, it may also reduce NDD kidney allocation to the DDWL, and disadvantage vulnerable populations, particularly O blood group candidates. Open KE chains (also termed ‘never‐ending’ chains) result in a permanent diversion of NDD kidneys from the DDWL. The concept of limited KE chains is discussed as an ethically preferable means for protecting NDDs and BDs from coercion and minimizing ‘backing out’, whereas ‘honor systems’ are rejected because they are coercive and override autonomy. Recent occurrences of BDs backing out argue for adoption of ethically based protective measures for NDD participation in KE....
We propose an integrated Cloud computing stack architecture to serve as a reference point for future mash-ups and comparative studies. We also show how the existing Cloud landscape maps into this architecture and identify an infrastructure gap that we plan to address in future work.
We propose, implement and evaluate three admission models for computational Grids. The models take the expected demand into account and offer a specific performance guarantee. The main issue addressed is how users and providers should make the tradeoff between a best effort (low guarantee) spot market and an admission controlled (high guarantee) reservation market. Using a realistically modeled high...
We present the implementation and analysis of a market-based resource allocation system for computational grids. Although grids provide a way to share resources and take advantage of statistical multiplexing, a variety of challenges remain. One is the economically efficient allocation of resources to users from disparate organizations who have their own and sometimes conflicting requirements for both...
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