Bioethics and Medical Ethics Commons^™

Development And Pilot Testing Of Internet-Delivered, Family-Based Cognitive Behavioral Therapy For Anxiety And Obsessive-Compulsive Disorders In Autistic Youth, Andrew G Guzick, Sophie C Schneider, Amanda B Perozo Garcia, Minjee Kook, Rebecca L Greenberg, David Riddle, Morgan Mcneel, Servando Rodriguez-Barajas, Michelle Yang, Blake Upshaw, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Cognitive behavioral therapy adapted for autistic youth with anxiety and/or OCD has a strong evidence base, but few have access. A 12-week family-based, Internet-delivered cognitive behavioral therapy (iCBT) program for 7-15 year-old autistic youth with anxiety and/or OCD was developed as a potential method to address this problem. Quantitative and qualitative feedback from stakeholders (parents, youth, clinicians) was gathered on an initial draft of content before conducting a pilot trial. This feedback suggested high quality, engagement, usability, and informativeness of the material. Suggestions were incorporated into the treatment program that was tested in a pilot trial. Eight families were randomized …

An Induced Annual Modulation Signature In Cosine-100 Data By Dama/Libra’S Analysis Method, Govinda Adhikari, Nelson Carlin, Jaejin Choi, Seonho Choi, Anthony Ezeribe, Luis Eduardo França, Chang Hyon Ha, In Sik Hahn, Sophia J Hollick, Eunju Jeon, Jay Hyun Jo, Han Wool Joo, Woon Gu Kang, Matthew Kauer, Bongho Kim, Hongjoo Kim, Jinyoung Kim, Kyungwon Kim, Sunghyun Kim, Sun Kee Kim, Won Kyung Kim, Yeongduk Kim, Yong-Hamb Kim, Young Ju Ko, Doo Hyok Lee, Eun Kyung Lee, Hyunseok Lee, Hyun Su Lee, Hye Young Lee, In Soo Lee, Jaison Lee, Jooyoung Lee, Moo Hyun Lee, Seo Hyun Lee, Seung Mok Lee, Yu Jin Lee, Douglas Leonard, Bruno B Manzato, Reina H Maruyama, Robert J Neal, James A Nikkel, Stephen L Olsen, Byung Ju Park, Hyang Kyu Park, Hyeonseo Park, Kangsoon Park, Se Dong Park, Ricardo L C Pitta, Hafizh Prihtiadi, Sejin Ra, Carsten Rott, Keon Ah Shin, Andrew Scarff, Neil J C Spooner, William G Thompson, Liang Yang, Gyun Ho Yu

Faculty and Staff Publications

The DAMA/LIBRA collaboration has reported the observation of an annual modulation in the event rate that has been attributed to dark matter interactions over the last two decades. However, even though tremendous efforts to detect similar dark matter interactions were pursued, no definitive evidence has been observed to corroborate the DAMA/LIBRA signal. Many studies assuming various dark matter models have attempted to reconcile DAMA/LIBRA's modulation signals and null results from other experiments, however no clear conclusion can be drawn. Apart from the dark matter hypothesis, several studies have examined the possibility that the modulation is induced by variations in detector's …

Do Adolescent Patients Have A Right To Be Informed About Fertility Preservation Options By Virtue Of The Conventions On The Rights Of The Child?, Giulia Adele Dinicola

Graduate Student Research Symposium

The 1989 United Nations Convention on the Rights of the Child not only states that children should be heard in matters of their concern according to their age and maturity, but also that children should have a right to have access to information. However, when it comes to medical indications, a consensus has not been reached on whether parents should disclose healthcare complications to their adolescent child. Adolescent disclosure becomes even more controversial when related to non-lifesaving procedures. In the United States, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the …

The Hermeneutics Of Nudging: The Reciprocity Between Transhumanism And Nudging, Ian Doherty

Graduate Student Research Symposium

This paper investigates and evaluates the implications of nudging someone toward transhumanism. Transhumanism offers a path to alleviate suffering and transcend our physical and mental limitations. Transhumanist technologies consist of alterations like genetic modification, neural implants, and molecular nanotechnology. These technologies are meant to give people full morphological freedom over their bodies. Although transhumanism remains a largely unknown movement, this is where nudge theory can help raise its prominence. Nudge theory aims to help people make better choices, and aid them in making better decisions related to their health and lifestyle. If paired correctly, transhumanism seems to be a perfect …

Hervs And Cancer-A Comprehensive Review Of The Relationship Of Human Endogenous Retroviruses And Human Cancers, Erik Stricker, Erin C Peckham-Gregory, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Genomic instability and genetic mutations can lead to exhibition of several cancer hallmarks in affected cells such as sustained proliferative signaling, evasion of growth suppression, activated invasion, deregulation of cellular energetics, and avoidance of immune destruction. Similar biological changes have been observed to be a result of pathogenic viruses and, in some cases, have been linked to virus-induced cancers. Human endogenous retroviruses (HERVs), once external pathogens, now occupy more than 8% of the human genome, representing the merge of genomic and external factors. In this review, we outline all reported effects of HERVs on cancer development and discuss the HERV …

Pressure, Motion, And Conformational Entropy In Molecular Recognition By Proteins, José A Caro, Kathleen G Valentine, Taylor R Cole, A Joshua Wand

Faculty and Staff Publications

The thermodynamics of molecular recognition by proteins is a central determinant of complex biochemistry. For over a half-century, detailed cryogenic structures have provided deep insight into the energetic contributions to ligand binding by proteins. More recently, a dynamical proxy based on NMR-relaxation methods has revealed an unexpected richness in the contributions of conformational entropy to the thermodynamics of ligand binding. Here, we report the pressure dependence of fast internal motion within the ribonuclease barnase and its complex with the protein barstar. In what we believe is a first example, we find that protein dynamics are conserved along the pressure-binding thermodynamic …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Ada Code Of Ethics (March 2023), American Dental Association

Code of Ethics

The ADA Code of Ethics has three main components: The Principles of Ethics, the Code of Professional Conduct and the Advisory Opinions. Contents may also include: Amendment to ADA Principles of Ethics and Code of Professional Conduct and Insert for the ADA Principles of Ethics and Code of Professional Conduct. The most current issue is available on the ADA’s website.

Ethics And Epidemiology Workshop Report: Towards Ethics-Informed Epidemiology And Epidemiology-Informed Ethics, Zoe Ritchie, Brendan T. Smith Phd, Maxwell J. Smith Phd

Health Studies Publications

Two key groups of researchers have worked in parallel to advance health equity—one on the descriptive component (those in public health sciences, e.g., epidemiologists) and one on the normative component (those in the humanities and social sciences, e.g., philosophers and ethicists). Yet a significant gulf exists between their respective research. Consequently, advances in thinking regarding the philosophical underpinnings and normative requirements of health equity have been largely divorced from the design of public health interventions that seek to reduce health inequities. As a consequence, public health interventions aiming to advance health equity may fail to target the most appropriate populations …

Sfd Indications And Technique: When And How To Use Sdf To Manage Caries Lesions, Margherita Fontana Dds, Phd

The Journal of the Michigan Dental Association

The aim of this article is to review indications for 38% SDF and the appropriate technique for use. Evidence-based recommendations by the American Dental Association and umbrella reviews of systematic reviews are summarized to provide indications for SDF use in primary and permanent teeth, including sound surfaces and those with non-cavitated and cavitated caries lesions. High-quality evidence supports that SDF is an effective treatment alternative for managing active cavitated coronal and root caries lesions and preventing root caries lesions. Dentists can help by incorporating SDF as an option into their caries prevention and management armamentarium and by helping to train …

Parents’ Decision-Making Regarding Whether To Receive Adult-Onset Only Genetic Findings For Their Children: Findings From The Babyseq Project, Stacey Pereira, Amanda M Gutierrez, Jill Oliver Robinson, Kurt D Christensen, Casie A Genetti, Carrie L Blout Zawatsky, Rebecca L Hsu, Bethany Zettler, Melissa Kurtz Uveges, Richard B Parad, Alan H Beggs, Ingrid A Holm, Robert C Green, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Most professional guidelines recommend against genetic screening for adult-onset only (AO) conditions until adulthood, yet others argue that there may be benefit to disclosing such results. We explored parents' decision-making on this issue in the BabySeq Project, a clinical trial of newborn genomic sequencing.

Methods: We conducted interviews with parents (N = 24) who were given the option to receive actionable AO results for their children. Interviews explored parents' motivations to receive and reasons to decline AO genetic disease risk information, their decision-making process, and their suggestions for supporting parents in making this decision.

Results: Parents noted several motivations …

Replication Competent Retrovirus Testing (Rcr) In The National Gene Vector Biorepository: No Evidence Of Rcr In 1,595 Post-Treatment Peripheral Blood Samples Obtained From 60 Clinical Trials, Kenneth Cornetta, Jing Yao, Kimberley House, Lisa Duffy, Prasad S Adusumilli, Rachel Beyer, Claire Booth, Malcolm Brenner, Kevin Curran, Bambi Grilley, Helen Heslop, Christian S Hinrichs, Rosandra N Kaplan, Hans-Peter Kiem, James Kochenderfer, Donald B Kohn, Sham Mailankody, Scott M Norberg, Roisin E O'Cearbhaill, Jennifer Pappas, Jae Park, Carlos Ramos, Antonio Ribas, Isabelle Rivière, Steven A Rosenberg, Craig Sauter, Nirali N Shah, Susan F Slovin, Adrian Thrasher, David A Williams, Tsai-Yu Lin

Center for Medical Ethics and Health Policy Staff Publications

The clinical impact of any therapy requires the product be safe and effective. Gammaretroviral vectors pose several unique risks, including inadvertent exposure to replication competent retrovirus (RCR) that can arise during vector manufacture. The US FDA has required patient monitoring for RCR, and the National Gene Vector Biorepository is an NIH resource that has assisted eligible investigators in meeting this requirement. To date, we have found no evidence of RCR in 338 pre-treatment and 1,595 post-treatment blood samples from 737 patients associated with 60 clinical trials. Most samples (75%) were obtained within 1 year of treatment, and samples as far …

The Legal Limits Of Parental Autonomy: Do Parents Have The Right To Refuse Intramuscular Vitamin K For Their Newborn?, Shannon M. Isennock

HCA Healthcare Journal of Medicine

The American Academy of Pediatrics recommends that all newborns receive an intramuscular (IM) dose of vitamin K within 6 hours of delivery for the prevention of vitamin K deficiency bleeding (VKDB). There has been an increase in the number of parents who have refused the IM vitamin K dose for their infant based on its possible link to leukemia, preservatives that may lead to adverse reactions, and wanting to avoid pain for the infant. When newborns do not receive IM vitamin K, the most serious feared potential complication is intracranial hemorrhage with potential neurologic sequela including seizures, developmental delay, and …

Detection And Characterization Of Constitutive Replication Origins Defined By Dna Polymerase Epsilon, Roman Jaksik, David A Wheeler, Marek Kimmel

Center for Medical Ethics and Health Policy Staff Publications

Background: Despite the process of DNA replication being mechanistically highly conserved, the location of origins of replication (ORI) may vary from one tissue to the next, or between rounds of replication in eukaryotes, suggesting flexibility in the choice of locations to initiate replication. Lists of human ORI therefore vary widely in number and location, and there are currently no methods available to compare them. Here, we propose a method of detection of ORI based on somatic mutation patterns generated by the mutator phenotype of damaged DNA polymerase epsilon (POLE).

Results: We report the genome-wide localization of constitutive ORI in POLE-mutated …

Characteristics Analysis And Inspiration Of The Us Brain Initiative, Mian Zu, Ying Wang, Wei Liu, Zexi Xin, Lei Wang

Bulletin of Chinese Academy of Sciences (Chinese Version)

Major countries have launched brain initiatives for competition, aiming to gain strategic priority in the area of brain ultimate frontier for human being in the course of recognizing nature. The US BRAIN Initiative is a scientific project comparable to the Human Genome Project in scale and potential impact. Accelerating the development and application of new technologies and tools is the driving force for the US BRAIN Initiative, which takes the lead in race owing to its realistic and innovative development mode. This study briefly reviews the implementation progress, the strategic reports and research achievements of the US BRAIN Initiative, and …

Repurposing Atovaquone As A Therapeutic Against Acute Myeloid Leukemia (Aml): Combination With Conventional Chemotherapy Is Feasible And Well Tolerated, Alexandra Mclean Stevens, Eric S Schafer, Minhua Li, Maci Terrell, Raushan Rashid, Hana Paek, Melanie B Bernhardt, Allison Weisnicht, Wesley T Smith, Noah J Keogh, Michelle C Alozie, Hailey H Oviedo, Alan K Gonzalez, Tamilini Ilangovan, Alicia Mangubat-Medina, Haopei Wang, Eunji Jo, Cara A Rabik, Claire Bocchini, Susan Hilsenbeck, Zachary T Ball, Todd M Cooper, Michele S Redell

Center for Medical Ethics and Health Policy Staff Publications

Survival of pediatric AML remains poor despite maximized myelosuppressive therapy. The pneumocystis jiroveci pneumonia (PJP)-treating medication atovaquone (AQ) suppresses oxidative phosphorylation (OXPHOS) and reduces AML burden in patient-derived xenograft (PDX) mouse models, making it an ideal concomitant AML therapy. Poor palatability and limited product formulations have historically limited routine use of AQ in pediatric AML patients. Patients with de novo AML were enrolled at two hospitals. Daily AQ at established PJP dosing was combined with standard AML therapy, based on the Medical Research Council backbone. AQ compliance, adverse events (AEs), ease of administration score (scale: 1 (very difficult)-5 (very easy)) …

A Phase Ii Window Of Opportunity Study Of Neoadjuvant Pd-L1 Versus Pd-L1 Plus Ctla-4 Blockade For Patients With Malignant Pleural Mesothelioma, Hyun-Sung Lee, Hee-Jin Jang, Maheshwari Ramineni, Daniel Y Wang, Daniela Ramos, Jong Min Choi, Taylor Splawn, Monica Espinoza, Michelle Almarez, Leandria Hosey, Eunji Jo, Susan Hilsenbeck, Christopher I Amos, R Taylor Ripley, Bryan M Burt

Center for Medical Ethics and Health Policy Staff Publications

Purpose: We report the results of a phase II, randomized, window-of-opportunity trial of neoadjuvant durvalumab versus durvalumab plus tremelimumab followed by surgery in patients with resectable malignant pleural mesothelioma (MPM; NCT02592551).

Patients and methods: The primary objective was alteration of the intratumoral CD8/regulatory T cell (Treg) ratio after combination immune checkpoint blockade (ICB) therapy. Secondary and exploratory objectives included other changes in the tumor microenvironment, survival, safety, tumor pathologic response (PR), and systemic immune responses.

Results: Nine patients received monotherapy and 11 received combination therapy. Seventeen of the 20 patients (85%) receiving ICB underwent planned thoracotomy. Both ICB regimens …

Effect Of Hiv And Antiretroviral Therapy Use On Body Weight Changes In A Cohort Of Us Veterans Living With And Without Hiv, Jose M Garcia, Yongquan Dong, Peter Richardson, Jennifer R Kramer, Christine M Hartman, Kathryn Royse, Donna L White, Elizabeth Y Chiao

Center for Medical Ethics and Health Policy Staff Publications

Objective: People living with HIV have high rates of obesity and obesity-related comorbidities. Our study sought to evaluate weight trajectory in a retrospective cohort of people living with HIV and matched HIV-negative veterans (controls) and to evaluate risk factors for weight gain.

Methods: This was a retrospective database analysis of data extracted from the VA Corporate Data Warehouse that included people living with HIV (n = 22 421) and age-matched HIV-negative controls (n = 63 072). The main outcomes were baseline body weight and weight change from baseline at 1, 2, and 5 years after diagnosis (baseline visit for controls). …

Effortful Control Moderates The Relation Between Negative Emotionality And Child Anxiety And Depressive Symptom Severity In Children With Anxiety Disorders, Elizabeth M Raines, Andres G Viana, Erika S Trent, Haley E Conroy, Karina Silva, Michael J Zvolensky, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

The present study investigated the interactive effect of reactive (negative emotionality) and regulatory (effortful control) aspects of temperament in the prediction of child anxiety and depressive symptoms. Clinically anxious children and their mothers completed a battery of questionnaires that included self- and mother-ratings of child effortful control, negative emotionality, anxiety, and depressive symptoms. Multiple regression analyses were conducted to examine the moderating effect of effortful control on the relation between negative emotionality and child anxiety and depressive symptom severity. The interaction between negative emotionality and effortful control was statistically significant and simple slopes revealed that as effortful control increased, the …

Genetic Enhancement Of The Inevitable, Varun Kota

Mako: NSU Undergraduate Student Journal

The invention of CRISPR-CAS9 allows one to edit the genome easily. As a result, many are excited by the potential breakthroughs in medical applications. Others worry that the development of this technology will lead to genetic enhancement, the modification of a set of genes toward a non-therapeutic end goal. After reviewing the philosophical and ethical literature regarding genetic enhancement it became apparent that there was a lack of specificity. Often, the arguments portrayed genetic enhancement as an unbelievable process. In reality, the effects of genetic enhancement are far tamer. The folly in these discussions lies in the notion that traits …

Indiana Law Fertility Fraud Expert Participates In Washington, Dc Roundtable, James Owsley Boyd

Keep Up With the Latest News from the Law School (blog)

Professor Jody Madeira, an internationally recognized expert in fertility fraud, bioethics, and law and medicine, participated this morning (January 26) in a bipartisan roundtable discussion with victims of fertility fraud. The event was facilitated by U.S. Representatives Stephanie Bice (R-OK), Mikie Sherrill (D-NJ), Julia Letlow (R-LA), and Chrissy Houlahan (D-PA) following the January 23 introduction of their Protecting Families From Fertility Fraud Act, which would—for the first time—make it a federal crime to knowingly misrepresent the source of DNA used in any procedure that involves assisted reproduction.

Mommy, Me, And We: Why Black Mothers Have Turned To Doulas, Janessa Harris

Crossings: Swarthmore Undergraduate Feminist Research Journal

Maternal mortality rates have disproportionately affected black mothers for far too long due to the lack of value that black bodies hold in medical spaces. Because of this concerns voiced by black people are often disregarded and ignored until the very last minute. But what if this was changed? This paper will focus on how black mothers have worked against Western medical systems that silence our voices, but instead turn to doulas who work to make these mothers feel seen, heard, and cared for. Through this, we make birthing a careful and collective effort to turn Mommy&Me to Mommy&We.

Masculinized Sovereignty: Understanding Violence Towards Mice And The Nonhuman, Anisha Prakash

Crossings: Swarthmore Undergraduate Feminist Research Journal

This paper attempts to analyze how the definition of the normative “human” categorizes bodies that represent alternative political order against settler colonialism, and how the subjects that go against the dominant ideal of human are prohibited from living a free life, if not altogether eliminated. While conducting research, I view the lab as a site of social advancement where the differences between humans and nonhumans create a community of shared purpose. An interrogation of the laboratory as a site of violence can help us better understand how the State’s capitalist modes of advancement and production harm those of indigenous people, …

Ada Constitution & Bylaws (2023), American Dental Association

Constitution & Bylaws

The ADA Commons Constitution & Bylaws archival collection comprises printed issues of the American Dental Association's Constitution and Bylaws. The collection also includes the ADA Charter and the ADA Code of Ethics issued 1924-1946.

Heightened Technology In The Care Of Type 1 Diabetes: An Ethical Symbiosis?, Susanna Larsen

OUR Journal: ODU Undergraduate Research Journal

This paper explores the common negative consequences and ethical issues associated with the evolving medical technology used in the care of Type 1 diabetes. In this paper, I will discuss the ethical impacts of technology on diabetic youth: their view of self, their mechanical requirements, and their health priorities. In order to define the scope of the issues, I will use the following intellectual tools: feminist theory, care ethics, and philosophical discussions of control. This paper will also outline some possible solutions to these ethical issues.

Covid Remains 2023, Sheila P. Davis

Journal of Health Ethics

Editor's introduction to Vol. 19, Issue 1 of the Journal of Health Ethics

Colour-Blind Racial Attitudes In Entry-Level Dental Hygiene Students In Virginia, Emily Ludwig, Jessica Suedbeck

Dental Hygiene Faculty Publications

Objective: Subscribing to colour-blind racial attitudes may contribute to inequities in the delivery of oral care and affect treatment of diverse patients. The purpose of this study was to survey all entry-level dental hygiene students in one state to determine colour-blind racial attitudes.

Methods: After IRB approval, a convenience sample of 219 dental hygiene students in all entry-level programmes in Virginia were invited to participate in this cross-sectional study. The Colour-Blind Racial Attitudes Scale (CoBRAS), an effective, validated measuring instrument, was used to quantify unawareness of contemporary racist ideals. Three subscales (Racial Privilege, Institutional Discrimination and Blatant Racial Issues) were …

Redefining Paternalistic Practices In Women’S Health: How Dysfunctional Trust Relationships Impact Medical Autonomy Of Female Patients In The Contemporary Clinical Setting, Lauren K. O'Dell

Theses and Dissertations--Philosophy

Utilizing Trudy Govier’s (1997) conception of social trust, this dissertation will provide a framework for understanding trust in healthcare relationships and highlight some of the ways that unequal power distribution and dependency, poorly defined roles, and institutions complicate trust between women and their providers. This framework will also explain how distrust, especially prejudicial distrust, leads to paternalistic attitudes on the part of providers. Paternalism limits patient autonomy because medical autonomy is constitutively relational. This means that insofar as distrust causes paternalism, it also damages autonomy. Through negative outcomes, this lack of autonomy can cause patients to distrust healthcare, which can …

Sacred Children, Taboo Tradeoffs, And Distorted Discourses, Sean Hannon Williams

University of Michigan Journal of Law Reform

This Article brings together three literatures—bioethics, psychological research on taboo tradeoffs, and family law—to reveal pervasive distortions in current family law scholarship and judicial reasoning. Empirical work in bioethics shows that child welfare occupies a unique moral sphere. People routinely resist making tradeoffs between spheres. Just as sacrificing adult lives for money is taboo, so too is sacrificing child welfare for adult welfare. When faced with the prospect of these tradeoffs, people engage in a predictable set of avoidance and moral mitigation strategies. Across five case studies, this Article shows how child welfare has talismanic qualities which, even in the …

Health Care Equity Through Intelligent Edge Computing And Augmented Reality/Virtual Reality: A Systematic Review, Vishal Lakshminarayanan, Aswathy Ravikumar, Harini Sriraman, Sujatha Alla, Vijay Kumar Chattu

Engineering Management & Systems Engineering Faculty Publications

Intellectual capital is a scarce resource in the healthcare industry. Making the most of this resource is the first step toward achieving a completely intelligent healthcare system. However, most existing centralized and deep learning-based systems are unable to adapt to the growing volume of global health records and face application issues. To balance the scarcity of healthcare resources, the emerging trend of IoMT (Internet of Medical Things) and edge computing will be very practical and cost-effective. A full examination of the transformational role of intelligent edge computing in the IoMT era to attain health care equity is offered in this …