Bioethics and Medical Ethics Commons^™

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)) …

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 …

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 …

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 …

The Ethical Dilemma Of Whether Or Not To Withhold Life Sustaining Treatments For Newborns, Chloe G. Payne

OUR Journal: ODU Undergraduate Research Journal

Deeply complex ethical questions can arise when deciding whether to continue or stop life-sustaining treatments for critically ill newborns. Various factors that can influence these decisions are explored, such as the expected quality of life for the newborn, the resources that the family and hospital have at their disposal, and the role of religious beliefs. Emphasis is placed on the importance of striking a balance between the child's best interest, the autonomy of the parents, and the medical facts. The potential psychological and physical consequences for parents who decide to stop treatment, which often results in the loss of their …

Confidentiality Over Privacy, Stacey A. Tovino

Faculty Articles

No abstract provided.

The Ethical Basis For Student-To-Student Training In Dentistry, Larry E. Jenson Dds, Ma, Joel M. White Dds, Ms

Journal of the American College of Dentists

This article will focus on the most ethically contentious student-to student training practice: local anesthesia administration. We will examine the factors that contribute to a broader understanding of the ethical issues involved and introduce a framework that will help to clarify these issues. We have identified six stakeholders in this issue: the student-as-patient, the student-as-student, the university, the faculty, the general public and the profession.

Redlining And Opioid Overdose Outcomes: Do Historical Housing Policies Still Impact Health Today?, Sahana Paravantavida

Honors Theses

This study examines the relationship between historical housing policies and current health outcomes, specifically the impact of redlining on opioid overdose rates. Using data collected from the state of New Jersey, neighborhoods with a history of redlining have higher rates of opioid overdose deaths. My findings suggest that historical housing policies, which systematically excluded certain populations from accessing affordable housing and resources, continue to impact health outcomes today.

Privacy For Student-Patients: A Call To Action, Stacey A. Tovino

Faculty Articles

Consider a law student who has a mental or reproductive health issue that the student wishes to keep private. If the student seeks care at an off-campus health clinic that is not affiliated with the student’s law school or university, the student typically has a number of federally enforceable privacy rights. For example, the federal HIPAA Privacy Rule will typically apply and prohibit the clinic from disclosing the student’s protected health information to professors, parents, and other third parties without the student’s prior written authorization. The law student also will have the right to receive a notice of privacy practices, …

Enhancing Education To Mitigate Workplace Violence To Increase Staff Safety In A High Acuity Setting: A Quality Improvement Project, Michelle Crowley

Master's Theses and Capstones

Background: The current microsystem is a critical access 8 bed Emergency Department with 3 hallway beds. On average it can see anywhere from 30-50 patients in a 24 hour period. Due to the nature of the microsystem, staff are at high risk for experiencing workplace violence (WPV). Within this microsystem staff do not have a readily available communication device on their person in case of an adverse event leaving them susceptible to patient to staff WPV. Staff within this microsystem are Management of Aggressive Behavior (MOAB) 1 and 2 trained, however this does not provide education on risk factors for …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

Dementia And The Fragility Of Self: Navigating Ethical Considerations In Medical Decision-Making, Grace Sauers

Scripps Senior Theses

As the global population ages, the incidence of degenerative memory disorders such as Alzheimer's and dementia is expected to rise. The frequency of complex medical decision-making challenges for these patients will subsequently increase. It is now common practice for patients to provide advance directives outlining the care they wish to receive; in the case they are deemed incompetent to perform adequate decision making. However, patients with dementia occasionally express wishes contrary to those stated in their advance directives. This divergence creates ambiguity about which wishes should be honored and for who those wishes are being honored for. I aim to …

Defining And Exploring Animal Sentience, Andrew N. Rowan, Joyce M. D'Silva Mrs, Ian J.H. Duncan, Nicholas Palmer

Animal Sentience

One of the commentaries on the target article notes that "animal sentience" is difficult to define operationally. This response to the commentaries develops a working, usable definition of animal sentience and examines the relationships between animal emotions and sentience.

Snail With The Right Heart (2021) By Maria Popova, Maughn Rollins Gregory

Picture Books

When a London scientist found a garden snail whose shell that spiraled left to right—opposite from others of its species—he sent it to the University of Nottingham for study. The snail’s internal organs were also arranged on the opposite side from other snails, including a heart on the right side of its body—a one-in-a-million condition known as situs inversus, which also occurs in humans. In explaining the snail’s story in terms of genetic evolution and biological reproduction, The Snail with the Right Heart also raises philosophical questions about the role of genetics, education, and personal choice in determining who …

Fresh Takes On Five Health Data Sharing Domains: Quality, Privacy, Equity, Incentives, And Sustainability, Christi J Guerrini, Mary A Majumder, Jill O Robinson, Robert Cook-Deegan, Matthew Blank, Juli Bollinger, Janis Geary, Amanda M Gutierrez, Maya Shrikant, Amy L Mcguire

Faculty, Staff and Students Publications

As entities around the world invest in repositories and other infrastructure to facilitate health data sharing, scalable solutions to data sharing challenges are needed. We conducted semi-structured interviews with 24 experts to explore views on potential issues and policy options related to health data sharing. In this Perspective, we describe and contextualize unconventional insights shared by our interviewees relevant to issues in five domains: data quality, privacy, equity, incentives, and sustainability. These insights question a focus on granular quality metrics for gatekeeping; challenge enthusiasm for maximalist risk disclosure practices; call attention to power dynamics that potentially compromise the patient's voice; …

Policy Options To Facilitate Cancer Genomic Variant Data Sharing: Outcomes Of A Modified Policy Delphi, Jill O Robinson, Amira Daoud, Janis Geary, Vasiliki Rahimzadeh, Juli Bollinger, Christi J Guerrini, Robert Cook-Deegan, Amy L Mcguire, Mary A Majumder

Center for Medical Ethics and Health Policy Staff Publications

Sharing cancer gene variant and relevant clinical data could accelerate progress in cancer genomics. However, data sharing is currently impeded by issues related to financial sustainability, equity, incentives, privacy and security, and data quality. Evidence-based policy options to facilitate data sharing in these domains, and ultimately improve interpretation of cancer-associated genomic variants, are therefore needed. We conducted a modified policy Delphi with expert stakeholders that involved generating, evaluating, and ranking potential policy options to address these issues, with a focus on the US context. We found policy options in the financial sustainability domain were highly ranked, particularly stable funding for …

Figg At 5: An Update On Us Public Perspectives On Forensic Investigative Genetic Genealogy Five Years After Its Introduction To Criminal Investigations, Sophie L Schott, April Adams, Ryan J Dougherty, Taylor Montgomery, Folasade C Lapite, Faith E Fletcher

Center for Medical Ethics and Health Policy Staff Publications

Nearly 50 years after Roe versus Wade, the United States Supreme Court's decision in Dobbs versus Jackson Women's Health Organization unraveled the constitutional right to abortion, allowing individual states to severely restrict or ban the procedure. In response, leading medical, public health, and community organizations have renewed calls for research to elucidate and address the burgeoning social and medical consequences of new abortion restrictions. Abortion research not only includes studies that establish the safety, quality, and efficacy of evidence-based abortion care protocols, but also encompasses studies on the availability of abortion care, the consequences of being denied an abortion, and …