Project description:BackgroundHealthcare professionals (HCPs), patients and families are often faced with ethical dilemmas. The role of healthcare ethics committees (HECs) is to offer support in these situations.AimThe primary objective was to study how often HCPs encounter ethical dilemmas. The secondary objective was to identify the main types of ethical dilemmas encountered and how HCPs solve them.Subjects and methodsWe conducted a cross-sectional, survey-based study among HCPs in 14 Slovenian hospitals. A questionnaire was designed and validated by HCPs who were selected by proportional stratified sampling. Data collection took place between April 2015 and April 2016.ResultsThe final sample size was n = 485 (385 or 79.4%, female). The response rates for HCPs working in secondary and tertiary level institutions were 45% and 51%, respectively. Three hundred and forty (70.4%) of 485 HCPs (very) frequently encountered ethical dilemmas. Frequent ethical dilemmas were waiting periods for diagnostics or treatment, suboptimal working conditions due to poor interpersonal relations on the ward, preserving patients' dignity, and relations between HCPs and patients. Physicians and nurses working in secondary level institutions, compared to their colleagues working in tertiary level institutions, more frequently encountered ethical dilemmas with respect to preserving patients' dignity, protecting patients' information, and relations between HCPs and patients. In terms of solutions, all HCPs most frequently discussed ethical dilemmas with co-workers (colleagues), and with the head of the department. According to HCPs, the most important role of HECs is staff education, followed by improving communication, and reviewing difficult ethical cases.ConclusionsWaiting periods for diagnostics and treatment and suboptimal working conditions due to poor interpersonal relations are considered to be among the most important ethical issues by HCPs in Slovenian hospitals. The most important role of HECs is staff education, improving communication, and reviewing difficult ethical cases.
Project description:Lessons learned from the rapid deployment of vaccines during the COVID-19 pandemic are reinvigorating the cancer vaccine field. Using delivery platforms including mRNA and synthetic long peptides, recent clinical trials have demonstrated that cancer vaccines are safe, feasible, and can be associated with the generation of antigen-specific memory T cells and, in some cases, durable clinical responses. Despite these advances, fundamental questions remain regarding the optimal delivery platforms and antigen targets to use in cancer vaccines. Ongoing and future studies that harness advances in the identification of novel sources of antigens, the prediction of immunogenic antigens, and the use of single-cell technologies to profile antigen-specific T cells will hopefully reveal correlates with clinical outcomes and provide a mechanistic basis for future progress.
Project description:Amyotrophic lateral sclerosis (ALS) is an extremely heterogeneous disease of motor neurons that eventually leads to death. Despite impressive advances in understanding the genetic, molecular, and pathological mechanisms of the disease, the only drug approved to date by both the FDA and EMA is riluzole, with a modest effect on survival. In this opinion view paper, we will discuss how to address some challenges for drug development in ALS at the conceptual, technological, and methodological levels. In addition, socioeconomic and ethical issues related to the legitimate need of patients to benefit quickly from new treatments will also be addressed. In conclusion, this brief review takes a more optimistic view, given the recent approval of two new drugs in some countries and the development of targeted gene therapies.
Project description:Centuries' worth of cultural stories suggest that self-sacrifice may be a cornerstone of our moral concepts, yet this notion is largely absent from recent theories in moral psychology. For instance, in the footbridge version of the well-known trolley car problem the only way to save five people from a runaway trolley is to push a single man on the tracks. It is explicitly specified that the bystander cannot sacrifice himself because his weight is insufficient to stop the trolley. But imagine if this were not the case. Would people rather sacrifice themselves than push another? In Study 1, we find that people approve of self-sacrifice more than directly harming another person to achieve the same outcome. In Studies 2 and 3, we demonstrate that the effect is not broadly about sensitivity to self-cost, instead there is something unique about sacrificing the self. Important theoretical implications about agent-relativity and the role of causality in moral judgments are discussed.
Project description:Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide and is associated with high mortality. The main reasons for treatment failure are a low rate of early diagnosis, high relapse rates, and distant metastasis with poor outcomes. These are largely due to a lack of diagnostic, prognostic, and predictive biomarkers in HNSCC. DNA methylation has been demonstrated to play an important role in the pathogenesis of HNSCC, and recent studies have also valued DNA methylation as a potential biomarker in HNSCC. This review summarizes the current knowledge on DNA methylation profiles in HPV-positive and HPV-negative HNSCC and how these may contribute to the pathogenesis of HNSCC. It also summarizes the potential value of DNA methylation as a biomarker in the diagnosis, prognosis, and prediction of the response to therapy. With the recent immunotherapy era in head and neck treatment, new strategies to improve immune responses by modulating TIMEs have been intensely investigated in early-phase trials. Therefore, this study additionally summarizes the role of DNA methylation in the regulation of TIMEs and potential predictive immunotherapy response biomarkers. Finally, this study reviews ongoing clinical trials using DNA methylation inhibitors in HNSCC.