Suchergebnisse

The mechanical interlocking of molecular components can lead to the appearance of novel and unconventional properties and processes, with potential relevance for applications in nanoscience, sensing, catalysis, and materials science. We describe a [3]rotaxane in which the number of recognition sites available on the axle component can be changed by acid-base inputs, encompassing cases in which this number is larger, equal to, or smaller than the number of interlocked macrocycles. These species exhibit very different properties and give rise to a unique network of acid-base reactions that leads to a fine p K a tuning of chemically equivalent acidic sites. The rotaxane where only one station is available for two rings exhibits a rich coconformational dynamics, unveiled by an integrated experimental and computational approach. In this compound, the two crown ethers compete for the sole recognition site, but can also come together to share it, driven by the need to minimize free energy without evident inter-ring interactions. ; This work was supported by the European Union's H2020 Research and Innovation Program (ERC Advanced Grant n.692981), the Italian Ministry of University and Research (FARE R16S9XXKX3 and PRIN 20173L7W8K), and FAR2019 Uninsubria, and L.C. and E.F. acknowledge the King Abdullah University of Science and Technology (KAUST) and the KAUST Supercomputing Laboratory (KSL) for support and for providing computational resources on the Shaheen II HPC system (project K1438).

"Virtually all Western societies embrace liberalism as a political and moral; it emphasizes individual rights and liberty, democracy, autonomy, limited government, consent, pluralism, and tolerance. Clinical ethics in these societies reflects those priorities. Human migration has made Western societies more diverse and expanded the plurality of values represented within them. As a consequence, clinical ethics consultants (CEC) have encountered cases which reflect a clash between the liberal values of contemporary medical ethics and non-liberal values of patients. Because CECs are steeped in liberalism, their default attitude toward the values outside of that tradition will be tolerance. This paper will argue that because tolerance implicitly contains a judgment of inferiority to other values, it is the wrong attitude for CECs to adopt towards parties whose fundamental values clash with medical ethics. In such cases, this attitude can disrespect to the holders of the values, endorse a consequentialist compromise of values, and leave medical professionals prone to moral distress. Agonism democracy is a political philosophy that accepts that values conflicts are inevitable, and there will be winners and losers from them. It aims to channel this conflict positively by promoting a process marked by openness to questioning fundamental values and genuine consideration of (even contrary) alternate values. As an alternative to tolerance, this paper will explore if cultivating an attitude of agonism can be a better disposition for CECs in such cases. It will use a case study to compare the results of the two approaches in cases of fundamental values clash. "

"In the aftermath of the 2014 Ebola outbreak, media coverage was scrutinized for sensationalism, weakness in explaining scientific uncertainty, dehumanization of patients, and lack of contextualization. The current COVID-19 crisis presents an opportunity to assess whether the media learned its lesson. Results are mixed. Early reporting on the origin of COVID-19 in "wet markets" indicates that the media continues to do poorly with contextualization. On the other hand, stories on mortality and the infectiousness of COVID-19 indicate there has been improvement. The situation remains fluid as COVID-19 threatens to transform into a pandemic at the time of submission. Data from new countries may alter the reported rates of lethality and infectiousness, and media reporting on these changes may or may not be responsible. The explosion of social media, as a medium to promote reporting, could provide bioethicists a tool to direct the public to reliable stories and criticize inaccurate ones. Using a bioethics perspective, this poster will critically evaluate the quality of U.S. and Italian news media's reporting on the evolving scientific understanding of COVID-19 and its contextualization. The presentation will employ QR technology to provide links to media coverage of COVID-19 from the U.S. and Italian news media. After critically appraising the quality of COVID-19 reporting, this poster will consider if bioethicists: 1) should provide comment to the media on pandemics; 2) should correct reporting for the public and 3) have a duty to publicly criticize sensationalism in the media. "

"Informed consent (IC) in older adults (≥ 70 years of age) is often complex. This holds even truer in the setting of organ transplantation (OTx), requiring patients to be informed of the risks and benefits associated with multiple options: whether or not to pursue a transplant, to opt for a living – where appropriate – or deceased donor, to consider a variety of choices concerning the potential for poorer organ quality or increased risk of disease transmission and others. IC overlaps with shared decision-making (SDM) in the presence of high-risk procedures, with low levels of certainty, and when two or more treatment alternatives exist. Patient decision aids (PDAs) (i.e. paper-based/electronic evidence-based tools) have been developed to complement and enhance SDM in clinical practice. Studies have proven PDAs to be an effective means to improve transplant knowledge, to foster patient participation, and to diminish decisional conflict across different settings in OTx. However, research is lacking on the effectiveness and appropriateness of these tools in older adults, which are increasingly entitled to receive OTx. The objective of our work is 1) to present the challenges posed by the use of PDAs in this group of patients and 2) to identify gaps so as to inform the agenda for research on this emergent issue. Our findings suggest that future studies should aim to the development, implementation and evaluation of PDAs for the oldest, more vulnerable segments of this specific patient population. "

"The Ethics Consultant (EC), where present, is called on to offer a resolution to ethical dilemmas at different times over the course of treatment. However, it is not yet clear under which particular circumstances the intervention of the EC should be requested when chronic diseases occur following an acute event. As part of the treatment of these evolutionary chronic conditions, the pathway is often complex and may involve multiple actors (i.e. departments, hospitals, and others). The role of the EC is often limited to a single department and to an isolated event. Therefore, there is frequently no possibility to take into consideration all of the options inherent to the entire continuum of care and of their consequences for the patient. From intensive care units, rehabilitation wards, long-term hospitalization, through to palliative care, the pathway presents important ethical-clinical questions for the patient, for the healthcare team, and for family members. For these reasons, our objective is to develop a model of consultation integrating the EC along the continuum of care. By analyzing a series of cases, we developed an integrated model of consultation allowing the EC to intervene at different subsequent stages of the process. Our findings suggest that this model is an effective means to allow the EC to provide support in relation to single events but also to coherently pursue – within a collaborative setting across different departments – a specific course of treatment which is respectful of clinical indications and of patients' and caregivers' preferences along the whole pathway. "