bluuebunny/crossref_metadata_2025 huggingface dataset:
MIL‐101‐SO3H: A Highly Efficient Brønsted Acid Catalyst for Heterogeneous Alcoholysis of Epoxides under Ambient Conditions
Authors: Zhou Yu‐Xiao , Chen Yu‐Zhen , Hu Yingli , Huang Gang , Yu Shu‐Hong , Jiang Hai‐Long
Published: October 2014

For the first time, a ∼100 % sulfonic acid functionalized metal–organic framework (MOF), MIL‐101‐SO3H, with giant pores has been prepared by a hydrothermal process followed by a facile postsynthetic HCl treatment strategy. The replete readily accessible Lewis acidic and especially Brønsted acidic sites distributed throughout the framework as well as high stability endow the resultant MOF exceptionally high efficiency and recyclability, which surpass all other MOF‐based catalysts, for the ring opening of epoxides with alcohols (especially, methanol) as nucleophiles under ambient conditions.
Variationen zum Thema Graphen
Authors: Groß Michael
Published: October 2014

Die mit dem Physik‐Nobelpreis 2010 ausgezeichnete Entdeckung des Graphens, einer stabilen Einzelschicht aus Kohlenstoffatomen mit der Wabenstruktur des Graphits, führte zu einer Flut von Versuchen, ähnliche Materialien auch aus anderen Elementen herzustellen. Interessant und ästhetisch reizvoll ist zum Beispiel eine stickstoffhaltige Analogverbindung, die aus Triazin‐Bausteinen zusammengesetzt ist.
Structure–Activity Relationship Study of Spider Polyamine Toxins as Inhibitors of Ionotropic Glutamate Receptors
Authors: Xiong Xiao‐Feng , Poulsen Mette H. , Hussein Rama A. , Nørager Niels G. , Strømgaard Kristian
Published: October 2014

The spider polyamine toxins Joro spider toxin‐3 (JSTX‐3) and Nephila polyamine toxins‐1 and ‐8 (NPTX‐1 and NPTX‐8) are isolated from the venom of the orb‐weaver spider Nephila clavata (Joro spider). They share a high degree of structural resemblance, their aromatic head groups being the only difference, and were recently found to be very potent open‐channel blockers of ionotropic glutamate (iGlu) receptors. In this study we designed and synthesized a collection of 24 analogues of these toxins using a recently developed solid‐phase synthetic methodology. Systematic variation in two regions of the toxins and subsequent evaluation of biological activity at AMPA and NMDA subtypes of iGlu receptors provided succinct information on structure–activity relationships. In particular, one set of analogues were found to display exquisite selectivity and potency for AMPA receptors relative to the natural products. Thus, this systematic SAR study has provided new pharmacological tools for studies of iGlu receptors.
Robust ℋ∞ tracking control for uncertain Markovian jumping systems with interval time‐varying delay
Authors: Xia Jianwei , Park Ju H. , Zhang Baoyong , Shen Hao
Published: October 2014

In this article, the problem of robust
tracking control for a class of uncertain Markovian jump systems with interval time‐varying delay is investigated. Based on an augmented Lyapunov–Krasovskii functional with triple integral term, partitioning the delay's lower bound and reciprocally convex approach, delay‐dependent conditions for the existence of desired controller are achieved. Meanwhile, stability criteria for delayed Markovian jump systems are also provided with less conservativeness and less matrix variables than some recent results. Finally, two simulation examples are given to illustrate the effectiveness of the proposed design method. © 2014 Wiley Periodicals, Inc. Complexity 21: 355–366, 2015
Cube‐like α‐Fe2O3 Supported on Ordered Multimodal Porous Carbon as High Performance Electrode Material for Supercapacitors
Authors: Chaudhari Nitin K. , Chaudhari Sudeshna , Yu Jong‐Sung
Published: October 2014

Well‐dispersed cube‐like iron oxide (α‐Fe2O3) nanoparticles (NPs) supported on ordered multimodal porous carbon (OMPC) are synthesized for the first time by a facile and efficient glycine‐assisted hydrothermal route. The effect of OPMC support on growth and formation mechanism of the Fe2O3 NPs is discussed. OMPC as a supporting material plays a pivotal role of controlling the shape, size, and dispersion of the Fe2O3 NPs. As‐synthesized α‐Fe2O3/OMPC composites reveal significant improvement in the performance as electrode material for supercapacitors. Compared to the bare Fe2O3 and OMPC, the composite exhibits excellent cycling stability, rate capability, and enhanced specific capacitances of 294 F g−1 at 1.5 A g−1, which is twice that of OMPC (145 F g−1) and about four times higher than that of bare Fe2O3 (85 F g−1). The improved electrochemical performance of the composite can be attributed to the well‐defined structure, high conductivity, and hierarchical porosity of OMPC as well as the unique α‐Fe2O3 NPs with cube‐like morphology well‐anchored on the OMPC support, which makes the composite a promising candidate for supercapacitors.
UCGNet: wireless sensor network‐based active aquifer contamination monitoring and control system for underground coal gasification
Authors: Barnwal Rajesh P. , Bharti Sujeet , Misra Sudip , Obaidat Mohammad S.
Published: October 2014

Underground coal gasification (UCG) is a potentially effective methodology for mining underground coal. Further, there are various situations in which coal mining using conventional methods is formidable or costly, and, thus, UCG makes it feasible for recovering those coal resources from underground as alternative forms of energy. However, the environmental risk, particularly aquifer contamination, is a major bottleneck in adopting this technology by the industry. Concurrently, wireless sensor network (WSN) is a promising technology currently for use in various industrial process monitoring and control applications. The easy deployment, scalability, and low power consumption make WSN specially attractive. In this work, we propose a WSN‐based aquifer contamination monitoring and controlling system for the UCG plant. Copyright © 2014 John Wiley & Sons, Ltd.
A non‐repudiable negotiation protocol for security service level agreements
Authors: Kannisto J. , Takahashi T. , Harju J. , Heikkinen S. , Helenius M. , Matsuo S. , Silverajan B.
Published: October 2014

Security service level agreements (SSLAs) provide a systematic way for end users at home or in the office to guarantee sufficient security level when doing business or exchanging sensitive personal or organizational data with an online service. In this paper, we propose an SSLA negotiation protocol that implements non‐repudiation with cryptographic identities and digital signatures and includes features that make it resistant to denial of service attacks. The basic version of the protocol does not rely on the use of a trusted third party, and it can be used for all kinds of simple negotiations. For the negotiation about SSLAs, the protocol provides an option to use an external knowledge base that may help the user in the selection of suitable security measures. We have implemented a prototype of the system, which uses JSON Web Signature for the message exchange and made some performance tests with it. The results show that the computational effort required by the cryptographic operations of the negotiation protocol remains at a reasonable level. Copyright © 2014 John Wiley & Sons, Ltd.
The international society for developmental psychobiology Sackler symposium: Early adversity and the maturation of emotion circuits—A cross‐species analysis
Authors: Callaghan Bridget L. , Sullivan Regina M. , Howell Brittany , Tottenham Nim
Published: October 2014

Early‐life caregiving shapes the architecture and function of the developing brain. The fact that the infant‐caregiver relationship is critically important for infant functioning across all altricial species, and that the anatomical circuits supporting emotional functioning are highly preserved across different species, suggests that the results of studies examining the role of early adversity and emotional functioning should be translatable across species. Here we present findings from four different research laboratories, using three different species, which have converged on a similar finding: adversity accelerates the developmental trajectory of amygdala‐prefrontal cortex (PFC) development and modifies emotional behaviors. First, a rodent model of attachment learning associated with adversity is presented showing precocial disruption of attachment learning and emergence of heightened fear learning and emotionality. Second, a model of infant‐mother separation is presented in which early adversity is shown to accelerate the developmental emergence of adult‐like fear retention and extinction. Third, a model of early life adversity in Rhesus monkeys is presented in which a naturally occurring variation in maternal‐care (abuse) is shown to alter the functioning of emotion circuits. Finally, a human model of maternal deprivation is presented in which children born into orphanages and then adopted abroad exhibit aberrant development of emotion circuits. The convergence of these cross‐species studies on early life adversity suggests that adversity targets the amygdala and PFC and has immediate impact on infant behavior with the caregiver, and emotional reactions to the world. These results provide insight into mechanisms responsible for caregiver induced mental health trajectory alterations. © 2014 Wiley Periodicals, Inc. Dev Psychobiol 56: 1635–1650, 2014.
Identification of the growth hormone‐releasing hormone analogue [Pro1, Val14]‐hGHRH with an incomplete C‐term amidation in a confiscated product
Authors: Esposito Simone , Deventer Koen , Van Eenoo Peter
Published: October 2014

In this work, a modified version of the 44 amino acid human growth hormone‐releasing hormone (hGHRH(1‐44)) containing an N‐terminal proline extension, a valine residue in position 14, and a C‐terminus amidation (sequence: PYADAIFTNSYRKVVLGQLSARKLLQDIMSRQQGESNQERGARARL‐NH2) has been identified in a confiscated product by liquid chromatography‐high resolution mass spectrometry (LC‐HRMS). Investigation of the product suggests also an incomplete C‐term amidation.

Similarly to other hGHRH analogues, available in black markets, this peptide can potentially be used as performance‐enhancing drug due to its growth hormone releasing activity and therefore it should be considered as a prohibited substance in sport. Additionally, the presence of partially amidated molecule reveals the poor pharmaceutical quality of the preparation, an aspect which represents a big concern for public health as well. Copyright © 2014 John Wiley & Sons, Ltd.
Extensive variation in chromosome number and genome size in sexual and parthenogenetic species of the jumping‐bristletail genus Machilis (Archaeognatha)
Authors: Gassner Melitta , Dejaco Thomas , Schönswetter Peter , Marec František , Arthofer Wolfgang , Schlick‐Steiner Birgit C. , Steiner Florian M.
Published: October 2014

Parthenogenesis in animals is often associated with polyploidy and restriction to extreme habitats or recently deglaciated areas. It has been hypothesized that benefits conferred by asexual reproduction and polyploidy are essential for colonizing these habitats. However, while evolutionary routes to parthenogenesis are manifold, study systems including polyploids are scarce in arthropods. The jumping‐bristletail genus Machilis (Insecta: Archaeognatha) includes both sexual and parthenogenetic species, and recently, the occurrence of polyploidy has been postulated. Here, we applied flow cytometry, karyotyping, and mitochondrial DNA sequencing to three sexual and five putatively parthenogenetic Eastern‐Alpine Machilis species to investigate whether (1) parthenogenesis originated once or multiply and (2) whether parthenogenesis is strictly associated with polyploidy. The mitochondrial phylogeny revealed that parthenogenesis evolved at least five times independently among Eastern‐Alpine representatives of this genus. One parthenogenetic species was exclusively triploid, while a second consisted of both diploid and triploid populations. The three other parthenogenetic species and all sexual species were diploid. Our results thus indicate that polyploidy can co‐occur with parthenogenesis, but that it was not mandatory for the emergence of parthenogenesis in Machilis. Overall, we found a weak negative correlation of monoploid genome size (Cx) and chromosome base number (x), and this connection is stronger among parthenogenetic species alone. Likewise, monoploid genome size decreased with elevation, and we therefore hypothesize that genome downsizing could have been crucial for the persistence of alpine Machilis species. Finally, we discuss the evolutionary consequences of intraspecific chromosomal rearrangements and the presence of B chromosomes. In doing so, we highlight the potential of Alpine Machilis species for research on chromosomal and genome‐size alterations during speciation.
Steady‐state and transient voltage stability analysis of a weak distribution system with a remote doubly fed induction generator‐based wind farm
Authors: Kunwar Amit , Bansal Ramesh , Krause Olav
Published: October 2014

In modern, stressed distribution system, voltage stability is a major concern from planning and operation perspectives. Remote wind farm connected to a weak distribution system through a long line could adversely affect the voltage stability of the respective distribution network. This paper investigates the transient and steady‐state voltage issues of a distribution network with a distant doubly fed induction generator (DFIG)‐based wind farm. Results show that a distant DFIG‐based wind farm could improve the voltage stability of a distribution network with a large motor load in steady‐state operating condition as well as following disturbances, like three‐phase faults, sudden load tripping, and motor starting.
Odorant volatile sulfur compounds in cat urine: occurrence of (+/−)‐3,7‐dimethyloct‐3‐sulfanyl‐6‐en‐1‐ol and its cysteine conjugate precursor
Authors: Starkenmann Christian , Niclass Yvan , Cayeux Isabelle , Brauchli Robert , Gagnon Anne‐Claire
Published: October 2014

Cat urine from female, male, spayed female or neutered male cats was fermented with an undefined soil microflora broth to create a typical cat urine malodour. This fermented urine was extracted and analysed by a gas chromatograph–mass spectrometer coupled to an olfactory port. Sulfur compounds are the major contributors to cat urine odour, the key odorants being 4‐methyl‐4‐sulfanyl‐pentan‐2‐one, 3‐methyl‐3‐sulfanyl‐butan‐1‐ol and 3‐methyl‐3‐sulfanyl‐1‐butyl formate. Other compounds contributing to aged cat urine odour are mainly indole and para‐cresol. In addition to felinine, a cysteine‐S‐conjugate precursor of 3‐methyl‐3‐sulfanyl‐butan‐1‐ol, the occurrence of S‐(1‐hydroxy‐3,7‐dimethyl‐6‐octen‐3‐yl)cysteine (1.4 mg/L (±0.2) on average in male cats is described for the first time. Its concentration is proportional to that of felinine. Copyright © 2014 John Wiley & Sons, Ltd.
A higher‐order unsplit 2D direct Eulerian finite volume method for two‐material compressible flows based on the MOOD paradigms
Authors: Diot S. , François M. M. , Dendy E. D.
Published: October 2014

A higher‐order unsplit multi‐dimensional discretization of the diffuse interface model for two‐material compressible flows proposed by R. Saurel, F. Petitpas and R. A. Berry in 2009 is developed. The proposed higher‐order method is based on the concepts of the Multidimensional Optimal Order Detection (MOOD) method introduced in three recent papers for single‐material flows. The first‐order unsplit multi‐dimensional Finite Volume discretization presented by SPB serves as foundation for the development of the higher‐order unlimited schemes. Specific detection criteria along with a novel decrementing algorithm for the MOOD method are designed in order to deal with the complexity of multi‐material flows. Numerically, we compare errors and computational times on several 1D problems (stringent shock tube and cavitation problems) computed on 2D meshes with the second‐ and fourth‐order MOOD methods using a classical MUSCL method as reference. Several simulations of a 2D shocked R22 bubble in the air are also presented on Cartesian and unstructured meshes with the second‐ and fourth‐order MOOD methods, and qualitative comparisons confirm the conclusions obtained with 1D problems. These numerical results demonstrate the robustness of the MOOD approach and the interest of using more than second‐order methods even for locally singular solutions of complex physics models. Copyright © 2014 John Wiley & Sons, Ltd.
Verfassung in neuem Antlitz
Authors: Dzwonnek Dorothee
Published: October 2014

Die DFG hat ihre Satzung novelliert. Der von den Mitgliedern in großer Eintracht beschlossene Text beschreibt Aufgaben und Arbeit unserer Organisation systematischer, transparenter und moderner – und ist so nicht zuletzt die Basis für das gemeinsame Handeln aller in der DFG für die Wissenschaft.
Zielstrebige Navigation
Authors: Unterstell Rembert
Published: October 2014

Die Medizininformatikerin und Heinz Maier‐Leibnitz‐Preisträgerin Lena Maier‐Hein will computergestützte Assistenzsysteme für minimalinvasive Eingriffe in der Krebsdiagnose und ‐therapie optimieren. Größte Herausforderung ist die Übertragung in den klinischen Alltag.
The Case for Phasing Out Experiments on Primates
Authors: Conlee Kathleen M. , Rowan Andrew N.
Published: October 2014

Whether they realize it or not, most stakeholders in the debate about using animals for research agree on the common goal of seeking an end to research that causes animals harm. The central issues in the controversy are about how much effort should be devoted to that goal and when we might reasonably expect to achieve it. Some progress has already been made: The number of animals used for research is about half what it was in the 1970s, and biomedical research has reached the point where we can reasonably begin to envision a time when it could advance without causing harm to animals. With some effort and aggressive development of new biomedical research technologies, full replacement of animals in harmful research is within our grasp. The goal will not be reached all at once, however, and phasing out invasive research on all nonhuman primates should be the priority.
Which Orphans Will Find a Home? The Rule of Rescue in Resource Allocation for Rare Diseases
Authors: LARGENT EMILY A. , PEARSON STEVEN D.
Published: October 2014

The rule of rescue describes the moral impulse to save identifiable lives in immediate danger at any expense. Think of the extremes taken to rescue a small child who has fallen down a well, a woman pinned beneath the rubble of an earthquake, or a submarine crew trapped on the ocean floor. No effort is deemed too great. Yet should this same moral instinct to rescue, regardless of cost, be applied in the emergency room, the hospital, or the community clinic?

In health care, the desire to save lives at any cost must be reconciled with the reality of resource scarcity. As one example, the estimated cost for prophylactic Factor VIII to treat one patient with hemophilia for one year is $300,000. Costs of this magnitude have been accepted by public and private insurers in the developed world, even though, in principle, these sums could provide greater overall health benefit if allocated to pay for the unmet health care needs of many other patients. Looking forward, however, broad application of the rule of rescue will be increasingly untenable. But the moral instinct will remain: the desire to help those weakest among us, especially when their small numbers allow us to see them as unique individuals. What, then, is the ethical framework that can guide coverage and reimbursement decisions for orphan drugs into the future?
The Ethics of Advocacy for Undocumented Patients
Authors: Berlinger Nancy , Raghavan Rajeev
Published: October 2014

Approximately 11.2 million undocumented immigrants have settled in the United States. Providing health care to these residents is an everyday concern for the clinicians and health care organizations who serve them. Uncertain how to proceed in the face of severe financial constraints, clinicians may improvise remedies–a strategy that allows our society to avoid confronting the clinical and organizational implications of public policy gaps. There is no simple solution‐no quick fix‐that will work across organizations (in particular, hospitals with emergency departments) in states with different concentrations of undocumented immigrants, varying public and private resources for safety‐net health care, and differing approaches to law and policy concerning the rights of immigrants. However, every hospital can help its clinicians by addressing access to health care for undocumented immigrants as an ethical issue. We offer some recommendations for doing this in a structured, fair, and transparent way. We also describe the problems that may result when clinicians are forced to grapple with this issue on their own.
Casting Light and Doubt on Uncontrolled DCDD Protocols
Authors: Rodríguez‐Arias David , Ortega‐Deballon Iván , Smith Maxwell J. , Youngner Stuart J.
Published: October 2014

The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fundamental issue of whether uDCDD donors are dead when organs are procured remains problematic for the New York City protocol and, indeed, for all uDCDD protocols.

In the United States, two amendments to the legal criteria of death have been suggested to avoid a formal violation of the dead donor rule in DCDD protocols: first, replacing the requirement “irreversible” with the weaker term “permanent,” and second, using the term “circulatory” instead of “cardiac” to identify the key function that must be lost to declare death. While intended to facilitate controlled DCDD, these modifications create a problem for uDCDD protocols: if extracorporeal membrane oxygenation is introduced to preserve the organs, then circulation is restored after death is declared. In this issue of the Hastings Center Report, Kevin Munjal and colleagues call for a new ethical construct and policy so that uncontrolled and controlled DCDD can coexist.
An Ethics Framework for a Learning Health Care System: A Departure from Traditional Research Ethics and Clinical Ethics
Authors: Faden Ruth R. , Kass Nancy E. , Goodman Steven N. , Pronovost Peter , Tunis Sean , Beauchamp Tom L.
Published: October 2014

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion.
H5N1 Avian Flu Research and the Ethics of Knowledge
Authors: Resnik David B.
Published: October 2014

Scientists and policy‐makers have long understood that the products of research can often be used for good or evil. Nuclear fission research can be used to generate electricity or create a powerful bomb. Studies on the genetics of human populations can be used to understand relationships between different groups or to perpetuate racist ideologies. While the notion that scientific research often has beneficial and harmful uses has been discussed before, the threat of bioterrorism—a concern that has only grown since 2001—has led to increased awareness about the need to prevent the misuse of biomedical research, particularly when it involves dangerous pathogens or toxins.

In 2012, the concern was ratcheted up another notch by two papers reporting the results of research on genetically engineered strains of the H5N1 avian influenza virus. Although the H5N1 papers have potential scientific and social value, some scientists and policy‐makers opposed their publication because they feared that terrorists (or others with nefarious motives) could use the research to create a bioweapon that could trigger a global pandemic.

The H5N1 papers raise difficult questions concerning the ethics of knowledge. Should scientific research with dangerous applications be published? Should some types of research be kept secret or not be conducted at all? What type of government oversight of dangerous research is appropriate? In this essay, I will develop a framework for thinking about the ethics of knowledge and apply it to the H5N1 controversy, focusing on issues related to publication. I will argue that redacted publication would have been a reasonable response to the dilemmas posed by the H5N1 papers if not for practical and legal problems with this option. Given these problems, full publication seems appropriate.
The Battle Lines of Sexual Politics and Medical Morality
Authors: Lantos John D.
Published: October 2014

One of two commentaries on “Normalizing Atypical Genitalia: How a Heated Debate Went Astray,” by Josephine Johnston, from the November‐December 2012 issue.
Fertility Treatment: Medically Necessary?
Authors: Haehl Anne L.
Published: October 2014

A commentary on “Why We Should All Pay for Fertility Treatment: An Argument from Ethics and Policy,” from the March‐April 2013 issue.
Futility on the Border
Authors: Klugman Craig M. , Bard Jennifer S.
Published: October 2014

Miguel is an eighteen‐year‐old male transferred to Alamo Hospital for antivenom treatment after a rattlesnake bite while sleeping on railroad tracks. His “coyote,” an individual who guides undocumented people across the U.S. border from Mexico, dropped him off at a clinic. By the time Miguel was transferred from the clinic to Alamo, he was in complete paralysis and at risk for heart failure, requiring ventilator support to breathe. A person who receives treatment for a snake bite within one to two hours has a 99 percent chance of recovery, but for Miguel, at least fifteen hours had already passed.

A hospital ethicist at Alamo contacted the Mexican consulate, and together they arranged for Miguel's father to come to Alamo and make decisions for him. His physicians have determined that he is in a persistent vegetative state and can no longer benefit from hospital treatment. However, no long‐term care facility will accept him. Miguel is undocumented and unfunded.

Miguel's father wishes to take his son home, but the cost of transporting him is high ,and their home state in Mexico has no ventilator available for him and no consistent supply of electricity to run it. What should the hospital do?
Incidental Findings in the Era of Whole Genome Sequencing?
Authors: Parens Erik , Appelbaum Paul , Chung Wendy
Published: October 2014

The rise of technologies that can inexpensively sequence entire genomes means that researchers and clinicians have access to ever vaster stores of genomic data, some of which could be of great use to research participants or patients, and most of which, at least for today, will be of little, uncertain, or no use. Those facts are essential features of a new ethical territory we are now entering with genetics research. As we explore that territory, we should try to be as clear as possible about the issues at hand.

Clarity about the ethical issues that delineate this new territory requires that we be wary about too hastily importing into it concepts from the old territory. We want to suggest a way in which the term “incidental findings” can impede our ability to see clearly some of the most important issues we face. To show how that term can sometimes obscure more than it illuminates, we focus on how it is being deployed in the context of research. Although it may have been useful, when considering older forms of genetic research, to speak about researchers stumbling across clinically significant findings, and although that way of speaking has certainly not yet become wholly obsolete, it is ever less appropriate as the technology becomes ever more powerful.
The “Good Planning Panel”
Authors: Smith Thomas J. , Bodurtha Joann N.
Published: October 2014

In “Avoiding a Death Panel Redux,” Nicole Piemonte and Laura Hermer make the argument that the advance care planning consultation provision during the health care reform debate collapsed both because the language in the provision was deliberately misread and because some features of the language could in fact be misleading. We agree on both counts. We add that the cost‐effectiveness provisions of the bill make us face difficult decisions we as a nation would rather avoid, but can and must face squarely and together.

It is time for an honest national conversation about at least two issues concerning medical care near the end of life. First, talking about or planning a good death with your doctor or nurse will not make death happen sooner. The data show that better planning for a well‐managed terminal illness leads to longer life as well as better symptom control and less distress. Second, we need to quickly and directly confront the cost of end of life care in the United State, recognize the political consequences, and work with the broad middle to advance the common good.
Genoism by Any other Name?
Authors: Miles Jonathan K.
Published: October 2014

The second of three commentaries on “A Defense of Genetic Discrimination,” from the July‐August 2013 issue.
How Big a Problem Is Genetics Exceptionalism in Employment?
Authors: Suter Sonia
Published: October 2014

The third of three commentaries on “A Defense of Genetic Discrimination,” from the July‐August 2013 issue.
Medical Education as Mission: Why One Medical School Chose to Accept DREAMers
Authors: Kuczewski Mark G. , Brubaker Linda
Published: October 2014

In October 2012, the Loyola University Chicago Stritch School of Medicine amended its eligibility requirements for admission. In addition to U.S. citizens and permanent residents, persons who qualify for the Deferred Action for Childhood Arrivals program of the United States Citizenship and Immigration Service are now eligible for admission. Simply put, we extended the educational opportunity of medical school to people who are in a particular category of undocumented immigrants. We became the first medical school in the United States to have an intentional, transparent policy of eligibility for persons eligible for the DACA program. This expanded admissions policy has gained some attention in the popular press and brought us many expressions of support. It has also dismayed a few members of our school's circle of faculty and alumni.

We wish to walk you through the history of our policy's development. We believe that viewing it as it developed will make clear three pertinent ideas: this policy flows directly from the mission of medical schools, it suits a positive notion of social justice and is also compelled by a duty not to discriminate on arbitrary grounds, and educators who steward educational institutions must have the moral courage to place considerations of institutional mission and social justice above the political views and negative responses of some alumni and donors.
Narrative Ethics:A Narrative
Authors: Brody Howard , Clark Mark
Published: October 2014

Once upon a time, medicine dismissed narrative as unimportant and uninteresting. Then, in the late 1980s, physicians and scholars became interested in how the study of narrative could enhance our understanding of illness and health care, and the field that came to be known as “narrative medicine” developed. Some of this scholarly activity focused on the idea of narrative ethics.

After a flurry of activity around the turn of the twenty‐first century, narrative ethics seemed to stall. The general interest in narrative in medicine continued but with few new ideas on how one might use narrative toward ethical ends. In the last few years, however, forward momentum has returned. The timing seems appropriate, therefore, for a “state of the field” report of sorts.
When Stories Go Wrong
Authors: Lindemann Hilde
Published: October 2014

Stories do many different kinds of moral work. Because they can depict time passing, feature certain details while downplaying others, draw connections among their internal elements, display causal relationships, and connect themselves to other stories, they are particularly well suited to the task of modeling a puzzling clinical situation. A story maps the situation's contours, picking out the details that, together, constitute the moral reasons for doing what may or must be done. When moral deliberators construct a story, they come to understand the situation in a certain way, and that, in turn, guides their sense of how they should act in or with respect to it.

But stories don't just represent situations‐they can also misrepresent them. For that reason, if we are to use stories as guides to action, we have to be sure we get them right. In what follows I offer three clinical situations that are either about to be or have already been narratively misrepresented. I'll explain how the stories go wrong, point out the undesirable consequences of acting on them, and offer alternative ways of depicting the situations that could bring them to a morally successful resolution.
Narrative Awareness in Ethics Consultations:The Ethics Consultant as Story‐Maker
Authors: Churchill Larry
Published: October 2014

Much has been written about the importance of narrative in teaching ethics and humanities to medical students and residents, as well as the value of narratives in clinical care. Relatively little has been said about the essential role of narrative in bioethics consultations. For most consults, the interpretation of narratives is the central moral feature, and the ethics consultant is inevitably one of the narrators. In a recent consult in which I participated, at least three narratives were in play. The medical record itself was a narrative, or really, a variety of narratives. A second distinct narrative was the story of why this case had come to be categorized as an ethical concern for the medical team. A third narrative was the tentative sketch running through my mind as a consultant‐partly factual, partly anticipatory and conjectural, inevitably personal‐about what was going on here.
Why We Need to Acknowledge the Multiple Aims of Advance Care Planning
Authors: Robins‐Browne Kate
Published: October 2014

A commentary on “What's Not Being Shared in Shared Decision‐Making?” from the July‐August 2013 issue.
The Ethics of Anonymous Gamete Donation:Is There a Right to Know One's Genetic Origins?
Authors: Melo‐Martín Inmaculada De
Published: October 2014

The vast majority of gamete donations worldwide are made anonymously, and in some countries, including Spain, France, and Denmark, the anonymity of donors is explicitly protected by law. Nonetheless, a growing number of countries have called into question the morality of such practices and are enacting laws allowing children access to identifying information about their gamete donor. A significant reason for the growing legislative support for nonanonymous gamete donations is the belief that donor‐conceived children have a fundamental moral right to know their genetic origins and that the right should be legally protected. A variety of factors, such as the increasing number of children born by means of gamete donation, advances in genetic science and technology that make it easy to discover the identity of a person's genetic parents, and the widespread belief that genetic information is important for protecting people's health, have made this alleged right quite salient, even leading some to challenge the ethical appropriateness of gamete donation practices altogether. Often, however, this right is assumed rather than explicitly justified. The purpose of this paper is to call into question the ethical justifications that are often thought to ground a right to know one's genetic origins.

Proponents of a right to know this information usually argue that such a right protects at least three vital interests: the interest of donor‐conceived people in having strong family relationships, their health interests, and their interest in forming a healthy identity. These different interests might be protected by different aspects of the right to know one's genetic origins: knowing one's mode of conception, accessing medically relevant information, and accessing identifying information about one's genetic parents. I will discuss each of these interests and explore whether and how they might be set back by an individual's lack of access to information about his or her genetic parentage. I will also evaluate whether donor anonymity policies are, as many of their opponents argue, morally impermissible because they fail to protect these important interests.
Physician Assistance in Dying: A Subtler Slippery Slope
Authors: Duffy Thomas P.
Published: October 2014

Shortly after discharge, my patient's husband called to inform me that his wife had died suddenly the previous evening. The call was not a surprise. I felt she had silently communicated to me that she was taking matters into her own hands, and the quantity of narcotics I prescribed was enough to be lethal if ingested as a single dose. I was aware that this was a possible and perhaps even likely outcome. I could have limited the drug amount, but this would have required that she return frequently to the clinic. I believed that such restrictions were an affront to her dignity and her autonomy. And she could always stockpile her drugs to achieve the same purpose.

In the midst of the ongoing contretemps surrounding the legality of physician‐assisted death, there is a grey zone of physician complicity. My action in providing my patient with a potentially lethal quantity of narcotics certainly marks me as an assistant, albeit at a remove, in her suicide.
Functional Neuroimaging: Technical, Logical, and Social Perspectives
Authors: Aguirre Geoffrey K.
Published: October 2014

Neuroscientists have long sought to study the dynamic activity of the human brain—what's happening in the brain, that is, while people are thinking, feeling, and acting. Ideally, an inside look at brain function would simultaneously and continuously measure the biochemical state of every cell in the central nervous system. While such a miraculous method is science fiction, a century of progress in neuroimaging technologies has made such simultaneous and continuous measurement a plausible fiction. Despite this progress, practitioners of modern neuroimaging struggle with two kinds of limitations: those that attend the particular neuroimaging methods we have today and those that would limit any method of imaging neural activity, no matter how powerful.

In this essay, I consider the liabilities and potential of techniques that measure human brain activity. I am concerned here only with methods that measure relevant physiologic states of the central nervous system and relate those measures to particular mental states. I will consider in particular the preeminent method of functional neuroimaging: BOLD fMRI. While there are several practical limits on the biological information that current technologies can measure, these limits—as important as they are—are minor in comparison to the fundamental logical restraints on the conclusions that can be drawn from brain imaging studies.
Seeing Responsibility:Can Neuroimaging Teach Us Anything about Moral and Legal Responsibility?
Authors: Wasserman David , Johnston Josephine
Published: October 2014

As imaging technologies help us understand the structure and function of the brain, providing insight into human capabilities as basic as vision and as complex as memory, and human conditions as impairing as depression and as fraught as psychopathy, some have asked whether they can also help us understand human agency. Specifically, could neuroimaging lead us to reassess the socially significant practice of assigning and taking responsibility?

While responsibility itself is not a psychological process open to investigation through neuroimaging, decision‐making is. Over the past decade, different researchers and scholars have sought to use neuroimaging (or the results of neuroimaging studies) to investigate what is going on in the brain when we make decisions. The results of this research raise the question whether neuroscience—especially now that it includes neuroimaging—can and should alter our understandings of responsibility and our related practice of holding people responsible. It is this question that we investigate here.
Living with the Ancient Puzzle
Authors: Parens Erik
Published: October 2014

We began this special report by suggesting that neuroimaging technologies are tools that can, when used carefully and in conjunction with the other tools of neuroscience and psychology, help illuminate the capacities and behaviors that constitute our minds. In the course of this special report we have called attention to some basic points that are worth remembering as we encounter more and more claims about human psychology that are based on evidence from imaging technologies like fMRI.
How Should We Model Rare Disease Allocation Decisions?
Authors: JOHN LONDON ALEX
Published: October 2014

When health budgets are insufficient to provide care for all, allocating resources to treat a person with a rare and expensive disorder entails that we cannot treat at least one person with a more common, less expensive disorder. Since any allocation scheme will entail such trade‐offs, how should prudent policy‐makers, concerned about justice and fairness, allocate their community's health resources? In their article in this issue of the Hastings Center Report, Emily Largent and Steven Pearson frame this problem as a conflict between the “rule of rescue” and utilitarian allocation schemes that try to maximize the benefits produced by a given budget. In his article, Norman Daniels discusses the related problem of the “identified victim bias.” I doubt that the problem of crafting an equitable health policy regarding orphan diseases maps onto either of these factors in a way that sheds light on the key moral issues.
The Irregular Terrain of Human Subjects Research Regulations
Authors: Forster David , Nelson Daniel K. , Borasky David , Botkin Jeffrey R.
Published: October 2014

The overlap and differences between the parallel regulatory systems for research create ample room for confusion and missteps, as discussed by Barbara Bierer and Mark Barnes in their report in this supplement. In practice, beyond the inherent differences in the two systems of regulations themselves, there are many issues that further complicate the application of these regulations. These include the variation in size of the institutions receiving PHS funding, the increased prevalence of multisite research, the allocation of research conduct and oversight to external organizations, and the variability in assignment of human subject protection roles between the IRB and the institution.
Parallel Processes at the NIH
Authors: Rockey Sally J. , Patterson Amy P.
Published: October 2014

The report by Barbara Bierer and Mark Barnes highlights the complexities experienced by institutions that conduct Public Health Service‐funded research involving human subjects and that need to negotiate the requirements of two sets of federal regulations: 45 C.F.R. 46, covering protections for human research subjects, and 42 C.F.R. 93, the PHS policies on research misconduct. As the nation's single largest sponsor of biomedical and behavioral research, the National Institutes of Health seeks to exemplify and promote human research protections and the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science. The NIH is committed to protecting the rights and welfare of research participants and to upholding integrity standards for research supported with public funds. However, human subjects protections must always take priority.
We Need Both Evidence and Values to Navigate Uncertainty
Authors: Upshur Ross E.G.
Published: October 2014

A commentary on “Ethics and Evidence in Medical Debates: The Case of Recombinant Activated Factor VII,” by Narcyz Ghinea, Wendy Lipworth, Ian Kerridge, Miles Little, and Richard O. Day, in the March‐April 2014 issue.
Emerging Ethical Issues in Reproductive Medicine: Are Bioethics Educators Ready?
Authors: Farrell Ruth M. , Metcalfe Jonathan S. , McGowan Michelle L. , Weise Kathryn L. , Agatisa Patricia K. , Berg Jessica
Published: October 2014

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?

To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine.