Mit zweierlei Maß: Die mangelnde Verbindlichkeit von Patientenverfügungen bei untergebrachten Personen mit psychischen Störungen in der Schweiz

Definition of the problem

Full age patients with mental disorders and preserved decision-making capacity are increasingly interested in drafting advance directives. Whereas in Switzerland (as well as in Germany) advance directives are binding in principle, an advance directive is not binding and has only to be considered in case of involuntary admission due to a mental disorder. Thereby, the virtual aim of an advance directive – the anticipated self-determination – is questioned.

Arguments

From an ethical perspective, patients with mental disorders have the same rights as patients with somatic diseases. Therefore, the question arises if there are good reasons for this unequal treatment. In the present contribution, four possible reasons are analyzed: (1) persons with mental disorders are “different”; (2) protection from self-harm; (3) often not present end-of-life context; (4) reduced bindingness as the more appropriate standard in general.

Conclusion

The authors come to the conclusion that patients with mental disorders are often capable of composing a valid advance directive, and just as any other human being, they have a principal and binding right for self-determination, even though they are particularly vulnerable in crisis situations.

     

Identification and optimization of key process parameters in noncontact laser scanning for reverse engineering

This Extended Technical Note shows that the final accuracy level of reverse engineered surfaces depends on scanning distance and scanning angle of the laser beam, hence it also depends on the morphology of the scanned objects. On scanning strongly curved objects, such as the ones with free form surfaces, the distance and impact angle of the laser beam are changing continuously during the scanning process. On the basis of these, two critical parameters are specified for the design model, which make it possible to predict these two factors in advance, depending on the morphology of the scanned object. First, a mathematical-statistical design model of the scanning process is generated, which relies on ANOVA (analysis of variance) and DOE (design of experiments). In the next step, a fitness function is optimized by the genetic algorithm (GA) program. This optimization improves the accuracy of the final scanned surfaces, in terms of the minimum standard deviation values of reverse engineered 3D surface model. The proposed approach was confirmed in a case study, which is presented at the end of this Technical Note.     

The Hydrophilic Loop of Arabidopsis PIN1 Auxin Efflux Carrier Harbors Hallmarks of an Intrinsically Disordered Protein

Much of plant development depends on cell-to-cell redistribution of the plant hormone auxin, which is facilitated by the plasma membrane (PM) localized PIN FORMED (PIN) proteins. Auxin export activity, developmental roles, subcellular trafficking, and polarity of PINs have been well studied, but their structure remains elusive besides a rough outline that they contain two groups of 5 alpha-helices connected by a large hydrophilic loop (HL). Here, we focus on the PIN1 HL as we could produce it in sufficient quantities for biochemical investigations to provide insights into its secondary structure. Circular dichroism (CD) studies revealed its nature as an intrinsically disordered protein (IDP), manifested by the increase of structure content upon thermal melting. Consistent with IDPs serving as interaction platforms, PIN1 loops homodimerize. PIN1 HL cytoplasmic overexpression in Arabidopsis disrupts early endocytic trafficking of PIN1 and PIN2 and causes defects in the cotyledon vasculature formation. In summary, we demonstrate that PIN1 HL has an intrinsically disordered nature, which must be considered to gain further structural insights. Some secondary structures may form transiently during pairing with known and yet-to-be-discovered interactors.     

Ion Electrodiffusion Governs Silk Electrogelation

Silk electrogelation involves the transition of an aqueous silk fibroin solution to a gel state (E-gel) in the presence of an electric current. The process is based on local pH changes as a result of water electrolysis - generating H(+) and OH(-) ions at the (+) and (-) electrodes, respectively. Silk fibroin has a pI=4.2 and when local pH相似文献   

Formulation of consistent restoring stiffness in ship hydroelastic analysis

In this article, the role of the restoring stiffness, as one of the basic parameters in ship hydroelastic analysis, is brought out. It is formulated using the variational principle and the method of virtual displacements. It is shown that asymmetry of the restoring stiffness is a physical reality. Moreover, it is confirmed that modal variation, still disputed in the relevant literature, has to be taken into account to satisfy the ship’s stability. Consistent stiffness is formulated here by regarding stiffness definition as relation between forces and displacements. Hybrid stiffness known from the literature is wrong since some terms are specified as relation between forces and displacement gradient. Influence of the consistent and symmetrized stiffness matrix, and the hybrid one, on dynamic response is illustrated for a prismatic pontoon and a large container ship. It is found that the latter two matrices do not assure convergence of transfer functions of sectional forces to zero value as the wave frequency approaches zero. The rigid body and elastic responses are compared, and pertinent conclusions are drawn. It is also shown that it is not necessary to use the unified geometric and restoring stiffness for ordinary hydroelastic analysis of ship structures. The consistent formulation of the restoring stiffness matrix will be useful for extending linear potential theory hydrodynamic codes for rigid body analysis to deformable bodies.     

The Impact of the Microbiome on Resistance to Cancer Treatment with Chemotherapeutic Agents and Immunotherapy

Understanding the mechanisms of resistance to therapy in human cancer cells has become a multifaceted limiting factor to achieving optimal cures in cancer patients. Besides genetic and epigenetic alterations, enhanced DNA damage repair activity, deregulation of cell death, overexpression of transmembrane transporters, and complex interactions within the tumor microenvironment, other mechanisms of cancer treatment resistance have been recently proposed. In this review, we will summarize the preclinical and clinical studies highlighting the critical role of the microbiome in the efficacy of cancer treatment, concerning mainly chemotherapy and immunotherapy with immune checkpoint inhibitors. In addition to involvement in drug metabolism and immune surveillance, the production of microbiota-derived metabolites might represent the link between gut/intratumoral bacteria and response to anticancer therapies. Importantly, an emerging trend of using microbiota modulation by probiotics and fecal microbiota transplantation (FMT) to overcome cancer treatment resistance will be also discussed.