"SpezPat"- common advance directives versus disease-centred advance directives: a randomised controlled pilot study on the impact on physicians' understanding of non-small cell lung cancer patients' end-of-life decisions.

Background: The advance directive represents patients' health care choices and fosters patients' autonomy. Nevertheless, understanding patients' wishes based on the information provided in advance directives remains a challenge for health care providers. Based on the ethical premises of positive obligation to autonomy, an advanced directive that is disease-centred and details potential problems and complications of the disease should help health care providers correctly understand patients' wishes.

Palliative sedation in amyotrophic lateral sclerosis: results of a nationwide survey among neurologists and palliative care practitioners in Germany.

Background: Palliative sedation has become widely accepted as a method to alleviate refractory symptoms in terminally ill patients. Controversies regarding this topic especially concern the use of palliative sedation for psychological symptoms, the use in patients who are not imminently dying and the simultaneous withdrawal of life-sustaining measures. Amyotrophic lateral sclerosis (ALS) is characterized by symptoms including muscle weakness, dysphagia, dysarthria, muscle spasms and progressive respiratory insufficiency.

Labeling Using a Clickable ER-Disrupting Probe Suggests a Role for Oleosins in Seedling ER Integrity.

Several small-molecule perturbagens of the plant endomembrane system are known, but few selectively disrupt endoplasmic reticulum (ER) structure and function. We conducted a microscopy-based screen for small-molecule disruptors of ER structure and discovered eroonazole, a 1,2-4-triazole that induces extensive ER vesiculation in seedlings. To identify eroonazole targets, we synthesized a clickable photoaffinity derivative and used it for whole-seedling labeling experiments.

Clinical Ethics Consultation in Neurology - a case series.

Background: The concept of clinical ethics consultation (CECs) was implemented to provide support in ethical controversies in clinical settings and are offered in at least every second hospital in Germany. Neurological disorders often require complex decision-making. The aims of this study were to determine which situations lead to CEC in neurology and to investigate the influence of the individual patient's wishes on the recommendation.

[Importance of electroconvulsive therapy (ECT) in forensic psychiatry].

Background And Objective: Electroconvulsive therapy (ECT) is recommended in guidelines for the treatment of severe affective and psychotic disorders that also can be found in patients in forensic psychiatric commitment; however, there are no systematically collected data concerning the use of ECT in forensic psychiatry. The aim of this study was to investigate the current state and estimated need for ECT in forensic psychiatry in Germany.

Material And Methods: A questionnaire was designed consisting of questions about the current practice and estimated need for ECT in this population.

The ethical debate over child priority in post-mortem organ allocation: A scoping review and practical-ethical outlook.

Background: Organ allocation guidelines in many countries give children relative priority, but the normative justification of child priority is seldom articulated.

Methodology: We conducted a scoping review of the recent international literature (2013-2019) to identify moral positions and normative frameworks to justify or criticize pediatric priority in all kind of organ allocation. We identified 11 relevant papers.

Electroconvulsive Therapy in Incapable Patients Refusing Treatment: Prevalence, Effectiveness, and Associated Factors.

Objectives: Severe psychiatric disorders may be accompanied by life-threatening conditions, lack of insight, and treatment refusal. Involuntary treatment may be indicated in patients who lack capacity to consent and refuse treatment. In this context, there is a lack of systematic data regarding the use of electroconvulsive therapy (ECT) in Germany.

Psychiatrists' views on different types of advance statements in mental health care in Germany.

Background: Advance directives enable patients to ensure that treatment decisions will be based on their autonomous will, even if they are incompetent at the time at which the treatment decision is taken. Although psychiatric advance directives are legally binding in Germany and their benefits are widely acknowledged, they are still infrequently used in German psychiatric practice.

Aims: The aim of this study is to assess psychiatrists' attitudes toward the use of advance statements in mental health care.

MicroRNA Dysregulation, Gene Networks, and Risk for Schizophrenia in 22q11.2 Deletion Syndrome.

The role of microRNAs (miRNAs) in the etiology of schizophrenia is increasingly recognized. Microdeletions at chromosome 22q11.2 are recurrent structural variants that impart a high risk for schizophrenia and are found in up to 1% of all patients with schizophrenia.

Copy number variable microRNAs in schizophrenia and their neurodevelopmental gene targets.

Background: MicroRNAs (miRNAs) are key regulators of gene expression in the human genome and may contribute to risk for neuropsychiatric disorders. miRNAs play an acknowledged role in the strongest of genetic risk factors for schizophrenia, 22q11.2 deletions.

[Between autonomy and coercion: compulsory treatment in psychiatry from an ethical perspective].

The actual decision of the German Supreme Court fueled the old debate of the moral and legal status of compulsory treatment in psychiatry in Germany. This article sheds a light on the background of this debate and reflects on possible justifications for involuntary treatment of mentally ill patients. Furthermore it will examine the significance of psychiatric patients' advance directives and joint crisis plans in the context of medical compulsory treatment and will offer recommendations on an ethical responsible way of dealing with compulsory treatment in German psychiatric practice.

Joint crisis plans and psychiatric advance directives in German psychiatric practice.

This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us.

Incipient stem cell niche conversion in tissue culture: using a systems approach to probe early events in WUSCHEL-dependent conversion of lateral root primordia into shoot meristems.

Adventitious shoot organogenesis contributes to the fitness of diverse plant species, and control of this process is a vital step in plant transformation and in vitro propagation. New shoot meristems (SMs) can be induced by the conversion of lateral root primorida/meristems (LRP/LRMs) or callus expressing markers for this identity. To study this important and fascinating process we developed a high-throughput methodology for the synchronous initiation of LRP by auxin, and subsequent cytokinin-induced conversion of these LRP to SMs.

A phenotypic screening platform to identify small molecule modulators of Chlamydomonas reinhardtii growth, motility and photosynthesis.

Chemical biology, the interfacial discipline of using small molecules as probes to investigate biology, is a powerful approach of developing specific, rapidly acting tools that can be applied across organisms. The single-celled alga Chlamydomonas reinhardtii is an excellent model system because of its photosynthetic ability, cilia-related motility and simple genetics. We report the results of an automated fitness screen of 5,445 small molecules and subsequent assays on motility/phototaxis and photosynthesis.

Advance directives: prevalence and attitudes of cancer patients receiving radiotherapy.

Purpose: Advance directives (AD) are becoming increasingly widespread. We examine the prevalence of AD and the factors associated with AD in tumor patients during radiotherapy.

Methods: A standardized questionnaire was handed out to all tumor patients on 9 random days with an interval of at least 12 weeks.

Implementing clinical ethics in German hospitals: content, didactics and evaluation of a nationwide postgraduate training programme.

The Hannover qualifying programme 'ethics consultation in hospitals', conducted by a four-institution cooperation partnership, is an interdisciplinary, scientifically based programme for healthcare professionals interested in ethics consultation services and is widely acknowledged by hospital managements and healthcare professionals. It is unique concerning its content, scope and teaching format. With its basic and advanced modules it has provided training and education for 367 healthcare professionals with 570 participations since 2003 (until February 2010).