Patient-specific embryonic stem cells derived from human SCNT blastocysts

Effects of PXD101 and Embryo Aggregation on the In Vitro Development of Mouse Parthenogenetic Embryos

To improve the isolation efficiency of parthenogenetic embryonic stem cells (pESCs) in mice, it is necessary to optimize the method to increase in vitro developmental competence of mice parthenogenetic blastocysts. Therefore, this study aims to investigate an optimal method for the production of mouse parthenogenetic blastocysts and isolation of pESC colonies by comparing the effects of two methods: (1) the treatment of histone deacetylase inhibitor PXD101 before, during, or after parthenogenetic activation; (2) parthenogenetic embryo aggregation; and (3) their combination treatment. The results suggest that application of PXD101 treatment and embryo aggregation could both improve the development of mouse parthenogenetic blastocysts (50 nM PXD101 treated 4 hours during activation and further 4 hours after activation: 40.0% vs. 20.0%; p < 0.05; two-cell embryo aggregation: 38.3% vs. 20.0%; p < 0.05) and also enhance the isolation rate of pESC colonies (PXD101: 33.3% vs. 11.8%; p < 0.05; two-cell embryo aggregation: 36.4% vs. 11.8%; p < 0.05). The combination of their treatments had the higher rate of parthenogenetic blastocyst development (41.7%) and significantly higher rate of pESC colony isolation from parthenogenetic blastocysts (45.0%); therefore, we concluded that the combination of these two methods (50 nM PXD101 treated for 8 hours and then aggregated at two-cell stage with 0.25% pronase for 10 minutes in our self-made concave) is considered the optimal way for the in vitro development of parthenogenetic blastocysts and subsequent pESC colony isolation in mice, opening new opportunities for application of this combination method to improve the parthenogenetic embryo development in other species.

Human Embryonic Stem Cell Research, Abortion, and Publication Bias in the New England Journal of Medicine

Publication bias in medical journals depends on outside influences and the particular ideological bent of the editorial board. The New England Journal of Medicine (NEJM) is a premier medical scientific publication having among the highest impact rankings of any research journal. The Vioxx question and industry ties it highlighted have led to legitimate questions of whether significant conflicts of interest have arisen within NEJM that compromise the free exchange of scientific information and ideas. Over the past two decades, several socially charged areas have been treated with considerable bias in the editorial policy of NEJM, including the issues of human embryonic stem cell research and abortion. From 2000 to 2017, NEJM published over twenty pieces favorable toward human embryonic stem cell research and over fifty pieces favorable to abortion, with virtually no publication of contrary opinion. An aggressive editorial defense of Planned Parenthood Federation most recently seems particularly striking. A secular journal which is meant to represent the entire spectrum of physician opinion in controversial issues has a practical, if not also an ethical, responsibility to provide an unbiased forum for intelligible discussion for evaluation of the merits of particular issues. To do otherwise is publication bias that suppresses legitimate contrary viewpoints having merit and validity.

NONTECHNICAL SUMMARY

Publication bias in medical journals is detrimental to the free exchange of ideas regarding controversial issues. From 2000 to 2017, a premier publication, the New England Journal of Medicine (NEJM), has shown considerable bias in only publishing articles and editorials highly favorable toward human embryonic stem cell research and abortion, without permitting valid discussion and publication of contrary opinion. The recent strong editorial defense by NEJM of Planned Parenthood Federation in their sale of aborted fetal body parts seems particularly striking and disproportionate. Publication bias suppresses legitimate contrary viewpoints with merit and validity, suppressing fair debate in controversial issues.

Researchers experience of misconduct in research in Malaysian higher education institutions

This article offers a qualitative analysis of research misconduct witnessed by researchers during their careers, either by research students or fellow researchers, when conducting or supervising research in their respective departments. Interviews were conducted with 21 participants from various research backgrounds and with a range of research experience, from selected universities in Malaysia. Our study found that misbehavior such as manipulating research data, misrepresentation of research outcomes, plagiarism, authorship disputes, breaching of research protocols, and unethical research management was witnessed by participants among junior and senior researchers, albeit for different reasons. This indicates that despite the steps taken by the institutions to monitor research misconduct, it still occurs in the research community in Malaysian institution of higher education. Therefore, it is important to admit that misconduct still occurs and to create awareness and knowledge of it, particularly among the younger generation of researchers. The study concludes that it is better for researchers to be aware of the behaviors that are considered misconduct as well as the factors that contribute to misconduct to solve this problem.

Effects of Embryo Aggregation and PXD101 on the In Vitro Development of Mouse Somatic Cell Nuclear Transfer Embryos

To improve the cloning efficiency of somatic cell nuclear transfer (SCNT) and to establish nuclear transfer embryonic stem cells (NT-ESCs) reliably, it is necessary to produce high-quality blastocysts derived from mice SCNT embryos. Therefore, the present study aims to investigate an optimal method for mouse SCNT embryo production and NT-ESCs derivation by comparing the effects of two methods: the treatment of histone deacetylase inhibitor PXD101 after SCNT, embryo aggregation and their combination treatment. The results suggest that embryo aggregation at four-cell stage and 50 nM PXD101 treated for 10 hours during and after activation could improve both mouse SCNT embryos' development (PXD101: 40.0% vs. 18.5%; p < 0.05; aggregation: 40.2% vs. 18.5%; p < 0.05) and also enhance the isolation rate of NT-ESCs (PXD101: 38.2% vs. 12.5%; p < 0.05; aggregation: 39.0% vs. 12.5%; p < 0.05). The combination of their treatments had a higher development rate (43.6%) and significantly higher NT-ESCs isolation rate (54.7%), therefore, we concluded that the combination of these two methods (50 nM PXD101 treated for 10 hours after SCNT and then aggregated at four-cell stage) is considered as the optimal way for the in vitro development of SCNT embryo and subsequent NT-ESCs isolation in mice, providing a new approach for the practical improvement of mouse cloning techniques and opening new opportunities to improve cloning efficiencies in other species.

End-Stage Organ Failure: Will Regenerative Medicine Keep its Promise?

End-stage organ failure is a major cause of death worldwide that can occur in patients of all ages and transplantation is the current standard of care for chronic end-stage disease of many organs. Despite the success of organ transplantation, it is becoming clear that there will never be enough organs made available through donation to meet the increasing demand. The past decade's rapid advancement in stem cell biology and tissue engineering generated an explosive outburst of reports that gave rise to regenerative medicine, a new field that promises to “fix” damaged organs through regeneration provided by transplanted cells, stimulation of endogenous repair mechanisms, or implantation of bioengineered tissue. Whether, and if so when, regenerative medicine will keep its promise is uncertain. As we continue to strive to find new effective solutions, alternative approaches based on the development of targeted, preventive interventions aimed at maintaining normal organ function, instead of repairing organ damage, should also be pursued.

Stem Cell and Related Therapies: Nurses and midwives representing all parties

Nurses and midwives are part of health care in all the stages of our lives from preconception to death. Recent scientific advances have introduced new techniques of screening and diagnosis linked to stem cell isolation and therapies. These could affect us at any age and therefore nurses will be involved as carers and patients advocates for these techniques. In this article stem cell techniques and therapies are outlined, as well as some of the ethical challenges faced by various nursing groups, whether in adult, learning difficulties, mental health, paediatric, primary care, public health or health visiting areas. Nurses have to understand the ethical issues and the rights of all parties (donor, recipient and families), which may conflict with each other, to be able to weigh up the benefits and costs to each group involved. Answers have to be found on a case-by-case basis within local moral frameworks and law. Nurses represent all parties in these therapies and act as advocates for every patient group. They need to act in an interprofessional environment to promote the best interests of all their clients, both clinically and ethically.

A non-aggressive, highly efficient, enzymatic method for dissociation of human brain-tumors and brain-tissues to viable single-cells

Background

Conducting research on the molecular biology, immunology, and physiology of brain tumors (BTs) and primary brain tissues requires the use of viably dissociated single cells. Inadequate methods for tissue dissociation generate considerable loss in the quantity of single cells produced and in the produced cells’ viability. Improper dissociation may also demote the quality of data attained in functional and molecular assays due to the presence of large quantities cellular debris containing immune-activatory danger associated molecular patterns, and due to the increased quantities of degraded proteins and RNA.

Results

Over 40 resected BTs and non-tumorous brain tissue samples were dissociated into single cells by mechanical dissociation or by mechanical and enzymatic dissociation. The quality of dissociation was compared for all frequently used dissociation enzymes (collagenase, DNase, hyaluronidase, papain, dispase) and for neutral protease (NP) from Clostridium histolyticum. Single-cell-dissociated cell mixtures were evaluated for cellular viability and for the cell-mixture dissociation quality. Dissociation quality was graded by the quantity of subcellular debris, non-dissociated cell clumps, and DNA released from dead cells. Of all enzymes or enzyme combinations examined, NP (an enzyme previously not evaluated on brain tissues) produced dissociated cell mixtures with the highest mean cellular viability: 93 % in gliomas, 85 % in brain metastases, and 89 % in non-tumorous brain tissue. NP also produced cell mixtures with significantly less cellular debris than other enzymes tested. Dissociation using NP was non-aggressive over time—no changes in cell viability or dissociation quality were found when comparing 2-h dissociation at 37 °C to overnight dissociation at ambient temperature.

Conclusions

The use of NP allows for the most effective dissociation of viable single cells from human BTs or brain tissue. Its non-aggressive dissociative capacity may enable ambient-temperature shipping of tumor pieces in multi-center clinical trials, meanwhile being dissociated. As clinical grade NP is commercially available it can be easily integrated into cell-therapy clinical trials in neuro-oncology. The high quality viable cells produced may enable investigators to conduct more consistent research by avoiding the experimental artifacts associated with the presence dead cells or cellular debris.

Electronic supplementary material

The online version of this article (doi:10.1186/s12868-016-0262-y) contains supplementary material, which is available to authorized users.

Ethical aspects of nuclear and mitochondrial DNA transfer

Somatic cell nuclear transfer (SCNT) (cloning), as a reproductive or therapeutic method, and mitochondrial DNA transfer, as a method to prevent the transmission of mitochondrial diseases, are analyzed in this paper from a bioethics perspective. The licit purpose of being able to treat certain diseases, as in the case of SCNT, cannot justify, in any case, resorting to illicit means such as the manipulation, selection, and elimination of human embryos in the blastocyst phase, by using cell lines obtained from them. Crossing this line paves the way (as utilitarian ethics advocates) to assuming any cost in scientific experimentation so long as satisfactory results are obtained. With mitochondrial replacement, either human embryos are directly manipulated (pronuclear transfer) or germline cells are manipulated (maternal spindle transfer); changes in these could be transmitted to the offspring.

LAY SUMMARY

This article analyzes somatic cell nuclear transfer (cloning) and mitochondrial DNA transfer techniques, in both reproductive and therapeutic applications, and preventive methods in the transmission of mitochondrial diseases, from a bioethical perspective. The manipulation, selection, and elimination of human embryos delimits the ethical acceptability of these promising techniques.

Ensuring the Quality, Fairness, and Integrity of Journal Peer Review: A Possible Role of Editors

A growing body of literature has identified potential problems that can compromise the quality, fairness, and integrity of journal peer review, including inadequate review, inconsistent reviewer reports, reviewer biases, and ethical transgressions by reviewers. We examine the evidence concerning these problems and discuss proposed reforms, including double-blind and open review. Regardless of the outcome of additional research or attempts at reforming the system, it is clear that editors are the linchpin of peer review, since they make decisions that have a significant impact on the process and its outcome. We consider some of the steps editors should take to promote quality, fairness and integrity in different stages of the peer review process and make some recommendations for editorial conduct and decision-making.

Stepping Into and Out of the Void: Funding Dynamics of Human Embryonic Stem Cell Research in California, Sweden, and South Korea

Nonprofit organizations and philanthropists stepped into a funding void caused by controversies over public funding of human embryonic stem cell (hESC) research. Based on interviews of 83 representatives of 53 funders, we examine the motivations and accountability structures of public agencies, corporations, fundraising dependent nonprofit organizations and philanthropic organizations that funded hESC research in three jurisdictions: California, Sweden, and South Korea. While non-traditional forms of funding are essential in the early stages of research advancement, they are unreliable for the long timeframes necessary to advance cell therapies. Such funding sources may enter the field based on high expectations, but may exit just as rapidly based on disappointing rates of progress.

Current Science of Regenerative Medicine with Stem Cells

Regenerative medicine with stem cells holds great hope for the treatment of degenerative disease. The medical potential of embryonic stem cells remains relatively untapped at this point, and significant scientific hurdles remain to be overcome before these cells might be considered safe and effective for uses in patients. Meanwhile, adult stem cells have begun to show significant capabilities of their own in repair of damaged tissues, in both animal models and early patient trials.

The Inherent Drawbacks of the Pressure to Publish in Health Sciences: Good or Bad Science

In recent years, there has been a significant increase in the number of scientific publications- it is the era of "hunting the article". This commentary discusses the drawbacks of the pressure to publish that certainly contribute to the 'dark side' of science. In fact, health science career progression greatly relies on the number of scientific publications a researcher has, and in many cases these may be more valorized than the health services provided. Of course, scientific publications help to develop the skills of health care professionals, but as Einstein highlighted " not everything that counts can be counted, and not everything that can be counted counts".

The Inherent Drawbacks of the Pressure to Publish in Health Sciences: Good or Bad Science

In recent years, there has been a significant increase in the number of scientific publications– it is the era of “hunting the article”. This commentary discusses the drawbacks of the pressure to publish that certainly contribute to the ‘dark side’ of science. In fact, health science career progression greatly relies on the number of scientific publications a researcher has, and in many cases these may be more valorized than the health services provided. Of course, scientific publications help to develop the skills of health care professionals, but as Einstein highlighted “ not everything that counts can be counted, and not everything that can be counted counts”.

Publication ethics

High-quality scientific literature is the cornerstone of scientific progress and is highly regarded by academia. However, scientific literature is often marred by plagiarism, data fabrication and falsification, redundant publication and illegitimate authorship. These problems are discussed in this article.

Data fabrication and falsification and empiricist philosophy of science

Scientists have rules pertaining to data fabrication and falsification that are enforced with significant punishments, such as loss of funding, termination of employment, or imprisonment. These rules pertain to data that describe observable and unobservable entities. In this commentary I argue that scientists would not adopt rules that impose harsh penalties on researchers for data fabrication or falsification unless they believed that an aim of scientific research is to develop true theories and hypotheses about entities that exist, including unobservable ones. This argument presents a challenge for constructive empiricists, such as van Fraassen. Constructive empiricists need to be able to explain why rules pertaining to data fabrication and falsification do not threaten their philosophy of science.

The commercialization of human eggs in mitochondrial replacement research

After the development of induced pluripotent stem cells (IPSCs) in 2007, the pressure to commercialize women's eggs for stem cell research could have been expected to lessen. However, the pressure to harvest human eggs in large quantities for research has not diminished; rather, it has taken different directions, for example in germline mitochondrial research. Yet there has been little acknowledgement of these technologies' need for human eggs, the possible risks to women and the ethical issues concerning potential exploitation. Rather, there has been a renewed campaign to legalize payment for eggs in research, although the actual scientific advances are at best modest. This article shows why a market in women's eggs is ethically problematic in terms of the doctor's duty to do no harm and the limitations of 'informed' consent.

The ups and downs of somatic cell nucleus transfer (SCNT) in humans

Achieving successful somatic cell nuclear transfer (SCNT) in the human and subhuman primate relative to other mammals has been questioned for a variety of technical and logistical issues. Here we summarize the gradual evolution of SCNT technology from the perspective of oocyte quality and cell cycle status that has recently led to the demonstration of feasibility in the human for deriving chromosomally normal stem cells lines. With these advances in hand, prospects for therapeutic cloning must be entertained in a conscientious, rigorous, and timely fashion before broad spectrum clinical applications are undertaken.

Views on the peer review system of biomedical journals: an online survey of academics from high-ranking universities

BACKGROUND

Peer review is the major method used by biomedical journals for making the decision of publishing an article. This cross-sectional survey assesses views concerning the review system of biomedical journals among academics globally.

METHODS

A total of 28,009 biomedical academics from high-ranking universities listed by the 2009 Times Higher Education Quacquarelli Symonds (THE-QS) World University Rankings were contacted by email between March 2010 and August 2010. 1,340 completed an online survey which focused on their academic background, negative experiences and views on biomedical journal peer review and the results were compared among basic scientists, clinicians and clinician scientists.

RESULTS

Fewer than half of the respondents agreed that the peer review systems of biomedical journals were fair (48.4%), scientific (47.5%), or transparent (25.1%). Nevertheless, 58.2% of the respondents agreed that authors should remain anonymous and 64.4% agreed that reviewers should not be disclosed. Most, (67.7%) agreed to the establishment of an appeal system. The proportion of native English-speaking respondents who agreed that the "peer review system is fair" was significantly higher than for non-native respondents (p = 0.02). Similarly, the proportion of clinicians stating that the "peer review system is fair" was significantly higher than that for basic scientists and clinician-scientists (p = 0.004). For females, (β = -0.1, p = 0.03), the frequency of encountering personal attacks in reviewers' comments (β = -0.1, p = 0.002) and the frequency of imposition of unnecessary references by reviewers (β = -0.06, p = 0.04) were independently and inversely associated with agreement that "the peer review system is fair".

CONCLUSION

Academics are divided on the issue of whether the biomedical journal peer review system is fair, scientific and transparent. A majority of academics agreed with the double-blind peer review and to the establishment of an appeal system. Female academics, experience of personal attacks and imposition of unnecessary references by reviewers were related to disagreement about fairness of the peer review system of biomedical journals.

Ethical modernization: research misconduct and research ethics reforms in Korea following the Hwang affair

The Hwang affair, a dramatic and far reaching instance of scientific fraud, shocked the world. This collective national failure prompted various organizations in Korea, including universities, regulatory agencies, and research associations, to engage in self-criticism and research ethics reforms. This paper aims, first, to document and review research misconduct perpetrated by Hwang and members of his research team, with particular attention to the agencies that failed to regulate and then supervise Hwang's research. The paper then examines the research ethics reforms introduced in the wake of this international scandal. After reviewing American and European research governance structures and policies, policy makers developed a mixed model mindful of its Korean context. The third part of the paper examines how research ethics reform is proactive (a response to shocking scientific misconduct and ensuing external criticism from the press and society) as well as reactive (identification of and adherence to national or international ethics standards). The last part deals with Korean society's response to the Hwang affair, which had the effect of a moral atomic bomb and has led to broad ethical reform in Korean society. We conceptualize this change as ethical modernization, through which the Korean public corrects the failures of a growth-oriented economic model for social progress, and attempts to create a more trustworthy and ethical society.

Sources and derivation of human embryonic stem cells

Human embryonic stem cells (hESCs) are pluripotent cells derived from the inner cell mass (ICM) of the developing embryo. hESCs culture as cell lines in vitro and possess great potential in such research fields as developmental biology and cell-based therapy, as well as such industrial purposes as drug screening and toxicology. When ESCs were first derived by Thomson and colleagues, traditional methods of immunostaining and culturing, using primary mouse embryonic fibroblasts and medium supplemented by serum were used. Considerable efforts have since led to improved methods for isolating new lines in defined and reproducible conditions. This chapter discusses sources for embryos for ESC isolation, commonly used methods for deriving hESC lines, and a number of possible culture systems.

Defining stem cell types: understanding the therapeutic potential of ESCs, ASCs, and iPS cells

Embryonic, adult, artificially reprogrammed, and cancer…- there are various types of cells associated with stemness. Do they have something fundamental in common? Are we applying a common name to very different entities? In this review, we will revisit the characteristics that define 'pluripotency', the main property of stem cells (SCs). For each main type of physiological (embryonic and adult) or synthetic (induced pluripotent) SCs, markers and functional behavior in vitro and in vivo will be described. We will review the pioneering work that has led to obtaining human SC lines, together with the problems that have arisen, both in a biological context (DNA alterations, heterogeneity, tumors, and immunogenicity) and with regard to ethical concerns. Such problems have led to proposals for new operative procedures for growing human SCs of sufficiently high quality for use as models of disease and in human therapy. Finally, we will review the data from the first clinical trials to use various types of SCs.

[Communication of scientific fraud]

There is for a scientific journal several levels of communication depending of the degree of suspicion or certainty of a case of error or fraud. The task is increasingly difficult for journal editors as disclosed cases of fraud are more common and scientific communication on this topic is growing. Biomedical fraud is fairly little reported by the mainstream press and causes of this low interest are not currently well understood. The difficulty of processing this type of news for journalists appears to be one possible reason. The potentially numerous and significant consequences of fraud on health professionals are poorly documented. Though it is likely to cause a feeling of distrust and create controversy, the impact of fraud on the general public is poorly studied and appears multifactorial.

Equivalency of buffalo (Bubalus bubalis) embryonic stem cells derived from fertilized, parthenogenetic, and hand-made cloned embryos

This study was aimed at establishing buffalo embryonic stem cells (ESCs) from in vitro fertilized (IVF), parthenogenetic, and hand-made cloned (HMC) embryos and to check their equivalency in terms of stem cell marker expression, longevity, proliferation, and differentiation pattern. ESCs derived from all three sources were found by immunofluorescence to express the pluripotency markers SSEA-4, TRA-1-60, TRA-1-81, OCT4, and SOX2 and were able to form embryoid bodies containing cells expressing genes specific to endoderm (AFP, HNF4, and GATA4), mesoderm (MSX1, BMP4, and ASA), and ectoderm (cytokeratin 8 and NF68). Reverse transcriptase PCR (RT-PCR) showed cells from all sources to be positive for pluripotency markers OCT4, SOX2, NANOG, STAT3, REX1, FOXD3, NUCLEOSTEMIN, and TELOMERASE. Pluripotency markers OCT4, SOX2, NANOG, and c-MYC were also analyzed by real-time PCR. No significant differences were observed among ESCs from all three sources for all these genes except NANOG, whose expression was higher (p<0.05) in HMC-derived ESCs (6.897±2.3) compared to that in parthenogenesis- and IVF-derived cells (1.603±0.315 and 1±0, respectively). Pluripotent, stable buffalo ESC lines derived from IVF, parthenogenesis, and HMC embryos may be genetically manipulated to provide a powerful tool for studies involving embryonic development, genomic imprinting, gene targeting, cloning, chimera formation, and transgenic animal production.

Ethical conundrums in research

Several ethical concerns are central to the field of medical research. A sampling of these ethical conundrums include fraudulent data, publication bias, conflict of interest, IRB compliance, and confidentiality. In this article we attempt to highlight some of the components central to these areas of concern. In doing so we hope to generate discussion regarding some of the main areas of ethical concern in dermatologic and scientific bench side research. Additionally, we suggest that the use of journal publications, presentations, and training sessions, in concert with the development of dermatoethics courses as components of dermatology residency program curricula, can be used to maintain the academic discourse on ethics and minimize the risk of ethical conflict in the field of dermatologic research. These efforts will serve to maintain the quality and integrity of research on skin diseases.

Social science in a stem cell laboratory: what happened when social and life sciences met

We describe the experience of conducting intensive social science research at the UK Stem Cell Bank from the viewpoint of both the person conducting the social science research and the Director of the Bank. We detail the initial misunderstandings and concerns held by both and the problems these caused. Then we describe how the relationship developed as the project progressed and shared benefits became apparent. Finally, while acknowledging potential areas of tension between the life and social sciences, we suggest further interaction between the disciplines would prove beneficial for both and speculate as to how this may be achieved. In the discussion we identify a set of learning points from our experience and definitions of social science terminology that may help to inform future engagements between life and social scientists.

Retracted science and the retraction index

Articles may be retracted when their findings are no longer considered trustworthy due to scientific misconduct or error, they plagiarize previously published work, or they are found to violate ethical guidelines. Using a novel measure that we call the "retraction index," we found that the frequency of retraction varies among journals and shows a strong correlation with the journal impact factor. Although retractions are relatively rare, the retraction process is essential for correcting the literature and maintaining trust in the scientific process.

Science at the Crossroads: Fact or Fiction?

Modern Academic Science is largely based on the formulation of hypotheses that are then confirmed through observations and experiments. There is little scope forcuriositythat played an important role in early Science. Results carrying negative implications are not easy to publish, and hypotheses have a tendency to take on the mantra of religious beliefs. Academic Science is facing on many fronts pressures that hardly existed in the past. Financial rewards apart from salary can be very high, in the form of fees for consultants, expert legal witnesses, patent development, and even the establishment of private companies. Commercial funding forms a significant percentage of the Total Research Budgets in Science and Medicine, but this often leads to loss of control over research protocols and freedom to communicate the results. Media attention confers fame and prestige that is assiduously sought out by some individual scientists, often supported by University resources, and Press Conferences prior to or synchronous with actual publication. Scientists have long been employed full-time by Government Departments, but research contracts are being increasingly offered by the latter to academic staff on a part-time basis. These pressures and opportunities, together with the priority given to research by most University Tenure and Promotion Committees, are tending to diminish the appetite of scientists for other important responsibilities such as teaching and administration. In a few decades, University scientists have moved from the »Ivory Tower« to the High Street, and many are serving more than one master. The above scenario may bring increased remuneration and the pursuit of research that would be too expensive without these external sources, but adverse consequences have also occurred. They may lead to the complicity of scientists, through no fault of their own, in the introduction of drugs and supplements that: a) fail to deliver the benefits claimed; b) increase the risk of some unrelated illness; c) possess dangerous side effects not known or reported at the time of introduction. Examples include hormone replacement therapy and antioxidant vitamins (A and E) to protect against Coronary Heart Disease; dietary fibre to prevent colon cancer; and arguably calcium supplements to treat osteoporosis. On occasions, academic scientists have served as fronts for the publication by the manufacturers of falsified reports minimizing the risk of serious drug side-effects to ensure Regulatory Approval, as occurred with Vioxx in the treatment of arthritis, and Seroquel for schizophrenia and bipolar depression. Individual fraud or misconduct is more frequent than suspected, because most incidents are without major impact and are suppressed by Universities and Funding Agencies. Major scandals are rare, but may have serious repercussions for the general public and bring science into disrepute. Recent examples include: the Cold Fusion controversy (Low Energy Nuclear Reaction); the link age by Andrew Wakefield of autism with Rubella vaccination; the infamous creation of stem cells by somatic cell nuclear transfer falsely reported by Hwang Woo-Suk. Fraud by commercial companies is subject to the full force of the law, but Science is treated as a self-regulating profession, and as such the punishments handed out are relatively trivial. In essence, Science prior to 1950, except in North America, proceeded along a highway that segregated the traffic into Commercial, Government and Academic streams, and passed through inspiring landscapes and green pastures. It later came to a crossroads from which the alternative road led to the Marketplace, and on which segregation into the above three streams was not enforced. It has now become the main thoroughfare for Science world-wide, but there are reasons to believe that this has increased the incidence of dangerous driving and traffic accidents in the form of conflicts of interest, unethical behaviour, misconduct and even fraud. It may be too late to return to the crossroads and continue along the original highway, but there could be considerable merit in restoring the original segregation between the three streams of Science and in developing, as well as enforcing, a stricter code of behaviour, for which some elements are proposed.

The implications of fraud in medical and scientific research

Fraud is an important issue that affects research of both scientific and clinical fields because of its potential to adversely affect patient care. Fraud can take many forms, each with varying prevalence and implications. A number of ethical institutions have been created to investigate and regulate this malpractice. Using case examples, we describe the various forms of fraud and their potential implications. The increasing importance of editorial responsibility is highlighted and discussed. Finally, we suggest solutions for how to effectively regulate and eradicate this practise.