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Yan YC, Li H, Tian Y. [Current status and challenges of long-term safety evaluation of using tests of cosmetics on human body]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:2220-2223. [PMID: 38186179 DOI: 10.3760/cma.j.cn112150-20230509-00358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
The use of cosmetics in the crowd has the long-term characteristics. The adverse reactions of cosmetics reported in other country in the world suggest that human patch tests and short-term human using test may not be sufficient to evaluate the safety of high-risk new cosmetic raw ingredients, and long-term human using test should be conducted for evaluation. Therefore, this article reviews the key factors that affect long-term human trial trials, such as site of use, single-use amount, frequency of use, duration of use, and subject conditions, providing supportive evidence for standardized safety evaluation standards for long-term human using test of cosmetics.
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Affiliation(s)
- Y C Yan
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing 100034, China
| | - H Li
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, National Medical Products Administration Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing 100034, China
| | - Y Tian
- Department of Dermatology, Air Force Medical Center of PLA, Beijing 100142, China
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Schütz M, Braswell H. Ethicizing history. Bioethical representations of Nazi medicine. Bioethics 2023; 37:581-590. [PMID: 37119534 DOI: 10.1111/bioe.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/17/2023] [Accepted: 04/04/2023] [Indexed: 06/11/2023]
Abstract
The article presents and analyzes different approaches of U.S. bioethicists in comprehending the Nazi medical crimes after 1945. The account is divided into two sections: one dealing with discussions on research ethics and the Nuremberg Code up until the 1970s and the other ranging from the 1970s to the present and highlighting bioethics' engagement with Nazi analogies. The portrayal of different bioethical scholars, institutions, and documents-most notably Henry K. Beecher, Jay Katz, the Belmont Report, the Hastings Center, Arthur L. Caplan, and Robert M. Veatch-provides a nuanced interpretation of the motives that bioethicists held and the strategies that they applied to establish an understanding of the Nazi medical crimes and their relation to contemporary bioethical issues. In this, the different approaches shared a common goal: To integrate the Nazi medical crimes into an ethical framework by means of selective acknowledgments and representation of their history.
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Affiliation(s)
- Mathias Schütz
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, München, Germany
| | - Harold Braswell
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, St. Louis, USA
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Nordling L. When science goes wrong-misrepresentation, coercion, and undue influence when paying research participants. BMJ 2023; 380:686. [PMID: 36977513 DOI: 10.1136/bmj.p686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Ross LF. The philosopher as partner: an introduction to the scholarship of Robert M. Veatch. Theor Med Bioeth 2022; 43:179-185. [PMID: 35831560 PMCID: PMC9281290 DOI: 10.1007/s11017-022-09572-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
A diverse group of scholars reflect on the scholarship of Robert M. Veatch, the breadth of which is unmatched in modern day bioethics. Essays were written by both philosophers and clinician-philosophers, by contemporaries and mentees. They span the breadth of Bob's work and include analyses of his ideas about death, dying and organ transplantation, human experimentation and research ethics, disability, equality and justice, the doctor-patient relationship, the history of bioethics, as well as his pedagogical approach to teaching bioethics to clinicians across the health care spectrum. Recognition of Bob's influence in the modern field of bioethics and the challenges that persist are clearly identified.
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Affiliation(s)
- Lainie Friedman Ross
- MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA.
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Johnson K. A Scientific Method to the Madness of Unit 731's Human Experimentation and Biological Warfare Program. J Hist Med Allied Sci 2022; 77:24-47. [PMID: 34897467 DOI: 10.1093/jhmas/jrab044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Japanese Imperial Army Unit 731's Biological Warfare (BW) research program committed atrocious crimes against humanity in their pursuit of biological weapons development during the Second World War. Due to an American cover-up, the details behind Unit 731's human experimentation were slow to be revealed. The recent literature discloses the gruesome details of the experiments but characterizes the human trials as crude in nature. Further, there is a lack of clarity as to how human trial results were extrapolated for use in real world missions. Through an examination of testimony from the Soviet Union's Khabarovsk War Crime Trials, this paper argues that Unit 731's inoculation and airborne warfare experiments on prisoners of war were scientifically rigorous. The scientific method is used as the basis against which the scientific rigor of the experiments is tested. The paper reveals that the successes and failures of the human trials were extrapolated to BW missions during the Sino-Japanese war. American researchers' expectations of BW data were fulfilled, thus paving the way for an immunity deal. Ethical standards in medicine before WWII were not well established, but wartime medical practices and experimentation reveal the context in which the pursuit of scientific knowledge has no boundaries.
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Różyńska J. Taking the principle of the primacy of the human being seriously. Med Health Care Philos 2021; 24:547-562. [PMID: 34318429 PMCID: PMC8557179 DOI: 10.1007/s11019-021-10043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
This paper targets an orphan topic in research ethics, namely the so called principle of the primacy of the human being, which states that the interests of the human subject should always take precedence over the interests of science and society. Although the principle occupies the central position in the majority of international ethical and legal standards for biomedical research, it has been commented in the literature mainly in passing. With a few notable exceptions, there is little in-depth discussion about the meaning and role of the principle. Several authors note that the principle is vogue, ambiguous and apparently conflicting with the accepted practice of conducting non-beneficial research on individuals unable to give consent. There are opinions that it is just "a vacuous figure of speech" and should be abandoned. This paper argues that the primacy principle is far from being "a vacuous figure of speech", rather it should be seen as a threefold concept: a fundamental interpretative rule, a procedural rule, and a substantive rule aimed at protecting research subjects from instrumental treatment and unacceptable risks. This interpretation tracks back to the principle regulatory and normative origins in the Declaration of Helsinki of 1975, but also acknowledges changes in research ethics and practice, which took place at the turn on the twentieth and twenty-first centuries. Thus, the proposed reading of the principle is not only original, but also historically grounded and normatively fruitful. It provides a fresh and ethically rich perspective on extensively debated, but still controversial problem of an upper limit of permissible risks in non-beneficial studies.
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Affiliation(s)
- Joanna Różyńska
- Center for Bioethics and Biolaw, Faculty of Philosophy, University of Warsaw, Krakowskie Przedmiescie 3, 00-047, Warsaw, Poland.
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Abstract
This article focuses on medical trials performed by Dr. Albert Kligman on the inmates of Philadelphia's Holmesburg Prison between 1951 and 1974, which have been widely criticized as exploitative. I seek to investigate the mechanics behind the "ethical blind spot" that enabled the American medical community to laud Kligman for his efforts while simultaneously condemning the medical atrocities of the Holocaust and supporting the development of the Nuremberg Code. I argue that this nonrecognition hinges on a colonial logic by which certain populations are produced as waste, both rhetorically and materially. Drawing on the incarcerated men's accounts included in Allen Hornblum's books on the subject, I trace the process by which human beings come to be reclassified as natural resources and their exploitation recast as industrious cultivation.
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Schicktanz S, Stoff H. The legacy of the Holocaust in bioethics. Bioethics 2021; 35:497-498. [PMID: 34318493 DOI: 10.1111/bioe.12909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Silke Schicktanz
- University Medical Center, University of Goettingen, Goettingen, Germany
| | - Heiko Stoff
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
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Tucker KD, Schanen BC, Phares TW, Sassano E, Terry FE, Hindocha P, Moise L, Kotraiah V, Martin WD, De Groot AS, Drake DR, Gutierrez GM, Noe AR. Identification, Selection and Immune Assessment of Liver Stage CD8 T Cell Epitopes From Plasmodium falciparum. Front Immunol 2021; 12:684116. [PMID: 34025684 PMCID: PMC8138313 DOI: 10.3389/fimmu.2021.684116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
Immunization with radiation-attenuated sporozoites (RAS) has been shown to protect against malaria infection, primarily through CD8 T cell responses, but protection is limited based on parasite strain. Therefore, while CD8 T cells are an ideal effector population target for liver stage malaria vaccine development strategies, such strategies must incorporate conserved epitopes that cover a large range of class I human leukocyte antigen (HLA) supertypes to elicit cross-strain immunity across the target population. This approach requires identifying and characterizing a wide range of CD8 T cell epitopes for incorporation into a vaccine such that coverage across a large range of class I HLA alleles is attained. Accordingly, we devised an experimental framework to identify CD8 T cell epitopes from novel and minimally characterized antigens found at the pre-erythrocytic stage of parasite development. Through in silico analysis we selected conserved P. falciparum proteins, using P. vivax orthologues to establish stringent conservation parameters, predicted to have a high number of T cell epitopes across a set of six class I HLA alleles representative of major supertypes. Using the decision framework, five proteins were selected based on the density and number of predicted epitopes. Selected epitopes were synthesized as peptides and evaluated for binding to the class I HLA alleles in vitro to verify in silico binding predictions, and subsequently for stimulation of human T cells using the Modular IMmune In-vitro Construct (MIMIC®) technology to verify immunogenicity. By combining the in silico tools with the ex vivo high throughput MIMIC platform, we identified 15 novel CD8 T cell epitopes capable of stimulating an immune response in alleles across the class I HLA panel. We recommend these epitopes should be evaluated in appropriate in vivo humanized immune system models to determine their protective efficacy for potential inclusion in future vaccines.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Anne S. De Groot
- EpiVax Inc., Providence, RI, United States
- University of Georgia Center for Vaccines and Immunology, Athens, GA, United States
| | | | | | - Amy R. Noe
- Leidos Life Sciences, Leidos Inc., Frederick, MD, United States
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Joshi D, Hill N, Hruby A, Viswanathan S, Ingo C, Roth H, Sukal-Moulton T. Stakeholder Perspectives on Engaging With Cerebral Palsy Research Studies After Onset of COVID-19 in the United States. Arch Phys Med Rehabil 2021; 102:1547-1555. [PMID: 33713698 PMCID: PMC8349750 DOI: 10.1016/j.apmr.2021.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/28/2022]
Abstract
Objective To investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on perspectives toward participation in cerebral palsy (CP) research. Design An online survey with questions relating to the comfort levels of research participation was filled out by people who had CP or had a child with CP. Setting The online survey was administered through Research Electronic Data Capture platform. Participants A total of 233 (n=233) individuals with CP (42.5%; n=99) or with a child with CP (57.1%; n=133) consented and at least partially completed the online survey (n=210 complete; n=23 partially complete). All participants resided in the United States. Interventions Not applicable. Main Outcome Measures Readiness to participate was analyzed in the context of the time point for research participation during COVID-19 and whether or not the study offered direct benefits to participants. Results Participants were consistently willing to participate sooner in studies that offered direct benefit than in those that did not. Adults responding for themselves had sooner time points for studies without direct benefit compared with parents answering for a child (P=.030). Gross Motor Function Classification System level, but not age or CP type, affected the time point for studies without direct benefit (P=.017). Personal values influenced selected time point for studies without direct benefit (P=.007), whereas environmental factors affected the time point for studies with direct benefit (P=.002). Local COVID-19 incidence rates were not associated with time points for either research type; however, respondents expected precautions to be taken if they chose to participate. Conclusions As the pandemic evolves, researchers should consider the perspectives of potential participants as well as ethical and safety factors when reinitiating in-person CP research.
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Affiliation(s)
- Divya Joshi
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Biomedical Engineering, Northwestern University, Evanston, IL
| | - Nayo Hill
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Biomedical Engineering, Northwestern University, Evanston, IL
| | - Alexandra Hruby
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Biomedical Engineering, Northwestern University, Evanston, IL
| | - Shreya Viswanathan
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA
| | - Carson Ingo
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Heidi Roth
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Shirley Ryan AbilityLab, Chicago, IL
| | - Theresa Sukal-Moulton
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL.
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Fernandez Lynch H, Largent EA. Compensating for research risk: permissible but not obligatory. J Med Ethics 2020; 46:827-828. [PMID: 33051381 DOI: 10.1136/medethics-2020-106829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Holly Fernandez Lynch
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Emily A Largent
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Reverby SM. Compensation and reparations for victims and bystanders of the U.S. Public Health Service research studies in Tuskegee and Guatemala: Who do we owe what? Bioethics 2020; 34:893-898. [PMID: 32608027 DOI: 10.1111/bioe.12784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
Using the infamous research studies in Tuskegee and Guatemala, the article examines the difference between victims and bystanders. The victims can include families, sexual partners, and children not just the participants. There are also the bystanders in the populations who are affected, even vaguely, decades after the initial studies took place. Differing reparations for victims and bystanders through lawsuits and historical acknowledgments has to be part of broader discussions of historical justice, and the weighing of the impact of racism and imperial research endeavors.
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Affiliation(s)
- Susan M Reverby
- Women's and Gender Studies Department, Wellesley College, Wellesley, Massachusetts
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Taylor HA, Mogul DB. Digital Negotiations: Navigating Parental Permission and Adolescent Assent for On-Line Survey Participation. Am J Bioeth 2020; 20:84-85. [PMID: 32945751 DOI: 10.1080/15265161.2020.1806375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Fish M, Shahvisi A, Gwaambuka T, Tangwa GB, Ncayiyana D, Earp BD. A new Tuskegee? Unethical human experimentation and Western neocolonialism in the mass circumcision of African men. Dev World Bioeth 2020; 21:211-226. [PMID: 32909369 DOI: 10.1111/dewb.12285] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022]
Abstract
Campaigns to circumcise millions of boys and men to reduce HIV transmission are being conducted throughout eastern and southern Africa, recommended by the World Health Organization and implemented by the United States government and Western NGOs. In the United States, proposals to mass-circumcise African and African American men are longstanding, and have historically relied on racist beliefs and stereotypes. The present campaigns were started in haste, without adequate contextual research, and the manner in which they have been carried out implies troubling assumptions about culture, health, and sexuality in Africa, as well as a failure to properly consider the economic determinants of HIV prevalence. This critical appraisal examines the history and politics of these circumcision campaigns while highlighting the relevance of race and colonialism. It argues that the "circumcision solution" to African HIV epidemics has more to do with cultural imperialism than with sound health policy, and concludes that African communities need a means of robust representation within the regime.
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Pieper IJ, Thomson CJH. Vulnerability in human research. Monash Bioeth Rev 2020; 38:68-82. [PMID: 32342442 DOI: 10.1007/s40592-020-00110-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The conduct of prior ethics review of human research projects helps to protect vulnerable groups or populations from potential negative impacts of research. Contemporary considerations in human research considers the concept of vulnerability in terms of access to research opportunities, impacts on the consenting process, selection bias, and the generalisability of results. Recent work questions the validity of using enumerated lists as a check box approach to protect research participants from exploitation. Through the use of broad categories to treat cohorts of human research participants as homogenous classes and label some participants as vulnerable merely because they are members of a particular class, some ethics reviewers have used the National Statement on Ethical Conduct in Human Research to strip individuals of their "ethical equality". Labelling people as vulnerable does not help researchers or human research ethics committee members develop an understanding of the complexities of applying the principles of respect and of justice in ethical decision-making. Conversely, defining specific cohorts of research participants as needing nuanced ethical consideration, due to their vulnerable nature, may imply that other population groups need not be considered vulnerable. We contend that this assumption is erroneous. This paper explores the way that human research ethics guidance documents treat vulnerability within the Australian context and draws on contemporary discussion to focus an alternative perspective based on the principles in the National Statement on Ethical Conduct in Human Research for researchers and human research ethics committee members to consider.
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Affiliation(s)
- Ian J Pieper
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George St., Brisbane, QLD, 4000, Australia.
| | - Colin J H Thomson
- Australasian Human Research Ethics Consultancy Services Pty Ltd, Brisbane, Australia
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Affiliation(s)
- Benjamin S Wilfond
- Seattle Children's Research Institute
- University of Washington School of Medicine
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Abstract
Zinc is an essential element for humans, and its deficiency was documented in 1963. Nutritional zinc deficiency is now known to affect over two billion subjects in the developing world. Conditioned deficiency of zinc in many diseases has also been observed. In zinc-deficient dwarfs from the Middle East, we reported growth retardation, delayed sexual development, susceptibility to infections, poor appetite, and mental lethargy. We never found a zinc-deficient dwarf who survived beyond the age of 25 y. In an experimental model of human mild zinc deficiency, we reported decreased thymulin (a thymopoietic hormone) activity in Th1 cells, decreased mRNAs of IL-2 and IFN-gamma genes, and decreased activity of natural killer cells (NK) and T cytotoxic T cells. The effect of zinc deficiency on thymulin activity and IL-2 mRNA was seen within eight to twelve weeks of the institution of zinc-deficient diet in human volunteers, whereas lymphocyte zinc decreased in 20 weeks and plasma zinc decreased in 24 weeks after instituting zinc-deficient diet. We hypothesized that decreased thymulin activity, which is known to proliferate Th1 cells, decreased the proliferation differentiation of Th1 cells. This resulted in decreased generation of IL-2 and IFN-gamma. We observed no effect in Th2 cell function; thus, zinc deficiency resulted in an imbalance of Th1 to Th2 function resulting in decreased cell-mediated immunity. Zinc therapy may be very useful in many chronic diseases. Zinc supplementation improves cell-mediated immunity, decreases oxidative stress, and decreases generation of chronic inflammatory cytokines in humans. Development of sensitive immunological biomarkers may be more sensitive than an assay of zinc in plasma and peripheral blood cells for diagnosis of marginal zinc deficiency in human.
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Affiliation(s)
- Ananda S. Prasad
- Department of Oncology, Wayne State University School of Medicine and Barbara Ann Karmanos Cancer Center, Detroit, Michigan 48201, USA
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Abstract
This article reports the outcomes of qualitative research on the teaching of "vulnerability in research" undertaken with principal investigators of international bioethics training programs funded by the Fogarty International Center of the National Institutes of Health (NIH) of the United States. To properly contextualize this research, we begin with an overview of the various ways in which vulnerability has been conceptualized both by writers and by ethical guidance from low-, middle-, and high-income countries. We conclude with some preliminary suggestions for best practice and recommendations for further research. To the best of our knowledge, this is the first time research of this kind has been carried out.
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Affiliation(s)
- Sana Loue
- Case Western Reserve University School of Medicine, Cleveland (USA)
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Madden VJ, Bedwell GJ, Chikezie PC, Rice ASC, Kamerman PR. A systematic review of experimental methods to manipulate secondary hyperalgesia in humans: protocol. Syst Rev 2019; 8:208. [PMID: 31426841 PMCID: PMC6700765 DOI: 10.1186/s13643-019-1120-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/26/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Neuropathic pain affects 7-10% of people, but responds poorly to pharmacotherapy, indicating a need for better treatments. Mechanistic research on neuropathic pain frequently uses human surrogate models of the secondary hyperalgesia that is a common feature of neuropathic pain. Experimentally induced secondary hyperalgesia has been manipulated with pharmacological and non-pharmacological methods to clarify the relative contributions of different mechanisms to secondary hyperalgesia. However, this literature has not been systematically synthesised. The aim of this systematic review is to identify, describe, and compare methods that have been used to manipulate experimentally induced secondary hyperalgesia in healthy humans. METHODS A systematic search strategy will be supplemented by reference list checks and direct contact with identified laboratories to maximise the identification of data reporting the experimental manipulation of experimentally induced secondary hyperalgesia in healthy humans. Duplicated screening, risk of bias assessment, and data extraction procedures will be used. Authors will be asked to provide data as necessary. Data will be pooled and meta-analyses conducted where possible, with subgrouping according to manipulation method. Manipulation methods will be ranked for potency and risk. DISCUSSION The results of this review will provide a useful reference for researchers interested in using experimental methods to manipulate secondary hyperalgesia in humans and will help to clarify the relative contributions of different mechanisms to secondary hyperalgesia. SYSTEMATIC REVIEW REGISTRATION This protocol will be registered on PROSPERO before the review begins. Review records will be updated on PROSPERO once the review is complete. This review is intended for publication in a peer-reviewed journal. Analyses and scripts will be made publicly available.
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Affiliation(s)
- Victoria J. Madden
- Pain Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, D23.30 Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Gillian J. Bedwell
- Pain Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, D23.30 Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Prince C. Chikezie
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Andrew S. C. Rice
- Pain Research Group, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Peter R. Kamerman
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, Australia
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Mildenberger FG. [Urology, gynecology, and andrology united against infertility? : The careers of Boris Belonoschkin (1906-1988)]. Urologe A 2019; 58:1338-1342. [PMID: 31236654 DOI: 10.1007/s00120-019-0979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Male arrogance, medical ignorance of anatomy and functioning of the human genitals, and social reservations about sex education have hampered urological and gynecological research since the 1920s. This changed under the premises of National Socialism when some physicians willing to cooperate were given the opportunity to perform human experiments. The gynecologist Boris Belonoschkin was one of them. He continued his career in Sweden after 1945, where he became an internationally respected scholar. As such, he was able to bring books of his former German colleagues to international attention again. He also promoted andrological research in Western Germany.
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Affiliation(s)
- Florian G Mildenberger
- Institut für Geschichte der Medizin, Robert Bosch Stiftung, Straußweg 17, 70184, Stuttgart, Deutschland.
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Sherman AC, Mehta A, Dickert NW, Anderson EJ, Rouphael N. The Future of Flu: A Review of the Human Challenge Model and Systems Biology for Advancement of Influenza Vaccinology. Front Cell Infect Microbiol 2019; 9:107. [PMID: 31065546 PMCID: PMC6489464 DOI: 10.3389/fcimb.2019.00107] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/28/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: Novel approaches to advance the field of vaccinology must be investigated, and are particularly of importance for influenza in order to produce a more effective vaccine. A systematic review of human challenge studies for influenza was performed, with the goal of assessing safety and ethics and determining how these studies have led to therapeutic and vaccine development. A systematic review of systems biology approaches for the study of influenza was also performed, with a focus on how this technology has been utilized for influenza vaccine development. Methods: The PubMed database was searched for influenza human challenge studies, and for systems biology studies that have addressed both influenza infection and immunological effects of vaccination. Results: Influenza human challenge studies have led to important advancements in therapeutics and influenza immunization, and can be performed safely and ethically if certain criteria are met. Many studies have investigated the use of systems biology for evaluating immune response to influenza vaccine, and several promising molecular signatures may help advance our understanding of pathogenesis and be used as targets for influenza interventions. Combining these methodologies has the potential to lead to significant advances in the field of influenza vaccinology and therapeutics. Conclusions: Human challenge studies and systems biology approaches are important tools that should be used in concert to advance our understanding of influenza infection and provide targets for novel therapeutics and immunizations.
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Affiliation(s)
- Amy Caryn Sherman
- Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, United States
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Iqbal A, Prince LR, Novodvorsky P, Bernjak A, Thomas MR, Birch L, Lambert D, Kay LJ, Wright FJ, Macdonald IA, Jacques RM, Storey RF, McCrimmon RJ, Francis S, Heller SR, Sabroe I. Effect of Hypoglycemia on Inflammatory Responses and the Response to Low-Dose Endotoxemia in Humans. J Clin Endocrinol Metab 2019; 104:1187-1199. [PMID: 30252067 PMCID: PMC6391720 DOI: 10.1210/jc.2018-01168] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/19/2018] [Indexed: 12/20/2022]
Abstract
CONTEXT Hypoglycemia is emerging as a risk for cardiovascular events in diabetes. We hypothesized that hypoglycemia activates the innate immune system, which is known to increase cardiovascular risk. OBJECTIVE To determine whether hypoglycemia modifies subsequent innate immune system responses. DESIGN AND SETTING Single-blinded, prospective study of three independent parallel groups. PARTICIPANTS AND INTERVENTIONS Twenty-four healthy participants underwent either a hyperinsulinemic-hypoglycemic (2.5 mmol/L), euglycemic (6.0 mmol/L), or sham-saline clamp (n = 8 for each group). After 48 hours, all participants received low-dose (0.3 ng/kg) intravenous endotoxin. MAIN OUTCOME MEASURES We studied in-vivo monocyte mobilization and monocyte-platelet interactions. RESULTS Hypoglycemia increased total leukocytes (9.98 ± 1.14 × 109/L vs euglycemia 4.38 ± 0.53 × 109/L, P < 0.001; vs sham-saline 4.76 ± 0.36 × 109/L, P < 0.001) (mean ± SEM), mobilized proinflammatory intermediate monocytes (42.20 ± 7.52/μL vs euglycemia 20.66 ± 3.43/μL, P < 0.01; vs sham-saline 26.20 ± 3.86/μL, P < 0.05), and nonclassic monocytes (36.16 ± 4.66/μL vs euglycemia 12.72 ± 2.42/μL, P < 0.001; vs sham-saline 19.05 ± 3.81/μL, P < 0.001). Following hypoglycemia vs euglycemia, platelet aggregation to agonist (area under the curve) increased (73.87 ± 7.30 vs 52.50 ± 4.04, P < 0.05) and formation of monocyte-platelet aggregates increased (96.05 ± 14.51/μL vs 49.32 ± 6.41/μL, P < 0.05). Within monocyte subsets, hypoglycemia increased aggregation of intermediate monocytes (10.51 ± 1.42/μL vs euglycemia 4.19 ± 1.08/μL, P < 0.05; vs sham-saline 3.81± 1.42/μL, P < 0.05) and nonclassic monocytes (9.53 ± 1.08/μL vs euglycemia 2.86 ± 0.72/μL, P < 0.01; vs sham-saline 3.08 ± 1.01/μL, P < 0.05), with platelets compared with controls. Hypoglycemia led to greater leukocyte mobilization in response to subsequent low-dose endotoxin challenge (10.96 ± 0.97 vs euglycemia 8.21 ± 0.85 × 109/L, P < 0.05). CONCLUSIONS Hypoglycemia mobilizes monocytes, increases platelet reactivity, promotes interaction between platelets and proinflammatory monocytes, and potentiates the subsequent immune response to endotoxin. These changes may contribute to increased cardiovascular risk observed in people with diabetes.
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Affiliation(s)
- Ahmed Iqbal
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Lynne R Prince
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Peter Novodvorsky
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Alan Bernjak
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Mark R Thomas
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Lewis Birch
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Danielle Lambert
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Linda J Kay
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Fiona J Wright
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University Nottingham, Nottingham, United Kingdom
| | - Richard M Jacques
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Robert F Storey
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Rory J McCrimmon
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, United Kingdom
| | - Sheila Francis
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Simon R Heller
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Correspondence and Reprint Requests: Simon R. Heller, DM, Department of Oncology and Metabolism, University of Sheffield, Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom. E-mail:
| | - Ian Sabroe
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Abstract
A recent National Academy report on research integrity noted that policies are not evidence-based, with no formal entity responsible to attend to this deficit. Here we describe four areas of research misconduct (RM) regulations governing Public Health Service funded research that are empirically and/or ethically questionable. Policies for human subject protection, RM and conflict of interest are not harmonized, making it extremely difficult to deal with complex cases which often contain allegations in all of these areas. Second, detection of RM has depended entirely on whistleblowers in spite of evidence of significant under-reporting. Third, the scientific record is far from cleansed of the effects of falsified/fabricated work through current mechanisms of retraction. Finally, lack of fairness in the regulations may reflect lack of a Belmont Report-like document to guide ethics of RM policy. These issues are likely common in other countries. RM regulations should be harmonized with related regulations and their effectiveness tracked, open access to data for independent replication and improved statistical tests are an essential supplement to whistleblowers, correction of the scientific record will require a major effort, and further ethical analysis and guidance are as important as is empirical study for the improvement of RM regulations. Further consideration should be given to assigning current regulations for human subjects protection, RM and conflict of interest to a single authority and to the further development of a Belmont-like report of essential principles, for RM.
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Affiliation(s)
- Barbara K Redman
- Division of Medical Ethics, New York University Langone Medical Center, 227 East 30th Street, #753, New York, NY, 10016, USA.
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Ballantyne A. Adjusting the focus: A public health ethics approach to data research. Bioethics 2019; 33:357-366. [PMID: 30667080 DOI: 10.1111/bioe.12551] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
This paper contends that a research ethics approach to the regulation of health data research is unhelpful in the era of population-level research and big data because it results in a primary focus on consent (meta-, broad, dynamic and/or specific consent). Two recent guidelines - the 2016 WMA Declaration of Taipei on ethical considerations regarding health databases and biobanks and the revised CIOMS International ethical guidelines for health-related research involving humans - both focus on the growing reliance on health data for research. But as research ethics documents, they remain (to varying degrees) focused on consent and individual control of data use. Many current and future uses of health data make individual consent impractical, if not impossible. Many of the risks of secondary data use apply to communities and stakeholders rather than individual data subjects. Shifting from a research ethics perspective to a public health lens brings a different set of issues into view: how are the benefits and burdens of data use distributed, how can data research empower communities, who has legitimate decision-making capacity? I propose that a public health ethics framework - based on public benefit, proportionality, equity, trust and accountability - provides more appropriate tools for assessing the ethical uses of health data. The main advantage of a public health approach for data research is that it is more likely to foster debate about power, justice and equity and to highlight the complexity of deciding when data use is in the public interest.
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Astaneh B, Khani P. The Frequency of Reporting Ethical Issues in Human Subject Articles Published in Iranian Medical Journals: 2009-2013. Sci Eng Ethics 2019; 25:159-170. [PMID: 29127671 DOI: 10.1007/s11948-017-9989-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
Researchers should strictly consider the participants' rights. They are required to document such protections as an ethical approval of the study proposal, the obtaining "informed consent", the authors' "conflict of interests", and the source of "financial support" in the published articles. The purpose of this study was to assess the frequency of reporting ethical issues in human subject articles published in Iranian medical journals during 2009-2013. In this cross-sectional study, we randomly reviewed 1460 human subject articles published in Iranian medical journals during 2009-2013 in two Persian and English language groups. Data collection was carried out by assessing articles, focusing on the documentation "ethics committee approval", patients' "informed consent", "financial support", "confidentiality", and "conflict of interest". Of 1460 evaluated articles, 443 (30.3%) reported "ethics committee approval", 686 (47.0%) reported "informed consent", 594 (40.7%) reported "financial support", and 341 (23.4%) reported "conflict of interest". 13% of the articles referred to patients' confidentiality in their text. There was a significant association between these ethical documentations and the year of publication. Articles published in English language journals reported "ethics committee approval", "financial support", and "conflict of interest" significantly more than Persian language journals, but the frequency of "informed consent" was similar. Ethical documentation rate in Iranian medical journals is not up to the expected standards of reputable journals which might be related to a lack of awareness and the education of the authors and the journal's editors. Precise reporting of ethical considerations in medical articles by authors are recommended. It is suggested journals and policymakers pay more attention to reporting this issue while providing standard guidelines in this regard.
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Affiliation(s)
- Behrooz Astaneh
- Medical Journalism Department, Paramedical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Khani
- Medical Journalism Department, Paramedical School, Shiraz University of Medical Sciences, Shiraz, Iran.
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Bouali Ave, Safayeh, P.O. Box 89195-999, Yazd, Iran.
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Vicens J, Perelló J, Duch J. Citizen Social Lab: A digital platform for human behavior experimentation within a citizen science framework. PLoS One 2018; 13:e0207219. [PMID: 30521566 PMCID: PMC6283465 DOI: 10.1371/journal.pone.0207219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/26/2018] [Indexed: 11/25/2022] Open
Abstract
Cooperation is one of the behavioral traits that define human beings, however we are still trying to understand why humans cooperate. Behavioral experiments have been largely conducted to shed light into the mechanisms behind cooperation-and other behavioral traits. However, most of these experiments have been conducted in laboratories with highly controlled experimental protocols but with limitations in terms of subject pool or decisions' context, which limits the reproducibility and the generalization of the results obtained. In an attempt to overcome these limitations, some experimental approaches have moved human behavior experimentation from laboratories to public spaces, where behaviors occur naturally, and have opened the participation to the general public within the citizen science framework. Given the open nature of these environments, it is critical to establish the appropriate data collection protocols to maintain the same data quality that one can obtain in the laboratories. In this article we introduce Citizen Social Lab, a software platform designed to be used in the wild using citizen science practices. The platform allows researchers to collect data in a more realistic context while maintaining the scientific rigor, and it is structured in a modular and scalable way so it can also be easily adapted for online or brick-and-mortar experimental laboratories. Following citizen science guidelines, the platform is designed to motivate a more general population into participation, but also to promote engaging and learning of the scientific research process. We also review the main results of the experiments performed using the platform up to now, and the set of games that each experiment includes. Finally, we evaluate some properties of the platform, such as the heterogeneity of the samples of the experiments, the satisfaction level of participants, or the technical parameters that demonstrate the robustness of the platform and the quality of the data collected.
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Affiliation(s)
- Julián Vicens
- Departament d’Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Tarragona, Spain
- Universitat de Barcelona Institute of Complex Systems UBICS, Universitat de Barcelona, Barcelona, Spain
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, Barcelona, Spain
| | - Josep Perelló
- Universitat de Barcelona Institute of Complex Systems UBICS, Universitat de Barcelona, Barcelona, Spain
- Departament de Física de la Matèria Condensada, Universitat de Barcelona, Barcelona, Spain
| | - Jordi Duch
- Departament d’Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Tarragona, Spain
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Geven C, van Lier D, Blet A, Peelen R, ten Elzen B, Mebazaa A, Kox M, Pickkers P. Safety, tolerability and pharmacokinetics/pharmacodynamics of the adrenomedullin antibody adrecizumab in a first-in-human study and during experimental human endotoxaemia in healthy subjects. Br J Clin Pharmacol 2018; 84:2129-2141. [PMID: 29856470 PMCID: PMC6089825 DOI: 10.1111/bcp.13655] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/18/2018] [Accepted: 05/27/2018] [Indexed: 12/29/2022] Open
Abstract
AIMS Adrenomedullin (ADM) is an important regulator of endothelial barrier function and vascular tone, and may represent a novel treatment target in sepsis. The non-neutralizing ADM antibody adrecizumab has shown promising results in preclinical sepsis models. In the present study, we investigated the safety, tolerability and pharmacokinetics (PK)/pharmacodynamics of adrecizumab in a first-in-man study and in a second study during experimental human endotoxaemia. METHODS Forty-eight healthy male volunteers were enrolled in two randomized, double-blind, placebo-controlled phase I studies. In both studies, subjects received placebo or one of three doses of adrecizumab (n = 6 per group). In the second study, a bolus of 1 ng kg-1 endotoxin was followed by infusion of 1 ng kg-1 h-1 endotoxin for 3 h to induce systemic inflammation, and the study medication infusion started 1 h after endotoxin bolus administration. RESULTS Adrecizumab showed an excellent safety profile in both studies. PK analyses showed proportional increases in the maximum plasma concentration of adrecizumab with increasing doses, a small volume of distribution, a low clearance rate and a terminal half-life of ~14 days. adrecizumab elicited a pronounced increase in plasma ADM levels, whereas levels of mid-regional pro-adrenomedullin remained unchanged, indicating that de novo synthesis of ADM was not influenced. In the second study, no effects of adrecizumab on cytokine clearance were observed, whereas endotoxin-induced flu-like symptoms resolved more rapidly. CONCLUSIONS Administration of adrecizumab is safe and well tolerated in humans, both in the absence and presence of systemic inflammation. These findings pave the way for further investigation of adrecizumab in sepsis patients.
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Affiliation(s)
- Christopher Geven
- Department of Intensive Care Medicine, Radboud Center for Infectious Diseases (RCI)Radboud University Medical CenterHP: 710, PO Box 91016500HBNijmegenThe Netherlands
| | - Dirk van Lier
- Department of Intensive Care Medicine, Radboud Center for Infectious Diseases (RCI)Radboud University Medical CenterHP: 710, PO Box 91016500HBNijmegenThe Netherlands
| | - Alice Blet
- Department of Anesthesia, Burn and Critical CareUniversity Hospitals Saint‐Louis – Lariboisière, AP‐HPParisFrance
- UMR‐S 942, InsermParisFrance
- Sorbonne Paris CitéParis Diderot UniversityParisFrance
| | - Roel Peelen
- Department of Intensive Care Medicine, Radboud Center for Infectious Diseases (RCI)Radboud University Medical CenterHP: 710, PO Box 91016500HBNijmegenThe Netherlands
| | - Bas ten Elzen
- Department of Intensive Care Medicine, Radboud Center for Infectious Diseases (RCI)Radboud University Medical CenterHP: 710, PO Box 91016500HBNijmegenThe Netherlands
| | - Alexandre Mebazaa
- Department of Anesthesia, Burn and Critical CareUniversity Hospitals Saint‐Louis – Lariboisière, AP‐HPParisFrance
- UMR‐S 942, InsermParisFrance
- Sorbonne Paris CitéParis Diderot UniversityParisFrance
| | - Matthijs Kox
- Department of Intensive Care Medicine, Radboud Center for Infectious Diseases (RCI)Radboud University Medical CenterHP: 710, PO Box 91016500HBNijmegenThe Netherlands
| | - Peter Pickkers
- Department of Intensive Care Medicine, Radboud Center for Infectious Diseases (RCI)Radboud University Medical CenterHP: 710, PO Box 91016500HBNijmegenThe Netherlands
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Abstract
Phishing is a fraudulent form of email that solicits personal or financial information from the recipient, such as a password, username, or social security or bank account number. The scammer may use the illicitly obtained information to steal the victim's money or identity or sell the information to another party. The direct costs of phishing on consumers are exceptionally high and have risen substantially over the past 12 years. Phishing experiments that simulate real world conditions can provide cybersecurity experts with valuable knowledge they can use to develop effective countermeasures and prevent people from being duped by phishing emails. Although these experiments contravene widely accepted informed consent requirements and involve deception, we argue that they can be conducted ethically if risks are minimized, confidentiality and privacy are protected, potential participants have an opportunity to opt out of the research before it begins, and human subjects are debriefed after their participation ends.
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Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), 111 Alexander Drive, Research Triangle Park, NC, 27709, USA.
| | - Peter R Finn
- Department of Psychological and Brain Sciences, Indiana University at Bloomington, Bloomington, IN, USA
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Han A, Poon JL, Powers JH, Leidy NK, Yu R, Memoli MJ. Using the Influenza Patient-reported Outcome (FLU-PRO) diary to evaluate symptoms of influenza viral infection in a healthy human challenge model. BMC Infect Dis 2018; 18:353. [PMID: 30055573 PMCID: PMC6064178 DOI: 10.1186/s12879-018-3220-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/26/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In clinical studies involving a healthy volunteer human challenge model, a valid and reliable measure to assess the evolution of patient-reported symptom type and severity following viral exposure is necessary. This study examines the use of the InFLUenza Patient-Reported Outcome (FLU-PRO) diary as a standardized measure of symptom severity in a healthy volunteer human challenge model. METHODS Healthy adults admitted to the NIH Clinical Center (Day - 1) underwent a 9-day inpatient quarantine after intranasal challenge with a wild-type influenza A/H1N1pdm virus (Day 0). Participants completed the 32-item FLU-PRO diary twice daily for 14 days to assess presence, severity, and duration of symptoms across six body systems. Secondary analyses included descriptive statistics to examine FLU-PRO scores over the course of illness and analysis of variance to compare scores on Day 3 post-challenge by presence of viral shedding, and pre-challenge hemagglutinin and neuraminidase inhibition (HAI and NAI) titers. RESULTS All but one subject (99%), who was lost to follow-up, completed twice daily FLU-PRO diaries on all study assessment days. FLU-PRO demonstrated that 61 of 65 subjects reported symptoms (Days: Median 5, Mean 6 ± 7), of whom 37 (61%) had viral shedding. Pre-challenge, 39 (64%) and 10 (16%) subjects had low (< 1:40) HAI and NAI titers, respectively. Nose, throat, body, and gastrointestinal (GI) symptoms reached peak intensity at Day 3, followed by chest/respiratory and eye symptoms at Day 4. Subjects with viral shedding had higher mean FLU-PRO scores compared to those without, except for Eye and GI domains (p <0.05). Mean FLU-PRO scores were significantly higher for subjects with low NAI titer (p <0.05) across all domains. No significant differences were observed between HAI titer groups. FLU-PRO scores of the low HAI-low NAI group (n = 10) were significantly higher (more severe) than the other two groups (p < 0.05) (high HAI-high NAI (n = 22), low HAI-high NAI (n = 29)). CONCLUSIONS The FLU-PRO had high adherence and low respondent burden. It can be used to track symptom onset, intensity, duration, and recovery from influenza infection in clinical research. In this human challenge study, scores were responsive to change and distinguished known clinical subgroups. TRIAL REGISTRATION NCT01971255 First Registered October 2, 2013.
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Affiliation(s)
- Alison Han
- LID Clinical Studies Unit, Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), 33 North Drive MSC 3203, Bethesda, MD 20892 USA
| | | | - John H. Powers
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, MD USA
| | | | - Ren Yu
- Evidera, Bethesda, MD USA
| | - Matthew J. Memoli
- LID Clinical Studies Unit, Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), 33 North Drive MSC 3203, Bethesda, MD 20892 USA
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Jecker NS, Wightman AG, Rosenberg AR, Diekema DS. Ethical Guidance for Selecting Clinical Trials to Receive Limited Space in an Immunotherapy Production Facility. Am J Bioeth 2018; 18:58-67. [PMID: 29621473 DOI: 10.1080/15265161.2018.1444817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Our aims are to (1) set forth a multiprinciple system for selecting among clinical trials competing for limited space in an immunotherapy production facility that supplies products under investigation by scientific investigators; (2) defend this system by appealing to justice principles; and (3) illustrate our proposal by showing how it might be implemented. Our overarching aim is to assist manufacturers of immunotherapeutic products and other potentially breakthrough experimental therapies with the ethical task of prioritizing requests from scientific investigators when production capacity is limited.
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Sheriff DS. A Dilemma in Healthcare Research. J R Soc Med 2018; 82:638. [PMID: 2593117 PMCID: PMC1292363 DOI: 10.1177/014107688908201102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sonne S, Gentilin S, Sampson RR, Bell L, Mauney T, Young S, Bright K, Flume P. Response to Commentary: Regulatory Support Improves Subsequent IRB Approval Rates in Studies Initially Deemed Not Ready for Review-A CTSA Institution's Experience. J Empir Res Hum Res Ethics 2018; 13:148. [PMID: 29345186 DOI: 10.1177/1556264617753316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Moreno JD, Schmidt U, Joffe S. The Nuremberg Code and Informed Consent for Research-Reply. JAMA 2018; 319:86. [PMID: 29297074 DOI: 10.1001/jama.2017.17724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jonathan D Moreno
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ulf Schmidt
- School of History, University of Kent Canterbury, Kent, England
| | - Steve Joffe
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Affiliation(s)
- Jon F Merz
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Hardman CS, Chen YL, Salimi M, Jarrett R, Johnson D, Järvinen VJ, Owens RJ, Repapi E, Cousins DJ, Barlow JL, McKenzie ANJ, Ogg G. CD1a presentation of endogenous antigens by group 2 innate lymphoid cells. Sci Immunol 2017; 2:eaan5918. [PMID: 29273672 PMCID: PMC5826589 DOI: 10.1126/sciimmunol.aan5918] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/07/2017] [Indexed: 01/02/2023]
Abstract
Group 2 innate lymphoid cells (ILC2) are effectors of barrier immunity, with roles in infection, wound healing, and allergy. A proportion of ILC2 express MHCII (major histocompatibility complex II) and are capable of presenting peptide antigens to T cells and amplifying the subsequent adaptive immune response. Recent studies have highlighted the importance of CD1a-reactive T cells in allergy and infection, activated by the presentation of endogenous neolipid antigens and bacterial components. Using a human skin challenge model, we unexpectedly show that human skin-derived ILC2 can express CD1a and are capable of presenting endogenous antigens to T cells. CD1a expression is up-regulated by TSLP (thymic stromal lymphopoietin) at levels observed in the skin of patients with atopic dermatitis, and the response is dependent on PLA2G4A. Furthermore, this pathway is used to sense Staphylococcus aureus by promoting Toll-like receptor-dependent CD1a-reactive T cell responses to endogenous ligands. These findings define a previously unrecognized role for ILC2 in lipid surveillance and identify shared pathways of CD1a- and PLA2G4A-dependent ILC2 inflammation amenable to therapeutic intervention.
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Affiliation(s)
- Clare S Hardman
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Yi-Ling Chen
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Maryam Salimi
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Rachael Jarrett
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - David Johnson
- Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Valtteri J Järvinen
- Oxford Protein Production Facility-UK, Harwell and Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Raymond J Owens
- Oxford Protein Production Facility-UK, Harwell and Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Emmanouela Repapi
- Computational Biology Research Group, Weatherall Institute of Molecular Medicine, Oxford, UK
| | - David J Cousins
- Department of Infection, Immunity and Inflammation, NIHR Leicester Respiratory Biomedical Research Unit, University of Leicester, Leicester, UK
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK
| | | | | | - Graham Ogg
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
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Ghoshal N, Wilkinson PO. Flowers for Algernon: The ethics of human experimentation on the intellectually disabled. Psychiatr Danub 2017; 29:194-195. [PMID: 28953762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Flowers for Algernon is a novel written in 1966 by Daniel Keyes. Since its publication, it has received significant critical acclaim, earning a Nebula science-fiction award, and was also adapted into a feature film. Set in the 1960s, the novel follows the story of Charlie Gordon, an intellectually disabled man who lives a simple but happy life working a cleaning job at a local bakery. Charlie's life, however, faces an abrupt change when he is offered the opportunity to participate in a novel surgical procedure to improve his intellect. Although he doesn't fully understand the risks of the operation, consent is provided on his behalf by his estranged sister and Charlie undergoes the experiment. The experiment is a success and Charlie develops intellectually at an alarming pace, soon surpassing the experimenters themselves. The rest of the book follows the, not all positive, changes that this intellect brings to Charlie's life. The novel is set in a time when American scientific experimentation could often occur without fully informed consent. This article explores the ethical side of such experiments like the one performed on Charlie, namely if it is morally right to perform a potentially dangerous experimental procedure on someone who doesn't fully understand the risks, even if it will potentially help them.
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Affiliation(s)
- Nishan Ghoshal
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland
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Rivera SM. Reasonable Research Oversight: A Work in Progress. IRB 2017; 39:15-19. [PMID: 30707526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
On January 19, 2017, the Office for Human Research Protections, released an updated "Common Rule" that was the product of a six-year administrative odyssey to modernize and improve the regulations that had been in place for more than thirty years. Although the impulse to update the regulatory landscape for human research is laudable, some of the changes proposed appear reactive and focused on making misconduct more difficult, rather than facilitating important science with reasonable safeguards. Instead of making research more difficult for all scientists across the board, a more sensible approach would involve better education of the public about the ways their specimens and data may be used to advance important scientific discoveries coupled with a legitimate method for holding bad actors accountable for deliberate violations of the rules. Regardless of what happens with the Common Rule, we need a reframing of research as a social good that requires reasonable oversight, not reactive rule making.
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Hildebrandt S, Benedict S, Miller E, Gaffney M, Grodin MA. "Forgotten" Chapters in the History of Transcervical Sterilization: Carl Clauberg and Hans-Joachim Lindemann. J Hist Med Allied Sci 2017; 72:272-301. [PMID: 28873982 DOI: 10.1093/jhmas/jrx018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Transcervical sterilization is a non-surgical method of permanent female sterilization that is widely used and critically discussed. A review of the historiography of the method reveals that instances of its coercive use are not included in the historical account. This study offers a reexamination of the work of Carl Clauberg and Hans-Joachim Lindemann, to more deeply contextualize within the framework of current usage the coercive use of transcervical sterilization during the Third Reich and in postwar Germany. This inquiry is based on postwar criminal trial records on Clauberg, and on archival documents detailing Lindemann's activities in 1979. A comparative analysis examines arguments by medical historian Karl-Heinz Roth, and identifies shared characteristics and differences between Clauberg and Lindemann, their methods and scientific connections. The results demonstrate that the technique of transcervical sterilization has an abusive potential that may be explained as a function of the person of the physician, of the scientific method itself, and of societal and political influences. The analysis supports the argument that insights from the cases of Clauberg and Lindemann are transferrable geographically and over time, and have the potential to inform current medical practice, such as transcervical sterilization with the Essure device, whose historiographic exploration remains a desideratum.
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Affiliation(s)
- Sabine Hildebrandt
- Boston Children's Hospital, Harvard Medical School, Dep. Medicine, 333 Longwood Avenue-LO 234, Boston, Massachusetts 02115
| | - Susan Benedict
- Medical University of South Carolina, Charleston, SC 29466, USA
| | - Erin Miller
- Project on Ethics and the Holocaust, Elie Wiesel Center for Jewish Studies, Boston University, 715 Albany Street, Talbot 358 West, Boston MA 02218
| | | | - Michael A Grodin
- Center for Health, Law, Ethics and Human Right. Project on Ethics and the Holocaust, Elie Wiesel Center for Jewish Studies, Boston University, 715 Albany Street, Talbot 358 West, Boston MA 02218
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Affiliation(s)
- Elisa A Hurley
- a Public Responsibility in Medicine and Research (PRIM&R)
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Porter CK, Louis Bourgeois A, Frenck RW, Prouty M, Maier N, Riddle MS. Developing and utilizing controlled human models of infection. Vaccine 2017; 35:6813-6818. [PMID: 28583306 DOI: 10.1016/j.vaccine.2017.05.068] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 04/11/2017] [Accepted: 05/24/2017] [Indexed: 11/18/2022]
Abstract
The controlled human infection model (CHIM) to assess the efficacy of vaccines against Shigella and enterotoxigenic Escherichia coli (ETEC) has several unique features that could significantly enhance the ability to test candidate vaccines. Despite increasing interest in these models, questions remain as to how to best incorporate them into vaccine development and how to maximize results. We designed a workshop focused on CHIM as part of the Vaccines Against Shigella and ETEC (VASE) Conference. The workshop, using the World Café method, focused on; clinical outcomes, nonclinical outcomes and model standardization. Researchers with a variety of expertise and experience rotated through each focus area and discussed relevant sub-topics. The results of these discussions were presented and questions posed to guide future workshops. Clinical endpoint discussions focused on the need for harmonized definitions; optimized attack rates; difficulties of sample collection and a need for non-stool based endpoints. Nonclinical discussions centered on evolving omics-based opportunities, host predictors of susceptibility and novel characterizations of the immune response. Model standardization focused on the value of shared procedures across institutions for clinical and non-clinical endpoints as well as for strain preparation and administration and subject selection. Participants agreed CHIMs for Shigella and ETEC vaccine development could accelerate vaccine development of a promising candidate; however, it was also appreciated that variability in the model and our limited understand of the host-pathogen interaction may yield results that could negatively impact a suitable candidate. Future workshops on CHIM are needed to ensure the optimal application of these models moving forward.
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Affiliation(s)
- Chad K Porter
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, United States.
| | - A Louis Bourgeois
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Robert W Frenck
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Michael Prouty
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, United States
| | | | - Mark S Riddle
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, United States
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Abstract
Bayesian truth serum (BTS) is an exciting new method for improving honesty and information quality in multiple-choice survey, but, despite the method's mathematical reliance on large sample sizes, existing literature about BTS only focuses on small experiments. Combined with the prevalence of online survey platforms, such as Amazon's Mechanical Turk, which facilitate surveys with hundreds or thousands of participants, BTS must be effective in large-scale experiments for BTS to become a readily accepted tool in real-world applications. We demonstrate that BTS quantifiably improves honesty in large-scale online surveys where the "honest" distribution of answers is known in expectation on aggregate. Furthermore, we explore a marketing application where "honest" answers cannot be known, but find that BTS treatment impacts the resulting distributions of answers.
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Affiliation(s)
- Morgan R. Frank
- Media Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Manuel Cebrian
- Media Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States of America
- Data61 Unit, Commonwealth Scientific and Industrial Research Organization, Melbourne, Victoria, Australia
| | - Galen Pickard
- Google Inc., Mountain View, CA, United States of America
| | - Iyad Rahwan
- Media Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States of America
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Abstract
The Standard View in research ethics maintains that, under certain conditions, investigators may deceive subjects and may enroll subjects without their consent. In contrast, it is always impermissible to coerce subjects to enroll, even when the same conditions are satisfied. This view raises a question that, as far as we are aware, has received no attention in the literature. Why is it always impermissible to undermine the validity of subjects' consent through coercion, but it can be permissible to undermine the validity of subjects' consent through deception, and it can be permissible to enroll subjects without any consent at all? The present analysis suggests that the answer traces to the conditions on the appropriate treatment of subjects. This conclusion suggests that some requirements for human subjects research, and for valid consent more generally, trace not to the protection of subjects per se but to the proper behavior of agents.
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Affiliation(s)
- Kjell Asplund
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
| | - Göran Hermerén
- Department of Medical Ethics, Lund University, Lund, Sweden
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