Should biomedical research with great apes be restricted? A systematic review of reasons.

BACKGROUND: The use of great apes (GA) in invasive biomedical research is one of the most debated topics in animal ethics. GA are, thus far, the only animal group that has frequently been banned from invasive research; yet some believe that these bans could inaugurate a broader trend towards greater restrictions on the use of primates and other animals in research. Despite ongoing academic and policy debate on this issue, there is no comprehensive overview of the reasons advanced for or against restricting invasive research with GA. To address this gap, we conducted a systematic review of the reasons reported in the academic literature on this topic. METHODS: Seven databases were searched for articles published in English. Two authors screened the titles, abstracts, and full texts of all articles. Two journals specialized in animal ethics, and the reference lists of included articles were subsequently also reviewed. RESULTS: We included 60 articles, most of which were published between 2006 and 2016. Twenty-five articles argued for a total ban of GA research, 21 articles defended partial restrictions, and 14 articles argued against restrictions. Overall, we identified 110 reason types, 74 for, and 36 against, restricting GA research. Reasons were grouped into nine domains: moral standing, science, welfare, public and expert attitudes, retirement and conservation, respect and rights, financial costs, law and legal status, and longer-term consequences. CONCLUSION: Our review generated five main findings. First, there is a trend in the academic debate in favor of restricting GA research that parallels worldwide policy changes in the same direction. Second, in several domains (e.g., moral standing, and respect and rights), the reasons were rather one-sided in favor of restrictions. Third, some prominent domains (e.g., science and welfare) featured considerable engagement between opposing positions. Fourth, there is low diversity and independence among authors, including frequent potential conflicts of interests in articles defending a strong position (i.e., favoring a total ban or arguing against restrictions). Fifth, scholarly discussion was not the norm, as reflected in a high proportion of non-peer-reviewed articles and authors affiliated to non-academic institutions.

Preclinical evaluation of chimeric antigen receptor T cells targeting the carcinoembryonic antigen as a potential immunotherapy for gallbladder cancer.

Gallbladder cancer (GBC) is commonly diagnosed at late stages when conventional treatments achieve only modest clinical benefit. Therefore, effective treatments for advanced GBC are needed. In this context, the administration of T cells genetically engineered with chimeric antigen receptors (CAR) has shown remarkable results in hematological cancers and is being extensively studied for solid tumors. Interestingly, GBC tumors express canonical tumor-associated antigens, including the carcinoembryonic antigen (CEA). However, the potential of CEA as a relevant antigen in GBC to be targeted by CAR-T cell-based immunotherapy has not been addressed. Here we show that CEA was expressed in 88% of GBC tumors, with higher levels associated with advanced disease stages. CAR-T cells specifically recognized plate-bound CEA as evidenced by up-regulation of 4-1BB, CD69 and PD-1, and production of effector cytokines IFN-γ and TNF-α. In addition, CD8+ CAR-T cells up-regulated the cytotoxic molecules granzyme B and perforin. Interestingly, CAR-T cell activation occurred even in the presence of PD-L1. Consistent with these results, CAR-T cells efficiently recognized GBC cell lines expressing CEA and PD-L1, but not a CEA-negative cell line. Furthermore, CAR-T cells exhibited in vitro cytotoxicity and reduced in vivo tumor growth of GB-d1 cells. In summary, we demonstrate that CEA represents a relevant antigen for GBC that can be targeted by CAR-T cells at the preclinical level. This study warrants further development of the adoptive transfer of CEA-specific CAR-T cells as a potential immunotherapy for GBC.

When is the Promotion of Prenatal Testing for Selective Abortion Wrong?

Medical professionals routinely offer prenatal genetic testing services to their expecting patients. Some bioethicists believe that when these professionals promote the use of such testing for abortion on grounds of disability, they express a devaluing message to and about extant disabled people. Supporters of this expressivist objection further maintain that, in expressing such a message, medical professionals reinforce negative attitudes about extant disabled people and thereby further stigmatize them. But while the expressivist objection has received quite a bit of support from disability rights theorists-in part because of its intuitive appeal-its current formulation suffers from various shortcomings that render it implausible. By invoking tools from the philosophy of language, I present the expressivist objection*: an improved and distinctive formulation of the expressivist objection that preserves some of its core insights. According to this improved formulation, the promotion of prenatal testing for selective abortion can at least sometimes be wrong.

Dimensión vertical de la cara en adultos con diferentes relaciones oclusales / Vertical dimension of face in adults with different Angle class

RESUMEN: Se ha postulado que la posición postural mandibular (PPM) no presentaría la menor actividad electromiográfica (EMG) de los músculos masetero y temporal, y que esta menor actividad se encontraría en una apertura mayor. El objetivo de este estudio fue analizar la PPM en pacientes con diferentes relaciones oclusales y según tipo de método de posicionamiento, relacionándolo con la actividad EMG de los músculos Masetero y Temporal, además del registro de la actividad EMG en diferentes aperturas orales. Se analizó una muestra de 25 adultos de 18 a 28 años. Estos fueron clasificados según su sexo y clasificación de Angle. Se realizaron simultáneamente registros de EMG de superficie -masetero y porción anterior del temporal- y de EMA -posición de la mandíbula respecto al maxilar obteniendo distancia y ángulo- en diferentes posiciones mandibulares: PPM-considerando método sin comando y de deglución- y apertura gradual hasta alcanzar la máxima apertura. Se realizó un análisis estadístico descriptivo. La menor PPM obtenida fue de 1,0 ± 0,6 mm en mujeres Clase III y utilizando la técnica sin comando; el mayor fue de 2,5 ± 0,2 mm en mujeres Clase II y utilizando la técnica de deglución. La apertura angular presentó menor variabilidad que las distancias lineales. La actividad de los músculos Maseteros derecho e izquierdo presentaron valores similares entre sí, al igual que en los rangos de apertura hasta 30 mm en hombres y mujeres y en las diferentes relaciones oclusales. La actividad de los Temporales para hombres y mujeres y en las diferentes relaciones oclusales mostraron variaciones importantes entre derecha e izquierda y en los diferentes grados de apertura. La técnica presentada permitió el estudio de la dimensión vertical y aperturas orales a través de EMA y EMG.

SUMMARY: It has been postulated that the mandibular postural position (MPP) could not present the lower electromyographic activity (EMG) of the Masseter and Temporal muscles, and that the lower activity could be found in a larger opening. The objective of this study was to analyze the PPM in patients with different occlusal relationships and according to the positioning method, relating it to the EMG activity of the Masseter and Temporal muscles, in addition to recording the EMG activity in different oral openings. A sample of 25 adults aged 18 to 28 years was analyzed. Participants were classified according to their sex and Angle classification. Simultaneous recordings of surface EMG -Masseter and anterior portion of the Temporal- and EMA -position of the Mandible with respect to the Maxilla obtaining distance and angle- were performed in different mandibular positions: PPM-considering the method "without command" and "swallowing"- and gradual opening until the maximum opening is reached. A descriptive statistical analysis was performed. The lowest PPM obtained was 1.0 ± 0.6 mm in Class III women and using the "without command" method; the largest was 2.5 ± 0.2 mm in Class II women and using the "swallowing" method. The angular opening presented less variability than the linear distances. The activity of the right and left masseter muscles presented similar values, as well as in the opening ranges up to 30 mm in men and women and in the different occlusal relationships. The activity of the Temporals for men and women and in the different occlusal relationships showed important variations between right and left and in the different degrees of opening. The presented technique allowed the study of the vertical dimension and oral openings through EMA and EMG.

Manejo de nuevos anticoagulantes orales en cirugía oral: Revisión de literatura / Management of new oral anticoagulants in oral surgery: literature review / Gestão de novos anticoagulantes orais na cirurgia oral: Revisão da literatura

En el año 2011 se introdujo una nueva generación de anticoagulantes orales cuyo manejo en cirugía oral aún no está completamente esclarecido. Objetivo: El objetivo de esta revisión fue describir los protocolos existen-tes sobre manejo de pacientes anticoagulados en cirugía oral. Método: Se realizó una búsqueda en PubMed, SCOPUS, EBSCO y BEIC, sin límite de idioma. Resultados: Se encontraron 4781 artículos, de los cuales 19 fueron seleccionados. Conclusión: Se debe evaluar el riesgo tromboembólico y la capacidad de control de un evento hemorrágico antes de suspender el anticoagulante.

In 2011, a new generation of oral anticoagulants was introduced, the management of which in oral surgery has not yet been fully clarified. Objective: The objective of this review was to describe the existing protocols for the management of anticoagulated patients in oral surgery. Method: A search was made in PubMed, SCO-PUS, EBSCO and BEIC, with no language limit. Results: 4781 articles were found, of which 19 were selected. Conclusion: The thromboembolic risk and the ability to control a bleeding event should be evaluated before suspension of the anticoagulant.

Em 2011, foi introduzida uma nova geração de anticoagulantes orais, cujo implicação em cirurgia oral ainda não foi totalmente esclarecida. Objetivo: O objetivo desta revisão foi descrever os protocolos existentes para a gestão de pacientes anticoagulados em cirurgia oral. Método: Foi realizada uma pesquisa no PubMed, SCOPUS, EBSCO e BEIC, sem limite de idioma. Resultados: Foram encontrados 4781 artigos, dos quais 19 foram selecionados. Conclusão: O risco tromboembólico e a capacidade de controlar um evento hemorrágico devem ser avaliados antes da interrupção do anticoagulante.