Extracellular Vesicles from Immune Cells: A Biomedical Perspective.

Research on the role of extracellular vesicles (sEV) in physiology has demonstrated their undoubted importance in processes such as the transportation of molecules with significance for cell metabolism, cell communication, and the regulation of mechanisms such as cell differentiation, inflammation, and immunity. Although the role of EVs in the immune response is actively investigated, there is little literature revising, in a comprehensive manner, the role of small EVs produced by immune cells. Here, we present a review of studies reporting the release of sEV by different types of leukocytes and the implications of such observations on cellular homeostasis. We also discuss the function of immune cell-derived sEV and their relationship with pathological states, highlighting their potential application in the biomedical field.

Estimating the impact of the COVID-19 pandemic on diagnosis and survival of five cancers in Chile from 2020 to 2030: a simulation-based analysis.

BACKGROUND: The COVID-19 pandemic has strained health system capacity worldwide due to a surge of hospital admissions, while mitigation measures have simultaneously reduced patients' access to health care, affecting the diagnosis and treatment of other diseases such as cancer. We estimated the impact of delayed diagnosis on cancer outcomes in Chile using a novel modelling approach to inform policies and planning to mitigate the forthcoming cancer-related health impacts of the pandemic in Chile. METHODS: We developed a microsimulation model of five cancers in Chile (breast, cervix, colorectal, prostate, and stomach) for which reliable data were available, which simulates cancer incidence and progression in a nationally representative virtual population, as well as stage-specific cancer detection and survival probabilities. We calibrated the model to empirical data on monthly detected cases, as well as stage at diagnosis and 5-year net survival. We accounted for the impact of COVID-19 on excess mortality and cancer detection by month during the pandemic, and projected diagnosed cancer cases and outcomes of stage at diagnosis and survival up to 2030. For comparison, we simulated a no COVID-19 scenario in which the impacts of COVID-19 on excess mortality and cancer detection were removed. FINDINGS: Our modelling showed a sharp decrease in the number of diagnosed cancer cases during the COVID-19 pandemic, with a large projected short-term increase in future diagnosed cases. Due to the projected backlog in diagnosis, we estimated that in 2021 there will be an extra 3198 cases (95% uncertainty interval [UI] 1356-5017) diagnosed among the five modelled cancers, an increase of nearly 14% compared with the no COVID-19 scenario, falling to a projected 10% increase in 2022 with 2674 extra cases (1318-4032) diagnosed. As a result of delayed diagnosis, we found a worse stage distribution for detected cancers in 2020-22, which is estimated to lead to 3542 excess cancer deaths (95% UI 2236-4816) in 2022-30, compared with the no COVID-19 scenario, among the five modelled cancers, most of which (3299 deaths, 2151-4431) are projected to occur before 2025. INTERPRETATION: In addition to a large projected surge in diagnosed cancer cases, we found that delays in diagnosis will result in worse cancer stage at presentation, leading to worse survival outcomes. These findings can help to inform surge capacity planning and highlight the importance of ensuring appropriate health system capacity levels to detect and care for the increased cancer cases in the coming years, while maintaining the timeliness and quality of cancer care. Potential delays in treatment and adverse impacts on quality of care, which were not considered in this model, are likely to contribute to even more excess deaths from cancer than projected. FUNDING: Harvard TH Chan School of Public Health. TRANSLATIONS: For the Spanish and Portuguese translations of the abstract see Supplementary Materials section.

Bioética y Bioderecho desde el punto de vista de las religiones: la gestación subrogada / Bioethics and Biolaw from a religious point of view: surrogacy

Este trabajo pretende un acercamiento al papel que juega el factor religioso en la bioética y el bioderecho y, más concretamente, analizar hasta qué punto influye dicho factor religioso en el rechazo de la figura de la gestación subrogada o de sustitución en nuestro país. Tras analizar la evolución de la ciencia, el derecho, la ética y la bioética en España, así como la indudable relación que tiene el factor religioso con la bioética, nos centraremos en estudiar la figura de la gestación subrogada y de la misma desde el punto de vista del factor religioso en nuestro país. Es decir, estudiaremos la visión religiosa y ética de la gestación subrogada y examinaremos jurisprudencia sobre el tema que nos llevará a darnos cuenta de cómo esta práctica, a pesar de estar expresamente prohibida en la legislación española, es reconocida indirectamente en los tribunales con el fin de dar protección al así nacido sobre la base del principio superior del interés del menor. Finalmente, pasaremos a observar cómo, aunque se parta del hecho objetivo de que estamos ante un Estado aconfesional, la mayoría de los motivos que alega la parte de la doctrina que rechaza la gestación por sustitución coinciden con los argumentos de rechazo dados por la Iglesia Católica ante esta figura

This paper seeks to explore the role played by religion in bioethics and biolaw and, more specifically, to analyse the extent to which this religious factor influences the rejection of the figure of surrogacy in our country. After analysing the evolution of science, law, ethics and bioethics in Spain, as well as the evident relationship between the religious factor and Bioethics, this paper will examine the figure of surrogacy from the Spanish religious point of view. As a result, we will study the religious and ethical vision of surrogacy and we will examine jurisprudence about the matter which will lead us to realize how this practice, despite being expressly prohibited under Spanish law, is indirectly recognized in courts in order to provide protection for the well born on the basis of superior interest of the child principle. Finally, we will observe how, despite being a secular state, most of the arguments against surrogacy put forward by non-religious actors correlate with the anti-surrogacy pronouncements of the Catholic Church