Examining the Social Benefits Principle in Research with Human Participants.

The idea that research with human participants should benefit society has become firmly entrenched in various regulations, policies, and guidelines, but there has been little in-depth analysis of this ethical principle in the bioethics literature. In this paper, I distinguish between strong and weak versions and the social benefits principle and examine six arguments for it. I argue that while it is always ethically desirable for research with human subjects to offer important benefits to society (or the public), the reasonable expectation of substantial public benefit should be a necessary condition for regarding research as ethical only when (a) it imposes more than minimal risks on non-consenting subjects; or (b) it is supported by public resources.

Neck stiffness and range of motion for young males and females.

Well characterised mechanical response of the normal head-neck complex during passive motion is important to inform and verify physical surrogate and computational models of the human neck, and to inform normal baseline for clinical assessments. For 10 male and 10 female participants aged 20 to 29, the range of motion (ROM) of the neck about three anatomical axes was evaluated in active-seated, passive-lying and active-lying configurations, and the neck stiffness was evaluated in passive-lying. Electromyographic signals from the agonist muscles, normalised to maximum voluntary contractions, were used to provide feedback during passive motions. The effect of sex and configuration on ROM, and the effect of sex on linear estimates of stiffness in three regions of the moment-angle curve, were assessed with linear mixed models and generalised linear models. There were no differences in male and female ROM across all motion directions and configurations. Flexion and axial rotation ROM were configuration dependent. The passive-lying moment-angle relationship was typically non-linear, with higher stiffness (slope) closer to end of ROM. When normalising the passive moment-angle curve to active lying ROM, passive stiffness was sex dependent only for lateral bending region 1 and 2. Aggregate moment-angle corridors were similar for males and females in flexion and extension, but exhibited a higher degree of variation in applied moment for males in lateral bending and axial rotation. These data provide the passive response of the neck to low rate bending and axial rotation angular displacement, which may be useful for computational and surrogate modelling of the human neck.

Pediatric specific challenges of the single institutional review board mandate.

BACKGROUND: The Common Rule Revision (CRR) mandates a single institutional review board (IRB) for all US federally funded nonexempt multisite human participant research. While the CRR aims to improve research efficiency, its success in pediatric research remains uncertain MAIN BODY: There are multiple challenges that threaten the purported efficiency of the single IRB mandate. While the CRR is clear that ethical review is the purview of the single IRB, responsibility for issues of local study governance are less well defined. Therefore, reliance agreements (RA) must be negotiated between single IRBs and participating institutions. These negotiations can vary significantly based upon the institution's local context and are often arduous, lengthy, and burdensome. Furthermore, in pediatric research, issues such as assent, surrogate consent, and IRB risk determination add additional layers of complexity that must be considered. No clear system exists for resolving disagreements surrounding these critical human participant protection issues. Finally, the variation in institutional resources directed towards pediatric research may mean that only a select few pediatric institutions will be able to function in the single IRB system. These challenges will need to be overcome to successfully implement the CRR and achieve its objective of improving multisite research efficiency. We suggest that an empiric and collaborative approach utilizing implementation strategies is necessary for the CRR and single IRBs to be effective. CONCLUSION: The CRR seeks to improve the efficiency of multisite human participant research in the US. There are multiple challenges that will need to be overcome. An empiric collaborative approach is necessary. If successful, single IRBs have the potential to usher in a new era of impactful and efficient multisite pediatric research.

Explant Analysis of Utah Electrode Arrays Implanted in Human Cortex for Brain-Computer-Interfaces.

Brain-computer interfaces are being developed to restore movement for people living with paralysis due to injury or disease. Although the therapeutic potential is great, long-term stability of the interface is critical for widespread clinical implementation. While many factors can affect recording and stimulation performance including electrode material stability and host tissue reaction, these factors have not been investigated in human implants. In this clinical study, we sought to characterize the material integrity and biological tissue encapsulation via explant analysis in an effort to identify factors that influence electrophysiological performance. We examined a total of six Utah arrays explanted from two human participants involved in intracortical BCI studies. Two platinum (Pt) arrays were implanted for 980 days in one participant (P1) and two Pt and two iridium oxide (IrOx) arrays were implanted for 182 days in the second participant (P2). We observed that the recording quality followed a similar trend in all six arrays with an initial increase in peak-to-peak voltage during the first 30-40 days and gradual decline thereafter in P1. Using optical and two-photon microscopy we observed a higher degree of tissue encapsulation on both arrays implanted for longer durations in participant P1. We then used scanning electron microscopy and energy dispersive X-ray spectroscopy to assess material degradation. All measures of material degradation for the Pt arrays were found to be more prominent in the participant with a longer implantation time. Two IrOx arrays were subjected to brief survey stimulations, and one of these arrays showed loss of iridium from most of the stimulated sites. Recording performance appeared to be unaffected by this loss of iridium, suggesting that the adhesion of IrOx coating may have been compromised by the stimulation, but the metal layer did not detach until or after array removal. In summary, both tissue encapsulation and material degradation were more pronounced in the arrays that were implanted for a longer duration. Additionally, these arrays also had lower signal amplitude and impedance. New biomaterial strategies that minimize fibrotic encapsulation and enhance material stability should be developed to achieve high quality recording and stimulation for longer implantation periods.

Evaluating Lymph Flow Through the Thoracic Duct Using Urine Osmolarity in Human Participants.

Background: Previous animal studies have shown that intragastric administration of water can accelerate mesenteric lymph flow. Similarly, human studies have shown that abdominal breathing can induce thoracic lymph drainage. In these studies, lymph flow was measured by hemodilution and a corresponding reduction in blood anti-diuretic hormone (ADH) levels, the latter being linked to urine osmolarity. Hence, we questioned if induction of lymph flow through water administration and supine positioning could be measured by monitoring urine osmolarity. Methods and Results: Volunteers were given 250 mL of distilled water and then made to rest for either 10 or 30 minutes in a supine position. Blood samples were taken pre and postrest to monitor changes in plasma ADH, total protein, plasma albumin, red blood cell, and hemoglobin concentrations. Urine was collected to monitor [Na+], [Cl-], and osmolarity. Intake of 250 mL distilled water with 10-minute rest caused a significant reduction in plasma ADH concentration, with decreases in urine [Na+], [Cl-], and osmolarity. We found a linear relationship between the ratio of plasma ADH concentrations after/before rest (between 1.1 and 3.0 pg·mL) and the ratio of urine osmolarity after/before rest (between 180 and 601 mOsm·L). Conclusions: Intake of 250 mL distilled water with 10-minute rest in a supine position caused hemodilution and a reduction in urine osmolarity consistent with thoracic lymph drainage. Urine osmolarity is a simple, safe clinical measure for monitoring lymph flow that could be used to evaluate the technique of lymph edema therapists.

Implications of the Revised Common Rule for Human Participant Research.

This paper looks at the implications of changes to the regulatory governance of human participant research that can be expected with implementation of the Revised Common Rule (RCR). The RCR refers to revisions of the existing federal regulations that govern the performance of research involving human subjects (ie, clinical research) in the United States and, under certain circumstances, when such research is also performed outside the United States. The term "common" is included because it refers to the fact that these regulations, often referred to as Code of Federal Regulations 46, is the common denominator regulations agreed to across a wide swath of federal agencies.

Bioethical Issues in Providing Financial Incentives to Research Participants.

Offering research subjects financial incentives for their participation is a common practice that boosts recruitment but also raises ethical concerns, such as undue inducement, exploitation, and biased enrollment. This article reviews the arguments for providing participants with financial incentives, ethical concerns about payment, and approaches to establishing appropriate compensation levels. It also makes recommendations for investigators, institutions, and oversight committees.

Formative evaluation using checklists to improve research proposals.

Developing research proposals that protect human participants and understanding the institutional review board (IRB) approval process require high-level application of many skills. The purpose of this article is to describe how faculty can use formative evaluation techniques and checklists to guide students to build skills in writing research proposals for studies that involve human participants or their data. Formative evaluation, the process of critically reviewing work to improve it, is emphasized, and checklists that summarize IRB criteria and standards and present the critical content of research proposals for studies involving human participants are provided. Teaching principles that can guide faculty in using the checklists to give feedback and help students develop high-quality research proposals are discussed.