Unethical human research in the field of neuroscience: a historical review

Neurological Sciences - Understanding the historical foundations of ethics in human research are key to illuminating future human research and clinical trials. This paper gives an overview of the...     

Neuropsychiatric evaluation of patients with brucellosis

Brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations. Neurobrucellosis is one of the complications. The objective of this study was to determine neuropsychiatric manifestations among patients with brucellosis. Twenty-seven consecutive patients with brucellosis (14 patients with manifest neurological manifestation and 13 patients without apparent neurological manifestation) were recruited from Assiut University hospital and compared with 50 healthy controls matched with respect to age, sex, and social economic and educational levels. They were subjected to systemic, meticulous neuropsychiatric evaluations, laboratory, radiological, neurophysiology, and psychometric assessment with Mini-Mental State Examination, Wechsler Memory Scale—Revised. and Hamilton Depression Rating. Overt or apparent neurological manifestation was recorded in 14 patients (51.85%) and 13 patients (48.15%) with brucellosis without apparent neuropsychiatric involvement. Central nervous system (CNS) involvement (vascular stroke, meningeoencephalitis, and dementia) was recorded in 9 patients (33.3%) and 6 patients (22.2%) had peripheral nervous sytem (PNS) involvement (polyneuropathy, radiculoapathy, and polyradiculoneuropathy). Depression was recorded in 7 (29.2%) patients; 3 patients (21.4%) of the neurobrucellosis group and 4 patients (30.8%) with brucellosis without neurological manifestations. Patients with brucellosis (neurobrucellosis and patients without neurological manifestations) reported highly significant impairment in some cognitive function measures (mental control, logical memory, visual reproduction) and higher scores on depressive symptoms compared with controls. Patients with a Brucella infection usually manifest central nervous system involvement. Clinicians, especially serving in endemic areas or serving patients coming from endemic areas, should consider the likelihood of neurobrucellosis in patients with unexplained neurological and psychiatric symptoms, and should perform the necessary tests, including cognitive function and depression tests.     

Trusted Autonomy and Cognitive Cyber Symbiosis: Open Challenges

This paper considers two emerging interdisciplinary, but related topics that are likely to create tipping points in advancing the engineering and science areas. Trusted Autonomy (TA) is a field of research that focuses on understanding and designing the interaction space between two entities each of which exhibits a level of autonomy. These entities can be humans, machines, or a mix of the two. Cognitive Cyber Symbiosis (CoCyS) is a cloud that uses humans and machines for decision-making. In CoCyS, human–machine teams are viewed as a network with each node comprising humans (as computational machines) or computers. CoCyS focuses on the architecture and interface of a Trusted Autonomous System. This paper examines these two concepts and seeks to remove ambiguity by introducing formal definitions for these concepts. It then discusses open challenges for TA and CoCyS, that is, whether a team made of humans and machines can work in fluid, seamless harmony.     

Clinical review: Serious adverse events associated with the use of rituximab - a critical care perspective

ABSTRACT: The advent of biologic agents has provided a more specific and targeted approach to the treatment of various hematological malignancies and other autoimmune disorders. Such biologic agents have been relatively well tolerated with fewer adverse events reported as compared with many other chemotherapeutic agents. Rituximab is a monoclonal antibody to the B-cell marker CD20 and is a common biologic agent widely used for the treatment of B-cell lymphoma, lymphoproliferative disorders, and inflammatory conditions that are refractory to conventional treatment, including rheumatoid arthritis and some vasculitides. However, through randomized controlled trials and post-marketing surveillance, an increasing number of serious adverse events are being associated with the use of rituximab, often leading to or complicating an intensive care unit admission. The purpose of this review is to focus on the severe complications that are associated with the use of rituximab and that require critical care. Management and prevention strategies for the most common complications along with some examples of its uses within the critical care setting are also discussed.     

Neuron navigator 3 alterations in nervous system tumors associate with tumor malignancy grade and prognosis

Copy number changes or reduced expression of the Neuron navigator 3 (NAV3) gene occurs in neuroblastomas and malignancies of epithelial or lymphoid origin. To elucidate whether NAV3 has a role in the tumorigenesis of nervous system tumors in general, we studied central and peripheral nervous system tumors for NAV3 copy number changes. In search for common tumorigenic denominators, we analyzed 113 central and peripheral nervous system tumors, including glial tumors (grades I–IV gliomas), medulloblastomas, and neuroblastomas. NAV3 copy number changes were studied by fluorescence in situ hybridization and correlated to survival analyses. To identify target genes of NAV3 deletion, NAV3 was silenced by siRNA in glioblastoma cell lines and gene expression profiles were analyzed by Agilent 4×44k dual‐color microarrays. Selected upregulations were confirmed by immunohistochemistry and quantitative polymerase chain reaction. We found NAV3 amplifications to dominate in neuronally differentiated tumors, whereas glial tumors showed almost equal proportions of NAV3 deletion and amplification. However, Grade IV gliomas had more frequent NAV3 deletions than grades I–III gliomas. Silencing of NAV3 in glioma cell lines led to the upregulation of receptor genes associated with gonadotropin‐releasing hormone and Jak‐Stat signaling pathways. Kaplan–Meier analysis of the entire clinical tumor material showed association between NAV3 amplifications and favorable prognosis, as well as NAV3 deletions and unfavorable prognosis. With Cox regression model, a hazard ratio of 0.51 was observed for NAV3 amplifications and 1.36 for NAV3 deletions. We conclude that NAV3 may be a potential new prognostic biomarker and a potential therapeutic target. © 2012 Wiley Periodicals, Inc.