Reviews of Functional MRI: The Ethical Dimensions of Methodological Critique

Neuroimaging studies involving human subjects raise a range of ethics issues. Many of these issues are heightened in the context of neuroimaging research involving persons with mental health disorders. There has been growing interest in these issues among legal scholars, philosophers, social scientists, and as well as neuroimagers over the last decade. Less clear, however, is the extent to which members of the neuroimaging community are engaged with these issues when they undertake their research and report results. In this study, we analyze the peer-reviewed review literature involving fMRI as applied to the study of mental health disorders. Our hypothesis is that, due to the critical orientation of reviews, and the vulnerability of mental health population, the penetrance of neuroethics will be higher in the review literature in this area than it is in the primary fMRI research literature more generally. We find that while authors of reviews do focus a great deal of attention on the methodological limitations of the studies they discussed, contrary to our hypothesis, they do not frame concerns in ethical terms despite their ethical significance. We argue that an ethics lens on such discussion would increase the knowledge-value of this scholarly work.     

Integrating Social Science into the Long-Term Ecological Research (LTER) Network: Social Dimensions of Ecological Change and Ecological Dimensions of Social Change

The integration of the social sciences into long-term ecological research is an urgent priority. To address this need, a group of social, earth, and life scientists associated with the National Science Foundations (NSF) Long-Term Ecological Research (LTER) Network have articulated a conceptual framework for understanding the human dimensions of ecological change for the LTER Network. This framework explicitly advocates that what is often divided into natural and human systems be considered a single, complex social-ecological system (SES). In this paper, we propose a list of core social science research areas, concepts, and questions; identify the need for multiscale investigatory frameworks crucial for implementing integrated research; and suggest practical approaches for integration. In sum, this paper is a general outline for empirical and cross-site research projects where investigators agree that bringing together social, biological, and earth scientists can lead to synthetic approaches and a unified understanding of the mechanisms regulating SES. Although the motivation for this goal is specific to the LTER Network and similar projects, we believe that the issues and ideas presented here are widely applicable to other interdisciplinary SES studies.     

Commercial Genetic Testing in Mainland China: Social, Financial and Ethical Issues

This paper provides an empirical account of commercial genetic predisposition testing in mainland China, based on interviews with company mangers, regulators and clients, and literature research during fieldwork in mainland China from July to September 2006. This research demonstrates that the commercialization of genetic testing and the lack of adequate regulation have created an environment in which dubious advertising practices and misleading and unprofessional medical advice are commonplace. The consequences of these ethically problematic activities for the users of predictive tests are, as yet, unknown. The paper concludes with a bioethical and social science perspective on the social and ethical issues raised by the dissemination and utilization of genetic testing in mainland China.     

精神药理影像遗传学研究进展及其临床应用前景

精神疾病危害严重,其发病机制复杂难解,临床治疗效果不一,且存在明显的个体差异.近期精准医学研究发现精神药物作用于脑神经的生化过程受到遗传多态性的影响.本文从五羟色胺能、去甲肾上腺素能和多巴胺能三大系统入手,系统综述精神药理影像遗传学的相关研究进展,深入探讨精神药理的神经作用机制以及药物-基因-脑之间的交互作用.我们发现:SLC6A4、BDNF、FKBP5、COMT和多巴胺相关受体等基因多态性与多种精神疾病的发生发展及其治疗效果具有一定的相关性,可能成为相关精神疾病诊断的候选基因.杏仁核、海马、眶额叶、扣带回和前额叶等皮层与皮层下脑结构可能是不同神经递质相关的基因多态性影响精神药物生化作用过程的关键靶点脑区.在建立精神药物-基因-脑影像-行为的因果链中,仍然存在很多相互矛盾的结果和一定的局限性.因此,开展同质性强的临床试验、研究表观遗传作用等可以作为未来的研究发展趋势.     

General Practitioners Can Evaluate the Material,Social and Health Dimensions of Patient Social Status

Objective

To identify which physician and patient characteristics are associated with physicians'' estimation of their patient social status.

Design

Cross-sectional multicentric survey.

Setting

Fourty-seven primary care private offices in Western Switzerland.

Participants

Random sample of 2030 patients ≥16, who encountered a general practitioner (GP) between September 2010 and February 2011.

Main measures

Primary outcome: patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP''s evaluation and patient''s own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients'' deprivation and its influence on health and care.

Results

To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients'' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (−0.7, p = 0.002). GP''s evaluation of patient social status was 0.5 point higher than the patient''s own estimate (p<0.0001).

Conclusions

GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients'' own evaluation, GPs overestimate patient social status.     

Chapter 7: Pharmacogenomics

There is great variation in drug-response phenotypes, and a “one size fits all” paradigm for drug delivery is flawed. Pharmacogenomics is the study of how human genetic information impacts drug response, and it aims to improve efficacy and reduced side effects. In this article, we provide an overview of pharmacogenetics, including pharmacokinetics (PK), pharmacodynamics (PD), gene and pathway interactions, and off-target effects. We describe methods for discovering genetic factors in drug response, including genome-wide association studies (GWAS), expression analysis, and other methods such as chemoinformatics and natural language processing (NLP). We cover the practical applications of pharmacogenomics both in the pharmaceutical industry and in a clinical setting. In drug discovery, pharmacogenomics can be used to aid lead identification, anticipate adverse events, and assist in drug repurposing efforts. Moreover, pharmacogenomic discoveries show promise as important elements of physician decision support. Finally, we consider the ethical, regulatory, and reimbursement challenges that remain for the clinical implementation of pharmacogenomics.

What to Learn in This Chapter

• Interactions between drugs (small molecules) and genes (proteins)
• Methods for pharmacogenomic discovery
  • Association- and expression-based methods
  • Cheminformatics and pathway-based methods
• Database resources for pharmacogenomic discovery and application (PharmGKB)
• Applications of pharmacogenomics into a clinical setting

This article is part of the “Translational Bioinformatics” collection for PLOS Computational Biology.

     

The Social and Interactional Dimensions of Human-Computer Interfaces

The Social and Interactional Dimensions of Human- Computer Interfaces. Peter J. Thomas. ed. Cambridge: Cambridge University Press, 1995. 268 pp.     

The Social Impacts of Nanotechnology: an Ethical and Political Analysis

This paper attempts some predictions about the social consequences of nanotechnology and the ethical issues they raise. I set out four features of nanotechnology that are likely to be important in determining its impact and argue that nanotechnology will have significant social impacts in—at least—the areas of health and medicine, the balance of power between citizens and governments, and the balance of power between citizens and corporations. More importantly, responding to the challenge of nanotechnology will require confronting “philosophical” questions about the sort of society we wish to create and the role that technology might play in creating it. This in turn will require developing institutions and processes that allow the public to wield real power in relation to technological trajectories. My ultimate contention is that the immediate task established by the likely social impacts of nanotechnology is not so much to develop an ethics of nanotechnology as to facilitate an ethical conversation about nanotechnology.

Pharmacogenomics of osteoporosis: opportunities and challenges

The genetics of osteoporosis can be considered in two broad areas: disease susceptibility and drug activity. While the former has been studied, the latter is still largely untouched. Pharmacogenomics is the utilization of genetic information to predict outcome of drug treatment, with respect to both beneficial and adverse effects. The pharmacotherapy of osteoporosis is characterized by variability in therapeutic response with limited prediction of response on a patient-by-patient basis. This is particularly problematic in a clinical situation where therapy is typically required for several years before outcomes can be evaluated for an individual. Thus, the emerging field of pharmacogenomics holds great potential for refining and optimising pharmacological treatment of osteoporosis. Key components for future development of the pharmacogenomics of osteoporosis should include improved understanding of mechanisms of drug action, identification of candidate genes and their variants and expansion of clinical trials to include genetic profiling. This approach could provide clinicians and scientists with powerful tools to dissect novel molecular pathways involved in osteoporosis and to identify new drug targets. The iterative combination of innovative genomics with classical endocrinological approaches in osteoporosis research can be examined as a model of biological research and innovate therapeutical approaches in a continuing interaction between clinical science and basic research.     

Social Psychological Dimensions of Bioenergy Development and Public Acceptance

The best technology does no good unless people use it. Thus, the future of biofuels depends not only on development of effective and efficient technologies but also on the social, economic, and political climate within which people decide to use or avoid these new fuel sources and technologies. On a social psychological level, individual behaviors are often guided by people’s attitudes toward the behavior or objects involved and by the norms established by others within the social setting. Therefore, understanding technology adoption requires an understanding of how public attitudes and beliefs are formed or changed, as well as the implications of these changes for social norms. We provide an overview of basic social psychology research connecting attitudes and norms to individual behavior, and we describe implications of these social factors for biofuel development and use.     

药物基因组学在新药临床试验及个体化用药中的应用

药物安全性和有效性评价是药物临床试验和个体化用药的核心,也是药物基因组学研究的主要内容。药物基因组学研究贯穿于药物 研发、上市评价和临床应用整个过程, 根据药物代谢酶、转运体、受体相关基因多态性对用药者进行分层分析,评价与药物体内的处置过程、 安全性、有效性个体差异的相关性。综述药物基因组学在新药临床试验、个体化用药中的应用研究新进展。