Stem cell tourism and future stem cell tourists: policy and ethical implications

Stem cell tourism is a small but growing part of the thriving global medical tourism marketplace. Much stem cell research remains at the experimental stage, with clinical trials still uncommon. However, there are over 700 clinics estimated to be operating in mostly developing countries--from Costa Rica and Argentina to China, India and Russia--that have lured many patients, mostly from industrialized countries, driven by desperation and hope, which in turn continue to fuel the growth of such tourism. While much research has focused on such dimensions as the promotions that allow such businesses to make their services known, media coverage, some patient research, and regulatory conditions for developing country clinics, little attention has been paid to the non-affected members of the general population, the future potential users of such services. This empirical study based on five focus group discussions with a diverse group of healthy adults in a Canadian city, explored participant views of patients who use stem cell tourism services, the likelihood they would avail themselves of such services if they were to suffer similar illnesses, and the conditions under which they might do so, and the impact that admonitions and advice from international expert bodies might have on their decisions. Our findings suggest that these healthy adults are sympathetic to the drivers of hope and desperation, and, despite cautions about research limitations, may seek such treatments themselves under similar conditions. These findings are discussed in the context of the policy and ethical issues raised by this form of medical tourism.     

An evolutionary modeling approach for designing a contractual REDD+ payment scheme

Economic development and sustainable ecological and environmental development generally target different goals, and there are trade-offs and game-like behaviors between implementers and donors in reducing emissions from deforestation and degradation (REDD+) program. This paper analyzed the effects of evolutionary behaviors of REDD+ implementers and donors with respect to environmental service payments. Within a theoretical analysis framework, the evolutionary stable strategies of the implementers and donors under different contractual payments for ecosystem services (PES) scenarios are analyzed to explore contractual REDD+ payments through evolutionary game models. On this basis, anon-parametric local regression approach is used to analyze arrange of market-based contractual PES schemes in five REDD+ countries (Congo, Brazil, Ecuador, Nepal and Uganda). The results show the following: First, when the opportunity costs are less than the environmental benefits, some middle and high income developing countries are sufficiently incentivized to conserve forests, even without formal contractual PES scheme. This conservation occurs regardless of whether the industrialized countries will pay for the ecosystem services. Second, when the opportunity costs are greater than the environmental benefits, developing countries will generally not take the initiative to conserve forests when industrialized countries do not pay for the associated ecosystem services. Third, when there are enough contractual PES fines, developing countries will conserve forests, and the industrialized countries will pay for the ecosystem services. Finally, contractual PES fines are related to the costs of reducing emissions. Nepal has the largest marginal effect, and Uganda has the smallest. These results have implications for REDD+ program design and implementation: market-based contractual PES scheme should be given priority to regulate behavior of industrialized countries and developing countries in the PES scheme. Developing a targeted and differentiated contractual PES scheme requires an accounting of emission reduction costs in different countries.     

Age-specific variation in the secular trend for stature: A comparison of samples from industrialized and nonindustrialized regions

Age-specific secular trend patterns for children in industrialized world regions have a regular pattern, beginning low at age 6 and increasing to a maximum at age 10 to 14, then declining. While magnitude differs, the patterns are ordinarily parallel, especially in the female samples. However, age-specific secular trend values for children from developing regions, or from areas of industrialized countries not benefitting substantially from development, are irregular in pattern and magnitude. Consequently, it is difficult to predict age at maximal secular change. We suggest that fluctuating environmental circumstances in these developing countries influence growth and, hence, the pattern of secular trend. As more stable environmental conditions relating to growth are present in the industrialized countries, this leads to more stable patterns of growth and age-specific patterns of secular change.     

Organoid technology for retinal repair

A major cause for vision impairment and blindness in industrialized countries is the loss of the light-sensing retinal tissue in the eye. Photoreceptor damage is one of the main characteristics found in retinal degeneration diseases, such as Retinitis Pigmentosa or age-related macular degeneration. The lack of effective therapies to stop photoreceptor loss together with the absence of significant intrinsic regeneration in the human retina converts such degenerative diseases into permanent conditions that are currently irreversible. Cell replacement by means of photoreceptor transplantation has been proposed as a potential approach to tackle cell loss in the retina. Since the first attempt of photoreceptor transplantation in humans, about twenty years ago, several research groups have focused in the development and improvement of technologies necessary to bring cell transplantation for retinal degeneration diseases to reality. Progress in recent years in the generation of human tissue derived from pluripotent stem cells (PSCs) has significantly improved our tools to study human development and disease in the dish. Particularly the availability of 3D culture systems for the generation of PSC-derived organoids, including the human retina, has dramatically increased access to human material for basic and medical research. In this review, we focus on important milestones towards the generation of transplantable photoreceptor precursors from PSC-derived retinal organoids and discuss recent pre-clinical transplantation studies using organoid-derived photoreceptors in context to related in vivo work using primary photoreceptors as donor material. Additionally, we summarize remaining challenges for developing photoreceptor transplantation towards clinical application.     

Transgenic crops,biotechnology and ownership rights: what scientists need to know

Ownership of intellectual and tangible property (IP/TP) rights in agricultural biotechnology (ag-biotech) and transgenic plants has become critically important. For scientists in all institutions, whether industrialized or developing country, public or private sector, an understanding of IP/TP rights is fundamental in both research and development. Transgenic plants and ag-biotech products embody numerous components and processes, each of which may have IP/TP rights attached. To identify these rights, a transgenic plant or ag-biotech product must be dissected into its essential components and processes, with each 'piece' analysed under the IP/TP 'microscope'. This product deconstruction is an integral step in product clearance (PC) analysis leading to freedom to operate (FTO). To facilitate a PC analysis, the following points are important: (1) knowing what one has and where it's from, (2) organizing material transfer agreements and licences, (3) researching scientific and patent databases and relevant literature, (4) instituting a laboratory notebook policy, (5) keeping track of ownership of germplasm and plant genetic resources, and (6) promoting ongoing IP/TP management, awareness and training. However, a FTO opinion does not solve the IP/TP issues of releasing a transgenic plant or ag-biotech product; rather, it is a management tool for assessing the risks of litigation. When transferring transgenic plants or ag-biotech to developing nations, scientists from industrialized countries have the heightened responsibility of verifying that IP/TP issues are fully addressed and documented. Successful technology transfer goes beyond research, development and licensing; it is an holistic package leading to long-term partnerships in international development. Managing IP/TP requires capacity-building in scientists and technology transfer offices, in both industrialized and developing countries.     

Development and Dematerialization: An International Study

Economic development and growth depend on growing levels of resource use, and result in environmental impacts from large scale resource extraction and emissions of waste. In this study, we examine the resource dependency of economic activities over the past several decades for a set of countries comprising developing, emerging and mature industrialized economies. Rather than a single universal industrial development pathway, we find a diversity of economic dependencies on material use, made evident through cluster analysis. We conduct tests for relative and absolute decoupling of the economy from material use, and compare these with similar tests for decoupling from carbon emissions, both for single countries and country groupings using panel analysis. We show that, over the longer term, emerging and developing countries tend to have significantly larger material-economic coupling than mature industrialized economies (although this effect may be enhanced by trade patterns), but that the contrary is true for short-term coupling. Moreover, we demonstrate that absolute dematerialization limits economic growth rates, while the successful industrialization of developing countries inevitably requires a strong material component. Alternative development priorities are thus urgently needed both for mature and emerging economies: reducing absolute consumption levels for the former, and avoiding the trap of resource-intensive economic and human development for the latter.     

Nutritional status influences peripheral immune cell phenotypes in healthy men in rural Pakistan

ABSTRACT: Immune status is influenced by malnutrition, but how this factor interacts in developing countries and whether these differences are similar to those determined in industrialized countries, is unclear. To establish whether malnutrition-associated immune profiles in a developing country are similar to those in industrialized countries we analyzed peripheral blood immune cell phenotypes by polychromatic flow cytometry in 50 young and 50 elderly subjects. Data on anthropometrics and diet were collected through interviews. Plasma samples were analyzed for common clinical chemistry variables. Subjects in 4 BMI categories differed in their immune parameters demonstrating influence of nutritional status on immunity. This was greater within the young group and affected the CD4 subset more profoundly than the CD8 subset. No nutrition-associated differences were seen in B or NK cells. CD8+ cells as a percentage of CD3+ T cells were positively associated with plasma CRP levels but not other factors. We conclude that there are differences in the immune signatures of obese, overweight and underweight versus normal-weight young and elderly, which seem broadly similar to the more extensively-documented state reported in industrialized countries, despite the marked societal, nutritional and many other differences.     

细胞药物的研发现状——细胞药物连载之三

近年来,细胞药物的研究受到了国内外重视。特别是干细胞药物,已成为世界各国竞相研究的热点领域,但各国的干细胞药物绝大多数仍处于研究阶段,全球真正上市的干细胞药物很少。目前正在研发的干细胞药物主要集中在治疗慢性疾病（关节炎、糖尿病和癌症等）和心脏相关疾病（心肌梗死、心脏衰竭等）。一些传统体细胞药物（软骨细胞、心肌细胞、胰岛细胞等）和免疫细胞药物已在临床应用。     

Life sciences and biotechnology in China

Life science and biotechnology have become a top priority in research and development in many countries as the world marches into the new century. China as a developing country with a 1.3 billion population and booming economy is actively meeting the challenge of a new era in this area of research. Owing to support from the government and the scientific community, and reform to improve the infrastructure, recent years have witnessed a rapid progress in some important fields of life science and biotechnology in China, such as genomics and protein sciences, neuroscience, systematics, super-hybrid rice research, stem cell and cloning technology, gene therapy and drug/vaccine development. The planned expansion and development of innovation in related sectors and the area of bioethics are described and discussed.     

Scientific publishing in non industrialized countries: a pilot wireless internet project for Africa

There is general agreement that the internet is the major means of future scientific communication and education. However not everybody appreciates that the development of electronic communication in industrialized societies is not matched, even to a small extent, in developing countries. Several new technologies offer the potential for developing countries to provide connectivity. Terrestrial wireless and satellite technologies offer many advantages in that they do not require installation of wire-line networks. Satellite facilities can also be installed where communication is needed, even in remote and isolated areas, rather than waiting for terrestrial networks to be extended from the cities.     

Miniaturized bacterial biosensor system for arsenic detection holds great promise for making integrated measurement device

Combining bacterial bioreporters with microfluidics systems holds great promise for in-field detection of chemical or toxicity targets. Recently we showed how Escherichia coli cells engineered to produce a variant of green fluorescent protein after contact to arsenite and arsenate can be encapsulated in agarose beads and incorporated into a microfluidic chip to create a device for in-field detection of arsenic, a contaminant of well known toxicity and carcinogenicity in potable water both in industrialized and developing countries. Cell-beads stored in the microfluidics chip at -20°C retained inducibility up to one month and we were able to reproducibly discriminate concentrations of 10 and 50 μg arsenite per L (the drinking water standards for European countries and the United States, and for the developing countries, respectively) from the blank in less than 200 minutes. We discuss here the reasons for decreasing bioreporter signal development upon increased storage of cell beads but also show how this decrease can be reduced, leading to a faster detection and a longer lifetime of the device.     

Biotechnology: developing countries and globalization

Biotechnology in a globalizing economy involves the participation of all countries–industrialized, developing and least developed, in the interconnected web of trade liberalization in closed and open-market economies. The various geopolitical or geocultural regions show striking approaches to the application of biotechnologies for development and the safeguarding of intellectual property rights. The generally held view that developing countries are doomed to being marginalized in a globalizing economy is, seemingly, in need of revision.     

Cancer stem cells in prostate adenocarcinoma: a target for new anticancer strategies

Prostate cancer (PC) is major common malignancy in males in most industrialized Western countries, where it is the most commonly diagnosed cancer affecting men after middle age (>50 years). Over 90% of PC patients with incurable disease respond to primary treatment, which consists of intervention to lower serum testosterone. However, the duration of response is short (12-33 months) and in almost all patients, is followed by the emergence of a phenotype resistant to androgen deprivation in therapy (known as hormone or androgen-resistant PC). Considerable research efforts have been directed towards the identification of markers associated with the initiation and progression of PC, yet there is little consensus about the target cell within prostate epithelium that is susceptible to malignant transformation. Stem cells may represent a major target for mutations leading to cancer as their longevity assures continued presence during the long latency between carcinogenic agents exposure and cancer development. Therefore in order to allow the development of more effective treatment strategies for PC, a better understanding of the molecular changes that underlie cancer stem cells is required.     

Applying Industrial Symbiosis to Smallholder Farms

The study of industrial symbiosis (IS) has largely focused on the exchange of energy and materials among industrial processes in an effort to increase value and reduce environmental impact. Agricultural systems, particularly those located in developing countries, can benefit from the principles of IS. Relatively few studies have analyzed the potential benefits of integrated material and energy flows in smallholder farming, even though these systems are considered essential to the world's food supply and poverty reduction. Although the concepts can be applied to virtually any system, the study of industrial symbiosis has traditionally focused on industrialized systems in developed countries. The research presented here applies the principles of IS to smallholder farms using optimization techniques to maximize farm output while minimizing wastes. Our research links IS to the growing field of integrated farming research (IFR), which seeks to create new technologies that increase the production of farms by viewing the farm as a system. Bridging these fields enriches the potential for robust research outcomes in both areas and fills a current knowledge gap. IS benefits from exploring new applications and increasing its penetration into the developing world. IFR benefits from established IS tools to create alternate pathways for increased output based on symbiotic relationships. A small farming system in Liberia, West Africa, is used as a case study. System integration of individual unit processes shows increased productivity and decreased waste. The results of this analysis indicate that there are unrealized opportunities for IS in developing countries, and integration of IS techniques into smallholder farming operations has the potential for impacting sustainable development.     

International Cooperation for Metal Recycling From Waste Electrical and Electronic Equipment

This article addresses a market‐based management concept for waste electrical and electronic equipment (WEEE) known as the “best‐of‐two‐worlds” approach. The concept is based on the idea that recyclers in developing countries and emerging economies can cooperate with technologically advanced refineries in industrialized countries to facilitate efficient recovery of valuable metals, such as gold and palladium, from e‐waste. The article provides an overview of technical and environmental concerns underlying the concept and sheds light on the political framework, the waste‐related trade issues, and the resource economics that need to be considered for further decision making. Building on this synthesis, I conduct a qualitative assessment of sustainability impacts of the proposed concept by analyzing two scenarios and their associated risks. The analysis suggests that, under certain preconditions, the best‐of‐two‐worlds concept could yield significant improvements in terms of management of hazardous substances, resource efficiency, greenhouse gas emissions, income generation, and investments into social and environmental standards. Generally, two potential implementation scenarios were identified: Whereas under Scenario 1 only WEEE generated within developing countries and emerging economies is managed through the best‐of‐two‐worlds approach, Scenario 2 additionally incorporates WEEE imported from industrialized countries. Although both scenarios can yield a variety of benefits, Scenario 2 might cause a net flow of hazardous substances from industrialized countries into developing countries and emerging economies, thus leading to less beneficial sustainability impacts.     

Spermatogonial stem cells, infertility and testicular cancer

The spermatogonial stem cells (SSCs) are responsible for the transmission of genetic information from an individual to the next generation. SSCs play critical roles in understanding the basic reproductive biology of gametes and treatments of human infertility. SSCs not only maintain normal spermatogenesis, but also sustain fertility by critically balancing both SSC self-renewal and differentiation. This self-renewal and differentiation in turn is tightly regulated by a combination of intrinsic gene expression within the SSC as well as the extrinsic gene signals from the niche. Increased SSCs self-renewal at the expense of differentiation result in germ cell tumours, on the other hand, higher differentiation at the expense of self-renewal can result in male sterility. Testicular germ cell cancers are the most frequent cancers among young men in industrialized countries. However, understanding the pathogenesis of testis cancer has been difficult because it is formed during foetal development. Recent studies suggest that SSCs can be reprogrammed to become embryonic stem (ES)-like cells to acquire pluripotency. In the present review, we summarize the recent developments in SSCs biology and role of SSC in testicular cancer. We believe that studying the biology of SSCs will not only provide better understanding of stem cell regulation in the testis, but eventually will also be a novel target for male infertility and testicular cancers.     

Public discourses of stem cell science in Singapore (1997–2010)

In most industrialized countries, policy debates around stem cell science manifest in public discourse. Assuming that a functioning public sphere exists where matters of science policy can be discussed, examination of these discourses can help provide an understanding of how science policies evolve. The aim of this paper is to provide a preliminary analysis of how the public discourses around stem cell science have developed in Singapore. Using a theoretical model of “focused discourse,” our analysis indicates that there have been five distinct phases, marked by discernible shifts that reflect important changes in how biomedical science is funded in Singapore. While our results are preliminary, we argue that public discourses around science policies do exist in Singapore but are limited by a lack of diversity that would be expected in a more heterogeneous public sphere.     

Helicobacter in the developing world

Helicobacter pylori in the developing world is associated with many unique challenges not encountered in an industrialized setting. The 20% prevalence of infection with H. pylori among adolescents in the United States pales in comparison to infection rates exceeding 90% by 5 years of age in parts of the developing world. While H. pylori within the developed world is associated with gastritis, which may lead to peptic ulcer and gastric carcinoma, the infection in the developing world appears to also be linked with chronic diarrhea, malnutrition and growth faltering as well as predisposition to other enteric infections, including typhoid fever and cholera. Once identified, treatment of H. pylori within the developing world presents increased difficulties due to the frequency of antibiotic resistance as well as the frequency of recurrence after successful treatment. Control, and possibly eradication, of H. pylori could likely be achieved through increased standards of living and improved public health, as it has in the industrialized world. However, these measures are distant objectives for most developing countries, making long-term control of the organism dependent on the development and administration of an effective vaccine.     

Stem cells sources for intervertebral disc regeneration

Intervertebral disc regeneration field is rapidly growing since disc disorders represent a major health problem in industrialized countries with very few possible treatments.Indeed, current available therapies are symptomatic, and surgical procedures consist in disc removal and spinal fusion, which is not immune to regardable concerns about possible comorbidities, cost-effectiveness, secondary risks and long-lasting outcomes. This review paper aims to share recent advances in stem cell therapy for the treatment of intervertebral disc degeneration. In literature the potential use of different adult stem cells for intervertebral disc regeneration has already been reported. Bone marrow mesenchymal stromal/stem cells, adipose tissue derived stem cells, synovial stem cells, muscle-derived stem cells, olfactory neural stem cells, induced pluripotent stem cells, hematopoietic stem cells, disc stem cells, and embryonic stem cells have been studied for this purpose either in vitro or in vivo. Moreover, several engineered carriers(e.g., hydrogels), characterized by full biocompatibility and prompt biodegradation, have been designed and combined with different stem cell types in order to optimize the local and controlled delivery of cellular substrates in situ. The paper overviews the literature discussing the current status of our knowledge of the different stem cells types used as a cell-based therapy for disc regeneration.     

Shiftworkers in developing countries: health and well-being and supporting measures

Developing countries currently represent approximately 79% of the world population. Living and working conditions in middle and low income countries are harder and worse than for workers in industrialized countries. In developing countries, workers usually face more dangerous workplaces and unhealthy environmental and occupational conditions than those of industrial countries. Shiftworkers can face even more difficulties, due to constraints caused by their working time and consequences on health. Occupational health actions oriented by health policies were implemented during the 1990s in several Asian countries and in Brazil. these actions are important to promote workers' health. The general aims of this report are: a) to discuss topics related to equity and health; b) to present the main items of international and Brazilian legislation for shiftworkers; and c) to review general and specific measures of occupational health for shiftworkers in developing countries. In order to have equity on health and well-being, supporting measures should encompass micro and macro improvements at local, regional and national levels. Governmental and non-governmental organizations, professional bodies, labor unions, research institutes, universities, technical schools and syndicates, would play important roles to achieve these goals.