Ethical Research Issues: Going Beyond the Declaration of Helsinki

La Vaque and Rossiter made a strong, supported argument that it is unethical to use a no treatment control group in a research study if a known, effective treatment is available. Their argument is based on the supposition that the Declaration of Helsinki is the ethical world standard for research with humans. Their argument appears to be straightforward, but is not simple to apply. The issues are very complex, include issues not discussed in their argument, and can lead to a different conclusion as pointed out in this paper. The World Medical Association developed the Declaration of Helsinki as one of their official policies. The Declaration of Helsinki, however, is not accepted as the world ethical standard, as demonstrated by its lack of adoption by many professional associations or even by the United States Federal Government. Perhaps it is not mentioned because its ethical provisions are aspirational rather than mandatory as implied by La Vaque and Rossiter. Researchers and clinicians should also be aware of other ethical issues not directly discussed in the La Vaque and Rossiter paper. The Belmont Report is the basis for the ethical protection of human research subjects for at least 17 federal agencies and does not mention the Declaration of Helsinki. The Belmont Report mentions several ethical principles that form the basis for informed consent, risk/benefit assessment, confidentiality of data, subject selection, Institutional Review Boards, and other protections needed when doing research with human subjects. At least 2 of these core principles have direct implications to the discussion related to the use of placebo controls. The ethical principle of fidelity is also important in guiding research activities with human subjects. Researchers should be familiar with the La Vaque and Rossiter argument, the Belmont Report, and the federal policies developed to implement the provisions of that report, for example, Regulation 45 CFR 46.     

Investigation of the mechanisms affecting Cu and Fe bioavailability from legumes

Chemical composition and content in polyphenols, phytic acid, and dietary fiber of whole cooked common bean (Phaseolus vulgaris L.) and faba bean (Vicia faba L.) and of soluble and insoluble fractions separated from them were determined. Simultaneous determination of Cu, Fe, and protein bioavailability in the small intestine of rat was carried out in single-dose, short-term (1 h) experiments. After cooking, about 80% of seed components (on a weight basis) of either legume was recovered in the precipitate (insoluble fraction) after extraction with water. Protein, lipid, starch, dietary fiber, and polyphenols underwent the most severe insolubilization, together with more than 70% of total Cu and Fe. Cu, Fe, and protein bioavailability showed a similar trend (i.e., the lower the protein, the lower the Cu and Fe availability). Availability of proteins, Cu, and Fe in the insoluble fractions were the lowest, but Cu bioavailability was higher than that of Fe in all fractions. The results provide evidence that the heat-induced insolubilization process adversely affects not only protein but also Cu and Fe bioavailability from legumes and that polyphenols are likely to be a major inhibitor on absorption.     

Enzyme treatment to reduce solids and improve settling of sewage sludge

The effect of microbial enzymes in reducing the disposable solid content of sludge was investigated. A mixture of industrial cellulase, protease, and lipase, in equal proportion by weight, reduced total suspended solids (TSS) by 30–50% and improved settling of solids. An increase in solid reduction was observed with increasing enzyme concentration. The effect of combinations of enzyme treatments indicated that two-enzyme combinations of protease and cellulase produced better solid reduction than individual enzymes and that lipase further augmented this effect. Among the individual enzymes, protease produced a more settleable sludge as compared to cellulase and lipase. Adjustment of the pH of the enzymatically treated sludge to the acidic range (pH 2–4) further improved solid reduction, and adjustment to the alkaline range (pH 10–12) improved settleability. Journal of Industrial Microbiology & Biotechnology (2001) 26, 383–386. Received 01 November 2000/ Accepted in revised form 29 April 2001     

In vitro reconstruction of full thickness human skin on a composite collagen material

Rapid progress of in vitro techniques in the lastyears enabled the creation of organotypic skin cultures offering newpossibilities in wound treatment. Rebuilding of graft is one of the keyelementsof successful outcome of the procedure.In search for the best scaffold for organotypic skin culture, the novelcomposite xenogenic collagen based material with unique properties has beencreated and used to reconstitute full thickness human skin invitro. Based on our long established technology used for theproduction of collagen dressings for the treatment of burns, this novel,composite material offers excellent growth support of highly biodegradablespongy layer, combined with mechanical strength of collagen membrane. Themodulation of collagen properties was accomplished by consecutive treatmentwithhigh temperature and gamma irradiation. The use of the substrate enabled toobtain organotypic culture that resembles full thickness skin with fibroblastslayer and well-developed multilayer epithelium. Our new material offers easyhandling of obtained graft during surgery along with accelerated cell growth andcontrolled biodegradation of the culture support.     

Influence of glutethimide on rat brain mononucleotides by sub-chronic codeine treatment

It was investigated the in vivo effect of glutethimide on the intracellular neuroadaptation characteristic for μ-opioid receptor tolerance induced by chronic codeine treatment and reflected by increased levels of adenylyl cyclase (AC) and cAMP-dependent protein kinase (PKA). AC activity was appreciated by cyclic-AMP (cAMP) formation, the levels of adenine and guanine nucleotides in brain extracts being assayed using a high performance liquid chromatographic method. The concomitant chronic administration of codeine and glutethimide resulted in a pronounced and long-lasting energetic depletion of the neurons, consistent with the high risk of overdose, and increase of cAMP's stable metabolite, 5'-AMP. This increase is persistent even after withdrawal and suggests an interference with the adenylyl cyclase system involved in the development of tolerance of opioid receptor and in relapse and provides a possible explanation of addiction and fast increase of doses observed in humans abusing this combination.     

Growth and nutrient dynamics of soft-stem bulrush in constructed wetlands treating nutrient-rich wastewaters

The growth characteristics and nutritional status ofSchoenoplectus tabernaemontani (C.C. Gmelin)Palla (soft-stem bulrush or lake clubrush) wereinvestigated during the second and third growthseasons in four equivalent subsurface-flow, gravel-bedconstructed treatment wetlands. Each wetland wassupplied with a different hydraulic loading rate ofagricultural wastewater, covering the range commonlyapplied to such systems. Harvest and demographictechniques were combined to determine seasonalpatterns and gradients of growth and nutrientallocation, and net annual primary productivity(NAPP). Marked seasonal patterns of early springemergence, summer growth and autumn senescence wereobserved, with little over-wintering of liveabove-ground biomass. Starch, the dominant long-termstorage substance, comprised 20% of rhizome dryweight (DW) in autumn. Mobilization during springreduced concentrations by around half, with a trend ofincreasing depletion in the higher loaded wetlands.NAPP, including above-ground mortality, during thesecond growth season ranged between 2.5 and 3.5 kg DWm^-2, with 10-23% allocated to below-groundgrowth. Mean above-ground live and dead biomass rangedbetween 1.75 and 2.65 kg DW m^-2 by mid-summer,with below to above-ground biomass ratios similar inall wetlands at between 0.6 and 0.7. Rhizomes, whichcomprised around 80% of the below-ground biomass,were generally restricted to the upper 10 cm of thesubstratum and over half the root biomass alsooccurred in this zone, with very few roots penetratingbelow 30 cm depth. High culm concentrations of N,P, Mg and Zn in spring declined markedly over thegrowth season, while S and Ca showed generalincreases, and K, Fe and Cu remained relativelystable. Gradients of decreasing tissue concentrationof most macronutrients were noted with increasingdistance from wastewater inflows. Plant accumulationof N rose by 20-35 g m^-2 and P by 4-9 g m^-2with seasonal re-growth of above-ground shoots. Netplant N and P uptake rates rose to maximum values of0.3 g N m^-2 d^-1 and 0.1 g P m^-2d^-1 in early summer, declining markedly duringlate summer and autumn. Mass balance assessments of Nand P accumulation in plants at near maximum seasonalbiomass, after three growth seasons, showed that only6 to 11% of the N removal and 6 to 13% of the Premoval recorded from wastewaters applied to thewetlands could be ascribed to plant uptake andaccumulation.     

Estrogen-alpha and progesterone receptor expression in cystic endometrial hyperplasia and pyometra in the bitch

Estrogen-alpha receptor (ER) and progesterone receptor (PR) were examined immunohistochemically in uteri of normal bitches, in uteri of bitches with cystic endometrial hyperplasia-mucometra (CEH-M) and in uteri of bitches with endometritis-pyometra (E-P), under exogenous progesterone treatment.In the CEH-M group, the ER- and PR-scores of all uterine cell types were higher than the ER- and PR-scores of normal uteri, although these differences were not always statistically significant. The ER-scores of E-P group were significantly lower than the ER-scores of the normal uteri and CEH-M group. The PR-scores of the E-P group tended to be higher than the PR-scores of the normal uteri, except for the surface epithelium, although these differences were not statistically significant. Exogenous progesterone treated bitches with CEH-M or E-P showed reduced ER- and PR-scores in the different uterine cell types, compared with the corresponding nontreated CEH-M or E-P group.The differences in ER and PR expression between CEH-M and E-P suggest different factors in the pathogenesis of both entities. Although, these changes in ER and PR expression do not seem to be directly involved in the pathogenesis of CEH-M and E-P. It is suggested that for CEH-M and progestin induced CEH-M a hormone dependent pathway is responsible. For P, the trigger may be bacterial infection.     

Mesophilic and thermophilic activated sludge post treatment of anaerobic effluent. Sludge and wastewater characterisation using batch experiments

Anaerobic pretreated paper process water was characterized interms of readily biodegradable, slowly biodegradable, very slowly biodegradable and inert wastewaterfractions under mesophilic and thermophilic conditions. The anaerobic pretreated paper process water containeda relatively high amount of slowly biodegradable components and few easily biodegradable componentsas indicated by the ratio of short term BOD over the BOD5. Wastewater readily biodegradable COD, determinedas short term BOD, was almost similar when measured under both temperature conditions. Fractions ofslowly biodegradable COD and inert COD of the same wastewater were found to depend on the type of biomassinvolved in the test. Thermophilic aerobic biomass was not able to degrade the wastewater to the sameextent as the mesophilic biomass resulting in higher apparent inert COD levels. Furthermore, wastewater colloidalCOD did not flocculate under thermophilic conditions and was thus not removed from the liquid phase.     

Combined effects of cadmium and nickel on testicular xenobiotic metabolizing enzymes in rats

When male rats were given a single dose of cadmium (Cd) (3.58 mg CdCl₂·H₂O/kg, ip) 72 hr prior to sacrifice, the testicular 7-ethoxyresorufin O-deethylase (EROD) and glutathione S-transferase (GST) activities toward the substrates 1-chloro-2,4-dinitrobenzene (CDNB), 1,2-dichloro-4-nitrobenzene (DCNB), ethacrynic acid (EAA), 1,2-epoxy-3-(p-nitrophenoxy)-propane (EPNP), and cumene hydroperoxide (CHPx) decreased significantly as compared to controls. Cd also inhibited reduced glutathione (GSH) level while increasing the lipid peroxidation (LP) level significantly. When the animals were given a single dose of nickel (Ni) (59.5 mg NiCl₂·6H₂O/kg, ip) 16 hr prior to sacrifice, significant decreases were observed in EROD and GST activities toward CDNB, EAA, EPNP, and CHPx, and GSH level. No significant alterations were noted in DCNB GST activity and LP level by Ni. For the combined treatment, rats received the single dose of Ni 56 hr after the single dose of Cd and were killed 16 hr later. In these animals, lesser depressions were observed on EROD activity and LP level than those of Cd alone. The combination of metals significantly inhibited GST activities and GSH level but not to a greater degree than noted by Cd or Ni alone. Plasma testosterone levels of Cd-, Ni-, and combination-treated rats decreased significantly compared to controls. The strongest depression was achieved by Cd alone. Cd, both alone and in combination with Ni, increased the tissue Ni uptake significantly. Ni, however, did not produce such an effect on the tissue uptake of Cd in either case. Cd treatment caused interstitial edema and coagulation necrosis in seminiferous tubules and also caused fibrinoidal necrosis in vascular endothelium. Ni treatment did not produce any pathological testicular alterations compared to controls. Combined treatment produced fewer pathological alterations (i.e., only interstitial edema) than that of Cd treatment. These results reveal that the combination of Cd and Ni does not have a synergistic effect on testicular xenobiotic metabolizing enzymes, and in contrast, Ni has an ameliorating effect on pathological disturbances caused by Cd alone in the rat testis.