Design bioethics:a theoretical framework and argument for innovation in bioethics research

Empirical research in bioethics has developed rapidly over the past decade, but has largely eschewed the use of technology-driven methodologies. We propose "design bioethics" as an area of conjoined theoretical and methodological innovation in the field, working across bioethics, health sciences and human-centred technological design. We demonstrate the potential of digital tools, particularly purpose-built digital games, to align with theoretical frameworks in bioethics for empirical research, integrating context, narrative and embodiment in moral decision-making. Purpose-built digital tools can engender situated engagement with bioethical questions; can achieve such engagement at scale; and can access groups traditionally under-represented in bioethics research and theory. If developed and used with appropriate rigor, tools motivated by "design bioethics" could offer unique insights into new and familiar normative and empirical issues in the field.</p

Granulosa Cell Tumor Associated with Occult Hyperadrenocorticism in a Yorkshire Terrier Bitch

Background: Hyperadrenocorticism (HAC), is considered a set of symptoms due to excessive exposure to cortisol. Naturally occurring HAC is most often related to pituitary tumors (pituitary-dependent HAC - PDH). Occult HAC, is referred as a clinical picture highly consistent with HAC; however, routine screening tests are negative. In addition, one or more steroids are elevated following administration of adrenocorticotrophic hormone (ACTH). Ovarian granulosa cell tumors, can produce steroids leading to paraneoplastic syndromes. The objective of this study was to report an unpublished case of ovarian granulosa cell tumor associated with occult hyperadrenocorticism in a Yorkshire Terrier.Case: A 13-year-old intact female dog, Yorkshire Terrier, was brought for consultation with slight weight loss, polyuria, polydipsia, irregular estrous cycles, increased abdominal volume and thin coat. On physical examination the animal was gasping and presented severe periodontal disease, bulging abdomen, alopecia and skin hyperpigmentation. Complete blood count presented no changes; however, serum biochemistry evaluation highlighted hyperalbuminemia, hypertriglyceridemia, alkaline phosphatase increased activity, and urinary specific gravity and creatinine below reference values. On abdominal ultrasonography left adrenal gland measured 2.08 cm x 1.08 cm and the right adrenal gland measured 2.11 cm x 0.84 cm, indicating bilateral adrenomegaly compatible with PDH. In the hypogastric abdomen, a large heterogeneous hypoechogenic mass was also observed, with areas of cystic cavities, measuring 5.80 cm x 7.30 cm. A low dose dexamethasone suppression test (LDDST) was performed, due to PDH suspicion. The test did not confirm HAC, suspecting, then, to be a case of occult/atypical HAC. Due to the strong clinical suspicion, and owner financial problems for further investigated occult HAC, trilostane treatment was initiated. Approximately one month after starting treatment, an ACTH stimulation test (AST) for cortisol and 17-hydroxyprogesterone (17-OHP) determination was performed, revealing high values for both hormones. Exploratory laparotomy was indicated due to the tumor image on hypogastric region visualized on abdominal ultrasonography. A cranial pole mass of the left ovary measuring 8.5 x 7.0 x 4.5 cm, of friable consistency and brownish color, was removed through ovariohysterectomy. A granulosa cell tumor on left ovary, as well as leiomyoma and cystic endometrial hyperplasia in the uterus, became clear through histopathological examination. Trilostane treatment was sustained after surgery. Few weeks later, the patient presented a clinical picture suggestive of hypoadrenocorticism, associated with a low sodium:potassium ratio (25:1), and AST results (basal and post-ACTH cortisol) below reference range, confirming Addisonian´ crises. The patient deceives within two days.Discussion: Granulosa cell tumors can produce estrogen and progesterone, as well as other steroids, leading to paraneoplastic syndromes with peculiar clinical presentations. Steroids transport in plasma occurs via specific carrier proteins. Increased production of other steroid hormones may result in higher concentration of free cortisol, thus leading to clinical manifestations of hypercortisolism. As 17-OHP is one of the precursors in cortisol synthesis and has been shown elevated on AST, it can be assumed that altered steroid hormone levels due to the granulosa cell tumor interfered on cortisol biodisponibility, leading to HAC signs. Dexamethasone suppression test results indicated that pituitary-adrenal axis was responsive to negative feedback. The Addisonian crises after tumor removal indicate that the main source for systemic excessive cortisol effects was the eminent steroid secretion by the granulosa cell tumor

Preschool children's emotional and behavioral descriptions of events

Preschool children already show interest in other people's mental states. The goal of the present research was to investigate if this interest is reflected in four to six year-old children's preferences for either emotional or behavioral descriptions of events, and whether there is a correlation between those preferences and their emotion understanding. Thirty-seven children (21 girls and 16 boys) were asked to describe four different movie scenes and their understanding of emotions was assessed. The results revealed an effect of age on the frequency of emotional descriptions, F(2, 34) = 6.7, p < 0.01, as well as a correlation between the frequency of emotional descriptions and participants' level of emotion understanding (r = 0.55, p < 0.001). These results are consistent with evidence suggesting an increase in the spontaneous production of emotion terms in the preschool years.Niños en edad preescolar se encuentran interesados en los estados mentales ajenos. El objetivo del presente estudio fue investigar si este interés se refleja en la tendencia de los niños de cuatro a seis años a describir eventos en términos emocionales o de comportamiento, y si hay correlácion entre estas preferencias y la comprensión emocional de los niños. A 37 niños (21 niñas y 16 niños) se les pidió que describieran escenas de cuatro películas y se evaluó la comprensión de las emociones. Los resultados revelaron un efecto de la edad sobre la frecuencia de las descripciones emocionales F(2, 34) = 6,7, p < 0,01 y una correlación entre la frecuencia de las descripciones emocionales y el nivel de comprensión de las emociones por los participantes (r = 0,55, p < 0,001). Estos datos son consistentes con evidencias del aumento en la producción espontánea de términos emocionales en el período preescolar.Crianças em idade pré-escolar já se interessam pelos estados mentais alheios. O presente estudo teve por objetivo investigar se o interesse por estados mentais alheios se reflete nas preferências de crianças entre quatro e seis anos de idade por descrições emocionais e/ou comportamentais de eventos e se há correlação entre essas preferências e sua compreensão emocional. Trinta e sete crianças (21 meninas e 16 meninos) foram solicitadas a descrever quatro cenas de filmes e foram avaliadas quanto à compreensão de emoções. Os resultados revelaram um efeito de idade para a frequência de descrições emocionais, F(2, 34) = 6,7, p < 0,01, bem como uma correlação entre a frequência de descrições emocionais e o nível de compreensão emocional dos participantes, (r = 0,55, p < 0,001). Esses dados são consistentes com evidências de um aumento na produção espontânea de termos emocionais no período pré-escolar

Granulosa cell tumor associated with occult hyperadrenocorticism in a Yorkshire Terrier bitch

Background: Hyperadrenocorticism (HAC), is considered a set of symptoms due to excessive exposure to cortisol. Naturally occurring HAC is most often related to pituitary tumors (pituitary-dependent HAC - PDH). Occult HAC, is referred as a clinical picture highly consistent with HAC; however, routine screening tests are negative. In addition, one or more steroids are elevated following administration of adrenocorticotrophic hormone (ACTH). Ovarian granulosa cell tumors, can produce steroids leading to paraneoplastic syndromes. The objective of this study was to report an unpublished case of ovarian granulosa cell tumor associated with occult hyperadrenocorticism in a Yorkshire Terrier. Case: A 13-year-old intact female dog, Yorkshire Terrier, was brought for consultation with slight weight loss, polyuria, polydipsia, irregular estrous cycles, increased abdominal volume and thin coat. On physical examination the animal was gasping and presented severe periodontal disease, bulging abdomen, alopecia and skin hyperpigmentation. Complete blood count presented no changes; however, serum biochemistry evaluation highlighted hyperalbuminemia, hypertriglyceridemia, alkaline phosphatase increased activity, and urinary specific gravity and creatinine below reference values. On abdominal ultrasonography left adrenal gland measured 2.08 cm x 1.08 cm and the right adrenal gland measured 2.11 cm x 0.84 cm, indicating bilateral adrenomegaly compatible with PDH. In the hypogastric abdomen, a large heterogeneous hypoechogenic mass was also observed, with areas of cystic cavities, measuring 5.80 cm x 7.30 cm A low dose dexamethasone suppression test (LDDST) was performed, due to PDH suspicion. The test did not confirm HAC, suspecting, then, to be a case of occult/atypical HAC. Due to the strong clinical suspicion, and owner financial problems for further investigated occult HAC, trilostane treatment was initiated. Approximately one month after starting treatment, an ACTH stimulation test (AST) for cortisol and 17-hydroxyprogesterone (17-OHP) determination was performed, revealing high values for both hormones. Exploratory laparotomy was indicated due to the tumor image on hypogastric region visualized on abdominal ultrasonography. A cranial pole mass of the left ovary measuring 8.5 x 7.0 x 4.5 cm, of friable consistency and brownish color, was removed through ovariohysterectomy. A granulosa cell tumor on left ovary, as well as leiomyoma and cystic endometrial hyperplasia in the uterus, became clear through histopathological examination. Trilostane treatment was sustained after surgery. Few weeks later, the patient presented a clinical picture suggestive of hypoadrenocorticism, associated with a low sodium:potassium ratio (25:1), and AST results (basal and post-ACTH cortisol) below reference range, confirming Addisonian´ crises. The patient deceives within two days Discussion: Granulosa cell tumors can produce estrogen and progesterone, as well as other steroids, leading to paraneoplastic syndromes with peculiar clinical presentations. Steroids transport in plasma occurs via specific carrier proteins. Increased production of other steroid hormones may result in higher concentration of free cortisol, thus leading to clinical manifestations of hypercortisolism. As 17-OHP is one of the precursors in cortisol synthesis and has been shown elevated on AST, it can be assumed that altered steroid hormone levels due to the granulosa cell tumor interfered on cortisol biodisponibility, leading to HAC signs. Dexamethasone suppression test results indicated that pituitary-adrenal axis was responsive to negative feedback. The Addisonian crises after tumor removal indicate that the main source for systemic excessive cortisol effects was the eminent steroid secretion by the granulosa cell tumor

Smarter Than Thou, Holier Than Thou: The Dynamic Interplay Between Cognitive and Moral Enhancement

The debate about the desirability of using drugs to enhance human skills encompasses cognitive abilities such as memory and attention, and moral capacities such as emotional empathy and a sense of fairness. These two strands of literature in bioethics have grown relatively independent from each other, and an implicit framing assumption has emerged suggesting that apparently morally neutral cognitive capacities and paradigmatically moral capacities are distinct and vary independently of each other. Here, we identify key distinctions between competing accounts of cognitive enhancement and moral enhancement and argue that, despite the polarized nature of the bioethical debate, cognitive and moral capacities are intertwined. For example, moral behavior can be improved by enhancing “morally neutral” abilities such as attention span; and cognitive skills can be honed by means of socio-moral interaction. Further, cognitive skill is frequently assigned the abstract status of virtue and treated in the same way as more paradigmatically “moral” traits. We argue that the distinction between moral and cognitive enhancement is more apparent than real, since despite being nominally treated as distinct, cognitive and moral skills are frequently interdependent. As such we present evidence to support the claim that the enhancement of these two kinds of capacities cannot be clearly disaggregated from each other in the way that the theoretical poles of the debate in the literature suggest. We synthesize relevant scientific and bioethical literature and combine it with a line of analysis derived from Peter Hacker to show more clearly the terms of what can be said intelligibly about cognitive and moral skills and their enhancement. As a result of this analysis, we conclude that ethical questions in human bioenhancement are only fully intelligible at the level of persons imbued with feelings, thoughts, intentions, desires, values, and abilities, embedded within a particular social context, rather than at the level of pharmacological modulation of particular cognitive or affective capacities which, though conceptually distinguishable, in the embodied context of moral agency are profoundly intertwined

Principais defeitos cardíacos em bovinos no sul do Brasil : estudo retrospectivo de necropsias em 20 anos (2000-2019)

Cardiac malformations are reported to be relatively rare in bovine species, with ventricular septal defects being the most common abnormality observed predominantly in young calves. This report aims to describe the cardiac malformations observed in bovids and review the literature related to those malformations in this species. The necropsy reports of 1,783 bovids were reviewed, and 0.4% were diagnosed with a cardiac congenital defect. The most common cardiac congenital malformation detected in this study was ventricular septal defect, observed alone or associated with other anomalies (in one case, as part of tetralogy of Fallot); followed by atrial septal defect, also alone or with other cardiac malformations. Secondary findings in the lungs and liver were observed in 75% of all cases. Histologic cardiac lesions were identified in 25% of all cases, characterized mainly by fibrosis. Other congenital malformations in different organs were observed in 25% of the cases. Considering the importance of cardiac congenital malformations observed in this study, these conditions should be considered as a differential diagnosis for calves who died with no specific clinical signs. Furthermore, macroscopic evaluation is crucial for the diagnosis of cardiac congenital malformations.Malformações cardíacas são descritas como relativamente raras para bovinos, e defeitos do septo interventricular são as anomalias mais observadas em bezerros. O objetivo deste artigo é descrever os casos de malformações cardíacas observadas em bovinos e uma revisão de literatura sobre estas malformações nesta espécie. Os relatórios de necropsia de 1.783 bovinos foram revisados, e 0,4% destes foram diagnosticados com defeitos cardíacos congênitos. A malformação cardíaca congênita mais diagnosticada neste estudo foi defeito do septo interventricular, observado sozinho ou associado a outras anomalias (em um caso de tetralogia de Fallot); seguida de defeito no septo interatrial, também observado sozinho ou juntamente com outras malformações cardíacas. Lesões secundárias nos pulmões e fígado foram observadas em 75% dos casos. As alterações histológicas no coração, visualizadas em 25% dos casos, foram caracterizadas principalmente por fibrose. Outras malformações congênitas em diferentes órgãos foram identificadas em 25% dos casos. Considerando a importância de malformações cardíacas congênitas observadas neste estudo, estas condições devem ser consideradas como diagnósticos diferenciais para bezerros que morrem sem sinais clínicos específicos. Adicionalmente, a avaliação macroscópica é fundamental para o diagnóstico de malformações cardíacas congênitas

The role of oxytocin in the facial mimicry of affiliative vs. non-affiliative emotions.

The present paper builds upon a growing body of work documenting oxytocin's role in social functioning, to test whether this hormone facilitates spontaneous mimicry of others' emotional expressions. In a double-blind, randomized trial, adult Caucasian males (n = 145) received a nasal spray of either oxytocin or placebo before completing a facial mimicry task. Facial expressions were coded using automated face analysis. Oxytocin increased mimicry of facial features of sadness (lips and chin, but not areas around the eyes), an affiliative reaction that facilitates social bonding. Oxytocin also increased mimicry of happiness, but only for individuals who expressed low levels of happiness in response to neutral faces. Overall, participants did not reliably mimic expressions of fear and anger, echoing recent theoretical accounts of emotional mimicry as dependent on the social context. In sum, our findings suggest that oxytocin facilitates emotional mimicry in ways that are conducive to affiliation, pointing to a possible pathway through which oxytocin promotes social bonding

Pathological findings of post-anesthetic myopathy associated with type 1 polysaccharide storage myopathy in a Percheron horse

Background: Post-anesthetic myopathy is the most common complication associated with general anesthesia in horses. Polysaccharide storage myopathy (PSSM) is characterized by an abnormal accumulation of glycogen and glycogen-related polysaccharides in the skeletal muscle, which is categorized in type 1 (PSSM1) and type 2 (PSSM2). The purpose of this study is to report the clinical, pathological and molecular findings in a Percheron mare with post-anesthetic myopathy associated with a PSSM1. Case: A 9-year-old Percheron mare was submitted to a caesarean section due to clinical dystocia during labor. Xylazine was employed during pre-anesthesia, followed by induction with ketamine and diazepam, while anesthetic maintenance was obtained with isoflurane. The mare showed good recovery, however 24 h later, sternal recumbency and hyperthermia (41° C) were observed. The mare was euthanized, and a necropsy was performed. Samples of multiple tissues were collected and routinely processed for histology. At necropsy, segments of skeletal muscles had bilateral pale areas. The kidneys had old and recent infarcts. The heart had whitish areas in the myocardium. The brain showed focally extensive reddish areas, with flattening of gyri. Histologically, skeletal muscle fibers had in the sarcoplasm multiple homogeneous globular clear eosinophilic formations, in addition to mild hyaline necrosis. In the heart and in the kidney, there were extensive areas of acute coagulative necrosis. The brain showed marked multifocal fibrinoid degeneration of vessels and hemorrhage. Refrigerated liver samples were submitted to DNA extraction to detect mutations in the GYS1 (type 1 PSSM) and RyR1 genes (malignant hyperthermia). A positive result for a homozygous dominant mutation in GYS1 (type 1 PSSM) was observed, while the mutation responsible for malignant hyperthermia was not identified Discussion: The diagnosis of post-anesthetic myopathy associated with PSSM was obtained by the presence of amylase resistant polysaccharide complex inclusions, glycogen subsarcolemmal aggregates, and central cytoplasmic corpuscles containing glycogen through PAS-amylase resistant histochemical technique, associated to the myopathy microscopical features. Microscopic findings were related to clinical history, and the diagnosis of PSSM underlying post-anesthetic myopathy was determined. The predisposition of the Percheron horse has been described as an inherited predisposition leading to PSSM susceptibility, as was observed in the present case. We speculated that the anesthetic procedure resulted in the precipitation of the drug and a presentation of an acute anesthetic myopathy, while the muscle damage most likely occurred due to the ischemia caused by systemic hypotension. In addition to these lesions, other lesions were considered related to the use of the anesthetics, which may predispose to vasculogenic injuries. This horse was diagnosed as being homozygous dominant for the GYS1 gene, which causes a gain-offunction and results in glycogenolysis with glycogen accumulation in myofibers. Horses that are homozygous for the GYS1 gene may exhibit more severe histological changes in the skeletal muscle fibers, such as necrosis, anisocytosis, endomysial fibrosis, and fatty infiltration In PSSM, there is a bilateral involvement of the skeletal muscles with areas of degeneration of whitish or greyish coloration, as well as pale muscle with whitish streaks due to coagulative necrosis and edema. In our study, we observed bilateral skeletal muscle lesions and cardiomyocyte necrosis. Post-anesthetic myopathy, along with skeletal muscle lesions, may predispose to vasculogenic injuries, with kidney and brain lesions in horses. Dominant homozygosis for the GYS1 gene with consequent PSSM1 disease probably aggravated the condition in this Percheron, with more severe histological muscular lesions. Our study should bring attention to the use of anesthetics in horses with PSSM1, especially in the Percheron breed

Disfunção da pars intermedia da hipófise em equinos associado a adenoma pituitário

The clinical syndrome of the pituitary pars intermedia dysfunction (PPID) is the most common endocrinopathy of older horses. This syndrome is characterized by several clinical and pathological changes, which are usually associated with adenomas of the pars intermedia (PI) of the pituitary gland. The aim of this work is to describe five cases of pituitary adenoma of the PI associated with PPID in horses, addressing its clinical and pathological aspects. The horses had a mean of 22 years of age. The main clinical signs were hirsutism and paresis of hind limbs, and at post mortem examination all horses had hirsutism, and a nodule in the pituitary gland, which was histologically characterized as an adenoma of PI (5/5). Furthermore, two horses had gross lesions suggestive of chronic laminitis. Moreover, there was intense parasitism of Sarcocystis neurona (2/5), Strongylus vulgaris (1/5), Parascaris equorum (1/5), Draschia megastoma (1/5), and Klossiella equi (1/5).A síndrome clínica da disfunção da pars intermedia da hipófise (PPID) é a endocrinopatia mais comum em cavalos idosos. Essa síndrome é caracterizada por várias alterações clínicas e patológicas, geralmente associadas a adenomas da pars intermedia (PI) da hipófise. O objetivo deste trabalho é descrever cinco casos de adenoma hipofisário de PI associado a PPID em equinos, abordando seus aspectos clínicos e patológicos. Os cavalos apresentaram média de 22 anos de idade. Os principais sinais clínicos incluíam hirsutismo e paresia dos membros pélvicos, e no exame post mortem todos os equinos apresentavam hirsutismo e um nódulo na glândula pituitária, que foi histologicamente caracterizada como um adenoma de PI (5/5). Além disso, dois cavalos tinham lesões macroscópicas sugestivas de laminite crônica. Ainda, havia intenso parasitismo de Sarcocystis neurona (2/5), Strongylus vulgaris (1/5), Parascaris equorum (1/5), Draschia megastoma (1/5) e Klossiella equi (1/5)

Coristoma pulmonar em um bezerro recém-nascido com múltiplas malformações cranianas e neurológicas

Multiple congenital malformations can occur concomitantly in several species since the anomaly in one organ may lead directly to the malformation of another. Additionally, the etiology is not always clarified. Choristoma refers to an ectopic tissue that is histologically normal in an abnormal location. A case of pulmonary and nodal choristoma associated with cranioschisis, hydrocephalus, and syringomyelia in a new-born calf is reported here. Clinically, the calf had a mass in the frontal region of the head associated with local bone deformation. At necropsy, there was cranioschisis in the junction of the frontal bones and a 14 × 10 × 7 cm mass, grossly consistent with well-differentiated pulmonary tissue covered by skin, covering the opening between the frontal bones, and extending into the cranial cavity, leading to local cerebral compression. With the pulmonary choristoma, there was a well-differentiated lymphoid tissue. Additionally, in the central nervous system, there was severe hydrocephalus involving lateral ventricles and multiple areas of syringomyelia in the spinal cord.Múltiplas malformações congênitas podem ocorrer concomitantemente em diversas espécies, uma vez que a anomalia em um órgão pode diretamente acarretar a malformação de outro. Ainda, a etiologia envolvida nem sempre é identificada. Coristomas são caracterizados por tecido ectópico histologicamente normal em uma localização anômala. Um caso de coristoma pulmonar e nodal associado a craniosquise, hidrocefalia e siringomielia em um bezerro recém-nascido é descrito neste trabalho. Clinicamente, o bezerro apresentava uma massa na região frontal da cabeça associada a deformação óssea local. No exame de necropsia, havia craniosquise na junção dos ossos frontais e tecido pulmonar bem diferenciado recoberto por pele, medindo 14 x 10 x 7 cm, recobrindo a abertura entre os ossos frontais e adentrando a cavidade craniana, acarretando o achatamento do córtex cerebral adjacente. Juntamente com o tecido pulmonar, havia um nódulo composto por tecido linfoide bem diferenciado. Adicionalmente, no sistema nervoso central, havia hidrocefalia severa envolvendo os ventrículos laterais e múltiplas áreas de siringomielia na medula espinhal