Dual consent? Donors' and recipients' views about involvement in decision-making on the use of embryos created by gamete donation in research

Background Reasonable disagreement about the role awarded to gamete donors in decision-making on the use of embryos created by gamete donation (EGDs) for research purposes emphasises the importance of considering the implementation of participatory, adaptive, and trustworthy policies and guidelines for consent procedures. However, the perspectives of gamete donors and recipients about decision-making regarding research with EGDs are still under-researched, which precludes the development of policies and guidelines informed by evidence. This study seeks to explore the views of donors and recipients about who should take part in consent processes for the use of EGDs in research. Methods From July 2017 to June 2018, 72 gamete donors and 175 recipients completed a self-report structured questionnaire at the Portuguese Public Bank of Gametes (response rate: 76%). Agreement with dual consent was defined as the belief that the use of EGDs in research should be consented by both donors and recipients. Results The majority of participants (74.6% of donors and 65.7% of recipients) were willing to donate embryos for research. Almost half of the donors (48.6%) and half of the recipients (46.9%) considered that a dual consent procedure is desirable. This view was more frequent among employed recipients (49.7%) than among non-employed (21.4%). Donors were less likely to believe that only recipients should be involved in giving consent for the use of EGDs in research (25.0% vs. 41.7% among recipients) and were more frequently favourable to the idea of exclusive donors' consent (26.4% vs. 11.4% among recipients). Conclusions Divergent views on dual consent among donors and recipients indicate the need to develop evidence-based and ethically sustainable policies and guidelines to protect well-being, autonomy and reproductive rights of both stakeholder groups. More empirical research and further theoretical normative analyses are needed to inform people-centred policy and guidelines for shared decision-making concerning the use of EGDs for research

17-jähriger Mann mit akuten Bauchschmerzen, Hämatochezie und Exanthem

Zusammenfassung: Ein 17-jähriger Patient stellte sich mit kolikartigen abdominellen Schmerzen und Diarrhö vor. Als weitere Symptome traten Petechien, Arthralgien und eine Hämatochezie auf. Sonographisch bestand eine auffällige Ileozökalregion. Endoskopisch fand sich eine Ileitis terminalis, und histologisch zeigte sich hier eine leukozytoklastische Vaskulitis mit IgA-Ablagerungen. Die Kasuistik zeigt exemplarisch die mehrzeitige klinische Manifestation der Purpura Schönlein-Henoch und deren Verlau

Longevidade de adultos de Anastrepha coronilli Carrejo e González (Diptera: Tephritidae) em condições de laboratório.

A utilização de dietas artificiais no processo de criação de moscas-das-frutas em laboratório é um passo importante no conhecimento da biologia das moscas-das-frutas. Este trabalho teve como objetivo verificar os efeitos de dietas à base de açúcar refinado e extrato de levedura na longevidade dos adultos de Anastrepha coronilli. Exemplares de A. coronilli foram obtidos de frutos de goiaba-de-anta, Bellucia grossularioides (L.) Triana (Melastomataceae), coletados em campo, direto da planta ou recém-caídos no solo. Os frutos foram acondicionados em bandejas de plástico cobertas por organza e transportados até o Laboratório de Entomologia da Embrapa Amapá, em Macapá. Os pupários obtidos foram acondicionados em câmaras climatizadas, sob condições controladas de temperatura (26 ± 0,5oC), umidade relativa do ar (70 ± 10%) e fotofase (12 horas), até a obtenção dos adultos. Após emergirem, os exemplares da A. coronilli foram transferidos para gaiolas medindo 20 x 10 x 10 cm, num total de três casais por gaiola, todos com até 24h de vida. Foram utilizadas 10 gaiolas com dieta à base de açúcar refinado e 10 gaiolas com dieta artificial composta de extrato de levedura Bionis® YE MF. Todas as gaiolas foram mantidas em sala com temperatura média de 26 ± 2°C, umidade relativa de 75 ± 10% e fotoperíodo de 12 horas. As moscas-das-frutas alimentadas à base de açúcar refinado sobreviveram no mínimo dois dias e no máximo 66 dias (média de 35,6 dias). As moscas-das-frutas que se alimentaram com dieta à base de extrato de levedura (Bionis) viveram no mínimo um dia e no máximo 117 dias (média de 49,3 dias). Os resultados obtidos demonstraram que a dieta à base de extrato de levedura foi mais eficaz na nutrição das moscas-das-frutas, provavelmente devido à presença de aminoácidos necessários ao desenvolvimento e maturação sexual do inseto. Por outro lado, o açúcar não fornece os nutrientes necessários ao pleno desenvolvimento do inseto.US38

Shake-induced order in nanosphere systems

Self-assembled patterns obtained from a drying nanosphere suspension are investigated by computer simulations and simple experiments. Motivated by the earlier experimental results of Sasaki and Hane and Schope, we confirm that more ordered triangular lattice structures can be obtained whenever a moderate intensity random shaking is applied on the drying system. Computer simulations are realized on an improved version of a recently elaborated Burridge-Knopoff-type model. Experiments are made following the setup of Sasaki and Hane, using ultrasonic radiation as source for controlled shaking.Comment: 7 pages, 10 figure

Neoadjuvant Chemotherapy for Intrahepatic, Perihilar, and Distal Cholangiocarcinoma:a National Population-Based Comparative Cohort Study

IntroductionData supporting the utilization of neoadjuvant chemotherapy (NAC) in patients receiving resection for cholangiocarcinoma (CCA) remains uncertain. We aimed to determine whether NAC followed by resection improves long-term survival in intrahepatic (iCCA), perihilar (hCCA), and distal (dCCA) cholangiocarcinoma, analyzed separately.MethodsPatients undergoing surgery for iCCA, hCCA, and dCCA, receiving either none, NAC, or adjuvant chemotherapy (AC) from 2010 to 2016 were identified from the National Cancer Database (NCDB). Cox regression was performed to account for selection bias and to assess the impact of surgery alone (SA) versus either NAC or AC on overall survival (OS).ResultsThere were 9411 patients undergoing surgery for iCCA (n = 3772, 39.5%), hCCA (n = 1879, 20%), and dCCA (n = 3760, 40%). Of these, 10.6% (n = 399), 6.5% (n = 123), and 7.2% (n = 271) with iCCA, hCCA, and dCCA received NAC, respectively. On adjusted analyses, patients receiving NAC followed by surgery had significantly improved OS, compared to SA for iCCA (HR 0.75, CI95% 0.64-0.88, p < 0.001), hCCA (HR 0.72, CI95% 0.54-0.97, p = 0.033), and for dCCA (HR 0.65, CI95% 0.53-0.78, p < 0.001). However, sensitivity analyses demonstrated no differences in OS between NACs, followed by surgery or AC after surgery in iCCA (HR 1.19, CI95% 0.99-1.45, p = 0.068), hCCA (HR 0.83 CI95% 0.59-1.19, p = 0.311), and dCCA (HR 1.13 CI95% 0.91-1.41, p = 0.264).ConclusionsThis study associated NAC with increased OS for all CCA subtypes, even in patients with margin-negative and node-negative disease; however, no differences were found between NAC and AC. Our results highlight that a careful and interdisciplinary evaluation should be sought to consider NAC in CCA and warrant the need of larger studies to provide robust recommendation

Parenting very preterm infants and stress in Neonatal Intensive Care Units

BACKGROUND: Assessing parental stress during infants' hospitalization in Neonatal Intensive Care Units (NICU) is essential to identify parents at risk for immediate and extended physical and emotional burden. AIMS: To identify sources of stress in mothers and fathers of very preterm infants hospitalized in NICU, and their association with sociodemographic, obstetric and infants' characteristics. STUDY DESIGN: Observational and cross-sectional study conducted between July 2013 and June 2014. SUBJECTS: Parents of very preterm infants hospitalized in all level III NICU in the Northern Health Region of Portugal were consecutively and systematically invited to participate in this study, being included 120 mothers and 91 fathers (participation rate: 96.8%). OUTCOME MEASURES: The Portuguese version of the Parental Stressor Scale: Neonatal Intensive Care Unit was used. RESULTS: The overall experience of hospitalization was classified as more stressful than the median for the subscales. "Change in parental role" was classified as the most stressful subscale by mothers (Median (P25-P75): 4.1(3.2-4.7)) and fathers (Median (P25-P75): 3.2(2.4-4.0)). Mothers scored significantly higher in all subscales. For mothers, multiple pregnancy was associated with lower levels of stress regarding "change in parental role" (β=-0.597; 95% CI=-1.020 to -0.174) and "overall stress" (β=-0.603; 95% CI=-1.052 to -0.153). Being ≥30years old was found to be a significant predictor for decreased fathers' stress. CONCLUSIONS: This study raises awareness for the need to develop sensitive instruments that take notice of gender, social support and family-centered care. The implementation of interventions focused on reducing parental stress is crucial to diminish disparities in family health

Fish Oil Supplementation Reduces Inflammation but Does Not Restore Renal Function and Klotho Expression in an Adenine-Induced CKD Model

BACKGROUND: Chronic kidney disease and inflammation promote loss of Klotho expression. Given the well-established anti-inflammatory effects of omega-3 fatty acids, we aimed to investigate the effect of fish oil supplementation in a model of CKD. METHODS: Male C57BL/6 mice received supplementation with an adenine-enriched diet (AD, n = 5) or standard diet (CTL, n = 5) for 10 days. Two other experimental groups were kept under the adenine diet for 10 days. Following adenine withdrawal on the 11th day, the animals returned to a standard diet supplemented with fish oil (Post AD-Fish oil, n = 9) or not (Post AD-CTL, n = 9) for an additional period of 7 days. RESULTS: Adenine mice exhibited significantly higher mean serum urea, creatinine, and renal expression of the pro-inflammatory markers Interleukin-6 (IL-6), C-X-C motif chemokine 10 (CXCL10), and Interleukin-1β (IL-1β), in addition to prominent renal fibrosis and reduced renal Klotho gene expression compared to the control. Post AD-Fish oil animals demonstrated a significant reduction of IL-6, C-X-C motif chemokine 9 (CXCL9), and IL-1β compared to Post AD-CTL animals. However, serum creatinine, renal fibrosis, and Klotho were not significantly different in the fish oil-treated group. Furthermore, renal histomorphological changes such as tubular dilatation and interstitial infiltration persisted despite treatment. CONCLUSIONS: Fish oil supplementation reduced renal pro-inflammatory markers but was not able to restore renal function nor Klotho expression in an adenine-induced CKD model

Albendazole is effective in controlling monogeneans in Colossoma macropomum (Serrasalmidae): therapeutic baths and their physiological and histopathological effects.

Na aquicultura mundial, a maioria dos quimioterápicos utilizados no controle e tratamento de doenças, são produtos químicos não regulamentados e oriundos da agricultura. Neste estudo, foi investigada a eficácia de banhos terapêuticos com albendazol contra monogeneas Anacanthorus spathulatus, Notozothecium janauachensis e Mymarothecium boegeri das brânquias de Colossoma macropomum, e os efeitos hematológicos e histopatológicos causados por esse anti-helmíntico nos peixes. Foram usados 500 mg/L de albendazol e um grupo controle (água do tanque de cultivo) com três banhos de 24 horas, mantendo intervalos de 24 horas entre cada banho, usando três repetições cada. Ao final dos banhos terapêuticos, foram realizadas análises hematológicas, histopatológicas e parasitológicas. Verificou-se que banhos terapêuticos com 500 mg/L de albendazol apresentaram alta eficácia (94,9%) contra monogenéticos de C. macropomum, causando poucas alterações fisiológicas e histopatológicas. Portanto, banhos com 500 mg/L de albendazol, na estratégia usada, podem ser recomendados para controle e tratamento de infecções por monogenéticos em C. macropomum