Allogeneic versus Autologous: ethical issues in umbilical cord blood use

OBJECTIVE. To analyse some ethical issues involved in umbilical cord blood (UCB) collection, storage and use. MATERIALS AND METHODS. Ethical issues were addressed in the light of the wellknown fundamental ethical principles for biomedicine: beneficence/non maleficence, respect for autonomy and justice. Specific issues that have been debated concerning the clinical utility of autologous use compared with allogeneic use for transplantation, the validity of informed consent, especially in private UCB banking, and finally the controversial question of private UCB banking for-profit compared to public UCB banking non-profit. RESULTS. Our ethical analysis has highlighted that the allogeneic UCB use for transplantation, compared to autologous UCB use, seems to fulfil the principle of beneficence/non maleficence as it provides “logistic” and clinical benefits and it decreases risks; the acquisition of informed consent requires some counselling, particularly for autologous collection; finally, public UCB banking seems to fulfil the criteria for justice more than private ones. CONCLUSION. Present and future therapeutic UCB possibilities for treating a wide variety of diseases need to increase the number of UCB units available. For this purpose, a “gift” culture and a “solidarity chain” between donors and recipients are requested. Moreover, in recent years, a further and emerging model of bank seems usable, i.e. “hybrid” banking

Allogeneic versus Autologous: ethical issues in umbilical cord blood use

OBJECTIVE. To analyse some ethical issues involved in umbilical cord blood (UCB) collection, storage and use. MATERIALS AND METHODS. Ethical issues were addressed in the light of the wellknown fundamental ethical principles for biomedicine: beneficence/non maleficence, respect for autonomy and justice. Specific issues that have been debated concerning the clinical utility of autologous use compared with allogeneic use for transplantation, the validity of informed consent, especially in private UCB banking, and finally the controversial question of private UCB banking for-profit compared to public UCB banking non-profit. RESULTS. Our ethical analysis has highlighted that the allogeneic UCB use for transplantation, compared to autologous UCB use, seems to fulfil the principle of beneficence/non maleficence as it provides “logistic” and clinical benefits and it decreases risks; the acquisition of informed consent requires some counselling, particularly for autologous collection; finally, public UCB banking seems to fulfil the criteria for justice more than private ones. CONCLUSION. Present and future therapeutic UCB possibilities for treating a wide variety of diseases need to increase the number of UCB units available. For this purpose, a “gift” culture and a “solidarity chain” between donors and recipients are requested. Moreover, in recent years, a further and emerging model of bank seems usable, i.e. “hybrid” banking

health technology assessment processes for nanotechnologies the ethical domain

The ethical assessment of the use of technologies is generally considered a component of the health technology assessment (HTA) processes. HTA is a multidisciplinary process that summarizes information about medical, economic, organizational, ethical, psychological, social and legal issues related to the implementation of a certain health technology in health care system and its main purpose is to inform policymaking. Unlike the other technologies nanotechnologies pose different risks and, therefore, new bioethical implications should be assessed. So, the ethical assessment of nanotechnologies within the HTA processes could be more problematic. The article intends to debate this complexity

Health technology assessment of pathogen reduction technologies applied to plasma for clinical use

Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains.Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed

Unanticipated Pseudocoarctation Highlights the Importance of Visualizing Aortic Arch Anatomy Before Transfemoral Transcatheter Aortic Valve Implantation

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Doubly resonant photoacoustic spectroscopy: ultra-high sensitivity meets ultra-wide dynamic range

Photoacoustic spectroscopy (PAS) based gas sensors with high sensitivity, wide dynamic range, low cost, and small footprint are desirable across a broad range of applications in energy, environment, safety, and public health. However, most works have focused on either acoustic resonator to enhance acoustic wave or optical resonator to enhance optical wave. Herein, we develop a gas sensor based on doubly resonant PAS in which the acoustic and optical waves are simultaneously enhanced using combined optical and acoustic resonators in a centimeter-long configuration. Not only the lower detection limit is enhanced by the double standing waves, but also the upper detection limit is expanded due to the short resonators. As an example, we developed a sensor by detecting acetylene (C2H2), achieving a noise equivalent absorption of 5.7*10-13 cm-1 and a dynamic range of eight orders. Compared to the state-of-the-art PAS gas sensors, the developed sensor increases the sensitivity by two orders of magnitude and extends the dynamic range by three orders of magnitude. Besides, a laser-cavity-molecule locking strategy is proposed to provide additional flexibility of fast gas detection

Hydrogen peroxide detection with quartz-enhanced photoacoustic spectroscopy using a distributed-feedback quantum cascade laser

A quartz-enhanced photoacoustic spectroscopy sensor system was developed for the sensitive detection of hydrogen peroxide (H2O2) using its absorption transitions in the v6 fundamental band at ∼7.73 μm. The recent availability of distributed-feedback quantum cascade lasers provides convenient access to a strong H2O2 absorption line located at 1295.55 cm−1. Sensor calibration was performed by means of a water bubbler that generated titrated average H2O2vapor concentrations. A minimum detection limit of 12 parts per billion (ppb) corresponding to a normalized noise equivalent absorption coefficient of 4.6 × 10−9 cm−1W/Hz1/2 was achieved with an averaging time of 100 s

Single-tube on-beam quartz-enhanced photoacoustic spectroscopy.

Quartz-enhanced photoacoustic spectroscopy (QEPAS) with a single-tube acoustic microresonator (AmR) inserted between the prongs of a custom quartz tuning fork (QTF) was developed, investigated, and optimized experimentally. Due to the high acoustic coupling efficiency between the AmR and the QTF, the single-tube on-beam QEPAS spectrophone configuration improves the detection sensitivity by 2 orders of magnitude compared to a bare QTF. This approach significantly reduces the spectrophone size with respect to the traditional on-beam spectrophone configuration, thereby facilitating the laser beam alignment. A 1σ normalized noise equivalent absorption coefficient of 1.21×10(-8) cm(-1)·W/√Hz was obtained for dry CO2 detection at normal atmospheric pressure

Quartz enhanced photoacoustic H2S gas sensor based on a fiber-amplifier source and a custom tuning fork with large prong spacing

A quartz enhanced photoacoustic spectroscopy (QEPAS) sensor, employing an erbium-doped fiber amplified laser source and a custom quartz tuning fork (QTF) with its two prongs spaced ∼800 μm apart, is reported. The sensor employs an acoustic micro-resonator (AmR) which is assembled in an “on-beam” QEPAS configuration. Both length and vertical position of the AmR are optimized in terms of signal-to-noise ratio, significantly improving the QEPAS detection sensitivity by a factor of ∼40, compared to the case of a sensor using a bare custom QTF. The fiber-amplifier-enhanced QEPAS sensor is applied to H2S trace gas detection, reaching a sensitivity of ∼890 ppb at 1 s integration time, similar to those obtained with a power-enhanced QEPAS sensor equipped with a standard QTF, but with the advantages of easy optical alignment, simple installation, and long-term stability