Identifying the nature and extent of public and donor concern about the commercialisation of biobanks for genomic research

Various forms of private investment are considered necessary for the sustainability of biobanks, yet pose significant challenges to public trust. To manage this tension, it is vital to identify the concerns of relevant stakeholders to ensure effective and acceptable policy and practice. This research examines the aspects of commercialisation that are of most concern to the Australian public (n = 800) and patients who had donated their tissue to two large disease specific (cancer) public biobanks (n = 564). Overall, we found a commercialisation effect (higher support for public relative to private) in relation to funding, research location and access to stored biospecimens. The effect was strongest for research locations and access compared to funding. A latent class analysis revealed the pattern of concern differed, with the majority (34.1%) opposing all aspects of commercialisation, a minority supporting all (15.7%), one quarter (26.8%) opposing some (sharing and selling tissue) but not others (research locations and funding), and a group who were unsure about most aspects but opposed selling tissue (23.5%). Patient donors were found to be more accepting of and unsure about most aspects of commercialisation. Members of the (general) public who were motivated to participate in biobanking were more likely to oppose some aspects while supporting others, while those who indicated they would not donate to a biobank were more likely to oppose all aspects of commercialisation. The results suggest that approaches to policy, engagement and awareness raising need to be tailored for different publics and patient groups to increase participation.Subject terms: Genetics research, Ethics     

Experience-hormone interactions and maternal behavior in rats

Three studies were conducted to determine the effects of reproductive condition and hormonal background on the acquisition and retention of a prior maternal experience. In the first study five experience conditions were compared. All animals gave birth and received either no postpartum contact with pups or 1/2 hr, 1 hr, 2 hr or 24 hr of pup contact and were tested for maternal behavior 10 days later. Animals receiving pregnancy and parturitional experience, but minimal social experience with young, exhibited significantly longer maternal onset latencies than did groups receiving 2 or 24 hr of prior experience; also, comparisons of 10- and 30-day retention intervals indicated that animals tested 10 days after a 24-hr experience exhibited shorter latencies than those tested 30 days later. Thus, the duration of the postpartum experience and the interval since prior experience both affect the level of maternal responsiveness shown. In the second study six groups of females were tested. Four groups were permitted one day of interaction with pups either after parturition (primiparous animals) or following pup induction procedures (nulliparous animals) and were tested for their maternal responsiveness to foster pups 25-35 days later, either on day 19 of a subsequent pregnancy or following resumption of estrous cycling. For most measures of maternal behavior there were significant main experience and test effects; experienced and pregnant animals exhibited shorter latencies to retrieve, lick and crouch over pups than did inexperienced and cycling animals, respectively. Significant interactions were also found for genital licking latency as well as for retrieval and crouch frequencies.(ABSTRACT TRUNCATED AT 250 WORDS)     

Amygdaloid inhibition of maternal behavior in the nulliparous female rat

In the first experiment, the effects of lesions of (1) the amygdala, (2) its major efferent projection system, the stria terminalis or (3) other non-limbic brain sites on the induction of maternal behavior in the nulliparous female rat were investigated. Animals sustaining lesions of either the amygdala or the stria terminalis became maternal more rapidly than did control animals. In the second study the effects of lesions to different portions of the amygdala on both maternal and fear responding were investigated. It was found that animals sustaining damage to the corticomedial amygdaloid nuclei became maternal more quickly than did animals sustaining either basolateral amygdaloid damage or no amygdaloid damage. Also in comparison to lesioned controls, animals with lesions of the amygdala showed reduced ‘fearfulness’ on a number of fear-mediated tasks. The third study attempted to interrelate fear responsiveness and maternal behavior by observing nulliparous animals with amygdaloid or stria terminalis lesions for their responses to unfamiliar foster pups placed daily into their preferred nesting quadrant. While control animals actively avoided pups placed into their nest sites (by moving their nest site to another quadrant of the cage), animals with amygdaloid lesions or lesions of the stria terminalis, did not. These results are interpreted to mean that nulliparous females generally do not respond maternally to pups because these females are, in general, more neophobic than parturient females and they tend to find pups and their novel odors, aversive. This aspect of their behavior is likely mediated by the amygdala. These data are discussed in terms of their relevance to the rapid maternal responsiveness normally shown by the female at parturition.     

Hairline aesthetics and styling in hair replacement surgery

Punch grafting and flap surgery are proven methods of correcting baldness. Using either method, the location and shape of a new hairline on the frontal and temporal scalp is one of the most important aspects of hair replacement surgery. If the hairline is not aesthetic, the results can be unacceptable or even devastating for the patient and surgeon alike. The principles of planning the frontal and temporal hairline are presented using punch grafts as well as flaps. Postoperative styling of the "new" hair will vary depending upon the method used to transfer the hair (flaps or grafts), the local factors involved (texture, direction, density, tufting, etc.), as well as the patient's preference. The various advantages and disadvantages of styling possibilities with each method are presented. These factors should be discussed with the patient preoperatively.     

Is the smoking decision an 'informed choice'? Effect of smoking risk factors on smoking beliefs

The argument that people freely choose to smoke assumes that individuals at the point of initiation of smoking (often in adolescence) hold accurate beliefs about smoking. Smoking beliefs and the presence of known smoking risk factors were assessed in interviews with a sample of 895 urban young people. The respondents greatly overestimated the prevalence of adult and peer smoking, negative attitudes of their peers were greatly underestimated, a large proportion believed that they would be less likely than other people to contract a smoking-related illness if they became smokers, and there was a general lack of understanding of the adverse consequences experienced upon smoking cessation. These misperceptions were more common among youngsters who were smokers, who intended to smoke, or who had friends or family members who smoked. Because misinformation among young people is widespread and those at greatest risk for smoking are the most misinformed, the tobacco industry's argument that the decision to smoke reflects an "informed choice" is without merit.     

Pseudosickling of hemoglobin Setif

Hemoglobin Setif produces pseudosickling of red cells in vitro; the nature of the process and the conditions that "trigger" it are unknown. Studies of red cells, hemolysates, purified hemoglobin solutions, and artificial mixtures of Hb A and Setif suggest that pseudosickling is produced by intracellular crystallization of insoluble hemoglobin. Increased tonicity of the suspending medium accentuates the process, probably by causing a rise in intracellular hemoglobin concentration. If precipitates from A/Setif mixtures are analyzed, they always contain Hb A, suggesting an unusual mechanism for the process. Despite the fact that osmolality in the renal medulla is similar to that which produces pseudosickling in vitro, carriers do not have renal dysfunction of the type found in patients with sickle cell disease.     

Impact of Anesthesiologist Experience on Early Outcomes in Adult Orthotopic Liver Transplantation

BackgroundLiver transplantation is a complex surgical procedure. The experience of the anesthesiologist, and its potential relationship to patient morbidity and mortality, is yet to be determined. We sought to explore this possible association using our institutional training patterns as the subject of study.MethodsThis is a single center retrospective analysis investigating the association of an anesthesiologist's experience with liver transplantation and its potential effect on early patient outcomes in adult liver transplant recipients from January 2010 to September 2016. Training of team members consisted of a 6-month period of clinical shadowing with a senior anesthesiologist and co-staffing 8 liver transplant procedures before solo staffing a liver transplant. Specifically, patient outcomes for the first 5 transplants after this training were investigated.ResultsThe only independent risk factor for early death or early graft loss was the amount of packed red blood cells administered during transplantation. With respect to secondary outcomes, the amount of packed red blood cells and hospitalization at the time of transplant were associated with the number of days on a ventilator, length of intensive care unit stay, and overall hospital length of stay.ConclusionsThe results of this study conclude that the training model currently in place for our new team members has no negative impact on patient outcomes after liver transplantation.     

Regulation of natural antibiotic expression by inflammatory mediators and mimics of infection in human endometrial epithelial cells

The natural antibiotic molecules, beta-defensins 1 and 2 (HBD1/2) and secretory leukocyte protease inhibitor (SLPI), have an important role in mucosal defence and are present in the uterus. This study details their regulation in primary endometrial epithelial cells and in two endometrial cell lines (MFE/HES). Cells were treated with proinflammatory molecules and mimics of infection [lipopolysaccharide (LPS) and lipoteichoic acid (LTA)]. mRNA for HBD1, HBD2 and SLPI was detected in primary endometrial epithelial cells using real-time quantitative PCR. HBD1 mRNA was present at very low levels preventing conclusive study of its regulation. However, HBD2 mRNA expression was increased by interferon-gamma, interleukin (IL)-1beta alone and IL-1beta+tumour necrosis factor (TNF)-alpha. SLPI mRNA was not affected by proinflammatory mediators, although protein levels fell in the presence of IL-1beta+TNFalpha. LPS had little effect on antimicrobial expression. However, there was a trend towards increased expression with LTA treatment for 4-8 h. Antimicrobial expression in endometrial cell lines was similar to that in primary cells, although SLPI was increased by IL-1beta+TNFalpha treatment. These results suggest that in endometrium some natural antibiotics (e.g. SLPI) may be constitutively expressed providing a basal level of protection, while others (e.g. HBD2) are inducible allowing maximal antimicrobial activity during infection. Natural antimicrobials will have an important role in endometrium in protecting against infection.