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Sulaieva ON, Artamonova O, Dudin O, Semikov R, Urakov D, Zakharash Y, Kacharian A, Strilka V, Mykhalchuk I, Haidamak O, Serdyukova O, Kobyliak N. Ethical navigation of biobanking establishment in Ukraine: learning from the experience of developing countries. JOURNAL OF MEDICAL ETHICS 2023:jme-2023-109129. [PMID: 37945338 DOI: 10.1136/jme-2023-109129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Building a biobank network in developing countries is essential to foster genomic research and precision medicine for patients' benefit. However, there are serious barriers to establishing biobanks in low-income and middle-income countries (LMICs), including Ukraine. Here, we outline key barriers and essential milestones for the successful expansion of biobanks, genomic research and personalised medicine in Ukraine, drawing from the experience of other LMICs. A lack of legal and ethical governance in conjunction with limited awareness about biobanking and community distrust are the principal threats to establishing biobanks. The experiences of LMICs suggest that Ukraine urgently needs national guidelines covering ethical and legal aspects of biospecimen-related research. National guidelines must be consistent with international ethical recommendations for safeguarding participants' rights, welfare and privacy. Additionally, efforts to educate and engage physicians and patient communities are essential for achieving biobanking goals and benefits for precision medicine and future patients.
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Affiliation(s)
- Oksana N Sulaieva
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
- Doctorate in Bioethics, Neiswanger Institute for Bioethics, Loyola University Chicago, Chicago, Illinois, USA
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
| | | | - Oleksandr Dudin
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
| | - Rostyslav Semikov
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | - Dmytro Urakov
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
| | | | | | | | - Ivan Mykhalchuk
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | | | - Olena Serdyukova
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | - Nazarii Kobyliak
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
- Department of Endocrinology, Bogomolets National Medical University, Kyiv, Ukraine
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Ahram M, Abdelgawad F, ElHafeez SA, Abdelhafiz AS, Ibrahim ME, Elgamri A, Mohammed Z, El-Rhazi K, Elsebaie E, Gamel E, Shahouri M, Mostafa NT, Adarmouch L, Silverman H. Perceptions, attitudes, and willingness of the public in low- and middle-income countries of the Arab region to participate in biobank research. BMC Med Ethics 2022; 23:122. [PMID: 36457067 PMCID: PMC9713115 DOI: 10.1186/s12910-022-00855-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 11/04/2022] [Indexed: 12/03/2022] Open
Abstract
Population-based genomics studies have proven successful in identifying genetic variants associated with diseases. High-quality biospecimens linked with informative health data from diverse segments of the population have made such research possible. However, the success of biobank research depends on the willingness of the public to participate in this type of research. We aimed to explore the factors associated with the willingness of the public to participate in biobank research from four low- and middle-income countries in the Arab region (Egypt, Jordan, Morocco, and Sudan). We used a previously validated questionnaire to assess several constructs that included the public's perceptions, attitudes, and willingness to participate in biobank research. We recruited 967 participants. More than half did not have prior awareness of biobanks. Participants' willingness to donate biospecimens and health data was less than 10%. Our results also showed that participants harbored concerns with trust, privacy, and with data-sharing involving international researchers. Predictors of willingness to participate in biobank research included no previous involvement in research and positive attitudes toward biobanks. Finally, our study showed several differences between the four countries regarding several of the investigated constructs. We conclude there should be additional efforts to raise public awareness and enhance perceptions of the public in biobanking research to enhance trust. We further recommend qualitative research to explore the underlying factors that contribute to the public's concerns with international data sharing that would enhance global health.
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Affiliation(s)
- Mamoun Ahram
- grid.9670.80000 0001 2174 4509School of Medicine, The University of Jordan, Amman, Jordan
| | - Fatma Abdelgawad
- grid.7776.10000 0004 0639 9286Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Samar Abd ElHafeez
- grid.7155.60000 0001 2260 6941High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | - Maha Emad Ibrahim
- grid.33003.330000 0000 9889 5690Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Alya Elgamri
- Faculty of Dentistry, University of Khartoum, Cairo, Egypt
| | - Zeinab Mohammed
- grid.411662.60000 0004 0412 4932Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Karima El-Rhazi
- Faculty of Medicine of Fez, Sidi Mohamed Ben Abellah University, Fez, Morocco
| | - Eman Elsebaie
- grid.7776.10000 0004 0639 9286Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ehsan Gamel
- grid.9763.b0000 0001 0674 6207Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | | | | | - Latifa Adarmouch
- grid.411840.80000 0001 0664 9298Faculty of Medicine, Cadi Ayyad University, Marrakesh, Morocco
| | - Henry Silverman
- grid.411024.20000 0001 2175 4264University of Maryland School of Medicine, Baltimore, MD USA
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No person left behind: Mapping the health policy landscape for genomics research in the Caribbean. LANCET REGIONAL HEALTH. AMERICAS 2022; 15:100367. [PMID: 36778076 PMCID: PMC9904062 DOI: 10.1016/j.lana.2022.100367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Caribbean has long been an under-represented geographical region in the field of genomics research. Such under-representation may result in Caribbean people being underserved by precision medicine and other public health benefits of genomics. A collaboration among regional and international researchers aims to address this issue through the H3ECaribbean project (Human Heredity, Environment, and Health in the Caribbean), which builds on the lessons and success of H3Africa. The Caribbean project aims to target issues of social justice by encouraging the inclusion of diverse Caribbean communities in genomics research. This paper explores a framework for the ethical and socially acceptable conduct of genomics research in the Caribbean, taking account of the cultural peculiarities of the region. This is done in part by exploring research ethics issues identified in indigenous communities in North America, Small Island Developing States, and similar endeavours from the African continent. The framework provides guidance for interacting with local community leaders, as well as detailing steps for obtaining informed consent of all participants. Specifically, the authors outline the methods to ensure effective interaction and enforce full transparency with study participants to combat historical neglect when working with under-represented communities in the Caribbean.
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Jaffal L, Mrad Z, Ibrahim M, Salami A, Audo I, Zeitz C, El Shamieh S. The research output of rod-cone dystrophy genetics. Orphanet J Rare Dis 2022; 17:175. [PMID: 35461258 PMCID: PMC9034540 DOI: 10.1186/s13023-022-02318-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
Non-syndromic rod-cone dystrophy (RCD) is the most common condition in inherited retinal diseases. The aim of this study was to evaluate the research output and productivity related to RCD genetics per countries as classified by the human development index (HDI), by analyzing publication frequency and citations, the choice of journals and publishers, since 2000 to date. We have also analyzed the use of next-generation sequencing (NGS) in publications originating from countries with different HDIs. One thousand four hundred articles focusing on non-syndromic RCD were downloaded and analyzed. Citations and published articles were adjusted per one million individuals. The research output is significantly higher in very high HDI countries (86% of the total publications and 95% of the citations) than countries with lower HDIs in all aspects. High and medium HDI countries published together 13.6% of the total articles worldwide and received 4.6% of the citations. On the publication level, the USA (26%), United Kingdom (10%), and Japan (7%) were the top 3 among very high HDI countries, while China (6%) and India (2%) ranked first in high and medium HDI countries respectively. On the citation level, similar profiles were found. Following adjustment for population size, Switzerland (~14%), Jordan (~ 1%) and Morocco (<0.2%) showed the highest rates of publications in very high, high and medium HDI countries respectively. Very high HDI countries published 71% of their papers in first quartile journals (first quartile in Scimago journal rank; Q1), and 23% in Q2 journals. High and medium HDI countries showed a similar profile in quartiles with ~ 40% of their papers published in Q1 journals and ~ 30% in Q2 journals. The first publication using NGS was issued in 2009 in very high HDI countries, while it appeared in 2012 in high HDI countries, and in 2017 in medium HDI countries, with a respective lag of 3 to 8 years compared to very high HDI countries. A profound gap exists between very high HDI countries and the rest of the world. To fill it in, we propose implementing NGS, supporting international collaborations, building capacities and infrastructures, improving accessibility of patients to services, and increasing national and international funding.
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Affiliation(s)
- Lama Jaffal
- Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon.,Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Zamzam Mrad
- Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon
| | - Mariam Ibrahim
- Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon
| | - Ali Salami
- Department of Mathematics, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, Paris, France.,CHNO Des Quinze-Vingts, INSERM-DGOS CIC1423, Paris, France.,University College London Institute of Ophthalmology, London, UK
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, Paris, France
| | - Said El Shamieh
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
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Leo CG, Tumolo MR, Sabina S, Colella R, Recchia V, Ponzini G, Fotiadis DI, Bodini A, Mincarone P. Health Technology Assessment for In Silico Medicine: Social, Ethical and Legal Aspects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031510. [PMID: 35162529 PMCID: PMC8835251 DOI: 10.3390/ijerph19031510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/28/2022]
Abstract
The application of in silico medicine is constantly growing in the prevention, diagnosis, and treatment of diseases. These technologies allow us to support medical decisions and self-management and reduce, refine, and partially replace real studies of medical technologies. In silico medicine may challenge some key principles: transparency and fairness of data usage; data privacy and protection across platforms and systems; data availability and quality; data integration and interoperability; intellectual property; data sharing; equal accessibility for persons and populations. Several social, ethical, and legal issues may consequently arise from its adoption. In this work, we provide an overview of these issues along with some practical suggestions for their assessment from a health technology assessment perspective. We performed a narrative review with a search on MEDLINE/Pubmed, ISI Web of Knowledge, Scopus, and Google Scholar. The following key aspects emerge as general reflections with an impact on the operational level: cultural resistance, level of expertise of users, degree of patient involvement, infrastructural requirements, risks for health, respect of several patients’ rights, potential discriminations for access and use of the technology, and intellectual property of innovations. Our analysis shows that several challenges still need to be debated to allow in silico medicine to express all its potential in healthcare processes.
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Affiliation(s)
- Carlo Giacomo Leo
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy; (C.G.L.); (M.R.T.); (V.R.)
| | - Maria Rosaria Tumolo
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy; (C.G.L.); (M.R.T.); (V.R.)
- Department of Biological and Environmental Sciences and Technology, University of Salento, 73100 Lecce, Italy;
| | - Saverio Sabina
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy; (C.G.L.); (M.R.T.); (V.R.)
- Correspondence:
| | - Riccardo Colella
- Department of Biological and Environmental Sciences and Technology, University of Salento, 73100 Lecce, Italy;
| | - Virginia Recchia
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy; (C.G.L.); (M.R.T.); (V.R.)
| | - Giuseppe Ponzini
- Institute for Research on Population and Social Policies, National Research Council, 72100 Brindisi, Italy; (G.P.); (P.M.)
| | - Dimitrios Ioannis Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—Foundation for Research and Technology Hellas (IMBB-FORTH), 45115 Ioannina, Greece
| | - Antonella Bodini
- Institute for Applied Mathematics and Information Technologies “E. Magenes”, National Research Council, 20133 Milan, Italy;
| | - Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, 72100 Brindisi, Italy; (G.P.); (P.M.)
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The DxConnect Virtual Biobank connects diagnostic researchers to clinical samples. Nat Biotechnol 2021; 40:18-19. [PMID: 34937882 DOI: 10.1038/s41587-021-01168-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ochieng J, Kwagala B, Barugahare J, Mwaka E, Ekusai-Sebatta D, Ali J, Sewankambo NK. Perspectives and ethical considerations for return of genetics and genomics research results: a qualitative study of genomics researchers in Uganda. BMC Med Ethics 2021; 22:154. [PMID: 34798900 PMCID: PMC8603565 DOI: 10.1186/s12910-021-00724-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The return of genetics and genomics research results has been a subject of ongoing global debate. Such feedback is ethically desirable to update participants on research findings particularly those deemed clinically significant. Although there is limited literature, debate continues in African on what constitutes appropriate practice regarding the return of results for genetics and genomics research. This study explored perspectives and ethical considerations of Ugandan genomics researchers regarding the return of genetics and genomics research results. METHODS This was a qualitative study that employed in-depth interviews. Thirty participants were purposively selected based on their expertise as genomics researchers in Uganda. Data were analysed through content analysis along the main themes of the study using a comprehensive thematic matrix, to identify common patterns arising from the narratives. NVivo software 12 was used to support data analysis. RESULTS The return of genetics and genomics research results was generally acceptable to researchers, and some indicated that they had previously returned individual or aggregate results to participants and communities. The main reasons cited for sharing research results with participants included their clinical utility, actionability and overall benefit to society. Ethical considerations for appropriate return of results included a need for effective community engagement, genetic counselling prior to disclosure of the results, adequate informed consent, and proper assessment of the implications of, or consequences of returning of results. However, the approaches to return of results were perceived as unstandardized due to the lack of appropriate regulatory frameworks. CONCLUSIONS The return of genetic and genomic research results is generally acceptable to researchers despite the lack of appropriate regulatory frameworks. Ethical considerations for return of genetics and genomics research results are highly divergent, hence the need for national ethical guidelines to appropriately regulate the practice.
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Affiliation(s)
- Joseph Ochieng
- Department of Anatomy, College of Health Sciences, School of Biomedical Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
| | - Betty Kwagala
- School of Business and Management Studies, Makerere University, Kampala, Uganda
| | | | - Erisa Mwaka
- Department of Anatomy, College of Health Sciences, School of Biomedical Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Deborah Ekusai-Sebatta
- Department of Anatomy, College of Health Sciences, School of Biomedical Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Joseph Ali
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Johns Hopkins Berman Institute of Bioethics, Baltimore, USA
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Vodosin P, Jorgensen AK, Mendy M, Kozlakidis Z, Caboux E, Zawati MH. A Review of Regulatory Frameworks Governing Biobanking in the Low and Middle Income Member Countries of BCNet. Biopreserv Biobank 2021; 19:444-452. [PMID: 33945303 DOI: 10.1089/bio.2020.0101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Biomedical research based on the sharing and use of ever larger volumes of samples and data is increasingly becoming an essential component of scientific discovery. The success of biobanking and genomic research is dependent on the broad sharing of resources for use by investigators. However, important ethical challenges need to be addressed for the sample and data sharing to be successful. Despite low- and middle-income countries (LMICs) carrying a higher burden of disease, biomedical research conducted to date has mainly focused on high-income countries. In order for LMICs to benefit from the advances in such research, normative documents (such as laws and guidelines) play a significant role in allowing LMIC projects to partake and be represented in global biomedical research. The administration and management of the ethical aspects of biobanking, including informed consent, are key components in ensuring that samples and data can legally and ethically be used and shared. As part of its support to the LMIC biobanks, the International Agency for Research on Cancer (IARC) established a biobank and population cohort building network (BCNet) in 2013 with the aims of providing support (including education and training) and facilitating the development and improvement of biobanking infrastructure in LMICs. A comparative analysis of the laws and guidelines in BCNet countries was completed to highlight some of the ethical and legal issues related to biobanking in LMICs and to identify examples of effective systems of governance already in operation.
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Affiliation(s)
| | | | - Maimuna Mendy
- MRC Unit The Gambia at LSHTM, London School of Health and Tropical Medicine, London, United Kingdom
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elodie Caboux
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ma'n H Zawati
- Center of Genomics and Policy, McGill University, Montreal, Canada
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Trein P, Wagner J. Governing Personalized Health: A Scoping Review. Front Genet 2021; 12:650504. [PMID: 33968134 PMCID: PMC8097042 DOI: 10.3389/fgene.2021.650504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/17/2021] [Indexed: 01/03/2023] Open
Abstract
Genetic research is advancing rapidly. One important area for the application of the results from this work is personalized health. These are treatments and preventive interventions tailored to the genetic profile of specific groups or individuals. The inclusion of personalized health in existing health systems is a challenge for policymakers. In this article, we present the results of a thematic scoping review of the literature dealing with governance and policy of personalized health. Our analysis points to four governance challenges that decisionmakers face against the background of personalized health. First, researchers have highlighted the need to further extend and harmonize existing research infrastructures in order to combine different types of genetic data. Second, decisionmakers face the challenge to create trust in personalized health applications, such as genetic tests. Third, scholars have pointed to the importance of the regulation of data production and sharing to avoid discrimination of disadvantaged groups and to facilitate collaboration. Fourth, researchers have discussed the challenge to integrate personalized health into regulatory-, financing-, and service provision structures of existing health systems. Our findings summarize existing research and help to guide further policymaking and research in the field of personalized health governance.
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Affiliation(s)
- Philipp Trein
- Department of Political Science and International Relations, University of Geneva, Geneva, Switzerland
| | - Joël Wagner
- Department of Actuarial Science, Faculty of Business and Economics (HEC Lausanne), University of Lausanne, Lausanne, Switzerland.,Swiss Finance Institute, University of Lausanne, Lausanne, Switzerland
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10
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Morocco's First Biobank: Establishment, Ethical Issues, Biomedical Research Opportunities, and Challenges. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8812609. [PMID: 33376744 PMCID: PMC7738781 DOI: 10.1155/2020/8812609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023]
Abstract
Background Biobanks are highly organized infrastructures that allow the storage of human biological specimens associated with donors' personal and clinical data. These infrastructures play a key role in the development of translational medical research. In this context, we launched, in November 2015, the first biobank in Morocco (BRO Biobank) in order to promote biomedical research and provide opportunities to include Moroccan and North African ethnic groups in international biomedical studies. Here, we present the setup and the sample characteristics of BRO Biobank. Methods Patients were recruited at several departments of two major health-care centers in the city of Oujda. Healthy donors were enrolled during blood donation campaigns all over Eastern Morocco. From each participant, personal, clinical, and biomedical data were collected, and several biospecimens were stored. Standard operating procedures have been established in accordance with international guidelines on human biobanks. Results Between November 2015 and July 2020, 2446 participants were recruited into the BRO Biobank, of whom 2013 were healthy donors, and 433 were patients. For healthy donors, the median age was 35 years with a range between 18 and 65 years and the consanguinity rate was 28.96%. For patients, the median age was 11 years with a range between 1 day and 83 years. Among these patients, 55% had rare diseases (hemoglobinopathies, intellectual disabilities, disorders of sex differentiation, myopathies, etc.), 13% had lung cancer, 4% suffered from hematological neoplasms, 3% were from the kidney transplantation project, and 25% had unknown diagnoses. The BRO Biobank has collected 5092 biospecimens, including blood, white blood cells, plasma, serum, urine, frozen tissue, FFPE tissue, and nucleic acids. A sample quality control has been implemented and suggested that samples of the BRO Biobank are of high quality and therefore suitable for high-throughput nucleic acid analysis. Conclusions The BRO Biobank is the largest sample collection in Morocco, and it is ready to provide samples to national and international research projects. Therefore, the BRO Biobank is a valuable resource for advancing translational medical research.
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11
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Manda-Taylor L, Liomba A, Taylor TE, Elwell K. Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi. J Empir Res Hum Res Ethics 2020; 14:152-168. [PMID: 30866724 DOI: 10.1177/1556264619830859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures.
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Buriak I, Fleck RA, Goltsev A, Shevchenko N, Petrushko M, Yurchuk T, Puhovkin A, Rozanova S, Guibert EE, Robert MC, de Paz LJ, Powell-Palm MJ, Fuller B. Translation of Cryobiological Techniques to Socially Economically Deprived Populations—Part 1: Cryogenic Preservation Strategies. J Med Device 2020. [DOI: 10.1115/1.4045878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Use of cold for preservation of biological materials, avoidance of food spoilage and to manage a variety of medical conditions has been known for centuries. The cryobiological science justified these applications in the 1960s increasing their use in expanding global activities. However, the engineering and technological aspects associated with cryobiology can be expensive and this raises questions about the abilities of resource-restricted low and middle income countries (LMICs) to benefit from the advances. This review was undertaken to understand where or how access to cryobiological advances currently exist and the constraints on their usage. The subject areas investigated were based on themes which commonly appear in the journal Cryobiology. This led in the final analysis for separating the review into two parts, with the first part dealing with cold applied for biopreservation of living cells and tissues in science, health care and agriculture, and the second part dealing with cold destruction of tissues in medicine. The limitations of the approaches used are recognized, but as a first attempt to address these topics surrounding access to cryobiology in LMICs, the review should pave the way for future more subject-specific assessments of the true global uptake of the benefits of cryobiology.
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Affiliation(s)
- Iryna Buriak
- Department of Cryomicrobiology, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Roland A. Fleck
- Centre for Ultrastructural Imaging, Kings College London, New Hunts House, Guy's Campus, London SE1 1 UL, United Kingdom
| | - Anatoliy Goltsev
- Department of Cryopathophysiology and Immunology, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Nadiya Shevchenko
- Laboratory of Phytocryobiology, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Maryna Petrushko
- Department for Cryobiology of Reproduction System, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Taisiia Yurchuk
- Department for Cryobiology of Reproduction System, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Anton Puhovkin
- Department for Cryobiology of Reproduction System, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Svitlana Rozanova
- Department of Cryobiophysics, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Edgardo Elvio Guibert
- Departamento de Ciencias Biologicas, Centro Binacional (Argentina-Italia) de Investigaciones en Criobiología Clínica y Aplicada, Universidad Nacional de Rosario, Avda. Arijon 28BIS, Rosario 2000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Avda. Arijon 28BIS, Rosario 2000, Argentina
| | - Maria Celeste Robert
- Centro Binacional (Argentina-Italia) de Investigaciones en Criobiología Clínica y Aplicada, Universidad Nacional de Rosario, Avda. Arijon 28BIS, Rosario 2000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Avda. Arijon 28BIS, Rosario 2000, Argentina
| | - Leonardo Juan de Paz
- Centro Binacional (Argentina-Italia) de Investigaciones en Criobiología Clínica y Aplicada, Universidad Nacional de Rosario, Avda. Arijon 28BIS, Rosario 2000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Avda. Arijon 28BIS, Rosario 2000, Argentina
| | - Matthew J. Powell-Palm
- Department of Mechanical Engineering, University of California Berkeley, 6124 Etcheverry Hall, Hearst Ave, Berkeley, CA 94720
| | - Barry Fuller
- Division of Surgery and Interventional Science, UCL Medical School, Royal Free Hospital, London NW3 2QG, United Kingdom
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Lang M, Knoppers BM, Zawati MH. International mHealth Research: Old Tools and New Challenges. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2020; 48:178-186. [PMID: 32342748 DOI: 10.1177/1073110520917045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this paper, we outline the policy implications of mobile health research conducted at the international level. We describe the manner in which such research may have an international dimension and argue that it is not likely to be excluded from conventionally applicable international regulatory tools. We suggest that closer policy attention is needed for this rapidly proliferating approach to health research.
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Affiliation(s)
- Michael Lang
- Michael Lang, B.C.L., LL.B., is an Academic Associate with the Centre of Genomics and Policy at McGill University. Bartha Maria Knoppers, Ph.D., is Canada Research Chair in Law and Medicine, Professor and Director of the Centre of Genomics and Policy at McGill University. Ma'n H. Zawati, LL.B., LL.M., Ph.D., is Assistant Professor and Executive Director, of the Centre of Genomics and Policy at McGill University
| | - Bartha Maria Knoppers
- Michael Lang, B.C.L., LL.B., is an Academic Associate with the Centre of Genomics and Policy at McGill University. Bartha Maria Knoppers, Ph.D., is Canada Research Chair in Law and Medicine, Professor and Director of the Centre of Genomics and Policy at McGill University. Ma'n H. Zawati, LL.B., LL.M., Ph.D., is Assistant Professor and Executive Director, of the Centre of Genomics and Policy at McGill University
| | - Ma'n H Zawati
- Michael Lang, B.C.L., LL.B., is an Academic Associate with the Centre of Genomics and Policy at McGill University. Bartha Maria Knoppers, Ph.D., is Canada Research Chair in Law and Medicine, Professor and Director of the Centre of Genomics and Policy at McGill University. Ma'n H. Zawati, LL.B., LL.M., Ph.D., is Assistant Professor and Executive Director, of the Centre of Genomics and Policy at McGill University
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Fachiroh J, Dwianingsih EK, Wahdi AE, Pramatasari FLT, Hariyanto S, Pastiwi N, Yunus J, Mendy M, Scheerder B, Lazuardi L. Development of a Biobank from a Legacy Collection in Universitas Gadjah Mada, Indonesia: Proposed Approach for Centralized Biobank Development in Low-Resource Institutions. Biopreserv Biobank 2019; 17:387-394. [PMID: 31009252 DOI: 10.1089/bio.2018.0125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction: The establishment of a biobank requires specific expertise along with relatively expensive infrastructure and appropriate technology. This causes certain challenges in biobank implementation for research in low-middle-income countries. Biobank development with established specimens and data collection (legacy collection) was an approach used in the Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada. This approach aimed to identify the resources available at present, while providing nontechnical information for further development of a centralized biobank. Materials and Methods: Retrospective modeling was done in 2015 by recruiting existing specimen collections and their associated data. The steps were as follows: (1) informing research stakeholders through discussion with experts and stakeholders; (2) identifying specimen collections to be used; (3) determining the system, infrastructure, and consumables needed; (4) determining inclusion criteria; (5) building an in-house database system; (6) organizing data and physical specimen collections; and (7) validating data and physical sample arrangement. All technical procedures were built into standard operating procedures. Results: The model included specimens from one -80°C freezer. The associated data included demographic, clinical diagnosis, and physical sample information. Samples came from six studies, collected between 2001 and 2014. A web-based database was built based on the MySQL programming system. Information on biospecimens from a total of 4196 subjects collected in 11,358 vials was entered into the database, following physical rearrangement of vials in the -80°C freezer with one-dimensional barcodes taped to vials, boxes, and racks. A validation test was done for data concordance between the database and physical arrangement in the -80°C freezer, showing no discrepancies. Conclusion: This report demonstrated current technical and nontechnical insights to further develop a centralized biobank for health research at an academic institution in Indonesia.
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Affiliation(s)
- Jajah Fachiroh
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - Amirah Ellyza Wahdi
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
- Center for Reproductive Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - F Linda Tri Pramatasari
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - Sunandar Hariyanto
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
- Information Technology Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - Nenes Pastiwi
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - Junaedy Yunus
- Department of Anatomy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
| | - Maimuna Mendy
- Education and Training Program, The International Agency for Research in Cancer (IARC), Lyon, France
| | - Bart Scheerder
- Biobank University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Lutfan Lazuardi
- Biobank Development Team, Molecular Biology Laboratory, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
- Department of Health Management and Policy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia
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Rothstein MA, Zawati MH, Knoppers BM. Regulatory Landscape of International Direct-to-Participant (DTP) Genomic Research: Time to Untie the Gordian Knot? THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2019; 47:336-341. [PMID: 31298096 DOI: 10.1177/1073110519857291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mark A Rothstein
- Mark A. Rothstein, J.D., is the Herbert F. Boehl Chair of Law and Medicine and Director, Institute for Bioethics, Health Policy and Law, University of Louisville Schoool of Medicine. Ma'n H. Zawati, Ph.D., is Academic Coordinator of the Centre of Genomics and Policy, and an Associate member of the Biomedical Ethics Unit, McGill University. Bartha Maria Knoppers, Ph.D., is Professor of Medicine and Director of the Centre of Genomics and Policy at McGill University
| | - Ma'n H Zawati
- Mark A. Rothstein, J.D., is the Herbert F. Boehl Chair of Law and Medicine and Director, Institute for Bioethics, Health Policy and Law, University of Louisville Schoool of Medicine. Ma'n H. Zawati, Ph.D., is Academic Coordinator of the Centre of Genomics and Policy, and an Associate member of the Biomedical Ethics Unit, McGill University. Bartha Maria Knoppers, Ph.D., is Professor of Medicine and Director of the Centre of Genomics and Policy at McGill University
| | - Bartha Maria Knoppers
- Mark A. Rothstein, J.D., is the Herbert F. Boehl Chair of Law and Medicine and Director, Institute for Bioethics, Health Policy and Law, University of Louisville Schoool of Medicine. Ma'n H. Zawati, Ph.D., is Academic Coordinator of the Centre of Genomics and Policy, and an Associate member of the Biomedical Ethics Unit, McGill University. Bartha Maria Knoppers, Ph.D., is Professor of Medicine and Director of the Centre of Genomics and Policy at McGill University
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Henderson MK, Kozlakidis Z. ISBER and the Biobanking and Cohort Network (BCNet): A Strengthened Partnership. Biopreserv Biobank 2018; 16:393-394. [PMID: 30325663 PMCID: PMC6206592 DOI: 10.1089/bio.2018.29043.mkh] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Marianne Krall Henderson
- Center for Global Health, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, Maryland
| | - Zisis Kozlakidis
- International Agency for Research on Cancer (IARC), World Health Organizaton (WHO), Lyon, France
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