P–488 Patients’ attitudes towards the anonymity of gamete donation in Spain

Study question

To what extent do infertility patients in Spain support different forms of anonymity for oocyte and sperm donation?

Summary answer

Most patients who undergo treatment with donated gametes in Spain consider that their children should not know the identity of the donors.

What is known already

Spain has a large tradition of gamete donation, probably influenced by its law that requires gamete donation to be anonymous for the donor and the recipient. Although there is a growing support for openness and identity-release in gamete donation, Spanish Society of Fertility has generated an Anonymity in Donations Framework Document which recommends revelation to the donor-conceived children their biological origin preserving the identity. However, there is no information on what the preferences of the patients are regarding the disclosure of the origins to their children.

Study design, size, duration

A prospective, cross-sectional multicenter study that includes all eleven clinics in Spain and involves women who had used donated gametes. From September to October 2020, a self-administered questionnaire was sent out to a total of 57 women which were asked to indicate their responses on a 7-point Likert. 57 (100%) women anonymously completed the questionnaire.

Participants/materials, setting, methods

The participants were asking for their socio-demographic characteristics, their opinions concerning secrecy or disclosure of the method of conception towards the child, what type of information should the child have access to – identifying or non-identifying – and whether they intend to inform their child and relatives about his/her origin. Statistical analysis was performed with Chi square test for dichotomous variables and one-sample T-Student for Likert items. p < 0.05 was considered significant.

Main results and the role of chance

Unlike homosexual or single women, 60% of heterosexual couples refuse to inform their offspring about the origin of their gametes and 47,5% would not tell anyone.

Patients do not want to know the identity of donors (0,276 p˂0,001) and they consider that knowledge about the origin of the gametes (0,278 p˂0,001) or the identity of the donor (0,178 p˂0,001) is not important to a child.

Patients do not believe that the donor has the right to know the identity of the offspring (0.098 p < 0.001) but they agree with his/her right to anonymity (0.679).

Limitations, reasons for caution

While the multicenter study design and the extraction of a complete time series from the population under study strengthens validity, the study is limited to women, without being able to extrapolate the results to men or children born by gamete donation, which constitutes a limitation.

Wider implications of the findings: The findings of this study can be used as a basis for further discussion between regulators and professionals with respect to anonymity related to donor conception. These opinions should be considered carefully in legal and ethical discussions on gamete donation.

Trial registration number

Not applicable

Contribution of a method of assessing minimum audible angle in headphones

OBJECTIVES

The main objective of this study was to test the feasibility of measuring minimum audible angle in headphones with different reference positions in the horizontal plane, and comparing different types of pre-recorded head-related transfer functions. The secondary objective was to assess spatial discrimination performance in simulated unilateral hearing loss by measuring the minimum audible angle under monaural conditions using headphones.

MATERIALS AND METHODS

Minimum audible angle was assessed in 27 normal-hearing subjects, to test their spatial discrimination abilities, using 4 datasets of pre-recorded head-related transfer functions: 2 recorded on mannequins (KU100, KEMAR), and 2 individualized head-related transfer function datasets (TBM, PBM). Performance was evaluated at 3 reference positions (0°, 50° and 180°) in 1 binaural and 2 monaural conditions.

RESULTS

KU100 generated minimum audible angle values smaller than KEMAR in frontal and lateral position P<0.005), with a suggestive difference (P<0.05) compared to TBM and PBM in the frontal and lateral planes. Comparison between binaural and monaural conditions showed significant differences in frontal position for MON-c (contralateral) and MON-i (ipsilateral) (P<0.001), in lateral position for MON-c only (P<0.001) and in posterior position for MON-c and MON-i (P<0.001).

CONCLUSION

This study suggests that evaluation of spatial discrimination capacity using minimum audible angle with the KU100 head-related transfer dataset was reliable and robust.

Anaerobic co-digestion of agro-food waste mixtures in a fed-batch basis

The agro-food industry (including livestock) generates millions of tonnes of waste products. A solution to this sector's waste disposal challenges was explored by a joint treatment model of organic waste products from several industries. An inventory of agro-food industry organic waste streams with high potential for biogas production was carried out in a logistically viable area (Cider Region, Asturias, Spain). Three industries were selected as those with the higher potential for this study: livestock, dairy and beverage. The kinetics of anaerobic degradation and methane production of four mixtures of selected waste streams were investigated. The specific methane production at five different substrate-to-inoculum ratios (0.50, 0.75, 1.00, 1.50 and 2.00) showed a slightly decreasing trend at the higher ratios. Some hints of a synergistic effect have been observed in mixtures with higher content in milled apple waste, while antagonistic symptoms were noted in mixtures mainly composed of dairy wastes. The estimation of fluxes of waste and methane potentials in the Cider Region suggests centralised anaerobic digestion as a sustainable solution for the valorisation of livestock and agro-food wastes generated in this area. Sector-specific waste streams (livestock and agro-food industry) could cover up to 12% of regional total energy demand.

Acidity, Proteolysis and Lipolysis Changes in Rapid-Cured Fermented Sausage Dried at Different Temperatures

Two batches of dry-cured fermented sausage were made by industrial methods at pilot scale. The difference between them was the drying temperature applied (5 or 12 °C) for a period of time extending from the moment when pH = 5 was attained until a weight loss of 20% was achieved. The other conditions were the same for the two processes. Changes in pH, total acidity, D and L-lactic acids, acetic acid, total volatile basic nitrogen (TVBN), free amino acids (FAA) and free fatty acids (FFA) were studied, and a discriminatory sensory analysis of the ready-to-eat product was carried out. Only L-lactic acid and total acidity within the acidity parameters showed substantial differences halfway through the drying process. No significant differences were found in any of the acidity variables at the end of the process. The drying temperature encouraged the production of TVBN, but no direct relationship was established between it and the quantity of FAA. The three fractions of FFA [SFA (saturated fatty acids), MUFA (monounsaturated fatty acids) and PUFA (polyunsaturated fatty acids)] increased during the curing period, always higher at 12 °C than at 5 °C throughout the process. No differences between the two processes were detected by the discriminatory sensory analysis.

[Serum microRNA-21 usefulness in inflammatory pathology of the colon]

BACKGROUND

MicroRNAs are 20-22 nucleotide molecular structures with post-transcriptional activity that are involved in the immune response, as well as in the inflammatory pathways of different cells and tissues.

AIMS

We present herein a prospective study in which serum microRNA-21 expression was determined in patients diagnosed with acute appendicitis as a model of bowel inflammation.

MATERIAL AND METHODS

A prospective cohort study of patients diagnosed with acute appendicitis was conducted. Serum microRNA-21 was analyzed through the PCR of blood samples taken from the patients prior to surgery. MicroRNA-21 values were compared with the analytic variables (leukocytes, hemoglobin, hematocrit, platelets, prothrombin activity, glucose, urea, and creatinine) and the anatomopathologic variables (normal appendix, phlegmonous, gangrenous, and perforated acute appendicitis).

RESULTS

A total of 60 patients with acute appendicitis diagnosis were consecutively included in the study from June to October 2009. Sixty-six percent of the patients were men (40 men and 20 women), with a mean age of 26.2±14.8 years. The mean absolute level of microRNA-21 was 24.8±0.93, whereas the mean microRNA-21 gene expression was 1.04±0.28. No correlation between the analytic and anatomopathologic parameters evaluated was observed (P=.47).

CONCLUSIONS

It is necessary to continue to search for the most appropriate microRNAs, so that their determination in serum can lead to greater precision in establishing the diagnosis and outcome of inflammatory disorders of the bowel.

Evaluation of pre-treatment processes for increasing biodegradability of agro-food wastes

Anaerobic digestion (AD) technology can be employed for treating sewage sludge, livestock waste or food waste. Generally, the hydrolysis stage is the rate-limiting step of the AD processes for solid waste degradation. Therefore, physical, chemical and biological pre-treatment methods or their combination are required, in order to reduce the rate of such a limiting step. In this study, four methods (mechanical shredding, acid hydrolysis, alkaline hydrolysis and sonication) were tested to improve methane production and anaerobic biodegradability of different agro-food wastes and their mixtures. The kinetics of anaerobic degradation and methane production ofpre-treated individual wastes and selected mixtures were investigated with batch tests. Sonication at lower frequencies (37 kHz) proved to give the best results with methane productivity enhancements of over 100% in the case of pig manure and in the range of 10-47% for the other wastes assayed. Furthermore, the ultimate methane production was proportional, in all the cases, to the specific energy input applied (Es). Sonication can, thus, enhance waste digestion and the rate and quantity of biogas generated. The behaviour of the other pre-treatments under the conditions assayed is not significant. Only a slight enhancement of biogas production (around 10%) was detected for whey and waste activated sludge (WAS) after mechanical shredding. The lack of effectiveness of chemical pre-treatments (acid and alkaline hydrolysis) can be justified by the inhibition of the methanogenic process due to the presence of high concentrations of sodium (up to 8 g l(-1) in some tests). Only in the case of WAS did the acid hydrolysis considerably increase the biodegradability of the sample (79%), because in this case no inhibition by sodium took place. Some hints of a synergistic effect have been observed when co-digestion of the mixtures was performed.

Experimental evidence of dynamic trapping in the scattering of H2 from Pd(110)

We have performed H2(D2) diffraction experiments on a Pd(110) surface using two different high-sensitivity set-ups. We have found that, although the total reflectivity of Pd(110) is comparable to that observed in other reactive systems, the corresponding H2(D2) diffraction patterns are quite different: no diffraction peak, including the specular one, is observed on Pd(110). This unexpected result is the consequence of dynamic trapping. Such interpretation is supported by classical dynamics calculations based on accurate ab initio potential energy surfaces.

Biology-based mapping of vector-borne parasites by geographic information systems and remote sensing

Application of growing degree day-water budget analysis and satellite climatology to vector-borne parasites will be reviewed to demonstrate the value of using the unique thermal-hydrological preferences and limits of tolerance of individual parasite-vector systems to define the environmental niche of disease agents in the landscape by modern geospatial analysis methods. Applications of geospatial modeling will be illustrated by examples on fascioliasis, malaria, leprosy and leishmaniasis.

Automated manometric method to assess anaerobic toxicity of chemicals

Industrial additives eventually used for different purposes (antifoaming, cleaning, bactericides, antiscale, etc) are discharged to the wastewater treatment plant. The anaerobic toxicity of these commercial products is not provided by suppliers. A new manometric method is developed and tested to evaluate anaerobic toxicity or inhibition using four different commercial products. Antifoaming Cleron 6 (50-200 ppm), bactericide Divosan-forte (0.05-1.0% v/v), bleach (0.1-1.0% v/v) and cleaning agent Topax 66 (0.10-1.0% v/v). According to the different methods proposed in the literature, from the methane production rate, it is possible to calculate both methanogenic activity evolution and final substrate removal and quantify the potential inhibitory effect of commercial additives. The experimental method is simple and reliable.

A classical dynamics method for H2 diffraction from metal surfaces

We present a discretization method that allows one to interpret measurements on diffraction of diatomic molecules from solid surfaces using six-dimensional (6D) classical trajectory calculations. It has been applied to the D2NiAl(110) and H2Pd(111) systems (which are models for activated and nonactivated dissociative chemisorption, respectively) using realistic potential energy surfaces obtained from first principles. Comparisons with experimental results and 6D quantum dynamical calculations show that, in general, the method is able to predict the relative intensity of the most important diffraction peaks. We therefore conclude that classical mechanics can be an efficient guide for experimentalists in the search for the most significant diffraction channels.

Geographical Information Systems risk assessment models for zoonotic fascioliasis in the South American Andes region

The WHO recognises Fasciola hepatica to be an important human health problem. The Andean countries of Peru, Bolivia and Chile are those most severely affected by this distomatosis, though areas of Ecuador, Colombia and Venezuela are also affected. As part of a multidisciplinary project, we present results of use of a Geographical Information Systems (GIS) forecast model to conduct an epidemiological analysis of human and animal fasciolosis in the central part of the Andes mountains. The GIS approach enabled us to develop a spatial and temporal epidemiological model to map the disease in the areas studied and to classify transmission risk into low, moderate and high risk areas so that areas requiring the implementation of control activities can be identified. Current results are available on a local scale for: (1) the northern Bolivian Altiplano, (2) Puno in the Peruvian Altiplano, (3) the Cajamarca and Mantaro Peruvian valleys, and (4) the Ecuadorian provinces of Azuay, Cotopaxi and Imbabura. Analysis of results demonstrated the validity of a forecast model that combines use of climatic data to calculate of forecast indices with remote sensing data, through the classification of Normalized Difference Vegetation Index (NDVI) maps.

Automated equipment for anaerobic sludge parameters determination

Methanogenic activity, anaerobic biodegradability and toxicity are key parameters in the design and operation of anaerobic bioreactors. A large variety of methods exist for the determination of these parameters but a normalized method has not been established so far. This paper presents the development of an automated manometric system for the determination of these anaerobic sludge parameters. The system is based on monitoring the production of methane by using a pressure transducer that measures the pressure in a gas-collecting chamber of known adjustable volume, which is independent of the space where biogas production takes place. The evolution of pressure generated by the accumulation of methane relates to the conversion of COD. In this way, the methanogenic activity of the sludge can be determined, as well as the biodegradability of solids and liquid, as well as the methanogenic toxicity of compounds. The equipment permits gas sampling, as well as extraction and introduction of liquid, without losing the anaerobic conditions. Various assays have been conducted to test the reliability and reproducibility of the obtained results, showing a high level of both. The methanogenic activities obtained in the assays ranged between 0.1 and 1.8 g COD g(-1) VSS d(-1), and the biodegradability of the organic compounds tested ranged between 20 and 90%.

In-plane and out-of-plane diffraction of H(2) from metal surfaces

We have measured in-plane and out-of-plane diffraction of H2 and D2 molecular beams scattered by reactive Pd(111) and nonreactive NiAl(110) surfaces at 140-150 meV. A comparison with six-dimensional quantum dynamics and classical trajectory calculations shows for the first time that accurate diffraction patterns can be obtained from state-of-the-art potential energy surfaces based on density functional theory. Our measurements show that, at general incidence conditions, out-of-plane diffraction is much more important than was assumed in previous experiments.

Factors constraining adherence to referral advice for severely ill children managed by the Integrated Management of Childhood Illness approach in Imbabura Province, Ecuador

AIM

Low referral completion rates in developing countries undermine the Integrated Management of Childhood Illness (IMCI) strategy for lowering child mortality. This study sought to identify factors constraining adherence to referral advice in a health system using the IMCI approach.

METHODS

Caregivers of 160 children urgently referred to hospital were prospectively interviewed. Caregivers who accessed and did not access hospital were compared for potential referral constraining factors, including demographics, family dynamics, the severity of their child's illness, their interaction with the health system, self-perceived problems, and physical and financial access.

RESULTS

67/160 (42%) referred children did not access hospital. Six factors were associated with non-access, including two health worker actions: not being given a referral slip [adjusted odds ratio (OR)= 15.3, 95% confidence interval (95% CI) 4.4-64.6] and not being told to go to the hospital immediately (adjusted OR = 5.3, 95% CI 1.9-16.3). Receiving both of these interventions reduced the risk of not accessing hospital to 19%, from 96% for those who received neither intervention. Several indicators of illness severity, including caregivers' ranking of their children's illness severity, the presence of severe illness signs and mortality, were investigated and found not to be important explanatory factors.

CONCLUSION

Providing a referral slip and counseling the caregivers of severely ill children to go to the hospital immediately appear to be powerful tools for increasing successful referral outcomes.

The interactions of cyanobacterial cytochrome c6 and cytochrome f, characterized by NMR

During oxygenic photosynthesis, cytochrome c(6) shuttles electrons between the membrane-bound complexes cytochrome bf and photosystem I. Complex formation between Phormidium laminosum cytochrome f and cytochrome c(6) from both Anabaena sp. PCC 7119 and Synechococcus elongatus has been investigated by nuclear magnetic resonance spectroscopy. Chemical-shift perturbation analysis reveals a binding site on Anabaena cytochrome c(6), which consists of a predominantly hydrophobic patch surrounding the heme substituent, methyl 5. This region of the protein was implicated previously in the formation of the reactive complex with photosytem I. In contrast to the results obtained for Anabaena cytochrome c(6), there is no evidence for specific complex formation with the acidic cytochrome c(6) from Synechococcus. This remarkable variability between analogous cytochromes c(6) supports the idea that different organisms utilize distinct mechanisms of photosynthetic intermolecular electron transfer.

Effect of nitrate and nitrite curing salts on microbial changes and sensory quality of rapid ripened sausages

The effect of the use of either nitrite or nitrate curing salts on microbial changes and sensory quality in rapid ripened sausages inoculated with a mixed starter culture (Lactobacillus sake and Staphylococcus carnosus) was investigated. Lactic acid bacteria and Micrococcaceae were not greatly affected by the added curing salt. Conversely, the inhibition exerted by nitrite on the undesirable flora (Enterobacteriaceae and psychrotrophs) was evident from the early stages of the processing keeping highly significant differences (P < 0.01) with respect to nitrate made sausages till the end of the ripening stage. The use of nitrite in sausage processing was found to reduce hygienic risks.

A spectroscopic NMR investigation of the calcium silicate hydrates present in cement and concrete

NMR spectroscopy is applied to study microstructure of calcium silicate hydrates present in cement and concrete. It is shown that 29Si NMR gives information on the siliceous skeleton of the hydrates. 1H NMR, using CRAMPS techniques, allows to discriminate between protons linked to silicon atoms or to calcium atoms. A first investigation of reference compounds indicates that 43Ca NMR will be powerful to determine calcium atom sites in the structure.

[Use of ticlopidine in primary care]

OBJECTIVES

To find the reasons for prescription of Ticlopidine, which acts against the aggregation of platelets and is catalogued as "with hospital diagnosis", and to evaluate the criteria for its correct use and whether it is actually used in Spain to treat authorised symptoms.

DESIGN

A descriptive, crossover and retrospective study.

SETTING

Primary Care districts in the catchment area of the Virgen del Rocío hospital in Sevilla.

PATIENTS

Those who requested permits for Ticlopidine prescriptions, documented by the clinical report.

MEASUREMENTS AND MAIN RESULTS

The following data were recorded from the clinical reports presented when the Ticlopidine prescription permits were requested: patient's identification, diagnosis, pharmaceutical speciality, dosage, length of treatment and recommendation of haematological check-ups. Out of 407 reports available, the diagnosis corresponded to one of the authorised symptoms in 50.6% of cases. In a third of the patients the recommended dose was half that endorsed by the published clinical trials. Only in 2.7% of cases was mention made of the desirability of having haematological check-ups to forestall possible adverse reactions. The possibility of a counter-indication to Acetylsalicylic acid was only rarely mentioned.

CONCLUSIONS

Ticlopidine is recommended in 50% of cases for symptoms for which it is not authorised in our country: moreover, in 35% of cases, at doses lower than those established as effective. The information given by the doctor who initiates the treatment is usually insufficient. There is a need to reassess whether cataloguing a medicine as "with hospital diagnosis" aids its rational use.

The inhibitory effect of ionizing radiation on Fc and C3 receptors on mouse and human leukocytes, and the protective potential of human albumin

The effect that ionizing radiation has in vitro on Fc and C3 receptors was evaluated at various doses and measured by means of erythrocytes coated with antibody (EA) and erythrocytes coated with antibody and complement (EAC) rosettes on human peripheral blood leukocytes (PBL) and on mouse bone marrow cells (BMC) and PBL. We found that the number of cells with either EA and EAC rosettes decreased as the radiation doses increased, and that they were almost absent when the highest doses were employed. We obtained evidence that albumin is a natural source of radio-protection for Fc and C3 receptors, and we showed that by increasing the amount of this molecule we could completely protect receptors for EA and EAC in vitro. Finally, the possible therapeutic value of the administration of human albumin to patients undergoing radiotherapy is discussed.

Detection of minimal residual disease in acute myelogenous leukemia by RNA-in situ hybridization

Several proto-oncogenes have been reported to be expressed in normal and malignant hematopoietic cells. Since these studies have been done almost exclusively by Northern and dot-blot analyses using mixed populations of cells, any conclusions concerning quantitative changes in gene expression are difficult to document. We have developed a rapid and sensitive RNA-in situ hybridization technique permitting detection of as few as 5 copies of mRNA per individual cell. Using this technique we have studied the expression levels of several oncogenes including MYC, SIS, FMS, p53, FOS and RAF in both normal hematopoietic cells and bone marrow (BM) cells obtained from acute myelogenous leukemia (AML) patients at presentation, at relapse and in complete remission (CR). Two of these oncogenes, MYC and SIS, are expressed at levels at least 2-5-fold higher in hematopoietic cells obtained from leukemia patients than in any normal hematopoietic cell examined, including cells obtained from regenerating bone marrow. The proportion of abnormal cells correlated well with the percentage of blast cells determined by morphological examination. In 7 out of 10 AML patients in morphological remission, a subpopulation of cells is detectable with abnormally high levels of MYC and/or SIS mRNA. These high levels of MYC expression are similar to those found in BM cells obtained from AML patients at presentation or relapse, but the percentage of cells with this abnormality is generally much lower. Continued follow-up of these patients has shown that 5 of them relapsed within 8 months. At this time, none of the 3 patients which were negative for MYC overexpression has relapsed.(ABSTRACT TRUNCATED AT 250 WORDS)