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Fulltext Social and communicative functions of informed consent forms in East Asia and beyond

Yoshizawa G, Sasongko TH, Ho CH, Kato K

Front Genet, 2017;8:99.
PMID: 28775738 DOI: 10.3389/fgene.2017.00099

The recent research and technology development in medical genomics has raised new issues that are profoundly different from those encountered in traditional clinical research for which informed consent was developed. Global initiatives for international collaboration and public participation in genomics research now face an increasing demand for new forms of informed consent which reflect local contexts. This article analyzes informed consent forms (ICFs) for genomic research formulated by four selected research programs and institutes in East Asia - the Medical Genome Science Program in Japan, Universiti Sains Malaysia Human Research Ethics Committee in Malaysia, and the Taiwan Biobank and the Taipei Medical University- Joint Institutional Review Board in Taiwan. The comparative text analysis highlights East Asian contexts as distinct from other regions by identifying communicative and social functions of consent forms. The communicative functions include re-contact options and offering interactive support for research participants, and setting opportunities for family or community engagement in the consent process. This implies that informed consent cannot be validated solely with the completion of a consent form at the initial stage of the research, and informed consent templates can facilitate interactions between researchers and participants through (even before and after) the research process. The social functions consist of informing participants of possible social risks that include genetic discrimination, sample and data sharing, and highlighting the role of ethics committees. Although international ethics harmonization and the subsequent coordination of consent forms may be necessary to maintain the quality and consistency of consent process for data-intensive international research, it is also worth paying more attention to the local values and different settings that exist where research participants are situated for research in medical genomics. More than simply tools to gain consent from research participants, ICFs function rather as a device of social communication between research communities and civic communities in liaison with intermediary agents like ethics committees, genetic counselors, and public biobanks and databases.
Fulltext Assessment and valuation of health impacts of fine particulate matter during COVID-19 lockdown: a comprehensive study of tropical and sub tropical countries

Bherwani H, Kumar S, Musugu K, Nair M, Gautam S, Gupta A, et al.

Environ Sci Pollut Res Int, 2021 Aug;28(32):44522-44537.
PMID: 33852112 DOI: 10.1007/s11356-021-13813-w

A novel coronavirus disease (COVID-19) continues to challenge the whole world. The disease has claimed many fatalities as it has transcended from one country to another since it was first discovered in China in late 2019. To prevent further morbidity and mortality associated with COVID-19, most of the countries initiated a countrywide lockdown. While physical distancing and lockdowns helped in curbing the spread of this novel coronavirus, it led to massive economic losses for the nations. Positive impacts have been observed due to lockdown in terms of improved air quality of the nations. In the current research, ten tropical and subtropical countries have been analysed from multiple angles, including air pollution, assessment and valuation of health impacts and economic loss of countries during COVID-19 lockdown. Countries include Brazil, India, Iran, Kenya, Malaysia, Mexico, Pakistan, Peru, Sri Lanka, and Thailand. Validated Simplified Aerosol Retrieval Algorithm (SARA) binning model is used on data collated from moderate resolution imaging spectroradiometer (MODIS) for particulate matters with a diameter of less than 2.5 μm (PM2.5) for all the countries for the month of January to May 2019 and 2020. The concentration results of PM2.5 show that air pollution has drastically reduced in 2020 post lockdown for all countries. The highest average concentration obtained by converting aerosol optical depth (AOD) for 2020 is observed for Thailand as 121.9 μg/m3 and the lowest for Mexico as 36.27 μg/m3. As air pollution is found to decrease in the April and May months of 2020 for nearly all countries, they are compared with respective previous year values for the same duration to calculate the reduced health burden due to lockdown. The present study estimates that cumulative about 100.9 Billion US$ are saved due to reduced air pollution externalities, which are about 25% of the cumulative economic loss of 435.9 Billion US$.
The role of a point-of-care ultrasound protocol in facilitating clinical decisions for snakebite envenomation in Taiwan: a pilot study

Ho CH, Ismail AK, Liu SH, Tzeng YS, Li LY, Pai FC, et al.

Clin Toxicol (Phila), 2021 Sep;59(9):794-800.
PMID: 33605805 DOI: 10.1080/15563650.2021.1881535

BACKGROUND: The incidence of acute compartment syndrome (ACS) following snakebite envenomation may be seriously overestimated in Taiwan. Snakebite-induced ACS is difficult to determine solely by clinical examination. Snakebite patients previously underwent surgical intervention based on speculation and general clinical examinations suggesting ACS presentations instead of direct intracompartmental pressure (IP) measurement prior to fasciotomy. Point-of-care ultrasound (POCUS) is a relatively widely available noninvasive tool. This study aimed to evaluate snakebite-envenomated patients for the presence of subcutaneous edema and diastolic retrograde arterial flow (DRAF).
MATERIALS AND METHODS: Snakebite patients were prospectively recruited between 2017 and 2019. All patients were examined with POCUS to locate edema and directly visualize and measure the arterial flow in the compressed artery. The presence of DRAF in the compressed artery is suggestive of ACS development because when compartment space restriction occurs, increased retrograde arterial flow is observed in the artery.
RESULTS: Twenty-seven snakebite patients were analyzed. Seventeen patients (63%) were bitten by Crotalinae snakes, seven (26%) by Colubridae, one (4%) by Elapidae, and two (7%) had unidentified snakebites. All Crotalinae bit patients received antivenom, had subcutaneous edema and lacked DRAF in a POCUS examination series.
DISCUSSION: POCUS facilitates clinical decisions for snakebite envenomation. We also highlighted that the anatomic site of the snakebite is an important factor affecting the prognosis of the wounds. There were limitations of this study, including a small number of patients and no comparison with the generally accepted invasive evaluation for ACS.
CONCLUSIONS: We are unable to state that POCUS is a valid surrogate measurement of ACS from this study but see this as a starting point to develop further research in this area. Further study will be needed to better define the utility of POCUS in patients envenomated by snakes throughout the world.

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