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1.
Conserv Biol ; 35(2): 533-547, 2021 04.
Article in English | MEDLINE | ID: mdl-32710456

ABSTRACT

Studies evaluating human-wildlife interactions (HWIs) in a conservation context often include psychometric scales to measure attitudes and tolerance toward wildlife. However, data quality is at risk when such scales are used without appropriate validation or reliability testing, potentially leading to erroneous interpretation or application of findings. We used 2 online databases (ProQuest Psych Info and Web of Science) to identify published HWI studies that included attitude and tolerance. We analyzed these studies to determine the methods used to measure attitudes or tolerance toward predators and other wildlife; determine the proportion of these methods applying psychometric scales; and evaluate the rigor with which the scales were used by examining whether the psychometric properties of validity and reliability were reported. From 2007 to 2017, 114 published studies were identified. Ninety-four (82%) used questionnaires and many of these (53 [56%]) utilized a psychometric scale. Most scales (39 [74%]) had at least 1 test of reliability reported, but reliance on a single test was notable, contrary to recommended practice. Fewer studies (35 [66%]) reported a test of validity, but this was primarily restricted to structural validity rather than more comprehensive testing. Encouragingly, HWI investigators increasingly utilized the necessary psychometric tools for designing and analyzing questionnaire data, but failure to assess the validity or reliability of psychometric scales used in over one-third of published HWI attitude research warrants attention. We advocate incorporation of more robust application of psychometric scales to advance understanding of stakeholder attitudes as they relate to HWI.


Análisis del Uso de Escalas Psicométricas en la Investigación sobre la Interacción Humano-Fauna para Determinar Actitudes y Tolerancia hacia la Fauna Resumen Los estudios que analizan las interacciones humano-fauna (IHF) dentro de un contexto de conservación con frecuencia incluyen escalas psicométricas para medir las actitudes y la tolerancia hacia la fauna. Sin embargo, la calidad de los datos se encuentra en riesgo cuando dichas escalas se usan sin una validación apropiada o una prueba de confiabilidad, lo que potencialmente puede llevar a interpretaciones o aplicaciones erróneas de los resultados. Usamos dos bases de datos virtuales (ProQuest Psych Info y Web of Science) para identificar estudios publicados sobre las IHF que incluyeran actitud y tolerancia. Analizamos estos estudios para determinar los métodos utilizados para medir las actitudes o la tolerancia hacia los depredadores y otros tipos de fauna; determinar la proporción de estos métodos aplicando escalas psicométricas; y evaluar el rigor con el cual se usaron las escalas al examinar si las propiedades psicométricas de validez y confiabilidad estuvieron reportadas en el estudio. Identificamos 114 estudios publicados entre 2007 y 2017. De estos estudios, 94 (82%) usaron cuestionarios y muchos de estos cuestionarios (53 [56%]) usaron una escala psicométrica. La mayoría de las escalas (39 [74%]) tuvieron al menos una prueba de confiabilidad reportada, pero la dependencia de una sola prueba fue notable, contrario a la práctica recomendada. Fueron menos los estudios (35 [66%]) que reportaron una prueba de validez, pero esto estuvo restringido primordialmente a una validez estructurada en lugar de un análisis más integral. De manera alentadora, los investigadores de las IHF cada vez usaron más las herramientas psicométricas necesarias para diseñar y analizar los datos de los cuestionarios, aunque la falta de análisis de la validez o confiabilidad de las escalas psicométricas utilizadas en más de un tercio de los estudios publicados sobre las actitudes hacia las IHF requiere de atención. Promovemos la incorporación de una aplicación más sólida de las escalas psicométricas para propiciar el entendimiento de las actitudes de los actores sociales conforme se relacionan con las IHF.


Subject(s)
Animals, Wild , Conservation of Natural Resources , Animals , Attitude , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
2.
J Helminthol ; 93(5): 559-566, 2019 Sep.
Article in English | MEDLINE | ID: mdl-29911512

ABSTRACT

Parasite distribution patterns in lotic catchments are driven by the combined influences of unidirectional water flow and the mobility of the most mobile host. However, the importance of such drivers in catchments dominated by lentic habitats are poorly understood. We examined parasite populations of Arctic charr Salvelinus alpinus from a series of linear-connected lakes in northern Norway to assess the generality of lotic-derived catchment-scale parasite assemblage patterns. Our results demonstrated that the abundance of most parasite taxa increased from the upper to lower catchment. Allogenic taxa (piscivorous birds as final host) were present throughout the entire catchment, whereas their autogenic counterparts (charr as final hosts) demonstrated restricted distributions, thus supporting the theory that the mobility of the most mobile host determines taxa-specific parasite distribution patterns. Overall, catchment-wide parasite abundance and distribution patterns in this lentic-dominated system were in accordance with those reported for lotic systems. Additionally, our study highlighted that upper catchment regions may be inadequate reservoirs to facilitate recolonization of parasite communities in the event of downstream environmental perturbations.


Subject(s)
Animal Distribution , Lakes/parasitology , Parasites/physiology , Trout/parasitology , Animals , Ecosystem , Norway
3.
Haemophilia ; 24(3): e84-e92, 2018 May.
Article in English | MEDLINE | ID: mdl-29359417

ABSTRACT

INTRODUCTION: Prophylaxis with extended half-life factor VIII (FVIII) is approved for haemophilia A, but data regarding routine clinical use are limited. AIM: To assess real-world experience of ADYNOVATE® (Antihemophilic Factor (Recombinant), PEGylated prophylaxis in children and adults with haemophilia A. METHODS: A retrospective chart review was conducted in three US haemophilia treatment centres. Records of all patients who began Adynovate prophylaxis in routine clinical practice were identified. Demographic, clinical and patient-reported information beginning 6 months before initiation of Adynovate until the record review was analysed. RESULTS: Fifteen patients (aged 9 months to 28 years), with median 9 months' use of Adynovate (range 1-15 months), were identified. All had switched from another prophylactic regimen, 13 (87%) from standard half-life recombinant FVIII. Nine (60%) patients had ≥1 bleed within 6 months preswitch. The most frequent reason for switching was to reduce infusion frequency (14 patients). After switching, infusion frequency reduced for 13 patients, and overall weekly factor consumption decreased by 19%. Eight (53%) patients had no bleeds postswitch, three (20%) had spontaneous joint bleeds (vs four pre-switch), and three (20%) had only mild traumatic bleeds. Patient/parental satisfaction with Adynovate was documented as positive in 13 of 15 (87%) cases; 2 patients were not satisfied and discontinued Adynovate. No adverse events were considered related to Adynovate. CONCLUSION: In patients who switched from a standard half-life FVIII to Adynovate prophylaxis in routine clinical practice, bleeding control was generally improved or maintained, with a lower infusion frequency and factor consumption in most patients.


Subject(s)
Factor VIII/chemistry , Factor VIII/therapeutic use , Hemophilia A/drug therapy , Polyethylene Glycols/chemistry , Adolescent , Adult , Factor VIII/pharmacology , Hemophilia A/complications , Humans , Male , Retrospective Studies , Severity of Illness Index , Young Adult
4.
Phys Chem Chem Phys ; 20(46): 29038-29044, 2018 Nov 28.
Article in English | MEDLINE | ID: mdl-30406789

ABSTRACT

Spontaneous orientation of molecular dipoles has been observed to produce bulk electric fields, termed 'spontelectric' fields, in a broad variety of molecular solid thin films formed by condensation from the gas phase. Such spontelectric fields are found in cis-methyl formate (cis-MF) and the present work combines observation of these fields with high quality ab initio studies of cis-MF monomers and dimers. This enables a prediction of the structural motif within the unit cell of the crystalline phase of solid cis-MF, showing it to be a non-polar dimer. Dimer formation at deposition temperatures of >90 K is therefore cited to contribute to the observed collapse of the spontelectric field at these temperatures. This is the first time that such a structural prediction has been made using observations of spontelectric behaviour as a key indicator.

5.
Phys Chem Chem Phys ; 20(7): 5112-5116, 2018 Feb 14.
Article in English | MEDLINE | ID: mdl-29392261

ABSTRACT

Using reflection-absorption infrared spectroscopy (RAIRS), we show that solids displaying spontaneous dipole orientation possess quite general non-local and non-linear characteristics, exemplified through their internal electric fields. The most graphic illustration of this, uncovered originally through electron beam studies, may be found in films of cis-methyl formate (cis-MF), for which data demonstrated the counter-intuitive property that the degree of dipole order in the film does not monotonically decrease as the temperature of deposition rises, but rather increases sharply above ∼77 K. Here we show how RAIRS provides independent evidence to support this conclusion. These new data confirm (i) that the behaviour of spontelectrics is governed by an expression for the degree of dipole orientation, which is continuous in temperature, but with a discontinuity in the derivative, and (ii) that the temperature of deposition associated with this discontinuity matches the temperature above which dipole order switches from the expected reduction with temperature to an increase with temperature.

6.
Haemophilia ; 23(6): 926-933, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28838029

ABSTRACT

INTRODUCTION: Radionuclide synovectomy/synoviorthesis (RS) to manage proliferative synovitis in persons with bleeding disorders has been utilized for decades; however, aggregate US results are limited. AIM: To determine the prevalence of RS utilization, patient and procedure related demographics and functional outcomes in United States haemophilia treatment centres (HTCs). The ATHNdataset includes US patients with bleeding disorders who have authorized the sharing of their demographic and clinical information for research. METHODS: We performed a multi-institutional, observational cohort study utilizing this dataset through 2010. Cases treated with RS procedure were compared to controls within the dataset. Standard template for data collection included patient and procedure related demographics as well as functional outcomes including range of motion (ROM) of the affected joint. Normative age- and sex-matched control ROM was obtained from published data. RESULTS: In the ATHNdataset there were 19 539 control-patients and 196 case-patients treated with RS. Patients with severe haemophilia were more likely to have had RS compared to those with mild/moderate haemophilia, although the proportion of RS performed was similar between severe HA and HB. Inhibitory antibodies, HIV and hepatitis C infection were significantly more common in cases. There were 362 RS procedures captured with 94 cases having >1 RS procedures. CONCLUSIONS: Right-sided joint procedures were more prevalent than left-sided procedures. Overall, case-patients had worse joint ROM compared to control-patients and published normative values. Geographically, there was regional variation in RS utilization, as the Southeast region had the largest percent of case-patients.


Subject(s)
Hemarthrosis/therapy , Hemophilia A/complications , Radioisotopes/therapeutic use , Synovectomy/methods , Synovitis/therapy , Adolescent , Adult , Child , Cohort Studies , Female , Hemarthrosis/etiology , Hemarthrosis/physiopathology , Humans , Male , Range of Motion, Articular , Synovitis/etiology , Synovitis/physiopathology , United States , Young Adult
7.
Haemophilia ; 23(1): 11-24, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27633342

ABSTRACT

INTRODUCTION: The implementation of early long-term, regular clotting factor concentrate (CFC) replacement therapy ('prophylaxis') has made it possible to offer boys with haemophilia a near normal life. Many different regimens have reported favourable results, but the optimum treatment regimens have not been established and the cost of prophylaxis is very high. Both for optimizing treatment and reimbursement issues, there is a need to provide objective evidence of both short- and long-term results and benefits of prophylactic regimens. AIMS: This report presents a critical review of outcome measures for use in the assessment of musculoskeletal health in persons with haemophilia according to the International Classification of Functioning, Disability and Health (ICF). This framework considers structural and functional changes, activities and participation in a context of both personal and environmental factors. METHODS: Results were generated by a combination of a critical review of available literature plus expert opinion derived from a two day consensus conference between 48 health care experts from different disciplines involved in haemophilia assessment and care. Outcome tools used in haemophilia were reviewed for reliability and validity in different patient groups and for resources required. RESULTS AND CONCLUSION: Recommendations for choice of outcome tools were made according to the ICF domains, economic setting, and reason for use (clinical or research). The next step will be to identify a 'core' set of outcome measures for use in clinical care or studies evaluating treatment.


Subject(s)
Hemophilia A/therapy , Outcome Assessment, Health Care/methods , Humans
8.
J Dairy Sci ; 100(3): 2068-2079, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28088405

ABSTRACT

The objectives of this study were to investigate colostrum feeding practices and colostrum quality on commercial grassland-based dairy farms, and to identify factors associated with colostrum quality that could help inform the development of colostrum management protocols. Over 1 yr, background information associated with dairy calvings and colostrum management practices were recorded on 21 commercial dairy farms. Colostrum samples (n = 1,239) were analyzed for fat, protein, lactose, and IgG concentration. A subset was analyzed for somatic cell count and total viable bacteria count. Factors associated with nutritional and IgG concentrations were determined using both univariate and multivariate models. This study found that 51% of calves were administered their first feed of colostrum via esophageal tube, and the majority of calves (80%) were fed >2 L of colostrum at their first feed (mean = 2.9 L, SD = 0.79), at a mean time of 3.2 h (SD 4.36) after birth, but this ranged across farms. The mean colostral fat, protein, and lactose percentages and IgG concentrations were 6.4%, 14%, 2.7%, and 55 mg/mL, respectively. The mean somatic cell count and total viable count were 6.3 log10 and 6.1 log10, respectively. Overall, 44% of colostrum samples contained <50 mg/mL IgG, and almost 81% were in excess of industry guidelines (<100,000 cfu/mL) for bacterial contamination. In the multivariate model, IgG concentration was associated with parity and time from parturition to colostrum collection. The nutritional properties of colostrum were associated with parity, prepartum vaccination, season of calving, and dry cow nutrition. The large variation in colostrum quality found in the current study highlights the importance of routine colostrum testing, and now that factors associated with lower-quality colostrum on grassland-based dairy farms have been identified, producers and advisers are better informed and able to develop risk-based colostrum management protocols.


Subject(s)
Colostrum/metabolism , Lactose , Animals , Animals, Newborn , Cattle , Female , Grassland , Immunoglobulin G/metabolism , Northern Ireland
9.
J Dairy Sci ; 100(1): 357-370, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27865490

ABSTRACT

The objectives were to evaluate the effect of (1) supplementing concentrates to multiparous Holstein cows during the dry period on colostral and milk immunoglobulin G (IgG) concentration; and (2) feeding calves colostrum at either 5 or 10% of their body weight (BW) on passive transfer of immunity, health, and performance. Holstein multiparous cows (n=37) were assigned to 1 of 2 nutritional treatments during an 8-wk dry period: (1) offered ad libitum grass silage only (GS) or (2) offered ad libitum access to the same grass silage plus concentrate [total mixed ration in a 75:25 dry matter (DM) ratio], providing a mean concentrate DM intake of 3.0kg/cow per day (GSC). Both treatment groups were offered identical levels of mineral and vitamin supplementation. Calves from these cows were weighed immediately after birth and fed either 5% (5BW) or 10% (10BW) of their BW in colostrum from their own dams within 2.5h of birth. Calves in the 10BW group received their second feed of colostrum from first-milking colostrum. Concentrate supplementation during the dry period had no effect on colostral IgG concentration, first-milking IgG yield, or fat, protein, and lactose contents. However, cows in GSC produced a greater mean milk yield over the first 8 milkings compared with cows in the GS group. Concentrate supplementation had no effect on calf BW or BW gain, serum IgG, or apparent efficiency of absorption (AEA) at 24h after birth. However, offspring from the GSC group had fewer cases of enteritis during the first 56d of life compared with offspring from the GS group. Calves in the 10BW group had greater mean serum IgG concentration for the first 3d following birth; however, at 24h after birth, we observed no treatment effect on AEA. The rate of enteritis was greater for calves in the 5BW treatment compared with 10BW. The colostrum-feeding regimen had no effect on BW gain or on the incidence of pneumonia among calf treatment groups. In conclusion, concentrate supplementation regimens offered during the dry period had a positive effect on colostrum yield, and offspring from the GSC group had a reduced rate of enteritis. Feeding 10% of BW of colostrum versus 5% of BW resulted in a greater serum IgG concentration for the first 3d postpartum, and 10BW calves had a reduced rate of enteritis. Overall, to achieve successful passive transfer, decrease the rate of enteritis, and increase efficiency in the dairy calf, we recommend that dairy calves be fed 10% of their BW in colostrum as soon as possible after birth.


Subject(s)
Animals, Newborn , Colostrum/immunology , Animals , Cattle , Diet/veterinary , Dietary Supplements , Female , Immunization, Passive , Milk/metabolism
10.
Soft Matter ; 10(44): 8955-62, 2014 Nov 28.
Article in English | MEDLINE | ID: mdl-25287556

ABSTRACT

Interfacial sliding speed and contact pressure between the sub-units of particulate soft matter assemblies can vary dramatically across systems and with dynamic conditions. By extension, frictional interactions between particles may play a key role in their assembly, global configuration, collective motion, and bulk material properties. For example, in tightly packed assemblies of microgels - colloidal microspheres made of hydrogel - particle stiffness controls the fragility of the glassy state formed by the particles. The interplay between particle stiffness and shear stress is likely mediated by particle-particle normal forces, highlighting the potential role of hydrogel-hydrogel friction. Here we study friction at a twinned "Gemini" interface between hydrogels. We construct a lubrication curve that spans four orders of magnitude in sliding speed, and find qualitatively different behaviour from traditional lubrication of engineering material surfaces; fundamentally different types of lubrication occur at the hydrogel Gemini interface. We also explore the role played by polymer solubility and hydrogel-hydrogel adhesion in hydrogel friction. We find that polymer network elasticity, mesh size, and single-chain relaxation times can describe friction at the gel-gel interface, including a transition between lubrication regimes with varying sliding speed.

11.
Diabet Med ; 30(8): 994-8, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23398488

ABSTRACT

AIM: An online diabetes course for medical residents led to lower patient blood glucose, but also increased hypoglycaemia despite improved trainee confidence and knowledge. Based on these findings, we determined whether an optimized educational intervention delivered to hospitalists (corresponding to an Acute Physician or Specialist in Acute Hospital Medicine in the UK) improved inpatient glycaemia without concomitant hypoglycaemia. METHODS: All 22 hospitalists at an academic medical centre were asked to participate in an online curriculum on the management of inpatient dysglycaemia in autumn 2009 and a refresher course in spring 2010. RESULTS: All hospitalists completed the initial intervention. Median event blood glucose decreased from 9.3 mmol/l (168 mg/dl) pre-intervention to 7.8 mmol/l (141 mg/dl) post-intervention and 8.5 mmol/l (153 mg/dl) post-refresher (P < 0.001 for both). Hospitalizations categorized as hyperglycaemia decreased from 83.3 to 55.6% (P = 0.014), with a trend towards euglycaemia (10-28.9%, P = 0.08) and no change in hypoglycaemia. Hyperglycaemic patient-days decreased from 72.0 to 57.3% (P = 0.004), with greater target glycaemia (27.3-39.4%, P = 0.016) and no change in hypoglycaemia. CONCLUSIONS: An optimized online educational intervention delivered to hospitalists yielded significant improvements in inpatient glycaemia without increased hypoglycaemia.


Subject(s)
Diabetes Mellitus/therapy , Hospitalists/education , Hyperglycemia/prevention & control , Hypoglycemia/prevention & control , Academic Medical Centers , Attitude of Health Personnel , Blood Glucose/analysis , Curriculum , Diabetes Mellitus/blood , Diabetes Mellitus/drug therapy , Diabetes, Gestational/blood , Diabetes, Gestational/drug therapy , Diabetes, Gestational/therapy , Female , Humans , Hyperglycemia/epidemiology , Hypoglycemia/chemically induced , Hypoglycemia/epidemiology , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Internet , Male , New York City/epidemiology , Personal Satisfaction , Pregnancy , Pregnancy in Diabetics/blood , Pregnancy in Diabetics/drug therapy , Pregnancy in Diabetics/therapy
12.
Haemophilia ; 19(3): 445-8, 2013 May.
Article in English | MEDLINE | ID: mdl-23294063

ABSTRACT

The incidence of inhibitor development in patients with severe haemophilia A is approximately 30%. Immune tolerance induction (ITI) is commonly utilized to eradicate these antibodies and is successful in 63-100% of cases. Potential predictors of a poor outcome in ITI include a high preinduction titre, high historical peak titre, older age at start of ITI and prolonged interval from diagnosis to start of ITI. The goal of this study was to characterize the outcomes of patients from our centre who have undergone late ITI, many of whom had poor prognostic features. Medical records of patients in our centre with severe/moderately severe haemophilia A (<2% FVIII activity) and history of inhibitor were reviewed. Data were abstracted from all patients who attempted late ITI. Nine patients underwent late ITI between January 1999 and December 2011. Within this cohort, 7 (78%) patients were black, 6 (67%) were <21 years old and 4 (44%) had a family history of inhibitor. Three patients had previously received ITI unsuccessfully. To date, 4 (44%) patients are tolerized (persistently negative inhibitor titre, FVIII recovery >66% and successfully treated with FVIII products ± FVIII t(½) of >6 h). Three patients are partially tolerized (have low responding inhibitor, variable FVIII recovery and successfully treated with FVIII products). Two patients are not tolerized. Some patients with haemophilia A and long-standing inhibitors may benefit from ITI.


Subject(s)
Hemophilia A/immunology , Immune Tolerance , Adolescent , Adult , Age Factors , Child , Child, Preschool , Cohort Studies , Factor VIII/antagonists & inhibitors , Factor VIII/immunology , Factor VIII/therapeutic use , Hemophilia A/drug therapy , Humans , Isoantibodies/blood , Male , Young Adult
13.
Dis Aquat Organ ; 106(3): 241-53, 2013 Nov 06.
Article in English | MEDLINE | ID: mdl-24192001

ABSTRACT

Dikerogammarus villosus, an invasive amphipod, has recently been detected in UK freshwaters. To assess the potential for pathogen introduction with the invader, a year-long histopathology survey of the D. villosus population inhabiting the initial site of detection (Grafham Water, Cambridgeshire, UK) was conducted. Additional samples were collected from 2 other subsequently identified populations within the UK (Cardiff Bay and Norfolk Broads), and from established populations in France (River Rhine) and Poland (River Vistula). The data revealed a range of pathogens and commensals. Several pathogens occurring within continental populations were not present within the UK populations. Microsporidian parasites and a novel viral pathogen were amongst those not observed in the UK. The absence of these pathogens at UK sites may therefore impart significant survival advantages to D. villosus over native fauna, thereby increasing its success as an invader. The contrast in pathogen profile between UK and continental-invasive populations of D. villosus provides preliminary evidence for so-called 'enemy release' in UK populations of D. villosus and is suggestive of single-point introductions, rather than continual incursion events as previously observed throughout its continental invasive range. This baseline survey provides important data on the pathogen and commensal profile of a high-impact, invasive species early in its invasion history of the UK. It can be utilised to assess potential for temporal pathogen acquisition by non-native invasive aquatic species and to investigate competitive advantages placed upon this invader due to absence of important pathogens experienced within its native range.


Subject(s)
Apicomplexa/physiology , Ciliophora/physiology , Crustacea/parasitology , Microsporidia/physiology , Trematoda/physiology , Animals , Apicomplexa/classification , Apicomplexa/isolation & purification , Ciliophora/classification , Ciliophora/isolation & purification , Demography , Ecosystem , Host-Parasite Interactions , Introduced Species , Microsporidia/classification , Microsporidia/isolation & purification , Predatory Behavior/physiology , Trematoda/classification , Trematoda/isolation & purification , United Kingdom
14.
Haemophilia ; 18(4): 532-9, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22226155

ABSTRACT

The prevalence of malignancies in US male patients with haemophilia, with or without concomitant viral infections, remains unknown. To estimate the prevalence of malignancy in US male patients with haemophilia. We investigated the prevalence of malignancies among male patients with haemophilia using data from a six-state haemophilia surveillance project. Case patients with malignancies were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes abstracted from hospital records and death certificates during the surveillance period. Cancer prevalence rates were calculated for each year during the surveillance and compared with age- and race-specific prevalence rates among the U.S. male population obtained from the Surveillance, Epidemiology and End Results (SEER) Program. A total of 7 cases of leukaemia, 23 cases of lymphoma and 56 classifiable solid malignancies were identified among 3510 case patients during a total of 15,330 annual data abstraction collections. The rates of leukaemia, lymphoma and liver cancer among case patients were significantly higher than the rates among U.S. males as judged by prevalence ratios of 3.1 [95% confidence interval (CI) = 1.4-7.0] and 2.9 (95% CI =1.8-4.6), respectively. In contrast, the prevalence ratio of prostate cancer was lower than expected at 0.49 (95% CI = 0.31-0.77). Overall the prevalence of most cancers among case patients was similar to that of the U.S. male population. However, patients with haemophilia who have unexplained symptoms should be evaluated for malignancy.


Subject(s)
Hemophilia A/epidemiology , Hemophilia B/epidemiology , Neoplasms/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Humans , Leukemia/epidemiology , Lymphoma/epidemiology , Male , Middle Aged , Population Surveillance , Prevalence , United States/epidemiology , Young Adult
15.
Haemophilia ; 18(6): 888-91, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22630567

ABSTRACT

Patients with bleeding disorders may be exposed to ionizing radiation during medical care. We hypothesized that children with severe haemophilia may have higher radiation exposure than those with mild bleeding disorders (MBDs). To compare medical radiation exposure rates between children with severe haemophilia and MBDs. Charts of 35 pediatric patients with severe haemophilia were randomly selected from a database of active male patients followed in our bleeding disorders clinic from 2000 to 2010. Case patients were age and sex matched with two control patients with MBDs [Type 1 von Willebrand disease (VWD) or mild platelet function defect (PFD)]. By retrospective review, data on radiation exposure in millisieverts (mSv) was collected from radiological studies performed within Emory/CHOA. The rates of exposure between cohorts were compared using the Mann-Whitney Test. Case patients had a mean of 11.3 (median 8, IQR = 29) radiographic studies compared with 1.8 (median 1, IQR = 11) for controls (P < 0.001). The mean effective dose of radiation per patient per year of study was two mSv for case patients (median 0.4, IQR = 3) and 0.4 mSv for control patients (median 0.01, IQR = 0.3) (P < 0.001). Overall, 1.4% of controls and 31.4% of cases accumulated high to very high levels of exposure ( > 20 mSv). Case patients with severe hemophilia accumulated significantly more medical radiation exposure than controls. While the use of ionizing radiation is often necessary for management of these patients, avoidance of unnecessary exposure along with exploration of alternative imaging techniques and low dose protocols should be considered whenever possible.


Subject(s)
Hemophilia A/diagnostic imaging , Hemophilia B/diagnostic imaging , Radiation, Ionizing , von Willebrand Disease, Type 1/diagnostic imaging , Child , Child, Preschool , Cohort Studies , Humans , Male , Radiation Dosage , Retrospective Studies , Risk Assessment , Tomography, X-Ray Computed
17.
Haemophilia ; 18(6): 926-32, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22642581

ABSTRACT

Blood flow properties play important roles in the regulation and formation of thrombus. To evaluate the influence of blood flow on thrombus formation in haemophilia, whole blood samples were obtained from FVIII-deficient (FVIII(-/-) ) and wild-type (FVIII(+/+) ) mice (n = 6 respectively), and from six human volunteers. Anti-FIXa aptamer was added to human blood to model acquired haemophilia B. Recalcified whole blood samples containing corn trypsin inhibitor and danaproid were perfused over the microchip coated with collagen and tissue thromboplastin at shear rates of 1100 and 110 s(-1) . Thrombus formation in the capillary was quantified by monitoring flow pressure changes. The intervals to 5 kPa (T(5) ) and 40 k Pa (T(40) ) reflect the onset and growth of thrombus formation respectively. Furthermore, fibrin and platelets in thrombi were quantified by immunostaining. T(5) at both shear rates were similar in FVIII(-/-) and FVIII(+/+) mice. T(40) of FVIII(-/-) mice (1569 ± 565 s) was significantly delayed compared with FVIII(+/+) mice (339 ± 78 s) at 110 s(-1) (P < 0.05), but not at 1100 s(-1) . The delay was normalized by adding human FVIII (2 IU mL(-1) ). Similarly, adding anti-FIXa aptamer to human blood prolonged T(40) at 110 s(-1) (P < 0.01), but not at 1100 s(-1) . Impaired production of fibrin due to anti-FIXa aptamer at 110 s(-1) was shown in the immunostained thrombus. Our perfusion experiments demonstrated that shear rates influence thrombus formation patterns in haemophilia, and that reduced activity of intrinsic tenase (FIXa-FVIIIa) becomes evident under venous shear rates.


Subject(s)
Blood Circulation , Factor IXa/metabolism , Factor VIII/metabolism , Thrombosis/physiopathology , Animals , Aptamers, Nucleotide/metabolism , Automation , Blood Coagulation , Blood Platelets/metabolism , Fibrin/metabolism , Humans , Mice , Mice, Transgenic , Microfluidic Analytical Techniques/instrumentation , Protein Binding , Shear Strength
19.
Haemophilia ; 18(6): 962-70, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22765835

ABSTRACT

Evaluation of prophylactic treatment of haemophilia requires sensitive methods. To design and test a new magnetic resonance imaging (MRI) scale for haemophilic arthropathy, two scales of a combined MRI scoring scheme were merged into a single scale which includes soft tissue and osteochondral subscores. Sixty-one joint MRI's of 46 patients with haemophilia were evaluated by four radiologists using the new and older scales. Forty-six of the joints were evaluated using two X-ray scales. For all MRI scores, interreader agreement and correlations with X-ray scores and lifetime number of haemarthroses were analysed. The interreader agreement intraclass correlation coefficient was 0.82, 0.89 and 0.88 for the soft tissue and osteochondral subscores and the total score, as evaluated according to the new MRI scale, compared to 0.80 and 0.89 as for the older scales. The total score and osteochondral subscore according to the new scale, as well as scores according to the older scales were correlated (P < 0.01) with number of haemarthroses (Spearman correlation 0.35-0.68) and with the X-ray scores (Spearman correlation 0.40-0.76), but no correlation (P > 0.05) was found between the soft tissue subscore of the new MRI scale and the X-ray scores. The new MRI scale is simpler to apply than the older and has similar reader reliability and correlation with lifetime number of haemarthroses, and by separating soft tissue and osteochondral changes it gives additional information. The new scale is useful for analyses of early and moderate stages of arthropathy, and may help to evaluate prophylactic haemophilia treatment.


Subject(s)
Hemophilia A/diagnostic imaging , Hemophilia B/diagnostic imaging , Joint Diseases/diagnostic imaging , Adolescent , Arthrography , Child , Child, Preschool , Factor IX/therapeutic use , Factor VIII/therapeutic use , Hemarthrosis/etiology , Hemophilia A/complications , Hemophilia A/drug therapy , Hemophilia B/complications , Hemophilia B/drug therapy , Humans , Joint Diseases/complications , Magnetic Resonance Imaging , Male , Severity of Illness Index
20.
Parasitology ; 139(6): 774-80, 2012 May.
Article in English | MEDLINE | ID: mdl-22310336

ABSTRACT

Branchiobdellidans or crayfish worms are clitellate annelids and ectosymbionts of freshwater crayfish. An investigation of branchiobdellidan infestation was undertaken in a population of endangered white-clawed crayfish (Austropotamobius pallipes) in the river Aire, UK. Thirty two percent of animals were infested either by the adult parasite or their cocoons (n=107). Parasite burden increased with host size, but did not differ with sex. Observations of crayfish gill tissue revealed a strong positive relationship between melanization of filaments and parasite prevalence and burden. Taxonomic identification revealed that 1 species of branchiobdellidan was present, Branchiobdella astaci. The first sequences were generated for this species and phylogenetically analysed alongside published sequences for 5 other branchiobdellidan species in Europe. The position of B. astaci within the genus Branchiobdella was confirmed, and it was found to cluster as a sister group to B. parasita.


Subject(s)
Annelida/classification , Astacoidea/parasitology , Gills/parasitology , Animals , Annelida/genetics , Astacoidea/classification , DNA, Mitochondrial/analysis , DNA, Mitochondrial/genetics , Female , Gills/metabolism , Male , Melanins/metabolism , Phylogeny , Prevalence , Sequence Analysis, DNA , Species Specificity , United Kingdom
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