Motivating first-time,group O blood donors to return: Rationale and design of a randomized controlled trial of a post-donation telephone interview

First-time blood donors are essential to the US donor pool, providing nearly a third of all donations. Unfortunately, there are a wide variety of obstacles to repeat donation and new donors are extremely difficult to retain. Because each donor experiences a unique set of deterrents, we developed a post-donation interview based on motivational interview principles in order to flexibly address individual barriers. The primary aim of this randomized clinical trial is to examine retention of first-time, group O blood donors who are randomly assigned to receive either a telephone-delivered interview with motivational and action planning components or a standard-of-care control call approximately six weeks after their donation. Measures of donation attitude, perceived behavioral control, intention, and motivational autonomy will be measured before and after the telephone contact using online surveys, and donation attempts will be tracked for one year using blood center donor databases. We hypothesize that, compared to controls, donors who receive the telephone interview will be more likely to make a donation attempt over the following year. In addition, we will examine possible mechanisms of action of the interview using key predictors of donation behavior as described by Self Determination Theory (i.e., motivational autonomy) and the Theory of Planned Behavior (i.e., attitude, perceived behavioral control, and intention). Results of this intervention may help to support a novel strategy to enhance retention of selected blood donors in an effort to better meet the nation's blood supply needs.     

孕前体质指数和孕期增重与子痫前期及其临床亚型的关系

目的 探讨孕前BMI和孕期增重与子痫前期（PE）及其临床亚型的发生风险的关系。方法 选取2012年3月至2016年9月在山西医科大学第一医院妇产科分娩的孕妇,根据纳入排除标准,共纳入9 274例孕妇,901例PE孕妇作为病例组,8 373例非PE孕妇作为对照组。收集一般人口学特征、孕前身高和体重、孕期生活方式、生育史和疾病史等资料,计算孕前BMI及孕期增重。采用非条件logistic回归分析孕前BMI和孕期增重与PE及其临床亚型的关系。结果 PE中早发型PE （EOPE）401例、晚发型PE （LOPE）500例,轻度PE （MPE）178例、重度PE （SPE）723例。PE孕妇和非PE孕妇在年龄、居住地、产次、妊娠期糖尿病及高血压家族史等方面差异有统计学意义（P<0.05）。调整以上因素后,logistic回归分析结果显示,孕前BMI<18.5 kg/m²和孕期增重不足是PE的保护因素（OR=0.74,95%CI：0.56~0.98;OR=0.78,95%CI：0.62~0.99）,孕前BMI ≥ 24.0 kg/m²和孕期增重过多是PE的危险因素（OR=1.82,95%CI：1.54~2.14;OR=1.82,95%CI：1.54~2.15）。对PE临床亚型分析后结果显示,孕前BMI<18.5 kg/m²是EOPE和MPE的保护因素（OR=0.52,95%CI：0.32~0.83;OR=0.47,95%CI：0.23~0.97）,孕前BMI ≥ 24.0 kg/m²和孕期增重过多是PE临床亚型的危险因素。按孕前BMI分层后,孕前18.5 kg/m² ≤ BMI<24.0 kg/m²和孕前BMI ≥ 24.0 kg/m²的孕妇中孕期增重过多（OR=1.86,95%CI：1.51~2.30;OR=1.90,95%CI：1.39~2.60）均是PE的危险因素;孕前BMI ≥ 24.0 kg/m²的孕妇中孕期增重不足（OR=0.55,95%CI：0.34~0.89）是PE的保护因素。孕前BMI<18.5 kg/m²的孕妇中孕期增重过多（OR=4.05,95%CI：1.20~13.69）是EOPE的危险因素;孕前18.5 kg/m² ≤ BMI<24.0 kg/m²的孕妇中孕期增重过多是PE各临床亚型的危险因素;孕前BMI ≥ 24.0 kg/m²的孕妇中孕期增重不足是EOPE和MPE的保护因素（OR=0.39,95%CI：0.19~0.80;OR=0.29,95%CI：0.11~0.77）,孕期增重过多是EOPE、LOPE和SPE的危险因素（OR=1.60,95%CI：1.06~2.42;OR=2.20,95%CI：1.44~3.37;OR=2.28,95%CI：1.58~3.29）。结论 孕前BMI和孕期增重影响PE及其临床亚型的发生风险,且不同孕前BMI人群孕期增重对PE的影响有差异,提倡同时关注孕前BMI和孕期体重变化,从而减少PE发生。     

Prognostic value of receptor tyrosine kinase-like orphan receptor (ROR) family in cancer: A meta-analysis

IntroductionIdentification of membrane proteins expressed exclusively on tumor cells is a goal for cancer drug development. The receptor tyrosine kinase-like orphan receptor type 1 and 2 (ROR1/2), are type-I transmembrane proteins expressed in cancer but not in adult normal tissue. Here, we explore the prognostic role ROR1/2 expression on patient outcome.MethodsA systematic search of electronic databases identified publications exploring the effect of ROR1/2 on overall survival (OS). Hazard ratios (HR) from collected data were pooled in a meta-analysis using generic inverse-variance and random effects modeling. Subgroup analyses were conducted based on disease site or tumor type.ResultsTwenty five studies met the inclusion criteria. ROR1 was associated with worse overall survival (HR 2.13, 95% confidence interval (CI) 1.62–2.80; P < 0.001) with subgroup analysis showing the strongest association between ROR1 and OS was in lung cancer. There was no significant difference between solid tumors and hematological malignancies (HR 2.15, 95% CI 1.52–3.06 vs. HR 2.02, 95% CI 1.46–2.84; subgroup difference P = 0.80). ROR2 was also associated with worse OS (HR 1.84, 95% CI 1.43–2.38; P < 0.001). There was no significant difference between disease sites although the highest association seen was in head and neck cancers (HR 3.19, 95% CI 1.13–8.97) and the lowest in gynecological cancers (HR 1.19, 95% CI 0.71–2.00; subgroup difference P = 0.10).ConclusionsROR1 and ROR2 expression is associated with adverse outcome in several tumors. ROR1/2 warrants study as a target for developmental therapeutics.     

Confirmatory bias in health decisions: Evidence from the MMR-autism controversy

Since Wakefield et al. (1998), the public was exposed to mixed information surrounding the claim that measles–mumps–rubella vaccine causes autism. A persistent trend to delay the vaccination during 1998–2011 in the US was driven by children of college-educated mothers, suggesting that these mothers held biases against the vaccine influenced by the early unfounded claim. Consistent with confirmatory bias, exposures to negative information about the vaccine strengthened their biases more than exposures to positive information attenuated them. Positive online information, however, had strong impacts on vaccination decisions, suggesting that online dissemination of vaccine-safety information may help tackle the sticky misinformation.