Different impact of factor VIII products on inhibitor development?

Inhibitors are the most serious side effect of haemophilia treatment; they occur in 25–30 % of all patients with severe haemophilia A. Over the last 2 decades, conflicting data on the impact of clotting products have been published.Due to small studies of selected cases, appreciation of the impact of any particular product has been difficult. Moreover, the emphasis on inhibitor testing has led to increased detection of low-titre inhibitors (to >10 %), while the percentage of high-titre inhibitors is still around 20 %.Other non-genetic risk factors, such as dosing and intensive treatment, are able to increase individual inhibitor risk. Early prophylaxis might reduce inhibitor risk. Well-defined large PUP studies including products should be considered. This can only be achieved in collaboration with all stakeholders.In conclusion, while the impact of FVIII products on inhibitor development is large, presently the actual impact of any specific product is unclear.     

Comparison of Different Virtual Follow-ups on Mother’s Lactation

This study compared the effect of telephone and social messaging application follow-up on mothers’ self-efficacy, perceived social support, and duration of exclusive breastfeeding. Participants were randomized into 3 groups. The control group received the breastfeeding education during hospitalization, and the 2 intervention groups received education sustained postdischarge follow-up via telephone or by a social messaging application. Both intervention groups had significant differences in breastfeeding self-efficacy, perceived social support, and the duration of EBF compared with the control group, but the intervention groups were similar in these regardes. The telephone and social messaging application follow-up both promote EBF duration.     

Evaluation of Different Preparation Procedures of Pathogen Reduction Technology(Mirasol®)-Treated Platelets Collected by Plateletpheresis

Summary

Background

The Mirasol® pathogen reduction technology (PRT) for platelet concentrates (PC) uses riboflavin and UV light (270-360 nm). We evaluated the impact of PRT on platelets in comparison to standard single-donor PC.

Material and Methods

Platelets were resuspended in autologous plasma. After 2 h rest without agitation, PC were split into an untreated control unit (C-PC) and an immediately treated unit (T-PC) (series I). In series IV, split PC were stored under agitation over night before PRT was carried out. Platelet quality was assessed by pH, glucose consumption, lactate production rate, LDH, soluble sCD62p and CD62p expression with and without TRAP (thrombin receptor-activating peptide) over 7 days.

Results

Series I: On day 5, pH values were lower for T-PC (6.8 ± 0.2 vs. 7.4 ± 0.1, C-PC), accompanied by a higher glucose consumption rate of 0.069 ± 0.016 vs. 0.035 ± 0.006 mmol/10¹² platelets/h and lactate production rate of 0.126 ± 0.031 vs. 0.063 ± 0.011 mmol/10¹² platelets/h. CD62p using TRAP was lower for T-PC (50 ± 11 vs. 62 ± 14%). Baseline activation was higher in T-PC (35 ± 12 vs. 28 ± 15%). Longer initial rest time had no impact on these results (series II/III/IV).

Conclusion

PRT leads to an increase of platelet metabolism and activation independent of the length of the initial rest times. PC resuspended in autologous plasma should be stored at maximum up to day 5.Key Words: Pathogen inactivation, Pathogen reduction, Platelet concentrates, Mirasol®, Riboflavin     

Do Psychological Characteristics of Mothers Predict Parenting Stress? A Cross-Sectional Study among Mothers of Children with Different Disabilities

BACKGROUND/OBJECTIVE

We aimed at assessing the parenting stress levels among mothers of children with different disabilities and its association with various mothers' psychological characteristics.

Capacity, Capability, and Performance: Different Constructs or Three of a Kind?

Holsbeeke L, Ketelaar M, Schoemaker MM, Gorter JW. Capacity, capability, and performance: different constructs or three of a kind?

Objectives

The present study focused on motor activities of young children with cerebral palsy (CP) and examined the relation between motor capacity (what a person can do in a standardized, controlled environment), motor capability (what a person can do in his/her daily environment), and motor performance (what a person actually does do in his/her daily environment).

Design

The relations between motor capacity, motor capability, and motor performance were calculated by using Pearson correlations and visualized by scatterplots.

Setting

A cross-sectional study of a hospital-based population of children with CP.

Participants

Subjects were children with CP (N=85) aged 30 months (Gross Motor Function Classification System levels I-V).

Interventions

Not applicable.

Main Outcome Measures

Motor capacity, motor capability, and motor performance were assessed with the Gross Motor Function Measure and 2 scales of the Pediatric Evaluation of Disability Inventory, respectively.

Results

Correlations between motor capacity, motor capability, and motor performance were high, between 0.84 and 0.92, and significant (P< .001). But when comparing children with the same level of motor capacity or motor capability, large ranges at the level of motor performance were found.

Conclusions

Results imply that motor performance levels are only partly reflected by the motor capacity and motor capability levels in young children children with CP. Contextual factors (physical and social environment) and personal factors (such as motivation) influence the relations between capacity, capability, and performance. This information is essential in making decisions about the focus of therapy to maximize a child's independent functioning in daily life.     

The Research on the Result of Parturient''''s Different Birth Postures During the Second Birth Process

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How specific is specific phobia? Different neural response patterns in two subtypes of specific phobia

Specific phobia of the animal subtype has been employed as a model disorder exploring the neurocircuitry of anxiety disorders, but evidence is lacking whether the detected neural response pattern accounts for all animal subtypes, nor across other phobia subtypes. The present study aimed at directly comparing two subtypes of specific phobia: snake phobia (SP) representing the animal, and dental phobia (DP) representing the blood-injection-injury subtype. Using functional magnetic resonance imaging (fMRI), brain activation and skin conductance was measured during phobogenic video stimulation in 12 DP, 12 SP, and 17 healthy controls. For SP, the previously described activation of fear circuitry structures encompassing the insula, anterior cingulate cortex and thalamus could be replicated and was furthermore associated with autonomic arousal. In contrast, DP showed circumscribed activation of the prefrontal and orbitofrontal cortex (PFC/OFC) when directly compared to SP, being dissociated from autonomic arousal. Results provide preliminary evidence for the idea that snake and dental phobia are characterized by distinct underlying neural systems during sustained emotional processing with evaluation processes in DP being controlled by orbitofrontal areas, whereas phobogenic reactions in SP are primarily guided by limbic and paralimbic structures. Findings support the current diagnostic classification conventions, separating distinct subtypes in DSM-IV-TR. They highlight that caution might be warranted though for generalizing findings derived from animal phobia to other phobic and anxiety disorders. If replicated, results could contribute to a better understanding of underlying neurobiological mechanisms of specific phobia and their respective classification.     

Why are Depressive Individuals Indecisive? Different Modes of Rumination Account for Indecision in Non-clinical Depression

Individuals with depressive symptoms tend to adopt an abstract-analytical (A-A) rather than a concrete-experiential (C-E) mode of rumination. A large body of evidence shows that this leads to many deficits that are associated with depression (Watkins in Psychol Bull 134:163–206, 2008). In two studies, the present research examined whether indecision in a non-clinical population could also result from the mode of rumination adopted. In the first study, 174 participants completed measures of depressive symptoms, rumination, decision-making styles and indecision. The results of this study showed that indecision and one dysfunctional decision-making style (hyper-vigilance) significantly correlated with A-A rumination, even when controlling for depression. In a second study, 71 participants with mild to severe depressive symptoms (MSDs) and 49 participants with no to minimal depressive symptoms were trained to adopt either an A-A or a C-E rumination mode, and subsequently requested to make 10 choices. Consistent with the results of the first study, the results of the second study showed that participants in the A-A condition took longer to make their choice compared to participants in the C-E condition, irrespective of their level of depression. Moreover, the group of participants with MSDs experienced slightly more difficulty in decision making when they were in the A-A mode than in the C-E mode. This suggests that the A-A rumination mode could be an antecedent of indecision, whereas the C-E mode predicts its reduction. These interpretations are in line with the idea that A-A rumination is maladaptive and C-E rumination is adaptive.     

Comparison of Two Different Blood Sample Tubes for Platelet Function Analysis with the Multiplate® System

BACKGROUND: For whole blood aggregation on the Multiplate? system, the use of thrombin inhibitor as anticoagulant is recommended. So far sample tubes containing liquid lepirudin were provided (Dynabyte, Munich, Germany). They are not sterile and have to be stored refrigerated. For better handling now also sterile tubes with dried hirudin, storable at room temperature, are also provided (Dynabyte). The aim of this study was to compare the performance of these both sample tubes on the Multiplate system. PATIENTS AND METHODS: Blood was collected from 30 patients, treated with aspirin and/or clopidogrel, in tubes, and ASPItest, ADPtest and TRAPtest were performed. RESULTS: The correlation between both sample tubes was excellent with ASPItest (r(2) = 0.96), good with ADPtest (r(2) = 0.91) and also satisfying with TRAPtest (r(2) = 0.85). CONCLUSION: Both sample tubes are well qualified for platelet function analysis with the Multiplate system. The new sterile sample tube with dried hirudin may be preferred for better handling.     

The Effect of Resuscitation After Hemerrhagic Shock Dogs Responded to be Used Hypertonic Saline in Different Phases

Nomatterwheninpeaceorinwarwoundhemor rhagicshockthreatenedthewounds’livesseverely .5 0 % quickhemorrhagicpersonsweredeadwithinonehour.Astoitstreatment,domesticandforeignschol arsgavevariousrescuemethods .Hypertonicsalinewaspaidattentiontobecauseitsusingdozewassmallandeffectwasgood .ThestudymadeaComparisonamongtheresuscitationresultsrespondedtoapplyhy pertonicsalineatdifferentphasesbytakingdoghem orrhagicshockmodelofrevisedWiggersmethod .1　Materialsandmethods[1 3 ]1 .1　Preparedthemodelsan…     

Effect of Different Factors During In Vitro Growth and Multiplication in Groundnut Cultivar ‘JL-24’

During the present study effect of different factors were studied during in vitro growth and multiplication of adventitious shoot buds induced from de-embryonated cotyledon explants of groundnut cultivar ‘JL-24’. Optimum shoot multiplication rate of 7.0 folds and average shoot length of 3.0 cm was achieved on Murashige and Skoog’s (MS) medium supplemented with 2.0 mgl^?1 6-benzylamino purine. During subsequent subculture after every 21 days, an initial shoot number of 3 shoots per explant produced a maximum of 21 shoots per explant after 9 weeks. Sucrose at 3.0 % concentration supported the optimum shoot multiplication rate of 7.0 folds. Lowering or increasing sucrose concentration from the control (3.0 %) proved detrimental for in vitro shoot multiplication and growth. In case of liquid MS medium (without agar) supplemented with 6-benzylamino purine (2.0 mgl^?1) and sucrose (3.0 %) the multiplication rate was reduced by 1.5 folds (after 6 weeks) as compared to the semi-solid medium (with 0.8 % agar). Hyperhydricity was also observed in liquid medium. Shoots measuring 3.0–4.0 cm obtained from multiplying cultures were found suitable for rooting. Cent per cent rooting was achieved on 1/4th MS medium with sucrose (2.0 %), agar (0.8 %) and indoleacetic acid (0.5 mgl^?1). Subsequent hardening and acclimatization led to 95 % survival of in vitro raised plants.     

Pain and Personality: Do Individuals with Different Forms of Chronic Pain Exhibit a Mutual Personality?

The role of personality in the experience of chronic pain is a growing field, with endless debate regarding the existence of a “pain personality”. This study aims to compare different chronic pain types and consolidate the existence of a common personality. Thirty‐two females with chronic orofacial pain and 37 age‐matched healthy females were assessed with the Temperament and Character Inventory‐Revised. Chronic pain subjects had either trigeminal neuropathy (neuropathic pain) or temporomandibular disorders (nociceptive pain). This study revealed that individuals with different chronic pain types exhibit a mutual personality profile encompassing significantly higher scores in Harm Avoidance and significantly lower scores in Self‐Directedness when compared to healthy subjects. In fact, this combination is associated with Cluster C personality disorders. In conclusion, our study reveals that irrespective of type, chronic pain may be associated with Cluster C personality disorders. Indeed, there has never been empirical evidence in the past to suggest that chronic pain as an overall concept is associated with any particular personality disorders. Therefore, a potential future avenue of chronic pain treatment may lie in targeting particular personality aspects and shift the target of pain‐relieving treatments from sensory and psychologically state focused to psychologically trait focused.     

Different manufacturers of syringes: A new source of variability in blood gas,acid–base balance and related laboratory test?

ObjectiveEvaluate whether four different brands/types of heparin coated syringes can represent a source of variability in blood gas analysis (BGA).Design and methodsBlood was collected from one hundred volunteers into different syringes: Syringe I (lithium heparin and calcium balanced); Syringe II: in-house prepared (sodium heparin); Syringe III: (spray-dried calcium-balanced lithium heparin); Syringe IV (lyophilized electrolyte-balanced lithium heparin).ResultsSignificant differences were as follows: a) Syringe I vs II: pO₂, sO₂, pCO₂^t, cHCO₃^?, ctCO₂, base excess (BE), total hemoglobin (tHb), sodium (Na⁺), potassium (K⁺), calcium (Ca²⁺), glucose (Glu), lactate (Lac), O₂ Hb and p 50; b) Syringe I vs III: pH, pO₂, cHCO₃^?, ctCO₂, BE, Na⁺, Glu, Lac and p 50; c) Syringe I vs IV: pH, pO₂, sO₂, pCO₂^t, BE, Na⁺, K⁺, Ca²⁺, Glu, Lac and O₂ Hb; d) Syringe II vs III: pH, pO₂, sO₂, pCO₂^t, cHCO₃^?, ctCO₂, ctO₂, tHb, Na⁺, K⁺, Ca²⁺, Lac and p 50; e) Syringe II vs IV: pH, pO₂, sO₂, pCO₂^t, cHCO₃^?, ctCO₂, BE, tHb, Na⁺, K⁺, Ca²⁺, Lac, O₂ Hb and p 50; f) Syringe III vs IV: pH, pO₂, sO₂, cHCO₃^?, ctCO₂, ctO₂, BE, Na⁺, K⁺, Ca²⁺, O₂ Hb and p 50.ConclusionThe different manufacturers of syringes can represent new source of variability on BGA.     

Are Menstrual and Nonmenstrual Migraine Attacks Different?

Migraine is the second most common headache condition next to tension-type headache. Up to one fourth of all women have migraine, and 20% of them experience migraine without aura attack in at least two thirds of their menstrual cycles. The current literature is analyzed in response to the question of whether menstrual and nonmenstrual migraine attacks are different. The different studies provide conflicting results, so it is not possible to answer the question firmly. Future studies should be based on the general population. Collection of both prospective and retrospective data is warranted, and headache diagnosis base on interviews by physicians with interest in headache are more precise than lay interviews or questionnaires.     

Effect of Different Spectral Transmittances through Tinted Animal Cages on Circadian Metabolism and Physiology in Sprague–Dawley Rats

The suprachiasmatic nucleus is synchronized by the light:dark cycle and is the master biologic clock that serves as a pacemaker to regulate circadian rhythms. We explored the hypothesis that spectral transmittance (tint) of light through caging alters circadian rhythms of endocrine and metabolic plasma constituents in nonpigmented Sprague–Dawley rats. Rats (Crl:SD; n = 12 per group) were housed in a 12:12-h light:dark environment (300 lx; 123.0 μW/cm²; lights on, 0600) in either clear-, amber-, blue-, or red-tinted rodent cages. Blood was collected at 0400, 0800, 1200, 1600, 2000, and 2400 and measured for melatonin, total fatty acids, pH, glucose, lactic acid, corticosterone, insulin, and leptin. As expected, plasma melatonin levels were low during the light phase but higher during the dark phase in all groups; however, when compared with the clear-cage group, rats in amber-, blue-, and red-tinted cages had 29%, 74%, and 48%, respectively, greater total daily melatonin levels due to an increased duration and, in some cases, amplitude of the nocturnal melatonin signal. No differences were found in dietary and water intake, body growth rates, total fatty acids, pH, or glucose among groups. Disruptions in circadian rhythms, manifesting as alterations in phase timing, amplitude, or duration, occurred in the melatonin, lactic acid, corticosterone, insulin, and leptin levels of rats in tinted compared with clear cages. Therefore, the use of variously tinted animal cages significantly alters circadian rhythms in plasma measures of metabolism and physiology in laboratory rats, thus potentially altering the outcomes of scientific investigations.Abbreviations: ipRGC, intrinsically photosensitive retinal ganglion cells; SCN, suprachiasmatic nucleusLight prompts photobiological changes by way of the photopigment melanopsin in intrinsically photosensitive retinal ganglion cells (ipRGC),¹⁹ with some modulation by the visual rod and cone photoreceptors.^2,17 This stimulus leads to a cascade of molecular events sending signals via the neural pathway of the retinohypothalmic tract to the suprachiasmatic nucleus (SCN), the master biologic clock⁵ which is located in the brain. The SCN synchronizes numerous circadian rhythms and contributes to regulation of homeostasis and circadian physiology via several circadian outputs including the pineal gland''s production of melatonin. Studies have shown that changes in lighting intensity, duration, wavelength, and timing can disturb these circadian rhythms.^7-9 Not all light is equivalent. The responses to different wavelengths produced by visible and nonvisual electromagnetic radiation in an organism form what is known as an action spectrum. These wavelengths are perceived as a color or tint by the visual system of the primary optic tract. In mammals, the range generally between 450 and 550 nm (that is, blue light) has the strongest influence on neuroendocrine and circadian responses; however, longer wavelength (that is, red) light at high intensities can have this effect also.^7,18,29Melanopsin is a photosensitive pigment in the plasma membrane of ipRGC, which are directly activated by light to drive photoentrainment of the circadian system.^14,28 The ipRGC reside in the ganglion cell layer, which is the first retinal layer to receive incoming light. Melanin, however, is a distinctly different pigment from the chromaphore melanopsin. Commonly, animals are considered to be pigmented due to the presence of melanin, a derivative of tyrosine. Such is the case of the nude rats used in our previous studies.¹¹ An animal with a deficiency or absence of melanin in the retinal epithelium, hair, or skin is considered to be nonpigmented. Animals commonly used in biomedical research include albino (nonpigmented) Sprague–Dawley rats that lack melanin in the eyes, hair, and skin. Studies have found that the lack of melanin results in the abnormal development of the retinal pigmented epithelium and central retina and rods, as well as abnormal neural connections between the eye and brain.^21,26 Previous studies conducted with tinted laboratory cages demonstrated significant disruptions of metabolic and endocrine parameters in pigmented female nude rats.¹¹ To our knowledge, testing of a nonpigmented rat has not been attempted.As the field of laboratory animal science grows and advances, changes are being made in industry standards for laboratory animal housing and care for various reasons. These changes include the use of materials more suitable for high-temperature cleaning and of cage designs that accommodate viewing. In response to these shifting needs, alterations in cage design, material, or coloration that have been implemented may have unintended consequences for animal physiology. Unfortunately, most of these changes have little to no scientific basis supporting their use. For example, researchers and animal care personnel commonly expose animals to red light for extended periods of time for continual dark-phase observation or procedures when, in fact, such exposure may be detrimental to animal physiology, metabolism, and behavior depending on exposure duration.¹⁸ In addition, the eighth edition of the Guide²² suggests the use of red-tinted windows for rat and mouse holding rooms for animal observation and blocking hallway light from entering the room.In this regard, our previous research investigated the effect of spectral transmittance (for example, cage tint) through standard laboratory caging in female pigmented athymic nude rats and showed that animals developed chronobiologic disruptions in various endocrine and metabolic constituents in plasma.¹¹ Although the circadian rhythm of total fatty acids in plasma remained unchanged, all other metabolic and physiologic rhythms measured were significantly altered when rats were housed in either amber- or blue-tinted cages as compared with clear cages. These disruptions in plasma analyte levels encompassed changes in rhythm duration, phasing (for example, timing), amplitude, or some combination of these elements. Clear cages allowed the full spectrum of animal room polychromatic fluorescent light to pass through the cage, whereas tinted cages limited the transmittance of specific wavelengths.In the present study, we expand our previous findings in pigmented rats by exploring the effect of changes in spectral transmittance during the light period in male albino Sprague–Dawley rats. These animals were selected not only because they are nonpigmented but also because they are among the most widely used rat strains in scientific research. We hypothesized that changes in the tint (for example, spectral transmittance) of laboratory cages disrupts circadian rhythmicity and therefore the production of various endocrine and metabolic plasma constituents in Sprague–Dawley rats throughout a 24-h light:dark cycle.