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BACKGROUND Acquired haemophilia A (AHA) is a rare acquired bleeding disorder that can present with life threatening bleeding. OBJECTIVE To describe recent Australian use of recombinant porcine FVIII (rpFVIII) replacement therapy as a haemostatic agent in patients with acquired haemophilia. PATIENTS/METHOD Four patients with acquired haemophilia treated in three different institutions around Australia in the last 12 (twelve) months were included in the study. Haemostatic efficacy of Obizur was assigned by the treating Haematologist according to previously published criteria. RESULTS Six bleeds were treated with rpFVIII, three of which were initially refractory to treatment with recombinant VIIa. RpFVIII was rated efficacious in 100% of bleeds by 24 hours. rpFVIII loading dose was 100 U kg-1 (100-120 U kg-1 ) and this increased the factor VIII level (via one-stage FVIII assay) from less then 1%-1.2% to 54%-306% taken 0.5-1.5 hours post infusion. Subsequent doses ranged from 40 to 60 U kg-1 twice daily or daily for 3 to 13 days. No rpFVIII related adverse events occurred. Three of the four patients achieved complete remission and were weaned from immunosuppression. One patient died prior to achieving partial remission, secondary to an arterial ischaemic event. CONCLUSION This case series demonstrates that recombinant porcine FVIII is efficacious to treat acute bleeds in acquired haemophilia, including in those who are refractory to bypassing agents. Doses of rpFVIII were able to be titrated based on FVIII level and clinical response. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.The activity of many water-splitting photocatalysts could be improved by the use of RhIII -CrIII mixed oxide (Rh2-x Crx O3 ) particles as cocatalysts. Although further improvement of water-splitting activity could be achieved if the size of the Rh2-x Crx O3 particles was decreased further, it is difficult to load ultrafine ( less then 2 nm) Rh2-x Crx O3 particles onto a photocatalyst by using conventional loading methods. In this study, a new loading method was successfully established and was used to load Rh2-x Crx O3 particles with a size of approximately 1.3 nm and a narrow size distribution onto a BaLa4 Ti4 O15 photocatalyst. The obtained photocatalyst exhibited an apparent quantum yield of 16 %, which is the highest achieved for BaLa4 Ti4 O15 to date. Thus, the developed loading technique of Rh2-x Crx O3 particles is extremely effective at improving the activity of the water-splitting photocatalyst BaLa4 Ti4 O15 . This method is expected to be extended to other advanced water-splitting photocatalysts to achieve higher quantum yields. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.Decades of research suggest that species richness depends on spatial characteristics of habitat patches, especially their size and isolation. In contrast, the habitat amount hypothesis predicts that (1) species richness in plots of fixed size (species density) is more strongly and positively related to the amount of habitat around the plot than to patch size or isolation; (2) habitat amount better predicts species density than patch size and isolation combined, (3) there is no effect of habitat fragmentation per se on species density and (4) patch size and isolation effects do not become stronger with declining habitat amount. Data on eight taxonomic groups from 35 studies around the world support these predictions. Conserving species density requires minimising habitat loss, irrespective of the configuration of the patches in which that habitat is contained. © 2020 John Wiley & Sons Ltd/CNRS.BACKGROUND AND PURPOSE Subjective cognitive decline (SCD) is a self-experienced decline in cognitive capacity with normal performance on standardized cognitive tests and has been shown to increase the risk of Alzheimer's disease (AD). SCD could also be related to other conditions such as normal aging, psychiatric, neurological or medical disorders. The SCD Initiative proposed a set of features (SCD-plus) that increase the likelihood of preclinical AD in individuals with SCD. Our aim was to assess the effect of these features on the risk of conversion from SCD to AD. METHODS In total 150 SCD subjects who underwent extensive neuropsychological investigation, assessment of cognitive complaints and apolipoprotein E (ApoE) genotyping at baseline and clinical-neuropsychological follow-up for a mean time of 11 years were included. RESULTS During the follow-up, 20 subjects developed AD. Considering SCD-plus features, age at onset ≥60 years and ApoE ε4 significantly increased the risk of conversion from SCD to AD. When our sample was stratified into three groups (no risk factor, one risk factor, two risk factors), the proportion of conversion was statistically significantly different between the three groups. CONCLUSIONS Our model allows the risk of AD to be stratified in patients experiencing SCD according to age at onset and ApoE genotype. ©2020 European Academy of Neurology.PURPOSE Central venous access devices (CVADs) are commonly employed in the management of cancer patients. this website While having several benefits they are associated with significant risks. We reviewed the incidence and risk factors for catheter-related thrombosis (CRT) in cancer patients with CVADs. METHODS We performed a prospective observational cohort study of adult patients with cancer requiring a CVAD between January 12 004 and June 292 016. The rate of, and risk factors for the development of, symptomatic catheter-related thrombosis were evaluated. RESULTS 4920 central lines were inserted into 3130 patients. The incidence of CRT was 3.6%. CRT developed a median of 12 days following line insertion. PICCs were associated with the highest rates of CRT (HR 22.2, 95% CI 2.9-170.6). Older age groups developed CRT at lower rates (HR 0.57; 95%CI 0.39-0.84 for age 50-61 years, and HR 0.63; 95% CI 0.45-0.89 for age > 61 years) compared to age less then  50 years. Increased CRT was seen in patients with prior CRT (HR 1.81; 95%CI 1.19-2.77). There was a trend to more for cancer subtype with a Khorana tumor score of 1 compared to those with a score of 0 (HR 1.37, 95% CI 1.00-1.88). Hodgkin lymphoma, germ cell and oesophagus cancers had the highest CRT rates. Side of insertion was not associated with thrombosis risk (HR 0.77; 95% CI 0.57-1.05 P = 0.10). link2 CONCLUSIONS Age less then  50, PICC lines and prior CRT were associated with highest CRT rate. Cancer subtype and insertion side were not predictive of thrombosis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND There is no sufficiently accurate short-language measure that could be used by speech-language pathologists, teachers or paraprofessionals to screen young school-aged children to identify those requiring in-depth language evaluations. This may be due to poor development of the available measures, which have omitted crucial test development steps. Applying more stringent development procedures could result in a measure with sufficient accuracy. AIMS To create and validate a short-language measure that has acceptable accuracy, validity and reliability, and which can be used to identify children who require further assessment and/or referral to speech-language services. METHODS & PROCEDURES The study consisted of two phases. In Phase 1 (measure creation), 56 children were assessed with 160 direction-following and sentence-recall test items and a reference measure, the Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4). Items were then examined for their individual characteristics (vabus language measure. Trialling a large set of direction-following and sentence-recall test items to select those with the highest individual characteristics could result in an effective short-language measure. What this paper adds to existing knowledge A short-language measure (SLaM) was created and validated on two independent samples of children. Items with the highest validities, reliabilities and discrimination capacities were selected to form SLaM. This procedure resulted in a measure with high validity and reliability that exceeded the criterion for adequate discrimination accuracy. What are the potential or actual clinical implications of this work? SLaM is an effective measure that can accurately identify children who require detailed evaluations by speech-language pathologists. © 2020 Royal College of Speech and Language Therapists.BACKGROUND Ultrasound imaging has been widely used for imaging of the diaphragm thickness (Tdi) and thickening. Few studies assessed the Tdi using ultrasonography in patients with chronic obstructive pulmonary disease (COPD). We measured the Tdi and thickening in patients with COPD compared with healthy younger and healthy older adults to reveal the influence of ageing and/or COPD. METHODS Thirty-eight male patients with COPD (age 72 ± 8 years), 15 healthy younger (age 22 ± 1 years) and 15 healthy older (age 72 ± 5 years) male volunteers were recruited. We measured Tdi at total lung capacity (TdiTLC ), functional residual capacity (TdiFRC ) and residual volume (TdiRV ) using B-mode ultrasonography. We calculated the change ratio of TdiTLC and TdiRV (ΔTdi%). link3 We used a one-way analysis of variance and multiple comparison test for the comparison analysis. RESULTS The TdiTLC and the ΔTdi% were significantly lower in patients with COPD compared to the healthy adults. There was no significant difference in these values with age. There was no between group difference in the TdiFRC or TdiRV . CONCLUSIONS Our results indicate significant differences in TdiTLC and ΔTdi% between patients with COPD and healthy adults. Therefore, diaphragm ultrasonography can assess diaphragm dysfunction associated with COPD. We suggest that it is better to use TdiTLC and ΔTdi% (not only Tdi at rest) to assess diaphragm function. © 2020 John Wiley & Sons Ltd.BACKGROUND Patients with parkinsonism are 1.5 times more likely than comparators to be hospitalized and have a significantly longer length of stay in hospital. Medication delays, inappropriate medication omission, and administration of contraindicated medications likely contribute to these poor outcomes. Education and hospital system interventions may reduce these errors. METHODS We performed an audit of hospital medication charts to establish the baseline medication error rate and patient outcomes over a three-month period. We then delivered an intervention consisting of staff education sessions, a sticker alert system and increased priority for pharmacist review of patient drug charts. We repeated the audit after the intervention. RESULTS In the initial audit, the medication error rate was 23%, the clinical complication rate was 45% and one death was directly attributable to medication error. At follow up, the medication error and complication rates were 9% (absolute difference 14% (95% CI 10 to 16.4) p less then  0.001) and 38% (absolute difference 7% (95% CI -19 to 34) p = 0.59) respectively and there were no attributable deaths. The average length of stay before and after the intervention was 13 days and 8 days respectively (absolute difference 5.7 days (95% CI -1.8 to 13.3) p = 0.135). CONCLUSIONS There was a high in-hospital medication error rate for parkinsonian patients. The intervention resulted in a statistically significantly improvement in the medication error rate. The estimated reductions in complication rate and length of stay may be clinically important. Similar interventions may be beneficial in other institutions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.