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Despite broad scientific consensus that sustainable use of wildlife can enhance conservation efforts, ethical concerns have led some community groups to oppose use of wild animals. Voicing those concerns is legitimate, but underlying philosophical bias should not influence science-based analysis and interpretation. We argue that philosophical biases are common in the scientific literature on trade in wildlife. The critically important case of bias surrounding the use of reptile leathers for luxury fashion illustrates the problem. Based on analysis of official seizures of fashion products made from wildlife, a recent study inferred that criminal activity (as inferred by noncompliance with regulations) was common and increasing and, hence, that authorities needed to adopt more stringent restrictions on the trade. In fact, the conclusions of that study are artifacts of pseudoreplication (e.g., multiple counts of single violations) and biased sampling (e.g., focus on companies with high rates of error) and run directly opposite to actual patterns in the data. As a proportion of overall trade, rates of noncompliance are exceptionally low ( less then 0.4%), are declining, and result primarily from paper-work errors rather than criminal intent (e.g., such errors are more frequent for goods shipped by government authorities than by the commercial fashion industry). The recommendation by the study authors to prohibit the international trade in wildlife-based fashion products is imperiling a sustainable trade that can benefit biodiversity and people's livelihoods by providing financial incentives for conservation of species and habitats. This example offers a warning of the dangers of basing research on the wildlife trade on ethical or philosophical positions rather than objective evaluations of evidence.

Nurse managers play key roles in creating and enforcing organisational hair policies and practices. selleck kinase inhibitor This challenging paper will provoke discussion, debate and hopefully the dismantling of racist hair policies that disproportionately target black students and nurses.

Black people have suffered from centuries of hair racism that continues today. Unfortunately, many nurse leaders underestimate the significance of this issue, while perpetuating the injustice.

This paper is based on research literature, media reports and authors' lived experiences regarding hair racism experienced by black people and nurses in particular.

Nurse managers often create and police organisational hair policies and dress codes. As health services pledge to eradicate racism 'in principle', ending discriminatory hair policies offers nurse managers a practical way to make this principle a reality.

Hair racism is real and damaging for many black nurses and has no place in a modern health service. Rather than designing and policing such structural racism, nurse managers can be instrumental in ending it.

Health service hair policies targeting black nurses especially are not 'neutral'. Nurse managers can challenge this institutional discrimination, demonstrating health services' commitment to ending racism in all of its guises.

Health service hair policies targeting black nurses especially are not 'neutral'. Nurse managers can challenge this institutional discrimination, demonstrating health services' commitment to ending racism in all of its guises.Pheochromocytoma and paraganglioma are frequently hereditary tumors commonly associated with succinate dehydrogenase (SDHx) pathogenic variants (PV). Genetic testing is recommended to relatives of patients carrying SDHx PV. This study aims to explore the experiences associated with genetic testing for this hereditary condition. Semi-structured interviews with 38 SDHx PV (tumor-affected and non-affected) carriers were transcribed and content-analyzed. Four ways of living with this genetic alteration emerged from the interviews 'living as if not knowing', 'preventing others from going through this', 'feeling privileged', and 'still suffering'. Within each, negative, neutral, and positive reactions to the actual test result emerged initially, in addition to blame and guilt. Recognition of the importance of the genetic test and of the follow-up occurred in all four, but views on fecundity were divided between having and not having children. Consideration for the four different meanings of carrying an SDHx PV can improve participants' experiences and clinical practice.

Hand-foot skin reaction (HFSR) is the most common regorafenib-induced adverse event and is in need of effective prevention and palliation.

The Regorafenib Dose Optimization Study (ReDOS), a four-arm, previously published trial with a 1111 randomization scheme, was analyzed in a manner in keeping with the original protocol to assess whether clobetasol 0.05% cream (a corticosteroid) applied to the palms and soles twice per day for 8 weeks was more effective when prescribed preemptively (before the development of HFSR) versus reactively (after the development of HFSR). Patients were assessed during the first two cycles of regorafenib.

Sixty-one patients received preemptive clobetasol, and 55 received reactive clobetasol. Groups were balanced on demographics. Over the first two cycles, no evidence of HFSR occurred in 30% with preemptive clobetasol versus 13% with reactive clobetasol (p = .03). During the first cycle, 54% and 45% of patients had no HFSR with preemptive and reactive clobetasol, respectively ( with their patients.

Regorafenib causes hand-foot skin reactions. Preemptive clobetasol, a high-potency topical corticosteroid, appears to lessen the severity of this adverse event. link2 Although further study is needed, the favorable adverse event profile of this intervention might prompt clinicians to discuss this option with their patients.

Illicitly manufactured fentanyl continues to fuel the opioid overdose crisis throughout the USA and Canada. However, little is known about factors associated with knowingly or unknowingly using fentanyl. Therefore, we sought to identify the prevalence and correlates of suspected/known and unknown exposure to fentanyl (excluding the prescribed one) among people who inject drugs (PWID), including associated overdose risks.

Data were derived from three prospective cohort studies of community-recruited people who use drugs in Vancouver, Canada in 2016-2017. Multivariable logistic regression was used to identify correlates of suspected/known exposure (i.e. urine drug screen positive and self-reporting past 3-day exposure) and unknown exposure to fentanyl (i.e. urine drug screen positive and self-reporting no past three-day exposure), respectively.

Among 590 PWID, 296 (50.2%) tested positive for fentanyl. Of those, 143 (48.3%) had suspected/known and 153 (51.7%) had unknown exposure to fentanyl. In multivariar additional overdose prevention efforts for this group.The genomic variation of an invasive species may be affected by complex demographic histories and evolutionary changes during the invasion. Here, we describe the relative influence of bottlenecks, clonality, and population expansion in determining genomic variability of the widespread red macroalga Agarophyton vermiculophyllum. Its introduction from mainland Japan to the estuaries of North America and Europe coincided with shifts from predominantly sexual to partially clonal reproduction and rapid adaptive evolution. A survey of 62,285 SNPs for 351 individuals from 35 populations, aligned to 24 chromosome-length scaffolds indicate that linkage disequilibrium (LD), observed heterozygosity (Ho ), Tajima's D, and nucleotide diversity (Pi) were greater among non-native than native populations. Evolutionary simulations indicate LD and Tajima's D were consistent with a severe population bottleneck. Also, the increased rate of clonal reproduction in the non-native range could not have produced the observed patterns by itself but may have magnified the bottleneck effect on LD. Elevated marker diversity in the genetic source populations could have contributed to the increased Ho and Pi observed in the non-native range. We refined the previous invasion source region to a ~50 km section of northeastern Honshu Island. Outlier detection methods failed to reveal any consistently differentiated loci shared among invaded regions, probably because of the complex A. vermiculophyllum demographic history. Our results reinforce the importance of demographic history, specifically founder effects, in driving genomic variation of invasive populations, even when localized adaptive evolution and reproductive system shifts are observed.

Controversies regarding infliximab treatment in elderly patients with inflammatory bowel diseases remain. link3 We evaluated the effect of patient's age on infliximab exposure, efficacy and safety.

Retrospective case-control data of patients receiving infliximab induction treatment were analysed. A population pharmacokinetic model was developed to estimate individual pharmacokinetic parameters. A logistic regression model was used to investigate the effect of exposure on endoscopic remission. Repeated time-to-event models were developed to describe the hazard of safety events over time.

A total of 104 patients (46 elderly, ≥65 years) were included. A two-compartment population pharmacokinetic model with linear elimination adequately described the data. Infliximab clearance decreased with older age, higher serum albumin, lower fat-free mass, lower C-reactive protein and absence of immunogenicity. Yet, infliximab exposure was not significantly different between elderly and nonelderly. Regardless of age, an inflignancy increased with age, but not with infliximab exposure.

To use the phenotyping data from the MAPP-II Symptom Patterns Study (SPS) to compare the systemic features between urologic chronic pelvic pain syndrome (UCPPS) with Hunner lesion (HL) versus those without HL.

We performed chart review on 385 women and 193 men with UCPPS who enrolled in the MAPP-II SPS. 223 had cystoscopy and documentation of HL status. Among them, 12.5% had HL and 87.5% did not.

UCPPS participants with HL were older, had increased nocturia, higher Interstitial Cystitis Symptom and Problem Indexes, and were more likely to report "painful urgency" compared with those without HL. On the other hand, UCPPS without HL reported more intense nonurologic pain, greater distribution of pain outside the pelvis, greater numbers of comorbid chronic overlapping pain conditions, higher fibromyalgia-like symptoms, and greater pain centralization, and were more likely to have migraine headache than those with HL. UCPPS without HL also had higher anxiety, perceived stress, and pain catastrophizing than those with HL. There were no differences in sex distribution, UCPPS symptom duration, intensity of urologic pain, distribution of genital pain, pelvic floor tenderness on pelvic examination, quality of life, depression, pain characteristics (nociceptive pain vs. neuropathic pain), mechanical hypersensitivity in the suprapubic area during quantitative sensory testing, and 3-year longitudinal pain outcome and urinary outcome between the two groups.

UCPPS with HL displayed more bladder-centric symptom profiles, while UCPPS without HL displayed symptoms suggesting a more systemic pain syndrome. The MAPP-II SPS phenotyping data showed that Hunner lesion is a distinct phenotype from non-Hunner lesion.

UCPPS with HL displayed more bladder-centric symptom profiles, while UCPPS without HL displayed symptoms suggesting a more systemic pain syndrome. The MAPP-II SPS phenotyping data showed that Hunner lesion is a distinct phenotype from non-Hunner lesion.