Human Blood Group Systems and Haemoglobinopathies

The past decade has seen remarkable improvements and advances in the fields of blood transfusion and hematology, particularly with regards to advances in science, technology, method development, quality, standardization, and governance. This book provides more evidenced-based insight into the field of blood transfusion and the management of hemoglobinopathies

Interstitial laser photocoagulation as a treatment for breast cancer

Conservative surgery is a safe alternative to mastectomy for some patients with breast cancer. A survey of surgeons in this thesis has shown that more surgeons would now undertake conservative surgery than they have done in the past. Recently a new technique, interstitial laser photocoagulation(ILP) has been described which is capable of in situ tissue necrosis with safe healing. The idea of ILP takes the concept of conservative surgery for breast cancer a step further. The main purpose of this thesis was to investigate the potential value of ILP as a future method of destroying breast cancers in situ leaving the area to heal via resorption and fibrosis. The aims of this thesis were to study the biology of laser interactions with breast cancers scheduled for surgery(and not to completely destroy the tumour), to optimise the laser parameters of power and exposure for a particular tumour and to find an imaging technique which will accurately predict the extent of laser damage. Forty five patients were treated with ILP prior to surgery(median 7 days). Tumour necrosis varied from 2-25mm. No laser damage was noted in 4 patients. Two patients developed minor complications and treatment was abandoned early due to pain in a further 4 patients. The presence of charring within the tumour was associated with larger diameters of necrosis than when charring was absent(median 13 vs 6 mm, p=0.002) and use of a precharred fibre produced similar lesions(median 14mm) which were more predictable.The histological features in the tumour following ILP were of coagulative necrosis which appeared to heal by the formation of fibrous tissue. An area of heat fixed, morphologically preserved tissue was noted within the zone of coagulative necrosis which was thought to be non-viable. Ultrasonography, Com puterised Tomography(CT) and M agnetic Resonace Imaging(MRI) were all used to monitor necrosis. Ultrasound was unable to predict the extent of necrosis as measured in the resected specimen(r=0.3, p=N.S.) but was reasonable at predicting tumour size(r=0.6, p=0.001). CT and MRI show some promise but were only investigated in small numbers of patients. This study has shown that ILP is simple and safe and when using a pre-charred fibre, predictable. If the initial results of imaging using CT and MRI are confirmed in larger studies then ILP could possibly have a role in the treatment of small breast cancers

Are we working towards global research priorities for management and conservation of sea turtles?

This is the final version. Available from Inter Research via the DOI in this recordThere is another ORE record for this publication: http://hdl.handle.net/10871/24817In 2010, an international group of 35 sea turtle researchers refined an initial list of more than 200 research questions into 20 metaquestions that were considered key for management and conservation of sea turtles. These were classified under 5 categories: reproductive biology, biogeography, population ecology, threats and conservation strategies. To obtain a picture of how research is being focused towards these key questions, we undertook a systematic review of the peer-reviewed literature (2014 and 2015) attributing papers to the original 20 questions. In total, we reviewed 605 articles in full and from these 355 (59%) were judged to substantively address the 20 key questions, with others focusing on basic science and monitoring that may lead to innovations or inform subsequent interpretation of effectiveness of conservation interventions and/or severity of threats. Progress to answering the 20 questions was not uniform and there were biases regarding focal turtle species, geographic scope and publication outlet. Whilst it offers some meaningful indications as to effort, quantifying peer-reviewed literature output is obviously not the only, and possibly not the best, metric for understanding research progress towards informing key conservation and management goals. Along with the literature review, an international group based on the original project consortium, with additional members, were assigned in groups of two or three (based on core expertise) to critically summarise recent progress towards answering each of the 20 questions. We found that significant research is being expended towards global priorities for management and conservation of sea turtles. Although highly variable, there has been significant progress in all the key questions identified in 2010. Undertaking this critical review has highlighted that it may be timely to undertake one or more new prioritizing exercises. For this to have maximal benefit we make a range of recommendations for its execution. These include a far greater engagement with social sciences, widening the pool of contributors and focussing the questions, perhaps disaggregating ecology and conservation.K.R.W-S is supported by the National Science Foundation Graduate Research Fellowship under Grant No. DGE-125252