Determinants of the intention to use performance-enhancing substances among Portuguese gym users

The present study examined the determinants of the intentions to use prohibited performance- enhancing substances (PES) and the hypothesis of gender and PES use influencing Theory of Planned Behavior (TPB) variables. A TPB approach was used. A convenience sample of Portuguese gym users (n = 453) completed an anonymous web-based survey. Variance-based structural equation modeling, multigroup analysis strategy, latent mean analysis approach and one-way ANOVA analysis were used. The findings showed that, at structural level, results support the TPB framework in terms of characterizing and predicting intentions to PES use in the gym users sample, and that subjective norms were the strongest predictor of PES use intentions. Female and male differed in intentions to use PES, subjective norms and beliefs. However, the predictive model in study remains invariable in both groups. Concerning PES use, results showed the existence of a significant difference, regarding all the TPB´s constructs of the PES users and nonusers’ groups, and that the predictive capacity of each predictor was different for each group. Psychological strategies should be based on subjective norms, alongside beliefs and attitudes towards PES use, since these variables influence the intention to use PES in that particular population

New insights into the outflows from R Aquarii

R Aquarii is a symbiotic binary surrounded by a large and complex nebula with a prominent curved jet. It is one of the closest known symbiotic systems, and therefore offers a unique opportunity to study the central regions of these systems and the formation and evolution of astrophysical jets. We studied the evolution of the central jet and outer nebula of R Aqr taking advantage of a long term monitoring campaign of optical imaging, as well as of high-resolution integral field spectroscopy. Narrow-band images acquired over a period of more than 21 years are compared in order to study the expansion and evolution of all components of the R Aqr nebula. The magnification method is used to derive the kinematic ages of the features that appear to expand radially. Integral field spectroscopy of the OIII 5007A emission is used to study the velocity structure of the central regions of the jet. New extended features, further out than the previously known hourglass nebula, are detected. The kinematic distance to R Aqr is calculated to be 178 pc using the expansion of the large hourglass nebula. This nebula of R Aqr is found to be roughly 650 years old, while the inner regions have ages ranging from 125 to 290 years. The outer nebula is found to be well described by a ballistic expansion, while for most components of the jet strong deviations from such behaviour are found. We find that the Northern jet is mostly red-shifted while its Southern part is blue-shifted, apparently at odds with findings from previous studies but almost certainly a consequence of the complex nature of the jet and variations in ionisation and illumination between observations.Comment: 13 pages, 8 figures, accepted for publication in A&

Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research priorities for mucocutaneous bleeding disorders

BACKGROUND: Excessive or abnormal mucocutaneous bleeding (MCB) may impact all aspects of the physical and psychosocial wellbeing of those who live with it (PWMCB). The evidence base for the optimal diagnosis and management of disorders such as inherited platelet disorders, hereditary hemorrhagic telangiectasia (HHT), hypermobility spectrum disorders (HSD), Ehlers-Danlos syndromes (EDS), and von Willebrand disease (VWD) remains thin with enormous potential for targeted research. RESEARCH DESIGN AND METHODS: National Hemophilia Foundation and American Thrombosis and Hemostasis Network initiated the development of a National Research Blueprint for Inherited Bleeding Disorders with extensive all-stakeholder consultations to identify the priorities of people with inherited bleeding disorders and those who care for them. They recruited multidisciplinary expert working groups (WG) to distill community-identified priorities into concrete research questions and score their feasibility, impact, and risk. RESULTS: WG2 detailed 38 high priority research questions concerning the biology of MCB, VWD, inherited qualitative platelet function defects, HDS/EDS, HHT, bleeding disorder of unknown cause, novel therapeutics, and aging. CONCLUSIONS: Improving our understanding of the basic biology of MCB, large cohort longitudinal natural history studies, collaboration, and creative approaches to novel therapeutics will be important in maximizing the benefit of future research for the entire MCB community

von Willebrand disease: proposing definitions for future research

Thrombosis and Hemostasi

ASH ISTH NHF WFH 2021 guidelines on the diagnosis of von Willebrand disease

Background: von Willebrand disease (VWD) is the most common inherited bleeding disorder known in humans. Accurate and timely diagnosis presents numerous challenges.Objective: These evidence-based guidelines of the American Society of Hematology (ASH), the International Society on Thrombosis and Haemostasis (ISTH), the National Hemophilia Foundation (NHF), and the World Federation of Hemophilia (WFH) are intended to support patients, clinicians, and other health care professionals in their decisions about VWD diagnosis.Methods: ASH, ISTH, NHF, and WFH established a multidisciplinary guideline panel that included 4 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Outcomes and Implementation Research Unit at the University of Kansas Medical Center (KUMC) supported the guideline-development process, including performing or updating systematic evidence reviews up to 8 January 2020. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subsequently subject to public comment.Results: The panel agreed on 11 recommendations.Conclusions: Key recommendations of these guidelines include the role of bleeding-assessment tools in the assessment of patients suspected of VWD, diagnostic assays and laboratory cutoffs for type 1 and type 2 VWD, how to approach a type 1 VWD patient with normalized levels over time, and the role of genetic testing vs phenotypic assays for types 2B and 2N. Future critical research priorities are also identified.Thrombosis and Hemostasi

The spectrum of bleeding in women and girls with haemophilia B

Although hemophilia B affects 1 in 25,000 males there may be 3 female hemophilia B carriers per affected male. This clinical review highlights the unique challenges faced by hemophilia B carriers including the under‐recognition of bleeding symptoms associated with and without FIX deficiency, discrepancies in correlation between genotype and bleeding phenotype and therapeutic considerations utilizing clinical vignettes of common scenarios