3. The pre-hurricane results revealed one community with association patterns NU7441 mouse that were consistent with previous work on this population as well as other well-documented populations. Post-hurricane associations revealed that the community split into two distinct units, whose members associated highly within, but rarely between units. Association patterns varied between units. Immigrants assimilated well into the population, especially males. Over half of the post-hurricane associations involved immigrants, the majority between

residents and immigrants, and primarily involving immigrant males. The costs/benefits of choosing to associate with an immigrant individual differ between males and females and may have been the driving force for the changes in social structure that occurred. “
“Although most eastern North Pacific (ENP) gray whales feed in the Bering, Beaufort, and Chukchi Seas during summer and fall, a small number of individuals, referred to Luminespib cell line as the Pacific Coast Feeding Group (PCFG), show intra- and interseasonal fidelity to feeding areas from northern California through southeastern Alaska. We used both mitochondrial DNA (mtDNA) and 12 microsatellite markers to assess whether stock structure exists among

feeding grounds used by ENP gray whales. Significant mtDNA differentiation was found when samples representing the PCFG (n = 71) were compared with samples (n = 103) collected from animals feeding further north (FST = 0.012, P = 0.0045). No significant nuclear differences were detected. These results indicate that matrilineal fidelity plays a role in creating structure among feeding grounds but suggests that individuals from different feeding areas may interbreed. Haplotype diversities were similar between strata (hPCFG = 0.945, hNorthern = 0.952), which, in combination with the low level of mtDNA differentiation identified, suggested that some immigration into the PCFG could be

occurring. These results are important in evaluating the management of ENP gray whales, especially in light of the Makah Tribe’s proposal to resume whaling in an area of the Washington coast utilized by both PCFG and migrating whales. “
“Electronic tags have proven to be valuable tools in medchemexpress assessing small cetacean movement and behavior. However, problems associated with tag size and attachment have limited duration and damaged dorsal fins. These outcomes have motivated researchers to develop a new satellite-linked tag design that reduces detrimental effects to tagged animals, while increasing transmission durations. The goals of this study were to review previous studies that deployed single-pin transmitters and determine factors that influence transmission duration. Then, test these factors utilizing computational fluid dynamics (CFD) models to identify an optimal single-pin satellite-linked tag design, and evaluate this prototype through field studies.

Results Patient characteristics: subtype 1a:86%, 1b:14%; Liver stiffness >9.5kPa:14%, no cirrhosis; Interleukin 28B rs12979860 SNP genotype C/C:29%, C/T:48%, T/T:24%; Treatment-naïve:71%, prior relapse:29%; All patients on combined antiretroviral therapy (tenofovir/emtricitabine/raltegra-vir); GSI-IX chemical structure Mean CD4+ T-lymphocyte (CD4+) count:545±193cells/ μL. Fourteen patients (67%) had a RVR and were eligible for the shortened W28 arm, while 7(33%) patients were allocated to the W48 arm. Three patients are still on treatment. No

breakthrough or relapse occurred in the W28 arm, resulting in a SVR12 rate of 100%(12/12). In the W48 arm, the SVR12 rate was (50%(3/6)), as 3 patients met the treatment week 12 futility rule. Thus, the preliminary overall SVR12 rate was 83%(15/18). Grade 3/4 hematologic abnormalities were observed in 5(24%) patients, while 9(43%) patients developed a CD4+ count <200cells/μL. PEGIFN and RBV dose reductions were necessary in 1(5%) and 10(48%) patients, respectively. Erythropoietin and granulocyte colony-stimulating factor analogues were administered in 7(33%) and 6(29%) patients, respectively, and 2(10%) patients received blood transfusions. All patients had at least one adverse event, while serious adverse events related click here to bacterial infections and exhaustion were observed in 5(24%) patients. Conclusions This is the first study to

validate the concept of response-guided triple therapy in HIV/HCV-GT1. The majority of patients were eligible for response-guided shortening of treatment duration to W28 and all of these patients had a SVR12. If second-generation direct-acting antivirals are not available, W28 of BOC-based triple therapy may be recommended for HIV/HCV-GT1 with RVR. Disclosures: Mattias Mandorfer – Consulting: Janssen; Grant/Research Support: MSD, Roche; Speaking and Teaching: Janssen, Roche, Bristol-Myers Squibb, Boehringer Ingelheim Michael Trauner – Advisory Committees or Review Panels: MCE MSD, Janssen, Gilead, Abbvie; Consulting: Phenex; Grant/Research Support: Intercept, Falk Pharma, Albireo; Patent Held/Filed: Med Uni Graz (norUDCA); Speaking and Teaching: Falk Foundation, Roche, Gilead Markus

Peck-Radosavljevic – Advisory Committees or Review Panels: Bayer, Gilead, Janssen, BMS, AbbVie; Consulting: Bayer, Boehringer-Ingelheim, Jennerex, Eli Lilly, AbbVie; Grant/Research Support: Bayer, Roche, Gilead, MSD; Speaking and Teaching: Bayer, Roche, Gilead, MSD, Eli Lilly Thomas Reiberger – Grant/Research Support: Roche, Gilead, MSD, Phenex; Speaking and Teaching: Roche, Gilead, MSD The following people have nothing to disclose: Sebastian Steiner, Philipp Schwabl, Berit A. Payer, Maximilian C. Aichelburg, Gerold Lang, Katharina Grabmeier-Pfistershammer Background: Liver transplants (LT) for hepatitis C virus (HCV) cirrhosis show an increased mortality compared to LT for most other causes of liver disease. By more successfully eradicating HCV, new direct antiviral agents (DAAs) may improve the mortality of this group.

The episodic component contains personally experienced events situated in subjective time and space, while the semantic component contains de-contextualized generic knowledge of one’s past (Tulving, Schacter, McLachlan, & Moscovitch, 1988). In recent years, it has been argued that the ability to remember the personal past Mitomycin C mouse is closely related to the ability to imagine possible future scenarios (Suddendorf & Corballis, 1997; Wheeler, Stuss, & Tulving, 1997). Autonoetic consciousness – the kind of consciousness

critically involved in becoming aware of the self in subjective time extending from the personal past through the present to the personal future, is the hallmark of episodic memory and episodic future thinking (Tulving, 1985; Wheeler et al., 1997). Autonoetic consciousness is thought to give rise to a sense of mental time travel, whereby one travels backwards in time to re-experience events in the personal past or forward in time to pre-experience personal events that may happen in the future (Suddendorf & Corballis, 1997). The idea that remembering the past and imagining the future rely on common neurocognitive processes has been supported by neuroimaging findings, demonstrating robust and consistent

overlap in neural activity within prefrontal, medial-temporal lobe (MTL), and posterior cortical regions, including the posterior cingulate and retrosplenial cortex, when remembering past events and imagining novel scenarios (Addis, Wong, and Schacter, 2007; Botzung, Denkova, & Manning, MCE 2008; Okuda et al., 2003; Szpunar, Watson, & McDermott, 2007), supporting the notion of a core brain network Osimertinib mouse underlying both processes (Buckner & Carroll, 2007; Hassabis & Maguire, 2007; Schacter, Addis, & Buckner, 2007; Spreng, Mar, & Kim, 2009). Additional support is found in neuropsychological studies showing that amnesic patients unable to remember events from their personal past show a corresponding deficit in imagining possible events in their personal future (Hassabis, Kumaran, Vann, & Maguire, 2007; Klein, Loftus, & Kihlstrom, 2002; Tulving, 1985). In the light of such findings,

Schacter and Addis (2007) proposed a connection between the constructive nature of episodic memory and episodic future thinking. According to their constructive episodic simulation hypothesis, the ability to flexibly recombine features of previous experiences allows one to simulate an endless number of possible future scenarios. This ability to mentally simulate the future provides a unique opportunity to test alternative plans of actions without the potential risks associated with actually carrying out these plans, and thus improving the chances of an adaptive behavioural outcome. In addition, the ability to foresee consequences of planned actions may facilitate behavioural flexibility and self control, in that it makes it possible to postpone an immediate reward to achieve long-term goals (Suddendorf & Busby, 2005).

The episodic component contains personally experienced events situated in subjective time and space, while the semantic component contains de-contextualized generic knowledge of one’s past (Tulving, Schacter, McLachlan, & Moscovitch, 1988). In recent years, it has been argued that the ability to remember the personal past http://www.selleckchem.com/GSK-3.html is closely related to the ability to imagine possible future scenarios (Suddendorf & Corballis, 1997; Wheeler, Stuss, & Tulving, 1997). Autonoetic consciousness – the kind of consciousness

critically involved in becoming aware of the self in subjective time extending from the personal past through the present to the personal future, is the hallmark of episodic memory and episodic future thinking (Tulving, 1985; Wheeler et al., 1997). Autonoetic consciousness is thought to give rise to a sense of mental time travel, whereby one travels backwards in time to re-experience events in the personal past or forward in time to pre-experience personal events that may happen in the future (Suddendorf & Corballis, 1997). The idea that remembering the past and imagining the future rely on common neurocognitive processes has been supported by neuroimaging findings, demonstrating robust and consistent

overlap in neural activity within prefrontal, medial-temporal lobe (MTL), and posterior cortical regions, including the posterior cingulate and retrosplenial cortex, when remembering past events and imagining novel scenarios (Addis, Wong, and Schacter, 2007; Botzung, Denkova, & Manning, 上海皓元医药股份有限公司 2008; Okuda et al., 2003; Szpunar, Watson, & McDermott, 2007), supporting the notion of a core brain network Wnt inhibitor underlying both processes (Buckner & Carroll, 2007; Hassabis & Maguire, 2007; Schacter, Addis, & Buckner, 2007; Spreng, Mar, & Kim, 2009). Additional support is found in neuropsychological studies showing that amnesic patients unable to remember events from their personal past show a corresponding deficit in imagining possible events in their personal future (Hassabis, Kumaran, Vann, & Maguire, 2007; Klein, Loftus, & Kihlstrom, 2002; Tulving, 1985). In the light of such findings,

Schacter and Addis (2007) proposed a connection between the constructive nature of episodic memory and episodic future thinking. According to their constructive episodic simulation hypothesis, the ability to flexibly recombine features of previous experiences allows one to simulate an endless number of possible future scenarios. This ability to mentally simulate the future provides a unique opportunity to test alternative plans of actions without the potential risks associated with actually carrying out these plans, and thus improving the chances of an adaptive behavioural outcome. In addition, the ability to foresee consequences of planned actions may facilitate behavioural flexibility and self control, in that it makes it possible to postpone an immediate reward to achieve long-term goals (Suddendorf & Busby, 2005).

The episodic component contains personally experienced events situated in subjective time and space, while the semantic component contains de-contextualized generic knowledge of one’s past (Tulving, Schacter, McLachlan, & Moscovitch, 1988). In recent years, it has been argued that the ability to remember the personal past TGF-beta inhibitor is closely related to the ability to imagine possible future scenarios (Suddendorf & Corballis, 1997; Wheeler, Stuss, & Tulving, 1997). Autonoetic consciousness – the kind of consciousness

critically involved in becoming aware of the self in subjective time extending from the personal past through the present to the personal future, is the hallmark of episodic memory and episodic future thinking (Tulving, 1985; Wheeler et al., 1997). Autonoetic consciousness is thought to give rise to a sense of mental time travel, whereby one travels backwards in time to re-experience events in the personal past or forward in time to pre-experience personal events that may happen in the future (Suddendorf & Corballis, 1997). The idea that remembering the past and imagining the future rely on common neurocognitive processes has been supported by neuroimaging findings, demonstrating robust and consistent

overlap in neural activity within prefrontal, medial-temporal lobe (MTL), and posterior cortical regions, including the posterior cingulate and retrosplenial cortex, when remembering past events and imagining novel scenarios (Addis, Wong, and Schacter, 2007; Botzung, Denkova, & Manning, 上海皓元 2008; Okuda et al., 2003; Szpunar, Watson, & McDermott, 2007), supporting the notion of a core brain network click here underlying both processes (Buckner & Carroll, 2007; Hassabis & Maguire, 2007; Schacter, Addis, & Buckner, 2007; Spreng, Mar, & Kim, 2009). Additional support is found in neuropsychological studies showing that amnesic patients unable to remember events from their personal past show a corresponding deficit in imagining possible events in their personal future (Hassabis, Kumaran, Vann, & Maguire, 2007; Klein, Loftus, & Kihlstrom, 2002; Tulving, 1985). In the light of such findings,

Schacter and Addis (2007) proposed a connection between the constructive nature of episodic memory and episodic future thinking. According to their constructive episodic simulation hypothesis, the ability to flexibly recombine features of previous experiences allows one to simulate an endless number of possible future scenarios. This ability to mentally simulate the future provides a unique opportunity to test alternative plans of actions without the potential risks associated with actually carrying out these plans, and thus improving the chances of an adaptive behavioural outcome. In addition, the ability to foresee consequences of planned actions may facilitate behavioural flexibility and self control, in that it makes it possible to postpone an immediate reward to achieve long-term goals (Suddendorf & Busby, 2005).

Subjects with HC iron generally had values (e.g., ALT, AST, total bilirubin, and platelet values) similar to those of the no-iron group. The mixed iron group tended to be intermediate or closer to the RES group versus the HC or no-iron groups for most values. Subjects in the mixed iron group had the highest iron stores according to serum iron, TS, and ferritin levels. This group also had a greater proportion of men (70%) versus the other groups. A comparison of the histological INK 128 nmr grade and stage for the various hepatic iron-staining

groups is shown in Table 4. There were significant differences across all groups in the proportions of subjects in different categories of severity for portal inflammation, HC ballooning, and NASH diagnosis but not for steatosis grade, lobular inflammation, or fibrosis stage. Mixed iron subjects had higher grades of HC and RES iron deposits than the HC or RES groups, respectively. The NAFLD activity score (NAS) was significantly different across all groups (Fig. 1A; P = 0.0007, Kruskal-Wallis test) and was highest among subjects with RES iron staining (NAS = 4.8) and lowest in the group

with HC iron staining (NAS = 4.0). The NAS was also significantly higher among subjects without iron versus those with an HC pattern (P = 0.005) or a mixed pattern (P = 0.006). As shown in Fig. 1B, the mean fibrosis score (0-4 LDK378 molecular weight scale) was also significantly different across all groups (P = 0.0012, Kruskal-Wallis test). The RES iron group had a significantly medchemexpress higher mean fibrosis stage (mean score = 1.9) versus each of the other groups, including the no-iron group (P = 0.006). In contrast, the HC group had a significantly lower mean fibrosis stage than the other three groups (mean score = 1.1). We also examined the relationship between the hepatic iron pattern and advanced histological features. The RES iron group had the highest

proportion of subjects in the most severe category for each histological feature (Fig. 2). In contrast, the HC iron group had the lowest proportion of subjects in the most severe categories for each histological feature, and the mixed iron group had intermediate proportions of subjects in the most severe categories (Fig. 2). The no-iron group had proportions similar to those of the mixed iron group (data not shown). The differences in the proportion of subjects with advanced histological features across all iron groups was statistically significant for advanced fibrosis (P = 0.049), portal inflammation (P = 0.002), HC ballooning (P = 0.006), and definite NASH (P = 0.007). In comparison with the HC iron group, the RES iron group had a significantly higher proportion of subjects with each advanced histological feature: stage 3-4 fibrosis (37% versus 19%, P = 0.01), grade 2-3 lobular inflammation (59% versus 43%, P = 0.04), grade 2 portal inflammation (32% versus 10%, P = 0.001), grade 2 ballooning (48% versus 24%, P = 0.002), and a definitive diagnosis of NASH (68% versus 44%, P = 0.003).

Subjects with HC iron generally had values (e.g., ALT, AST, total bilirubin, and platelet values) similar to those of the no-iron group. The mixed iron group tended to be intermediate or closer to the RES group versus the HC or no-iron groups for most values. Subjects in the mixed iron group had the highest iron stores according to serum iron, TS, and ferritin levels. This group also had a greater proportion of men (70%) versus the other groups. A comparison of the histological see more grade and stage for the various hepatic iron-staining

groups is shown in Table 4. There were significant differences across all groups in the proportions of subjects in different categories of severity for portal inflammation, HC ballooning, and NASH diagnosis but not for steatosis grade, lobular inflammation, or fibrosis stage. Mixed iron subjects had higher grades of HC and RES iron deposits than the HC or RES groups, respectively. The NAFLD activity score (NAS) was significantly different across all groups (Fig. 1A; P = 0.0007, Kruskal-Wallis test) and was highest among subjects with RES iron staining (NAS = 4.8) and lowest in the group

with HC iron staining (NAS = 4.0). The NAS was also significantly higher among subjects without iron versus those with an HC pattern (P = 0.005) or a mixed pattern (P = 0.006). As shown in Fig. 1B, the mean fibrosis score (0-4 AZD6738 cell line scale) was also significantly different across all groups (P = 0.0012, Kruskal-Wallis test). The RES iron group had a significantly 上海皓元医药股份有限公司 higher mean fibrosis stage (mean score = 1.9) versus each of the other groups, including the no-iron group (P = 0.006). In contrast, the HC group had a significantly lower mean fibrosis stage than the other three groups (mean score = 1.1). We also examined the relationship between the hepatic iron pattern and advanced histological features. The RES iron group had the highest

proportion of subjects in the most severe category for each histological feature (Fig. 2). In contrast, the HC iron group had the lowest proportion of subjects in the most severe categories for each histological feature, and the mixed iron group had intermediate proportions of subjects in the most severe categories (Fig. 2). The no-iron group had proportions similar to those of the mixed iron group (data not shown). The differences in the proportion of subjects with advanced histological features across all iron groups was statistically significant for advanced fibrosis (P = 0.049), portal inflammation (P = 0.002), HC ballooning (P = 0.006), and definite NASH (P = 0.007). In comparison with the HC iron group, the RES iron group had a significantly higher proportion of subjects with each advanced histological feature: stage 3-4 fibrosis (37% versus 19%, P = 0.01), grade 2-3 lobular inflammation (59% versus 43%, P = 0.04), grade 2 portal inflammation (32% versus 10%, P = 0.001), grade 2 ballooning (48% versus 24%, P = 0.002), and a definitive diagnosis of NASH (68% versus 44%, P = 0.003).

A meta-analysis was conducted to estimate postoperative morbidity and mortality, blood loss, transfusion requirement, and liver injury based on the levels

of bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Meta-analysis was performed using either the fixed-effects model or random-effects model. Five RCT published between 2006 and 2012 containing a total of 403 patients were eligible for final analysis. Meta-analysis of operative time showed it was lower in the IP group than the IC group with weighted mean difference (WMD) of −18.23 (95% confidence interval (CI), −28.58 to −7.87; P = 0.0006). Meta-analysis of ALT levels www.selleckchem.com/products/z-ietd-fmk.html indicated lower levels in the IP group on postoperative days 3 and 7 (WMD on day buy Trametinib 3: –45.27, 95% CI, −49.92 to −40.62; P < 0.00001;

I2 = 0%; WMD on day 7: –24.33, 95% CI, −28.04 to −20.62; P < 0.00001; I2 = 0%). Meta-analyses revealed no significant difference in blood loss, transfusion requirement, mortality, morbidity, ischemic duration, hospital stay, AST and bilirubin levels on postoperative days 1, 3 and 7, and ALT levels on postoperative day 1 between IP and IC groups. On currently available evidence, IP does not offer a satisfying benefit to patients undergoing hepatic resection. However, they have lower operative time and less liver injury after liver resections. "
“Aim:  Host genetic variants leading to inosine triphosphatase (ITPA) deficiency, a condition not thought to be clinically important, protect against hemolytic anemia in chronic hepatitis C patients receiving ribavirin. In this study, we evaluated the clinical significance of ITPA variants in Japanese hepatitis C patients who were treated with pegylated interferon plus ribavirin. Methods:  In this multicenter retrospective cross-sectional study, 474 hepatitis C patients were enrolled who were treated with pegylated interferon plus ribavirin 上海皓元 in four geographically different hospitals in Japan. Patients were grouped according to hemoglobin decline

of more than 3 g/dL at week 4. Two single nucleotide polymorphisms (SNP) within or adjacent to the ITPA gene (rs6051702, rs1127354) were genotyped. Results:  A functional SNP, rs1127354, within the ITPA exon was strongly associated with protection against anemia with only one (0.8%) in 129 patients with the ITPA minor variant A developing severe anemia (P = 5.9 × 10−20). For rs6051702, which had significant association in European-Americans, significant but weak association with severe hemoglobin reduction was found in Japanese (P = 0.009). In patients excluding genotype 1b and high viral load, those with the ITPA minor variant A achieved significantly higher sustained viral response rate than those with the major variant (CC) (96% vs 70%, respectively, P = 0.0066).

A meta-analysis was conducted to estimate postoperative morbidity and mortality, blood loss, transfusion requirement, and liver injury based on the levels

of bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Meta-analysis was performed using either the fixed-effects model or random-effects model. Five RCT published between 2006 and 2012 containing a total of 403 patients were eligible for final analysis. Meta-analysis of operative time showed it was lower in the IP group than the IC group with weighted mean difference (WMD) of −18.23 (95% confidence interval (CI), −28.58 to −7.87; P = 0.0006). Meta-analysis of ALT levels GSK2126458 concentration indicated lower levels in the IP group on postoperative days 3 and 7 (WMD on day see more 3: –45.27, 95% CI, −49.92 to −40.62; P < 0.00001;

I2 = 0%; WMD on day 7: –24.33, 95% CI, −28.04 to −20.62; P < 0.00001; I2 = 0%). Meta-analyses revealed no significant difference in blood loss, transfusion requirement, mortality, morbidity, ischemic duration, hospital stay, AST and bilirubin levels on postoperative days 1, 3 and 7, and ALT levels on postoperative day 1 between IP and IC groups. On currently available evidence, IP does not offer a satisfying benefit to patients undergoing hepatic resection. However, they have lower operative time and less liver injury after liver resections. "
“Aim:  Host genetic variants leading to inosine triphosphatase (ITPA) deficiency, a condition not thought to be clinically important, protect against hemolytic anemia in chronic hepatitis C patients receiving ribavirin. In this study, we evaluated the clinical significance of ITPA variants in Japanese hepatitis C patients who were treated with pegylated interferon plus ribavirin. Methods:  In this multicenter retrospective cross-sectional study, 474 hepatitis C patients were enrolled who were treated with pegylated interferon plus ribavirin 上海皓元 in four geographically different hospitals in Japan. Patients were grouped according to hemoglobin decline

of more than 3 g/dL at week 4. Two single nucleotide polymorphisms (SNP) within or adjacent to the ITPA gene (rs6051702, rs1127354) were genotyped. Results:  A functional SNP, rs1127354, within the ITPA exon was strongly associated with protection against anemia with only one (0.8%) in 129 patients with the ITPA minor variant A developing severe anemia (P = 5.9 × 10−20). For rs6051702, which had significant association in European-Americans, significant but weak association with severe hemoglobin reduction was found in Japanese (P = 0.009). In patients excluding genotype 1b and high viral load, those with the ITPA minor variant A achieved significantly higher sustained viral response rate than those with the major variant (CC) (96% vs 70%, respectively, P = 0.0066).

A good HRQL measure would investigate environmental and personal aspects that influence function. Finally, HRQL should be measured from a subjective point of view (i.e., from the patient’s perspective), take into account the individual patient’s values, desires, expectations and autonomy of choice

(i.e., measure function against what the patient wants to achieve, rather than what the questionnaire developers expect or feel to be normal) [39,40,42]. Health status and HRQL measures are sometimes divided into generic and disease-specific. Generic measures have the advantage of being applicable across the whole spectrum of diseases, and therefore allow standardization and comparison between persons with haemophilia and patients with other diseases. However, selleck products the effects of interventions directed specifically towards haemophilia

(e.g. factor prophylaxis to reduce bleeding frequency) may not be measurable with generic measures (that may not, for example, have specific questions about bleeding). Several generic HRQL measures have been used in haemophilia studies, namely the Short Form 36 (SF-36), SF-12, Sickness Impact Profile (SIP) and the Quality of Well-Being Index (QWB) [43]. Bullinger, et al., representing the International Prophylaxis Study Group (IPSG) have reviewed the haemophilia-specific HRQL questionnaires [43]. For adults, these are Alectinib manufacturer the Haemo-Qol-A [44], Haem-A-Qol [45], the Hemofilia-QoL [46], Hemolatin-QoL [47] and QUAL-HEMO. For children, these are the Haemo-QoL [48], CHO-KLAT [49] and a proxy measure for very young patients [50]. Most of these tools were studied and shown to have good to excellent reliability and construct validity; i.e., most of these tools have demonstrated measurement properties that make them suitable for use in studies

and in the clinic. Furthermore, in general, these tools address five domains of health – physical, emotional/social, functional, mental and treatment-related MCE公司 – and can therefore be thought of as addressing some of the main areas defined by the ICF model. There are some ways, though, in which these measures fall short of the ideal detailed above. Although persons with haemophilia (or in some cases their parents) answer these questions from their own experience – the questions asked, the scoring options listed and the values attached to those scores reflect the values and expectations of the questionnaire developers,1 rather than the values and expectations of the individual patient answering the questionnaire. That is, these measures are not fully subjective, and do not take into account individual autonomy of choice. They are missing key elements important for the assessment of QoL. A better name for these tools, then, might be ‘self-reported measures of health status’.