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Is narrative persuasion effective when promoting new behaviours in favour of the environment? Does this effectiveness vary depending on whether individuals are already thinking about changing? This paper has two main objectives: (1) to explore how individuals at different stages of the behavioural change process perceive air pollution, focussing on the perceived psychological distance of its environmental risks (Study 1); and (2) to test whether the effects of presenting the risks of air pollution in a narrative vs. statistical format on pro-environmental intentions vary depending on the individuals' stage of behavioural change (Study 2). Study 1 (N = 263) is based on a survey measuring individuals' perceived psychological distance of the environmental risks of air pollution, and the perceived effectiveness of different pro-environmental behaviours. Results suggest that perceived distance and perceived effectiveness vary across different stages of behavioural change. Study 2 (N = 258) presents a 2(Format: narrative vs. statistical) × 3(Stages of change) protocol, testing the effectiveness of a narrative format depending on individuals' stage of behavioural change. Results suggest that proximising a threat through a narrative format of communication is more effective especially for individuals in the pre-action stage of change. We also present a moderated mediation model explaining the influence of the interaction between the message format and the stage of behavioural change on behavioural intentions and on efficacy appraisal via narrative engagement. Findings are discussed with regards to the stage model and narrative persuasion.

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Aim: More data is required regarding the association between HLA allele and red blood cell (RBC) antigen expression in regard to SARS-CoV-2 infection and COVID-19 susceptibility. Methods: ABO, RhD, 37 other RBC antigens and HLA-A, B, C, DRB1, DQB1 and DPB1 were determined using high throughput platforms in 90 Caucasian convalescent plasma donors. Results: The AB group was significantly increased (1.5×, p = 0.018) and some HLA alleles were found to be significantly overrepresented (HLA-B*44:02, C*05:01, DPB1*04:01, DRB1*04:01 and DRB1*07:01) or underrepresented (A*01:01, B51:01 and DPB1*04:02) in convalescent individuals compared with the local bone marrow registry population. Conclusion: Our study of infection-susceptible but non-hospitalized Caucasian COVID-19 patients contributes to the global understanding of host genetic factors associated with SARS-CoV-2 infection and severity.

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How do individuals rationalize the cognitive dissonance between their environmental awareness and the maintenance of environmentally unfriendly behaviors? The main goal is to explore the rationalization strategies used by individuals in order to maintain their current behaviors. The secondary goal is to understand if it is possible to induce cognitive consonance, and how this influences intention to change. We present a study (N = 222) with three experimental conditions: inconsistency, control, and consistency. The method to induce inconsistency and consistency was inspired by the paradigm of induced hypocrisy. Results demonstrated that induced inconsistency elicits two main barriers in participants: considering the change as unnecessary, and perceiving to lack knowledge about how to change. Induced consistency elicits tokenism, resulting in a licensing effect. However, behavioral intentions did not differ among experimental groups. Results are discussed considering methodological limitations and possible intervening variable.

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BACKGROUND: The determination of the RhD phenotype is crucial to avoid alloimmunization, especially in childbearing women. Following the 2015 recommendation from the Work Group on RHD Genotyping, a large-scale RHD genotyping program was implemented in the province of Quebec (Canada) and offered to women ≤45 years old with a serological weak D or discordant results. Since weak D type 42 was previously shown to be prevalent among French Canadians, genotyping for that variant was also performed. Our aim was to report the prevalence of the weak D alleles in the province of Quebec. STUDY DESIGN AND METHODS: A retrospective study of 2105 women with serological weak D referred to Hema-Quebec's immunohematology reference laboratory (IRL) between June 2016 and May 2020 was conducted. Results from the serological tests performed by the referring hospital were compiled and RHD were genotyped. RESULTS: Most patients presented at least one serological result ≤2+ before being referred to Hema-Quebec. Weak D type 42 was the most prevalent variant, representing 17.5% (368/2105) of all individuals tested. Only 15.3% (323/2105) of patients were weak D type 1, 3.3% (69/2105) were type 2, and 8.6% (180/2105) were type 3. Weak D type 42 is highly expressed in regions with low immigration rate and known for their founder effect. CONCLUSION: Our RHD genotyping program allowed for a better management of weak D. The province of Quebec presents a unique RHD genotype distribution. We confirmed that weak D type 42 is associated with a founder effect found in Caucasian French Canadians.

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BACKGROUND: A global downtrend in blood usage has been observed by many countries, while the demand for antigen-negative red blood cell (RBC) units used in antigen-matched transfusions keeps increasing. The declining number of units collected exposes blood providers to a rapidly evolving supply challenge. METHODS: This study was conducted retrospectively with use of internal data analysis to weigh Québec's situation regarding global and antigen-negative RBC demand, to measure the effects of community-directed recruitment and blood drives, and to evaluate the benefits of mass-scale RBC genotyping. RESULTS: Our findings confirm a global RBC usage downtrend of over 20% total in the past 10 years with a steady antigen-negative usage and highlight the most requested negative antigen combinations. Our data also show our +39.5% progress regarding the number of Black donors recruited for antigen matching of patients with sickle cell disease in the past 3 years, as well as a constantly growing number of just-in-time blood collection for complex orders. Finally, our data summarize the efficiency of our mass-scale RBC genotyping efforts. CONCLUSION: Altogether, this study confirms the demand trends for regular and antigen-negative RBC units in Québec and the efficient effects of our recruitment and typing strategies.

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OBJECTIVE: To retrospectively evaluate the accuracy of pelvic magnetic resonance (MR) imaging for the characterization of complex sonographic adnexal masses discovered in women during pregnancy. STUDY DESIGN: The study population comprised 31 pregnant women (median age: 32 years (range: 19-42); mean gestation age of 16 weeks) referred to our institution for MR imaging for characterization of an adnexal mass discovered incidentally during routine ultrasound (US) for other indications. The population comprised of 31 women, with 36 adnexal lesions (mean size: 103mm [range: 20-290]), of which 27 were benign and 9 were malignant masses. Prospective US and MR reports were reviewed to determine the presence of a benign or malignant lesion. Two radiologists (R1 and R2) blinded to the final outcome, retrospectively evaluated the MR images using the criteria based on the ADNEXMR-SCORE and classified the lesion as benign or malignant. The reference standard was surgical pathology or at least a 1-year imaging follow-up. RESULTS: Prospective US and MR imaging correctly identified the diagnosis in 27/36 (75%) (95% confidence interval (CI): 58.9%-86.2%) and in 32/36 (88.9%) (95% CI: 74.6%-95.6%) of lesions, respectively. MR imaging with ADNEXMR-SCORE allowed a correct diagnosis in 32/36 (88.9%) (95% CI: 74.6%-95.6%) of lesions for R1 and in 30/36 (83.3%) (95% CI: 68.1%-92.1%) of lesions for R2. The sensitivities and specificities of MR imaging using the MR ADNEXMR-SCORE were 100% (95% CI: 70.1%-1000%) for both readers and 85.1% (95% CI: 67.5%-94%) and 77.7% (95% CI: 59.2%-89.4%) for R1 and R2, respectively. No malignancy was classified as benign using MR criteria. The reproducibility between the two readers was almost perfect, with a kappa of 0.914. CONCLUSION: MR imaging is highly accurate for the characterization of complex adnexal masses incidentally discovered during pregnancy. CLINICAL RELEVANCE: MR imaging can accurately characterize adnexal masses in pregnancy and could be useful in opting for expectant management until delivery.

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Magnetic resonance imaging (MRI)-guided breast biopsy is an essential tool of a breast imager; yet, a decade after its introduction, this technique remains challenging and imperfect. This article presents the technique of MRI-guided biopsy, with an emphasis on challenges particular to the technique: technical considerations related to adequate lesion sampling and difficulties in confirming radiologic-pathologic correlation for enhancing lesions. Through clinical vignettes, challenges unique to MRI-guided biopsy are discussed and practical tips are offered. Prebiopsy planning including second-look targeted studies, patient preparation, and equipment is covered. Challenging situations pertaining to breast size, lesion location, or type of enhancement are illustrated, as well as the topic of performing multiple MRI-guided breast biopsies in a single session and biopsies of women with implants. Postbiopsy management is discussed. Success of MRI-guided biopsies requires careful prebiopsy planning, as well as appropriate choice of biopsy device, optimized for the specifics of breast shape and lesion size and location. Special features of biopsy systems (smaller apertures and blunt tips) facilitate the sampling of lesions in challenging locations. Vanishing lesions should undergo short-term follow-up, because malignancy cannot be excluded, as should lesions diagnosed as benign after pathologic analysis when the result is felt to be concordant with imaging features. To this end, radiologic-pathologic correlation is essential. Underestimation rates after MRI-guided breast biopsy are superior to those for vacuum-assisted stereotactic biopsy and ultrasound-guided biopsy. Close follow-up and rebiopsy should be considered when there is imaging-discordant histology. For benign and concordant histology, a first follow-up can be offered at 6 months.

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Lung transplantation (LT) is an established procedure for chronic end-stage lung diseases. Complications are frequent and diverse and are the consequence of the complex surgical technique, the severity of the initial pathology, and the deep state of posttransplantation immunosuppression. Complications following LT include primary graft dysfunction, rejection (hyperacute, acute, and chronic), infections, posttransplantation lymphoproliferative disease, pleural and airway complications, native lung complications, and recurrence of primary disease. An understanding of these complications, their temporal evolution, and the role of radiology and other diagnostic methods in their diagnosis and management will help reduce the morbidity and mortality associated with LT.

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The Seventh Review Conference of the Biological Weapons Convention in December 2011 provides an opportunity to modernize the treaty to better address the challenges of the 21st century. The key to this modernization is to redesign the treaty's Confidence-Building Measures (CBMs), the only formal mechanism for increasing transparency and demonstrating compliance with the treaty, to address changes in the global scientific, health, and security environments since the end of the Cold War. The scope of the CBMs should be expanded beyond state-run biological warfare programs to encompass a broader array of threats to global security, such as biological terrorism, laboratory accidents, dual-use research, and disease pandemics. Modernizing the CBM mechanism to take into account these new risks would extend the transparency-enhancing benefits of CBMs to a range of new and important topics, such as biosafety, laboratory biosecurity, and dual-use research oversight; make the CBMs and the treaty itself more relevant to the concerns and priorities of more states; and build on progress made during the recent series of intersessional meetings. To accomplish this, the CBMs need to be revised to shift their focus from hardware, the dual-use capabilities relevant to the treaty, to software, the political and legal institutions that govern the development and use of these capabilities. A more modern CBM mechanism should encourage greater participation in the confidence-building process, improve international cooperation against the full spectrum of biological risks, and promote the goal of universal membership in the treaty.

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BACKGROUND: Hepatitis B virus (HBV) infection can be detected in blood donations by many serologic markers. Since the introduction of routine anti-hepatitis B core antigen (HBc) donor screening at Héma-Québec in April 2003, a large number of donors have been deferred on the basis of reactive anti-HBc test results. The objective of this study was to evaluate the correlation between the anti-HBc-reactive donations and the detection of HBV DNA with an in-house nucleic acid testing (NAT) assay. STUDY DESIGN AND METHODS: The in-house HBV NAT assay is a conventional polymerase chain reaction amplifying part of the viral S gene. From October 2004 to November 2005, a total of 1169 anti-HBc-reactive donations were tested with this in-house assay. The results were correlated with hepatitis B surface antigen (HBsAg) and anti-HBs markers. HBV DNA-positive samples were further investigated by DNA sequencing. RESULTS: All HBsAg-positive samples were detected by the NAT assay. Overall, 38 (3.25%) of anti-HBc-positive samples were found to be positive for the presence of HBV DNA. Of these 38, a total of 12 donations with a low level of HBV DNA were HBsAg-negative. The sequencing results clearly showed various genotypes and subtypes within a same genotype. CONCLUSION: The 3.25 percent HBV DNA positivity rate among the anti-HBc-reactive donations and more particularly the low level of HBV DNA observed in occult donations underline the importance of the use of a sensitive assay to detect HBV DNA in conjunction with other markers. The HBV genetic diversity found in our donor population reflects the province demographics, particularly in the Montreal area where most of the positive donors were from.

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BACKGROUND: Transfusion of blood products to immunoglobulin A (IgA)-deficient patients who have developed IgA antibodies can result in serious adverse reactions. To prepare compatible blood components for these patients, blood centers usually maintain a list of IgA-deficient blood donors. An in-house enzyme-linked immunosorbent assay (ELISA) was used to identify new IgA-deficient blood donors. STUDY DESIGN AND METHODS: An in-house ELISA was used to screen blood samples. IgA-deficient samples, defined as an IgA level below 0.05 mg per dL, were sent to the American Red Cross for confirmatory testing. RESULTS: Seventy-three confirmed IgA-deficient blood donors were identified among 38,759 screened blood donor samples (frequency, 1:531). IgA antibodies were found in 39 of these 73 blood donors (53%), although only 9 donors had a history of adult IgA exposure (transfusion or pregnancy). CONCLUSIONS: With a simple in-house ELISA, 73 blood donors were identified as IgA-deficient. From this number, 34 donors, without detectable anti-IgA in their plasma, were added to our IgA-deficient blood donor panel to maximize the management of our inventory of IgA-deficient frozen blood components.

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Enzyme-antibody (Ab) conjugates specific for IgG are widely used in indirect immunological assays and have been until recently routinely prepared with polyclonal IgG-specific animal Abs. The use of monoclonal Abs (MAbs) could permit a better standardization of the IgG-specific conjugate reagents but is expected to result in lower reactivity due to the recognition of a single epitope by the MAbs. In this work, we have characterized a monoclonal anti-human IgG-peroxidase (HRP) reagent and compared its reactivity with commercial reagents. The murine C5-1 anti-human IgG MAb was selected for conjugation because of its high affinity (K(a) = 1.9 x 10(10)M), pan-IgG reactivity and absence of cross-reactivity with various structures including animal IgGs. The specific activity and binding kinetics of the C5-1:HRP conjugate were similar to the ones of two polyclonal anti-IgG:HRP conjugates when tested with immobilized human IgG. The C5-1:HRP conjugate could detect low amounts of human IgG much more effectively than two commercial monoclonal conjugates although it was slightly less effective than a polyclonal conjugate. However, the C5-1 conjugate yielded reduced background reactivity compared to the polyclonal conjugate, resulting in similar signal-to-noise ratios. These results indicate that the C5-1:HRP conjugate could be a suitable substitute for anti-human IgG conjugates prepared from animal antisera.

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