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Introduction: In Dar es Salaam, Tanzania, death from road traffic crashes (RTC) occurs at roughly double the global rate. In this study, we sought to understand the locations and types of vehicles involved in RTC in Dar es Salaam encountered by a cohort of motorcycle taxi drivers previously trained in first aid. Methods: This was a quasi-non-randomized interventional study, cohort subtype, with three-month follow-up. Some 186 motorcycle taxi drivers were selected by convenience sampling from 16 heavily populated, central wards and trained in a basic hemorrhage control course. Participants reported the location and types of vehicles involved in RTCs they encountered and intervened upon through performing bleeding control interventions. Surveys were designed on KoboToolbox and administered via phone call at monthly intervals over a three-month period. The main outcome measures were the location of crash encounters and types of vehicles involved. Results: In all 62 unique participants (33.3 %) encountered and provided bleeding control interventions to 83 injured individuals following 69 RTC in at least 31 distinct city wards, despite training only having occurred in 16 wards. Eight crash locations were not recorded. Crashes in distant wards typically contained major roads. Most commonly, crashes involved a motorcycle without the involvement of another vehicle (n=20), followed by motorcycle vs. car/three-wheeled vehicle (n=15), motorcycle vs. bus/van (n=10), motorcycle vs. motorcycle (n=9), motorcycle vs. pedestrian (n=7), pedestrian vs. bus/van (n=2), pedestrian vs. car/three-wheeled vehicle (n=1), motorcycle vs. bicycle (n=1), multi vehicle (n=1), and other (n=3). Conclusions: Motorcycle taxi drivers trained in hemorrhage control frequently encounter and intervene upon RTC in wards where they are based as well as in distant locations, commonly in wards containing major roads. Expanding first aid training for motorcycle taxi drivers could improve timely access to emergency care for RTC victims. Since most crashes involved motorcycles, road safety training should be integrated into future courses.

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For several decades, US government agencies have partially supported regional networks of Hemophilia Treatment Centers (HTC). HTC multidisciplinary teams provide comprehensive and coordinated diagnosis, treatment, prevention, education, outreach and surveillance services to improve the health of people with genetic bleeding disorders. However, national data are scarce on HTC-patient population trends and services. The aim of the study was to examine national trends over the past 20 years in patient diagnoses, demographics and health services utilization among the Health Resources and Services Administration (HRSA) and Centers for Disease Control and Prevention (CDC)-supported HTC network. Diagnoses, demographics and health services utilization data from 1990 to 2010 were aggregated from all HTCs using the Hemophilia Data Set (HDS). From 1990 to 2010, the HTC population grew 90% from 17 177 to 32 612. HTC patients with von Willebrand's disease increased by 148%, females by 346%, Hispanic patients by 236% and African Americans by 104%. Four thousand and seventy-five deaths were reported. From 2002 to 2010, annual comprehensive evaluations grew 38%, and persons with severe haemophilia on a home intravenous therapy programme rose 37%. In 2010, 46% of patients were less than 18 years vs. 24% for the general US population. The Hemophilia Data Set documents the growth and diversity of the US Hemophilia Treatment Center Network's patient population and services. Despite disproportionate deaths due to HIV, the HTC patient base grew faster than the general US population. The HDS is a vital national public health registry for this rare-disorder population.

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This study examined the reproductive performance of rhesus macaques maintained in two different housing conditions: high-density semi-sheltered gang cages and low-density outdoor corrals. Two hundred sixteen subjects were housed in 49 gang cages, each of which contained one breeding male and between one and eight breeding females. Two hundred seven subjects were housed in 13 corrals, each of which contained between two and four breeding males and between 9 and 26 breeding females. Over a 3-year period, pregnancy, live birth, and production rates were significantly greater for females in corrals than for females in gang cages. Fetal death rate was lower in corrals than in gang cages, while neonatal death rates did not differ between housing conditions. These differences did not result from potential confounds such as differential age structures or virological statuses between housing conditions. We conclude that, for rhesus macaques, outdoor corral housing leads to better reproductive performance than does semi-sheltered gang housing, probably as a result of increased individual space and relaxation of intense social stressors.

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In the present report, we examined the effects of group formation strategy and corral design on wounding and reproduction rates in rhesus macaques. Specifically, we examined group formation using a staged strategy, in which small groups of animals were introduced incrementally over a period of weeks, and a rapid formation strategy, in which all animals were introduced in 1 day. We also examined group formation using a divided corral design that facilitated visual and social separation of individuals, and an undivided corral design that did not facilitate visual or social separation. Dependent measures were wounding and reproductive rates over each of the 2 years that followed group formation. Results indicate that incrementally releasing subgroups of animals, and using a corral design that provides for visual and social separation of individuals, are effective strategies for reducing rates of traumatic wounding when forming multimale-multifemale rhesus macaque breeding groups. However, it must be noted that differences in formation strategy and corral design did not lead to higher reproductive rates. We conclude that incrementally releasing animals in hierarchical subgroups, and using a divided vs. undivided housing design, reduced intra-group wounding and associated demands on veterinary and animal management resources following formation of rhesus macaque breeding groups.

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The presence of human immunodeficiency virus (HIV) antibody in hemophilia patients was correlated with the loss of existing antibody to hepatitis B surface antigen (HBsAb) or the inability to develop an antibody to hepatitis B after receiving commercially available hepatitis B vaccine. Of the 137 patients studied 66 were HIV-positive and 71 were HIV-negative. Evidence of HBsAb (n = 44) or exposure to hepatitis vaccine (n = 12) was found in 85% of HIV positive patients at some time during their care in our clinic. However, 20% demonstrated subsequent antibody loss and/or did not respond to hepatitis vaccine. Loss of HBsAb or vaccine nonresponse was restricted to patients less than 21 years of age (72% of all patients). This result contrasted to only a 3% loss of HBsAb or vaccine nonresponse in the HIV-negative patients who had acquired the HBsAb (n = 23) or were given the hepatitis vaccine (n = 29). This result suggests that loss or alterations of hepatitis B immunity occur in association with HIV infection or exposure.

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