Rationale for using insensitive quality control rules for today's hematology analyzers

Diverse approaches have been used to assure the analytical quality of automated hematology; as such, there is great variation in their error detection capabilities. We summarize the intralaboratory performance of a cohort of Sysmex XE-2100’s running e-Check hematology quality control (QC). The imprecisions of a median performing (50th percentile imprecision) and more imprecise [15th percentile (15P) imprecision] Sysmex XE-2100 are compared with measures of total allowable error (regulatory and physiologically based) to obtain multiples of the usual imprecision that must be detected to prevent the hematology analyzer from producing medically unacceptable results. The resultant large multiples of the usual imprecision (s) demonstrate the need for insensitive QC rules employing very broad control ranges, control rules that have been implicitly supported by hematology analyzer manufacturers for the last several decades. For today’s highly precise hematology analyzers, the following control rules are strongly advised: 13.5s, 14s and 14.5s rules (violated if a single control observation exceeds either its ±3.5, ±4.0 and ±4.5s limits, respectively). In order for the hematology laboratory to totally embrace expanded QC limits, manufacturers must make available their instruments’ usual and poorer (e.g. the 15P performance) imprecision’s. Users of hematology analyzers that require more sensitive but less specific rules to prevent the reporting of clinically erroneous data are advised to acquire more precise (and thus more dependable) instrumentation

Mapping the onshore/offshore crustal transition at the Westernmost Mediterranean from seismic profiling

Cembrowski, Marcel... et. al.-- European Geosciences Union General Assembly 2013, 7-12 April, Vienna, Austria.-- 1 pageThe evolution of theWesternMediterranean is strongly affected by the collision of the African and Eurasian plates. The plate boundary as seen from earthquakes is diffuse over a wide area extending north and south of Gibraltar strait. The Western end of the Mediterranean is delineated by the Gibraltar Arc System, comprising the arcuate Spanish Betic and Moroccan Rif Mountain Belts, together with the Alboran-Sea Basin in-between. The extension of the Alboran Basin which started from Late Eocene and which coexisted with the Africa -Europe conversion is still under debate and is one of the key points to constrain the evolution of the Western Mediterranean. This motivated our interest to map the still unknown crustal transition from the Betic-Rif chain into the Alboran Sea, taking advantage of the coincidence in time (October 2011) of two seismic experiments in the area, on land (Rifsis project) and at sea (Gassis-WestMed project). For this purpose we deployed several tens of seismic stations, both in Morocco and Spain, to record the air-gun shooting (every 50 m) of the Sarmiento de Gamboa Spanish vessel performing multichannel reflection profiles at the Alboran sea, and hence to extend these marine lines to wide-angle distances in-land. The airguns were calibrated for the near zero-offset marine reflection study and it turns out to be difficult to observe clear signals on the records in-land at offsets larger than about 70 km. The data has therefore been processed with a frequency-dependent lateral coherence filter to enhance coherent reflection/refraction signals through the frequency-dependent attenuation of incoherent noise and signals. This processing has permitted to track signals (seismic energy) up to more than 200 km on some profiles. Hence, a classical procedure of forward modeling (ray tracing approach) to fit the travel times of the identified wide-angle phases is now underway, taking advantage of the sedimentary/basement sequences inferred from the multichannel sections to constrain the upper part of the velocity-depth model. The first structural results delineate significant lateral variations in crustal depths, particularly at the Rif-Alboran transition. In our presentation we will show and discuss data processing examples which enabled signal detection to large offsets, the signal identification and their interpretation, and the different 2-D cross sections which image the crustal transition to the Alboran BasinPeer Reviewe

Pharmacy study of natural health product adverse reactions (SONAR): a cross-sectional study using active surveillance in community pharmacies to detect adverse events associated with natural health products and assess causality

OBJECTIVES: To investigate the rates and causality of adverse event(s) (AE) associated with natural health product (NHP) use, prescription drug use and concurrent NHP-drug use through active surveillance in community pharmacies. DESIGN: Cross-sectional study of screened patients. SETTING: 10 community pharmacies across Alberta and British Columbia, Canada from 14 January to 30 July 2011. PARTICIPANTS: The participating pharmacy staff screened consecutive patients, or agents of patients, who were dropping or picking up prescription medications.PRIMARY OUTCOME MEASURES: Patients were screened to determine the proportions of them using prescription drugs and/or NHPs, as well as their respective AE rates. All AEs reported by the screened patients who took a NHP, consented to, and were available for, a detailed telephone interview (14%) were adjudicated fully to assess for causality.RESULTS: Over a total of 105 pharmacy weeks and 1118 patients screened, 410 patients reported taking prescription drugs only (36.7%; 95% CI 33.9% to 39.5%), 37 reported taking NHPs only (3.3%; 95% CI 2.4% to 4.5%) and 657 reported taking prescription drugs and NHPs concurrently (58.8%; 95% CI 55.9% to 61.6%). In total, 54 patients reported an AE, representing 1.2% (95% CI 0.51% to 2.9%), 2.7% (95% CI 0.4% to 16.9%) and 7.3% (95% CI 5.6% to 9.6%) of each population, respectively. Compared with patients who reported using prescription drugs, the patients who reported using prescription drugs and NHPs concurrently were 6.4 times more likely to experience an AE (OR; 95% CI 2.52 to 16.17; p<0.001). Combined with data from Ontario, Canada, a national proportion was calculated, which found that 45.4% (95% CI 43.8% to 47.0%) of Canadians who visit community pharmacies take NHPs and prescription drugs concurrently, and of those, 7.4% (95% CI 6.3% to 8.8%) report an AE.CONCLUSIONS: A substantial proportion of community pharmacy patients use prescription drugs and NHPs concurrently; these patients are at a greater risk of experiencing an AE. Active surveillance provides a means of detecting such AEs and collecting high-quality data on which causality assessment can be based

Mantle flow and deep electrical anisotropy in a main gateway: MT study in Tierra del Fuego

Asthenospheric mantle flow drives lithospheric plate motion and constitutes a relevant feature of Earth gateways. It most likely influences the spatial pattern of seismic velocity and deep electrical anisotropies. The Drake Passage is a main gateway in the global pattern of mantle flow. The separation of the South American and Antarctic plates since the Oligocene produced this oceanic and mantle gateway connecting the Pacific and Atlantic oceans. Here we analyze the deep crustal and upper mantle electrical anisotropy of its northern margin using long period magnetotelluric data from Tierra del Fuego (Argentina). The influence of the surrounding oceans was taken into account to constrain the mantle electrical conductivity features. 3D electrical models were calculated to fit 18 sites responses in this area. The phase tensor pattern for the longest periods reveals the existence of a well-defined NW-SE electrical conductivity anisotropy in the upper mantle. This anisotropy would result from the mantle flow related to the 30 to 6 Ma West Scotia spreading, constricted by the subducted slab orientation of the Pacific plate, rather than the later eastward mantle flow across the Drake Passage. Deep electrical anisotropy proves to be a key tool for a better understanding of mantle flow.This work was supported through projects CTM2014-60451-C2-02/01 and CTM2017-89711-C2-2/1-P from Ministry of Science, Innovation and Universities of Spain and the RNM-148 from Junta de Andalucía (Spain)

Study of Natural Health Product Adverse Reactions (SONAR): Active Surveillance of Adverse Events Following Concurrent Natural Health product and Prescription Drug Use in Community Pharmacies

Background: Many consumers use natural health products (NHPs) concurrently with prescription medications. As NHP-related harms are under-reported through passive surveillance, the safety of concurrent NHP-drug use remains unknown. To conduct active surveillance in participating community pharmacies to identify adverse events related to concurrent NHP-prescription drug use. Methodology/Principal Findings: Participating pharmacists asked individuals collecting prescription medications about (i) concurrent NHP/drug use in the previous three months and (ii) experiences of adverse events. If an adverse event was identified and if the patient provided written consent, a research pharmacist conducted a guided telephone interview to gather additional information after obtaining additional verbal consent and documenting so within the interview form. Over a total of 112 pharmacy weeks, 2615 patients were screened, of which 1037 (39.7%; 95% CI: 37.8% to 41.5%) reported concurrent NHP and prescription medication use. A total of 77 patients reported a possible AE (2.94%; 95% CI: 2.4% to 3.7%), which represents 7.4% of those using NHPs and prescription medications concurrently (95%CI: 6.0% to 9.2%). Of 15 patients available for an interview, 4 (26.7%: 95% CI: 4.3% to 49.0%) reported an AE that was determined to be “probably” due to NHP use. Conclusions/Significance: Active surveillance markedly improves identification and reporting of adverse events associated with concurrent NHP-drug use. Although not without challenges, active surveillance is feasible and can generate adverse event data of sufficient quality to allow for meaningful adjudication to assess potential harms

Uncovering memory-related gene expression in contextual fear conditioning using ribosome profiling

Contextual fear conditioning (CFC) in rodents is the most widely used behavioural paradigm in neuroscience research to elucidate the neurobiological mechanisms underlying learning and memory. It is based on the pairing of an aversive unconditioned stimulus (US; e.g. mild footshock) with a neutral conditioned stimulus (CS; e.g. context of the test chamber) in order to acquire associative long-term memory (LTM), which persists for days and even months. Using genome-wide analysis, several studies have generated lists of genes modulated in response to CFC in an attempt to identify the "memory genes", which orchestrate memory formation. Yet, most studies use naïve animals as a baseline for assessing gene-expression changes, while only few studies have examined the effect of the US alone, without pairing to context, using genome-wide analysis of gene-expression. Herein, using the ribosome profiling methodology, we show that in male mice an immediate shock, which does not lead to LTM formation, elicits pervasive translational and transcriptional changes in the expression of Immediate Early Genes (IEGs) in dorsal hippocampus (such as Fos and Arc), a fact which has been disregarded by the majority of CFC studies. By removing the effect of the immediate shock, we identify and validate a new set of genes, which are translationally and transcriptionally responsive to the association of context-to-footshock in CFC, and thus constitute salient "memory genes"

Latent Print Proficiency Testing: An Examination of Test Respondents, Test‐Taking Procedures, and Test Characteristics

Proficiency testing is a key component of quality assurance programs within crime laboratories and can help improve laboratory practices. However, current proficiency testing procedures contain significant limitations and can be misinterpreted by examiners and court personnel (Garrett & Mitchell, 2018). To evaluate some of these limitations, we surveyed latent print examiners (n = 198) after they completed a Collaborative Testing Services, Inc. proficiency test. Additionally, we evaluated test performance and used a quality metric algorithm to evaluate the quality of test prints. Results do not suggest that respondents are dissimilar to the broader examiner population, although they may engage in different behaviors when completing tests versus casework. Findings show that proficiency testing contains prints of high quality and is perceived as both relatively easy and representative of casework. The test discriminated between inexperienced and experienced respondents, and verification procedures were largely ineffective in reducing errors. Objective quality metrics may provide a path forward to improving proficiency testing in a measurable manner

Ant-Pollinator Conflict Results in Pollinator Deterrence but no Nectar Trade-Offs

Direct and indirect negative interactions between ant guards and pollinators on ant-plants are expected for two reasons. First, aggressive ants may deter pollinators directly. Second, pollinators benefit from plant investment in reproduction whilst ants benefit from plant investment in indirect defense, and resource allocation trade-offs between these functions could lead to indirect conflict. We explored the potential for ant-pollinator conflict in a Mexican myrmecophile, Turnera velutina, which rewards ants with extrafloral nectar and pollinators with floral nectar. We characterized the daily timing of ant and pollinator activity on the plant and used experiments to test for direct and indirect conflict between these two groups of mutualists. We tested for direct conflict by quantifying pollinator responses to flowers containing dead specimens of aggressive ant species, relative to unoccupied control flowers. We assessed indirect conflict by testing for the existence of a trade-off in sugar allocation between ant and pollinator rewards, evidenced by an increase in floral nectar secretion when extrafloral nectar secretion was prevented. Secretion of floral and extrafloral nectar, activity of ants and pollinators, and pollen deposition all overlapped in daily time and peaked within the first 2 h after flowers opened. We found evidence of direct conflict, in that presence of ants inside the flowers altered pollinator behavior and reduced visit duration, although visit frequency was unchanged. We found no evidence for indirect conflict, with no significant difference in the volume or sugar content of floral nectar between control plants and those in which extrafloral nectar secretion was prevented. The presence of ants in flowers alters pollinator behavior in ways that are likely to affect pollination dynamics, though there is no apparent trade-off between plant investment in nectar rewards for pollinators and ant guards. Further studies are required to quantify the effect of the natural abundance of ants in flowers on pollinator behavior, and any associated impacts on plant reproductive success