Assessment of Immature Platelet Fraction in the Diagnosis of Wiskott-Aldrich Syndrome.

Children with Wiskott-Aldrich syndrome (WAS) are often first diagnosed with immune thrombocytopenia (ITP), potentially leading to both inappropriate treatment and the delay of life-saving definitive therapy. WAS is traditionally differentiated from ITP based on the small size of WAS platelets. In practice, microthrombocytopenia is often not present or not appreciated in children with WAS. To develop an alternative method of differentiating WAS from ITP, we retrospectively reviewed all complete blood counts and measurements of immature platelet fraction (IPF) in 18 subjects with WAS and 38 subjects with a diagnosis of ITP treated at our hospital. Examination of peripheral blood smears revealed a wide range of platelet sizes in subjects with WAS. Mean platelet volume (MPV) was not reported in 26% of subjects, and subjects in whom MPV was not reported had lower platelet counts than did subjects in whom MPV was reported. Subjects with WAS had a lower IPF than would be expected for their level of thrombocytopenia, and the IPF in subjects with WAS was significantly lower than in subjects with a diagnosis of ITP. Using logistic regression, we developed and validated a rule based on platelet count and IPF that was more sensitive for the diagnosis of WAS than was the MPV, and was applicable regardless of the level of platelets or the availability of the MPV. Our observations demonstrate that MPV is often not available in severely thrombocytopenic subjects, which may hinder the diagnosis of WAS. In addition, subjects with WAS have a low IPF, which is consistent with the notion that a platelet production defect contributes to the thrombocytopenia of WAS. Knowledge of this detail of WAS pathophysiology allows to differentiate WAS from ITP with increased sensitivity, thereby allowing a physician to spare children with WAS from inappropriate treatment, and make definitive therapy available in a timely manner

Neighbourhood Reading Clubs: Rekindling Reading Interest among Nigerian Children

A common comment on the state of reading in Nigeria today is that we have a poor reading culture. Yet up to the early 70s’ school children had a healthy respect for reading because there was supportive environment for such activities through the school system, township/mobile libraries, British Council and United States Information Service (USIS) libraries, etc. To rekindle this interest would require not only the provision of reading materials but also democratising access, quality in time and space, environment considerations and technical expertise by teachers and enthusiasts. Above all, any intervention must be unobtrusive, yet must captivate the children especially given the ICT revolution which revolves round audio-visuals. One avenue for achieving this is the neighbourhood reading club. In this paper we present a report of a volunteer reading club situated within the University of Calabar for children of the neighbourhood. Insights into reading interests, impact of the club on the children’s emotional, educational and psychological development are explored with very surprising results and outcomes. Keywords: Neighbourhood reading clubs, reading culture, mobile libraries, reading materials democratizing access, volunteer reading club, reading interest, educational and psychological development

Multiscale Partition of Unity

We introduce a new Partition of Unity Method for the numerical homogenization of elliptic partial differential equations with arbitrarily rough coefficients. We do not restrict to a particular ansatz space or the existence of a finite element mesh. The method modifies a given partition of unity such that optimal convergence is achieved independent of oscillation or discontinuities of the diffusion coefficient. The modification is based on an orthogonal decomposition of the solution space while preserving the partition of unity property. This precomputation involves the solution of independent problems on local subdomains of selectable size. We deduce quantitative error estimates for the method that account for the chosen amount of localization. Numerical experiments illustrate the high approximation properties even for 'cheap' parameter choices.Comment: Proceedings for Seventh International Workshop on Meshfree Methods for Partial Differential Equations, 18 pages, 3 figure

Coherent excitation of a nonlinear microcavity

Coherent excitation of a nonlinear semiconductor microcavity is theoretically reported. It intends to counterbalance the frequency drift ofthe cavity resonance driven by the nonlinear refractive effects, which causes a limitation in the energy coupling efficiency of an input pulseinto the cavity resonance. We show that exciting such a nonlinear microcavity with tailored chirped pulses allows to maintain the benefit oflight localization and to further enhance light-matter interactions, opening the way to the realization of highly efficient nonlinear devices

Classification Criteria for Multiple Sclerosis-Associated Intermediate Uveitis

PURPOSE: The purpose of this study was to determine classification criteria for multiple sclerosis-associated intermediate uveitis. DESIGN: Machine learning of cases with multiple sclerosis-associated intermediate uveitis and 4 other intermediate uveitides. METHODS: Cases of intermediate uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used in the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the intermediate uveitides. The resulting criteria were evaluated in the validation set. RESULTS: A total of 589 cases of intermediate uveitides, including 112 cases of multiple sclerosis-associated intermediate uveitis, were evaluated by machine learning. The overall accuracy for intermediate uveitides was 99.8% in the training set and 99.3% in the validation set (95% confidence interval: 96.1-99.9). Key criteria for multiple sclerosis-associated intermediate uveitis included unilateral or bilateral intermediate uveitis and multiple sclerosis diagnosed by the McDonald criteria. Key exclusions included syphilis and sarcoidosis. The misclassification rates for multiple sclerosis-associated intermediate uveitis were 0 % in the training set and 0% in the validation set. CONCLUSIONS: The criteria for multiple sclerosis-associated intermediate uveitis had a low misclassification rate and appeared to perform sufficiently well enough for use in clinical and translational research