2021 Update of the International Council for Standardization in Haematology Recommendations for Laboratory Measurement of Direct Oral Anticoagulants

International audienceIn 2018, the International Council for Standardization in Haematology (ICSH) published a consensus document providing guidance for laboratories on measuring direct oral anticoagulants (DOACs). Since that publication, several significant changes related to DOACs have occurred, including the approval of a new DOAC by the Food and Drug Administration, betrixaban, and a specific DOAC reversal agent intended for use when the reversal of anticoagulation with apixaban or rivaroxaban is needed due to life-threatening or uncontrolled bleeding, andexanet alfa. In addition, this ICSH Working Party recognized areas where additional information was warranted, including patient population considerations and updates in point-of-care testing. The information in this manuscript supplements our previous ICSH DOAC laboratory guidance document. The recommendations provided are based on (1) information from peer-reviewed publications about laboratory measurement of DOACs, (2) contributing author's personal experience/expert opinion and (3) good laboratory practice

A new anionic, hydrolysis-resistant polymerizable surfactant: synthesis and polymerization

The synthesis and some surfactant properties of a new type of sulfonated anionic monomer which is useful for free-radical polymerization are described. The monomer is based on the isobutenyl moiety as a reactive group. Higher homologues behave as polymerizable surfactants ("surfmers"). Copolymerization with a number of standard monomers is possible, as well as homopolymerization under micellar conditions

Synthesis and investigation of new amphiphilic poly(carbobetaine)s made from diallylammonium monomers

A series of new hydrolytically stable poly(carbobetaine)s was synthesised varying the length and the position of the hydrophobic side chains, together with their cationic analogues. The synthetic strategy avoids the presence of residual salt in the polybetaines, thus making them well suited for model studies. The betaine monomers as well as their cationic analogues bearing the equivalent of an undecyl chain exhibit surfactant properties ("surfmers"). The corresponding polymers, however, which are formed by cyclopolymerisation, are insoluble in water, though hygroscopic. In contrast, the hydrophobic chains favour the solubility in alcohols and allow the formation of superstructures in bulk. The poly(carbobetaine)s form homogeneous blends with selected inorganic salts, to provide organic-inorganic hybrid materials. (C) 2001 Elsevier Science Ltd. All rights reserved

New poly(carbobetaine)s made from zwitterionic diallylammonium monomers

A series of new hydrolytically stable poly(carbobetaine)s with varying distance between the ammonium and the carboxylate group was synthesized, excluding the presence of residual salt in the polymers, together with cationic and sulfobetaine analogues. The poly(carbobetaine)s show improved solubility compared to analogous poly(sulfobetaine)s, and are more hygroscopic. Their thermal stability depends strongly on the length of the spacer group separating the ammonium and the carboxylate group. The poly(carbobetaine)s are typically amorphous, but for long spacer groups, they exhibit a superstructure. They are capable of forming homogeneous blends with a number of inorganic salts, following the selectivity of the Hofmeister series, thus giving access to new organic-inorganic hybrid materials

Human Factors Issues of Tcas: a Simulation-Based Study

Since its introduction in the 90’s, TCAS II, presented as a straightforward and very reliable technological tool, has significantly reduced the risk of collision. Paradoxically, the introduction of this system has been accompanied with numerous incidents and one major accident in 2002, mainly due to unclear rules, poor air-ground cooperation and poor human decision. In order to investigate these potential human factors issues, a part-task air-ground simulation was conducted: 10 pilots and 10 controllers were involved in the simulations of 4 scenarios containing TCAS occurrences. Data collected included video camera recordings for behavioral analysis, Heart Rate (HR) for stress evaluation, questionnaires and debriefings for perceived risk levels and situational awareness assessment. The observations and errors were analyzed through the CREAM methodology. The debriefings were led through a self-confrontation technique, together with pilots and controllers. Results show that the simulations of TCAS situations were able to produce a significant physiological stress response with significant increase of HR when a resolution happens. Questionnaires and debriefings show that, in most of the observed cases, aircrew, and controllers are not sharing the same mental picture of the involved traffic and the risk of collision. This raises important issues in terms of cooperation between controllers and aircrews in such demanding occurrences. This should allow identifying risky situations and the related generic causes. The results will be discussed, aiming at a potential improvement of the system, in terms of Human Machine Interface, training and consistency of procedures

Synthesis and free radical copolymerisation of new zwitterionic monomers: amphiphilic carbobetaines based on isobutylene

Several new, hydrolytically stable ammonioacetate and pyridiniocarboxylate monomers were synthesised varying the length of hydrophobic side chains and the nature of the zwitterionic moiety. The synthetic strategy chosen avoids the presence of residual salt in the betaines, thus making them well suited for model studies. The monomers bearing long alkyl spacers between the polymerisable group and the zwitterionic moiety exhibit surfactant properties ("surfmers"). The monomers do not undergo free radical homopolymerisation, but are suited for copolymerisation with a number of different monomers. Copolymers of monomers with long alkyl spacers tend to form superstructures in bulk. (C) 2001 Elsevier Science Ltd. All rights reserved