Full Screen Research Articles

A pilot study evaluating the effectiveness of preventing railway suicides by mid-track fencing, which restrict easy access to high-speed train tracks

Background: Suicides in the railway system is a serious health, societal, and transportation concern. Restriction of the access to suicide methods in the form of different physical barriers is a promising approach for suicide prevention. Method: Mid-track fencing, which is fencing placed in-between the high-speed and commuter train tracks, was installed at one out of seven stations along a train line outside of Stockholm in the years 2013/2014. The number of suicides at the intervention station was compared to six other stations used as controls, over a total period of 20 years (2002–2021). Results: Suicides at high-speed tracks occurring at stations was the major cause of death on the investigated railway line. Prior to the year 2014, the intervention and control stations displayed similar time trends in the number of suicides. After installation of the mid-track fencing in 2014, there was a 62.5% reduction in the rate of suicides occurring at the intervention station. Compared to the six other control stations, the intervention station displayed a significant reduction in the number of suicides during the years 2014–2021 (OR = 0.14, 95%CI 0.013–0.95). Suicides at the railway lines in-between stations were not increased post-intervention. However, nearby control stations showed a 162% increase in suicides after the intervention, suggesting the induction of transfer effects. Conclusion: Mid-track fences restricting access to high-speed train tracks may have a large effect on reducing the number of railway suicides at intervention stations, but may also induce an increase in suicides at nearby stations without mid-track fences. Practical applications: Partial physical barriers such as mid-track fencing is deemed to be relatively easy and cheap to install (as compared to full barriers; e.g., full height platform screen doors) and should be considered at all stations on railway lines that have high-speed trains passing by.

Less is more: repellent-treated fabric strips as a substitute for full screening of open eave gaps for indoor and outdoor protection from malaria mosquito bites

BackgroundProviding protection from malaria vector bites, both indoors and outdoors, is crucial to curbing malaria parasite transmission. Screening of house entry points, especially with incorporated insecticides, confers significant protection but remains a costly and labour-intensive application. Use of spatial repellents has shown promise in creating areas of protection in peri-domestic areas.MethodsThis study aimed at comparing the protection provided by transfluthrin-treated and untreated complete screens over open eave gaps with incomplete transfluthrin-treated eave strips as a potential replacement for a full screen. Human landing catches were implemented independently inside and outside an experimental hut under controlled semi-field conditions, with insectary-reared Anopheles arabiensis mosquitoes.ResultsThe odds of a female mosquito finding a human volunteer indoors and attempting to bite were similar whether the eaves were completely open or there was an untreated fabric strip fixed around the eaves. However, when the eave gap was completely screened without insecticide, the odds of receiving a bite indoors were reduced by 70% (OR 0.30, 95% CI 0.20–0.47). Adding transfluthrin to the full screen, further increased the protection indoors, with the odds of receiving a bite reduced by 92% (0.08, 95% CI 0.04–0.16) compared to the untreated screen. Importantly, the same protection was conferred when only a narrow transfluthrin-treated fabric strip was loosely fixed around the eave gap (OR 0.07, 95% CI 0.04–0.13). The impact of the transfluthrin treatment on outdoor biting was correlated with evening temperatures during the experiments. At lower evening temperatures, a transfluthrin-treated, complete screen provided moderate and variable protection from bites (OR 0.62, 95% CI 0.37–1.03), whilst at higher evening temperatures the odds of receiving a bite outdoors was over four times lower in the presence of transfluthrin, on either a full screen (OR 0.22 95% 0.12–0.38) or a fabric strip (OR 0.25, 95% 0.15–0.42), than when no treatment was present.ConclusionThe findings suggest that transfluthrin-treated fabric strips can provide a substitute for complete eave screens. They are a simple, easy-to-handle tool for protecting people from malaria mosquito bites indoors and potentially around the house in climatic areas where evening and night-time temperatures are relatively high.

Synthesis of biotinylated-LPG as a chemical biology tool enabling discovery of ALCAT1 modulators

As a mitochondrial signature phospholipid, cardiolipin (CL) is required for membrane structure, respiration, dynamics, fragmentation, and mitophagy. Alteration of CL by reactive oxygen species (ROS) can cause mitochondrial dysfunction, which is implicated in the pathogenesis of many diseases. The enzyme ALCAT1 (acyl-CoA: lysocardiolipin acyltransferase-1) facilitates the conversion of CL by incorporating polyunsaturated fatty acids into lysocardiolipin. Accumulating evidence suggests that overexpression of ALCAT1 is involved in pathological cardiolipin remodeling and mitochondrial bioenergetics. Few ALCAT1 modulators are reported in the literature, and the enzymatic activity was tested via a low-throughput TLC (thin layer chromatography) assay. To identify small molecule ALCAT1 inhibitors, a robust assay was needed to enable a full deck high throughput screen. Scintillation proximity assay (SPA) was the method of choice because it permits the rapid and sensitive measurement of a broad range of biological processes in a homogeneous system. A biotinylated ALCAT1 substrate was required as a chemical biology tool in developing SPA. Among a panel of phospholipids, lysophosphatidyl glycerol (LPG) was identified as the best substrate for ALCAT1. Herein we report the synthesis of biotinylated-LPG analogs with varied linker lengths and their activity towards ALCAT1.

15‐1: Novel Multi‐Frequency Driving of OLED for Low Power Consumption

In a recent, OLED display has been required to larger and higher resolution by the years. So, display image quality and power consumption are getting important. It is necessary to reduce power consumption to increase battery usage time. Low frequency driving is the significant factor for long‐term use. We can operate low frequency driving using oxide TFT with small leakage current. However, the low frequency driving operates when the entire screen is a still image. To improve power consumption, we propose Multi‐Frequency Driving (MFD) technology. MFD is a technology that divides moving and still image areas in full screen display and drives them at different frame frequency. In this paper, we suggest what MFD technology is and how to implement the OLED driving system. And then we show how much it can improve power consumption for OLED.

12‐2: High Accuracy In‐Cell Integrated Ambient Light and Color Temperature Sensor LCD

In this paper, we present a novel integrated light‐dependent sensor which can be used to detect the illuminance and color temperature of the ambient light. Based on the low temperature polysilimn (LTPS) thin film transistor (TFT) process and photosensitivity qf PIN photodiode, the sensor can realize 0–100K lux of the monitor range and an accuracy of 0.5 lux/step. Meanwhile, it can identify the color temperature from 2000 K to 8000 K with an accuracy of ± 250 K. The LCD panel with this optical sensor could adjust brightness and color temperature adaptively according to the ambient light. It saves more space for terminal product which will also facilitates the full screen display.

Graphdiyne Electrochemistry: Progress and Perspectives.

Graphdiyne, a carbon allotrope, wassynthesized in 2010 for the first time. It consists of two acetylene bonds between adjacent benzene rings. Graphdiyne and its composites thus exhibit ultrahigh intrinsic electrochemical activities. As "star" electrode materials, they have been utilized for various electrochemical applications. With the aim of giving a full screen of graphdiyne electrochemistry, this review starts from the history of graphdiyne materials, followed by their structural and electrochemical features. Recent progress and achievements in the synthesis of graphdiyne materials and their composites are overviewed. Subsequently, various electrochemical applications of graphdiyne materials and their composites are summarized, covering those in the fields of electrochemical energy conversion, electrochemical energy storage, and electrochemical sensing. The perspectives of graphdiyne electrochemistry are also discussed and outlined.

Video Features, Engagement, and Patterns of Collective Attention Allocation

Network analytics has the potential to examine new behaviour patterns that are often hidden by the complexity of online interactions. One of the varied network analytics approaches and methods, the model of collective attention, takes an ecological system perspective to exploring the dynamic process of participation patterns in online and flexible learning environments. This study selected “Fundamentals of C++ programming (Spring 2019)” on XuetangX as an example through which to observe the allocation patterns of attention within MOOC videos, as well as how video features and engagement correlate with the accumulation, circulation, and dissipation pattern of collective attention. The results showed that the types of instructions in videos predicted attention allocation patterns, but they did not predict the engagement of video watching. Instead, the length and whether the full screen was used in the videos had a strong impact on engagement. Learners were more likely to reach a high level of engagement in video watching when their attention had been circulated around the videos. The results imply that understanding the patterns and dynamics of attention flow and how learners engage with videos will allow us to design cost-effective learning resources to prevent learners from becoming overloaded.

Comments: Staying Ahead of the Curve

JPT’s editorial and production staff wish you the best in 2022! We are planning our year’s content to continue to bring you the latest deep technical insights and industry updates with an eye toward all disciplines. Our industry’s technology, goals, and business priorities are continually adjusting and changing. Our goal is to stay ahead of the curve. The editors of JPT, Oil and Gas Facilities, HSE Now, Data Science and Digital Engineering, and TWA work together to ensure our content provides SPE members with forward-thinking concepts, technologies, and applications to help you also stay ahead of the curve. We have you to thank for many of the ideas and technical expertise you share with us despite your own busy schedules and other commitments. Your time, effort, and willingness to share information are much appreciated. This issue of JPT debuts our refreshed design. We’ve made the presentation of the content “cleaner” and “easier on the eyes” by increasing the spacing of letters and lines of text, using two columns instead of three, and presenting graphics and captions more attractively. While we realize technical content does not demand “being pretty,” we also appreciate in our own reading how the creative presentation of content can be inviting. We’ve also changed the digital edition to a more user-friendly flipbook. When you move your cursor to the bottom of each page, you’ll see a toolbar where you can elect to zoom in or out, download the issue as a PDF to read offline, search within the issue, click to display the Table of Contents and click to go to a selected article, and view in full screen mode. If you prefer to read JPT on the website each month, you’ll continue to be able to do so when you log in. And, if you haven’t yet done so, follow JPT on LinkedIn to get our articles in your LinkedIn feed. Our industry is starting the year with a rebound and outlooks of guarded optimism. Wood Mackenzie’s Fraser McKay, vice president, upstream research, wrote in mid-December, “At a Brent price of around US$70/bbl, oil and gas cash flows will be at near-record levels. At US$80/bbl, it would soar towards US$1 trillion … Despite this, for many stakeholders and even some chief executives, the sector’s risks outweigh its upsides. This tension will define 2022.” The positive outlook will be tempered by concerns about its future as pressure grows to respond to COP26 pledges. In other words, 2022 is likely to deliver a mix of ups and downs. If you are the type who makes New Year’s resolutions (and remains committed to them), you are on your way to making changes, be they large or small. For others (like myself), resolutions fade all too quickly. But for all of us, a new year brings with it the anticipation of what lies ahead, be it joy or sorrow. Staying ahead of our own unpredictable curves professionally and personally is impossible, but the result is generally and thankfully a mix of highs and lows. Here’s to much more joy than sorrow, many more highs than lows.

Coexisting Prolactin-Secreting Macroadenoma, Hypopituitarism and Type 1 Diabetes Mellitus in a Young Adult Male Patient

The association between type 1 diabetes mellitus (DM) and pituitary prolactinoma is rarely reported in the literature. Herein we present a 23-year-old male patient with co-existing type 1 DM, pituitary macro-prolactinoma and panhypopituitarism secondary to mass effect. The patient presented with generalised symptoms including fatigability, cold hands, decreased insulin requirement secondary to frequent hypoglycaemic episodes two weeks following the diagnosis of type 1 DM. Initial blood workup showed evidence of possible secondary hypothyroidism. The full pituitary profile screen showed profound anterior hypopituitarism with a prolactin level of 67,168 miu/L (normal range 86-324 miu/L). Pituitary MRI showed macroadenoma, 37mm in size, with a suprasellar cystic extension but no chiasmal compression. It was treated medically with cabergoline and a repeat pituitary MRI after eight weeks of initiating treatment showed a 4-mm reduction in the size of the adenoma, and prolactin level decreased to 6,794 miu/L. The case was discussed at the Neurosurgical MDT and the outcome was to continue to monitor while on cabergoline. This case report is the second in the literature, which documented the association between type 1 DM and pituitary prolactinoma in adolescents. These patients might not present with the classical clinical features of hyperprolactinemia, and instead, they present with frequent hypoglycaemia and decreased insulin requirement due to secondary adrenal insufficiency as a consequence of the mass effect of the prolactinoma. Furthermore, non-specific symptoms, such as generalised tiredness and fatiguability, despite reasonable blood sugar control, in young patients with type 1 DM should trigger screening for all anterior pituitary hormones to exclude hypopituitarism.

Design of Small Multiband Full-Screen Smartwatch Antenna for IoT Applications

Smartwatch is a potential candidate for the Internet of Things (IoT) hub. However, the performance of smartwatch antennas is severely restricted by the smartwatch structure, especially when the antennas are designed by traditional methods. For adapting smartwatches to the role of IoT hub, a novel method of designing multi-band smartwatch antenna is presented in this paper, aiming at increasing the number of frequency bands, omni-directivity, and structural suitability. Firstly, the fundamental structure (including the full screen and the system PCB) of the smartwatch is analyzed as a whole by characteristic mode analysis (CMA). Thus, abundant resources of characteristic modes are introduced. The fundamental structure is then modified as the radiator of a multi-band antenna. Then, a non-radiating capacitive coupling element (CCE) excites the desired four 0.5-wavelength modes from this structure. This method could fully utilize the intrinsic modes of the smartwatch structure itself, thus exhibits multiple advantages: significantly small size, smaller ground, omni-directional radiation, and fitting to the full-screen smartwatch structure.

Full Screen Optical Fingerprint for LCD Based on LTPS Technology

Full Screen Optical Fingerprint for LCD Based on LTPS Technology

Athena Speciality Certificate Examination case for male genital dermatology.

A 42-year-old uncircumcised male presents in clinic with a seven year history of progressive difficulty in retracting his foreskin, accompanied by soreness, itching and variable redness around the head of his penis (Figure 1). He mentions occasional splits in the skin at this site, and, on direct questioning, avoidance of sexual activity on account of pain. He had taken it upon himself to obtain a full sexual health screen which was reported as negative.

O30 Case report of Cogan syndrome in a child with audiovestibular dysfunction and ocular inflammation

Case report - IntroductionCogan syndrome is a very rare disorder of probable autoimmune vasculitic origin, first described in 1934. The age of onset seems to range from 3 to 50 years with an average age of disease onset at 29 years. It is characterised by audiovestibular dysfunction and ocular inflammation. The cause remains unknown and the epidemiology of the disease is purely based on case reporting. As of 2015, there were fewer than 250 case reports. Interestingly, it seems extremely rare in Arabic and Middle Eastern countries in which a new case has been recently diagnosed and is being reported in this abstract.Case report - Case descriptionA 14-year-old girl of Arabic origin first presented to the ENT specialist with a 3-week history of balance problems, left tinnitus and sensorineural hearing loss in both ears worse on the left. She first received treatment for vestibular neuritis with no improvement. Two months later, she complained of bilateral red eyes and excessive lacrimation when diffuse interstitial keratitis was diagnosed by the ophthalmologist. An array of blood tests including a full autoimmune disease was arranged and a rheumatology opinion was sought.The patient had a normal inflammatory response and her screen for antinuclear antibodies, extractable nuclear antigen, rheumatoid factor and antineutrophil cytoplasmic antibodies were all negative. A full virology screen was also negative. Having failed to respond to all supportive treatment modalities, a trial of a tapering 2-week course of prednisolone starting at 25mg daily was instigated. The patient’s symptoms improved by more than 50% on glucocorticoids subsequent to which the diagnosis of Cogan syndrome was anticipated. As the patient’s symptoms relapsed when glucocorticoids were stopped, she was recommenced on prednisolone 25mg in line with azathioprine 100mg daily. The patient’s hearing, which was almost lost in the left ear, improved significantly by more than 70% initially, and then to normal hearing as stated by the patient supported by special ENT testing. Her balance problems and vertigo also improved remarkably. Her tinnitus, which was the last symptom to resolve, almost went away over the subsequent 2 months. The patient had already come off glucocorticoids 6 months down the line, and stayed on azathioprine 75-100mg daily for almost a year after which gradual weaning was trialled and then eventually succeeded. She has now been off azathioprine for 6 months without experiencing any disease relapse.Case report - DiscussionCogan syndrome can be difficult to diagnose particularly in children. The diagnosis is essentially clinical depending on the presence of audio-vestibular symptoms and interstitial keratitis along with a prompt response to immunosuppressive medication.In this patient, the consistent clinical picture supported by the positive response to glucocorticoids especially in the absence of an alternative diagnosis would have made the diagnosis of Cogan syndrome likely.Given the rarity of this disorder, there are no classification criteria as yet hence the ongoing need for case reporting. Moreover, there is no clear guidance on the duration of immunosuppressive treatment of this condition.Case report - Key learning pointsIt is pivotal in managing conditions with a suspected autoimmune origin to have a multidisciplinary approach involving other relevant specialties in a holistic approach.The prompt response to glucocorticoid therapy still remains the key in securing the diagnosis of a number of conditions in clinical practice especially in the absence of diagnostic criteria and/ or supportive investigations such as serological and tissue-based testing.Case reporting has a crucial role in enhancing awareness of rare medical conditions.

P31 Cogan's syndrome—a neglected autoimmune vasculitis

P31 Cogan's syndrome—a neglected autoimmune vasculitis

MP10-04 SURGEON ASSESSMENT OF A NOVEL MULTI-RESOLUTION FOVEATED LAPAROSCOPE

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-04 SURGEON ASSESSMENT OF A NOVEL MULTI-RESOLUTION FOVEATED LAPAROSCOPE Mike Nguyen, Jamal Nhabani, Allan Hamilton, Sangyoon Lee, Jeremy Katz, and Hong Hua Mike NguyenMike Nguyen More articles by this author , Jamal NhabaniJamal Nhabani More articles by this author , Allan HamiltonAllan Hamilton More articles by this author , Sangyoon LeeSangyoon Lee More articles by this author , Jeremy KatzJeremy Katz More articles by this author , and Hong HuaHong Hua More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To improve safety in minimally invasive surgery, we developed a multi-resolution foveated laparoscope (MRFL) which can simultaneously obtain and display wide and zoomed in views in order to avoid surgical tunnel vision and improve situational awareness. We assessed surgeon objective task performance and subjective attitudes towards the MRFL for ex vivo box trainer tasks and in vivo porcine surgery. METHODS: The MRFL utilizes two sensors to simultaneously obtain a wide-angle view and obtain and pan a high-resolution magnified view. Options for displaying the two images including side by side view, full screen views, and 3 variations of overlaid images. A pedal changes views and controls retargeting of the zoomed view. 6 urologists and 2 general surgeons performed box trainer and porcine surgery tasks with both a standard laparoscope and the MRFL. Task time, use of display options, and subjective assessments were obtained. RESULTS: For box trainer tasks, task time was shorter for standard laparoscopy than MRFL for internal peg transfer tasks (28.5 vs 56.6 secs, p=0.0055) in one of two sessions but was not different for external peg transfer tasks (69.2 vs 77.2 secs, p=0.52 and 124.2 vs 127.5 secs, p=0.93). For porcine nephrectomy, laparoscopy surgical time was significantly shorter than MRFL (17.5 vs 33.3 min, p=0.049). For the simpler oophorectomy surgical task, time did not differ significantly. As a surgeon, participants were most likely to use side by side view (46.4%) followed by full screen overview or zoomed view (26.6%). Assistants predominately used the side-by-side view (80.1%). Subjectively, surgeons rated situational awareness, depth perception, and interference with other instruments as similar between the systems for the trainer session while the MRFL was rated as having less interference for the animal lab session (2 vs 6.3, p=0.0093). MRFL was rated as having lower image quality than laparoscopy in both the trainer (6.4 vs 8.4, p=0.012) and animal lab sessions (3.5 vs 9.2, p=0.0003). Participants rated having different MRFL views as being useful for different roles (8.1 out of a scale of 10) and being likely to use the MRFL for laparoscopic surgery (8.1) and robotic surgery (8.3). CONCLUSIONS: Ex vivo and in vivo surgeon assessments of the MRFL demonstrated its feasibility for performing complex surgery. Surgeons had favorable attitudes towards its functional features and expressed likelihood to use the device if it were available. Users utilized different view types based on different task needs. Poorer image quality of the prototype MRFL was associated with longer task times. Source of Funding: NIH RO1 EB18921 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e169-e170 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mike Nguyen More articles by this author Jamal Nhabani More articles by this author Allan Hamilton More articles by this author Sangyoon Lee More articles by this author Jeremy Katz More articles by this author Hong Hua More articles by this author Expand All Advertisement Loading ...

Video Abstracts

Purpose/Background: It is well recognised that patients following long course chemoradiotherapy can have a complete clinical response. This offers the possibility for organ preservation. However these patients require intense surveillance which commonly involves frequent MRI scans and flexible sigmoidoscopy. LumenEye is a state of the art endoscopic kit, which allows a convenient, comfortable and efficient way of visualising the ano-rectal area in OPD with high quality images avoiding the need for a formal endoscopic procedure. Methods/Interventions: The device includes (a) LumenEye X1 endoscope (b) Tablet display with full HD screen (c) Intuitive CHiP software and (d) Portable case with workstation. The kit displays full HD images and can capture videos. Results/Outcomes: We have used the LumenEye X1 endoscope to survey patients following a complete clinical response who have opted for organ preservation. It avoids the need for an endoscopy and detailed images and videos can be shared with specialist centres. This has been of particular benefit during the Covid 19 pandemic where there has been a limited endoscopy resource. The technology also has other applications such as the intraoperative assessment of left sided colonic anastomosis. Conclusion/Discussion: LumenEye X1 endoscope offers an alternative to the use of endoscopy in the surveillance of patients with a complete clinical response. It also has the potential to free up valuable endoscopy resources.

P‐7.1: Calculation of actual lens parameters based on specific pattern in a SMV display system

Cylindrical lens array (CLA) is often used in a SMV display system. The display effects is directly related to the parameters of the CLA. In some cases, it is difficult to measure the actual parameters of CLA because of the limitation of measurement condition. In this paper, an indirect method is proposed to calculate the actual parameters of the CLA, like thickness ,lens pitch, bounding angle, and radius, by testing the specific patterns displayed on the panel. The specific patterns are number array displayed full screen. The numbers of different views are different. The measurement efficiency is effectively improved by this method.

P‐4.4: Path Planning Analysis of Pad Bending Process for the Full Screen OLED Panel

In the pad‐bending process of the full‐screen panel, the metal wire in the bending area is easily broken due to deformation, and the occurrence of the break is related to the bending path. This paper analyzes the influence of different bending paths on the peak stress of the metal wire, determines the method to explore the reasonable path based on mathematical theory, and provides guidance for the pad‐bending process design, which can be used to improve the yield of pad‐bending process of OLED panels.

Referral for Thrombophilia Testing in an Obstetric Patient Population: A Tertiary Centre Experience

Introduction:Thrombophilias augment the risk of pregnancy related morbidity, increasing the likelihood of adverse events such as fetal loss [1,2]. Current guidelines recommend women be tested for antiphospholipid antibodies when they present with recurrent miscarriage (3 or more consecutive pregnancy losses before 24 weeks) or with a late miscarriage (loss between 12-24 weeks) [1]. Inherited thrombophilia testing (including factor V Leiden, prothrombin gene mutation and protein S) is also recommended for women with 2nd trimester miscarriage [1]. Controversy exists around the benefit of universal thrombophilia screening given the low relative increase in risk of pregnancy events and the lack of evidence surrounding interventions such as low molecular weight heparin (LMWH) and aspirin in most thrombophilias [2,3].Our aim was to evaluate our own testing for thrombophilia in pregnancy related events. We aimed to assess the frequency of positive results and evaluate whether testing resulted in a change in management for our cohort of women.Methods:Data was collected retrospectively on 151 thrombophilia screens requested for obstetric reasons from July 2016 to July 2017 at Waikato Hospital. The tests comprised antiphospholipid antibodies (APL) including lupus anticoagulant (LA), factor V Leiden (FVL), protein C and S levels, antithrombin III (ATIII) and prothrombin (PT) gene mutations. Data pertaining to request information, outcome of current and previous results were included. Cost analysis was done using NZ $300 (US $223) for a full thrombophilia screen and NZ $30 (US $22) for protein S alone. GraphPad Prism 7 software was used for all data interpretation.Results:The mean patient age was 31 years (range 18-48 years). The commonest reason for referral for testing was recurrent miscarriage (49/151) (Figure 1) and the majority of requests were from the obstetrics department (79/151) (Figure 2).83% (126/151) of tests requested were for a full thrombophilia screen; the remainder (25/151) were for single tests or a combination. The majority were being tested for the first time; 16.5% (25/151) had previous testing done. Of those with previous tests 52% (13/25) had no abnormality found; the others had low protein S levels or ATIII deficiency, or both.With the current test, almost two thirds of patients (62%, 94/151) had no abnormality found. Of the others, low protein S levels made up the majority of positive tests (26/57) (Figure 3). Of these 4/26 tests were repeated with 1 ongoing low result representing a likely true protein S deficiency. The laboratory cost of negative tests was estimated to be NZ $28,200 (US $20,992); while the cost of testing for protein S, including repeat testing due to low levels likely associated with pregnancy, was estimated at NZ $879 (US $648).Results that could potentially change management (APL antibodies, presence of VTE with positive inherited thrombophilia result) were few (6/151).Conclusion:In our tertiary centre, the majority of thrombophilia testing done for obstetric reasons over a 12 month period was negative. Most positive results (low protein S) were likely attributable to recent pregnancy, with a lack of repeat testing undertaken. There was a potential change in management for only 6 patients. Our results are in line with the literature which shows a scarcity of evidence supporting thrombophilia screens in pregnancy related morbidity. These tests are not only costly but for the majority provide no clinical benefit. Our next step is to disseminate these results locally and we aim to educate our colleagues on the utility of thrombophilia testing in pregnancy related events and when it is clinically helpful. We await with interest the results of ongoing randomised controlled trials assessing the role of LMWH and aspirin in thrombophilia in pregnancy.[1] Royal College of Obstetricians and Gynaecologists (RCOG) Green-top guideline No 7. The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. April 2011.[2] Baglin T, Gray E, Graves M, et al . Clinical guidelines for testing for heritable thrombophilia. Br J Haematol 2010; 149(2): 209-20[3] de Jong PG, Kaandorp S, Di NM, et al . Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia. Cochrane Database Syst Rev . 2014;7:CD004734 [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

A Validated and Licensed Method of Bone Marrow Aspirate Procurement to Support Advanced Therapy Investigational Medicinal Product (ATIMP) Manufacture

The Blood & Tissue Establishment (BTE) of Galway University Hospitals supplies sterile bone marrow (BM) aspirate to European cellular manufacturing facilities as a starting material in ATIMP manufacture. We have developed a validated, sterile bone marrow procurement method in accordance with the European Union Tissue & Cells Directive (EUTCD) and Good Manufacturing Practice (GMP). The BTE achieved the requisite procurement licence, from the Irish competent authority, the Health Products Regulatory Authority (HPRA).Under the BTE Quality Management System all standard operating procedures and forms are document controlled, all consumable items are batch accepted, all staff involved undergo training and competency assessment (including adequate sanitisation of the iliac crest), and all issues are recorded and reported appropriately to the HPRA.The prospective donor must first undergo a two part ‘donor assessment’ procedure which evaluates the donor's ‘fitness’ to undergo the procedure, while also having due regard for any potential recipient.Part One of the assessment process requires that the entire procedure is explained by a trained clinician / nurse; a patient information leaflet is provided and written consent obtained. A full blood count, coagulation screen, glucose test, chemistry screen, blood group and virology screen is performed. The virology screen must, at minimum, include the viruses listed by the EUTCD and the donation must take place within 30 days of sample collection. The patient will then undergo a ‘lifestyle questionnaire’ to assess donor medical, travel, sexual and other risk history. Guidance for allowing the donation to proceed will depend on a number of factors, including, whether it is an allogeneic or autologous donation. Consideration is given to the ‘Bone Marrow and Peripheral Blood Stem Cell Donor Selection Guidelines for Unrelated Donors’ of the ‘Guidelines for the Blood Transfusion Services in the United Kingdom’. HPRA and European Centre for Disease Prevention and Control alerts are also incorporated into selection criteria.The Responsible Person (RP) of the BTE (also a Consultant Haematologist) must review the answers to the questionnaire, together with the blood test results and assess whether the donor is fit to proceed to aspiration.Part Two of the assessment process takes place immediately prior to the scheduled aspiration. The donor will repeat the lifestyle questionnaire once more and the answers will be reviewed and compared with the previous questionnaire. The Consultant Haematologist will carry out a clinical examination and assessment of the donor. Upon completion, final donor eligibility is signed off and the aspiration can proceed. The procedure takes place in an operating theatre by a scrubbed Consultant Haematologist. A sterile field is created around the aspiration site. The aspiration site is cleansed with Chlorhexadine. Local anaesthetic (lidocaine 2%) is administered. 11 Gauge BM needles are used to puncture. Syringes are flushed with heparin sodium flushing solution. The flushed syringes are used to withdraw the BM, handed to a sterile assistant and transferred into 10ml lithium heparin vacutainers. The volume of 30ml of BM is aspirated from the iliac crest of both healthy donors (allogeneic) and patients (autologous) enrolled in clinical trials.These vacutainers are capped and inverted several times to prevent clotting, labelled and packaged for transport.The puncture site is dressed, donor vitals are observed and noted post procedure and the donor may be discharged after 2 hours.BM is transported to the manufacturing facility at monitored ambient temperature. Within the Grade A controlled environment, the BM is pooled and 1ml is used to inoculate one aerobic and one anaerobic blood culture bottle (validated for 0.5ml in each, incubated for 14 days, automated detection system).As of July 2017, we have performed 24 collections, 11 of which are allogeneic donations from healthy volunteers. The average white cell count in the aspirate from healthy donors is 43.1 x 106/ml. The sterility is satisfactory, with only one instance of contamination over the 24 collections, where, on the final day of incubation (day 14), we detected propionibacterium spp, a notoriously slow-growing commensal skin flora.Our regulatory approved protocol provides a steady supply of GMP grade bone marrow aspirates for the purpose of clinical trials. DisclosuresNo relevant conflicts of interest to declare.