Highly Sensitive Determination of Arsenic and Antimony Based on an Interrupted Gas Flow Atmospheric Pressure Glow Discharge Excitation Source.

A novel interrupted gas flow (IF) technique has been proposed for highly sensitive determination of ultratrace levels of arsenic and antimony in water samples by atmospheric pressure glow discharge (APGD) excitation source coupled with HCl-KBH4 hydride generation (HG). It is demonstrated that the gas flow interruption technique provides a dramatic and reproducible enhancement of emission signals of 1-2 orders of magnitude for As and Sb over conventional continuous gas flow (CF) in APGD. The enhanced analyte emission sensitivities in IF-APGD were investigated from the viewpoint of changes in plasma excitation temperature and analyte density. With eight As lines as the thermometric probe, no measurable change in excitation temperature was found, suggesting that the enhancement is caused by an increase in analyte number density in the plasma immediately following the gas flow interruption. Furthermore, the enhancement factor was found to increase with the time interval in between the gas interruption, supporting an analyte adsorption (or trap)-release mechanism hypothesis. Under optimized conditions, the detection limits (DLs) of IF-APGD mode for As and Sb were calculated to be 0.02 and 0.003 µg L-1, which are, respectively, about 27- and 120-fold improved compared to CF-APGD mode. The linearity of calibration for both As and Sb reached R2 > 0.999 in the 0.1-5 µg L-1 range. The accuracy of the proposed method was validated by the determination of certified reference materials (CRMs), and the results agreed well with the certified values.

International normalised ratio monitoring in the community populations of the Auckland and Northland regions of New Zealand: time in therapeutic range and frequency of testing.

BACKGROUND: Warfarin remains a commonly used anticoagulant for the treatment and prevention of thrombosis. To balance the risks and benefits of therapy, monitoring of the international normalised ratio (INR) is necessary. Patients derive most benefit from warfarin when they spend ≥65% of time in the therapeutic range (INR 2-3). We performed an analysis of INR monitoring for the Auckland and Northland regions of New Zealand in order to estimate anticoagulation control and appropriateness of testing at the population level. METHODS: INR test results and patient demographics (age and sex) were extracted from the laboratory information system of Labtests and Northland Pathology Laboratories for the period of 1 January 2016 to 27 July 2016. RESULTS: We included 126 184 INR results from 10 922 patients. The median age of patients represented was 74 years and 57% were male. The overall mean time in therapeutic range was 63%, with a mean interval between INR tests of 14 days. CONCLUSION: Our results indicate that anticoagulant control in our communities could be improved, and that inappropriately frequent INR testing should be redressed. Appropriate interventions could lead to net clinical benefits and reduce resource misallocation.

Solid matrix transformation and tracer addition using molten ammonium bifluoride salt as a sample preparation method for laser ablation inductively coupled plasma mass spectrometry.

Solid sampling and analysis methods, such as laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS), are challenged by matrix effects and calibration difficulties. Matrix-matched standards for external calibration are seldom available and it is difficult to distribute spikes evenly into a solid matrix as internal standards. While isotopic ratios of the same element can be measured to high precision, matrix-dependent effects in the sampling and analysis process frustrate accurate quantification and elemental ratio determinations. Here we introduce a potentially general solid matrix transformation approach entailing chemical reactions in molten ammonium bifluoride (ABF) salt that enables the introduction of spikes as tracers or internal standards. Proof of principle experiments show that the decomposition of uranium ore in sealed PFA fluoropolymer vials at 230 °C yields, after cooling, new solids suitable for direct solid sampling by LA. When spikes are included in the molten salt reaction, subsequent LA-ICP-MS sampling at several spots indicate that the spikes are evenly distributed, and that U-235 tracer dramatically improves reproducibility in U-238 analysis. Precisions improved from 17% relative standard deviation for U-238 signals to 0.1% for the ratio of sample U-238 to spiked U-235, a factor of over two orders of magnitude. These results introduce the concept of solid matrix transformation (SMT) using ABF, and provide proof of principle for a new method of incorporating internal standards into a solid for LA-ICP-MS. This new approach, SMT-LA-ICP-MS, provides opportunities to improve calibration and quantification in solids based analysis. Looking forward, tracer addition to transformed solids opens up LA-based methods to analytical methodologies such as standard addition, isotope dilution, preparation of matrix-matched solid standards, external calibration, and monitoring instrument drift against external calibration standards.

Targeted Metabolomics Approach To Detect the Misuse of Steroidal Aromatase Inhibitors in Equine Sports by Biomarker Profiling.

The use of anabolic androgenic steroids (AAS) is prohibited in both human and equine sports. The conventional approach in doping control testing for AAS (as well as other prohibited substances) is accomplished by the direct detection of target AAS or their characteristic metabolites in biological samples using hyphenated techniques such as gas chromatography or liquid chromatography coupled with mass spectrometry. Such an approach, however, falls short when dealing with unknown designer steroids where reference materials and their pharmacokinetics are not available. In addition, AASs with fast elimination times render the direct detection approach ineffective as the detection window is short. A targeted metabolomics approach is a plausible alternative to the conventional direct detection approach for controlling the misuse of AAS in sports. Because the administration of AAS of the same class may trigger similar physiological responses or effects in the body, it may be possible to detect such administrations by monitoring changes in the endogenous steroidal expression profile. This study attempts to evaluate the viability of using the targeted metabolomics approach to detect the administration of steroidal aromatase inhibitors, namely androst-4-ene-3,6,17-trione (6-OXO) and androsta-1,4,6-triene-3,17-dione (ATD), in horses. Total (free and conjugated) urinary concentrations of 31 endogenous steroids were determined by gas chromatography-tandem mass spectrometry for a group of 2 resting and 2 in-training thoroughbred geldings treated with either 6-OXO or ATD. Similar data were also obtained from a control (untreated) group of in-training thoroughbred geldings (n = 28). Statistical processing and chemometric procedures using principle component analysis and orthogonal projection to latent structures-discriminant analysis (OPLS-DA) have highlighted 7 potential biomarkers that could be used to differentiate urine samples obtained from the control and the treated groups. On the basis of this targeted metabolomic approach, the administration of 6-OXO and ATD could be detected for much longer relative to that of the conventional direct detection approach.

Tunable Ionization Modes of a Flowing Atmospheric-Pressure Afterglow (FAPA) Ambient Ionization Source.

Plasma-based ambient desorption/ionization sources are versatile in that they enable direct ionization of gaseous samples as well as desorption/ionization of analytes from liquid and solid samples. However, ionization matrix effects, caused by competitive ionization processes, can worsen sensitivity or even inhibit detection all together. The present study is focused on expanding the analytical capabilities of the flowing atmospheric-pressure afterglow (FAPA) source by exploring additional types of ionization chemistry. Specifically, it was found that the abundance and type of reagent ions produced by the FAPA source and, thus, the corresponding ionization pathways of analytes, can be altered by changing the source working conditions. High abundance of proton-transfer reagent ions was observed with relatively high gas flow rates and low discharge currents. Conversely, charge-transfer reagent species were most abundant at low gas flows and high discharge currents. A rather nonpolar model analyte, biphenyl, was found to significantly change ionization pathway based on source operating parameters. Different analyte ions (e.g., MH(+) via proton-transfer and M(+.) via charge-transfer) were formed under unique operating parameters demonstrating two different operating regimes. These tunable ionization modes of the FAPA were used to enable or enhance detection of analytes which traditionally exhibit low-sensitivity in plasma-based ADI-MS analyses. In one example, 2,2'-dichloroquaterphenyl was detected under charge-transfer FAPA conditions, which were difficult or impossible to detect with proton-transfer FAPA or direct analysis in real-time (DART). Overall, this unique mode of operation increases the number and range of detectable analytes and has the potential to lessen ionization matrix effects in ADI-MS analyses.

Femtosecond laser ablation molecular isotopic spectrometry for zirconium isotope analysis.

Laser ablation molecular isotopic spectrometry (LAMIS) for rapid isotopic analysis of zirconium at atmospheric pressure was studied with a femtosecond-laser system operated under high repetition rate (1 kHz) and low pulse energy (160 µJ). The temporal evolution of zirconium neutral-atomic and ionic lines, as well as zirconium oxide molecular bands, were studied. Six molecular bands, belonging to the d(3)Δ-a(3)Δ (i.e., the α system) and E(1)Σ(+)-X(1)Σ(+) transitions, were observed with appreciable isotopic shifts. The assignments of the isotopic bandheads were first based on theoretical predictions of the band origins and the associated isotopic shifts of various dipole-allowed ZrO electronic transitions, followed by an experimental confirmation with a (94)Zr-enriched ZrO2 sample. In this work, the α(0,1) band from the d(3)Δ3-a(3)Δ3 subsystem was utilized for Zr isotope analysis based on a compromise between the magnitude of isotopic shifts in emission wavelengths, emission strengths, signal-to-background ratios, and spectral interferences. The analysis was performed in a standardless calibration approach; the isotopic information was extracted from the experimentally measured molecular spectra through theoretical spectral fitting. The results demonstrate the feasibility to obtain isotopic information for a spectrally complicated element like zirconium, without the need to use isotopically labeled calibration standards. The availability of comprehensive molecular constants will further improve the analytical accuracy of this standardless calibration approach.

EXPRESS: Landmark Publications in Analytical Atomic Spectrometry: Fundamentals and Instrumentation Development.

The almost-two-centuries history of spectrochemical analysis has generated a body of literature so vast that it has become nearly intractable for experts, much less for those wishing to enter the field. Authoritative, focused reviews help to address this problem but become so granular that the overall directions of the field are lost. This broader perspective can be provided partially by general overviews but then the thinking, experimental details, theoretical underpinnings and instrumental innovations of the original work must be sacrificed. In the present compilation, this dilemma is overcome by assembling the most impactful publications in the area of analytical atomic spectrometry. Each entry was proposed by at least one current expert in the field and supported by a narrative that justifies its inclusion. The entries were then assembled into a coherent sequence and returned to contributors for a round-robin review.

Spatial emission profiles for flagging matrix interferences in axial-viewing inductively coupled plasma-atomic emission spectrometry: 1. Profile characteristics and flagging efficiency.

Spatially resolved measurements of analyte emission along the cross-sectional axis of an axially viewed inductively coupled plasma (ICP) are utilized to indicate the presence of any of the three major categories of matrix interferences (i.e., plasma-related, sample introduction-related, and spectral interferences). Barium at concentrations of 0.05 or 0.1 M was chosen as a prototype element for plasma-related matrix effects, whereas common mineral acids (nitric, hydrochloric, sulfuric, and phosphoric) at volumetric concentrations from 1% to 20% were used to simulate sample introduction-related matrix effects. Three spectrally interfering line pairs (As and Cd at 228.81 nm, Er and Co at 239.73 nm, and Er and Ce at 302.27 nm) were selected for the study of spectral interferences. Due to dependence on the nature of the interference, the analytical bias at the center of the cross-sectional profile varied between -40% and +50%. In all matrix-interference categories, because plasma characteristics and excitation conditions are heterogeneous along this cross-sectional axis, matrix-induced shifts in analyte emission vary accordingly. As a result, the concentrations determined for an analyte along the cross-sectional plasma axis are not constant but exhibit a position dependence that allows the interference to be flagged. With the exception of spectral interference from emission lines whose total excitation potentials (i.e., the sum of ionization and excitation energies of an ionic emission line) are very close, the spatially resolved concentrations provide an effective indicator for flagging any other matrix interference in axial-viewing ICP-emission spectrometry. The method can be employed under the plasma forward power and carrier-gas flow conditions that are common for robust plasma operation.

Spatial emission profiles for flagging matrix interferences in axial-viewing inductively coupled plasma-atomic emission spectrometry: 2. Statistical protocol.

A statistical protocol was developed and verified for automated signaling of matrix interferences in inductively coupled plasma-atomic emission spectrometry (ICP-AES). Spatial emission profiles in ICP-AES are versatile indicators for flagging matrix interference. A family of calibration curves is first generated by measurements of standard solutions at different spatial locations in the plasma. The determined-concentration profile of the analyte along a spatial measurement axis of the plasma is then obtained by analyzing the sample at each spatial location by reference to the respective calibration curve. The absence or presence of a matrix interference is gauged from the shape of the determined-concentration profile of the analyte. A flat determined-concentration profile indicates absence of matrix interference, whereas a dissimilar (i.e., curved) concentration profile offers a clear warning signal that the analytical results are compromised by interferences. The developed protocol automatically classifies a spatial profile as flat or curved; it involves the computation of three statistical parameters: relative range(0.05-0.95), σ(sample), and σ(successive). The term relative range(0.05-0.95) refers to the ratio of the range to the mean of the relative-intensity (or determined concentration) values between the 5th and 95th percentiles in a spatial profile, whereas σ(sample) and σ(successive) refer to the sample standard deviation and the standard deviation of successive values, respectively, of all values in a spatial profile. It was found that whenever the relative range(0.05-0.95) of a spatial profile is below 1.5%, the profile can be considered to be flat and no further statistical testing is needed. If relative range(0.05-0.95) > 1.5%, the σ(successive)/σ(sample) ratio provides useful information on the flatness of the profile. If the profile is flat, σ(successive) will be statistically equivalent to σ(sample) (i.e., σ(successive)/σ(sample) = 1). In contrast, if curvature is present in the profile, σ(successive) will be statistically smaller than σ(sample) (i.e., σ(successive)/σ(sample)< 1). A statistical test, based on the transformation of the experimental σ(successive)/σ(sample) ratio to the z value of a standard normal distribution, was used to judge if the difference between σ(successive) and σ(sample) is statistically significant. This statistical protocol for characterization of flatness in a spatial profile was verified in experiments carried out under the influence of various matrix interferences and different plasma operating conditions.

Halo-shaped flowing atmospheric pressure afterglow: a heavenly design for simplified sample introduction and improved ionization in ambient mass spectrometry.

The flowing atmospheric-pressure afterglow (FAPA) is a promising new source for atmospheric-pressure, ambient desorption/ionization mass spectrometry. However, problems exist with reproducible sample introduction into the FAPA source. To overcome this limitation, a new FAPA geometry has been developed in which concentric tubular electrodes are utilized to form a halo-shaped discharge; this geometry has been termed the halo-FAPA or h-FAPA. With this new geometry, it is still possible to achieve direct desorption and ionization from a surface; however, sample introduction through the inner capillary is also possible and improves interaction between the sample material (solution, vapor, or aerosol) and the plasma to promote desorption and ionization. The h-FAPA operates with a helium gas flow of 0.60 L/min outer, 0.30 L/min inner, and applied current of 30 mA at 200 V for 6 W of power. In addition, separation of the discharge proper and sample material prevents perturbations to the plasma. Optical-emission characterization and gas rotational temperatures reveal that the temperature of the discharge is not significantly affected (<3% change at 450 K) by water vapor during solution-aerosol sample introduction. The primary mass-spectral background species are protonated water clusters, and the primary analyte ions are protonated molecular ions (M + H(+)). Flexibility of the new ambient sampling source is demonstrated by coupling it with a laser ablation unit, a concentric nebulizer, and a droplet-on-demand system for sample introduction. A novel arrangement is also presented in which the central channel of the h-FAPA is used as the inlet to a mass spectrometer.

Characterization and Optimization of a Spectral Window for Direct Gaseous Uranium Hexafluoride Enrichment Assay Using Laser-Induced Breakdown Spectroscopy.

Through a systematic scanning of 235U and 238U emission lines between 280 nm and 745 nm, the optimal emission line for direct gaseous uranium hexafluoride (UF6) enrichment assay using laser-induced breakdown spectroscopy (LIBS) was found. Screening for spectral features that are potentially useful for U isotopic analysis was gauged from the magnitude of the 235U-238U isotopic shift and the signal-to-background ratio of the emission line through a parameter termed ΔSBR 235U-238U. The ΔSBR spectrum shows peaks at wavelength positions where there are strong lines with significant 235U-238U shifts. The screening identified 13 spectral-window candidates, which were down selected based on their overall accuracy in predicting the 235U enrichment of three UF6 samples of natural (0.720 atom% 235U) and low-enriched (4.675 atom% and 9.157 atom% 235U) grades. The U(I) 646.498 nm emission line, with a determined 235U-238U isotopic shift of -17.7 pm, was found to be the optimal spectral window for direct UF6 enrichment assay. The root mean square error for enrichment assays on the three natural and low-enriched UF6 samples, with each sample measured in six replicates, was 0.31% in absolute 235U content. Each measurement comprised LIBS signals accumulated from 3000 laser shots. The analytical bias and precision were better than 0.5% and 0.3%, respectively, in absolute [235U/(235U + 238U)] ratios. Specific for the two low-enriched UF6 samples, the relative standard deviations from six replicated measurements were around 2%.

Characterization of a Low-Temperature Plasma (LTP) Ambient Ionization Source Using Temporally Resolved Monochromatic Imaging Spectrometry.

The low-temperature plasma (LTP) probe is a common plasma-based source used for ambient desorption-ionization mass spectrometry (MS). While the LTP probe has been characterized in detail with MS, relatively few studies have used optical spectroscopy. In this paper, two-dimensional (2D) imaging at selected wavelengths is used to visualize important species in the LTP plasma jet. First, 2D steady-state images of the LTP plume for N2+ (391.2 nm), He I (706.5 nm), and N2 (337.1 nm) emissions were recorded under selected plasma conditions. Second, time-resolved 2D emission maps of radiative species in the LTP plasma jet were recorded through the use of a 200 ns detection gate and varying gate delays with respect to the LTP trigger pulse. Emission from He I, N2+, and N2 in the plasma jet region was found to show a transient behavior (often referred to as plasma bullets) lasting only a few microseconds. The N2+ and He I maps were highly correlated in spatial and temporal structure. Further, emission from N2 showed two maxima in time, one before and one after the maximum emission for N2+ and He I, due to an initial electronic excitation wave and ion-electron recombination, respectively. Third, the interaction of the LTP probe with a sample substrate and an electrically grounded metallic needle was studied. Emission from a fluorophore on the sample substrate showed an initial photon-induced excitation from plasma-generated photons followed by electronic excitation by other plasma species. The presence of a grounded needle near the plasma jet significantly extended the plasma jet lifetime and also generated a long-lived corona discharge on the needle. The effect of LTP operating parameters on emission spectra was correlated with mass-spectral results including reagent-ion signals. Lastly, five movies provide a side-by-side comparison of the temporal behavior of emitting species and insights into the interactions of the emission clouds with a sample surface as well as an external needle. Temporally and spatially resolved imaging provided insights into important processes in the LTP plasma jet, which will help improve analyte ion sampling in LTP-MS.

A diagnostic mystery solved by electron microscopy: a case of an "atypical" lymphoproliferative disorder.

An elderly woman with a previous diagnosis of atypical chronic lymphocytic leukemia (CLL) was noted to have a strikingly abnormal blood film, with the lymphocytes displaying numerous large cytoplasmic granules. This appearance had not been described before in the literature to the best of the authors' knowledge. After a series of investigations, electron microscopy was eventually performed, which demonstrated that the abnormal granules were composed of immunoglobulin crystals. The immunofixation study confirmed that they were monoclonal IgM paraprotein. These results led to a change of diagnosis to lymphoplasmacytic lymphoma. This report illustrates how electron microscopy can be used as a valuable additional diagnostic tool in difficult cases.

Factors Contributing to Early Intervention Evaluation.

OBJECTIVE: Early Intervention (EI) programs promote early childhood development but remain underutilized. Few studies have examined correlations with completion of EI referrals using a standardized referral system. Our study examined a minority, underserved population for characteristics that affect this critical step. METHODS: Subjects were referred from an inner-city pediatric primary care clinic for EI evaluation from 3/1/15-5/31/18. Subjects were <3 years of age at the time of referral, received pediatric care at the clinic, and were referred for EI. The dependent variable was completion of EI evaluation, verified by the medical record. Independent variables included demographic, maternal (eg, depression), child (eg, chronic illness), and referral characteristics. A multivariable logistic regression model was used to determine the predictors for completing an evaluation. RESULTS: Of 181 children referred to EI, 61.9% completed an EI evaluation; the average age was 18.9 (SD 7.4) months at first referral. For every additional month of age at the initial referral, a child was 5.0% less likely to complete an evaluation (adjusted odds ratio [aOR], 0.95; 95% confidence interval [CI], 0.90-0.99; P = .02). Two factors more than doubled the odds of completing an EI evaluation: having a chronic medical illness at the time of referral (aOR = 2.41, CI 1.21-4.79; P = .01), and being a child from a non-English speaking family (aOR = 2.22, CI 1.09-4.50; P = .03). CONCLUSIONS: The child's age and medical history, and language spoken at home affected the odds of successfully completing an EI evaluation. These findings can help clinicians target families at risk of failing to complete EI programs.

Elucidation of reaction mechanisms responsible for afterglow and reagent-ion formation in the low-temperature plasma probe ambient ionization source.

The development of ambient desorption/ionization mass spectrometry has shown promising applicability for the direct analysis of complex samples in the open, ambient atmosphere. Although numerous plasma-based ambient desorption/ionization sources have been described in the literature, little research has been presented on experimentally validating or determining the desorption and ionization mechanisms that are responsible for their performance. In the present study, established spectrochemical and plasma physics diagnostics in combination with spatially resolved optical emission profiles were applied to reveal a set of reaction mechanisms responsible for afterglow and reagent-ion formation of the Low-Temperature Plasma (LTP) probe, which is a plasma-based ionization source used in the field of ambient mass spectrometry. Within the dielectric-barrier discharge of the LTP probe, He(2)(+) is the dominant positive ion when helium is used as the plasma supporting gas. This helium dimer ion (He(2)(+)) has two important roles: First, it serves to carry energy from the discharge into the afterglow region in the open atmosphere. Second, charge transfer between He(2)(+) and atmospheric nitrogen appears to be the primary mechanism in the sampling region for the formation of N(2)(+), which is an important reagent ion as well as the key reaction intermediate for the formation of other reagent ions, such as protonated water clusters, in plasma-based ambient ionization sources. In the afterglow region of the LTP, where the sample is usually placed, a strong mismatch in the rotational temperatures of N(2)(+) (B (2)Σ(u)(+)) and OH (A (2)Σ(+)) was found; the OH rotational temperature was statistically identical to the ambient gas temperature (~300 K) whereas the N(2)(+) temperature was found to rise to 550 K toward the tail of the afterglow region. This much higher N(2)(+) temperature is due to a charge-transfer reaction between He(2)(+) and N(2), which is known to produce rotationally hot N(2)(+) (B (2)Σ(u)(+)) ions. Furthermore, it was found that one origin of excited atomic helium in the afterglow region of the LTP is from dielectronic recombination of vibrationally excited He(2)(+) ions.

Perceptions of Audio-Visual Impact Events in Younger and Older Adults.

Previous studies have examined whether audio-visual integration changes in older age, with some studies reporting age-related differences and others reporting no differences. Most studies have either used very basic and ambiguous stimuli (e.g., flash/beep) or highly contextualized, causally related stimuli (e.g., speech). However, few have used tasks that fall somewhere between the extremes of this continuum, such as those that include contextualized, causally related stimuli that are not speech-based; for example, audio-visual impact events. The present study used a paradigm requiring duration estimates and temporal order judgements (TOJ) of audio-visual impact events. Specifically, the Schutz-Lipscomb illusion, in which the perceived duration of a percussive tone is influenced by the length of the visual striking gesture, was examined in younger and older adults. Twenty-one younger and 21 older adult participants were presented with a visual point-light representation of a percussive impact event (i.e., a marimbist striking their instrument with a long or short gesture) combined with a percussive auditory tone. Participants completed a tone duration judgement task and a TOJ task. Five audio-visual temporal offsets (-400 to +400 ms) and five spatial offsets (from -90 to +90°) were randomly introduced. Results demonstrated that the strength of the illusion did not differ between older and younger adults and was not influenced by spatial or temporal offsets. Older adults showed an 'auditory first bias' when making TOJs. The current findings expand what is known about age-related differences in audio-visual integration by considering them in the context of impact-related events.

Ethnic differences in acute promyelocytic leukaemia between New Zealand Polynesian and European patients.

Ethnic differences in haematologic malignancies remain poorly elucidated, hence research in this area is important. This was a retrospective study into potential ethnic disparity in the presentation and outcomes of acute promyelocytic leukaemia (APL) between New Zealand (NZ) Polynesian and European patients. Data were analysed for patients treated at Auckland City Hospital (ACH; n = 55) and recorded in the New Zealand Cancer Registry (NZCR; n = 173), both for the period 2000-2017. We found that Polynesian patients treated at ACH presented at a younger age than European (P = 0.005), showed higher blast counts (P = 0.033), and a marginally higher prothrombin ratio (P = 0.02). Treatment with all-trans retinoic acid (ATRA) was started faster in Polynesian patients than European (P = 0.021), suggesting Polynesians were sicker at presentation but were managed accordingly. There were no differences in bleeding events, transfusion requirements and early deaths during the first month of treatment. Long-term survival was also similar. Data extracted from the NZCR confirmed NZ Polynesian patients with APL were younger than European (P < 0.001), but long-term survival was similar (P = 0.920). In summary, this study indicates a discrepancy in the presentation and severity of APL between NZ Polynesian and European patients but treatment initiation was rapid with no difference in outcomes. The distinctive features of APL in NZ Polynesians raise the possibility of a predisposing genetic factor or a different risk factor profile, elucidation of which is important for all patients with APL.

Unravelling androgens in sport: Altrenogest shows strong activation of the androgen receptor in a mammalian cell bioassay.

Altrenogest is a commonly used progestogen for the suppression of oestrus and associated distracting behaviours that interfere with training and performance of female racehorses. The steroid is derived from 19-nor testosterone and is structurally similar to the anabolic androgenic steroid, trenbolone. In this study, the relative androgen potency of altrenogest was determined by a kidney (HEK293) cell androgen bioassay. The HEK293 bioassay shows that in its pure form, altrenogest has a high relative potency compared with testosterone but is not as strong as ß-trenbolone. Our results also show that altrenogest is able to activate the androgen receptor at the concentrations relevant to the administration regime of racehorses and retains its activity ex vivo. Thus, we show unequivocally that altrenogest, a progestogen used widely in female racehorses, acts as a strong androgen in a mammalian cell bioassay.

A three-way comparison of glycated haemoglobin: are results from the three platforms interchangeable?

AIMS: To determine whether glycated haemoglobin (HbA1c) results from three commonly used platforms can be interpreted cumulatively and used interchangeably in individuals with common haemoglobinopathies. A secondary goal was to assess the relationship between HbA1c concentrations, and haemoglobin and mean corpuscular volume in this population. METHODS: One hundred and forty-five samples, mostly with haemoglobinopathies, were tested by each of: Roche Gen.3 Cobas c513, Capillarys 2 Flex-Piercing and Bio-Rad D-100 platforms. Statistical comparisons and limits of performance based on biological variation, international recommendations, and local diagnostic cut-offs were drawn upon to determine comparability of results. RESULTS: Inter-platform measurements were not significantly different for the large majority of results. The four HbA1c results that showed maximum discrepancy between triplicates had the following abnormalities: heterozygous haemoglobin S/ beta thalassemia, heterozygous haemoglobin S/ alpha thalassemia, beta thalassemia trait and alpha thalassemia trait. Six triplicates of results in the thalassemia groups (7.5% of thalassemia samples) had levels that misclassified patients' glycaemic status. There was no correlation between HbA1c concentration and mean corpuscular volume, and a weak negative correlation between HbA1c concentration and haemoglobin concentration. CONCLUSION: HbA1c concentrations measured by Cobas c513, Capillarys 2 Flex-Piercing and the Bio-Rad D-100 were found to be comparable in the large majority of samples. While discordance was due to assay imprecision in some cases, in others no biological or analytical explanation could be found.

Doping control analysis of total arsenic in equine plasma.

Arsenic can be easily found in our surrounding environment. Because of its ubiquitous nature, horse urine and blood invariably contain low levels of arsenic. Nevertheless, inorganic arsenic, despite its general use as a tonic for horses, is an effective doping agent having a deleterious effect because of its ability to induce gastroenteritis. The misuse of arsenic in horseracing has been controlled by an international urinary threshold of total arsenic at 0.3 µg/mL. However, an equivalent threshold for total arsenic in plasma is yet to be established. In this study, an inductively coupled plasma-mass spectrometry method has been developed for quantifying total arsenic in equine plasma. Statistical analysis determined that the data from a population study of 1,552 post-race and out-of-competition plasma samples fits a Gaussian mixture model with two Gaussian components. A rounded-up provisional threshold for plasma total arsenic at 2.5 ng/mL was subsequently established. Results from administration trials with a sodium arsanilate-containing supplement showed that both urinary and plasma arsenic was significantly elevated after administration. The maximum urinary detection time was around 22 h based on the international threshold. However, the maximum plasma detection time would be longer than 73 h if the provisional threshold of 2.5 ng/mL was adopted. In view of the high discrepancy between the urine and plasma detection times, a revised plasma threshold of 15 ng/mL is proposed to afford a comparable detection time in both matrices. The risk of a normal sample exceeding the proposed plasma total arsenic threshold is practically zero.