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Background: Acquired activated protein C resistance (APCr) has been identified in antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). Objective: To assess agreement between the ST-Genesia® and CAT analysers in identifying APCr prevalence in APS/SLE patients, using three thrombin generation (TG) methods. Methods: APCr was assessed with the ST-Genesia using STG-ThromboScreen and with the CAT using recombinant human activated protein C and Protac® in 105 APS, 53 SLE patients and 36 thrombotic controls. Agreement was expressed in % and by Cohen's kappa coefficient. Results: APCr values were consistently lower with the ST-Genesia® compared to the CAT, using either method, in both APS and SLE patients. Agreement between the two analysers in identifying APS and SLE patients with APCr was poor (≤65.9%, ≤0.20) or fair (≤68.5%, ≥0.29), regardless of TG method, respectively; no agreement was observed in thrombotic controls. APCr with both the ST Genesia and the CAT using Protac®, but not the CAT using rhAPC, was significantly greater in triple antiphospholipid antibody (aPL) APS patients compared to double/single aPL patients (p < 0.04) and in thrombotic SLE patients compared to non-thrombotic SLE patients (p < 0.05). Notably, the ST-Genesia®, unlike the CAT, with either method, identified significantly greater APCr in pregnancy morbidity (median, confidence intervals; 36.9%, 21.9–49.0%) compared to thrombotic (45.7%, 39.6–55.5%) APS patients (p = 0.03). Conclusion: Despite the broadly similar methodology used by CAT and ST-Genesia®, agreement in APCr was poor/fair, with results not being interchangeable. This may reflect differences in the TG method, use of different reagents, and analyser data handling.

Early television crime drama portrayed an ordered universe where evil was punished and good triumphed. Dragnet, the prototype for police procedurals for many years, depicted the police officer as a public hero who always got his man. More recently, beginning with Hill Street Blues, the police officer has been shown to fail occasionally and even to question his or her own self worth. These men and women often express the absurdity of life as a cop.The purpose of this study is to examine two recent television crime dramas, Homicide: Life on the Streets and NYPD Blue, with special emphasis on Homicide, for their representations of existential themes through character relationships and behaviors. While these programs do not portray a world as dark as that offilm noir, the characters often examine the reasons for their own existence as they regularly encounter death in the community and criminals of various types who have either lost their sense of self worth or respect for their fellow human beings.Most crime stories have an "existential aura" to them, particularly those that deal with death in any way, but especially with murder and suicide. After World War II, French critics, conversant with the writings of Jean Paul Sartre and Albert Camus, recognized representations of an existential world in American detective and thriller films, many of which were based on the "hard-boiled" detective novels written by Dashiell Hammett, Raymond Chandler, and James M. Cain, among others. The critics named these films noir films because they depicted a dark and ominous world revealing social sickness and corruption in the large urban environment. The protagonists of these films were not heroes in the traditional sense but more cynical and pessimistic anti-heroes who, though confronted by unwholesome, dangerous, and inhumane characters-and ultimately by death-act responsibly, at least in the end, to reaffirm their own existence, even though they often found their existence detestable.During the late 1940s and early 1950s, some of these anti-heroes appeared on radio in such programs as Dyke Easter, Detective, Box 13, 137

IntroductionThe investigation of platelet function by aggregometry requires specialist equipment and is labour intensive. We have developed an automated platelet aggregation method on a routine coagulation analyser.MethodsWe used a CS-2000i (Sysmex) with prototype software to perform aggregation in platelet-rich plasma (PRP), using the following agonists: ADP (0.5–10 μm), epinephrine (0.5–10 μm), collagen (0.5–10 mg/μL), ristocetin (0.75–1.25 mg/mL) and arachidonic acid (0.12–1.0 mm). Platelet agonists were from Hyphen Biomed, and an AggRAM aggregometer (Helena Biosciences) was used as the reference instrument.ResultsCS-2000i reaction cuvette stirrer speed was found to influence reaction sensitivity and was optimized to 800 rpm. There were no clinically significant changes in aggregation response when the PRP platelet count was 150–480 x 109/L, but below this there were changes in the maximum amplitude (MA) and slope (rate). Dose response with each of the agonists was comparable between CS-2000i and an AggRAM aggregometer and normal subjects receiving antiplatelet drugs. Aggregation imprecision was similar on both the CS-2000i and AggRAM systems, with a cv for 2–5 μm ADP MA and slope varying between 3–12%.ConclusionOur preliminary studies indicated that optimal sensitivity using the CS-2000i was obtained with a reaction cuvette stirrer speed of 800 rpm and a PRP platelet count of 200–300 x 109/L; aggregation with a PRP count <100 x 109/L showed poor sensitivity. Imprecision and detection of antiplatelet drug effects was similar between the CS-2000i and AggRAM. These data demonstrate that CS-2000i is comparable to a stand-alone aggregometer, although CS-2000i has the advantages of walk-away technology and also required a smaller sample volume than the AggRAM (44% less).

Introduction Plasma samples with gross lipaemia present a challenge for coagulation laboratories using optical analysers. High‐speed centrifugation may be used to remove excess lipids but it has not established whether this affects haemostasis tests. The aims were to determine whether the removal of lipid by centrifugation affects PT, APTT, fibrinogen, D‐dimer and von Willebrand factor activity measurements. Methods Twenty‐six lipaemic samples (median [range]): triglyceride 4.6 mmol/L [0.5‐17.0]; cholesterol: 4.06 mmol/L [2.20‐9.41] and 20 plasmas spiked with Intralipid 20 or lipid isolated from patient plasmas (median triglyceride of 11.95 mmol/L [5.0‐17.0] and cholesterol 4.33 [3.22‐7.06]), were tested before and after the removal of the lipid layer by centrifugation (10000 g for 10 minutes). Tests were performed using the CS‐5100 (Sysmex) coagulation analyser. Results Thirteen, 9, 3 and 1 of the lipaemic or spiked samples failed to give PT, APTT, fibrinogen and D‐dimer results, respectively. Centrifugation significantly reduced triglyceride (median 2.7, [0‐6.1 mmol/L]) and cholesterol (median 0.52 [0‐3.5]), allowing clot detection in all tests. There were no statistically significant differences in fibrinogen, D‐dimer or VWF levels in samples before and after lipid removal. A small but clinically insignificant change in PT and APTT was observed after lipid removal. Conclusion High‐speed centrifugation reduces lipaemia sufficiently to allow testing on an optical coagulation analyser without introducing clinically significant differences PT, APTT, fibrinogen, D‐dimer or VWF activity values.