A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon

1. BMC Clin Pathol. 2014 May 1;14:19. doi: 10.1186/1472-6890-14-19. eCollection 2014. A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon. Nagler M, Keller P, Siegrist D, Alberio L. Author information: Department of Hematology and Central Hematology Laboratory, Inselspital University Hospital and University of Berne, CH-3010 Berne, Switzerland. BACKGROUND: EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is a common laboratory phenomenon with a prevalence ranging from 0.1-2% in hospitalized patients to 15-17% in outpatients evaluated for isolated thrombocytopenia. Despite its harmlessness, EDTA-PTCP frequently leads to time-consuming, costly and even invasive diagnostic investigations. EDTA-PTCP is often overlooked because blood smears are not evaluated visually in routine practice and histograms as well as warning flags of hematology analyzers are not interpreted correctly. Nonetheless, EDTA-PTCP may be diagnosed easily even by general practitioners without any experiences in blood film examinations. This is the first report illustrating the typical patterns of a platelet (PLT) and white blood cell (WBC) histograms of hematology analyzers. CASE PRESENTATION: A 37-year-old female patient of Caucasian origin was referred with suspected acute leukemia and the crew of the emergency unit arranged extensive investigations for work-up. However, examination of EDTA blood sample revealed atypical lymphocytes and an isolated thrombocytopenia together with typical patterns of WBC and PLT histograms: a serrated curve of the platelet histogram and a peculiar peak on the left side of the WBC histogram. EDTA-PTCP was confirmed by a normal platelet count when examining citrated blood. CONCLUSION: Awareness of typical PLT and WBC patterns may alert to the presence of EDTA-PTCP in routine laboratory practice helping to avoid unnecessary investigations and over-treatment. PMCID: PMC4012027 PMID: 24808761 [PubMed]

Financial performance drivers and strategic control: The case of cancer treatment centers

Strategic control is defined as the use of qualitative and quantitative tools for the evaluation of strategic organizational performance. Most research in strategic planning has focused on strategy formulation and implementation, but little work has been done on strategic performance evaluation particularly in the area of cancer research. The objective of this study was to identify strategic control approaches and financial performance metrics used by major cancer centers in the country as an initial step in expanding the theory and practice behind strategic organizational performance. Focusing on hospitals which share similar mandate and resource constraints was expected to improve measurement precision. The results indicate that most cancer centers use a wide selection of evaluation tools, but sophisticated analytical approaches were less common. In addition, there was evidence that high-performing centers tend to invest a larger degree of resources in the area of strategic performance analysis than centers showing lower financial results. The conclusions point to the need for incorporating higher degree of analytical power in order to improve the tracking of strategic performance. This study is one of the first to concentrate in the area of strategic control.^

Towards a Transfer Model of Scientific and Technological Knowledge: the Case of Mexico

This paper shows the development of a science-technological knowledge transfer model in Mexico, as a means to boost the limited relations between the scientific and industrial environments. The proposal is based on the analysis of eight organizations (research centers and firms) with varying degrees of skill in the practice of science-technological knowledge transfer, and carried out by the case study approach. The analysis highlights the synergistic use of the organizational and technological capabilities of each organization, as a means to identification of the knowledge transfer mechanisms best suited to enabling the establishment of cooperative processes, and achieve the R&D and innovation activities results.

Effectiveness of safety-based incentives in Public Private Partnerships: Evidence from the case of Spain

Many countries around the world are implementing Public?Private?Partnership (PPP) contacts to manage road infrastructure. In some of these contracts the public sector introduces economic incentives to the private operator to foster the accomplishment of social goals. One of the incentives that have been introduced in some PPP contracts is related to safety in such a way that the better the safety outcome the greater will be the economic reward to the contractor. The aim of this paper is at identify whether the incentives to improve road safety in highway PPPs are ultimately effective in improving safety ratios. To this end Poisson and negative binomial regression models have been applied using information from highway sections in Spain. The findings indicate that even though road safety is highly influenced by variables that are not much controllable by the contractor such as the Average Annual Daily Traffic and the percentage of heavy vehicles, the implementation of safety incentives in PPPs has a positive influence in the reduction of fatalities, injuries and accidents.

In disperse solution, “osmotic stress” is a restricted case of preferential interactions

In the practice of “osmotic stress,” the effect of excluded cosolvents on a biochemical equilibrium is interpreted as the number of water molecules participating in the reaction. This action is attributed to lowering of solvent water activity by the cosolvent. This concept of osmotic stress in disperse solution is erroneous: (i) A cosolvent cannot be both excluded and inert, i.e., noninteracting, because exclusion requires a positive free energy change; (ii) a decrease in water activity alone by addition of solute cannot affect an equilibrium when the reacting surface is in contact with the solvent; and (iii) osmotic stress in disperse solution is a restricted case of preferential interactions; the reaction is driven by the free energy of cosolvent exclusion, and the derived number of water molecules is solely a measure of the mutual perturbations of the chemical potentials of the cosolvent and the protein.

The Catholic Question in Contemporary Portuguese Civil Society: A Case of Muted Vibrancy? CES Papers - Open Forum #14, 2012

The ‘Catholic question’ in contemporary Portugal obliges us to consider whether Catholicism will remain a force in Portuguese associational life in the next century, or whether it faces a future of slow and steady decline. On the one hand, an overall statistical drop of church membership, and the lack of religious practice by almost half of self-identified Roman Catholics, suggests that the future of the Catholic Church in Portugal will probably be very different than the past. On the other hand, the church’s support for democratic processes, the important social services it provides, and its educational establishment, have certainly been a positive factor in Portuguese associational life, and helped the larger process of democratic-regime consolidation since the Carnation Revolution of 1974. This paper suggests that social scientists need to move beyond the lens normally applied to the question of Catholicism in contemporary Europe (i.e. it is a dying, anti-modern, anti-rational, conservative institution), and instead consider the complex interplay of its demographic challenges combined with the popular sources of its theological and spiritual strength, as well as its vital societal contributions, to assess whether or not it will remain a force in Portuguese associational life in the future.

Accounting for residential and non-residential environments to measure contextual effects on health behavior : the case of recreational walking behavior

Thèse réalisée en cotutelle entre l'Université de Montréal et l'Université Pierre et Marie Curie, Paris 06, Sorbonne Universités.

Dissemination of a community-based physical activity project: The case of 10,000 steps

This paper describes the use of a web-site for the dissemination of the community-based '10,000 steps' program which was originally developed and evaluated in Rockhampton, Queensland in 2001-2003. The website provides information and interactive activities for individuals, and promotes resources and programs for health promotion professionals. The dissemination activity was assessed in terms of program adoption and implementation. In a 2-year period (May 2004-March 2006) more than 18,000 people registered as users of the web-site (togging more than 8.5 billion steps) and almost 100 workplaces and 13 communities implemented aspects of the 10,000 steps program. These data support the use of the internet as an effective means of disseminating ideas and resources beyond the geographical borders of the original project. Following this preliminary dissemination, there remains a need for the systematic study of different dissemination strategies, so that evidence-based physical activity programs can be translated into more widespread public health practice. (c) 2006 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Corporate social responsibility reporting in developing countries:the case of Bangladesh

Historically, the study of corporate social responsibility (CSR) reporting has largely been within the context of Western economies. However, in the wake of highly publicized incidents such as Bhopal and the struggle of the Ogoni people in Nigeria, many large corporations now claim to be taking steps to improve their environmental and social performance within developing countries. Using the lens of stakeholder theory, this book examines whether the current practice of CSR reporting in developing countries is motivated by a desire to discharge accountability to all relevant stakeholders or whether it is being driven by the imperative of advancing corporate economic interests. While concepts like CSR reporting have become more fashionable, they vary widely in different national contexts; this book therefore clarifies the types and roles of CSR reporting and the underlying corporate motivations. The author considers the current CSR reporting practices in a number of developing countries, with particular attention given to illuminating a case study of Bangladesh.

Personal privacy as a positive experience of shopping:an illustration through the case of online grocery shopping

Purpose - This paper aims to demonstrate the need for an improved understanding of the opportunities offered by privacy online. This is contextualized in the case of supermarket purchases of food in particular, often described as an intimate and personal choice. In the case of grocery shopping, the "intimacy" may be at the household level between members or/and between e-grocers' food offerings, and their other "non-food" related services Design/methodology/approach - This paper draws upon social practice theory research, retailing and consumer behaviour in order to develop a conceptual framework for understanding the value of positive privacy. The research uses 39 in-depth interviews of e-grocery shoppers in the area of Portsmouth (UK). Findings - This paper suggests a framework for embedded elements of positive privacy into retailing strategy as a driver for growth in the e-grocery sector. Three meta-themes requiring different approaches to privacy are uncovered. Positive privacy is dynamic and contextual at the consumer/household levels as well as for product/e-grocery brands. Research limitations/implications - This paper advocates the building of long-term sustainable relationship through sharing, offering, and exchange of information rather than pure technological chasing of data. Originality/value - A consumer centred bottom-up approach is employed demonstrating the value of two-way dialogues with consumers on sensitive issues. E-grocery is used as an illustration that involves regular re-purchase of a basket of staple goods over a long period of time where privacy becomes a latent long-term concern. © Emerald Group Publishing Limited.

Developing a knowledge-based perspective on coordination:the case of global software projects

We have attempted to bring together two areas which are challenging for both IS research and practice: forms of coordination and management of knowledge in the context of global, virtual software development projects. We developed a more comprehensive, knowledge-based model of how coordination can be achieved, and\illustrated the heuristic and explanatory power of the model when applied to global software projects experiencing different degrees of success. We first reviewed the literature on coordination and determined what is known about coordination of knowledge in global software projects. From this we developed a new, distinctive knowledge-based model of coordination, which was then employed to analyze two case studies of global software projects, at SAP and Baan, to illustrate the utility of the model.

Predictors of household hardship in a resource constrained environment:the case of sub-Saharan Africa

Using data from the 2004 wave of the Afrobarometer survey, this study examines correlates of household hardship in three countries of sub-Saharan Africa: Tanzania, Zambia, and Zimbabwe. Findings provide partial support for the hypothesized relationship. Specifically, poverty reduction initiatives and informal assistance are associated with reduced hardship while civic engagement is related to an increase in household hardship. We also note that certain demographic characteristics are linked to hardship. Policy and practice implications are suggested. © The Author(s) 2011.

Aranyszabály helyett adósságfék - a német példa = Debt-brake instead of the golden rule - the case of Germany

Az Európai Unió megújuló gazdasági kormányzási rendszerének egyik meghatározó pillére a diszkrecionális gazdaságpolitikával szemben megfogalmazott szabályalapúság lesz. A minden korábbinál erősebb és vélhetően hatékonyabb szabályok bevezetésének legelkötelezettebb híve Németország. Az elmúlt évtizedekben a folyó költségvetési kiadások hiányból történő finanszírozásának tilalmát előíró aranyszabályt inkább kevesebb, mint több sikerrel alkalmazó Németország most arra vállalkozott, hogy nem csak saját hatáskörben vezeti be az ún. adósságféket, hanem követendő példaként állítja azt a többi tagország elé is. Írásunkban az aranyszabály, illetve az adósságfék előnyeit és hátrányait vesszük számba a német tapasztalatok felhasználásával. / === / The need to strengthen rules-based fiscal policy has emerged as a widely shared consensus amongst policy-makers in the recent economic and financial crisis. Germany has become the most devoted advocator of the new regime, where more innovative and effective fiscal rules are supposed to play an even bigger role than before. Germany supports such a move however not only in rhetoric but also in practice. It decided to abandon its several decade old golden rule and to adopt a more sophisticated one, the so-called debt-brake. This article provides a cost-benefit analysis of both the previous and the new fiscal rule.

Introduction of soft budget constraint as an analyzing tool into public management. The case of the Hungarian public administration reform

Public management reforms are usually underpinned by arguments that they will make the public administration system more effective and efficient. In practice, however, it is very hard to determine whether a given reform will improve the efficiency and effectiveness of the public administration system in the long run. Here, I shall examine how the concept of the soft budget constraint (SBC) introduced by János Kornai (Kornai 1979, 1986; Kornai, Maskin & Roland 2003) can be applied to this problem. In the following, I shall describe the Hungarian public administration reforms implemented by the Orbán government from 2010 onward and analyze its reforms, focusing on which measures harden and which ones soften the budget constraint of the actors of the Hungarian public administration system. In the literature of economics, there is some evidence-based knowledge on how to harden/soften the budget constraint, which improves/reduces the effectiveness and hence the efficiency of the given system. By using the concept of SBC, I also hope to shed some light on the rationale behind the Hungarian government’s introduction of such a contradictory reform package. Previously, the concept of SBC was utilized narrowly in public management studies, mostly in the field of fiscal federalism. My goal is to apply the concept to a broader area of public management studies. My conclusion is that the concept of SBC can significantly contribute to public management studies by deepening our knowledge on the reasons behind the success and failure of public administration reforms.