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The prothrombin time (PT) and activated partial thromboplastin time (APTT) are screening tests used to detect congenital or acquired bleeding disorders. An unexpected PT and/or APTT prolongation is often evaluated using a mixing test with normal plasma. Failure to correct (\"noncorrection\") prolongation upon mixing is attributed to an inhibitor, whereas \"correction\" points to factor deficiency(ies). To define an optimal method for determining correction or noncorrection of plasma mixing tests through an international, multisite study that used multiple PT and APTT reagents and well-characterized plasma samples. Each testing site was provided 22 abnormal and 25 normal donor plasma samples, and mixing studies were performed using local PT and APTT reagents. Mixing study results were evaluated using 11 different calculation methods to assess the optimal method based on the expected interpretation for factor deficiencies (correction) and noncorrection (inhibitor effect). Misprediction, which represents the failure of a mixing study interpretation method, was assessed. Percentage correction was the most suitable calculation method for interpreting PT mixing test results for nearly all reagents evaluated. Incubated PT mixing tests should not be performed. For APTT mixing tests, percentage correction should be performed, and if the result indicates a factor deficiency, this should be confirmed with the subtraction III calculation where the normal pooled plasma result (run concurrently) is subtracted from the mixing test result with correction indicated by a result of 0 or less. In general, other calculation methods evaluated that performed well in the identification of factor deficiency tended to have high misprediction rates for inhibitors and vice versa. No single method of mixing test result calculation was consistently successful in accurately distinguishing factor deficiencies from inhibitors, with between-reagent and between-site variability also identified.

Combining original historical research with literary analysis, Adam Barrows takes a provocative look at the creation of world standard time in 1884 and rethinks the significance of this remarkable moment in modernism for both the processes of imperialism and for modern literature. As representatives from twenty-four nations argued over adopting the Prime Meridian, and thereby measuring time in relation to Greenwich, England, writers began experimenting with new ways of representing human temporality. Barrows finds this experimentation in works as varied as Victorian adventure novels, high modernist texts, and South Asian novels—including the work of James Joyce, Virginia Woolf, H. Rider Haggard, Bram Stoker, Rudyard Kipling, and Joseph Conrad. Demonstrating the investment of modernist writing in the problems of geopolitics and in the public discourse of time, Barrows argues that it is possible, and productive, to rethink the politics of modernism through the politics of time.

Purpose: This paper proposes model-based standard times estimates, using multiple linear regression, nonlinear optimization, and fuzzy systems in four real cases assembly lines. The work includes a description of the models and a comparison of their performance with values obtained using the conventional chronometer method. These models allow estimating standard times without reconducting field studies. Design/methodology/approach: For the development of the time study, the methodology applied by the International Labour Organization (ILO) was used as a baseline. This methodology is structured in three phases: selection of the case study, registration of the process by direct observation, and calculation/estimation of the standard time. The selected case studies belong to real assembly lines of motorcycles, television sets, printed circuit boards, and bicycles. Findings: In the motorcycle's assembly case, the study allowed constructing seven linear regression models to estimate standard times for assembling the front parts, and seven linear regression models to predict standard times for the rear parts of the different motorcycle types. Compared to the classical chronometer method, the results obtained never exceeded 10%. Regarding the case studies of assembling TV sets and PCBs, the study considered the construction of nonlinear optimization models that allow making appropriate predictions of the standard times in their assembly lines. Finally, for the bicycle assembly line, a fuzzy logic model to represent the standard time was constructed and validated. Research limitations/implications: For reasons of confidentiality of information, this work omitted the names of companies, services, and models of manufactured products. Originality/value: The literature consulted does not refer to the representation of standard time on assembly lines using mathematical models. The construction of these models with empirical data from actual assembly lines was a valuable aid to the companies involved in supporting activity planning.

Background The English National Health Service has multiple waiting time standards relating to cancer diagnosis and treatment. Targets can have unintended effects, such as prioritisation based on targets instead of clinical need. In this case, a `threshold effect’ will appear as a spike in hospitals just meeting the target. Methods We conducted a retrospective study of publicly available cancer waiting time data, including a 2-week wait for a specialist appointment, a 31-day decision to first treatment and a 62-day referral to treatment standard that attracted a financial penalty. We examined the performance of hospital trusts against these targets by financial year to look for threshold effects, using Cattaneo et al. manipulation density test. Results Trust performance against cancer waiting targets declined over time, and this trend accelerated since the start of the Covid-19 pandemic. Statistical evidence of a threshold effect for the 2-week and 31-day standard was only present in a few years. However, there was strong statistical evidence of a threshold effect for the 62-day standard across all financial years ( p  < 0.01). Conclusion The data suggests that the effect of threshold targets alters hospital behaviour at target levels but does not do so equally for all standards. Evidence of threshold effects for the 62-day standard was particularly strong, possibly due to some combination of a smaller volume of eligible patients, a larger penalty, multiple waypoints where hospitals can intervene, baseline performance against the target and where the target is set (i.e. how much headroom is available). RCTs of the use of threshold targets and of different designs for such targets in the future would be extremely informative.

Abstract Daylight saving time (DST) refers to the practice of advancing clock time by 1 h each spring, with a return (setting back) to standard time (ST) each fall. Numerous sleep and circadian societies other than the Sleep Research Society have published statements in support of permanent ST, and permanent ST has also received support from multiple medical societies and organizations. This perspective discusses the positive and negative health and economic consequences of permanent DST, permanent ST, and maintaining the status quo (DST for part of the year). After a thorough review of the existing literature, the SRS advocates the adoption of permanent ST.

Depositional sequences originating in semi-enclosed basins with endemic biota, partly or completely isolated from the open ocean, frequently do not allow biostratigraphic correlations with the standard geological time scale (GTS). The Miocene stages of the Central Paratethys represent regional chronostratigraphic units that were defined in type sections mostly on the basis of biostratigraphic criteria. The lack of accurate dating makes correlation within and between basins of this area and at global scales difficult. Although new geochronological estimates increasingly constrain the age of stage boundaries in the Paratethys, such estimates can be misleading if they do not account for diachronous boundaries between lithostratigraphic formations and for forward smearing of first appearances of index species (Signor-Lipps effect), and if they are extrapolated to whole basins. Here, we argue that (1) geochronological estimates of stage boundaries need to be based on sections with high completeness and high sediment accumulation rates, and (2) that the boundaries should preferentially correspond to conditions with sufficient marine connectivity between the Paratethys and the open ocean. The differences between the timing of origination of a given species in the source area and timing of its immigration to the Paratethys basins should be minimized during such intervals. Here, we draw attention to the definition of the Central Paratethys regional time scale, its modifications, and its present-day validity. We suggest that the regional time scale should be adjusted so that stage boundaries reflect local and regional geodynamic processes as well as the opening and closing of marine gateways. The role of eustatic sea level changes and geodynamic processes in determining the gateway formation needs to be rigorously evaluated with geochronological data and spatially-explicit biostratigraphic data so that their effects can be disentangled.

Monitoring of direct inhibitors of thrombin (DTI) is critical for their safe and effective use as anticoagulants. We examined samples containing several concentrations of argatroban or lepirudin in reconstituted standard human plasma and plasma from medical outpatients and intensive care patients. Prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin time (TT) were determined using automated analyzers. Ecarin clotting time (ECT) was measured using a 10 IU/mL dilution of ecarin in 0.05 mol/L CaCl2. Calibration curves were approximately linear for TT and ECT in samples containing argatroban and lepirudin, respectively. Activated partial thromboplastin curves reached a plateau at DTI concentrations ≥2 µg/mL, suggesting that the aPTT may not reliably detect overdosing. Prothrombin time increased exponentially. A broad range of clotting times was seen in patient samples with all tests suggesting that individual morbidity and therapies may strongly influence test results and may lead to underestimation of DTI doses.

Recently, the discussion on the feasibility of the annual transition to summer and winter time has significantly intensified in the society of many countries in the world. Considering a certain discomfort from daylight-saving, the most people suggest to abandon it. But there is no final reasoned decision on permanent time: winter (zone, standard) or summer time. Daylight-saving was introduced to save electricity, but currently there are no accurate calculations to confirm it. The article is devoted to solving the urgent problem of determining the most effective order of calculating time for more complete use of sunlight and, accordingly, to reduce the electrical energy losses for lighting in the life of modern world society. The purpose of the study is to develop a technique for precise calculating the lost daylight hours and electrical energy losses for lighting in different countries of the world under different time calculation scenarios – when applying the  transition to summer time; when refusing summer time and final introducing winter (zone, standard) time; when applying permanent summer time. The article presents the main arguments of supporters and opponents of the introduction of permanent winter and summer time. The calculation and comparative analysis of the losses of daylight hours and, as a result, the losses of electrical energy for lighting per year have been carried out under different time calculation options. The approximate cost of electrical energy losses for lighting under different time calculation options for some European countries has been calculated. To increase the accuracy of the calculations, the sociological aspect of the study was considered in combination with the astronomical one. The developed technique is recommended to be used in calculations when determining the optimal order of time calculation in different countries of the world for its introduction at the international or national legislative level.The application of the technique will allow saving significant quantity of electricity during the evening peak energy consumption, that will contribute to the stability of the country's energy system and preservation of the fuel and financial resources. References 19, figures 7, tables 6.

The Clinical and Laboratory Standards Institute guidelines require special processing of whole blood specimens with hematocrits greater than 55% due to the possibility of spurious prolongation of routine coagulation studies (PT, aPTT). As samples with hematocrits above 60% are rare at our institution, our study seeks to determine the effect of relative citrate excess on routine coagulation studies in samples with hematocrits of 60% to determine whether special processing is necessary. A calculated volume of 3.2% citrate was added to 1 mL aliquots of 40 whole blood samples in citrated tubes from adult patients to simulate a hematocrit of 60%. A dilutional control was created by adding an equivalent volume of saline to a separate 1 mL aliquot. Routine coagulation studies (PT, aPTT) were run on both samples on the STA Compact Analyzer in accordance with manufacturer instructions. While a paired Student's t-test demonstrated a clinically significant change in both PT and aPTT with the addition of citrate (p = 0.0002 for PT and p = 0.0234 for aPTT), clinical management would not have been altered by any observed change. More interestingly, we observed a shortening of 27/40 PTs and 23/40 aPTTs rather than the expected prolongation. Based on our data, no adjustment of citrate volume appears to be necessary in samples with hematocrits less than or equal to 60%.

A strong demand of a separate time zone by northeast populace has been a matter of great debate for a very long period. However, no implementable solution to this genuine problem has yet been proposed. The CSIR-National Physical Laboratory, CSIR-NPL (the National Measurement Institute, NMI, of India and custodian of Indian Standard Time, IST) proposes an implementable solution that puts the country in two time zones: (i) IST-I (UTC + 5 : 30 h, represented by longitude passing through 82°33′E) covering the regions falling between longitude 68°7′E and 89°52′E and (ii) IST-II (UTC + 6 : 30 h, represented by longitude passing through 97°30′E) encompassing the regions between 89°52′E and 97°25′E. The proposed demarcation line between IST-I and IST-II, falling at longitude 89°52′E, is derived from analyses of synchronizing the circadian clocks to normal office hours (9 : 00 a.m. to 5 : 30 p.m.). This demarcation line passes through the border of West Bengal and Assam and has a narrow spatial extension, which makes it easier to implement from the railways point of view. Once approved, the implementation would require establishment of a laboratory for ‘Primary Time Ensemble – II’ generating IST-II in any of the north-eastern states, which would be equivalent to the existing ‘Primary Time Ensemble-I’ at CSIR-NPL, New Delhi.