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transport of activated fatty acids (acyl-CoAs) from the cytosol across the inner mitochondrial membrane into the matrix where fatty acid oxidation takes place. It has now become clear that a net effl ux of acylcarnitine species from the mitochondria into the cytosol and ultimately into plasma is particularly important in situations of impaired fatty acid oxidation to prevent accumulation of potentially toxic acyl-CoA intermediates in the mitochondrion ( 2, 3 ). How acylcarnitines are released into the extracellular space is not known, but changes in plasma and/or urinary acylcarnitine profi les are used to detect disorders in fatty acid and amino acid oxidation ( 4 ). More recently, alterations in plasma acylcarnitine profi les were described as strongly associated with obesity and type 2 diabetes ( 5-7 ). A broad spectrum of short-, medium-, and long-chain acylcarnitine species is generated from multiple metabolic routes including various fatty acid and amino acid oxidation pathways. A comprehensive quantifi cation that covers as many as possible of these entities is therefore not only important for proper clinical diagnosis of inherited enzymatic impairments, but also for basic studies of complex diseases such as the metabolic syndrome.Acylcarnitine profiles are commonly established by direct infusion ESI-MS/MS. This technology, however, does not allow the discrimination of isomeric acylcarnitine species. Furthermore, isobaric matrix interferences can lead to an overestimation of metabolite concentrations producing false positive results, in particular, for compounds with low abundance ( 8 ). Although LC-MS/ MS methods have been developed for successful separation of isomeric compounds ( 9-12 ), the identifi cation of the exact compound in the chromatogram often remains Acylcarnitines are intermediates in fatty acid and amino acid breakdown generated from the conversion of acylCoA species by the action of carnitine acyltransferases ( 1 ). The formation of carnitine conjugates is crucial for the

BACKGROUND & AIMS:Sufficient bowel preparation is crucial for successful screening and surveillance colonoscopy. However, rates of inadequate preparation are still high. We investigated the effects of reinforced patient education using a smartphone application software (APP) for colonoscopy preparation in participants in a CRC screening program. METHODS:We performed a prospective, endoscopist-blinded study of 500 patients undergoing split-dose bowel preparation for CRC screening or surveillance colonoscopies at multiple centers in Germany, from November 2017 through January 2019. Participants (n [ 500) were given oral and written instructions during their initial appointment and then randomly assigned (1:1) to groups that received reinforced education starting 3 days before the colonoscopy (APP group) or no further education (controls). The primary outcome was quality of bowel preparation according to the Boston bowel preparation scale. Secondary outcomes included polyp and adenoma detection rates, compliance with low-fiber diet, split-dose laxative intake, perceived discomfort from the preparation procedure. RESULTS:The mean Boston bowel preparation scale score was significantly higher in the APP-group (7.6 -0.1) than in the control group (6.7 -0.1) (P < .0001). The percentage of patients with insufficient bowel preparation was significantly lower in the APP group (8%) than in the control group (17%) (P [ .0023). The adenoma detection rate was significantly higher in the APP group (35% vs 27% in controls) (P [ .0324). Use of the APP was accompanied by a lower level of non-compliance with correct laxative intake (P [.0080) and diet instructions (P [ .0089). The APP group reported a lower level of discomfort during preparation (P < .0001). CONCLUSIONS:In a randomized trial, reinforcing patient education with a smartphone application optimized bowel preparation in the 3 days before colonoscopy, increasing bowel cleanliness, adenoma detection, and compliance in patients undergoing CRC screening or surveillance. ClinicalTrials. gov no: NCT03290157

P-selectin is an adhesion molecule found in the alpha granules of platelets. Activation occurs in response to a range of inflammatory and thrombotic agents resulting in rapid up-regulation. Flow cytometry methods have recently been described for the analysis of platelet P-selectin expression in whole blood. While introducing these methods into our laboratory it was noted that expression could be stimulated, in vitro, in a number of ways. This study shows that red cell lysis, the anticoagulant K3 EDTA and the time elapse between blood collection and antibody labelling had statistically significant effects on P-selectin expression. Post-labelling fixation, with CellFIX, caused no significant effect. We conclude that blood for P-selectin analysis should be collected in sodium citrate and that red cell lysis and centrifugation should be avoided. When comparing samples, the time between collection and labelling should be standardized. The relatively high CV for the assay indicates that all samples should be labelled and analysed in duplicate with the mean level reported.