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16 pages, 1719 KiB  
Article
A Snapshot of Vitamin D Status, Performance, Blood Markers, and Dietary Habits in Runners and Non-Runners
by Francesco Pegreffi, Sabrina Donati Zeppa, Marco Gervasi, Eneko Fernández-Peña, Giosuè Annibalini, Alessia Bartolacci, Eugenio Formiglio, Deborah Agostini, Claudia Barbato, Piero Sestili, Antonino Patti, Vilberto Stocchi and Rosa Grazia Bellomo
Nutrients 2024, 16(22), 3912; https://doi.org/10.3390/nu16223912 (registering DOI) - 15 Nov 2024
Viewed by 291
Abstract
Background: Vitamin D can influence athletic performance and infection risk. This study aimed to investigate vitamin D status, hematochemical factors, anthropometric and performance parameters, and dietary habits in runners (n = 23) and sedentary healthy individuals (non-runners, n = 22) during the autumn [...] Read more.
Background: Vitamin D can influence athletic performance and infection risk. This study aimed to investigate vitamin D status, hematochemical factors, anthropometric and performance parameters, and dietary habits in runners (n = 23) and sedentary healthy individuals (non-runners, n = 22) during the autumn season. Methods: Both groups had their serum 25-Hydroxyvitamin D (ng/mL) levels, blood and performance parameters, and dietary habits measured. Results: Serum 25-Hydroxyvitamin D levels were significantly lower in non-runners (runners: males 30.0 ± 5.6, females 31.2 ± 5.2 vs. non-runners: males, 22.8 ± 6.5, females 24.7 ± 6.5 ng/mL, p < 0.001). White blood cells, monocyte, and neutrophil levels were higher in non-runners for both males and females. Among the subjects, 23 had optimal vitamin D levels (>29 ng/mL), while 22 had insufficient/deficient levels (<29 ng/mL), with a higher prevalence of insufficiency in non-runners compared to runners (63.6% vs. 34.8%; p = 0.053). Maximal isometric force and jump height were equal in both groups, but VO2max was higher in runners. Linear regression analysis identified monocyte count as the only predictor of vitamin D levels for both males (y = −24.452 x + 40.520; R2 = 0.200; p = 0.015) and females (y = −33.409 x + 45.240; R2 = 0.368; p = 0.003). Conclusions: This study highlights significant differences in vitamin D status between runners and non-runners, with runners exhibiting higher serum 25-Hydroxyvitamin D levels, although this finding is likely due to the increased sun exposure that runners receive. It also provides valuable insights into the vitamin D status of healthy young sedentary individuals and runners, enhancing the understanding of how physical activity influences vitamin D levels. Full article
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<p>Raincloud plots of (<b>a</b>) total vitamin D3-25(OH)D, (<b>b</b>) count of white blood cells, (<b>c</b>) monocytes, and (<b>d</b>) estimated VO<sub>2</sub>max for female non-runners (Non-run (F)), female runners (Run (F)), male non-runners (Non-run (M)), and male runners (Run (M)) groups. The boxplots represent the median and the interquartile range, while the one-sided violin plots represent the smoothed distribution curve.</p>
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<p>Correlation plot of monocytes on vitamin D3-25(OH) total for females and males.</p>
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14 pages, 1004 KiB  
Article
The Roles of Vitamin D Levels, Gla-Rich Protein (GRP) and Matrix Gla Protein (MGP), and Inflammatory Markers in Predicting Mortality in Intensive Care Patients: A New Biomarker Link?
by Fatih Seğmen, Semih Aydemir, Onur Küçük and Recep Dokuyucu
Metabolites 2024, 14(11), 620; https://doi.org/10.3390/metabo14110620 - 13 Nov 2024
Viewed by 401
Abstract
Objectives: Identifying reliable biomarkers to predict mortality in critically ill patients is crucial for optimizing management in intensive care units (ICUs). Inflammatory and metabolic markers are increasingly recognized for their prognostic value. This study aims to evaluate the association of various inflammatory and [...] Read more.
Objectives: Identifying reliable biomarkers to predict mortality in critically ill patients is crucial for optimizing management in intensive care units (ICUs). Inflammatory and metabolic markers are increasingly recognized for their prognostic value. This study aims to evaluate the association of various inflammatory and metabolic markers with ICU mortality. Methods: This prospective observational study was conducted from January 2023 to January 2024 in the City Hospital’s ICU. A total of 160 critically ill patients were enrolled. Laboratory parameters, including white blood cell (WBC) count, red cell distribution width (RDW), platelet count, neutrophil count, mean platelet volume (MPV), monocyte count, lymphocyte count, procalcitonin (PCT), C-reactive protein (CRP), calcium (Ca++), and vitamin D levels, were analyzed. Additionally, ratios such as the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory index (SII), and pan-immune-inflammation value (PIV) were calculated. Plasma levels of Gla-rich protein (GRP) and dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP) were measured using ELISA. Results: The mean age of the patients included in the study was 60.5 ± 15.8 years. Cardiovascular disease was present in 72 patients (45%), respiratory system disease in 58 (36%), and chronic kidney disease (CKD) in 38 (24%). Additionally, 61 patients (38%) had diabetes, and 68 (42%) had hypertension. Inflammatory markers, including PLR, NLR, and PIV, were all significantly higher in non-survivors, while calcium and vitamin D levels were lower (p < 0.05). Higher WBC, RDW, neutrophil count, PLR, NLR, PIV, CRP, procalcitonin, GRP, and dp-ucMGP levels were positively correlated with longer hospital stays and increased mortality. In contrast, platelet and lymphocyte counts were negatively correlated with both outcomes (p < 0.05). Vitamin D levels showed an inverse relationship with both hospital stay and mortality, indicating that lower levels were associated with worse outcomes (p < 0.05). In multiple logistic regression analysis, elevated WBC count (OR = 1.20, p = 0.02), RDW (OR = 1.35, p = 0.01), neutrophil count (OR = 1.25, p = 0.01), MPV (OR = 1.20, p = 0.02), PLR (OR = 1.30, p = 0.01), NLR (OR = 1.40, p = 0.001), PIV (OR = 1.50, p = 0.001), CRP (OR = 1.32, p = 0.01), procalcitonin (OR = 1.45, p = 0.001), GRP (OR = 1.40, p = 0.001), and dp-ucMGP (OR = 1.30, p = 0.001) levels were significantly associated with increased mortality. Conclusions: Inflammatory and metabolic markers, particularly NLR, PLR, PIV, GRP, and dp-ucMGP, are strong predictors of mortality in ICU patients. These markers provide valuable insights for risk stratification and early identification of high-risk patients, potentially guiding more targeted interventions to improve outcomes. Full article
(This article belongs to the Special Issue The Interplay Between Inflammation and Metabolism in Disease)
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<p>ROC analysis results in patients with mortality.</p>
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<p>Conceptual scheme of biomarkers and ICU outcomes.</p>
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10 pages, 893 KiB  
Article
Exposure to Gas Flaring Among Residents of Oil-Producing Communities in Bayelsa State, Niger Delta Region of Nigeria: A Cross-Sectional Study of Haematological Indices
by Domotimi James Jato, Felix M. Onyije, Osaro O. Mgbere and Godwin Ovie Avwioro
J 2024, 7(4), 472-481; https://doi.org/10.3390/j7040028 - 11 Nov 2024
Viewed by 494
Abstract
Air pollution contributes significantly to morbidity and mortality globally. The Niger Delta Region of Nigeria flares the second largest amount of natural gas in the world, with residents of oil-producing communities bearing the burden of outdoor pollution that may have adverse effects on [...] Read more.
Air pollution contributes significantly to morbidity and mortality globally. The Niger Delta Region of Nigeria flares the second largest amount of natural gas in the world, with residents of oil-producing communities bearing the burden of outdoor pollution that may have adverse effects on their health and well-being. Our study aimed to investigate the haematological indices of residents of a selected gas-flaring site. We conducted a cross-sectional study, wherein a total of eighty adults aged 24 to 73 years were recruited from communities located within a radius of approximately 5 to 10 km from the gas-flaring facility. Blood specimens were collected from consenting participants and analysed for various haematological parameters, including Red Blood Cell (RBC) count, Packed Cell Volume (PCV), Haemoglobin (HB), Mean Cell Haemoglobin (MCH), platelet count (PLT), White Blood Cell (WBC) count, neutrophil (NEU), lymphocytes (LYMs), and Monocyte + Basophil + Eosinophil (MXD). The analysis was performed using an automated Sysmex KX21N haematological analyser. Overall, there was a significant decrease in RBC counts (p < 0.001) and a significant elevation in WBCs (p < 0.001) among people residing within a 5 km radius compared to those residing within a 10 km radius. About 42.5% of males residing within a 5 Km radius exhibited low RBC counts in contrast to only 15% of males residing within a 10 km radius. The WBC levels were found to be significantly higher (p < 0.001) than the reference range among both males and females residing within a 5 km radius compared to those residing at a distance of 10 km. In the female population, 15% of individuals residing within a 5 km and 10 Km radius exhibited RBC levels below the reference category, while 7.5% showed RBC levels above the reference range. Exposure to gas flaring may alter haematological indices. It is, therefore, recommended that a comprehensive longitudinal study be conducted among residents of oil-producing communities and workers at gas-flaring facilities in the Niger Delta region of Nigeria to assess the potential environmental and health implications of their exposure to chemical pollutants. Full article
(This article belongs to the Special Issue Feature Papers of J—Multidisciplinary Scientific Journal in 2024)
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<p>Characteristics of study participants by sex and age group.</p>
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<p>Relationships between WBC, RBC, and age of participants by distance from gas-flaring sites. The color bands indicate data point density within a specific area of the plot, highlighting where data clusters are most concentrated. Darker colors represent higher density, while lighter colors indicate lower density. The bands display the confidence intervals around fitted lines or model predictions.</p>
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14 pages, 1902 KiB  
Article
Genomic Variants Associated with Haematological Parameters and T Lymphocyte Subpopulations in a Large White and Min Pig Intercross Population
by Naiqi Niu, Runze Zhao, Ming Tian, Wencheng Zong, Xinhua Hou, Xin Liu, Ligang Wang, Lixian Wang and Longchao Zhang
Animals 2024, 14(21), 3140; https://doi.org/10.3390/ani14213140 - 1 Nov 2024
Viewed by 458
Abstract
The breeding of disease-resistant pigs has consistently been a topic of significant interest and concern within the pig farming industry. The study of pig blood indicators has the potential to confer economic benefits upon the pig farming industry, whilst simultaneously providing valuable insights [...] Read more.
The breeding of disease-resistant pigs has consistently been a topic of significant interest and concern within the pig farming industry. The study of pig blood indicators has the potential to confer economic benefits upon the pig farming industry, whilst simultaneously providing valuable insights that can inform the study of human diseases. In this study, an F2 resource population of 489 individuals was generated through the intercrossing of Large White boars and Min pig sows. A total of 17 haematological parameters and T lymphocyte subpopulations were measured, including white blood cell count (WBC), lymphocyte count (LYM), lymphocyte count percentage (LYM%), monocyte count (MID), monocyte count percentage (MID%), neutrophilic granulocyte count (GRN), percentage of neutrophils (GRN%), mean platelet volume (MPV), platelet distribution width (PDW), platelet count (PLT), CD4+/CD8+, CD4+CD8+CD3+, CD4+CD8−CD3+, CD4−CD8+CD3+, CD4−CD8−CD3+, and CD3+. The Illumina PorcineSNP60 Genotyping BeadChip was obtained for all of the F2 animals. Subsequently, a genome-wide association study (GWAS) was conducted using the TASSEL 5.0 software to identify associated variants and candidate genes for the 17 traits. Significant association signals were identified for PCT and PLT on SSC7, with 1 and 11 significant SNP loci, respectively. A single nucleotide polymorphism (SNP) on SSC12 was identified as a significant predictor of the white blood cell (WBC) trait. Significant association signals were detected for the T lymphocyte subpopulations, namely CD4+/CD8+, CD4+CD8+CD3+, CD4+CD8−CD3+, and CD4−CD8+CD3+, with the majority of these signals observed on SSC7. The genes CLIC5, TRIM15, and SLC17A4 were identified as potential candidates for influencing CD4+/CD8+ and CD4−CD8+CD3+. A missense variant, c.2707 G>A, in the SLC17A4 gene has been demonstrated to be significantly associated with the CD4+/CD8+ and CD4-CD8+CD3+ traits. Three missense variants (c.425 A>C, c.500 C>T, and c.733 A>G) have been identified in the TRIM15 gene as being linked to the CD4+/CD8+ trait. Nevertheless, only c.425 A>C has been demonstrated to be significantly associated with CD4-CD8+CD3+. In the CLIC5 gene, one missense variant (c.957 T>C) has been identified as being associated with the CD4+/CD8+ and CD4-CD8+CD3+ traits. Additionally, significant association signals were observed for CD4+CD8+CD3+ and CD4+CD8−CD3+ on SSC2 and 5, respectively. Subsequently, a gene ontology (GO) enrichment analysis was conducted on all genes within the quantitative trait loci (QTL) intervals of platelet count, CD4+/CD8+, and CD4−CD8+CD3+. The MHC class II protein complex binding pathway was identified as the most significant pathway among the three immune traits. These results provide guidance for further research in the field of breeding disease-resistant pigs. Full article
(This article belongs to the Section Animal Genetics and Genomics)
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<p>Identification of GWAS of the haematological parameters. (<b>A</b>) Manhattan plot displaying the GWAS results of plateletocrit (PCT). The blue horizontal line indicated the Bonferroni significance threshold (1.17 × 10<sup>−6</sup>). (<b>B</b>) Manhattan plot displaying the GWAS results of the platelet count (PLT). (<b>C</b>) Manhattan plot displaying the GWAS results of white blood cell count (WBC).</p>
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<p>Comparison of three genotypes of significant SNP for haematological traits. (<b>A</b>) The difference analysis of MARC0014928 for PCT in SSC7. (<b>B</b>) The difference analysis of MARC0014928 for PLT in SSC7. (<b>C</b>) The difference analysis of ASGA0098229 for WBC in SSC12. (* <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, *** <span class="html-italic">p</span> &lt; 0.001, **** <span class="html-italic">p</span> &lt; 0.0001, (<span class="html-italic">p</span> &gt; 0.05, ns)).</p>
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<p>Identification of GWAS of the T lymphocyte subpopulation. (<b>A</b>) Manhattan plot displaying the GWAS results of the CD4+/CD8+. The blue horizontal line indicated the Bonferroni significance threshold (1.17 × 10<sup>−6</sup>). (<b>B</b>) Manhattan plot displaying the GWAS results of the CD4+CD8+CD3+. (<b>C</b>) Manhattan plot displaying the GWAS results of the CD4+CD8−CD3+. (<b>D</b>) Manhattan plot displaying the GWAS results of the CD4−CD8+CD3+.</p>
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<p>Comparison of three genotypes of significant SNP in T lymphocyte subpopulation traits. (<b>A</b>) The difference analysis of ASGA0031860 for CD4+/CD8+ in SSC7. (<b>B</b>) The difference analysis of ALGA0017071 for CD4+CD8+CD3+ in SSC2. (<b>C</b>) The difference analysis of ASGA0032099 for CD4+CD8−CD3+ in SSC7. (<b>D</b>) The difference analysis of ASGA0031860 for CD4−CD8+CD3+ in SSC7. (* <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, *** <span class="html-italic">p</span> &lt; 0.001, **** <span class="html-italic">p</span> &lt; 0.0001, (<span class="html-italic">p</span> &gt; 0.05, ns)).</p>
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<p>Bubble chart of GO function enrichment analysis of genes in SSC7. (<b>A</b>) PLT of GO function enrichment analysis. (<b>B</b>) CD4+/CD8+ of GO function enrichment analysis. (<b>C</b>) CD4−CD8+CD3+ of GO function enrichment analysis.</p>
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16 pages, 3469 KiB  
Article
Hydrogen Gas Inhalation Alleviates Airway Inflammation and Oxidative Stress on Ovalbumin-Induced Asthmatic BALB/c Mouse Model
by Wenjing He, Md. Habibur Rahman, Johny Bajgai, Sofian Abdul-Nasir, Chaodeng Mo, Hui Ma, Seong Hoon Goh, Kim Bomi, Hyeran Jung, Cheol-Su Kim, Hyungdon Lee and Kyu-Jae Lee
Antioxidants 2024, 13(11), 1328; https://doi.org/10.3390/antiox13111328 - 30 Oct 2024
Viewed by 566
Abstract
Airway inflammatory diseases, such as asthma, are a global public health concern owing to their chronic inflammatory effects on the respiratory mucosa. Molecular hydrogen (H2) has recently been recognized for its antioxidant and anti-inflammatory properties. In this study, we examined the [...] Read more.
Airway inflammatory diseases, such as asthma, are a global public health concern owing to their chronic inflammatory effects on the respiratory mucosa. Molecular hydrogen (H2) has recently been recognized for its antioxidant and anti-inflammatory properties. In this study, we examined the therapeutic potential of H2 in airway inflammation using an ovalbumin (OVA)-induced BALB/c mouse model of allergic asthma. Female BALB/c mice were sensitized and challenged with OVA to induce airway inflammation, and 30 mice were randomly divided into five groups: NT (non-treatment), HTC (3% H2 treatment only), NC (negative control, OVA only), PC (positive control, OVA + intranasal 1 mg/mL salbutamol 50 μL), and HT (H2 treatment, OVA + inhaled 3% H2). Various inflammatory and oxidative stress (OS)-induced markers such as white blood cells (WBCs) and their differential counts, lung histology, cytokine levels such as interleukin (IL)-4, (IL)-5, (IL)-13, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), granulocyte-macrophage colony-stimulating factor (GM-CSF), (IL)-10, reactive oxygen species (ROS), nitric oxide (NO), glutathione peroxidase (GPx), and catalase (CAT), and total immunoglobulin E (IgE) levels were investigated. Our results showed that inhaled H2 significantly reduced inflammatory cell infiltration, OS markers, and pro-inflammatory cytokine expression while upregulating antioxidant enzyme activity. Furthermore, H2 also significantly decreased serum IgE levels, a marker of allergic inflammation. Collectively, our findings suggest that H2 inhalation is a promising treatment option for airway inflammation, offering a novel approach with potential clinical applications. Full article
(This article belongs to the Section Health Outcomes of Antioxidants and Oxidative Stress)
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<p>Animal experimental procedures.</p>
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<p>Effects of H<sub>2</sub> gas inhalation on body and lung weight characteristics. (<b>A</b>) Mice body weight, (<b>B</b>) lung weight, (<b>C</b>) appearance of lung organs, (<b>D</b>) lung tissue histological analysis with H&amp;E staining, highlighting morphological features. Data are expressed as mean ± SD (<span class="html-italic">n</span> = 5). Statistical significance is indicated as * <span class="html-italic">p</span> &lt; 0.05.</p>
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<p>Inhalation of H<sub>2</sub> gas regulates the inflammatory cell levels in the blood of allergic mouse models. (<b>A</b>) Total WBCs, (<b>B</b>) eosinophils, (<b>C</b>) neutrophils, (<b>D</b>) lymphocytes, and (<b>E</b>) neutrophil-to-lymphocyte ratio. Data are expressed as mean ± SD (<span class="html-italic">n</span> = 5). Statistical significance is indicated as * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01; *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Inhalation of H<sub>2</sub> gas modulates the expression of serum cytokine levels in an OVA-induced airway inflammatory mouse model. (<b>A</b>) IL-4, (<b>B</b>) IL-5, (<b>C</b>) IL-13, (<b>D</b>) IFN-γ, (<b>E</b>) TNF-α, (<b>F</b>) GM-CSF, and (<b>G</b>) IL-10. Data are expressed as mean ± SD (<span class="html-italic">n</span> = 5). Statistical significance is indicated as ** <span class="html-italic">p</span> &lt; 0.01; *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Inhalation of H<sub>2</sub> gas effects on redox markers in an airway inflammatory mouse model. Serum levels of (<b>A</b>) ROS, (<b>B</b>) NO, (<b>C</b>) GPx, and (<b>D</b>) CAT levels. Data are expressed as mean ± SD (<span class="html-italic">n</span> = 5). Statistical significance is indicated as * <span class="html-italic">p</span> &lt; 0.05; *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Inhalation of H<sub>2</sub> gas reduced the total IgE level in the serum of the OVA-induced airway inflammatory mouse model. Data are expressed as mean ± SD (<span class="html-italic">n</span> = 5). Statistical significance is indicated as <span class="html-italic">* p</span> &lt; 0.05.</p>
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16 pages, 2544 KiB  
Article
Monitoring Cell Activation and Extracellular Vesicle Generation in Platelet Concentrates for Transfusion
by Ana Kolenc, Maja Grundner, Irma Hostnik and Elvira Maličev
Int. J. Mol. Sci. 2024, 25(21), 11577; https://doi.org/10.3390/ijms252111577 - 28 Oct 2024
Viewed by 565
Abstract
Platelets play a crucial role in blood transfusions, and understanding the changes that occur during their storage is important for maintaining the quality of preparations. In this study, we examined key alternating factors, with a particular focus on platelet activation and the release [...] Read more.
Platelets play a crucial role in blood transfusions, and understanding the changes that occur during their storage is important for maintaining the quality of preparations. In this study, we examined key alternating factors, with a particular focus on platelet activation and the release of extracellular vesicles. Additionally, we compared two detection methods—imaging flow cytometry (IFC) and nanoparticle tracking analysis (NTA)—for their effectiveness in detecting particles. Platelet concentrates were prepared by pooling buffy coats from five blood group-compatible donors in an additive solution. Samples were analysed after one, three, and seven days of storage for residual white blood cells (WBCs), glucose levels, platelet activation, and extracellular vesicle concentrations. Over the storage period, the total platelet concentration decreased slightly, while the residual WBC count remained stable. Glucose levels declined, whereas platelet activation and extracellular vesicle concentration increased, with a positive correlation between the two. The particle size remained relatively unchanged throughout the storage period. Ultimately, despite controlled processing and storage conditions, platelet activation, and the release of extracellular vesicles still occurred, which may have implications for transfusion recipients. Although an optimised method is still needed, IFC has proved to be specific and potentially appropriate for detecting extracellular vesicles in transfusion preparations. Full article
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<p>Platelet concentration in stored platelet concentrates on days 1, 3, and 7 after pooling. The figure shows individual measurements and average values with standard deviation of three independent experiments.</p>
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<p>Concentration of residual white blood cells at different time points. Figure shows individual measurements and average values with standard deviation of three independent experiments.</p>
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<p>(<b>A</b>) Concentration of glucose at different time points. Figure shows individual measurements and average value with standard deviation of three independent experiments. Statistical difference is indicated with asterisks, **** <span class="html-italic">p</span> &lt; 0.0001. (<b>B</b>) Correlation between glucose concentration and platelet activation. Figure represents the percentage of activated platelets compared to glucose concentration analysed using the Pearson Correlation and Student’s <span class="html-italic">t</span>-test (n = 44). An r value of 0.72 indicates a significant correlation with <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>The percentage of activated platelets, identified by the presence of P-selectin on their surface, over a storage period of seven days. The figure shows individual measurements and average values with a standard deviation of three independent experiments. Statistical difference is indicated with asterisks, *** <span class="html-italic">p</span> &lt; 0.001 and **** <span class="html-italic">p</span> &lt; 0.0001.</p>
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<p>The gating strategy used on the FACSCalibur flow cytometer to determine the percentage of activated platelets (CD62P) among the total platelet population (CD61). Initially, platelets were gated based on their characteristic forward scatter (FSC) and side scatter (SSC) properties.</p>
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<p>Results of analysis using ImageStream Imaging Flow Cytometer. (<b>A</b>) Concentration of extracellular vesicles over the storage time of platelet preparations. The figure shows individual measurements and average values with a standard deviation of three independent experiments. Statistical difference is indicated with asterisks, **** <span class="html-italic">p</span> &lt; 0.0001. (<b>B</b>) Examples of CD9-positive events from days 1, 3, and 7 samples that correlate with events on respective scatterplots. (<b>C</b>) Gating strategy for the final positive results after excluding coincidence events and multiple events, along with events with high SSC. All the used controls and calibration beads are also included. (<b>D</b>) Examples of small and large fluorescent calibration bead populations used for the initial acquisition gate. (<b>E</b>) Examples of multiple events excluded from the analysis with appropriate masks and features of IDEAS software (Version 6.3).</p>
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<p>The concentration of extracellular vesicles, as measured by the NTA. The figure shows individual measurements and average values with a standard deviation of three independent experiments. Statistical difference is indicated with asterisks, ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>The size of extracellular vesicles according to NTA. (<b>A</b>) Figure shows individual measurements and average values with standard deviation of three independent experiments. (<b>B</b>) Example of the size distribution of extracellular vesicles of individual sample on days 1, 3, and 7.</p>
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<p>Correlation between the concentration of extracellular vesicles and platelet activation on ImageStream IFC (<b>A</b>) and NTA (<b>B</b>). The figure represents the percentage of activated platelets compared to the percentage of activated platelets analysed using the Pearson Correlation and Student’s <span class="html-italic">t</span>-test (n = 44 for A and n = 18 for B).</p>
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<p>The concentration of extracellular vesicles measured by IFC and NTA. The correlation between the two methods was analysed using the Pearson Correlation and Student’s <span class="html-italic">t</span>-test (n = 18). An r value of 0.78 indicates a significant correlation with <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Study design.</p>
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19 pages, 2028 KiB  
Article
Elevated Platelet Aggregation in Patients with Ovarian Cancer: More than Just Increased Platelet Count
by Zitha Redempta Isingizwe, Brooke A. Meelheim and Doris Mangiaracina Benbrook
Cancers 2024, 16(21), 3583; https://doi.org/10.3390/cancers16213583 - 24 Oct 2024
Viewed by 558
Abstract
Background: Patients with ovarian cancer have high platelet counts, which correlate with disease burden, incidence, and lethality of blood clots (thrombosis). We hypothesized that elevated aggregation is associated with both increased platelet number and altered behavior of platelets in patients with ovarian cancer. [...] Read more.
Background: Patients with ovarian cancer have high platelet counts, which correlate with disease burden, incidence, and lethality of blood clots (thrombosis). We hypothesized that elevated aggregation is associated with both increased platelet number and altered behavior of platelets in patients with ovarian cancer. Methods: Healthy controls and patients with suspected or diagnosed ovarian cancer were evaluated for complete blood counts. To evaluate the effects of platelet count versus platelet behavior, equal platelet-rich plasma (PRP) volumes versus equal platelet numbers were used in platelet aggregation assays. Arachidonic acid, adenosine diphosphate, and collagen platelet agonists were used to induce aggregation. Volunteers were grouped into healthy controls (23), benign/borderline cases (7), and cancer cases (25 ovarian, 1 colorectal, and 2 endometrial). Results: The rate and amount of platelet aggregation were higher in patients compared to healthy controls regardless of whether the same platelet number or PRP volume was used. Compared to healthy controls, patients with untreated ovarian cancer exhibited high levels of platelet activation markers, P-selectin (27.06 vs. 31.06 ng/mL, p = 0.03), and beta-thromboglobulin (3.073 vs. 4.091 µg/mL, p = 0.02) in their plasma. The significance of the elevation and its correlations with platelet number or PRP volume varied depending on the agonist. Platelet (305.88 vs. 134.12, p < 0.0001) and white blood cell (8.459 vs. 5.395, p < 0.01) counts (×109/L) were elevated pre-chemotherapy and decreased post-chemotherapy, respectively. Conclusions: Elevated platelet aggregation is caused by both altered platelet number and behavior in patients with ovarian cancer. These results support the study of antiplatelet agents for thrombosis prevention in these patients. Full article
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<p>Schematic representation of this study's inclusion and exclusion criteria. Healthy participants were included based on age, lack of recent use of antiplatelet drugs, and ability to physically give blood samples. Patients with benign ovarian tumors or borderline diseases were included in the benign group. Ovarian cancer participants were included based on the diagnosis of epithelial ovarian cancer. Primary comparisons are indicated by asterisks. All other comparisons were exploratory. The bottom boxes show the numbers (n) of patient specimens evaluated using equal numbers of platelets (Behavior) and equal volumes of platelet-rich plasma (Number).</p>
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<p>Comparison of CBCs in citrated whole blood between healthy controls and patients with untreated ovarian cancer. (<b>A</b>) white blood cells, (<b>B</b>) red blood cells, (<b>C</b>) platelets. Venous blood (8.5 mL) was collected using acid citrate dextrose (1.5 mL) anticoagulant. A VetScan HM5 Hematology Analyzer was used to count blood cells in each sample. (Healthy: Healthy controls, Untreated: patients with ovarian cancer before surgery or chemotherapy) Mann-Whitney or <span class="html-italic">t</span>-test; ns = not significant, **** <span class="html-italic">p</span> &lt; 0.0001.</p>
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<p>Platelet aggregation and aggregation slope comparing platelet behavior and platelet count. (<b>A</b>) Platelet aggregation comparing platelet behavior, (<b>B</b>) aggregation slope comparing platelet behavior, (<b>C</b>) platelet aggregation comparing platelet count, (<b>D</b>) aggregation slope comparing platelet count: Arachidonic acid, ADP, or collagen platelet aggregation agonists were used to induce platelet. Kruskal-Wallis test * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Concentrations of <span class="html-italic">P</span>-selectin, PF4, and beta-TG in PRP samples from healthy controls and patients with untreated ovarian cancer. <span class="html-italic">t</span>-test; ns = not significant, * <span class="html-italic">p</span> &lt; 0.05.</p>
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15 pages, 1322 KiB  
Article
Immune Marker and C-Reactive Protein Dynamics and Their Prognostic Implications in Modulated Electro-Hyperthermia Treatment in Advanced Pancreatic Cancer: A Retrospective Analysis
by Nikolett Kitti Dobos, Tamas Garay, Magdolna Herold, Alexandra Simon, Viktor Madar-Dank, Gyula Balka, Jozsef Gajdacsi, Magdolna Dank, Attila Marcell Szasz and Zoltan Herold
Immuno 2024, 4(4), 385-399; https://doi.org/10.3390/immuno4040025 - 18 Oct 2024
Viewed by 549
Abstract
Background: Previous research has suggested that modulated electro-hyperthermia (mEHT) can be used to induce anti-tumor immune effects and to extend patient survival. The use of mEHT in advanced pancreatic cancer is beneficial; however, its immune-mediating effects were never investigated. Methods: A retrospective observational [...] Read more.
Background: Previous research has suggested that modulated electro-hyperthermia (mEHT) can be used to induce anti-tumor immune effects and to extend patient survival. The use of mEHT in advanced pancreatic cancer is beneficial; however, its immune-mediating effects were never investigated. Methods: A retrospective observational study was conducted. Leukocyte counts, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and granulocyte-to-lymphocyte ratio (GLR) were measured at baseline, midpoint, and after mEHT treatment. Results: A total of 73 mEHT treated pancreatic cancer patients were included. The time elapsed between tumor diagnosis and the first mEHT treatment was 4.40 ± 5.70 months. While no change could be observed between the baseline and the first follow-up visits, the total white blood cell (WBC), neutrophil, and granulocyte count, CRP, NLR, and GLR were significantly higher at the second follow-up compared to both previous visits. Higher levels of the latter parameters following the last mEHT treatment were signaling significantly poor prognostic signs, and so were their longitudinal changes. Conclusions: After the initiation of mEHT, immune markers stabilize with the treatment, but this positive effect is eroded over time by progressive disease. Monitoring the changes in these markers and the occurrence of their increase is a prognostic marker of shorter survival. Full article
(This article belongs to the Section Cancer Immunology and Immunotherapy)
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<p>The predicted mean ± standard error and <span class="html-italic">p</span>-values of the (<b>A</b>) total white blood cell count, (<b>B</b>) C-reactive protein level, (<b>C</b>) granulocyte–lymphocyte ratio, and (<b>D</b>) neutrophil–lymphocyte ratio at the three different study visits, obtained from the linear mixed-effects models.</p>
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<p>The cumulative leukocyte cell counts at the baseline measurement and the two follow-ups: (<b>A</b>) all five leukocyte subtypes including lymphocytes, monocytes, basophil granulocytes, eosinophil granulocytes, and neutrophil granulocytes; (<b>B</b>) only the lymphocytes, monocytes, and granulocytes.</p>
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<p>Differences in the overall survival of patients with (<b>A</b>) total white blood cell counts (WBC) lower or higher than 8.65 × 10<sup>9</sup>/L, (<b>B</b>) C-reactive protein (CRP) levels lower or higher than 6.20 mg/L, (<b>C</b>) granulocyte–lymphocyte rate (GLR) values lower or higher than 3.30, and (<b>D</b>) neutrophil–lymphocyte rate (NLR) values lower or higher than 7.76.</p>
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13 pages, 1797 KiB  
Article
Prognostic Value of Coronary Artery Calcification in Patients with COVID-19 and Interstitial Pneumonia: A Case-Control Study
by Gianni Dall’Ara, Sara Piciucchi, Roberto Carletti, Antonio Vizzuso, Elisa Gardini, Maria De Vita, Chiara Dallaserra, Federica Campacci, Giovanna Di Giannuario, Daniele Grosseto, Giovanni Rinaldi, Sabine Vecchio, Federica Mantero, Lorenzo Mellini, Alessandra Albini, Emanuela Giampalma, Venerino Poletti and Marcello Galvani
J. Cardiovasc. Dev. Dis. 2024, 11(10), 319; https://doi.org/10.3390/jcdd11100319 - 11 Oct 2024
Viewed by 1204
Abstract
Background: Patients suffering from coronavirus disease-19 (COVID-19)-related interstitial pneumonia have variable outcomes, and the risk factors for a more severe course have yet to be comprehensively identified. Cohort studies have suggested that coronary artery calcium (CAC), as estimated at chest computed tomography (CT) [...] Read more.
Background: Patients suffering from coronavirus disease-19 (COVID-19)-related interstitial pneumonia have variable outcomes, and the risk factors for a more severe course have yet to be comprehensively identified. Cohort studies have suggested that coronary artery calcium (CAC), as estimated at chest computed tomography (CT) scan, correlated with patient outcomes. However, given that the prevalence of CAC is gender- and age-dependent, the influence of baseline confounders cannot be completely excluded. Methods: We designed a retrospective, multicenter case-control study including patients with COVID-19, with severe course cases selected based on death within 30 days or requiring invasive ventilation, whereas controls were age- and sex-matched patients surviving up to 30 days without invasive ventilation. The primary outcome was the analysis of moderate-to-severe CAC prevalence between cases and controls. Results: A total of 65 cases and 130 controls were included in the study. Cases had a significantly higher median pulmonary severity score at chest CT scan compared to controls (10 vs. 8, respectively; p = 0.0001), as well as a higher CAC score (5 vs. 2; p = 0.009). The prevalence of moderate-to-severe CAC in cases was significantly greater (41.5% vs. 23.8%; p = 0.013), a difference mainly driven by a higher prevalence in those who died within 30 days (p = 0.000), rather than those requiring invasive ventilation (p = 0.847). White blood cell count, moderate-to-severe CAC, the need for antibiotic therapy, and severe pneumonia at CT scan were independent primary endpoint predictors. Conclusions: This case-control study demonstrated that the CAC burden was higher in COVID-19 patients who did not survive 30 days or who required mechanical ventilation, and CAC played an independent prognostic role. Full article
(This article belongs to the Section Cardiovascular Clinical Research)
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<p>Coronary artery calcium (CAC) score distribution in cases and controls.</p>
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<p>Anatomic recognition of the coronary segments with the highest calcium scores in the case group.</p>
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<p>Primary endpoint of the study (<b>A</b>). Coronary artery calcium (CAC) distribution according to 30-day death (<b>B</b>) and need for invasive ventilation (<b>C</b>).</p>
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<p>Receiver operating characteristic curve comparison between the two variables obtained from chest CT: pneumonia severity score and coronary artery calcium score.</p>
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11 pages, 645 KiB  
Article
Modified Laboratory Risk Indicator and Machine Learning in Classifying Necrotizing Fasciitis from Cellulitis Patients
by Sujitta Suraphee, Piyapatr Busababodhin, Rapeeporn Chamchong, Pinyo Suparatanachatpun and Khemmanant Khamthong
Appl. Sci. 2024, 14(20), 9241; https://doi.org/10.3390/app14209241 - 11 Oct 2024
Viewed by 422
Abstract
Necrotizing fasciitis (NF) is a severe and life-threatening soft tissue infection that requires timely and accurate diagnosis to improve patient outcomes. The early diagnosis of NF remains challenging due to its similarity to other subcutaneous soft tissue infections like cellulitis. This study aims [...] Read more.
Necrotizing fasciitis (NF) is a severe and life-threatening soft tissue infection that requires timely and accurate diagnosis to improve patient outcomes. The early diagnosis of NF remains challenging due to its similarity to other subcutaneous soft tissue infections like cellulitis. This study aims to employ machine learning techniques to differentiate NF from cellulitis and enhance the diagnostic accuracy of NF by developing a modified LRINEC (MLRINEC) score. These modifications aimed to improve the sensitivity and specificity of NF diagnosis. The study utilized three machine learning classifiers—Logistic Regression, decision tree, and Random Forest—to assess their effectiveness in distinguishing between NF and cellulitis cases. The MLRINEC score was developed by incorporating six key blood test parameters: creatinine, hemoglobin, platelet count, sodium, white blood cell count, and C-reactive protein using laboratory data from Maha Sarakham Hospital in Northeastern Thailand. Our findings indicate that the decision tree classifier demonstrated superior performance, achieving the highest recall, particularly in accurately identifying NF cases. A feature importance analysis revealed that hemoglobin levels and white blood cell counts were the most critical factors influencing the model’s predictions. The platelet count (PT), C-reactive protein (CRP), and creatinine (CT) also played important roles, while sodium levels (NA) were the least influential. The MLRINEC score demonstrates high accuracy in classifying NF and cellulitis patients, paving the way for improved diagnostic protocols in clinical settings. Full article
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<p>Feature importance of the model.</p>
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<p>Boxplot of platelet counts (PT) in cellulitis and necrotizing fasciitis (NF) patients. The circles represent the outlier. The dark lines in each box correspond to the median of PT in each group. The red lines are the normal PT range.</p>
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14 pages, 4037 KiB  
Article
Serum Derivatives–Reactive Oxygen Metabolite Levels as a Marker of Clinical Conditions in Patients with Bronchial Asthma, COPD, or Asthma–COPD Overlap: A Prospective Study
by Keitaro Nakamoto, Masato Watanabe, Masaoki Saito, Keisuke Kasuga, Chika Miyaoka, Yuki Yoshida, Fumi Kobayashi, Hiroki Nunokawa, Jumpei Aso, Yasuo Nakamoto, Manabu Ishida, Mitsuru Sada, Kojiro Honda, Saori Takata, Takeshi Saraya, Masafumi Shimoda, Yoshiaki Tanaka, Mikio Saotome, Ken Ohta and Haruyuki Ishii
J. Clin. Med. 2024, 13(19), 6022; https://doi.org/10.3390/jcm13196022 - 9 Oct 2024
Viewed by 818
Abstract
Background: Oxidative stress plays an important role in the pathophysiology of bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), and asthma–COPD overlap (ACO), but its relevance has not been fully elucidated. The aim of this study was to measure the levels of oxidative [...] Read more.
Background: Oxidative stress plays an important role in the pathophysiology of bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), and asthma–COPD overlap (ACO), but its relevance has not been fully elucidated. The aim of this study was to measure the levels of oxidative stress and investigate its clinical significance in patients with BA, COPD, or ACO. Methods: We recruited 214 patients between June 2020 and May 2023 (109 patients with BA, 63 with COPD, and 42 with ACO). To assess clinical conditions, we evaluated patient characteristics, results of respiratory function tests and blood tests, and administered several questionnaires. We evaluated oxidative stress using the test for derivatives–reactive oxygen metabolites (d–ROMs) in serum. Results: The d–ROMs levels were significantly higher in patients with COPD or ACO than in patients with BA. There was no difference in serum d–ROMs levels between the COPD and ACO groups. In BA, d–ROMs levels were positively correlated with interleukin (IL)-6, IL-8, serum amyloid A (SAA), and C-reactive protein (CRP) levels; white blood cell (WBC) and neutrophil counts; and St. George’s Respiratory Questionnaire (SGRQ) scores, and they were negatively correlated with forced expiratory volume in 1 s (%FEV1) and asthma control test (ACT) score. In COPD, d–ROMs levels were positively correlated with IL-6, SAA, and CRP levels; WBC, neutrophil, and eosinophil counts; and COPD assessment test (CAT) and SGRQ scores, and they were negatively correlated with forced vital capacity (%FVC), %FEV1, and %FEV1/FVC scores. In ACO, d–ROMs levels were positively correlated with IL-6, SAA, tumor necrosis factor alpha (TNF-α), and CRP levels; and CAT and SGRQ scores, and they were negatively correlated with %FVC and %FEV1 scores. Conclusions: Serum d–ROMs levels may serve as a marker reflecting clinical conditions such as systemic inflammation, symptom severity, and airflow limitation in patients with BA, COPD, and ACO. Full article
(This article belongs to the Section Pulmonology)
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<p>Serum d–ROMs levels in patients with BA, COPD, or ACO. d–ROMs, derivatives–reactive oxygen metabolites; BA, bronchial asthma; COPD, chronic obstructive pulmonary disease; ACO, asthma–COPD overlap; * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Receiver operating characteristic curve for serum d–ROMs levels to discriminate BA from COPD and ACO. AUC, area under the curve.</p>
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<p>Correlation between serum d–ROMs levels and lung function test parameters in BA. FVC, forced vital capacity; FEV1, forced expiratory volume in 1 s.</p>
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<p>Correlation between serum d–ROMs levels and lung function test parameters in COPD.</p>
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<p>Correlation between serum d–ROMs levels and lung function test parameters in ACO.</p>
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<p>Correlation between serum d–ROMs levels and respiratory questionnaire score in BA. ACT, asthma control test; SGRQ, St. George’s Respiratory Questionnaire.</p>
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<p>Correlation between serum d–ROMs levels and respiratory questionnaire score in COPD. CAT, COPD assessment test.</p>
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<p>Correlation between serum d–ROMs levels and respiratory questionnaire score in ACO.</p>
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12 pages, 1196 KiB  
Article
Predictive Factors of Canine Malignant Hepatic Diseases with Multifocal Hepatic Lesions Using Clinicopathology, Ultrasonography, and Hepatobiliary Ultrasound Scores
by Aphinan Phosri, Pinkarn Chantawong, Niyada Thitaram, Kidsadagon Pringproa and Atigan Thongtharb
Animals 2024, 14(19), 2910; https://doi.org/10.3390/ani14192910 - 9 Oct 2024
Viewed by 713
Abstract
Multifocal hepatic lesions in dogs arise from various benign and malignant liver diseases. Diagnosing these lesions is challenging because clinical signs, hematological data, and serum biochemistry are not definitive indicators. Ultrasound is utilized as a diagnostic imaging tool to evaluate liver parenchyma and [...] Read more.
Multifocal hepatic lesions in dogs arise from various benign and malignant liver diseases. Diagnosing these lesions is challenging because clinical signs, hematological data, and serum biochemistry are not definitive indicators. Ultrasound is utilized as a diagnostic imaging tool to evaluate liver parenchyma and detect hepatic lesions. This study aims to investigate the predictive factors that differentiate between benign and malignant multifocal hepatic lesions by examining ultrasound characteristics, blood tests, and serum biochemistry. In total, 43 dogs with multifocal hepatic lesions were included in this study. All dogs were classified into benign hepatic diseases (n = 32) and malignant haptic diseases (n = 11). For all dogs, their liver characteristics, lesion characteristics, and hepatobiliary ultrasound score by ultrasound were evaluated and we collected individual clinicopathological data for analysis. The findings of the univariate analysis revealed significant differences in four hematological and blood chemical parameters (hematocrit, white blood cell count, aspartate transaminase (AST), and alkaline phosphatase (ALP)) and six ultrasonographic parameters (liver parenchymal echogenicity, lesion homogeneity, lesion echogenicity, maximum lesion dimension, average lesion dimension, and hepatobiliary ultrasound score). Using multivariate analysis, only two parameters, hepatobiliary ultrasound score and lesion homogeneity, showed significant differences (p-value < 0.001 and p-value = 0.011, respectively). Additionally, these parameters demonstrated high accuracy in predicting malignant multifocal liver lesions, with accuracy rates of 97.67% and 93.02%, respectively. Therefore, the hepatobiliary ultrasound score and lesion homogeneity are considered effective parameters for screening malignant multifocal liver lesions in dogs. Full article
(This article belongs to the Section Veterinary Clinical Studies)
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<p>Dog. Hepatocellular carcinoma. Ultrasonographic image illustrates multifocal heterogeneous heteroechoic lesions (asterisks). Hepatobiliary ultrasound score is severe (score 7–12). B-mode (10 MH<sub>z</sub> probe).</p>
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<p>Dog. Hepatic nodular hyperplasia. Ultrasonographic image illustrates multifocal homogeneous hypoechoic lesions (asterisks) and hyperechoic liver parenchyma. Hepatobiliary ultrasound score is moderate (score 3–6). B-mode (10 MH<sub>z</sub> probe).</p>
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<p>Comparison of hepatobiliary ultrasound score between benign and malignant multifocal liver lesion groups. The graph indicated that the malignant group had a severe score, whereas the majority of the benign group exhibited moderate scores, which were significantly different (* <span class="html-italic">p</span>-value &lt; 0.001).</p>
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12 pages, 1170 KiB  
Systematic Review
AI Algorithms for Modeling the Risk, Progression, and Treatment of Sepsis, Including Early-Onset Sepsis—A Systematic Review
by Karolina Tądel, Andrzej Dudek and Iwona Bil-Lula
J. Clin. Med. 2024, 13(19), 5959; https://doi.org/10.3390/jcm13195959 - 7 Oct 2024
Viewed by 1098
Abstract
Sepsis remains a significant contributor to neonatal mortality worldwide. However, the nonspecific nature of sepsis symptoms in neonates often leads to the necessity of empirical treatment, placing a burden of ineffective treatment on patients. Furthermore, the global challenge of antimicrobial resistance is exacerbating [...] Read more.
Sepsis remains a significant contributor to neonatal mortality worldwide. However, the nonspecific nature of sepsis symptoms in neonates often leads to the necessity of empirical treatment, placing a burden of ineffective treatment on patients. Furthermore, the global challenge of antimicrobial resistance is exacerbating the situation. Artificial intelligence (AI) is transforming medical practice and in hospital settings. AI shows great potential for assessing sepsis risk and devising optimal treatment strategies. Background/Objectives: This review aims to investigate the application of AI in the detection and management of neonatal sepsis. Methods: A systematic literature review (SLR) evaluating AI methods in modeling and classifying sepsis between 1 January 2014, and 1 January 2024, was conducted. PubMed, Scopus, Cochrane, and Web of Science were systematically searched for English-language studies focusing on neonatal sepsis. Results: The analyzed studies predominantly utilized retrospective electronic medical record (EMR) data to develop, validate, and test AI models to predict sepsis occurrence and relevant parameters. Key predictors included low gestational age, low birth weight, high results of C-reactive protein and white blood cell counts, and tachycardia and respiratory failure. Machine learning models such as logistic regression, random forest, K-nearest neighbor (KNN), support vector machine (SVM), and XGBoost demonstrated effectiveness in this context. Conclusions: The summarized results of this review highlight the great promise of AI as a clinical decision support system for diagnostics, risk assessment, and personalized therapy selection in managing neonatal sepsis. Full article
(This article belongs to the Section Hematology)
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<p>Flowchart for selection of publications.</p>
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<p>Review of sources of data used across included studies from the first stage of the identification process.</p>
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<p>Number of SLRs included over the years.</p>
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12 pages, 479 KiB  
Article
Stent-Induced Inflammation: A Comparative Cross-Sectional Study of Post-Implantation Syndrome in Venous and Arterial Procedures
by Nur Dikmen, Evren Ozcinar, Ali Ihsan Hasde, Ahmet Kayan, Nadir Polat, Ali Ardakani, Ezel Kadiroğlu Yuruyen and Zeynep Eyileten
J. Clin. Med. 2024, 13(19), 5937; https://doi.org/10.3390/jcm13195937 - 5 Oct 2024
Viewed by 702
Abstract
Background: Postimplantation syndrome (PIS) is a known inflammatory response following endovascular stent placement, yet comparative data between venous and arterial stenting remains limited. This study seeks to evaluate the incidence, characteristics, and clinical implications of PIS across these two distinct vascular territories. Methods: [...] Read more.
Background: Postimplantation syndrome (PIS) is a known inflammatory response following endovascular stent placement, yet comparative data between venous and arterial stenting remains limited. This study seeks to evaluate the incidence, characteristics, and clinical implications of PIS across these two distinct vascular territories. Methods: We retrospectively analyzed 191 patients who underwent either venous (n = 36) or arterial (n = 155) stent placement. Data collection encompassed demographic profiles, perioperative laboratory findings, and clinical outcomes. The primary endpoint was the incidence of PIS, defined as the presence of fever (≥38 °C), leukocytosis, and elevated C-reactive protein (CRP) within 30 days postprocedure. Secondary outcomes included length of hospital and ICU stay, incidence of endoleaks, reintervention rates, and 30-day mortality. Comparative statistical analyses were conducted to assess differences between the venous and arterial stent groups. Results: PIS was observed more frequently in arterial stent patients, as evidenced by significantly elevated postoperative white blood cell counts at 24 and 48 h (p = 0.046 and p = 0.014, respectively), along with borderline CRP increases (p = 0.052). Fever occurrence peaked at 72 and 96 h postprocedure, predominantly in the arterial cohort. Furthermore, patients with arterial stents had significantly longer hospital stays (5.59 ± 0.46 days vs. 3.42 ± 0.36 days; p = 0.0018) and a higher rate of 30-day endoleaks (7.1% vs. 0%; p = 0.005). Despite similar mortality and major adverse cardiac event (MACE) rates between groups, arterial stent patients exhibited a greater need for reintervention. While PIS was less common among venous stent recipients, its potential impact on postoperative recovery warrants careful monitoring. Conclusions: Arterial stenting is associated with a higher incidence of PIS and a more pronounced systemic inflammatory response, contributing to longer hospitalization and increased postoperative complications. Although venous stent patients experience PIS less frequently, its occurrence should not be overlooked, as it may influence overall recovery and clinical outcomes. Recognition and management of PIS in both venous and arterial stent patients are critical to improving patient care and optimizing procedural success. Full article
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<p>Study design and process.</p>
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15 pages, 3592 KiB  
Article
Evaluation of the Microscanner C3 for Automated Cell Counting in Cerebrospinal Fluid Analysis
by Insu Park, Minkyeong Choi, Eunji Lee, Seoyeon Park, Woong Sik Jang, Chae Seung Lim and Sun-Young Ko
Diagnostics 2024, 14(19), 2224; https://doi.org/10.3390/diagnostics14192224 - 5 Oct 2024
Viewed by 538
Abstract
Background: Cerebrospinal fluid (CSF) analysis is essential for diagnosing various disorders affecting the central nervous system (CNS). Traditionally, CSF cell count analysis is performed manually using a Neubauer chamber hemocytometer, which is labor-intensive and prone to subjective interpretation. Methods: In this [...] Read more.
Background: Cerebrospinal fluid (CSF) analysis is essential for diagnosing various disorders affecting the central nervous system (CNS). Traditionally, CSF cell count analysis is performed manually using a Neubauer chamber hemocytometer, which is labor-intensive and prone to subjective interpretation. Methods: In this study, we evaluated the analytical and clinical performance of the Microscanner C3, an automated cell counting system, for CSF analysis using artificially prepared samples and 150 clinical CSF samples. Results: The lowest detectable white blood cell (WBC) count was 3.33 cells/µL, and the lowest detectable red blood cell (RBC) count was 3.67 cells/µL. The coefficients of variation (CV%) for the Microscanner C3 were lower than those for the Neubauer chamber at all cell concentrations. The correlation coefficients (R) between the Microscanner C3 and conventional methods were high: 0.9377 for WBCs and 0.9952 for RBCs when compared with the Neubauer chamber, and 0.8782 for WBCs and 0.9759 for RBCs when compared with the flow cytometer. Additionally, the Microscanner C3 showed good agreement with both the Neubauer chamber and flow cytometer in the Passing–Bablok regression analysis and Bland–Altman analysis for WBC count at all concentrations and RBC count at concentrations of 0–1000 cells/µL. Conclusions: The Microscanner C3 proved to be more sensitive, precise, and consistent compared to the conventional hemocytometer. The new system is also compact, convenient, and cost-effective, making it a valuable option for clinical laboratories. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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<p>An overview of the Microscanner C3 for counting CSF cells. The Microscanner C3, equipped with a digital microscope and image analysis software, has dimensions of 245 mm (width) × 280 mm (depth) × 240 mm (height) and weighs 4.5 kg (<b>A</b>). The BZ-1 chip is loaded into the micro-scanner, and images are captured (<b>B</b>). The Microscanner C3 system captures single optical bright-field (BF), green-field (GF), and cyan-field (CF) images of blood cells in CSF. The images of BF, GF, and CF are obtained by photographing white blood cells stained with SYBR Green I (<b>C</b>) and by photographing red blood cells stained with APC mouse anti-human CD235a (<b>D</b>). The analysis workflow for the images describes the algorithm of the artificial intelligence-based hematology analysis program. WBCs and RBCs are classified based on the presence, location, size, and fluorescence of the cells within the three images (<b>E</b>).</p>
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<p>Results of the Microscanner C3 image analysis program. The X-axis represents the fluorescence intensity of the CF images, and the Y-axis represents that of the GF images. The graph is divided into four sections based on the staining strength of the cells (<b>A</b>). The C1 zone is defined as an area where both fluorescence signals are negative. Fluorescence signals in the C2 and C3 zones represent WBCs stained with SYBR Green I and RBCs stained with APC, respectively. The signals in the C4 area are differentiated using an artificial intelligence image analysis program to separate overlapping signals generated from WBCs, RBCs, or artifacts. The distribution of the two fluorescence signal intensities can be output as a histogram (<b>B</b>). Signals in WBCs are classified as the G1 zone (on the left), while signals in RBCs are classified as the G2 zone (on the right).</p>
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<p>The linearity of cell counts was measured by the Microscanner C3 for WBCs (<b>A</b>) and RBCs (<b>B</b>) (<span class="html-italic">r</span><sup>2</sup> values: WBC = 0.9943, RBC = 0.9859). The agreement between the expected and measured cell counts is shown in a scatter plot with the line y = x (in red). The X-axis represents the expected cell counts of the quality control material, and the Y-axis represents the measured cell count results obtained from the Microscanner C3. Each concentration was measured three times.</p>
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<p>Correlation analysis plot of WBC (<b>A</b>,<b>C</b>,<b>E</b>) and RBC (<b>B</b>,<b>D</b>,<b>F</b>) counts in the CSF samples using the Neubauer chamber, Microscanner C3, and flow cytometer (N = 150). The baseline (y = x) is indicated by solid red lines, and the regression lines are indicated by dashed black lines.</p>
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<p>Passing–Bablok regression analysis of WBC (<b>A</b>,<b>C</b>,<b>E</b>) and RBC (<b>B</b>,<b>D</b>,<b>F</b>) counts in the CSF samples using the Neubauer chamber, Microscanner C3, and flow cytometer (N = 150). The baseline (y = x) is indicated by red solid lines, the slope by black dashed lines, and the 95% confidence interval by red dotted lines.</p>
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<p>Bland–Altman analysis of WBC (<b>A</b>,<b>C</b>,<b>E</b>) and RBC (<b>B</b>,<b>D</b>,<b>F</b>) counts in the CSF samples using the Neubauer chamber, Microscanner C3, and flow cytometer (N = 150). The mean difference is indicated by horizontal black solid lines, while the limits of agreement, defined as the mean difference plus or minus 1.96 times the standard deviation of the difference, are indicated by red dotted lines.</p>
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