Serum Calcium Research Articles

Autoantibodies in sarcoidosis: Innocent bystander or promising biomarker for organ involvement?

Sarcoidosis is a rare inflammatory disease that can affect any organ in the body, but most commonly involves lungs and lymph nodes. Sarcoidosis is often considered an autoimmune disease, attributed to many factors, including autoantigen-specific T cells, antibodies producing B lymphocytes, autoimmune inflammation, although its exact cause and classification are still under debate.The aim of our study was to evaluate the possible role of autoantibodies, such as anti-nuclear (ANA), extractable nuclear antigen (ENA) and antiphospholipids, in sarcoidosis patients. We conduct a retrospective study on our patients with confirmed diagnosis of sarcoidosis involving lungs, lymph nodes and multiple organs, and we collected and analyzed data on blood and urine tests (C-reactive protein, CRP, amount of calcium in blood and urine, CD4/CD8 ratio, lymphocyte count), lung function, radiological patterns, ongoing treatments (steroid therapy, hydroxychloroquine or methotrexate, other immunosuppressive agents). We enrolled 328 sarcoidosis patients, and we focused our attention on 32 patients with positive ANA antibodies (11%), observing a high percentage of them with sarcoidosis involving the lungs (77%), but more specifically a significant discrepancy, in percentage terms, in the blood CD4/CD8 ratio. In the ANA-positive group we observed 26% of patients with a high blood CD4/CD8 ratio (average CD4/CD8 ratio of 2.41), whereas in the ANA-negative group, patients with a high CD4/CD8 ratio (average ratio 1.78) represented a much smaller percentage (13%). This finding may be a source of further investigation for other studies on the topic. Analysis of autoantibodies expressed in our case series did not identify a specific autoantibodies pattern in sarcoidosis. Few studies have analyzed autoantibody patterns in sarcoidosis patients and involved smaller populations. In conclusion, our study evaluates a sizable population, and underlines the need for further, larger clinical studies to evaluate possible associations between sarcoidosis and autoimmunity.

Chronic administration of Musa acuminata Colla (BANANA) to Wistar albino rats induces hyperkalemia

ABSTRACT Background Hyperkalemia is a medical condition characterized by excess potassium in the blood. Overindulgence in foods high in potassium can also result in hyperkalemia, particularly in individuals with severe kidney disease.. Aim of the study In this study, hyperkalemia was assessed in Wistar albino rats administered with M. acuminata. Material and Methods Thirty-six rats underwent various treatments over three months after being randomly divided into groups of six. Standard medications administered included Lisinopril and keyaxalate. The proximate and mineral content of raw banana (RB) and normal rat pellets (NRP) were compared and evaluated with that of cooked banana (CB). The rats’ serum and urine calcium and potassium levels were measured using established protocols. Results In comparison to RB, CB was found to have significantly higher levels of nutrients (proteins and fats) and minerals (calcium, sodium, and potassium). Administration of CB markedly significantly increased serum potassium levels however, keyaxalate decreased urine potassium levels; the treatment of kayexalate plus lisinopril markedly decreased urine Ca concentration (p<0.05). Conclusions Cooked banana has a higher mineral and nutritional content than raw banana. Continuous and daily consumption of cooked bananas led to hyperkalemia in Wistar rats as evidenced by elevated serum potassium levels.

The impact of creatine levels on musculoskeletal health in the elderly: a mendelian randomization analysis

BackgroundMusculoskeletal health among the elderly emerges as a pivotal public health concern against the backdrop of a globally aging population. Creatine, popular within fitness circles, has emerged as a subject of scientific inquiry for its potential benefits on elderly’ musculoskeletal well-being. Despite extensive documentation of its effects on athletic performance, investigations into creatine’s long-term contributions to the musculoskeletal health of the elderly are comparatively limited. Utilizing publicly accessible genetic datasets, this study aimed to explore the potential causal link between creatine levels and a variety of musculoskeletal health markers in the elderly population, such as osteoarthritis (OA), rheumatoid arthritis (RA), osteoporosis (OP), bone-specific alkaline phosphatase, bone mineral density(BMD), serum calcium levels, and reduced hand grip strength in individuals aged 60 and above.MethodsOur methodological approach was grounded in Mendelian Randomization (MR) analysis, with a primary emphasis on the Inverse Variance Weighted (IVW) technique, to explore potential causal links under specific assumptions and limitations inherent to MR analysis.ResultsA significant inverse relationship was observed between creatine levels and reduced hand grip strength in individuals aged 60 and above (OR = 0.64, b=-0.44, p = 0.01), suggesting higher creatine levels might be beneficial in maintaining hand grip strength. Conversely, analysis of other bone health parameters, including bone-specific alkaline phosphatase, bone mineral density, serum calcium levels, and conditions such as osteoarthritis, rheumatoid arthritis, and osteoporosis, yielded p-values exceeding 0.05, denoting no statistically significant associations.ConclusionsThis study provides preliminary evidence indicating a link between creatine levels and decreased hand grip strength among the elderly, notably in individuals aged 60 and older. This finding is significant for understanding the potential impact of creatine supplementation on elderly Musculoskeletal health and underscores the need for evidence-based decision-making in nutritional supplementation. To robustly validate these observations, it is essential to conduct future randomized controlled trials with large sample sizes.

Opportunistic Assessment for Parathyroid Adenoma on CT: A Retrospective Cohort Study Evaluating Primary Hyperparathyroidism-Associated Morbidity Over 10 Years of Follow-Up.

Background: Primary hyperparathyroidism (PHPT) is underdiagnosed. Opportunistic imaging-based parathyroid gland assessment is a proposed strategy for identifying patients at increased risk of undiagnosed PHPT. However, whether this approach is likely to identify individuals with clinically significant disease is unknown. Objective: This study's objective was to assess for associations of the presence of an enlarged parathyroid gland on contrast-enhanced CT with clinical outcomes causally related to PHPT. Methods: This retrospective cohort study included patients age 18 years old or older with at least one contrast-enhanced chest or neck CT performed from January 2012 to December 2012, at least one noncontrast CT covering the chest or neck region without date restriction, and at least one clinical encounter in the health system from January 2022 to December 2022. A neuroradiologist reviewed the CT examinations to determine the presence versus absence of an enlarged parathyroid gland on the 2012 study. Patient demographics, serum calcium results, and diagnosis codes for clinical outcomes causally related to PHPT were extracted from the EHR. Calcium results and diagnosis codes were classified as pre-existing if documented before, and as incident if documented after, the 2012 contrast-enhanced CT examination. Results: The cohort included 1198 patients (593 male; 605 female; mean age, 51.6 years), of whom 43 (3.6%) were assessed as having an enlarged parathyroid gland on the 2012 contrast-enhanced CT examination. PHPT was diagnosed in 16.3% of patients with, versus 0.3% of patients without, an enlarged parathyroid gland. After adjusting for age, sex, race, and ethnicity, presence of an enlarged parathyroid gland was associated with significantly increased odds of pre-existing nephrolithiasis (OR=2.71; p=.03), hypercalcemia (OR=5.30; p<.001), and PHPT (OR=12.59; p=.008) as well as increased odds of incident osteopenia or osteoporosis (OR=2.78; p=.008), nephrolithiasis (OR=4.95; p<.001), hypercalcemia (OR=7.58; p<.001), and PHPT (OR=148.01; p<.001). Conclusion: An enlarged parathyroid gland indicated increased PHPT risk as well as increased risk of pre-existing and incident clinical conditions causally related to PHPT. Clinical Impact: Opportunistic CT-based assessment is a promising strategy for identifying patients at increased risk of undiagnosed PHPT; such assessment could potentially prevent some PHPT-related complications through earlier diagnosis and treatment.

Evaluation of bone mineral density and biochemical markers in pediatric patients with phenylketonuria

ObjectivesPhenylketonuria is a hereditary condition caused by the deficiency of the enzyme phenylalanine hydroxylase, leading to abnormal phenylalanine metabolism. Managing phenylketonuria involves implementing dietary interventions to control phenylalanine levels and prevent complications. However, these treatments can lead to long-lasting negative effects, including impacts on bone health and abnormal biochemical test findings. The aim of the study was to examine the relationship between biological markers and bone density in individuals with phenylketonuria. MethodsThis cross-sectional study was conducted out at Motahari Hospital in Urmia, Iran. The study involved 19 patients with phenylketonuria, examining their demographic information, laboratory findings, and bone density by statistical methods. ResultsThe study examined the association between age and bone densitometry outcomes, along with the connection between different biochemical markers and bone densitometry results. The analysis showed no statistically significant link between age and bone densitometry data (P-value = 0.31). The p-values for correlation between bone densitometry and serum calcium, serum phosphorus, phenylalanine, alkaline phosphatase, and 25-hydroxyvitamin D₃ were found to be 0.30, 0.27, 0.57, 0.86, and 0.95, respectively. The only significant relationship was between the result of bone densitometry and alkaline phosphatase levels in the age group below 8 years with a correlation of 0.720 (P-value = 0.01). ConclusionsThe study revealed no association between bone densitometry and levels of serum calcium, serum phosphorus, phenylalanine, and 25-hydroxyvitamin D₃. The only meaningful association was between bone densitometry and alkaline phosphatase in the age group below 8 years.

Methionine supplementation regulates eggshell quality and uterine transcriptome in late-stage broiler breeders

This study aimed to compare the effects of dietary methionine (Met) and 2-hydroxy-4-(methylthio)-butanoate (HMTBA) on the eggshell quality of broiler breeder hens and elucidate the mechanism of Met in improving eggshell quality from the perspectives of eggshell microstructure and shell gland physiological function. A total of 720 WOD188 broiler breeder hens at 40 wk old were assigned to 3 groups, with 8 replicates per group and 30 birds per replicate. Over 7 weeks, birds were fed a basal diet or the same diet supplemented with 0.15% Met or 0.17% HMTBA. Our findings revealed significant improvements in the Met group for egg shape index, shell thickness, breaking strength, and fracture toughness (P < 0.05), whereas the HMTBA group showed no significant improvements (P > 0.05). Met supplementation increased calcium and phosphorus levels in both serum and shell gland tissue (P < 0.05), and enhanced Ca2+ ATPase activity in shell gland tissue (P < 0.05). Histomorphological changes included enhanced mucosal fold dimensions and increased epithelial height in the shell gland (P < 0.05). Met also improved eggshell ultrastructure, resulting in a thicker effective layer and broader mammillae with fewer type B structures (P < 0.05). The mRNA levels for genes regulating eggshell ultrastructure, such as OC-116, CALB1, and ITM2C, were significantly upregulated in the Met group (P < 0.05). Transcriptome analysis identified 248 differentially upregulated genes in the Met group, primarily linked to the non-canonical Wnt/Ca2+ signaling pathway, crucial for calcium ion transport and cellular proliferation. This research highlights that Met supplementation improves eggshell quality by enhancing calcium transport and cellular proliferation in uterine function, particularly through the modulation of WNT11 and CALB1, influencing calcium deposition and ultrastructural development.

Parathyroid allotransplantation for severe post-surgical hypoparathyroidism: a Brazilian experience.

This study presents the cases of two women who developed severe permanent hypoparathyroidism after neck surgery for papillary thyroid cancer and underwent parathyroid allotransplantation. Despite taking high doses of calcium and calcitriol supplements, the patients experienced persistent hypocalcemic symptoms. Fresh parathyroid tissue was removed and prepared from two patients with hyperparathyroidism secondary to end-stage kidney disease and was implanted in the non-dominant forearm of the recipients. Donors and recipients were ABO-compatible, and immunological screening was performed only in Case 2 (HLA typing, panel reactive antibody, and crossmatch tests). A short-term immunosuppressive regimen was adopted, consisting of 3days of methylprednisolone followed by 7days of prednisone. In Case 1, oral supplementation decreased to half of the initial dose 1month after transplantation and to one-fifth at the end of a 12-month follow-up period. In Case 2, intravenous calcium was discontinued 1-week post-transplantation, with no need for its use during the 12-month follow-up period. Serum parathyroid hormone levels did not increase and remained undetectable in both cases. In contrast, serum calcium levels increased significantly, and both patients experienced relief from hypocalcemic symptoms. Parathyroid allotransplantation can be an effective and safe treatment for PH and should be considered in severe cases. Nevertheless, formal recommendations depend on additional studies and validated protocols.

Construction and verification of prediction model for postoperative hypokalemia in patients with oral cancer.

This study aimed to explore the risk factors of postoperative hypokalemia in patients with oral cancer and to provide a basis for preventing and controlling postoperative hypokalemia. We included 366 patients undergoing oral cancer surgery in the Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University from January 2022 to August 2022. Univariate and multivariate analyses were used to determine the risk factors of postoperative hypokalemia. The receiver operation characteristic (ROC) curve was used to quantify the effectiveness of the factors. A nomogram of the risk factors for postoperative hypokalemia in oral cancer patients was developed and validated. A total of 224 patients (61.20%) had postoperative hypokalemia, the lowest serum potassium level (3.50±0.35) mmol/L on the 4th day after surgery, and the highest incidence of hypokalemia (54.68%). Variables with P<0.05 in the univariate analysis were quantified by ROC curve followed by multivariate logistic regression analysis. Results showed an independent correlation with postoperative hypokalemia as follows: preoperative serum potassium<3.87 mmol/L (P=0.008), preoperative serum calcium<2.31 mmol/L (P=0.033), preoperative PNI<49.16 (P=0.032), postoperative drainage volume>264.25 mL (P=0.002). The above variables were constructed into a postoperative hypokalemia risk nomogram and verified, and a good degree of fit was found. The independent risk factors for postoperative hypokalemia in patients with oral cancer were as follows: preoperative serum potassium<3.87 mmol/L, preoperative serum calcium<2.31 mmol/L, preoperative PNI<49.16, and postoperative drainage volume>264.25 mL. Clinical attention should be paid to managing the above high-risk patients. Preventive potassium supplementation should be performed as soon as possible to reduce hypokalemia occurrence.

Analysis of blood calcium levels in calcium water consumers

Introduction: Water is a primary and basic human need. One of the chemical parameters that must be met for drinking water needs is mineral content, such as calcium and magnesium. Water hardness is a condition in which there is excessive calcium and magnesium content, which is commonly known as calcareous water. If consumed long-term, high-water hardness that exceeds normal limits can interfere with body health. Specifically, excess calcium in the body can cause hypercalcemia, hyperparathyroidism, kidney stones, and muscle tissue damage (muscle weakness). Objective: This study aims to determine blood calcium levels in individuals who consume calcareous healthy water. Methods: The type of research used is descriptive-analytical, with blood calcium level analysis carried out using the Ion Selective Electrode (ISE) method through the Electrolyte Analyzer (CBS400). Result: Based on the results of the study, it was obtained that blood calcium levels in 30 community respondents in Ranomeeto District (100%) were above the reference value, indicating high blood calcium levels. Conclusion: blood calcium levels in people who consume lime juice indicate high blood calcium levels. Consuming water with a high lime content can hurt health. Therefore, people need to consider the quality of the drinking water they drink, especially those that have a high lime content, to maintain heart and kidney health in the long term.

Prediction of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Patients Receiving Anti-resorptive Therapy Using Machine Learning Models

BackgroundMedication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with the use of antiresorptive agents, impacting patient quality of life and treatment outcomes. Predictive modeling may aid in a better understanding of MRONJ development. PurposeThe study aimed to evaluate machine learning (ML)-based models for predicting MRONJ in patients receiving antiresorptive therapy.Study Design, Setting, Sample: This retrospective in silico study analyzed electronic medical records from Thammasat University Hospital, covering the period from January 2012 to December 2022. The sample included subjects receiving antiresorptive therapy, excluding those with a history of radiation therapy or metastatic jaw disease. Predictor VariablesThe primary predictor variable was the predicted probability of MRONJ development from the ML models. Outcome VariablesThe outcome variable was MRONJ status coded as present or absent based on chart review. CovariatesCovariates included demographic data, MRONJ occurrence, location and staging of MRONJ, comorbidities, diseases related to antiresorptive agents, types of antiresorptive agents, therapy duration, concurrent medications, blood calcium levels, and dental factors. AnalysesModel performance was assessed via accuracy, sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve (AUROC). Additionally, univariate and multivariate Cox regression analyses were conducted to identify factors significantly associated with MRONJ development. P ≤ 0.05 was statistically significant. ResultsThe study analyzed data from 5,305 subjects with a mean age of 75 ± 11.1 years, predominantly female. MRONJ was observed in 81 cases (1.5%), with a median time to development of 33 months (IQR = 3). Among the six models tested, the best-performing model had an accuracy of 0.95 and an AUROC of 0.89–0.90. Significant predictors identified through Cox regression included metabolic syndrome (HR = 14.064, 95% CI = 1.111–178.067, P = 0.041) and patients receiving intravenous pamidronate (HR = 5.932, 95% CI = 1.755–20.051, P = 0.004), indicating their strong association with MRONJ development. Conclusions and RelevanceML-based predictive and time-to-event models effectively predict MRONJ risk, aiding in the strategic prevention and management for patients undergoing antiresorptive therapy.

Association between hypertension, diabetes, depression, and serum calcium with the risk of all-cause and vascular dementia: findings from the UK biobank.

The associations between serum calcium levels and the risk of all-cause dementia and vascular dementia (VaD) are not well understood. Additionally, the potential roles of hypertension, diabetes, and depression in this association need to be explored. This study aimed to investigate the links between serum calcium and all-cause dementia and VaD and to assess the role of hypertension, diabetes, and depression in that association. For this cohort study, data were extracted from the UK Biobank, a population-based longitudinal survey with baseline assessments from 2006 to 2010 in England, Wales, and Scotland. A total of 363 182 participants without dementia at baseline were included. Cases of all-cause dementia and VaD were identified through database linkage until December 31, 2022. The hazards of all-cause dementia and VaD were estimated using Cox proportional hazards regression models. Mediation analyses were performed to evaluate the mediation effect of hypertension, diabetes, and depression. During a median follow-up of 13.8years, 5 836 cases of all-cause dementia and 1 301 cases of VaD were identified. Participants with higher levels of serum calcium (in the third and fourth quartile, > 2.37 to ≤ 2.43mmol/L and > 2.43mmol/L) had a lower risk of all-cause dementia compared to those in the first quartile (≤ 2.32mmol/L) (Hazard Ratio [HR] [95% Confidence Interval (CI)] in Q3: 0.87 (0.81-0.93), HR [95% CI] in Q4: 0.90 [0.84-0.97]). For VaD, HRs (95% CIs) in the second, third, and fourth quartiles were 0.80 (0.69-0.93), 0.76 (0.65-0.89), and 0.80 (0.69-0.93), respectively. Hypertension, diabetes, and depression significantly explained 18.67%, 2.57%, and 18.91% of the mediation effects on serum calcium-related dementia, respectively. Diabetes and depression contributed 1.85% and 15.34% of mediation effects on the association between serum calcium and the risk of VaD. This study found that individuals with higher serum calcium levels (> 2.37mmol/L) had a reduced risk of developing dementia. Hypertension, diabetes, and depression significantly mediated the association. These findings highlight the significance of considering serum calcium levels as a potential indicator for the development of dementia. Further, optimizing the treatment of associated diseases and managing risk factors, particularly for individuals with lower serum calcium levels, is important.

The roles of mTORC1 in parathyroid gland function in chronic kidney disease-induced secondary hyperparathyroidism: Evidence from male genetic mousemodels and clinical data.

Secondary hyperparathyroidism (SHP) associated with chronic kidney disease (CKD) contributes to morbidity and mortality, yet the related parathyroid signaling pathways are not fully understood. Previous studies have indicated that the parathyroid mTORC1 pathway is activated in both experimental CKD and hypocalcemia-induced SHP. Furthermore, mice with parathyroid-specific mTOR deficiency (PT-mTOR-/-) exhibit disrupted parathyroid glands, but maintain normal serum PTH levels. Conversely, PT-Tsc1-/- mice, with mTORC1 hyperactivation, have enlarged glands and high serum PTH and calcium levels. We now uncover links between mTORC1 function, parathyroid gland morphology, and the response to CKD. Despite impaired gland structure, PT-mTOR-/- mice increased serum PTH to levels similar to controls in response to CKD, but not to acute kidney injury (AKI), highlighting the adaptability of their parathyroid glands to chronic but not acute stimulation. PT-Tsc1-/- mice, with enlarged glands also exhibited a CKD-induced rise in serum PTH comparable to controls, but with a reduced magnitude, suggesting compromised secretion capacity. Parathyroid glands from PT-Tsc1-/- mice displayed sustained high PTH secretion in culture, with no further increase when exposed to calcium-depleted media, unlike control glands. Complementing these findings, human data from 106 healthcare organizations demonstrated that drug-induced mTORC1 inhibition is associated with reduced serum PTH and a lower incidence of SHP in kidney transplant recipients. Collectively, our findings underscore the complex interplay between mTORC1 signaling and gland structure in the pathogenesis of SHP.

The effects of soy protein and soy isoflavones intake on chronic kidney disease: a systematic review and meta-analysis.

Existing literatures on the potential impact of soy protein consumption on kidney function present conflicting findings. In this study, a meta-analysis has been conducted to assess the impact of soy protein consumption in comparison to animal protein consumption among individuals with chronic kidney disease (CKD). A structured electronic search was conducted on Medline, EMBASE, and Cochrane Library for randomized controlled trials published up to March 2024. The outcome measures were serum creatinine (SCR), triglyceride (TG), total cholesterol (TC), calcium (Ca), C-reactive protein, proteinuria, high-density lipoprotein (HDL), low-density lipoprotein (LDL), uric acid (UA) and phosphorus concentrations. Mean differences were calculated for net changes using random-effects models. Eighteen trials with a total of 522 participants were included in this systematic review. The results showed that consumption of soy protein led to a significant decrease in total cholesterol, LDL, and proteinuria levels. The average reduction was - 20.55mg/dL (95% CI - 38.25, - 2.85mg/dL) for total cholesterol (P = 0.02), - 8.26mg/dL (95% CI - 13.35, - 3.17mg/dL; P = 0.001) for LDL and - 140.53 (95% CI - 205.83, - 75.23mg/day) for proteinuria. No statistically significant impact was observed on serum creatinine, triglycerides, calcium, C-reactive protein, HDL, uric acid, or phosphorus levels. The findings of the meta-analysis showed a potential protective impact of soy protein intake on hyperlipidemia and proteinuria inCKD patients. It is important to note that the evidence presented may be of limited accuracy due to relatively small number of trials and participants.

Effect of multidisciplinary medical nutrition therapy on the nutrition status of patients receiving peritoneal dialysis: A randomized controlled trial.

Malnutrition is a prevalent complication in patients undergoing peritoneal dialysis (PD). This study established a multidisciplinary team for medical nutrition therapy (MNT) to investigate the impact of this approach on enhancing the nutrition, anemic, and microinflammatory status of patients receiving PD. This randomized controlled trial study involved 81 patients undergoing PD (n = 41 in the intervention group, n = 40 in the control group). The intervention group received comprehensive MNT management, whereas the control group received standard nutrition care. The intervention spanned a 6-month period. Various nutrition parameters, markers of anemia, and microinflammatory indexes were assessed before the intervention, at 3 months, and at 6 months postintervention. Repeated-measures analysis of variance and the nonparametric Scheirer-Ray-Hare test were used for within-group and between-group comparisons. There were no statistically significant differences between the groups in terms of age, sex, duration of dialysis, primary disease, or baseline prenutrition inflammation data. At 6 months postintervention, the intervention group exhibited higher levels of serum albumin, blood calcium, serum iron, hemoglobin, total iron-binding capacity, body mass index, midarm circumference, triceps skinfold thickness, handgrip strength, and daily energy and protein intake compared with the control group (P < 0.05). Additionally, the intervention group demonstrated lower levels of subjective nutrition assessment value, C-reactive protein, and neutrophil-to-lymphocyte ratio than the control group (P < 0.05), with no statistically significant differences in other markers after interventions. Multidisciplinary MNT can ameliorate the nutrition status of patients receiving PD, decrease the incidence of malnutrition, and improve anemia and microinflammatory outcomes.

Two dimensional computational model of calcium and IP3 interacting system dynamics in an obese hepatocyte cell

Abstract Calcium ion (Ca2+) signaling is crucial in regulating numerous cellular processes vital for preserving structural integrity and functional equilibrium across diverse cell types. Both the calcium stores and mitochondria play significant roles in this signaling pathway. The calcium source may be in the form of a blip or a puff depending on the various conditions of the cellular systems. The one dimensional model of calcium dynamics with IP3 gives crucial insight of feedback mechanisms influencing calcium homeostasis. In order to obtain deeper insights of local impacts of various mechanisms and feedbacks in hepatocyte cell, it is necessary to develop the models in higher dimensions. In order to get more deeper insights, two dimensional model is proposed assuming the phenomena to be uniform along z dimension. This research presents a two-dimensional computational model to analyse the interactive system dynamics of inositol 1,4,5-trisphosphate (IP3) and Ca2+, aiming to assess how these signaling patterns influence hepatocyte functionality which allows to incorporate puff type of calcium source under both obese and normal physiological states. It further examines the implications of calcium signaling on NADH synthesis, ATP production, and degradation rates. Numerical simulations are executed utilising the Crank-Nicolson method for temporal analysis and the Linear Finite Element Method for spatial analysis. Additionally, the study conducts a comparative analysis of calcium signaling between obese and normal hepatocyte. The findings offer enhanced insights into the interactive system dynamics of IP3 and Ca2+ in hepatocytes, elucidating the effects of various parameter alterations on cellular behaviour in both states.

Prediction of acute pancreatitis severity based on early CT radiomics

BackgroundThis study aims to develop and validate an integrated predictive model combining CT radiomics and clinical parameters for early assessment of acute pancreatitis severity.MethodsA retrospective cohort of 246 patients with acute pancreatitis was analyzed, with a 70%-30% split for training and validation groups. CT image segmentation was performed using ITK-SNAP, followed by the extraction of radiomics features. The stability of the radiomics features was assessed through inter-observer Intraclass Correlation Coefficient analysis. Feature selection was carried out using univariate analysis and least absolute shrinkage and selection operator (LASSO) regression with 10-fold cross-validation. A radiomics model was constructed through logistic regression to compute the radiomics score. Concurrently, univariate and multivariate logistic regression were employed to identify independent clinical risk factors for the clinical model. The radiomics score and clinical variables were integrated into a combined model, which was visualized with a nomogram. Model performance and net clinical benefit were evaluated through the area under the receiver operating characteristic curve (AUC), the DeLong test, and decision curve analysis.ResultsA total of 913 radiomics features demonstrated satisfactory consistency. Eight features were selected for the radiomics model. Serum calcium, C-reactive protein, and white blood cell count were identified as independent clinical predictors. The AUC of the radiomics model was 0.871 (95% CI, 0.793–0.949) in the training cohort and 0.859 (95% CI, 0.751–0.967) in the validation cohort. The clinical model achieved AUCs of 0.833 (95% CI, 0.756–0.910) and 0.810 (95% CI, 0.692–0.929) for the training and validation cohorts, respectively. The combined model outperformed both the radiomics and clinical models, with an AUC of 0.905 (95% CI, 0.837–0.973) in the training cohort and 0.908 (95% CI, 0.824–0.992) in the validation cohort. The DeLong test confirmed superior predictive performance of the combined model over both the radiomics and clinical models in the training cohort, and over the clinical model in the validation cohort. Decision curve analysis further demonstrated that the combined model provided greater net clinical benefit than the radiomics or clinical models alone.ConclusionThe clinical-radiomics model offers a novel tool for the early prediction of acute pancreatitis severity, providing valuable support for clinical decision-making.

Establishment and evaluation of nomogram for predicting acute respiratory distress syndrome in meconium-stained amniotic fluid neonates.

To delineate risk factors and develop a predictive nomogram for acute respiratory distress syndrome (ARDS) in neonates exposed to meconium-stained amniotic fluid (MSAF). We conducted a comprehensive retrospective analysis of neonates with MSAF, classifying them into ARDS and non-ARDS groups based on the onset of ARDS within the first week after birth. Clinical and laboratory data are collected to screen the risk factors for ARDS in MSAF neonates, multivariate logistic regression was performed to identify independent predictors and establish a nomogram to predict the occurrence of neonatal ARDS. We recognized five variables as independent risk factors for ARDS with MSAF neonates via logistic regression analysis, consisting of 1-min Apgar score (Apgar 1 min), white blood cell (WBC), platelet (PLT), red cell distribution width (RDW) and serum calcium (Ca). These predictors were integrated into a nomogram designed to estimate the individual risk of ARDS development in neonates. The predictive model achieved a C-index of 0.942 (95% CI: 0.915-0.970), indicating high predictive accuracy. Additionally, the nomogram was internally validated, demonstrating excellent calibration and practical utility for clinical decision-making. The validated nomogram, based on five pivotal factors, provides clinicians with a reliable tool for early identification and management of ARDS in MSAF neonates, potentially improving outcomes by facilitating timely and appropriate therapeutic interventions.

Can Supplementation with the Cow Start Complete Bolus Result in Elevated Blood Calcium Status in a Group of At-Risk Dairy Cows During the First Four Days of Lactation

The prophylactic supplementation of freshly calved multiparous cows with oral calcium supplements (bolus, drink, drench, paste) has increased in popularity in recent years. Oral calcium supplements are generally only effective for 12 hours, yet the high-risk period for hypocalcaemia in freshly calved multiparous cows is 48 hours post-partum. Therefore, a second application 12 hours post-partum is suggested by manufacturers, yet due to labour shortages on dairy farms, it is very common for the second application to not be carried out. The objectives of this study were to ascertain if a the administration of a single dose of the sustained release bolus (Cow Start Complete, Anchor Life Science, Co. Cork, Ireland) given to the cow at calving, could offer the combined benefits of elevated calcium status over the first 48 hours post-partum from a labour efficient single dose given at calving and also to evaluate if this enhanced calcium status could have a positive effect on daily rumination time and milk production yields in the first three months of lactation. The two groups consisted of an un-supplemented control (CON) group and a Cow Start Complete (CSC) group in which cows were given a single bolus dose at the point of calving. The CON group experienced a clinical milk fever (Blood Ca &amp;lt;1.5mmol/L) incidence rate of 13.3% compared to 0% for the CSC group. Cows given the CSC treatment had significantly (P&amp;lt;0.0001) higher total blood calcium levels (2.14 mmol/L) from the point of calving (0h) to 4 days post-partum (96h) compared to CON (1.98mmol/L), with significant increases at 12h (P&amp;lt;0.01), 24h (P&amp;lt;0.001) and 36h (P&amp;lt;0.01) post-partum. Rumination time for CSC cows (471mins/day) was significantly (P&amp;lt;0.05) higher during the first 14 days post-partum when compared to CON (434mins/day) group. Milk production was also significantly (P&amp;lt;0.01) higher for CSC cows (+1.8kg/day) than in CON cows during the first 90 days of lactation. These findings demonstrate that the convenience of giving a single dose of CSC at calving, can be combined with desired outcomes in a range of key benefits in freshly calved multiparous cows.

Jumbo quail responses to diets containing incremental levels of apple (Malus domestica Borkh) pomace

The utilization of nutraceutical sources such as apple (Malus domestica Borkh) pomace powder (APP) could be a strategy to reduce the excessive disposal of this agro-waste in landfills and promote sustainable Jumbo quail (Coturnix sp.) production. However, the amount of the APP that can be included in Jumbo quail diets to achieve optimum production is unknown. This study evaluated the impact of including incremental levels of APP on performance metrics, haemato-biochemical parameters, and meat quality responses in Jumbo quail. A total of 350 Jumbo quail (7-day-old; 28.0 ± 0.817 g live weight) were weighed and randomly allotted to five dietary treatments, where each treatment had seven replicates with 10 birds each. The diets were formulated to contain 0, 25, 50, 75, and 100 g/kg APP. Dietary APP induced negative quadratic effects (p < 0.05) on feed intake in weeks 2 and 3. Body weight gain and gain-to-feed ratio decreased linearly in weeks 2, 3, and 4, but quadratically responded to APP levels in week 5. Platelets, heterophils, lymphocytes, and serum phosphorus and calcium showed linear or quadratic responses (p < 0.05) as APP levels increased. Increasing levels of APP linearly (p < 0.05) reduced carcass performance and 24-hour breast meat redness and chroma values but increased 1-hour yellowness and 24-hour lightness. The inclusion of APP compromised growth and carcass performance in young growing Jumbo quail. However, feed efficiency and final body weight were maximized between 50 and 75 g APP levels/kg diet in five-week-old Jumbo quail without compromising blood and meat quality parameters.

Early hypocalcemia following thyroidectomy in Kurmitola General Hospital, Dhaka, Bangladesh

Background: Hypocalcaemia is a recognized complication after thyroidectomy, which may be transient or permanent due to impairment of blood supply, injury, or inadvertent removal of the parathyroid gland. Parathormone, secreted by parathyroid gland, plays an important role in calcium homeostasis. Purpose of this study was to enable early detection of hypocalcaemia after thyroidectomy, aiding in patient management, early discharge, and reduced hospital stay. Methods: This study was conducted in the otolaryngology and head-neck surgery department of Kurmitola General Hospital over 12 months, from January 2020 to December 2020. Patients with various indications were selected based on eligibility criteria through convenience sampling. Data were collected using a data collection sheet, then cleaned, edited, and tabulated. The results were analyzed using the student’s unpaired t-test (quantitative data) to determine their significance, with a p cut-off set at &lt;0.05. Results: Data analysis of 30 patients (30% male, 70% female) revealed that 13 patients experienced hypocalcaemia, while 17 showed normocalcaemia. Among the 13 hypocalcaemic patients, 10 (76.92%) had asymptomatic (subclinical) hypocalcaemia, and 3 (23.08%) had symptomatic hypocalcaemia. Hypocalcaemia was observed in 46.15% of patients within 24 hours post-surgery, 38.46% within 48 hours, and 15.39% within 72 hours. The results indicated a female predominance in the development of hypocalcaemia. Conclusions: The study suggests that serum calcium levels significantly decrease after total thyroidectomy, with most cases occurring within 48-72 hours post-surgery.