Citrated Samples Research Articles

A-123 Comparative Assessment of Unmanned High-Speed Aerial Vehicles in Medical Logistics: Blood Sample Transportation Amidst Weather Variability

Abstract Background Drones, as an innovative technology, hold transformative potential in the field of medical logistics, especially in the transportation of sensitive medical materials like blood samples. This study aimed to assess and compare the impact of high-speed drone transportation with conventional car transportation on the integrity and preanalytics of blood samples, taking into account various blood materials and analytes. Methods Blood samples, including EDTA whole blood, serum, and plasma anticoagulated with Citrate and Lithium-Heparin transported as whole blood, were subjected to transportation via both drone and car. Drone flights were tested under diverse weather conditions (ranging between 4 and 20 degrees Celsius), and results were compared to samples stored without transportation. The maximum drone speed exceeded 100 km/h. A total of 28 analytes were tested on Serum, 20 on EDTA, 26 on Lithium-Heparin, and 5 on Citrate blood. Statistical analyses were performed using Passing Bablok and Bland-Altman methods. Results For Serum samples, the correlation coefficient (r) ranged from 0.830 to 1.000, and slopes varied from 0.913 to 1.111. Five analytes (total bilirubin, Calcium, Ferritin, Kalium, and Sodium) exhibited discrepancies between the negative control and the transported sample, with r lower than 0.800, slopes not between 0.8 and 1.2, and mean (%) not between +/- 10%. However, no significant differences were noted between drone and car transportation. Similar patterns emerged for EDTA, Lithium-Heparin, and Citrate samples, with r ranging from 0.829 to 0.997, 0.939 to 0.998, and 0.830 to 1.000, respectively. Slopes ranged from 0.956 to 1.051, 0.938 to 1.085, and 0.913 to 1.111. Despite identifying a few discrepancies in specific analytes, no significant differences were observed between transportation methods. Conclusions n comparison to transportation by car, drone transportation of blood samples did not lead to alterations in concentrations of commonly used analytes. Notably, instances of differences before and after transportation were attributed to the transportation process itself rather than the mode of transportation. This suggests that the use of drones for medical sample transport can be deemed comparable to, if not superior to, traditional car transportation methods.

Preanalytic Integrity of Blood Samples in Uncrewed Aerial Vehicle (UAV) Medical Transport: A Comparative Study

The integration of unmanned aerial vehicles or uncrewed aerial vehicles (UAVs)—commonly known as drones—into medical logistics offers transformative potential for the transportation of sensitive medical materials, such as blood samples. Traditional car transportation is often hindered by traffic delays, road conditions, and geographic barriers, which can compromise timely delivery. This study provides a comprehensive analysis comparing high-speed drone transportation with traditional car transportation. Blood samples, including EDTA whole blood, serum, lithium-heparin plasma, and citrate plasma tubes, were transported via both methods across temperatures ranging from 4 to 20 degrees Celsius. The integrity of the samples was assessed using a wide array of analytes and statistical analyses, including Passing–Bablok regression and Bland–Altman plots. The results demonstrated that drone transportation maintains blood sample integrity comparable to traditional car transportation. For serum samples, the correlation coefficients (r) ranged from 0.830 to 1.000, and the slopes varied from 0.913 to 1.111, with minor discrepancies in five analytes (total bilirubin, calcium, ferritin, potassium, and sodium). Similar patterns were observed for EDTA, lithium-heparin, and citrate samples, indicating no significant differences between transportation methods. Conclusions: These findings highlight the potential of drones to enhance the efficiency and reliability of medical sample transport, particularly in scenarios requiring rapid and reliable delivery. Drones could significantly improve logistical operations in healthcare by overcoming traditional transportation challenges.

Structural polymorphism research of alverine citrate

The study compares the active substance alverine citrate from three commercial sources in order to demonstrate polymorphic forms using the XRPD, SEM, and ATR-FTIR techniques. Based on the solubility tests of alverine citrate, a hard capsule was prepared with the highest possible dose of the active substance. The release profiles of alverine citrate and its stability were also investigated. XRPD and ATR-FTIR analysis shows that all alverine citrate samples (despite differences in the synthesis process) are in the same polymorphic Form I. Scanning electron micrographs of alverine citrate from each manufacturer show differences in morphology (texture). The solubility studies confirmed the complete solubility of the highest dose of alverine citrate in media with a pH of 1.2-6.8. The release studies show that the release of the active substance, regardless of the manufacturer type, meets the immediate release requirement. Accelerated stability studies confirm the stability of the alverine citrate from selected manufacturers. As a result, the manufacturer of the final medicinal product may allow their inter-changeability during production without compromising the safety or efficacy of the medicinal product.

Synthesis, structure and properties of nanoparticles based on SrFe12-xRxO19 (R = Er, Tm) compounds

In this work a comprehensive analysis of the structure and properties of doped SrFe12-xRxO19 (R = Er, Tm) hexaferrites has been studied. The hexaferrtes were synthesized by two methods: mechanochemical and citrate approaches. The solubility of rare-earth elements (REE) has been studied by precision determination of the lattice spacings and cell volume of the samples, synthesized by mechanochemical method. It has been shown that the solubility of Er and Tm at a temperature of 1200 °C does not exceed × = 0.08 REE ions per formula unit. According to Mössbauer spectroscopy, REE atoms preferentially occupy 12k positions. Nanoparticles of SrFe12-xRxO19 (R = Er,Tm) compounds for MRI were obtained by high-energy ball milling of the citrate samples for 50 h in an octadecene solution with oleic acid. Stable hydrosols of nanoparticles were obtained after their coating with Pluronic F127 polymer. It has been shown that the obtained nanoparticles can be used for biomedical applications as contrast agents.

Stability over time of immature platelet fraction and comparison between EDTA and citrated whole blood samples.

Immature platelets (IP) are the youngest circulating platelets, released from megakaryocytes, and demonstrating increased dimensions, significant RNA content, and enhanced activity. Immature platelet research focuses on a differential diagnostic help in patients with thrombocytopenia. The objectives of this study were to compare the variability of IP in citrate and EDTA samples, and to determine stability over time. Fifty-six patients were included for comparison between EDTA and citrate whole blood sample collection. Among the patients, 28 had thrombocytopenia (platelet count < 150G/L). Platelet measurement impedancemetry and fluorimetry were performed with Sysmex XN-9000. The immature platelet fraction (IPF) and absolute immature platelet count (A-IPC) were determined with a fluorescent method. The mean value of platelet count with fluorescence was, in EDTA sample, 215 ± 171 and, in citrate sample, 153 ± 118 G/L. No significant difference was observed between IPF between EDTA and citrate (7.74 ± 6.68% vs. 8.45 ± 7.37%, p = 0.69), respectively. With the Bland-Altman analysis, the mean difference in the EDTA sample, between 1 and 24 h, was 8.06 ± 6.96% and 8.73 ± 7.12% for IPF, whereas in the citrate sample, between 1 and 6 h, it was 8.60 ± 7.29% and 7.54 ± 6.97%, for IPF. Comparing 1 h EDTA sample with 6 h citrate sample, the variance ratio was 0.974 (95% CI: 0.864-1.084) in IPF. We confirmed the potential to conduct IP measurements up to 24 h in the EDTA sample and IPF measurements in the citrate sample for up to 6 h. These results may be useful for the use of IPF, which is a promising parameter whose interest in clinical practice and standardization is not yet well defined.

Extended sample storage for platelet function testing in healthy dogs.

Platelet function testing is important for monitoring the effects of antiplatelet therapy but is not readily used due to time constraints for testing and the need for specialized equipment. This study evaluated the effects of various storage methods on selected platelet function tests to determine if delayed platelet function testing is feasible in canine blood samples. Our hypotheses were that platelet function would not decline during storage and, thus, no differences in test results would be found over time. Thirteen healthy dogs were studied. Citrated blood samples were tested with a Platelet Function Analyzer-200 (PFA), which mimics high-shear conditions, using P2Y and CADP cartridges, after being held at room temperature for 2 h and refrigerated for 24 and 48 h. Plateletworks (PW), which measures aggregation based on platelet counting, was performed on an optical hematology analyzer using 10-min-old native samples, citrated samples held at room temperature for 3-4 h and refrigerated for 24 and 48 h, and samples stored in the preservative solution, AGGFix, up to 7 days. PFA closure times increased with storage, especially with the P2Y cartridge. Median aggregation with fresh PW was 94%, and this was maintained at all time points (range of median values 88%-94%). Most samples showed decreased, yet still robust (>70%), aggregation with longer storage. Spontaneous aggregation in citrate was noted in most dogs. AGGFix stabilized platelet aggregates to allow for delayed testing. Delayed platelet function testing is feasible, but ranges of expected values may differ from tests using fresh samples.

Evaluation of 18 quality indicators from the external quality assurance preanalytical programme of the Spanish Society of Laboratory Medicine (SEQCML).

Most errors in laboratory medicine occur in the pre- and post-analytical phases of the total testing process (TTP). In 2014, the Spanish Society of Laboratory Medicine (SEQCML) started the current Preanalytical Phase EQA Programme, with the objective of providing a tool for the improvement of the preanalytical phase. The aim of this study was to review the evolution of quality indicators (QI) and the comparability of established performance specifications (PS) with other EQA programmes. In the SEQCML programme, participants were asked to register rejections of the main specimens and the causes for rejections. Data collected from 2014 to 2017, and then reviewed biennially (2018-2019), was used to calculate the percentiles; p25, p50, p75, and p90 for every round, and their means were set as PS. These PS were compared with the results of other programmes. The evolution of QI results for 2018-2019 period showed general maintenance or improvement, e.g., a significant decrease in the number of serum samples with a haemolytic index≥0.5g/L, except for EDTA and citrate samples handle, maybe for an improvement in detection. The comparison with PS for the QI of the IFCC Working Group "Laboratory Errors and Patient Safety" and the Key Incident Management and Monitoring System (KIMMS) programme of the RCPA showed comparable results, supporting the validity of the established specifications. The PS obtained are a helpful tool for benchmarking and to identify processes of the preanalytical phase whose improvement should be set as a priority.

Physico-chemical properties and digestibility of native and citrate starches change in different ways by synchrotron radiation

The physico-chemical properties and digestibility of native and citrate cassava starches changed as a result of synchrotron radiation treatment. In this study, the native and citrate starch samples were exposed to radiation doses of 0.1, 0.4, 0.8 and 3.9 kGy. The granular morphology revealed that all samples were rupture and damage after radiation. As increasing radiation doses, the relative crystallinity as determined by WAXS and the ratio of 1047/1015 cm−1 from FTIR result decreased while the degree of degradation and solubility increased for all samples. The swelling power of radiated native starches decreased with higher radiation doses indicating that the cross-linking of starch was induced by synchrotron radiation which was related to an increase in the resistant starch content. On the contrary, for radiated citrate samples, the FTIR peak at 1724 cm−1 was observed. The ratio of 1724/2900 cm−1 and total esterified citric acid did not change. The swelling and degree of di-esterification were reduced while the degree of mono-esterification increased with higher doses. It implied that the cross-linking by ester bonds was broken into mono-ester bonds. This work demonstrated that synchrotron radiation changed the physical and chemical properties of native and citrate starches in different ways.

International Council for Standardization in Haematology (ICSH) recommendations for processing of blood samples for coagulation testing.

This guidance document has been prepared on behalf of the International Council for Standardization in Haematology (ICSH). The aim of the document is to provide guidance and recommendations for the processing of citrated blood samples for coagulation tests in clinical laboratories in all regions of the world. The following areas are included in this document: Sample transport including use of pneumatic tubes systems; clots in citrated samples; centrifugation; primary tube storage and stability; interfering substances including haemolysis, icterus and lipaemia; secondary aliquots-transport, storage and processing; preanalytical variables for platelet function testing. The following areas are excluded from this document, but are included in an associated ICSH document addressing collection of samples for coagulation tests in clinical laboratories; ordering tests; sample collection tube and anticoagulant; preparation of the patient; sample collection device; venous stasis before sample collection; order of draw when different sample types are collected; sample labelling; blood-to-anticoagulant ratio (tube filling); influence of haematocrit. The recommendations are based on published data in peer-reviewed literature and expert opinion.

Rapid Assessment of Coagulation at the Point of Care With the Hemochron Signature Elite System

Real-time point-of-care (POC) measurement of coagulation parameters, including activated clotting time (ACT), activated partial thromboplastin time, and prothrombin time with calculated international normalized ratio can improve patient outcomes in clinical settings, such as surgical and minimally invasive cardiac procedures, critical care units, and emergency departments. Point-of-care analyzers used in these settings must be small, portable, robust, and easy to use. The Hemochron Signature Elite system (Instrumentation Laboratory) offers 6 types of single-use disposable coagulation test cartridges, ACT+ (to measure high to moderate unfractionated heparin concentrations), ACT-LR (to measure moderate to low unfractionated heparin concentrations), activated partial thromboplastin time (citrate or whole-blood samples), and prothrombin time/international normalized ratio (citrate or whole-blood samples). Using a mechanical clot-detection technology, 1 to 2 drops of blood are mixed with an assay-specific reagent. Results are analyzed, displayed, and archived within minutes of testing. An integral barcode reader scans patient and operator IDs, and reagent lot details for documentation and traceability. The system supports remote connectivity (POCT01-A–compliant) and POC management of data, operators, and analyzers with GEMweb Plus 500 Custom Connectivity solution (Instrumentation Laboratory). The Hemochron Signature Elite system provides rapid and reliable testing with the broadest coagulation test menu of any POC instrument.

Determining the maximal storage time of centrifuged citrated samples for performing add-on routine coagulation tests

BackgroundSeveral routine coagulation tests have been developed to give insight in the coagulation pathway. The laboratory diagnostical process consists of 3 phases, the pre-analytical, analytical and post-analytical phase; however, the pre-analytical phase is most sensitive to errors. The amount of time blood is stored, can affect the measurements of these coagulation tests and result in an incorrect conclusion. Therefore, we performed experiments to determine the maximal storage time, centrifuged blood samples can be reliably measured. MethodsCitrated whole blood from hospital patients, who were tested for routine coagulation, was collected in 2.7 mL citrate tubes. These whole blood samples were centrifuged and the plasma was stored on top of the cell pellet at room temperature. After 2 h, 4 h, 6 h, 12 h and 24 h, the prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen concentration, antithrombin activity, D-dimer concentration and thrombin time were measured using Sysmex CS2100 coagulation analysers. Results and conclusionAnalytical evaluation of routine coagulation tests resulted in various significant differences and large variations between the various time intervals. Our results indicated that the PT and INR can be measured up till 24 h of storage. Centrifuged blood for measuring the fibrinogen concentration, antithrombin activity, D-dimer concentration and thrombin time can be stored up to 4 h, while 2 h of storage might already be too long for obtaining reliable aPTT measurements.

Effects of Time-Interval since Blood Draw and of Anticoagulation on Platelet Testing (Count, Indices and Impedance Aggregometry): A Systematic Study with Blood from Healthy Volunteers.

Platelet count, indices (mean volume, young—immature platelet fraction) and aggregation are widely used laboratory parameters to investigate primary hemostasis. We performed a systematic, thorough evaluation of the influence of the time-interval since blood draw from 20 healthy individuals and of the anticoagulation of collected blood on such parameters. Blood was anticoagulated with citrate, K2-ethylenediaminetetraacetic acid (EDTA) and hirudin and analyzed 5, 30, 60, 120 and 180 min after blood draw. Multiple electrode aggregometry (MEA) was performed with either hirudin (half-diluted with NaCl) or citrate samples (half-diluted with NaCl or CaCl2 3 mM). Platelet count and indices (Sysmex XN-20) were rather stable over time with EDTA blood. MEA results were lower with citrate blood than with hirudin blood; supplementation with calcium was partially compensatory. MEA results were also lower when performed less than 30 or more than 120 min after blood draw. Platelet clumping, quantitatively estimated with microscope examination of blood smears, was more important in hirudin blood than citrate or EDTA blood and could explain some of the differences observed between preanalytical variables. The results stress once more the importance of preanalytical variables in hemostasis laboratory testing. Decision thresholds based on those tests are only applicable within specific preanalytical conditions.

Comparison of the Effects of Three Anticoagulants on Hematological Analytes in the Eastern Indigo Snake (Drymarchon couperi)

Studies on the effects of anticoagulants on blood samples in reptiles are limited. Eastern indigo snakes (Drymarchon couperi) have unique physiological features that are still not well understood. The objective of this study was to evaluate the effects of lithium heparin, tripotassium ethylendiaminetetraacetic acid (EDTA), trisodium citrate, and the use of no anticoagulant on various hematological analytes of the eastern indigo snake. Blood was collected from 10 female eastern indigo snakes and transferred in aliquots into three anticoagulants; it was also processed without anticoagulant. Packed cell volume (PCV), total solids (TS), plasma color, and data from blood film evaluations were compared. Significant differences were found for PCV (P < 0.0001) and TS (P < 0.0001). Both analytes were significantly lower in citrated samples, and heparinized samples had lower TS than EDTA-preserved and non-anticoagulated samples. Although there were no differences in absolute numbers and morphological quality among treatments, heparinized blood samples had a higher heterophil percentage (P = 0.039) compared to non-anticoagulated samples, and both heparinized and EDTA-preserved samples had lower azurophil percentages (P = 0.039) than non-anticoagulated samples. Hemolysis was absent in all samples. Heparinization produced a blue background hue on blood films that was absent in all other methods. This preliminary study demonstrates that heparinized, EDTA-preserved, and non-anticoagulated blood samples are equally superior for hematological evaluation over citrated samples because of its effect on the PCV. This finding has clinical application and it is advised to avoid citrate as an anticoagulant in eastern indigo snakes.

Effects of chelating agents on the sol-gel synthesis of nano-zirconia: Comparison of the Pechini and sugar-based methods

This study focused on the comparison of the Pechini and sugar-based combustion synthesis methods to produce nano-zirconia. Zirconium hydroxide was utilized as metal precursor and citric acid, sucrose, and fructose were used as chelating agents, followed by calcination at 500, 600, and 700°C in air, respectively. Characterization was conducted by thermal analysis, specific surface area measurement, Fourier transform infrared spectroscopy, X-ray diffraction, and scanning and transmission electron microscopy. When sucrose and citric acid were used as chelating agents during synthesis, mixtures of monoclinic and tetragonal phases were formed after calcination at 600 and 700°C. In the fructose samples, the tetragonal structure was the unique characterized phase. The tetragonal parameters in the fructose samples were determined using the diffraction data and the lattice parameter ratio was proven to increase with the temperature increase. Compared with the citrate and sucrose samples, the largest specific surface area (27 m2·g−1) and smallest particle size (39.1 nm) were obtained for the fructose sample after calcination at 700°C. The study revealed the formation of single-phase stabilized tetragonal zirconia using fructose as chelating agent after calcination at 500°C, and the presence and formation mechanism of stabilized tetragonal phase were also discussed on the basis of the X-ray and electron diffraction studies.

Effects of malaria parasitaemia on some haemostatic parameters among pregnant women of African descent in Specialist Hospital Sokoto, Nigeria.

Malaria in pregnancy is a major contributor to adverse maternal and prenatal outcome. In hyper endemic areas like ours, it is a common cause of anaemia in pregnancy and is aggravated by poor socioeconomic circumstance. This study evaluated the prothrombin time and activated partial thromboplastin time of malaria parasitized pregnant women. A total of 90 pregnant women participated in the study, 60 of which were malaria positive and 30 of which were malaria negative. Participants were recruited from the antenatal Clinic of Specialist Hospital Sokoto, Nigeria. A structured interviewer-administered questionnaire was used to obtain some socio-demographic characteristics of subjects. Blood samples were collected in ethylene diamine tetra acetic acid and examined for malaria parasite and platelet count while citrated samples were used for the determination of some haemostatic parameters (prothrombin time and activated partial thromboplastin time). Data generated was analyzed using SPSS 25.0 statistical package. A p-value ⩽ 0.05 was considered significant in all statistical comparisons. There was a statistically significant decrease (p= 0.000) in the platelet counts of the parasitized subjects compared to the non-parasitized controls. We observed a significant prolongation on both the prothrombin time and activated partial thromboplastin time among the parasitized subjects compared to the non-parasitized controls (p= 0.000). This study has shown that malaria in pregnancy causes a significant decrease in the platelet count and prolongation in the prothrombin (PT) and the activated partial thromboplastin time (APTT). There is need for the malaria and haemostatic parameters to be assayed routinely on pregnant women particularly those presenting to antenatal clinic with febrile illness.

Stability of thromboxane in blood samples.

Introduction: Conventional venous blood collection requires a puncture with a needle through the endothelium of a vessel. The endothelial injury causes activation of circulating platelets and the release of thromboxane A2. The aim of the study was to investigate if platelets continue to form thromboxane A2 in the blood tube after sample collection, but such synthesis would give false information about the actual circulating thromboxane A2 value.Methods: Thromboxane B2 is a biologically inactive but stable metabolite of thromboxane A2 and can be measured in blood samples by a standard enzyme immunoassay. Thromboxane B2 measurements reflect thromboxane A2 concentration. Blood samples were collected in 3.2% sodium citrate vials and EDTA vials from ten individuals and centrifuged and frozen at different time points (0, 30, and 120 minutes). Plasma aliquots were transferred to and frozen in 1.8 mL polypropylene tubes and the citrate samples were also transferred to and frozen in propylene tubes containing indomethacin.Results: Concentrations of thromboxane B2 in plasma samples collected in citrate vials and stored in propylene tubes increased very rapidly as the samples were left for longer after sampling and allowed to stand at room temperature. After 120 minutes, the amount of thromboxane B2 was 400% higher than in the reference sample at time zero. In comparison, thromboxane B2 concentration was about 200% higher in the 120-minute samples compared to the reference in samples collected in citrate vials but stored in indomethacin tubes. In samples collected in EDTA vials, a 10% reduction in thromboxane B2 concentration in the 120-minute samples was observed.Conclusion: Storage conditions, type of sampling vial and time from sampling until sample processing (centrifuging) has a major impact on thromboxane B2 stability.

139-LB: Haptoglobin Phenotype and Levels in Type 2 Diabetes and Effects of Fenofibrate

Background: Haptoglobin (Hp) is a plasma protein with anti-oxidant, anti-inflammatory and pro-angiogenic properties. Based on the Hp gene alleles there are three Hp phenotypes (1-1, 2-1 and 2-2). In diabetes, Hp-2 is associated with substantially increased risk of cardiac and renal damage relative to Hp-1. AIMS: To evaluate 1) associations between Hp phenotype and levels; and 2) effects of fenofibrate vs. placebo on Hp levels. Methods: A substudy of 180 adults with type 2 diabetes (T2D) (50% females) from the FIELD trial. Average age was 60±6 years, BMI 30.4±5.1 kg/m2 and HbA1c 6.8±1.3%. Plasma (citrate) samples were evaluated at baseline, after 6-weeks daily 200 mg co-micronised fenofibrate (end of active run-in) and 2-years after randomisation to fenofibrate or placebo. Results: Hp phenotype 1-1 was detected in 19%, Hp 2-1 in 48% and Hp 2-2 in 33% subjects. Hp levels at baseline were 1.44±1.10, 1.31±0.49 and 0.99±0.46 mg/mL in type 1-1, 2-1 and 2-2 respectively (all p&amp;lt;0.0001). In Hp type 2-2 baseline Hp levels correlated with HbA1c (r=0.35, p=0.005), BMI (r=0.30, p=0.02) and HDL-C (r=0.29, p=0.02). No such correlations were observed for Hp type 1-1 and 2-1. After 6-weeks fenofibrate Hp levels dropped by 22.3, 19.9 and 17.7% in type 1-1. 2-1 and 2-2 respectively (all p&amp;lt;0.0001; difference between types p=ns.). After 2-years of fenofibrate vs. placebo Hp levels in the placebo group had increased back to baseline values whereas Hp levels in the fenofibrate group remained reduced similar to 6-weeks levels. In Hp 1-1 subjects Hp levels dropped after 6-weeks fenofibrate in 94% of subjects, in Hp 2-1 - in 92% and in Hp 2-2 only in 73% of subjects (difference between phenotypes: p=0.002). Conclusions: Hp levels differ by Hp phenotype in T2D adults. Fenofibrate lowers Hp levels in all phenotypes, however the effect is significantly attenuated in Hp 2-2. Disclosure A.S. Januszewski: None. H.K. Young: Other Relationship; Self; Medtronic. L. Li: None. R.L. OConnell: None. T. Lyons: None. C.B. Kelly: None. D. Sullivan: None. R. Scott: None. A.C. Keech: None. A. Jenkins: Advisory Panel; Self; Abbott, Australian Diabetes Society, Medtronic. Research Support; Self; Abbott, GlySens Incorporated, Medtronic, Mylan. Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk Inc. Funding Sydney Medical School Foundation; National Health and Medical Research Council of Australia

Influence of hypertriglyceridemia, hyperbilirubinemia and hemolysis on thrombin generation in human plasma.

Background Although accumulating evidence suggests that the hemostatic balance is impaired in patients with hypertriglyceridemia, hyperbilirubinemia or hemolytic anemias, little is known on the underlying biological mechanisms. This experimental study was aimed at exploring whether increasing values of triglycerides, bilirubin or cell-free hemoglobin promote thrombin generation in plasma. Methods Three different pools were prepared from three different sets of 20 normal routine plasma citrate samples. The native pools were spiked with increasing amounts of exogenous triglycerides (up to 8.8 mmol/L), bilirubin (up to 350 μmol/L) or autologous hemolyzed blood (up to 3.5 g/L cell-free hemoglobin). Using the fully-automated thrombin generation analyzer ST Genesia, we measured the following parameters: lag time (LT), time to peak (TP), peak height (PH) and endogenous thrombin potential (ETP). Results A sustained increase of PH and ETP was found in parallel with increasing triglyceride concentrations, peaking in the aliquot with 8.8 mmol/L. Conversely, LT and TP displayed an opposite trend, reaching a maximum decrease in the 8.8 mmol/L aliquot. Increasing bilirubin concentrations promoted remarkable increases of PH and ETP and decreases of TP and LT, up to 211 μmol/L. After this threshold, all parameters tended to return towards baseline values. A constant increase of PH and ETP was also noted in hemolyzed samples, peaking in the 3.5 g/L cell-free hemoglobin aliquot, whereas the TP and LT remained unchanged in all hemolyzed aliquots. Conclusions Our findings suggest that hypertriglyceridemia, hyperbilirubinemia and hemolysis may promote a hypercoagulable state in human plasma.

Biofouling mitigation of bilayer polysulfone membrane assisted by zinc oxide-polyrhodanine couple nanoparticle

Biofouling is known as a serious problem for membrane applications. There are several techniques to improve membrane biofouling resistance. In this work, polysulfone (PSf) membrane was modified using polyvinyl alcohol (PVA) layer and zinc oxide-polyrhodanine (ZnO-PRh) couple nanoparticles. The ZnO-PRh couple nanoparticles as a new antibacterial agent were immobilized upon the surface using a dip coating method. Also, the PVA layer was used in order to improve the hydrophilicity and binding of nanoparticles on the membrane surface. Fourier transform infrared (FTIR), X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), scanning electron microscopy (SEM), atomic force microscopy (AFM) and contact angle analysis were utilized for characterization of the samples. The effects of the ZnO-PRh nanoparticles and cross-linker concentration on the membrane performance were investigated. The highest flux of treated membranes was obtained for the combination of 5% and 0.75% for Glutaraldehyde (GA) and nanoparticle, respectively. It was observed that by adding ZnO-PRh/PVA to the membrane, surface hydrophilicity (from 111.8 to 59.0˚ of water contact angle), permeate flux (from 24.458 to 46.653 kg. m−2. h-1 for the PVA and ZnO-PRh/PVA membranes, respectively), the rejection (from 81.521 to 97.52 and 83.77 to 98.97 for citrate and total phosphate samples), fouling resistance, and antibacterial property increased.

Effect of sample type on plasma concentrations of cell-free DNA and nucleosomes in dogs

Cell-free DNA (cfDNA) and nucleosomes are two biomarkers of cell death and neutrophil extracellular trap formation that are increased in dogs with sepsis, immune-mediated haemolytic anaemia, cancer and following trauma...