Coagulation Tests Research Articles

Chemical composition and antioxidant activity of Physalis angulata L. (Solanaceae) and its effect on blood clotting and biofilm formation of some wound bacterial isolates

Physalis angulata a member of the Solanaceae family, is a plant recognized for its significant nutritional and medicinal properties. Widely distributed across tropical and subtropical regions, this plant has garnered attention for its diverse biological activities. The ethanol extract from the plant is being used in this study to investigate its biological and antioxidant properties. The ability of the extract to reduce free radicals was also tested using the compound phenyl-1-picrylhydrazyl). The DPPH method was used because it is a modern color method and is considered the most common and easy to apply, in addition to its speed and superior sensitivity in testing antioxidants for samples of plant extracts, and the values were compared with the value of ascorbic acid IC50. The study also looks at the extract's ability to prevent the formation of biofilms by different pathogens, including E. coli and Staphylococcus strains that were isolated from community labs and Ramadi Teaching Hospital. The ethanol extract demonstrated a noteworthy ability to inhibit the formation of cellular membranes in staphylococcal bacteria and E. coli. The efficacy of the extract at different concentrations (150, 200, 250 mg/mL) was also assessed, revealing that a concentration of 250 mg/mL resulted in significant inhibition rates (74.3% and 61.45% for E. coli). Furthermore, the study explores the impact of ethanol extract on blood coagulation. At high concentrations (150, 200, 250 mg/mL), the extract exhibited properties akin to aspirin and warfarin, extending the clotting times in both total and partial coagulation tests (Prothrombin time, Partial thromboplastin time) at lower concentrations (100, 50, 10 mg/mL), the extract appeared to promote blood clot formation, suggesting a concentration-dependent effect on hemostasis. This dual action positions P.angulate as a potential therapeutic agent, warranting further investigation into its biomedical applications.

Correction of Trauma-induced Coagulopathy by Goal-directed Therapy: A Secondary Analysis of the ITACTIC Trial.

Trauma hemorrhage induces a coagulopathy with a high associated mortality rate. The Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy (ITACTIC) randomized trial tested two goal-directed treatment algorithms for coagulation management: one guided by conventional coagulation tests and one by viscoelastic hemostatic assays (viscoelastic). The lack of a difference in 28-day mortality led the authors to hypothesize that coagulopathic patients received insufficient treatment to correct coagulopathy. During ITACTIC, two sites were coenrolling patients into an ongoing prospective observational study, which included serial blood sampling at the same intervals as in ITACTIC. The subgroup in both studies had conventional and viscoelastic test results for each patient available for analysis. A goal-directed treatment was defined as one triggered by an ITACTIC algorithm. Coagulopathy was defined as rotational thromboelastometry EXTEM A5 less than 40 mm. The primary outcome was correction of coagulopathy by the 12th unit of erythrocyte transfusion during resuscitation. Full viscoelastic and conventional coagulation test results were available for 133 patients. Of these patients, 71% were coagulopathic on admission, and 16% developed a coagulopathy during resuscitation. ITACTIC viscoelastic hemostatic assay group patients were more likely to receive goal-directed treatment than the standard group (76% vs. 47%; odds ratio, 3.73; 95% CI, 1.64 to 8.49; P = 0.002). However, only 54% of patients received goal-directed treatment, and only 20% corrected their coagulopathy (vs. 0% with empiric treatment alone; not significant). Median time to first goal-directed treatment was 68 (53 to 88) min for viscoelastic and 110 (77 to 123) min for standard (P = 0.005). In ITACTIC, many bleeding trauma patients did not receive an indicated goal-directed treatment. Interventions arrived late during resuscitation and were only partially effective at correcting coagulopathy.

External quality assurance experience with Royal College of Pathologists of Australasia Program at an academic hospital in South Africa.

Laboratories use their performance in external quality assurance (EQA) to establish quality planning strategies and to assess whether testing processes require improvement. The EQA performance of the hematology and coagulation test parameters on the Royal College of Pathologists of Australasia EQA program was evaluated over a 4-year cycle at an academic hospital in Johannesburg, South Africa. The test performance was determined from analytical quality specification (APS) and/or z-scores. Bias and imprecision were used to calculate sigma (σ) metric scores. Specifications from European Federation of Laboratory Medicine and/or biological variation were applied. The laboratory achieved a mean testing score of 98.7±4.0%. There were 103 (10.7%) unacceptable results. On investigation, root causes included: presurvey issues (83%), transcription errors (9%), random errors (6%), and test performance errors (3%). All test parameters evaluated achieved an acceptable median APS during the study period. The mean z-scores, however, were >2 and unacceptable for mean cell hemoglobin concentration and hematocrit. On investigation, this was attributed to significant delay in transport and storage of full blood count samples. White cell count and d-dimer achieved a σ ≥ 6. EQA participation assisted the laboratory in maintaining a quality system. Close monitoring is necessary for international laboratories to avoid sample delays that can affect result quality.

Research on Predictive Auxiliary Diagnosis Method for Gastric Cancer Based on Non-Invasive Indicator Detection

Chronic atrophic gastritis is a serious health issue beyond the stomach health problems that affect normal life. This study aimed to explore the influencing factors related to chronic atrophic gastritis (CAG) using non-invasive indicators and establish an optimal prediction model to aid in the clinical diagnosis of CAG. Electronic medical record data from 20,615 patients with CAG were analyzed, including routine blood tests, liver function tests, and coagulation tests. The logistic regression algorithm revealed that age, hematocrit, and platelet distribution width were significant influences suggesting chronic atrophic gastritis in the Chongqing population (p < 0.05), with an area under the curve (AUC) of 0.879. The predictive model constructed based on the Random Forest algorithm exhibited an accuracy of 83.15%, precision of 97.38%, recall of 77.36%, and an F1-score of 70.86%, outperforming the models constructed using XGBoost, KNN, and SVC algorithms in a comprehensive comparison. The prediction model derived from this study serves as a valuable tool for future studies and can aid in the prediction and screening of chronic atrophic gastritis.

A Randomized Controlled Trial to Optimize Antivenom Therapy for Carpet Viper (Echis romani)-Envenomed Children in Nigeria.

In an open randomized controlled trial, we compared one vial (10 mL) to two vials (20 mL) of EchiTAb-plus-ICP (EPI) antivenom among children with systemic carpet viper (Echis romani) envenoming of moderate severity in northeastern Nigeria. Systemic envenoming, presenting with incoagulable blood, was diagnosed using the 20-minute whole blood clotting test (20WBCT). Eligible patients with positive 20WBCT whose guardians assented were recruited and randomly allocated to receive either one vial or two vials of EPI administered either as a bolus or as a slow continuous infusion. The primary outcome was permanent restoration of blood coagulability 6 hours after the start of treatment, assessed by the 20WBCT and repeated at 6, 12, 24, and 48 hours after treatment. Secondary outcomes were the incidences of early adverse reactions to antivenom treatment. Initial doses permanently restored blood coagulability at 6 hours in 34/39 (87.2%) of those treated with one vial and 39/41 (95.1%) of those treated with two vials of EPI (P = 0.258). However, the proportion with permanent restoration of clotting at 6 hours among patients randomized to bolus administration was 41 of 42 (97.6%) patients compared with 32 of 38 (84.2%) patients randomized to slow infusion of EPI antivenom (P = 0.049); however, the difference was not sustained through the remaining time points. There was no difference in early adverse reactions between those treated with the two different doses or modes of delivery. We conclude that the one-vial dose compared favorably to two vials of EPI antivenom with regards to effectiveness and safety among children with carpet viper envenoming of moderate severity in Nigeria.

Utilization of blood and blood components in the department of clinical hematology of a tertiary care hospital: A prospective hospital-based study

Background: To have proper utilization of blood and its components adherence to established guidelines is essential. Hence, periodic review of blood components is necessary to improve transfusion practices and decrease the inappropriateness of blood components. Aims and Objectives: Our study aims to assess the utilization and appropriateness of blood and blood components in the Department of Clinical Hematology SKIMS, Soura, Srinagar. Materials and Methods: This prospective observational study was conducted in the Department of Blood Transfusion and Immunohematology, SKIMS, Soura, Srinagar, over a period of 1 year from August 2020 to July 2021 on patients admitted in Clinical Hematology requiring transfusion therapy. The number of all blood and blood component units supplied over a period of 1 year was assessed. The usage of different types of blood component was recorded and correlated with the patient’s diagnosis and indications for transfusion. Results: A total of 250 patients were transfused with 2099 blood and blood components, among them 64.32% (1350) units were used appropriately and 35.68% (749) units were used inappropriately. Transfusions of packed red blood cells were found to be inappropriate in patients with asymptomatic chronic anemia with Hemoglobin >7 g/dL. Fresh frozen plasma was given inappropriately in cases of bleeding without derangement of coagulation tests. Inappropriate use of platelets was seen in patients who had received platelets prophylactically with platelet count above 10,000/μL. Conclusion: Proper implementation of guidelines for the use of various blood components would help reduce their inappropriateness.

A multicenter study of the risk of major bleeding in patients with and without cirrhosis undergoing percutaneous liver procedures.

Percutaneous liver procedures are frequently performed in patients with abnormal coagulation tests. Current guidelines suggest prophylactic transfusion is not mandatory in all patients with liver disease or cirrhosis, depending on the risk of bleeding. This study aims to describe the incidence and risk of major bleeding after percutaneous liver procedure in patients with and without cirrhosis. This retrospective study includes patients who underwent percutaneous liver biopsy and radiofrequency and microwave ablation of liver lesions at 3 centers in Spain. A transfusion protocol was considered for platelet counts <50,000 and/or international normalized ratio >1.5. The primary outcome was major bleeding. A total of 1797 patients were included in the study, with 316 having cirrhosis (18%) and 1481 without cirrhosis (82%). Among the patients with cirrhosis, 80 were classified as Child A, and percutaneous liver biopsy was the most frequent procedure (86%). Fourteen patients (0.8%) experienced major bleeding, with 0.4% occurring in radiofrequency and microwave ablation and 0.8% in percutaneous liver biopsy. Bleeding occurred in 0.6% of patients with cirrhosis compared to 0.8% in those without ( p = ns). No clinical or procedural variables were associated with bleeding. Twenty-five patients (1.4%) had an international normalized ratio >1.5, and 22 patients (1.2%) had a platelet count <50,000. Only 24% (6/25) of patients with an international normalized ratio >1.5 were transfused with fresh frozen plasma, and 72% (16/22) of those with platelet counts <50,000 received platelet transfusion. Patients with cirrhosis were more frequently transfused (5.9% vs. 1.5%). None of the patients who met the criteria for transfusion experienced major bleeding, regardless of whether they received a transfusion, and none of the patients who had a major bleeding episode met the transfusion criteria. In this cohort, major bleeding after percutaneous liver procedure occurred in <1% of patients, making it a low-risk procedure for patients with and without cirrhosis. Although not uniformly adopted, the current transfusion protocol still led to unnecessary blood product administration.

Enhanced dewatering of dredging slurry by Fenton preoxidation and composite coagulants: optimization experiments and dewatering mechanisms.

In this work, the Fenton preoxidation and composite coagulant method was used to carry out the rapid dewatering experiment of Chaohu Lake (China) dredging slurry. The changes in extracellular polymeric substances (EPS), particle size distribution, zeta potential, specific resistance to filtration (SRF), and capillary suction time (CST) of the dredging slurry were characterized. The results showed that the molar ratio of H2O2 and Fe2+ had the greatest effect on the dewatering of dredging slurry by Fenton preoxidation. The coagulant selected through the coagulation test was polyaluminum ferric chloride. The model simulated by the response surface method exhibited significant adaptability and high accuracy (p < 0.01, R2 = 0.9461, accuracy is 12.115). Fenton preoxidation resulted in the transformation of tightly bound EPS to soluble EPS. After preoxidation-coagulation treatment, the dewatering performance of the slurry improved significantly. The EPS quantity rose by 20.3%, while the SRF (3.65 × 109 s2/g), CST (71.25s), and zeta potential (- 28.0mV) shifted to 0.33 × 109 s2/g, 27.60s, and - 14.9mV, respectively. The disintegration of EPS by Fenton peroxidation and the subsequent adsorption bridging and charge neutralization through coagulation were the key mechanism for improving the dewatering performance of the dredging slurry.

Effect of oral tranexamic acid on postoperative bleeding in spinal surgery: a randomized controlled trial.

This study aimed to investigate the effect of oral administration of tranexamic acid (TXA) on reducing intraoperative bleeding during spinal surgeries. The study was a single-center, double-blind, randomized, placebo-controlled clinical trial. Participants were individuals over 20 years old who underwent spinal surgery. Patients received 1.5g of TXA orally, 2 h before surgery. Intraoperative bleeding volume, blood volume in the drain after surgery, length of hospital stays after surgery, incidence of nausea or vomiting, decrease in hemoglobin (Hb) level, and postoperative coagulation test results were evaluated in each group. In this study, patients were assigned to each study group based on inclusion and exclusion criteria. The mean age of patients was 69.6±6.47 years, and 65% were male. There was no significant difference in age, sex, pre and postoperative Hb levels, prothrombin time (PT), or international normalized ratio (INR) between the study groups. Intraoperative bleeding volume and blood volume in the drain after surgery were significantly lower in the TXA group. Additionally, the length of hospital stay after surgery was significantly shorter in the TXA group. The incidence of nausea or vomiting was significantly higher in the TXA group. Furthermore, postoperative partial thromboplastin time (PTT) was significantly higher in the TXA group compared to the placebo group. Oral administration of TXA before spinal surgery leads to a significant reduction in intraoperative and postoperative bleeding without significant adverse effects and also reduces the length of hospital stay.

Coagulation disorders in liver cirrhosis - Diagnostics and management

Patients with liver cirrhosis often exhibit complex alterations in their hemostatic system that can be associated with both bleeding and thrombotic complications. While prophylactic correction of abnormal coagulation parameters should be avoided, an individualized approach is recommended prior to invasive procedures, whereby specific preventive measures to stabilize hemostasis should be based on the periprocedural bleeding risk. While the haemostatic system of patients with compensated cirrhosis is often in a rebalanced haemostatic state due to a parallel decline in both pro- and anti-haemostatic factors, a decompensation of liver cirrhosis can lead to destabilization of this fragile equilibrium. Since conventional coagulation tests do not adequately capture the complex changes in the hemostatic system in cirrhosis, functional analysis methods such as viscoelastic tests or thrombin generation assays can be used for evaluating the coagulation status. This review describes the underlying pathophysiological changes in the hemostatic system in liver cirrhosis, provides an overview of diagnostic methods and discusses therapeutic measures in case of bleeding and thrombotic complications.

Assessing the impact of severe acute respiratory syndromecoronavirus2infection on hematological parameters.

The current study is a retrospective study designed to evaluate changes in complete blood count and coagulation parameters in adult coronavirus disease 2019 (COVID-19) patients at a prominent Saudi tertiary center to predict disease severity and mortality. The cohort consisted of 74 800 adult patients divided into four groups based on a COVID-19 test and the patient's sex: 35 985 in the female negative COVID-19 group, 23 278 in the male negative COVID-19 group, 8846 in the female positive COVID-19 group and 6691 in the male positive COVID-19 group. Patients with COVID-19 demonstrated decreased white blood cell counts and increased red blood cell counts. Also, COVID-19-positive participants exhibited more prolonged partial thromboplastin time and lower D-dimer levels than those of COVID-19-negative subjects (p<0.05). The study also revealed gender-dependent impacts on platelet counts, implying a possible relationship with the greater infection mortality rate in men than in women (p<0.001). In addition, the study found a link between changes in coagulation test results and death in COVID-19 patients (p<0.001). The evidence regarding the effects of COVID-19 on blood cell counts and coagulation, on the other hand, is conflicting, most likely due to variances in study populations and the timing of testing postinfection. According to the findings, COVID-19-related alterations in blood cell count and clotting ability may be risk factors for death.

The fibrinolytic potential of Bacillus amyloliquefaciens isolates from salt-fermented shrimp paste terasi

Abstract. Pinontoan R, City S, Widjaja AN, Purnomo JS, Dikson. 2024. The fibrinolytic potential of Bacillus amyloliquefaciens isolates from salt-fermented shrimp paste terasi. Biodiversitas 25: 3193-3199. Thrombosis, a major pathology in Cardiovascular Diseases (CVDs), significantly contributes to global mortality. Although medicinal prevention and management of recurrent thromboses do exist, alternative means using natural sources are actively sought because of their lower costs, better compatibility, and lower risks of side effects. Due to their beneficial microorganisms, fermented foods offer a potential thrombolytic source for managing CVDs. In this study, we aimed to isolate and identify bacteria with thrombolytic activity from fermented shrimp paste terasi. Potential protease-producing bacteria from terasi were determined via cell and colony morphology, biochemical properties, and 16S rRNA sequence analyses. Subsequently, the thrombolytic and fibrinolytic activities of the bacteria were assessed by performing whole-blood clot tests and fibrin degradation assays; two protease-producing bacteria, designated as TJU5 and TMAD4 isolates were identified as Bacillus amyloliquefaciens. The isolates demonstrated thrombolytic activity by significantly reducing whole-blood clot mass after 2 h of incubation. The thrombolytic mechanism involves fibrinolysis indicated by the rapid degradation of A?, B?, and ? fibrin chains observed within 1 min of incubation. These findings highlight the beneficial bacteria from fermented shrimp paste terasi, identified as B. amyloliquefaciens TJU5 and TMAD4, with high thrombolytic and fibrinolytic activities, underscoring their potential role in bolstering cardiovascular health.

Web-Based Warfarin Management (Alfalfa App) Versus Traditional Warfarin Management: Multicenter Prospective Cohort Study.

Poor anticoagulation management of warfarin may lead to patient admission, prolonged hospital stays, and even death due to anticoagulation-related adverse events. Traditional non-web-based outpatient clinics struggle to provide ideal anticoagulation management services for patients, and there is a need to explore a safer, more effective, and more convenient mode of warfarin management. This study aimed to compare differences in the quality of anticoagulation management and clinical adverse events between a web-based management model (via a smartphone app) and the conventional non-web-based outpatient management model. This study is a prospective cohort research that includes multiple national centers. Patients meeting the nadir criteria were split into a web-based management group using the Alfalfa app or a non-web-based management group with traditional outpatient management, and they were then monitored for a 6-month follow-up period to collect coagulation test results and clinical events. The effectiveness and safety of the 2 management models were assessed by the following indicators: time in therapeutic range (TTR), bleeding events, thromboembolic events, all-cause mortality events, cumulative event rates, and the distribution of the international normalized ratio (INR). This national multicenter cohort study enrolled 522 patients between June 2019 and May 2021, with 519 (99%) patients reaching the follow-up end point, including 260 (50%) in the non-web-based management group and 259 (50%) in the web-based management group. There were no observable differences in baseline characteristics between the 2 patient groups. The web-based management group had a significantly higher TTR than the non-web-based management group (82.4% vs 71.6%, P<.001), and a higher proportion of patients received effective anticoagulation management (81.2% vs 63.5%, P<.001). The incidence of minor bleeding events in the non-web-based management group was significantly higher than that in the web-based management group (12.1% vs 6.6%, P=.048). Between the 2 groups, there was no statistically significant difference in the incidence of severe bleeding and thromboembolic and all-cause death events. In addition, compared with the non-web-based management group, the web-based management group had a lower proportion of INR in the extreme subtreatment range (17.6% vs 21.3%) and severe supertreatment range (0% vs 0.8%) and a higher proportion in the treatment range (50.4% vs 43.1%), with statistical significance. Compared with traditional non-web-based outpatient management, web-based management via the Alfalfa app may be more beneficial because it can enhance patient anticoagulation management quality, lower the frequency of small bleeding events, and improve INR distribution.

TEG® 6s coagulation testing with a novel heparin neutralization cartridge: Technical validation and determination of normal reference ranges.

We sought to establish normal reference ranges (NRRs) for a novel TEG 6s cartridge (TEG 6s Citrated: K, KH, RTH, FFH [Global Hemostasis]) (Haemonetics Corporation, Boston, MA, US). Healthy volunteers (≥18 years of age) included in this single-arm study provided single samples of whole blood. Primary end points included TEG parameters in the citrated kaolin (CK), CK with heparinase (CKH), RapidTEG with heparinase (CRTH), and functional fibrinogen with heparinase (CFFH) assays. Evaluable data were contributed by 164 volunteers (48.8% female; 62% White/Caucasian). The following NRRs were established: CK maximum amplitude (MA), 51.0 to 67.6mm; CKH-MA, 51.8 to 67.9mm; CRTH-MA, 53.0 to 68.9mm; CFFH-MA, 15.3 to 34.4mm; CK reaction time, 5.0 to 9.1 minutes; CKH reaction time, 4.9 to 9.4 minutes; CKH lysis 30 minutes after MA, 0% to 3.2%. Duplicate measurements demonstrated high reproducibility. CFFH-MA correlated with Clauss fibrinogen concentration (Pearson correlation coefficient, 0.74). Laboratory-based studies demonstrated maintenance of the relationship between CFFH-MA and fibrinogen up to 1344mg/dL (hyperfibrinogenemic samples) and acceptability of heparin neutralization up to concentrations of low molecular weight and unfractionated heparin of 1.3 IU/mL and 5 IU/mL, respectively. This study established NRRs for the Global Hemostasis cartridge and serves as a proof of concept for the validity of results obtained using this cartridge.

Hypercoagulable state and effect of low-molecular-weight heparin prophylaxis on coagulation after lung cancer resection: results from thrombo-elastography.

Lung cancer patients undergoing surgery are at increased risk for Venous thromboembolism (VTE). We monitored changes in perioperative coagulation status through Thrombo-elastography (TEG), and monitored the anticoagulant effect of low molecular weight heparin through TEG for the first time. From July 2019 to January 2020, 207 patients receiving curative surgery were retrospectively screened. and 23 patients were excluded because they did not meet the inclusion criteria. Blood samples were required at three time points (prior to, the first and third day after surgery). Some patients were administrated nadroparin calcium daily from the first day after surgery. Repeated measures ANOVA and Chi-square test were used to analyze the coagulation states variation. To balance the confounders, propensity score matching (PSM) was used to determine the differences of coagulation states between patients with or without Low-molecular-weight heparin (LMWH) prophylaxis. In 184 patients, TEG parameters displayed significant procoagulant changes after lung surgery but conventional coagulation tests exhibited paradoxical trends. There were 6.5% (12/184) of patients identified as hypercoagulability before surgery. According to TEG results, the proportion of patients with hypercoagulability rose from 21.7% to 25% postoperatively, but more were classified into platelet or mixed hypercoagulability at third day compared with that at first day (3.8% vs 14.1%, P < 0.001). By PSM analysis, there were no significant differences in the proportion of hypercoagulable patients postoperatively between chemoprophylactic and nonprophylactic group. TEG was eligible to distinguish changing states of hypercoagulability postoperatively and indicate the role of platelet in blood hypercoagulability. Administration of postoperative LMWH prophylaxis showed little mitigation on hypercoagulable states.

Evaluation of dust and endotoxin exposure among rice mill workers in northeast India

Exposure to particulate matter and endotoxin can lead to acute and chronic respiratory problems in workers. A study was conducted to quantify particulate matter with an aerodynamic diameter of ≤10 μm (PM10) and endotoxin levels in rice mills in northeast India. Sixty-four PM10 dust samples were collected from eight rice mills at two locations: the feeding and polishing sections for two varieties of paddy: Ranjit and Hali. Endotoxin exposures were analyzed using the Limulus Amoebocyte Lysate (LAL) gel clot test. The results showed that the geometric mean of the 8-h time-weighted average (TWA) PM10 dust concentration and endotoxin level in the rice mills were 10.69 mg/m³ and 2.2 EU/m³, respectively. Dust and endotoxin exposure were higher in the feeding section than in the polishing section. Endotoxin exposure in the feeding section during the milling of the Hali variety of paddy was 56.0 % higher than the milling of the Ranjit variety. Additionally, endotoxin exposure during the milling of the Hali variety was 24.2 % higher than that of the milling of the Ranjit variety in the polishing section. The dust exposure in the rice mills was 194.5 % higher than the standards set up by the United States Environmental Protection Agency. However, the exposure to endotoxin in rice mills was approximately 40.10 times below the recommended limit of 90 EU/m3.

An injectable fibronectin3-alginate hydrogel driven by dynamic dissolving equilibrium for irregular wound repair

Managing irregular wounds with varying depths presents a challenge due to the limited effectiveness of traditional dressings in promoting wound healing. Injectable hydrogels represent a promising approach for managing irregular wounds with varying depths. However, many existing hydrogels are limited by poor biocompatibility and a lack of active ingredients, which significantly undermines their effectiveness in promoting wound healing. In this study, an injectable alginate hydrogel incorporating Fibronectin3 (FN3) as the active component was developed through the modulation of Ca2+ balance and a gradual physical crosslinking process, enabling administration with a 30 G needle. This gel demonstrates remarkable self-healing properties, capable of withstanding 1500 % strain, and exhibits high biocompatibility. Moreover, blood clotting tests demonstrate a lower clotting index than gauze. Additionally, the cell scratch test shows the positive biological activity of the gel and its potential to enhance the migration of L-929 calls. Experiments on full-thickness wounds in mice significantly confirm that gels containing FN3 can effectively accelerate wound healing. In conclusion, this study presents a simple method utilizing the solvation equilibrium of Ca2+ for creating injectable hydrogels with exceptional wound repair properties, thereby indicating their promise as wound dressings in clinical applications.

Analytical and Clinical Validation of a Non-Ristocetin Based VWF Assay on 2 Automated Analyzers in a Large Reference Laboratory.

Historically, von Willebrand factor (VWF) activity assays utilized ristocetin despite limitations including poor limits of detection and high imprecision. Newer VWF activity assays such as the INNOVANCE® VWF Ac assay, however, do not rely on ristocetin to measure platelet-dependent VWF function. The purpose of this study was to evaluate the analytical and clinical performance of the Siemens Healthineers INNOVANCE VWF Ac Assay on the Siemens BCS® XP and the Sysmex® CS-2500 systems in a large reference laboratory setting. Performance indicators for the INNOVANCE VWF Ac assay were the limit of quantitation (LoQ), precision, and method comparison. Method comparison studies were performed using remnant plasma patient samples from routine coagulation tests and analyzed using both the INNOVANCE VWF Ac assay and the Siemens Healthineers ristocetin-dependent BC von Willebrand Reagent. Evaluation of the INNOVANCE VWF Ac assay on the BCS® XP and CS-2500 systems demonstrated good precision and a lower LoQ compared to the BC von Willebrand Reagent. Method comparisons support the use of the INNOVANCE VWF Ac assay on the BCS® XP and CS-2500 systems to measure platelet-dependent VWF function. The INNOVANCE VWF Ac assay was able to further assist in von Willebrand disease classification in 6/7 (86%) samples when the result was below the LoQ for the BC von Willebrand Reagent (ristocetin cofactor activity). These data are consistent with the 2021 American Society of Hematology/International Society on Thrombosis and Haemostasis/National Hemophilia Foundation/World Federation of Hemophilia von Willebrand disease guidelines that suggest using newer assays such as the INNOVANCE VWF Ac assay in place of ristocetin cofactor activity assays.

Strategic reuse of rapid antigen tests for coagulation status assessment: an integrated machine learning approach

Addressing the pressing demand for rapid and inexpensive coagulation testing in cardiovascular care, this study introduces a novel application of repurposed COVID-19 rapid antigen tests (RATs) as paper-based lateral flow assays (LFAs) combined with machine learning for coagulation status evaluation. By further developing a mobile app prototype, we present a platform that enables clinicians to perform immediate and accurate anticoagulant dosing adjustments using existing post-pandemic resources. Our proof-of-concept employs a random forest machine learning classifier to interpret image feature variations on RAT NC membrane, correlating red blood cell (RBC) wicked diffusion distance in recalcified citrated whole blood with changes in coagulative viscosity, easily interpreted. Enhanced by confocal imaging studies of paper microfluidics, our approach provides insights into the mechanisms dissecting coagulation components, achieving high classification precision, recall, and F1-scores. The inverse relationship between RBC wicked diffusion distance and enoxaparin concentration paves the way for machine learning to inform real-time dose prescription adjustments, aligning with individual patient profiles to optimize therapeutic outcomes. This study not only demonstrates the potential of leveraging surplus RATs for coagulation management but also exemplifies a cost-effective, rapid, and smart strategy to enhance clinical decision-making in the post-pandemic era.Graphical

Thromboelastogram and coagulation function index: relevance for female breast cancer.

Screening and postoperative intervention of breast tumors are critical for the effective diagnosis and treatment of disease development, and reliable diagnostic/screening methods become a key link. Thromboelastogram (TEG), routine platelet (PLT) count, and the coagulation function indicators in patients with different breast diseases were determined and analyzed to explore their predictive value in secondary bleeding disorders. A total of 131 patients with breast diseases, admitted to Jiangsu University Affiliated Hospital from January 2019 to December 2022, were selected as the research subjects. The detection items were analyzed using the receiver operating curve (ROC) after grouping for secondary bleeding disorders of patients with breast cancer. The reaction (R) and the coagulation (K) times were lower in the malignant breast disease group, while the coagulation angle (α), maximum amplitude (MA), coagulation index (CI), fibrinogen (FIB), and D-dimer (D-D) were higher than those in the benign breast disease group. The t-tests proved that the MA and FIB values were statistically significant (p < 0.05) in the benign and malignant breast disease groups. The R and K in patients with breast diseases were positively correlated with the activated partial thromboplastin time (aPTT) and D-D, but were negatively correlated with PLT. The α angle was negatively correlated with aPTT and D-D, but was positively correlated with PLT. The MA for PLT function was positively correlated with FIB and PLT. CI was negatively correlated with aPTT, thrombin time (TT), and D-D, but was positively correlated with PLT. ROC curve analysis showed that the CI and α angle had a significant predictive value, whereas the correlation of the other indicators was relatively low. Coagulation tests showed significant differences in patients with breast cancer, differing from those with benign breast diseases. TEG combined with conventional coagulation indicators is potentially valuable for the prediction of secondary bleeding disorders in patients with breast cancer.