Cut Off Research Articles

Investigation of the relationship between type I (α,β) interferon and viral load in patients with Crimean-Congo haemorrhagic fever (CCHF)

In this study, type I interferon (IFN-α ve IFN-β) levels, viral load levels, the relationship between viral load and interferons, and the relationship between interferon levels and disease severity and mortality in patients with Crimean-Congo Haemorrhagic Fever (CCHF) were investigated. 100 patients diagnosed with CCHF between April-2010 and September-2011 and 74 healthy individuals were selected as control group. IFN-α ve in patient sera was analysed by IFN-β seviyeleri ELISA method and viral load levels were analysed by Real-Time PCR method. Individuals in the patient group were classified as severe (group1) and mild (group2) patients according to the criteria defined by Swanepoel et al. During the follow-up, 25 of the patients in the severe group died. Patients in the severe group who died were classified as group1a and patients who survived were classified as group1b. INF-α ve β düzeyleri CCHF patients in the control group, group1 patients in group2 and control group was found to be significantly higher than the group (p<0.05). When the viral load levels detected in patients in group1 and group2 were compared, the statistical difference was found to be insignificant (p>0.05). Viral load levels in group1a were statistically significant compared to group1b and group2 (p<0.05). In the ROC analysis performed in terms of IFN-α düzeyleri detected in the first blood samples of the patients, the cut off value for predicting mortality was 25042 pg/ml. In this analysis, the area under the curve (AUC) of IFN-α için was 0.713 and statistically significant (p<0.05). IFN-β için values were statistically insignificant (p>0.05). The cut off value for viral load was 8445500 copies/ml, AUC was 0.870 and statistically significant (p<0.05). There was a significant and positive correlation between IFN-α ile and IFN-β arasında in group1a (r=0.551, p<0.05). In conclusion, we found high levels of interferon and viral load in CCHF patients in this study, suggesting that high levels of interferon are released in CCHF patients, but the secreted interferon cannot prevent viral replication adequately. It is likely that the CCHF virus has various evasion mechanisms to avoid the effect of interferon. Further studies are needed to clarify/confirm this situation.

Covert airflow obstruction dominates the overt ones in interstitial lung disease: An appraisal.

Background & objectives The co-presence of non-emphysematous airflow obstruction in interstitial Lung disease (ILD) is not elaborated. The present study aims the job with spirometry. Methods ILD affected individuals with or without airflow obstruction (FEV1/FVC<0.7 or >0.7) on spirometry were compared in terms of FEV1 and FEF25-75 derived variables [FEF25-75 (%-predicted), FEV1-FEF25-75 distance, reversibility of FEV1 and FEF25-75 to salbutamol and change in FEV1 and FEF25-75 in %-predicted values]. Those showing significant difference (P=0.0001) suggesting obstruction were selected to draw respective receiver operating curve (ROC) curves to identify the best cut-off value for individual parameters. The efficacy of each surrogate was tested to identify airflow obstruction in both the initial 'overlap' as well as the 'unmixed' ILD affected individual for the presence of airflow obstruction. Results FEV1/FVC identified 30 overlap from 235 ILDs. The FEF25-75 (%-predicted), FEV1-FEF25-75 distance, FEF25-75 reversibility (in ml) and FEV1 (%-predicted) were significantly (P<0.0001) different between the two groups. Of these, the FEF25-75 (%-predicted) had high specificity and sensitivity (93.33 and 79.47%) to identify airflow limitation in the initial unmixed ILD-group. The surrogates with their cut off values identified 92 extra individuals making it 122/235 (51.91%) of ILD having airflow obstruction. The 'unmixed' group showed higher frequency and degree of FEV1 reversibility. Interpretation & conclusions The findings of this study suggest that the airflow obstruction in ILD involves both the intrathoracic large and small airways. Although seemingly parallel, their relative status (qualitative and quantitative) needs research especially in light of the a etio pathology and the extent of involvement of ILD.

Using Cerebrospinal Fluid Biomarkers To Enhance Diagnostic Testing For Alzheimer's Disease In A Tertiary Memory Service

Abstract Background Cerebrospinal Fluid (CSF) biomarkers are useful in the definitive diagnosis of Alzheimer’s disease (AD) when basic investigations and neuroimaging are inconclusive. In our tertiary memory clinic, the standard CSF biomarker panel consists of Amyloid Beta (AB) 42, Total tau, and Phosphorylated tau. AB42/40 is an additional CSF biomarker which has been shown to improve diagnostic accuracy for AD but is not part of our standard CSF biomarker panel (1). We examined the use of AB42/40 in patients attending our service. Methods In our service, diagnosis of dementia is based on a multidisciplinary consensus meeting (including Geriatricians, Neurologists, Psychiatrists) who review clinical presentation and neuroimaging. In a minority of cases, CSF analysis is performed. We retrospectively evaluated how the addition of AB40/42 to our standard CSF panel impacted diagnostic accuracy for AD, taking a ratio of &amp;lt;0.067 to indicate AD (2). Results Of 1853 patients attending the Memory service between September 2022 and December 2023, CSF was available for 107 patients. Of these 107, average age was 68. 56 were female (52%) and 51 were male (48%). At the multidisciplinary consensus meeting, 81 of these 107 patients were diagnosed with AD (75%), with the remaining 26 (24%) patients being diagnosed with a non-AD process (Vascular disease, Lewy Body etc) or an inconclusive diagnosis. After the addition of AB42/40 to CSF, 8 of the 26 patients (31%) with non-AD or an inconclusive diagnosis were identified as potential AD. Of the 81 with a diagnosis of AD, none were reclassified after addition of AB42/40. Receiver Operating Characteristic (ROC) curve analysis was performed to determine relevant cut off values. Conclusion This study suggests the addition of AB42/40 ratio to our standard CSF biomarker panel improves identification of potential AD cases in our sample. This biomarker is being added to the standard CSF panel for our Memory service.

Identifying timing and risk factors for early recurrence of resectable rectal cancer: A single center retrospective study.

Colorectal cancer is a common malignancy and various methods have been introduced to decrease the possibility of recurrence. Early recurrence (ER) is related to worse prognosis. To date, few observational studies have reported on the analysis of rectal cancer. Hence, we reported on the timing and risk factors for the ER of resectable rectal cancer at our institute. To analyze a cohort of patients with local and/or distant recurrence following the radical resection of the primary tumor. Data were retrospectively collected from the institutional database from March 2011 to January 2021. Clinicopathological data at diagnosis, perioperative and postoperative data, and first recurrence were collected and analyzed. ER was defined via receiver operating characteristic curve. Prognostic factors were evaluated using the Kaplan-Meier method and Cox proportional hazards modeling. We included 131 patients. The optimal cut off value of recurrence-free survival (RFS) to differentiate between ER (n = 55, 41.9%) and late recurrence (LR) (n = 76, 58.1%) was 8 mo. The median post-recurrence survival (PRS) of ER and LR was 1.4 mo and 2.9 mo, respectively (P = 0.008) but PRS was not strongly associated with RFS (R² = 0.04). Risk factors included age ≥ 70 years [hazard ratio (HR) = 1.752, P = 0.047], preoperative concurrent chemoradiotherapy (HR = 3.683, P < 0.001), colostomy creation (HR = 2.221, P = 0.036), and length of stay > 9 d (HR = 0.441, P = 0.006). RFS of 8 mo was the optimal cut-off value. Although ER was not associated with PRS, it was still related to prognosis; thus, intense surveillance is recommended.

One Pot Synthesis of Thiopyrimidine Derivatives from Lignin Reproductions by Microwave-Assisted Ultrasonic Microscopy with DFT Description for Clarifying the Mass Spectrum

In this work, an efficient and sustainable procedure for the one-pot synthesis of thiopyrimidine derivatives starting 1,3-diketone cut off β-O-4 lignin precursors to create anticancer agents. Microwave-ultrasonic assisted lignin extract in accessing various heterocyclic precursors such as pyrimidine, pyridine, and thiophene moieties. The results designated the ultrasonic-assisted microwave significantly accelerated synthesis with reduced time. We have diversely prolonged to tight-binding approaches to the electron ionization mass spectrometry with quantum stimulation (DFT/EIMS) to examine electron ionization mass spectra correlated to the experiment. Moreover, DFT/EIMS provides into the mechanism of the reaction of mass spectra trials. It cabins on the fragmentation method to raise the challenging bond breaking and structural rearrangements. The quantum chemical process for effective precursors of a mass spectrum is exactness required and discussed. Foremost fragmentation designs are studied and related to experimental data of the pyrimidin-thione derivatives and their glycosides.

Influence of dissolved organic matter on U(VI) removal at varying hydrogeochemical scenarios in ultrafiltration process

Uranium (U) is a chemical and radioactive groundwater contaminant that needs to be regulated in drinking water to avoid health hazards. In this study, we have investigated the mechanisms underlying ultrafiltration (UF) process, a low energy-intensive technology, for the removal of uranium from contaminated groundwater, in the presence of dissolved organic matter (i.e. Humic Acid [HA]) under environmentally-relevant conditions representative of regional scenario of Punjab, India. Stirred cell UF experiments with aqueous solutions containing uranium were performed with five different UF membranes with molecular weight cut off (MWCO) ranging from 1 kDa to 30 kDa at a pH of 8.5 that represented ambient groundwater scenario. In the absence of HA, the U(VI) removal was highest for the UF membrane with the lowest MWCO (i.e. 1 kDa) and vice-versa. Further, the effect of various solution parameters viz. pH, concentration of HA, and salinity have been studied using three different UF membranes viz. 5 kDa, 10 kDa, and 30 kDa. Uranium rejection was found to be maximum at pH 5.5 with ca. 97 %, 94 %, and 87 % rejection for 5 kDa, 10 kDa, and 30 kDa membranes, respectively. Further, U(VI) speciation results of the hydrogeochemical model corroborated that the removal of U(VI) in the presence of HA was highly dependent on feed solution pH. Moreover, U(VI) removal increased significantly with an increase in HA concentration, indicating the dominant role of U(VI)-HA complexes. Further, it was observed that increasing the salinity levels to 100 mM in the feed solution (i.e. semi-brackish water scenario) decreased U(VI) rejection primarily due to the charge screening effect. Our results show that using the UF separation process, the World Health Organization’s drinking water guideline value of 30 µg of U L−1 could be achieved in U(VI) contaminated groundwater that contains significant HA levels.

Investigation on growth, structural, mechanical, linear and nonlinear optical properties of DiLithium Fumarate TetraHydrate single crystal

In this work reports on the growth and characterization of semiorganic NLO single crystal of DiLithium Fumarate TetraHydrate (DLFTH) using a slow evaporation technique. The crystal structure was an orthorhombic crystal system with the centrosymmetric space group Pbcn, as demonstrated by single crystal X-ray diffraction (SCXRD) investigations. The UV–Vis-NIR spectrum is used to derive optical parameters, such as the lower cut off wavelength (277 nm) and optical energy band gap Eg = 4.98 eV. DLFTH crystals belongs to hard material category using Vickers microhardness test. From NLO studies, the nonlinear optical parameters were studied, such as the nonlinear refractive index (n2), absorption coefficient (β) and third order NLO susceptibility (χ3). The crystal has the properties of saturable absorption and self-defocusing nature. Third order NLO susceptibility (χ3) were found to be 4.14384 × 10-10esu. The higher χ3 number is due to the presence of hydrogen bonds between C-H-O and O-H-O atoms. Therefore, we confirm that it’s applicability for optical device applications.

18F]FDG-PET/CT in adrenal lesions: diagnostic performance in different clinical settings.

Data regarding [18F]FDG-PET/CT for the characterization of adrenal lesions are limited. Most of the studies proposed the tumor-to-liver maximum standardized uptake values (SUVratio) > 1.5 as the best cut off to predict malignancy. The aim of the study was to calculate the optimum cut off in a heterogeneous population with adrenal lesions and evaluate the diagnostic performance SUVratio >1.5. Retrospective analysis of adrenal lesions undergoing [18F]FDG-PET/CT (2013-2022) for different reasons (atypical adrenal incidentalomas, extra adrenal tumor staging). The diagnosis of benignity was assessed by: (i) histology; (ii) stability or minimal diameter increase (<20%/<5 mm) on 12-months follow-up for non-operated patients. The optimal SUVratio and performance of SUVratio >1.5 were calculated by ROC curves. Forty-two consecutive lesions (diameter 36.1 ± 20.3 mm, 6 bilateral) underwent [18F]FDG-PET/CT (19F, age 61.2 ± 11.7 years). Twenty-nine lesions were benign, 11 malignant [8 metastases (2 bilateral) and 1 adrenocortical carcinoma (ACC)] and 2 pheochromocytomas. The SUVratio cut-off in our population was 1.55 (Sn 100%, Sp 73.7%, AUC 0.868), with similar values excluding pheochromocytomas and metastases (SUVratio cut-off 1.49, Sn 100%, Sp 96.3%, AUC 0.988). The SUVratio cut-off of 1.5 showed 100% Sn, 87% Sp, 73% PPV, and 100% NPV. [18F]FDG-PET/CT could help in decision making process avoiding unnecessary surgery. The SUVratio cut-off of 1.5 has a good performance in a heterogenous population.

Academic and non-academic predictors of common mental health difficulties among university students during the COVID-19 pandemic.

Public concern for the mental health of university students has been rising over recent years. Newly arising stressors associated with the COVID-19 pandemic could contribute to further mental health burden for students. This study aimed to understand the mental health status of university students at an early stage in the pandemic and to identify academic, non-academic, and COVID-19-related predictors of common mental health difficulties at this time. This study examined how academic and non-academic predictors relate to common mental health difficulties using a cross-sectional sample of university students (n = 3817). There were high levels of depression and anxiety during the pandemic, with more than 50% experiencing levels above the clinical cut offs. Academic stress, social isolation, intolerance of uncertainty, and more negative attitudes towards remote teaching and learning predicted higher levels of depression and anxiety. University identification predicted lower levels of depression whereas receiving a diagnosis of COVID-19 was associated with higher levels of depression. This study identified COVID-19-related factors that uniquely contributed to students' distress during the pandemic, over and above social connectivity variables. As COVID-19 factors, such as the uncertainty surrounding the pandemic, may have driven an increase in distress levels among students, these findings provide insights that could help universities and policymakers develop targeted interventions to support the mental health and well-being of university students during future crises.

Evaluation of Handoff Drop Call Rate in GSM Network in Delta State with Dynamic Cut off Channel Allocation Scheme

This study aims at evaluating Handoff drop call rate in GSM Network using dynamic Cut off Channel Allocation Scheme by evaluating different Mobile Network Operators, MNOs, and comparing with Nigerian Communication Commission (NCC)’s Key Performance Indicator (KPI). A hybrid handoff algorithm was developed to reduce drop calls, analyze the performance of the hybridized handoff algorithm; and compare the simulated results of the hybridized algorithm with that of the existing Mobile network operators, MNOs. The current handoff failure and drop call rates of the best mobile communication network in Nigeria was evaluated and was discovered that the existing Hand off failure rate HFR per cell was 5% and the drop call rate DCR was 10%. These were above the NCC maximum target of 2%. These defects account for the unacceptable drop call rates experienced and thus negatively impact on the quality of service QoS. An optimal solution was provided by developing an enhanced and highly sensitive handoff algorithm from two different algorithms - the Entire Channel Allocation, and the Fixed Channel Allocation - while putting the Modified Reserved Channel Scheme with Guard Channel, and the Fuzzy handoff initiation method into consideration. A software known as Netbeans 7.2 was interfaced with Octave 5.1.0 and used to simulate the developed algorithm. The programme trial was made to run repeatedly for 1200s. Our simulation results indicated HFR of 3% as against 5% from that of the existing network, and DCR of 6% as against the 10% from the network. In further comparing the existing DCR with that obtained from our simulation, an average of 40% dropped calls reduction was realized. This implied that the algorithm reduced drop calls thereby enhancing connectivity and mobility management through the minimization of handoff failures.

Negative Differential Resistance with Ultralow Peak-to-Valley Voltage Difference in Td-WTe2/2H-MoS2 Heterostructure.

Negative differential resistance (NDR) devices with a low peak-to-valley voltage difference (ΔV) exhibit a high cut off frequency and low power consumption efficiency, which is significant for fabricating high-performance oscillators. However, achieving an ultralow ΔV is challenging. In this work, we report the first construction of an NDR device utilizing a van der Waals heterostructure composed of semimetallic Td-WTe2 and semiconducting 2H-MoS2. Our findings reveal that the narrow energy region of the decreasing density of states (DOS) above the Fermi level of WTe2 acts as a narrow band gap, facilitating type-III band alignment with MoS2 and enabling band-to-band tunneling-based NDR transport. Notably, the NDR device exhibits an ultralow ΔV of approximately 0.01 V, which is at least an order of magnitude lower than previously reported values. This work not only introduces a new approach for NDR device fabrication but also provides new insights into the pivotal role of Td-WTe2 in NDR transport.

A FAPα-activated MRI nanoprobe for precise grading diagnosis of clinical liver fibrosis

Molecular imaging holds the potential for noninvasive and accurate grading of liver fibrosis. It is limited by the lack of biomarkers that strongly correlate with liver fibrosis grade. Here, we discover the grading potential of fibroblast activation protein alpha (FAPα) for liver fibrosis through transcriptional analysis and biological assays on clinical liver samples. The protein and mRNA expression of FAPα are linearly correlated with fibrosis grade (R2 = 0.89 and 0.91, respectively). A FAPα-responsive MRI molecular nanoprobe is prepared for quantitatively grading liver fibrosis. The nanoprobe is composed of superparamagnetic amorphous iron nanoparticles (AFeNPs) and paramagnetic gadoteric acid (Gd-DOTA) connected by FAPα-responsive peptide chains (ASGPAGPA). As liver fibrosis worsens, the increased FAPα cut off more ASGPAGPA, restoring a higher T1-MRI signal of Gd-DOTA. Otherwise, the signal remains quenched due to the distance-dependent magnetic resonance tuning (MRET) effect between AFeNPs and Gd-DOTA. The nanoprobe identifies F1, F2, F3, and F4 fibrosis, with area under the curve of 99.8%, 66.7%, 70.4%, and 96.3% in patients’ samples, respectively. This strategy exhibits potential in utilizing molecular imaging for the early detection and grading of liver fibrosis in the clinic.

Optimizing workflow efficiency for analyzing low molecular weight endogenous peptides in colostrum.

Bovine milk and colostrum play pivotal roles in the nutritional support of both human and bovine infants. Colostrum, the initial milk secretion, is crucial for neonatal growth, providing essential nutrients, growth factors, immunity, and defense mechanisms through a diverse array of bioactive compounds, including bioactive proteins and peptides. Peptidomics, leveraging the potential health benefits of peptides derived from food and body fluids, has become prominent in contemporary research. Endogenous peptides (EPs) have gained notable scientific and commercial interest due to their potential biofunctional significance in areas such as immune health, antimicrobial, anti-inflammatory, antihypertensive, and antioxidative studies. In this investigation, we aimed to extract and analyze low molecular weight EPs from colostrum using four distinct peptide extraction methods, previously employed for EPs extraction from other bodily fluids. The efficiency of these methods was systematically compared and analysed to identify the most effective extraction technique for maximizing the identification of low molecular weight EPs from colostrum. This study represents a pioneering effort as no prior research has systematically compared different extraction methods for low molecular weight EPs from colostrum. Given the unique physical and chemical composition of colostrum compared to milk and other body fluids, a comprehensive analysis of EPs extraction methods was deemed essential. In the present study, we successfully extracted over 3200 EPs from colostrum using trichloroacetic acid (TCA) and a molecular weight cut off (MWCO) extraction method. The findings of this study revealed the extraction of EPs from colostrum, demonstrating potential inherent bioactivities as predicted by in silico tools.

Cancer-associated fibroblasts barrier breaking via TGF-β blockade paved way for docetaxel micelles delivery to treat pancreatic cancer

TGF-β is a crucial regulator in tumor microenvironment (TME), especially for myofibroblastic cancer-associated fibroblasts (myCAFs). The myCAFs can be motivated by TGF-β signaling to erect pro-tumor TME, meanwhile, myCAFs overexpress TGF-β to mediate the crosstalk between tumor and stromal cells. The blockade of TGF-β can break cancer-associated fibroblasts barrier, consequently opening the access for drugs into tumor. The TGF-β is a promising target in anti-tumor therapy. Herein, we introduced a two-stage combination therapy (TC-Therapy), including TGF-β receptor I inhibitor SB525334 (SB) and cytotoxicity agent docetaxel micelle (DTX-M). We found that SB and DTX-M synergistically inhibited myCAFs proliferation and elevated p53 protein expression in BxPC-3/3T3 mixed cells. Gene and protein tests demonstrated that SB cut off TGF-β signaling via receptor blockade and it did not arouse TGF-β legend compensated internal autocrine. On the contrary, two agents combined decreased TGF-β secretion and inhibited myCAFs viability marked by α-SMA and FAPα. TC-Therapy was applied in BxPc-3/3T3 mixed tumor-bearing mice model. After TC-Therapy, the α-SMA+/ FAPα+ myCAFs faded increasingly and collagenous fibers mainly secreted by myCAFs decreased dramatically as well. More than that, the myCAFs barrier breaking helped to normalize micro-vessels and paved way for micelle penetration. The TGF-β protein level of TC-Therapy in TME was much lower than that of simplex DTX-M, which might account for TME restoration. In conclusion, TGF-β inhibitor acted as the pioneer before nano chemotherapeutic agents. The TC-Therapy of TGF-β signaling inhibition and anti-tumor agent DTX-M is a promising regimen without arising metastasis risk to treat pancreatic cancer. The therapeutic regimen focused on TGF-β related myCAFs reminds clinicians to have a comprehensive understanding of pancreatic cancer.

SP5.4 - Is Fecal Calprotectin a useful test?

Abstract Aim To identify whether there is a correlation between a positive Fecal Calprotectin level(FCP) and a diagnosis of Inflammatory Bowel Disease. Method Data was collected retrospectively from a database of all colonoscopies performed at a District General Hospital. Data was collected including patient demographics, FCP result, colonoscopy and histology report from the hospital electronic record system. Results A total of 450 patients underwent a colonoscopy for any reason with 250 male and 200 female. The average age was 63.5 years. Patients undergoing surveillance or interventional colonoscopies were excluded. 90 patients were referred for colonoscopy with a change in bowel habit and all these patients had a FCP. Out of these, 42 had a FCP greater than 99 ug/g. Only 4 had IBD confirmed on histology, 3 had non-specific bowel inflammation. Of the other 360 patients who underwent a colonoscopy for other indications, 33 had a FCP sent, with 6 being positive. Out of a total of 48 patients who had a positive FCP, 25 had a FCP result greater than 250 ug/g. however, only three of these patients had IBD confirmed on histology. Conclusion The results show no correlation between a positive FCP and a diagnosis of IBD even using a higher cut off at 250 ug/g. For most cases with altered bowel habits or rectal bleeding, a FCP should not be recommended as it will not change the need for a colonoscopy.

Growth, Characterizations of Aspartame-ASP Crystals for Mechano, Spectral, Photonic, Opto-Electronic and Sensor Applications

The organic crystal has prevalent outcome and Aspartame-ASP crystal which is in anhydrate form is of 160–200 times sweeter than the sucrose and the single crystalline X-ray diffraction (XRD) data for ASP are a, b, c in Å as 19.4077, 4.9604, 15.6547, and alpha and gamma as 90°, beta as 94.877° and system is monoclinic, the space group is P21. The XRD reveals the monoclinic arrangement of the ASP crystal, the UV effect with Tauc’s plot for lower frequency cut off at 295 nm and band gap as 4.203 eV, morphology by scanning electron microscopy study in μm scaling, Vicker’s proviso by hardness profile, basic functional groups by Fourier transform infrared and basic examinations, excitation—emission by PhotoLuminescence-PL peak at 513 nm, electronic sort of ASP filters in 4.3275 microns, electric depiction by dielectric study and mechano use by hardness profile of ASP are studied and reported. Hardness coefficient by Vicker’s intended for ASP with n as 2.91. The NLO-SHG is of 1.76 times KDP with phase matched effect of ASP is reported. Also, the room-temperature sensor study of ASP is measured and compliance by red light-emitting diode source.

Association between Hematological Parameters and Severity of COVID-19 disease.

This study aimed to determine the relationships between hematological parameters- hemoglobin, Total Leucocyte Counts (TLC), platelet counts, Absolute Neutrophil Counts (ANC), Absolute Lymphocyte Counts (ALC), Neutrophil Lymphocyte Ratio (NLR), Systemic Immune Inflammatory Index (SII), Neutrophil Monocyte Ratio (NMR), Platelet Lymphocyte Ratio (PLR) and the severity of COVID-19 disease and their use in predicting severity of COVID-19 disease. This was a prospective, observational, single-center study of 573 symptomatic adult inpatients of COVID 19 admitted to our tertiary care center. The above-mentioned hematological parameter levels were noted and compared between the two categories of COVID-19 disease, namely non-severe and severe COVID-19 using logistic regression methods. Their cut-off values were detected using the ROC curve. The median TLC, ANC, NLR, SII, NMR, PLR were notably higher in patients with severe COVID-19 than in those with non-severe COVID-19. Logistic regression analysis showed that NMR (OR=1.029, p=0.006) and ALC (OR=0.999, p=0.002) were statistically significant independent predictors of COVID-19 severity. The hematological parameters mentioned, can be used for predicting severe COVID-19 disease at admission. ALC and NMR levels could be used as hematological markers to predict severity of COVID-19 in adult patients with their cut off values being < 1105 cells/cubic millimeter and > 10.434 respectively.

On the cutoff, reappearance, and persistence of subsonic leaky A0 Lamb waves

Abstract Subsonic leaky A0 Lamb waves, whose phase speeds are lower than the fluid’s sound speed, exhibit several peculiar behaviours. In this work, we investigate three such behaviours: Cutoff, where the A0 branch cuts off at some point in the subsonic domain, reappearance, where the cut-off A0 branch reappears at lower frequencies, and persistence, where the A0 branch is never cut off at all. From the literature, we take the case of a 1 mm thick aluminium plate immersed in air of varying density. We then analyse its exact leaky A0 wave solutions by means of a sound radiation model that takes energy conservation into account. This analysis explains these peculiar behaviours by connecting them with the conditions that allow sound-radiating subsonic leaky A0 Lamb waves.

Maternal angiogenic factor disruptions prior to clinical diagnosis of preeclampsia: insights from the REVAMP study.

Preeclampsia is characterized by impaired angiogenesis and assessment of angiogenic factors can play a crucial role in the early diagnosis of preeclampsia. The current study reports the levels of angiogenic factors longitudinally from early pregnancy in women with preeclampsia and in the subtypes of preeclampsia, to identify their role in early prediction of preeclampsia. A total of 1154 women with singleton pregnancies were recruited in early pregnancy from 2 hospitals. Blood samples were collected, plasma samples were separated and stored at four time points across gestation: V1 = 11-14 weeks, V2 = 18-22 weeks, V3 = 26-28 weeks, and V4 = at delivery. The current study includes a total of 108 women developed preeclampsia (PE), and 216 matched controls. Angiogenic factors were estimated using commercially available ELISA kits. Receiver operating characteristic (ROC) curves were used to evaluate the potential diagnostic value in the prediction of PE. Lower levels of VEGF, PlGF, and higher levels of sEng and sEng/PlGF ratio (p < 0.05 for all) predate clinical diagnosis in women with preeclampsia. sEng levels and sEng/PlGF ratio showed significant correlation with odds of preeclampsia at all the timepoints. This study identifies a cut off of 33.5 for sFlt-1/PlGF and 25.9 for sEng/PlGF for prediction of early onset preeclampsia. This study reports various angiogenic factors serially across gestation in a general population to identify women at risk of developing preeclampsia and its subtypes. The study also reports a potential biomarker and a pragmatic window for estimation of angiogenic markers to identify women at risk.

Association of Preoperative Neutrophil to Lymphocyte Ratio with Early Postoperative Acute Kidney Injury Following Isolated Off-Pump Coronary Artery Bypass Grafting

Objective: Acute kidney injury (AKI) is a frequent complication after off-pump coronary artery bypass grafting (OPCAB) that complicates recovery, increases treatment cost and mortality. Neutrophil to lymphocyte ratio (NLR) is a systemic inflammatory marker easily derived from complete blood count that has many prognostic potentials. The purpose of this study was to evaluate if there is an association of preoperative NLR with early postoperative AKI following isolated OPCAB. Methods: This cross-sectional study was carried out in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD) on a total of 60 patients aged 31-70 years with no preoperative renal dysfunction undergoing isolated OPCAB between August 2021 and July 2022. Group A included 30 patients with preoperative NLR &lt; 2.65 and Group B included 30 patients with preoperative NLR ≥ ≥≥2.65. Patients were monitored for development of early postoperative AKI according to serum creatinine criteria of Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline. Results: Two patients from group A and twenty patients from group B developed early postoperative AKI (p &lt; 0.001). Events of AKI were significantly higher in group B patients at all postoperative time points. Multivariate binary logistic regression analysis revealed preoperative NLR ≥ ≥≥2.65 as an independent predictor of early post OPCAB AKI (p = 0.004, OR = 13.746). In receiver operating curve (ROC) analysis area under curve (AUC) was 0.933 (95% CI 0.874-0.992, p &lt; 0.001). It showed 90.91% sensitivity and 73.7% specificity at the pre-set cut off value of NLR at 2.65 where optimal predictability of post-OPCAB AKI occurred with 66.67% positive predictive value, 93.33% negative predictive value and 80% accuracy. Conclusion: Preoperative NLR is significantly associated with early postoperative AKI following isolated OPCAB and therefore it should be incorporated in routine clinical practice for early prediction of AKI and implementing timely preventive strategies. (Bangladesh Heart Journal 2024; 39(2): 151-160