Erythrocytes Research Articles

A-340 Analysis of OrganOx Liver Perfusate at the Point-of-Care on the Abbott iSTAT and Nova Glucometer to Support Clinical Evaluations of Donor Livers Prior to Transplantation

Abstract Background The recently FDA-approved OrganOx Metra normothermic perfusion system for maintaining donor livers under physiologic conditions prior to transplantation comes equipped with a limited onboard blood gas analyzer for monitoring pO2, pCO2 and temperature. In clinical practice, however, additional biomarkers are used to assess the functional performance of the donor liver, including perfusate lactate clearance and glucose utilization. Liver perfusate contains a mixture of packed red blood cells, albumin, heparin, antibiotic, and solutions of amino acids and electrolytes and bile salts to support metabolic function, and is a specimen type that is not approved by the FDA. Implementation of the OrganOx Metra at Loyola University Medical Center (LUMC), a quaternary care transplant center, led to the validation of liver perfusate for the evaluation of glucose and lactate at the point-of-care (POC) using the Nova STATStrip Glucometer and Abbott iSTAT CG4 cartridge, respectively. Methods Lactate was measured on the Abbott iStat CG4 cartridge, and glucose which was measured using the Nova STATStrip Glucometer. Recovery studies were performed by mixing liver perfusate (non-centrifuged, n=16 independent specimen) with heparinized whole blood. Results The average recovery for the evaluation of lactate was 100% (range = 78 to 122%), and the average recovery for glucose was 109% (range = 93 to 112%). Conclusions Recovery studies evaluating matrix effect for the analysis of lactate (Abbott iSTAT, CG4) and glucose (Nova STATStrip) in liver perfusate indicate that the matrix of the perfusate does not affect the analytical accuracy, as compared to heparinized whole blood, the FDA-approved specimen type. Measurement of the OrganOx liver perfusate for lactate and glucose on these POC devices demonstrates reliable assessments to guide transplant teams in evaluating the viability of donor livers.

An epidemiologic blood group-1

Aim Polycythemia, also known as erythrocytosis, is an abnormal accumulation of red blood cells, packed cell volume, and hemoglobin that can lead to debilitating symptoms and significant mortality. Polycythemia is estimated to affect 22 people per 100,000. The epidemiology of polycythemia in Iraq is limited. This study aimed to investigate the prevalence and incidence of polycythemia in Babylon City, Iraq, from 2018 to 2022 and to identify populations at high risk. Materials and Methods Due to the relative scarcity of epidemiological studies on polycythemia in Iraq, this study was conducted to identify some epidemiological features of polycythemia patients in Babylon province. A study conducted at the Babylon Central Blood Bank included 220 polycythemia patients. This data was obtained by reviewing all patient documents and the registration book from 2018 to 2022. Participants completed a questionnaire with information about their Sex, age, place of residence, smoking habits, and blood group. Statistics were analyzed using SPSS version 23.0 and Prism software. Results were presented in numbers and percentages and analyzed using the Chi-square test. Results Results indicated that polycythemia increased between 2018 and 2020, with the highest numbers in 2018 and decreasing in 2022. There was a higher frequency in the age group of (41-50) years, and it was more common in males with polycythemia (92.72%) who were smokers (79.09%). Most polycythemia patients had the B blood group (38.2%), while the AB blood group had the lowest percentage (5.5%), and most cases were Rh-positive (91.8%). Conclusion this study provided an overview of the epidemiology of polycythemia in Babylon, Iraq. The findings indicate that polycythemia was more prevalent in men of middle age and with blood group B+. Therefore, further research is needed to examine the relevance of the ABO blood group to polycythemia severity and susceptibility. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1068-1074

A-037 A1c by separation and enzymatic methods: what's the difference?

Abstract Background Accurate values for hemoglobin A1c (HbA1c) are crucial for diagnosing and monitoring diabetes mellitus. Two common methods to measure HbA1c are capillary electrophoresis (CE) and immunoassay (IA). Many methods used to measure HbA1c are prone to interferences from hemoglobin variants and abnormalities affecting the red blood cell’s (RBC) turnover. Consequently, the average estimated glucose levels using the HbA1c value can be unreliable in diabetics with hemoglobinopathies and other RBC lifetime disorders. Separation methods such as CE can capture hemoglobinopathy information, while IA methods may not. We performed this study in a population with relatively high levels of hemoglobin disorders to evaluate the performance of HbA1c testing on the Alinity platform (IA) against the Sebia Capillarys 3 Tera instrument (CE). Methods Samples were identified retrospectively based on a search of the Electronic Medical Record for all patients with an ordered and resulted HbA1c and complete blood count in the Montefiore Medical Center the day prior to sampling. Routine HbA1c testing was performed by an Abbott Immunoassay method on the Abbott Alinity Instrument and CBC results were obtained from a Sysmex XN2100 instrument. Records were compared by patient name, medical record number, and sample collection time to identify all patients with CBC and HbA1c drawn within one hour of each other. Those samples were retrieved from storage (a 4° automated refrigerator) within 48 hours of draw and tested via the Sebia Capillarys 3 Tera instrument using HBA1c kits. Results In this large representative population study (N=2075), there was overall excellent agreement between IA and CE. The correlation coefficient (R2) of the whole dataset was 0.989, with an average bias of 2.7% between the two methods. Additional analysis was performed on those with possible RBC turnover disorder (patients with RBC counts below 4x106/uL or above 6x106/uL, MCVs above 96 fL or below 80 fL, RDW above 17%, or abnormal A2 value: total of 638 samples), those with a hemoglobin variant as detected by the Capillarys 3 instrument (162 samples), or with a measurable hemoglobin F value detected by the Capillarys 3 instrument (37 samples). Samples were sorted into these groups independently and thus there was significant overlap between groups, notably with 23 of 37 samples with elevated HbF also having a hemoglobin variant. In both the RBC disorder and hemoglobinopathies group, similar low bias and high correlations were seen. The elevated F samples showed a clear negative bias (5.6%) for all patients on the IA method as compared with CE. The IA method states that samples with HbF above 5% should not be tested. However, as this is not a separation method, there is no way to test samples for HbF before analysis, and bias was seen for samples below 5%. Conclusions The IA and CE methods showed similar performance across patients regardless of RBC lifetime or hemoglobin disorder status, though presence of HbF is a potential interference and should be considered. Further questions remain for these instruments in terms of correlation with average glucose levels as calculated through CGM instruments.

Key biomarkers in type 2 diabetes patients: A systematic review.

Type 2 diabetes mellitus (T2DM) is not just a local health issue but a significant global health burden, affecting patient outcomes and clinical management worldwide. Despite the wealth of studies reporting T2DM biomarkers, there is an urgent need for a comparative review. This review aims to provide a comprehensive analysis based on the reported T2DM biomarkers and how these are linked with other conditions, such as inflammation and wound healing. A comparative review was conducted on 24 001 study participants, including 10 024 T2DM patients and 13 977 controls (CTL; age 30-90 years). Four main profiles were extracted and analysed from the clinical reports over the past 11 years: haematological (1084 cases vs. 1458 CTL), protein (6753 cases vs. 9613 CTL), cytokine (975 cases vs. 1350 CTL) and lipid (1212 cases vs. 1556 CTL). This review provides a detailed analysis of the haematological profile in T2DM patients, highlighting fundamental changes such as increased white blood cells and platelet counts, accompanied by decreases in red blood cell counts and iron absorption. In the serum protein profile, a reduction in albumin and anti-inflammatory cytokines was noted along with an increase in globulin levels and pro-inflammatory cytokines. Furthermore, changes in lipid profiles were discussed, specifically the decreases in high-density lipoprotein (HDL) and the increases in low-density lipoprotein (LDL) and triglycerides. Understanding the changes in these four biomarker profiles is essential for developing innovative strategies to create diagnostic and prognostic tools for diabetes management.

Characteristics of risk factors and molecular genetic parameters in children with chronic kidney disease

Introduction. Information about the health status of children with nephrological pathology includes many manifestations of functional system disorders. However, early diagnosis of chronic kidney disease (CKD) is rarely carried out due to the lack of reliable predictors of this process.The aim: To analyze the association of anamnestic signs, laboratory and genetic research results with chronic kidney disease in children to identify potential predictors of the disease.Material and Methods. The data were obtained from a single-center retrospective catamnestic cohort study (2011–2022). The main group included 128 children with chronic kidney disease aged 1 to 17 years. The comparison group consisted of 30 children without diagnosed kidney pathology aged from 1 to 17 years. There were no statistically significant differences in sex and age between the two groups. The informative value of more than 150 features, including anamnestic ones, the state of the mother’s health during pregnancy, antenatal and perinatal factors, features of the child’s development and manifestation of the disease, the results of clinical, laboratory, and genetic research methods were evaluated. An integrated approach to the study included methods for hypotheses testing on statistical significance of indicators differences, regression analysis, and ROC analysis.Results. Hereditary burden of nephrological pathology in the family, unfavorable course of pregnancy (anemia, toxicosis of the first half), obstetric and somatic pathology in the mother, the serial number of childbirth are associated with the subsequent development of CKD. Erythrocytes in the urine and daily protein loss were detected only in the group of children with CKD. In this group, a decrease in the number of red blood cells, increased erythrocyte sedimentation rate (ESR), allergies at an early age, otitis media, persistent viral and bacterial infections, and a number of signs of connective tissue dysplasia were more common. The main group statistically significantly differed from the comparison group by a number of polymorphic genetic markers. It can be assumed that the polymorphisms AGT1 Thr174Thr, AGT2 Thr235Thr, NO3 C786T are associated with a predisposition to CKD, and the products of polymorphisms AGT1 Thr174Met, AGT2 Met235Met, R1 AGT2 C1166C, NO3 T786T may have a protective effect according to development of CKD.Conclusion. The risk factors for CKD identified in this study can be used to develop software to support medical decision making for early detection of children at high risk of disease progression.

B-307 Comparative studies on serum quantitative immunoglobulin assay and serum protein electrophoresis for the diagnosis of multiple myeloma

Abstract Background Various clinical laboratory tests are valuable in enhancing the diagnosis of monoclonal gammopathy. The nephelometric-based serum quantitative immunoglobulin test provides great utility to understand the magnitude of antibody-mediated responses and is useful in interpreting Serum protein electrophoresis (SPEs). In clinical practice, several (SPEs) are ordered without a preliminary order of serum quantitative immunoglobulins but pathologists can and do order the test for comparison. However, there is seldom any data in the literature describing the correlative relationship between the two tests. It is therefore imperative to create an evidenced-based system of test-ordering for the laboratory investigation of the presence of monoclonal protein. The goal of the project is to compare the results of quantitative serum immunoglobulin assay and SPE in order to determine their concordance. Methods In this preliminary phase of the project, retrospective results of quantitative serum immunoglobulin assay and SPEs that were performed simultaneously were retrieved from the electronic medical records. The span of data extended to the past 1 year. If there is an additional immunofixation (IFE) order associated with the SPE, the IFE report was also retrieved for further comparison. Based on the etiology of multiple myeloma, results of calcium, red blood cell count and creatinine were also pooled and analyzed. Results of free light chain assay and associated kappa-lambda ratios were also obtained. All the data obtained were entered into and filtered in excel spreadsheet program and subsequently analyzed with GraphPad prism. Results 1000 patient results were analyzed, of which 404 were males and 596 were females. 200 of the patients had either SPE or quantitative immunoglobulin performed which had the following age demographic; 23 were between 18-39 years, 52 were 40-59 years and 125 were 60-89 years. This data suggests geriatric population are more likely to be seen for multiple myeloma suspicion. There were 60 concurrent orders. Of this, there was 65.5% agreement between the serum quantitative immunoglobulin assay and SPE or IFE while 34.5% showed a mismatch. 26% of the orders for quantitative immunoglobulins assay had no follow-up SPE. A high Kappa/lambda ratio was concordant with a positive SPE 83% of the time. But only 66% of normal kappa/lambda ratio matched a normal SPE. Conclusions Here, we have shown that in addition to the kappa/lambda ratio, the quantitative immunoglobulins test has a considerable agreement with SPE and may be an important preliminary test. The test could be useful to rule out monoclonal gammopathy, confirm polyclonal pattern or embolden a normal SPE interpretation. The present research will have a direct impact on the diagnosis and monitoring of monoclonal gammopathy and enhance appropriate test utilization. The research will improve the development of a better ordering policy for laboratory operations with respect to the work up of multiple myeloma. As more data is unraveled, better understanding will be gained into the relationship between quantitative immunoglobulin and SPE for better patient care.

An evaluation of the analytical and biological robustness of a method for quantifying iron in individual red blood cells via single-cell tandem ICP-mass spectrometry

This work evaluated the analytical and biological robustness of iron (Fe) determination in individual red blood cells (RBCs) via single-cell ICP-MS (SC-ICP-MS). RBCs were separated from other whole blood constituents using Ficoll-Paque™ density gradient centrifugation. While fixation with paraformaldehyde (PFA) led to RBC lysis, the use of glutaraldehyde (GA) left the RBCs intact and permitted storage of RBC cell suspensions in ultra-pure water for up to 16 months at 4 °C. GA-fixation also rendered the RBCs sufficiently robust to maintain integrity during their introduction into the ICP by means of nebulization of dilute suspensions. Obtaining quantitative data on a cell-per-cell basis required determination of the transport efficiency using the particle size method and external calibration against aqueous Fe standard solutions. The average Fe content per RBC obtained using SC-ICP-MS (average value of 103 fg/cell) agreed well with the value obtained using solution-based ICP-MS obtained after cell pellet digestion and with values obtained from literature. Variation of the cell number density in the suspensions analyzed between 1.5 × 105 and 6.0 × 105 cells per mL did not affect the result. Identical results from one-week interval blood drawings from healthy individuals demonstrate biological consistency. Compared to bulk analysis, the SC-ICP-MS approach offers the added value of providing information on the cell-to-cell heterogeneity in Fe content.

Hypertonicity and/or acidosis induce marked rheological changes under hypoxic conditions in sickle trait red blood cells.

Deformability and sickling of red blood cells (RBCs) from individuals with sickle cell trait (SCT) was evaluated under harsh biophysical conditions that mimic certain vascular beds invivo. RBC deformability in osmotic-gradient ektacytometry was decreased in HbAS (SCT) compared to HbAA (wild-type) RBCs at supraphysiological osmolalities. RBC deformability was also measured by oxygen-gradient ektacytometry. Whereas RBC sickling was not observed under isotonic and neutral pH conditions, hypertonicity and acidosis alone or in combination induced reversible sickling of SCT RBC. These data suggest that hyperosmolality and/or acidosis enhance hypoxia-induced sickling of SCT RBC.

Soluble adenylyl cyclase is an acid-base sensor in rainbow trout red blood cells that regulates intracellular pH and haemoglobin-oxygen binding.

To identify the physiological role of the acid-base sensing enzyme, soluble adenylyl cyclase (sAC), in red blood cells (RBC) of the model teleost fish, rainbow trout. We used: (i) super-resolution microscopy to determine the subcellular location of sAC protein; (ii) live-cell imaging of RBC intracellular pH (pHi) with specific sAC inhibition (KH7 or LRE1) to determine its role in cellular acid-base regulation; (iii) spectrophotometric measurements of haemoglobin-oxygen (Hb-O2) binding in steady-state conditions; and (iv) during simulated arterial-venous transit, to determine the role of sAC in systemic O2 transport. Distinct pools of sAC protein were detected in the RBC cytoplasm, at the plasma membrane and within the nucleus. Inhibition of sAC decreased the setpoint for RBC pHi regulation by ~0.25 pH units compared to controls, and slowed the rates of RBC pHi recovery after an acid-base disturbance. RBC pHi recovery was entirely through the anion exchanger (AE) that was in part regulated by HCO3 --dependent sAC signaling. Inhibition of sAC decreased Hb-O2 affinity during a respiratory acidosis compared to controls and reduced the cooperativity of O2 binding. During invitro simulations of arterial-venous transit, sAC inhibition decreased the amount of O2 that is unloaded by ~11%. sAC represents a novel acid-base sensor in the RBCs of rainbow trout, where it participates in the modulation of RBC pHi and blood O2 transport though the regulation of AE activity. If substantiated in other species, these findings may have broad implications for our understanding of cardiovascular physiology in vertebrates.

Measurement and analysis of ionic leakage profiles in refrigerated human red blood cells using dielectrophoresis and inductively coupled mass spectroscopy.

Human red blood cells (RBCs) undergo ionic leakage through passive diffusion during refrigerated storage, affecting their quality and health. We investigated the dynamics of ionic leakage in human RBCs over a 20-day refrigerated storage period using extracellular ion quantification and dielectrophoresis (DEP). Four type O- human blood donors were examined to assess the relationship between extracellular ion concentrations (Na+, K+, Mg2+, Ca2+, and Fe2+), RBC cytoplasm conductivity, and membrane conductance. A consistent negative correlation between RBC cytoplasm conductivity and membrane conductance, termed the "ionic leakage profile" (ILP), was observed across the 20-day storage period. Specifically, we noted a gradual decline in DEP-measured RBC cytoplasm conductivity alongside an increase in membrane conductance. Further examination of the electrical origins of this ILP using inductively coupled plasma mass spectrometry revealed a relative decrease in extracellular Na+ concentration and an increase in K+ concentration over the storage period. Correlation of these extracellular ion concentrations with DEP-measured RBC electrical properties demonstrated a direct link between changes in the cytoplasmic and membrane domains and the leakage and transport of K+ and Na+ ions across the cell membrane. Our analysis suggests that the inverse correlation between RBC cytoplasm and membrane conductance is primarily driven by the passive diffusion of K+ from the cytoplasm and the concurrent diffusion of Na+ from the extracellular buffer into the membrane, resulting in a conductive reduction in the cytoplasmic domain and a subsequent increase in the membrane. The ILP's consistent negative trend across all donors suggests that it could serve as a metric for quantifying blood bank storage age, predicting the quality and health of refrigerated RBCs.

Finite element analysis and detection of melanoma cells under dual-cell photoacoustic interference conditions

In order to detect the presence of melanoma cells in two cells under the condition of cell photoacoustic wave interference, this paper conducted a finite element analysis of the photoacoustic wave interference field of two cells. First, the wavelength corresponding to the dominant frequency of the signal from a single red blood cell (mean diameter) was calculated. Then, the distance between two identical red blood cells (mean diameter) was set as a multiple of the wavelength to identify the optimal interference distance and the position of the enhanced zone detection point. Next, under the optimal distance, the signal curves of two cells as red blood cells and when melanoma cells exist in two cells were calculated in sequence. Finally, the frequency domain sound pressure level curve of the detection point under the two states was compared with the single-cell signal to obtain the Frechet distance. The results show that when both cells are red blood cells, the Frechet value is less than 48; when melanoma cells exist in both cells, the Frechet value is greater than 52. This study shows that the presence of melanoma cells in two cells can be determined by adjusting the distance between the cells, arranging the positions of the detection points, and employing the Frechet distance metric curve difference under the condition that the two-cell photoacoustic waves interfere with each other.

Impact of Same Red Blood Cell Infusion at Different Intervals on Premature Infants' Hemoglobin Levels.

Blood transfusions are performed in small amounts in premature infants. Few studies have focused on the effect of the same red blood cell (RBC) package at different intervals on increasing hemoglobin(Hb) concentration. We aimed to determine the effect of infusion of the same RBC package at different time intervals on Hb levels in premature infants. Data were collected about premature infants who received the same package of RBC transfusion at two different intervals. Venous blood Hb levels before and within 24hours after transfusion were measured for the first and second transfusions. Overall, 196 premature infants with anemia were included in the study. The data were categorized into four groups (Group I, Group II, Group III and Group IV) based on the varying intervals between transfusions of the same red blood cells. Hb levels of the first and second transfusions with the same RBC package showed a significant difference pre and posttransfusion. Hb increments varied among groups: Group I (43.00 g/L), Group II (34.50 g/L), Group III (32.00 g/L), and Group IV (32.50 g/L), with Group I demonstrating a significant difference compared to Groups II, III, and IV (P<0.05), while no differences were noted among the latter groups. In premature infants with anemia, hemoglobin levels significantly increased after infusion of the same RBC package at different intervals. An interval of 1week had the most significant effect. There are differences in the effect of infusion of the same RBC at different time intervals on hemoglobin levels in premature infants. An interval of 1week had the most significant effect.

Accuracy of the model derived from red blood cell indices in predicting α0-thalassemia trait among non-anemic pregnant women

BackgroundThe study aims to establish prediction model derived from red blood cell indices to improve the accuracy of α0-thalassemia trait screening in non-anemic pregnant women. MethodA diagnostic study as secondary analysis on the prospective database was conducted. The participants were pregnant women, undergoing α0-thalassemia screening at first visit antenatal care using red blood cell indices with confirmation by PCR method. Diagnostic performance of each of red blood cell parameter and their combination derived from logistic regression analysis in predicting α0-thalassemia trait were determined. FindingsThe total 587 Thai pregnant women were included in the analysis, consisting of 136 cases of α0-thalassemia trait and 451 normal controls. Diagnostic performance analysis revealed that, the mean corpuscular volume (MCV) provided a sensitivity of 98.5 % and a false positive rate of 20.2 %. While The mean corpuscular hemoglobin (MCH) provided a sensitivity of 99.3 % and a false positive rate of 15.7 %. The combined-parameters prediction model including hemoglobin (Hb), MCV, MCH, mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and red blood cell (RBC) count, demonstrated excellent diagnostic performance with an area under the curve (AUC) of 0.992, sensitivity of 99.3 %, and much lower false positive rate of 4 %. InterpretationThe combined-parameter prediction model provided excellent diagnostic performance with low false positive rate. The application of the prediction model could decrease unnecessary PCR method for α0-thalassemia testing, thereby decreasing the cost of investigation. Our proposed model can possibly have a great impact or significant change in clinical practice, especially in Southeast Asia.

Method validation of an inductively coupled plasma mass spectrometry (ICP-MS) assay for the analysis of magnesium, copper and zinc in red blood cells

BackgroundLaboratory measurements of trace elements such as magnesium (Mg), copper (Cu), and zinc (Zn) in red blood cells (RBCs) are essential for assessing nutritional status and diagnosing metal toxicity. The purpose of this study was to develop and validate an ICP-MS method for quantifying these elements in RBCs. MethodsPacked RBCs were aliquoted and diluted in an alkaline diluent solution containing internal standards, 0.1 % Triton X-100, 0.1 % EDTA, and 1 % ammonium hydroxide. The resulting diluted specimen was analyzed using inductively coupled plasma mass spectrometry (ICP-MS) to quantitatively determine the levels of Mg, Cu, and Zn. The method underwent validation for accuracy, precision, method comparison, linearity, analytical sensitivity, and carryover. Additionally, retrospective data were analyzed, and non-parametric reference intervals were calculated. ResultsAccuracy and linearity fell within the expected range of ≤±15 % for all analytes. Within-run, between-run, and total imprecision were ≤15 % coefficient of variation. All other validation experiments met the established acceptance criteria. Retrospective data analysis was conducted on patient samples using the method. The application of Tukey’s HSD test for multiple comparisons revealed statistically significant mean differences (p < 0.05) in Mg, Cu, and Zn concentrations between all pairwise groups of age and sex, except for the mean Cu concentration in adult males versus females and the mean Mg concentrations in adult versus minor males. ConclusionsThe presented method was successfully validated and met the criteria for clinical use. Retrospective data analysis of patient results demonstrated the method’s suitability for assessing nutritional deficiency and toxicity.

Blood EPA and DHA status among people living in the United States from 2000 to 2023

Long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs), specifically eicosapentaenoic acid (EPA, C20:5n-3) and docosahexaenoic acid (DHA, C22:6n-3), are well-known for their various health benefits, including cardiovascular and cognitive health. In this study we explored the EPA+DHA blood status across different states within the United States. A widely used marker to assess the EPA+DHA status is the omega-3 index – defined as the % of EPA+DHA in red blood cells (RBC) in relation to total fatty acids. A systematic literature search was conducted for US-studies from 2000 until October 2023 reporting EPA+DHA blood values. Further inclusion criteria were: information in which US state the study was carried out, no pregnant women, at least 16 years of age. A total of 46 studies met all inclusion criteria. EPA+DHA levels from studies utilizing blood metrics other than RBC were converted to an estimated RBC EPA+DHA (eRBC EPA+DHA) status marker using established conversion equations. The mean eRBC EPA+DHA across the US was 5.28% and, is in line with previous investigations. Most US states showed an average eRBC EPA+DHA in the range 4.50% to 5.50%. Furthermore, we found that coastal states tend to have higher eRBC EPA+DHA (5.26%) than inland states (4.86%). This is consistent with the slightly higher fish consumption in coastal states compared to inland states. The data from the studies included in the evaluation show that the blood status of EPA+DHA is suboptimal. The supply of EPA and DHA should be improved, especially in inland states. Further research is needed to better monitor EPA+DHA status in the US. Since the EPA+DHA blood status is a modifiable risk factor for many diseases, public health officials should take steps to emphasize the significance of n-3 PUFAs in preserving the health of the US population.

Platelet Indices – Are They Really Biomarkers in Psoriasis? A Cross-sectional Study

Background: Psoriasis is a chronic inflammatory disorder with multiple systemic manifestations in common with other inflammatory disorders. Platelet activation has recently been proposed a major pathogenic factor in psoriasis. Mean platelet volume (MPV) and platelet distribution width (PDW) are considered platelet activation markers. Although there are various inflammatory markers reported to be abnormal in psoriasis, a simple cost-effective and clinically useful marker that could predict the severity of the disease and be used to know about its association with systemic abnormalities and response to treatment is still under study. Aim: The aim of our study was to look at the association of platelet indices with psoriasis and its severity. Methods: This was a single-center cross-sectional study in which 50 patients with psoriasis and 50 apparently healthy age and sex-matched controls who fulfilled the inclusion and exclusion criteria were enrolled after obtaining informed consent. A detailed history was elicited, and a clinical examination was done including anthropometric measurements and calculation of psoriasis area and severity index (PASI). Investigations including hemoglobin, red blood cell (RBC) count, packed cell volume (PCV), mean corpuscular volume, mean corpuscular hemoglobin (MCH), MCH concentration, white blood cell (WBC) and platelet count, plateletcrit, MPV, PDW, and red cell distribution width (RDW) were done. Results: Out of 50 psoriasis patients recruited, 40 (80%) had moderate-to-severe psoriasis, whereas 10 had mild psoriasis (10%) based on PASI scores. In majority of cases, the hemoglobin, PCV, RBC, and WBC counts were within the normal range and were comparable with that of controls. There was no statistically significant difference in the mean values of platelet count, MPV, PDW, plateletcrit, and RDW between cases and controls. There was no significant association between platelet indices and severity of psoriasis. Conclusion: There was no significant association between platelet indices including RDW and the presence or absence of psoriasis in our study. Furthermore, among patients with psoriasis, there was no significant association between platelet indices and severity of the disease.

Correlation of the Transfusion Camp knowledge assessment test with clinical transfusion practice.

It is uncertain how transfusion knowledge translates to practice. The purpose of the study was to determine if higher scores on a validated Transfusion Camp knowledge assessment test were associated with transfusion order appropriateness. Eligible participants included postgraduate trainees and faculty physicians who had prescribed at least four transfusion orders in the preceding 6 months at two hospitals. Participant data and knowledge were collected using a web-based questionnaire with a validated Transfusion Camp knowledge assessment tool. The most recent 4-10 consecutive transfusion orders per prescriber were independently dually adjudicated for appropriateness based on published criteria. The primary outcome was the correlation between the score on six questions on red blood cells (RBCs), platelets (PLTs), and plasma from the validated test and the percentage order appropriateness. Generalized linear regression was conducted to determine if factors (sex, specialty, participation in Transfusion Camp, previous transfusion education, self-rated knowledge) were associated with appropriate orders. Seventy-four participants (45 trainees, 29 faculty; 31 females, 43 males) completed the test. Median score was 66.7% (interquartile range [IQR]: 50.0, 83.3) for six questions on RBCs, PLTs, and plasma transfusions. Of 546 transfusion orders adjudicated, appropriateness was 90.7% (95% confidence interval [CI]: 87.9%-93.0%). The correlation between prescriber test scores and order appropriateness was very weak (r = -.08). In multivariable analysis, female prescribers (p = .02) and beginner (vs. intermediate) self-rated knowledge (p = .01) were associated with higher transfusion appropriateness. Transfusion knowledge test scores did not correlate with order appropriateness. Factors other than knowledge are key to understanding how to improve appropriate blood use.

Revealing the Structural Intricacies of Biomembrane-Interfaced Emulsions with Small- and Ultra-Small-Angle Neutron Scattering.

Utilizing cell membranes from diverse cell types for biointerfacing has demonstrated significant advantages in enhancing colloidal stability and incorporating biological properties, tailored specifically for various biomedical applications. However, the structures of these materials, particularly emulsions interfaced with red blood cell (RBC) or platelet (PLT) membranes, remain an underexplored area. This study systematically employs small- and ultra-small-angle neutron scattering (SANS and USANS) with contrast variation to investigate the structure of emulsions containing perfluorohexane within RBC (RBC/PFH) and PLT membranes (PLT/PFH). The findings reveal that the scattering length density of RBC and PLT membranes is 1.5 × 10-6Å-2, similar to 30% (w/w) deuterium oxide. Using this solvent as a cell membrane-matching medium, estimated droplet diameters are 770nm (RBC/PFH) and 1.5µm (PLT/PFH), based on polydispersed sphere model fitting. Intriguingly, calculated patterns and invariant analysis reveal native droplet architectures featuring entirely liquid PFH cores, differing significantly from the observed bubble-droplet core system in electron microscopy. This highlights the advantage of SANS and USANS in differentiating genuine colloidal structures in complex dispersions. In summary, this work underscores the pivotal role of SANS and USANS in characterizing biointerfaced colloids and in uncovering novel colloidal structures with significant potential for biomedical applications and clinical translation.

Longitudinal Assessment of Transfusion Intensity in Patients With JAK Inhibitor—Naive or—Experienced Myelofibrosis Treated With Momelotinib

PurposeAnemia is a cardinal feature of myelofibrosis often managed with red blood cell (RBC) transfusions, which may contribute to negative prognostic, quality-of-life, and healthcare-related economic impacts. The Janus kinase (JAK) 1/JAK2/activin A receptor type 1 inhibitor momelotinib was approved for the treatment of patients with myelofibrosis and anemia based on clinical trial evidence of anemia, spleen, and symptom benefits illustrated using binomial response/nonresponse endpoints. In the present post hoc, descriptive analyses, the impact of momelotinib on RBC transfusion burden over time was further characterized across JAK inhibitor–naive and –experienced patients MethodsAll RBC units transfused were collected during the baseline and 24-week treatment periods, initially in a single-arm phase 2 study as proof-of-concept analysis, and then versus comparators (ruxolitinib, best available therapy [BAT], and danazol) in the phase 3 SIMPLIFY-1, SIMPLIFY-2, and MOMENTUM studies, respectively. ResultsIn the phase 2 study, mean transfusion requirement changed by −1.5 units/28 days, with 85% of patients (35/41) achieving numeric transfusion reduction. Across SIMPLIFY-1, SIMPLIFY-2, and MOMENTUM, mean transfusion requirements decreased with momelotinib (−0.1, −0.36, and −0.86 units/28 days), while mean requirements with ruxolitinib, BAT, and danazol changed by +0.39, 0, and ‒0.28 units/28 days, respectively. Overall, 87% (185/213), 77% (79/103), and 85% (110/130) of patients had improved or stable transfusion intensities with momelotinib versus 54% (117/216), 62% (32/52), and 63% (41/65) with ruxolitinib, BAT, and danazol. ConclusionThese novel time-dependent transfusion burden analyses demonstrate that momelotinib is associated with anemia-related benefits in most patients and greater transfusion burden reduction versus comparators. Trial registrationClinicalTrials.gov identifiers: NCT02515630, NCT01969838, NCT02101268, NCT04173494.

The Effect of Fermented Wheat Germ Extract on Broiler Chicks’ Growth Performance, Immunological Status, and Carcass Characteristics

Abstract Many studies have mentioned the advantages of adding wheat germ to chicken diets, but few were interested in studying the effect of the fermentation process on this addition. The present study aimed to investigate the effects of adding fermented wheat germ extract (FWGE) and immunostimulant (IS) to the broiler diet and water, respectively, on growth performance, hematological and blood biochemical parameters, immune status, and carcass characteristics. A total of 180 one-day-old broiler chicks (Cobb 500) were randomly and equally assigned into four treatment groups of 5 replicates (9 chicks/replicate) each. The first group (G1) served as a control group with a basal diet and normal drinking water, while the second (G2) and the third (G3) groups were treated with a basal diet supplemented with 0.1 and 0.2% of FWGE, respectively. The fourth group (G4) was treated with one level of immunostimulant (ORGA IMMU®, 0.2% in drinking water) and served as a positive control. The experiment lasted 35 days. According to the results, adding 0.2% FWGE to the broiler diet (G3) improved (P≤0.05) feed conversion ratio and increased (P≤0.05) live body weight and body weight gain compared to the control group (G1). The G3 also showed improvements (P≤0.05) in red blood cells (RBCs), hemoglobin concentration (Hb), packed cell volume (PCV), and white blood cell (WBC) counts. Blood biochemical parameters, such as total protein, aspartate aminotransferase (AST), and alanine aminotransferase (ALT), were positively affected (P≤0.05) by FWGE and immunostimulant treatments. Hemagglutination inhibition (HI) titers for Newcastle disease and avian influenza viruses, phagocytic activity (PA), phagocytic index (PI), and lysozyme activity (LA) were significantly (P≤0.05) improved by FWGE and immunostimulant treatments. Furthermore, carcass traits, such as carcass weight and dressing percentage, were improved (P≤0.05) by adding FWGE and immunostimulant treatments. The inclusion of FWGE in the broiler chicken diet by 0.2% had a considerably positive impact on the birds’ growth performance, health, and carcass quality.