Red Cell Distribution Width-standard Deviation Research Articles

Using blood routine indicators to establish a machine learning model for predicting liver fibrosis in patients with Schistosoma japonicum

This study intends to use the basic information and blood routine of schistosomiasis patients to establish a machine learning model for predicting liver fibrosis. We collected medical records of Schistosoma japonicum patients admitted to a hospital in China from June 2019 to June 2022. The method was to screen out the key variables and six different machine learning algorithms were used to establish prediction models. Finally, the optimal model was compared based on AUC, specificity, sensitivity and other indicators for further modeling. The interpretation of the model was shown by using the SHAP package. A total of 1049 patients’ medical records were collected, and 10 key variables were screened for modeling using lasso method, including red cell distribution width-standard deviation (RDW-SD), Mean corpuscular hemoglobin concentration (MCHC), Mean corpuscular volume (MCV), hematocrit (HCT), Red blood cells, Eosinophils, Monocytes, Lymphocytes, Neutrophils, Age. Among the 6 different machine learning algorithms, LightGBM performed the best, and its AUCs in the training set and validation set were 1 and 0.818, respectively. This study established a machine learning model for predicting liver fibrosis in patients with Schistosoma japonicum. The model could help improve the early diagnosis and provide early intervention for schistosomiasis patients with liver fibrosis.

The Response of the Amputee Athlete Heart to Chronic Core Exercise: A Study on Hematological and Biochemical Parameters, and N-Terminal Pro Brain Natriuretic Peptide.

Background and Objectives: mortality and morbidity due to cardiovascular causes are frequently experienced in amputees. Research on the effects of chronic exercise on biomarkers and cardiac damage indicators in these individuals is limited. The aim of this study was to investigate the effects of a core training program on brain natriuretic-related peptide, as well as hematological and biochemical parameters in amputee soccer players. Materials and Methods: The participants were randomly allocated to the following two groups: a core exercise group (CEG) and a control group (CG). While the CG continued routine soccer training, the CEG group was included in a core exercise program different from this group. During the study, routine hemogram parameters of the participants, various biochemical markers, and the concentration of brain natriuretic-related peptide (NT-pro-BNP) were analyzed. Results: after the training period, notable improvements in various hematological parameters were observed in both groups. In the CEG, there were significant enhancements in red blood cell count (RBC), hematocrit (HCT), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular hemoglobin (MCH) values. Similarly, the CG also showed substantial improvements in RBC, HCT, mean corpuscular volume (MCV), MCHC, MCH, red cell distribution width-standard deviation (RDW-SD), platelet-to-lymphocyte ratio (PLCR), mean platelet volume (MPV), and platelet distribution width (PDW). Moreover, in the CEG, serum triglycerides (TG) and maximal oxygen uptake (MaxVO2) exhibited significant increases. Conversely, TG levels decreased in the CG, while high-density lipoprotein (HDL), low-density lipoprotein (LDL), and MaxVO2 levels demonstrated substantial elevations. Notably, the N-terminal pro-brain natriuretic peptide (BNP) levels did not undergo significant changes in either the CEG or the CG following the core exercise program (p > 0.05). However, in the CEG, a meaningful positive correlation was observed between NT-pro-BNP and creatine kinase (CK) levels before and after the core exercise program. Conclusions: the findings emphasized the potential benefits of core training in enhancing specific physiological aspects, such as erythrocyte-related parameters and lipid metabolism, as well as aerobic capacity. Furthermore, the observed correlation between NT-pro-BNP and CK levels in the CEG provides intriguing insights into the unique physiological adaptations of amputee athletes.

Analysis of hematological indicators via explainable artificial intelligence in the diagnosis of acute heart failure: a retrospective study.

Acute heart failure (AHF) is a serious medical problem that necessitates hospitalization and often results in death. Patients hospitalized in the emergency department (ED) should therefore receive an immediate diagnosis and treatment. Unfortunately, there is not yet a fast and accurate laboratory test for identifying AHF. The purpose of this research is to apply the principles of explainable artificial intelligence (XAI) to the analysis of hematological indicators for the diagnosis of AHF. In this retrospective analysis, 425 patients with AHF and 430 healthy individuals served as assessments. Patients' demographic and hematological information was analyzed to diagnose AHF. Important risk variables for AHF diagnosis were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) feature selection. To test the efficacy of the suggested prediction model, Extreme Gradient Boosting (XGBoost), a 10-fold cross-validation procedure was implemented. The area under the receiver operating characteristic curve (AUC), F1 score, Brier score, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were all computed to evaluate the model's efficacy. Permutation-based analysis and SHAP were used to assess the importance and influence of the model's incorporated risk factors. White blood cell (WBC), monocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), red cell distribution width-standard deviation (RDW-SD), RDW-coefficient of variation (RDW-CV), and platelet distribution width (PDW) values were significantly higher than the healthy group (p < 0.05). On the other hand, erythrocyte, hemoglobin, basophil, lymphocyte, mean platelet volume (MPV), platelet, hematocrit, mean erythrocyte hemoglobin (MCH), and procalcitonin (PCT) values were found to be significantly lower in AHF patients compared to healthy controls (p < 0.05). When XGBoost was used in conjunction with LASSO to diagnose AHF, the resulting model had an AUC of 87.9%, an F1 score of 87.4%, a Brier score of 0.036, and an F1 score of 87.4%. PDW, age, RDW-SD, and PLT were identified as the most crucial risk factors in differentiating AHF. The results of this study showed that XAI combined with ML could successfully diagnose AHF. SHAP descriptions show that advanced age, low platelet count, high RDW-SD, and PDW are the primary hematological parameters for the diagnosis of AHF.

Increased MCHC*RDW-SD interaction values: indicators of neurological impairment in lead-poisoned children.

The neurotoxic effects of lead in children can have long-lasting and profound impacts on the developing nervous system. This study aimed to identify a reliable and easily accessible biomarker to monitor neurological impairment in lead-poisoned children. We analyzed hematological data from 356 lead-poisoned children, comparing them with age and gender-matched healthy controls. Multivariate logistic regression and receiver operating characteristic (ROC) analysis were employed to identify and evaluate potential biomarkers for neurological damage. Significant changes in erythrocyte parameters were observed in lead-poisoned children. Upon further analysis, increased mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width-standard deviation (RDW-SD) interaction values were found to be significantly associated with neurological impairment. The MCHC*RDW-SD interaction model demonstrated an AUC of 0.76, indicating its effectiveness in reflecting neurological damage. Additionally, the MCHC*RDW-SD Interaction value showed weak or no correlation with other erythrocyte parameters, suggesting its independence as an indicator. Our findings propose the increased MCHC*RDW-SD interaction value as a robust and independent biomarker for detecting neurological impairment in lead-poisoned children. This underscores the potential of utilizing specific erythrocyte parameters for screening the neurotoxic effects of lead exposure in pediatric populations.

Predicting colorectal cancer risk: a novel approach using anemia and blood test markers.

Colorectal cancer remains an important public health problem in the context of the COVID-19 (Corona virus disease 2019) pandemic. The decline in detection rates and delayed diagnosis of the disease necessitate the exploration of novel approaches to identify individuals with a heightened risk of developing colorectal cancer. The study aids clinicians in the rational allocation and utilization of healthcare resources, thereby benefiting patients, physicians, and the healthcare system. The present study retrospectively analyzed the clinical data of colorectal cancer cases diagnosed at the Affiliated Hospital of Guilin Medical University from September 2022 to September 2023, along with a control group. The study employed univariate and multivariate logistic regression as well as LASSO (Least absolute shrinkage and selection operator) regression to screen for predictors of colorectal cancer risk. The optimal predictors were selected based on the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. These predictors were then utilized in constructing a Nomogram Model for predicting colorectal cancer risk. The accuracy of the risk prediction Nomogram Model was assessed through calibration curves, ROC curves, and decision curve analysis (DCA) curves. Clinical data of 719 patients (302 in the case group and 417 in the control group) were included in this study. Based on univariate logistic regression analysis, there is a correlation between Body Mass Index (BMI), red blood cell count (RBC), anemia, Mean Corpuscular Volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet count (PLT), Red Cell Distribution Width-Standard Deviation (RDW-SD), and the incidence of colorectal cancer. Based on the findings of multivariate logistic regression analysis, the variables of BMI and RBC exhibit a decrease, while anemia and PLT demonstrate an increase, all of which are identified as risk factors for the occurrence of colorectal cancer. LASSO regression selected BMI, RBC, anemia, and PLT as prediction factors. LASSO regression and multivariate logistic regression analysis yielded the same results. A nomogram was constructed based on the 4 prediction factors identified by LASSO regression analysis to predict the risk of colorectal cancer. The AUC of the nomogram was 0.751 (95% CI, OR: 0.708-0.793). The calibration curves in the validation and training sets showed good performance, indicating that the constructed nomogram model has good predictive ability. Additionally, the DCA demonstrated that the nomogram model has diagnostic accuracy. The Nomogram Model offers precise prognostications regarding the likelihood of Colorectal Cancer in patients, thereby helping healthcare professionals in their decision-making processes and promoting the rational categorization of patients as well as the allocation of medical resources.

The influence of breed's difference on the hemogram and biochemistry profile of goats raised in Libya during winter

Background: In Libya, goats are considered as one of the most important livestock in which there are many breeds of goats such as Kurdi, Hegazi, Cyprus, Shami and Mahali. A little hematological and biochemical information is known on these goat breeds raised in Libya. Aim: Main purpose was to verify the effect of breed variations on the hematological and biochemical parameters of goat breeds raised in Libya. Methods: The blood samples collected in the winter season from 70 clinically healthy animals of different breeds for hematology and biochemical analysis. Results: Regarding the effect of breeds on blood hematology, significantly higher number (p &lt; 0.01) of Mid cells were found in Hegazi (3.12±1.30×103/µL) and Cyprus (2.41±1.69×103/µL) when compared to other goat's breeds including Kurdi (2.28±0.95×103/µL), Shami (1.90±0.84×103/µL) and Mahali (1.37±0.88 ×103/µL). Moreover, the percentage of Mid cells was highest in Hegazi (22.34±9.40%), 11.40±4.34%), followed by Kurdi (17.71±8.16%), Cyprus (15.84±8.33%) Shami (13.38±5.76%) and lowest in Mahali (11.40±4.34%). There are significant differences (p &lt; 0. 01) in hemoglobin (Hg), red blood cells (RBC), hematocrit (HCT), mean corpuscular volume (MCH), red cell width distribution-coefficient of variation (RDW-CV, %) and red cell distribution width-standard deviation (RDW-SD, fl) values among all different breeds of Libyan goats. The results of biochemistry displayed significant changes among the studied goats' breeds, where the highest serum alanine aminotransferase (ALT, U/L) activity was observed in Cyprus (17.81±7.95) and Shami (17.27±1.15) compared with Hegazi (15.31±6.13) and Mahali (14.60±0.46), while Kurdi breed (11.68±7.95) showed the lowest ALT activity. Moreover, significant differences (p &lt; 0. 01) in serum lactate dehydrogenase (LDH, U/L), total and direct bilirubin, glucose, creatinine, lipid profile and electrolytes levels were recorded among different breeds used in this study. On the other hand, non- significant variations (p &gt;0. 05) are reported in aspartate aminotransferase (AST, U/L), alkaline phosphatase (ALP, U/L), total protein (TP, g/dl), albumin (Alb, g/dl), urea and magnesium (Mg, mg/dl) levels. Conclusion: These results showed a significant difference between some blood parameters of goat breeds raised in Libya. This could aid veterinarians to interpret laboratory data properly in order to improve management and conservation of those breeds.

User verification of Abbott Alinity HQ hematology analyzer

Abstract Objectives This study aims to evaluate the performance characteristics of the Alinity HQ hematology analyzer in a routine laboratory setting. Methods In the study, precision (short-term and long-term precision), accuracy (method comparison with Abbott Cell Dyn Ruby and estimation of bias), confirmation of a background (Limit of Blank, LoB), and carry-over were used to evaluate the performance of Alinity HQ as recommended by ICSH, CLSI guidelines EP15-A3, EP09, EP17A2, and H26-A2. Acceptance criteria were based on manufacturer technical specifications and the EFLM Biological Variation Database. Results According to the short-term precision results, except for mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC), all measurements exhibited coefficient variations (CV) lower than their verification limits. Basophil, eosinophil, and monocyte counts, as well as mean corpuscular hemoglobin (MCH), MCHC, and red cell distribution width standard deviation (RDW-SD), did not meet the allowable imprecision criteria for the long-term precision study. The estimated bias for all analytes was within verification limits. However, the method comparison study showed concentration-dependent variations for MCHC, MCH, and mean platelet volume (MPV) parameters. Furthermore, the correlation of parameters between Alinity HQ and Cell Dyn Ruby ranged from 0.46 to 1.00. The LoB and carry-over studies demonstrated satisfactory performance for the Alinity HQ analyzer. Conclusions Although some parameters had higher CVs than expected and concentration-dependent bias, the overall analytical performance of Alinity HQ was found to be satisfactory. Alinity HQ is an accurate, highly precise analyzer with good analytical performance, suitable for high-volume laboratories.

Red Blood Cell Distribution Width (RDW) as a predictor of septic shock in children

Link of Video Abstract: https://youtu.be/Exh1T2szfoE Background: Septic shock is a prevalent PICU condition requiring prompt intervention. Using the PELOD II score, which has multiple characteristics to examine, it is challenging to predict prognosis in healthcare-limited settings. A link has recently been shown between red blood cell distribution width (RDW) and mortality risk in critically ill patients, albeit the exact mechanism is unknown. Methods: This retrospective observational study examined RDW values in pediatric septic or non-septic shock patients. This study examined patient clinical features, RDW hematological markers (RDW-CV, RDW-SD, and RDW/albumin ratio), and the area under the curve to determine the cut-off for the hematological marker, sensitivity, and specificity. Results: Sixty-one pediatric patients met the inclusion criteria (33 with septic shock and 28 with non-septic shock). The red cell distribution width coefficient variation (RDW-CV) (p=0,058), red cell distribution width standard deviation (RDW-SD) (p=0,05), and RDW Albumin Ratio (RAR) (p=0,014) were shown to be significantly different between the septic shock and non-septic shock groups. The cut-off value for RDW-CV was 15.3% (53.6% sensitivity and 97% specificity), 47.4 fl for RDW-SD (64.3% sensitivity and 84.8% specificity), and 5.65 for RDW/albumin ratio (71.4% sensitivity and 84.8% specificity). RDW-CV odd ratio was 36.9 (95% confidence interval (CI) 4.41-308.96, p 0.001), RDW-SD odd ratio was 10.08 (95% confidence interval (CI) 2.95-34.34, p 0,001), and RDW/albumin ratio was 14.00 (95% confidence interval (CI) 3.98-49.16, p 0,001). Conclusion: Increased RDW can be one marker in pediatric patients with septic shock. Increased levels of RDW/albumin ratio are significantly associated with the incidence of septic shock. Through the (ROC) area under the curve, the RDW/albumin ratio has better capabilities compared to other predictor markers.

Frequency of Rh-e Antigen and reference values of Erythrocyte Sedimentation Rate and Red Cell Indices in an Undergraduate Students’ population in Port Harcourt, Nigeria.

Introduction: Red cell antigens alongside red cell indices provide an essential support to the diagnosis and monitoring of haematological diseases while the erythrocyte sedimentation rate (ESR) indicates and monitor an increase in inflammatory activity within the body. This study aims to determine Rh-e antigen, Erythrocyte Sedimentation Rate and Red cell indices values in apparently healthy undergraduate students of the Rivers State University, Port Harcourt, Nigeria. Material and Methods: One hundred and fifty (150) undergraduate students aged between 17-28years were enrolled in the study and standard venipuncture technique used to collect 5ml of blood. Determination of the Rh-e antigen was carried out using anti-e monoclonal antibodies (Lorne Diagnostics UK), Red cell indices obtained using BC 5000 Mindray Haematology Analyser and ESR by Westergren method. Results: Among the 150 subjects, 130 (86.6%) were positive while 20 (13.3%) were negative for Rh-e antigen. The mean±SD of the mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), red cell distribution width co-efficient of variation (RDW-CV), red cell distribution width-standard deviation (RDW-SD) and erythrocyte sedimentation rate (ESR) were 83.12 ± 10.74, 31.13 ± 3.25, 34.00 ± 3.32, 13.32 ± 1.61, 39.70 ± 2.26 and 30.36 ± 2.15 in the same order, while the reference ranges were 61.64-104.6 for MCV, 24.63-37.63 for MCH, 27.36–40.64 for MCHC, 10.10–16.54 for RDW (CV), 35.18–44.22 for RDW (SD) and 26.06-34.66 for ESR. Gender had no effect on MCV (p=0.3007) and MCHC (p=0.1436) but significant effect on MCH (p=0.030), RDW-CV (p&lt;0.001), RDW-SD (p=0.0005) and ESR (p=0.036) with a perfect positive correlation (r=1) between all the studied parameters. Conclusion: This study revealed a high (86.6%) prevalence for Rh-e antigen, established normal reference ranges for red cell indices and erythrocyte sedimentation rates and showed that gender has significant effects on MCH, RDW-CV, RDW-SD and ESR among healthy undergraduate students of Rivers State University. These findings are of clinical and research relevance.

Effects of dietary supplementation of natural Spirulina on growth performance, hemato-biochemical indices, gut health, and disease resistance to Aeromonas hydrophila of Stinging catfish (Heteropneustes fossilis) fingerling

Spirulina is a popular edible blue-green alga that has piqued the interest of aqua-feed formulations due to its high concentration of micronutrients, macronutrients, and antioxidants. To investigate the impacts of natural Spirulina as a feed additive on Stinging catfish (Heteropneustes fossilis) growth, feed utilization, hematology and serum biochemistry, gut morphology, as well as disease resistance to Aeromonas hydrophila, a 60-day feeding experiment was performed. The fish (N = 240), with an initial weight of 4.23 ± 0.50 g, were placed in 12 aquaria tanks (100 L/ tank) and fed twice daily until they were satisfied. Four different experimental diets: 0% (D0, control diet), 1% (D1), 3% (D2), and 5% (D3) natural Spirulina meal were used to feed the fish. This study found that Stinging catfish fed with a 5% Spirulina diet obtained notably higher (p < 0.05) specific growth rate, final weight, weight gain, and average daily weight gain than other supplemented regimens. Furthermore, as Spirulina inclusion in diets increased, feed utilization parameters such as feed conversion ratio and protein efficiency ratio improved remarkably (p < 0.05). Red blood cell, white blood cell, lymphocytes, neutrophil, monocytes, basophil, hemoglobin, red cell distribution width-standard deviation, and mean corpuscular hemoglobin were all substantially (p < 0.05) greater in 5% Spirulina diet-fed fish. The basal diet-fed fish had lower (p < 0.05) total protein, globulin, and albumin levels and higher glucose, cholesterol, and triglyceride levels than those fed with other test diets. Compared to other fish groups, light microscopic examination of intestinal tissues revealed that fish fed 3% and 5% Spirulina had well-organized enterocytes, intact epithelial barrier, abundant goblet cells, and lacking luminal cell debris, as well as exhibited no signs of inflammation (edema). Spirulina diets significantly (p < 0.05) affected intestinal villi height and width, mucosa width, crypt depth, villi, and lumen area. Furthermore, a 5% Spirulina diet-fed fish demonstrated remarkably (p < 0.05) greater resistance (68.57%) to A. hydrophila during the bacterial challenge trial. Based on the findings, applying natural Spirulina powder at 5% in diets as a feed supplement could benefit H. fossilis nutrient utilization, growth performance, health status, as well as disease resistance.

Mide Kanserli Hastaların Hematolojik Parametre Sonuçlarının Değerlendirilmesi

Objective: Gastric cancer is a major health concern which fourth leading cause of cancer death and fifth most common cancer. It has difficulties such as having a poor prognosis and diagnoses at an advanced stage. There are studies to find prognostic indicators that are easily and less invasively obtained in gastric cancer and hematological tests are one of them. In this study, we aimed to investigate the relation between hematological test and gastric cancer.&#x0D; Materials-Methods: In this study, 48 patients diagnosed with gastric cancer and 45 healthy adults in the control group were examined prospectively. All participants' demographic data and laboratuary results were obtained from the hospital database and recorded.&#x0D; Results: In the gastric cancer group compared to the healthy control group, while red blood cells (RBC), hemoglobin (HBG), hematocrit (HTC), mean cell hemoglobin concentration (MCHC), platelet distribution width (PDW), lymphocyte (LYM), eosinophil (EU) values were statistically lower, mean corpuscular hemoglobin (MCH), red cell distribution width-standard deviation, red cell distribution width-coefficent of variation (RDW-CV), nucleated red blood cells (NRBC), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and monocyte lymphocyte ratio (MLR) values were observed to be statistically higher (p

Erythrocyte Indices in Asymptomatic Malaria Infected Pregnant Women

Background: Red blood cell changes are one of the most common complications in malaria and they play a very crucial role in malaria pathogenesis. Malaria infections are one of the common causes of maternal anaemia especially during pregnancy. The aim of this study was to determine red cell indices of pregnant women with asymptomatic malaria.&#x0D; Place and Duration of Study: Department of Haematology and Antenatal Unit both of Enugu State University of Science and Technology Teaching Hospital, between June and September 2022.&#x0D; Methodology: The study population consisted of 90 pregnant women (65 pregnant women positive to malaria parasite without symptoms and 25 pregnant women negative to malaria parasite) and 26 control non-pregnant women. For the whole study population, red cell indices which include hemoglobin (HGB), packed cell volume (PCV), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width standard deviation (RDW-SD), red cell distribution width coefficient of variation (RDW-CV) were measured by automated haematology analyzer.&#x0D; Results: In the asymptomatic malaria group (AMG), 21 (32.3%) had mild anaemia (HGB level 9.0-10.0 g/dl), 11 (16.9%) had moderate anaemia (HGB level 7.0-8.0 g/dl) and 2 (3.1%) had severe anaemia (HGB level &lt;7.0 g/dl). Also in AMG group, the RDW-SD was 54.22 +/- 11.45 fl, whereas in control group it was 48.75 +/- 10.24 fl (p=0.002). Again in the AMG group the MCHC of those that had two pluses was 318.03 +/- 16.31 g/l, whereas in those that had one plus, it was 309 +/- 20.17 g/l. The comparison between the first, second and third trimester showed significant decrease in HGB (7.63 +/- 1.36 vs 11.64 +/- 0.72 g/dl) and PCV (26.98 +/- 5.14 vs 36.20 +/- 2.19 %) in third trimester compared to first trimester (p= &lt;0.001, &lt;0.001). whereas RDW-CV (18.96 +/- 5.04 vs 15.00 +/- 2.64 %) and RDW-SD (59.04 +/- 15.19 vs 49.16+/- 7.00 fl) (p= 0.002, 0.003) significantly increased in third trimester compared to first trimester&#x0D; Conclusion: This study found anaemia in asymptomatic malaria infected pregnant women, significant decrease in haemoglobin and packed cell volume at third trimester, higher MCHC in those with two pluses of malaria and significant increase in red cell distribution width at third trimester.

Research use only and cell population data items obtained from the Beckman Coulter DxH800 automated hematology analyzer are useful in discriminating MDS patients from those with cytopenia without MDS.

We investigated the performance of research use only/cell population data (RUO/CPD) items obtained from the Beckman Coulter DxH800 automated hematologic analyzer in discriminating MDS patients from cytopenic patients without MDS.Total of 14 routine CBC, 18 research use only (RUO) items, and 70 CPD items were obtained retrospectively at diagnosis. The results were then compared between 94 MDS patients and 100 cytopenic patients without MDS. In items with statistically significant differences, receiver operating characteristic (ROC) analysis was performed and the results were compared.Four CBC/RUO items [red cell distribution width-standard deviation (RDW-SD), immature reticulocyte fraction (IRF), mean sphered cell volume (MSCV), high light scatter reticulocytes (HLR)], and two CPD items [mean volume of neutrophils (NE-V-Mean) and mean volume of early granulated cells (EGC-V-Mean)] showed area-under the curve (AUC) scores > 0.750. Notably, four RUO/CPD items (MSCV > 81.4/HLR > 0.15%/NE-V-Mean > 145/EGC-V-Mean > 156) showed high sensitivity (91.9%/93.6%/88.1%/90.2%, respectively) in discriminating MDS patients from cytopenic patients without MDS. With these six items, scores ≥ 4 (defined as ≥ 4 items exceeding cutoff values out of six items) showed AUC scores/sensitivity/specificity/accuracy (0.891/87.3%/79.0%/83.0%, respectively).Six CBC/RUO/CPD items showed satisfactory AUC scores of > 0.750, and four RUO/CPD items showed high sensitivity in discriminating MDS patients from cytopenic patients without MDS. Scoring system with six items showed high sensitivity, specificity, and accuracy with decision criteria of ≥ 4 scores. Therefore, DxH800 RUO/CPD items would be useful in discriminating MDS patients from cytopenic patients without MDS.

Effect of myostatin gene mutation on erythrocyte osmotic fragility, hematological parameters and fatty acid composition of serum and erythrocyte membranes in piglets

Fatty acid composition of serum and erythrocyte membrane, erythrocyte osmotic fragility and hematological parameters were estimated with the objective of determining effects of the gene mutation in one-week-old MSTN homozygous mutant (KO, MSTN−/−), heterozygous mutant (MSTN−/+) and wild type (WT, MSTN+/+) piglets (n = 4 each). Erythrocyte osmotic fragility, complete blood count (CBC), and fatty acid composition of serum and erythrocyte membrane were determined by flow cytometric analysis, automated hematology analyzer system, and liquid chromatography, respectively. Mean of median corpuscular fragility (MCF) was lower (P < 0.05, 0.001) in KO than MSTN−/+ and WT piglets. KO piglets had decreased (P < 0.05) white blood cell (WBC) count, lymphocyte (LYM) count, platelet (PLT) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cell distribution width-standard deviation (RDW-SD), red cell distribution width-coefficient volume (RDW-CV), plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), platelet-large cell ratio (P-LCR), and an increased red blood cell (RBC) count when compared with MSTN−/+ and WT piglets. The ratios of unsaturated fatty acid (UFA) to saturated fatty acid (SFA) concentrations in serum and erythrocyte membranes of MSTN KO piglets were 2-fold and 4-fold higher compared to WT piglets (P < 0.001), respectively. In conclusion, MSTN KO piglets had a decreased erythrocyte osmotic fragility, and altered hematological profile and fatty acid composition of serum and erythrocyte membranes, as characteristic phenotype.

Thyroid Hormones and Red Cell Indices of HIV Subjects at Enugu

Background: Thyroid hormones act on nearly every cell in the body including red blood cells. Thyroid hormones are also important to proper development and differentiation of all cells of the human body. Human Immunodeficiency Virus (HIV) is a virus that destroys certain cells in the immune system. The aim of this study was to determine free triiodothyronine (FT3), free thyroxine (T4) and red cell indices level of HIV subjects attending clinic at Enugu State University of Science and Technology Teaching Hospital.&#x0D; Study Design: Case control study.&#x0D; Place and Duration of Study: Human Immunodeficiency Virus (HIV) clinic and Haematology Laboratory both of Enugu State University of Science and Technology Teaching Hospital, between August and October 2021.&#x0D; Methodology: Sixty HIV subjects and thirty apparently healthy individuals within the age range of 30 - 60 years were recruited for this study. Free triiodothyronine (FT3), free thyroxine (FT4), hemoglobin (HGB), packed cell volume (PCV), red blood cell count (RBC), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), red cell distribution width standard deviation (RDW-SD), red cell distribution width coefficient of variation (RDW-CV) were determined in HIV subjects and apparently healthy individuals. &#x0D; Results: There was significant difference in MCV (125.79+/- 7.57 vs 78.89+/- 5.71 fl), MCH (23.17+/- 2.10 vs27.21+/- 3.68 pg), MCHC (25.08+/- 2.74 vs30.09+/- 3.27 g/dl), RDW-SD (61.52+/- 7.55 vs46.23+/- 5.87 fl), RDW-CV (23.06+/- 5.78 vs43.87+/- 1.28 fl) and PCV (39.38+/- 3.06 vs31.75+/- 2.44 %) between patients on antiretroviral therapy (ART) and ART-naïve patients respectively. There was significant difference in T4 (8.29+/- 1.29 vs 6.12 µg/dl), MCV (78.89+/- 5.71 vs 84.47 +/- 3.79 fl), MCH (27.21+/- 3.68 vs 29.20 +/- 2.27 pg), RDW-CV (43.87+/- 1.28 vs 12.51 +/- 1.08 fl) and PCV (31.75+/-2.44vs 37.63+/-2.95 %) on ART-naïve patients and apparently healthy subjects respectively. There was a positive correlation between FT3 and MCH in HIV patients on antiretroviral therapy (ART) (p= 0.016).&#x0D; Conclusion: In people taking antiretroviral therapy, mean cell haemoglobin, mean cell hemoglobin concentration and red cell distribution width coefficient of variation significantly reduced, as well as raised mean cell volume and red cell distribution width standard deviation. This study also observed reduced mean cell haemoglobin, mean cell haemoglobin concentration and mean cell volume in ART- naïve subjects.

P773: THE ELEVATION OF RED BLOOD CELL DISTRIBUTION IS AN INDEPENDENT PROGNOSTIC FACTOR FOR JUVENILE MYELOMONOCYTIC LEUKEMIA

Background: Juvenile myelomonocytic leukemia (JMML) is an overlapping myeloproliferative and myelodysplastic disorder of infants and early children. The existing clinical and laboratory prognostic features are inadequate to predict a worse outcome alone. New prognostic indicators are urgently needed since the great clinical heterogeneity. Red cell distribution width (RDW) is a parameter of the complete blood count (CBC) measured automatically by haematology analyzers to reflect the heterogeneity of erythrocyte size. In recent years, RDW has been suggested to have a high negative value for outcomes in various cancers. However, the role of RDW at diagnosis in patients with JMML is still unclear. Aims: Our aim is to investigate the prognostic role of RDW in children with JMML. Methods: We conducted a single center retrospective study to investigate the prognostic role of RDW in children with JMML. Seventy-seven patients were enrolled from January 1, 2008 to November 31, 2019. Survival rates were calculated and compared using Kaplan-Meier methods and log-rank tests. Univariate and Multivariate analysis was carried out according to the Cox proportional hazard regression model. Results: The mean red cell distribution width standard deviation (RDW-SD) for patients is 53.3(39.3-73.7) fl. Cox proportional hazard models showed that patients with RDW-SD >50.50fl at diagnosis were significantly associated with poor overall survival (OS) (HR = 5.22, CI = 1.50-18.21, P=0.010). The multivariate analysis demonstrated that the RDW-SD count was the independent risk factor for OS. Patients with PTPN11 mutation and RDW elevation displayed the worst survival rate, in comparison with other subgroups (P=0.00013). Summary/Conclusion: The results suggested that the elevated level of RDW is an independent prognostic factor for JMML. Furthermore, the PTPN11 mutation and a high RDW level may involve a synergy during the natural course of JMML.

Red cell distribution width as a predictor of impaired exercise capacity in patients with heart failure

Aim To test a hypothesis that increased values of red cell distribution width (RDW) in patients with chronic heart failure (CHF) can be related with low exercise tolerance.Material and methods 102 patients were evaluated who had CHF with mid-range and reduced left ventricular ejection fraction (LV EF) without anemia (72% men, mean age 66±10.2 years). Cardiopulmonary stress test (CPST), echocardiography, 6‑min walk test (6MWT), blood count, and measurements of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and serum iron were performed.Results The average LV EF was 39±8.7 %; the peak oxygen consumption (VO2peak) was 13.7±4.8 ml /kg /min; and the median NT-pro-BNP was 595.3 pg /ml (Q1-3 1443-2401). RDW variables, including the RDW coefficient of variation (RDW-CV) and RDW standard deviation (RDW-SD), were not significantly related with serum iron or hemoglobin concentrations. A one-factor linear regression analysis showed a significant correlation of VO2peak with RDW-SD (р=0.039). A multivariate linear regression analysis with adjustments for LV EF, hemoglobin concentration, and age did not reveal any significant correlation of VO2peak with RDW variables. The distance covered in the 6MWT was significantly associated with RDW-CV both in the one-factor analysis and with adjustments for LV EF, hemoglobin and serum iron concentrations, and age.Conclusion This study showed that high RDW values in CHF patients without anemia predicted low exercise tolerance regardless of the age, LV systolic function, and hemoglobin and serum iron concentrations. A 16% increase in RDW-CV significantly decreased the likelihood of covering a distance longer than 360 m during 6 min.

Determination of Sigma metric based on various TEa sources for CBC parameters: the need for Sigma metrics harmonization

Abstract Objectives The application of Sigma metrics can be used for assessing the performance of diagnostic laboratories. Clinical laboratories are confronted with the trouble of having to select the best and suitable quality specifications that are required for quality planning. In this regard, our study aims at evaluating the performance of Sysmex XN-1000 hematology analyzer by using Sigma metrics based on different total allowable error (TEa) source and to determine the effects of these variations in Sigma metric evaluation. Methods Five TEa requirements were selected to calculate Sigma metrics of 11 complete blood count (CBC) parameters. Coefficient of variation (CV) and bias data were supplied from internal quality control (IQC) and External Quality Assessment Scheme (EQAS) respectively. Results According to TEa based on desirable biological variation (BV) database specifications, the highest Sigma value was achieved by white blood cell count for each level, the lowest value was achieved by Red Cell Distribution Width-Standard Deviation parameter. The Sigma calculation based on Spanish TEa showed that seven CBC parameter achieved Sigma value ≥3. Conclusions According to the results of the study, it can be concluded that Sigma scores have a significant fluctuation based on which TEa sources are utilized and the need for Sigma metrics harmonization and standardization is highlighted. Additionally, low Sigma values of most CBC parameters are resulted in the conclusion that the use of performance goals depending on BV data is difficult for common clinical use. Therefore, clear standardized criteria are quite necessary for the selection of TEa goal by laboratories.

Association Between Red Blood Cell Indices and Preoperative Deep Vein Thrombosis in Patients Undergoing Total Joint Arthroplasty: A Retrospective Study.

To investigate the association of red blood cell (RBC), hemoglobin (Hb), red cell distribution width-coefficient of variation (RDW-CV), and red cell distribution width-standard deviation (RDW-SD) with preoperative deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). A total of 2059 TJA patients were enrolled. We used the ratios of RBC, Hb, RDW-CV, and RDW-SD to DVT before TJA to create the receiver operator characteristic (ROC) curve, thereby calculating the cut-off values and the area under the curve (AUC). The patients were categorized into groups based on cut-off value, and risk factors for DVT before TJA were subsequently analyzed. We included the variates that were statistically significant in the univariate analysis in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 107 cases (5.20%). Based on the ROC curve, we found that the AUC for RBC, Hb, RDW-CV, and RDW-SD were 0.658, 0.646, 0.568, and 0.586, respectively. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with RBC≤3.92*109 /L, Hb≤118g/L, RDW-CV≥13.2%, and RDW-SD≥44.6fL increased 3.02 (P < 0.001, 95% confidence interval (CI) [2.0-4.54]), 2.15 (P < 0.001, 95% CI [1.42-3.24]), 1.54 (P = 0.038, 95% CI [1.03-2.3]), and 1.98 times (P = 0.001, 95% CI [1.32-2.98]), respectively. The risk of preoperative DVT in patients with corticosteroid use increased approximately 2.6 times (P = 0.002, 95% CI [1.22-5.81]). We found that decreased RBC and Hb, increased RDW-CV and RDW-SD, and corticosteroid use were independent risk factors for preoperative DVT in patients undergoing TJA.

Effects of Carbon Monoxide on Haematological and Haemostatic Parameters among the Exposed Workers at Generator Servicing Centres in Benin City

Objectives: Carbon monoxide (CO) is an odourless and highly toxic gas produced from incomplete combustion of fuel. This gas has capacity to bind with haemoglobin to compete for oxygen uptake when inhaled, thereby altering the blood physiology. Aim: The aim of this study is to determine the effect of carbon monoxide on haematology and haemostasis parameters among the exposed workers at gasoline generators service centre in Benin City. Methodology: Eighty-eight participants (workers n = 44 and; controls n = 44) took part in this study. Carbon monoxide used for this study was sourced from the smoke being emitted by gasoline generators during repairs. The participants’ haematological parameters were analysed using haematology autoanalyzer (Sysmex Poch 100i model, Germany), while PT and PTTK were assayed using standard methods. Results: The mean values of red blood cells (RBC), white blood cells (WBC), platelets (PLT), haemoglobin concentration (Hb), hematocrit (HCT), mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell hemoglobin concentration (MCHC) and red cell distribution width coefficient variation (RDW-CV) observed in both the workers at generator service center and their controls fell within normal ranges, but the mean red cell distribution width standard deviation (RDW-SD) of workers at generator service center fell below normal as against the normal value for controls. There were no significant differences in serum concentrations of lymphocytes (p = 0.134), and granulocytes (p = 0.584). In contrast, significantly (p < 0.001) higher mean monocyte level was observed in the workers at the generator service center compared with the controls. Also, there was significantly lower mean platelet volume (MPV) (p = 0.002), platelet distribution width (PDW) (p = 0.001), platelet large cell ratio (PLCR) (p = 0.013) and higher plateletcrit (PCT) (p = 0.001) in the workers at the generator service center compared with the control group. PT and PTT values fell within normal range among the controls, while the values are higher among the exposed workers at the centres. Conclusion: In this study, carbon monoxide emitted during repairs has no deleterious effects on haematological and haemostasis parameters of the exposed workers at generator service centre in Benin City. However, PT and PTT exceeded normal value in the workers at the generator service centre compared to the controls. More work needs to be done especially on longer duration of exposure and at various concentrations of carbon monoxide exposure.