TAT Values Research Articles

Clinical value of TAT, PIC and t-PAIC as predictive markers for severe sepsis in pediatric patients.

Sepsis in pediatric patients can progress to severe sepsis, and identifying biomarkers of this progression may permit timely intervention to prevent it. This study aimed to investigate the ability of thrombin-antithrombin complex (TAT), α2-plasmininhibitor-plasmin complex (PIC) and tissue-type plasminogen activator-inhibitor complex (t-PAIC) to predict severe sepsis in pediatrics early. 148 eligible pediatric sepsis patients were enrolled in this study, and were then divided into those who progressed to severe sepsis (n = 50) or not (n = 98). Serum levels of TAT, PIC, and t-PAIC were analysed, and simplified pediatric critical illness score (PCIS) and DIC score were calculated on the day of pediatric sepsis diagnosis. Compared with sepsis patients, severe sepsis patients had higher levels of TAT, PIC and t-PAIC. Correlation analysis revealed that TAT, PIC and t-PAIC were significantly correlated with simplified PCIS and DIC score. ROC curve analysis suggested that TAT, PIC and t-PAIC could serve as biomarkers for predicting severe sepsis with the AUC up to 0.862, 0.759 and 0.851, respectively. Stratified analysis demonstrated that the patients with increased levels of TAT, PIC and t-PAIC had worse illness severity and clinical outcome. Univariate logistic regression analysis revealed that TAT, PIC and t-PAIC were all risk factors for severe sepsis, yet only TAT and t-PAIC were independent risk factors in multivariate model. TAT, PIC and t-PAIC could serve as biomarkers for predicting severe sepsis, and correlated with illness severity in pediatrics, what's more, serum levels of TAT and t-PAIC may be independent risk factors for pediatric severe sepsis.

Quantitative computed tomography analysis of body composition changes in paediatric patients with acute lymphoblastic leukaemia.

Children with acute lymphoblastic leukaemia (ALL) are at risk for obesity and cardiometabolic diseases. To gain insight into body composition changes among children with ALL, we assessed quantitative computed tomography (QCT) data for specific body compartments (subcutaneous adipose tissue [SAT], visceral adipose tissue [VAT], total adipose tissue [TAT], lean tissue [LT], LT/TAT and VAT/SAT at lumbar vertebrae L1 and L2) at diagnosis and at off-therapy for 189 children with ALL and evaluated associations between body mass index (BMI) Z-score and clinical characteristics. BMI Z-score correlated positively with SAT, VAT and TAT and negatively with LT/TAT and VAT/SAT. At off-therapy, BMI Z-score, SAT, VAT and TAT values were higher than at diagnosis, but LT, LT/TAT and VAT/SAT were lower. Patients aged ≥10 years at diagnosis had higher SAT, VAT and TAT and lower LT and LT/TAT than patients aged 2.0-9.9 years. Female patients had lower LT and LT/TAT than male patients. Black patients had less VAT than White patients. QCT analysis showed increases in adipose tissue and decreases in LT during ALL therapy when BMI Z-scores increased. Early dietary and physical therapy interventions should be considered, particularly for patients at risk for obesity.

The Natural History and Management of Hepatic Hemangioma.

Knowledge of the natural history and management of hepatic hemangiomas is lacking. The aim of this study was to investigate the natural history of hemangiomas and to elucidate the factors that determine tumor growth and optimal management. A total of 211 adult patients were enrolled, with follow-up for more than three years. Follow-up was performed with repeated ultrasonography (US) and laboratory tests for liver function and coagulation factors (platelets, prothrombin time (PT), fibrinogen, thrombin-antithrombin III complex (TAT), D-dimer, and fibrin and fibrinogen degradation products (FDP)). Tumor size decreased in 38.9% of patients, showed no change in 31.3%, and increased in 29.8%. The incidence of a size increase was very high in patients under 40 years of age and decreased gradually with age, whereas the incidence of a size decrease increased with age and increased markedly over 60 years of age. The incidence of an increase in size decreased gradually with size enlargement, whereas the incidence of a decrease in size increased markedly with tumor size and further increased rapidly when hemangiomas became larger than 60 mm. Values of TAT, D-dimer, FDP, and Mac-2 binding protein glycosylation isomer (M2BPGi) were closely related to the change in size of hemangiomas. Hemangiomas in older patients (>60 years of age) and larger tumors (>60 mm in size) had a tendency to decrease in size, resulting from the reduction in coagulation disorders and the progression of liver fibrosis. Therefore, the majority of patients with hemangiomas can be safely managed by clinical observation.

Karakteristik Kefir Susu Sapi Dengan Penambahan Ekstrak Bunga Telang (Clitoria ternatea)

Kefir is made from a kefir seed starter consisting of L kefiri, genus Leuconostoc, Lactococcus, and Acetobacter that grow side by side. The addition of butterfly pea flowers extract to kefir can improve functional properties and sensory. The aim of this study was to investigate the physical characteristic, chemical characteristics, microorganisms, antioxidant activity, and organoleptic properties of cow’s milk kefir with the addition of butterfly pea flowers during storage at refrigerator temperature (1‒4°C). The research analysis used a completely randomized design with a 3x3 factorial pattern with three repetitions. The first factor was the addition of butterfly pea flowers (0%, 3%, and 6%), and the second factor was storage time (0, 3, and 6 days). The physical, chemical, antioxidant activity, and microorganism characteristics were tested using two-factor ANOVA and further tested by the Duncan test. Data on organoleptic properties were analyzed by the nonparametric Kruskal-Wallis and then verified using the Mann-Whitney test. The results showed that during storage the kefir increased the pH value and TAT value and decreased the viscosity and fat content. The inhibition of DPPH and the antioxidant capacity of the addition of butterfly pea flowers extract increased and decreased with the length of storage. Lactic acid bacteria (LAB) and the yeast did not change. Sensory hedonic test panelists prefer the color and aroma of kefir with the addition of telang flower extract. Sensory test of hedonic quality with the best characteristics, namely the addition of 6% butterfly pea flowers extract.
 
 Keywords: butterfly pea extract, kefir, storage organoleptic

Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis.

ObjectiveTo investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC).MethodsWe prospectively collected patient data with sepsis diagnosed in the PICU of Shanghai Children's Medical Center from June 2019 to June 2021. sTM,t-PAI·C, TAT,PIC and classical coagulation laboratory tests (CCTs) were evaluated on the day of sepsis diagnosis.ResultsFifty-nine children were enrolled, There were significant differences in t-PAI·C (P = 0.001), Plt (P < 0.001), PT (P < 0.001), INR (P < 0.001), aPTT (P < 0.001), and TT (P = 0.048) between the pSIC and non-pSIC groups, logistic regression analysis showed that Plt (P = 0.032) was an independent risk factor for pSIC. Logistic regression analysis showed that sTM (P = 0.007) and Plt (P = 0.016) were independent risk factors for the outcome in pediatrics sepsis following discharge. The AUC of sTM combined with Plt on the mortality outcome of children with sepsis at discharge was 0.889 (95%CI: 0.781,0.956). which was better than that for PRISM III (AUC, 0.723), pSOFA (AUC, 0.764), and blood Lac (AUC, 0.717) when sepsis was diagnosed in the PICU.ConclusionsThe t-PAI·C increased in children with pSIC. The prediction of sepsis outcome using sTM combined with Plt was better than with PRISM III, pSOFA, or Lac.Further research is still needed in the future to explore the clinical value of sTM, TAT, PIC, and t-PAI·C in diagnosis and outcome of pediatrics sepsis and pSIC.

Pengaruh Jenis dan Konsentrasi Penstabil Terhadap Karakteristik Fisikokimia dan Nilai Kesukaan Minuman Yogurt Jeruk

Orange yogurt drink is one of the diversivication of yogurt products, but syneresis still often occurs during the storage period which can affect consumer assessments. Therefore, it is necessary to add a stabilizer to overcome this problem. The purpose of this study was to determine the effect of different types of stabilizers and the concentration level of stabilizers added to the physicochemical characteristics and preference of orange yogurt drinks. Characteristics of yogurt drinks that were observed included pH values, Total Titrated Acid/TAT, Total Dissolved Solids/TPT, vitamin C, wheying off, viscosity, and organoleptic tests which included preference for color, aroma, texture appearance and taste of orange yogurt drinks This study uses a completely randomized design (CRD) with two factors, namely the type of stabilizer (Carboxy Methyl Cellulose/CMC, pectin, gum arabic) and the concentration of stabilizer (0.01%, 0.03%, and 0.05%). The results of this study indicate that pH value of the orange yogurt drink ranged from 3.907-4.058, total soluble solids (TPT) of the orange yogurt drink was 14.350-16,367 °Brix, vitamin C content of the orange yogurt drink was between 6.453-10.560 mg/100 g, and TAT value. 6.133 – 8.067%. The treatment of different types of stabilizers affects the physicochemical characteristics of orange yogurt drinks, including the value of pH, TPT, vitamin C, TAT, wheying off and viscosity. While the treatment of different concentrations of stabilizer affects the wheying off and the viscosity of the orange yogurt drink. The results of the interaction between the type and concentration of stabilizer significantly affect the value of pH, vitamin C, TAT, wheying off, viscosity also the value of preference for color, appearance and texture of orange yogurt drink.

Predicting CRT outcome by combining markers from personalized ventricular models of electrophysiology and clinical data

Abstract Introduction Up to 30% of chronic heart failure (CHF) patients undergoing cardiac resynchronization therapy (CRT) do not respond to the treatment. Low CRT response can be associated with incorrect pacing lead positioning in ventricles and not accounting for individual structural changes in myocardium. Therefore, patient stratification for CRT, operation planning and optimization of CRT device settings remain a challenge. Purpose In this study, we develop a predictive model of CRT outcomes based on a combination of clinical data recorded in patients before CRT and on simulations of the response to biventricular pacing in personalized computational models of the ventricles. Methods We used retrospective data from 27 CHF patients who underwent CRT device implantation. CRT responders were defined using clinical data in a year after therapy as showing a decrease in the end-systolic volume of the left ventricle (LV) and an increase in the ejection fraction. For each patient, an anatomical model of the heart and torso was reconstructed from CT images and used to compute ventricular activation and ECGs without pacing and under bi-ventricular pacing with various locations of stimulating leads. For building a predictive model of patient response to CRT, we used clinical data before CRT (12 features in total per patient) together with model-derived biomarkers under biventricular pacing with clinical lead position (16 features in total per a model). Using nested stratified cross-validation, logistic regression models were fitted to various combinations of datasets. Results The best classifier using a complete set of clinical and simulation data showed an average accuracy = 0.78, ROC AUC = 0.78, sensitivity = 0.75, specificity = 0.8, that were much higher than in the model built on the clinical data only. When the best model was fitted to all data on biventricular pacing with clinical lead position, all ten clinical non-responders were truly classified by the model (Fig. 1, left). Using simulations with optimal lead location as input data for this model, seven out of the ten patients were predicted as responders (Fig. 1, right). Blue and orange colours indicate clinical responders and non-responders. Red circles and numbers mark some clinical non-responding patients that are predicted as responders using optimal TAT values. Conclusion Our pilot results show that combination of clinical and simulation data significantly increases the accuracy of classification models for CRT outcomes. Our results suggest that model predictions on the optimal ventricular lead location may essentially increase the probability of CRT success. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Russian Science Foundation Figure 1

Coagulation and Fibrinolysis Biomarkers as Potential Indicators for the Diagnosis and Classification of Ovarian Hyperstimulation Syndrome

Background: Accurate diagnosis and classification of ovarian hyperstimulation syndrome (OHSS) is important for its management. We employed a new high-sensitivity chemiluminescence immunoassay to detect the thrombin-antithrombin complex (TAT), plasmin alpha2-plasmin inhibitor complex (PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator-inhibitor complex (TPAI-C), and evaluated their diagnostic and classification performance for OHSS.Methods: A total of 106 women were enrolled, including 51 patients with OHSS (25 mild or moderate OHSS, 26 severe OHSS), and 55 without OHSS (control group). TAT, PIC, sTM, and TPAI-C levels were measured using the Sysmex HISCL5000 automated analyzer.Results: Compared to the control group, TAT, PIC, and TPAI-C levels were significantly higher (P < 0.001, P < 0.001, P < 0.001, respectively), whereas the sTM level was significantly lower (P < 0.001) in the patients with OHSS. The receiver operating characteristic was used to evaluate the diagnostic efficiency. For the diagnosis of OHSS, the area under the curves (AUCs) for TAT, PIC, sTM, and TPAI-C were 0.991, 0.973, 0.809, and 0.722, respectively. In particular, the sensitivity, specificity, positive predictive value, and negative predictive value for TAT and PIC were all above 90%. For the differential diagnosis of mild–moderate and severe OHSS, the AUCs for TAT, PIC, and TPAI-C were 0.736, 0.735, and 0.818, respectively. The cutoff values of TAT, PIC, and TPAI-C for the differential diagnosis of mild–moderate and severe OHSS were 11.5 ng/mL, 2.4 μg/mL, and 5.8 ng/mL, respectively. Based on these cutoff values, eight cases of mild–moderate OHSS exceeded the cutoff values, two of which developed to severe OHSS in the following days. However, of the remaining 17 cases of mild–moderate OHSS patients with negative biomarkers, none subsequently developed severe OHSS.Conclusions: TAT, PIC, sTM, and TPAI-C can be used as sensitive biomarkers in the diagnosis of OHSS. Meanwhile, TAT, PIC, and TPAI-C also displayed remarkable potential in the classification of OHSS. In addition, the levels of TAT, PIC, and TPAI-C above the cutoff values in patients with mild–moderate OHSS might predict a high risk of developing severe OHSS.

Evaluation the Value of TAT, PIC, tPAIC, TM in Diagnosing Disseminated Intravascular Coagulation in Chinese population: a Multi-Center Prospective Observational Study

Objective: Accurate and early diagnosis are important in the management of disseminated intravascular coagulation (DIC). New specific coagulation markers have always been explored. In this study, we employed new automation technology to detect plasma biomarkers, including Thrombin-Antithrombin Complex (TAT), α2-Plasmininhibitor-Plasmin Complex(PIC), thrombomoduline (TM), tissue plasminogen activator-inhibitor Complex (tPAIC), and evaluated their diagnostic performance for DIC in Chinese population.Method: A prospective observational study was conducted in 9 hospitals located across the entire China. 406 patients suspected DIC and 137 normal people were included. These four molecular markers were measured by qualitative chemiluminescence enzyme immunoassay performed on automated analyzers HISCL. All patients suspected DIC were followed for development of overt-DIC in 7 days, and for mortality in 28 days.Results: The plasm level of TAT, PIC, tPAIC and TM in normal Chinese people were 1.1 (0.7-1.6), 0.44 (0.37-0.56), 7.2(5.1-9.3) and 8.6 (7.3-9.9). According to the ISTH scoring system, 146 patients were diagnosed as overt-DIC, and 37 were diagnosed as pre-DIC. All four biomarkers were significantly higher in DIC group than non-overt DIC group, and tPAIC and TM were significantly higher in pre-DIC group than non-overt DIC group (Table 1). Besides, these molecular markers were different among various underlying diseases(Fig.1). As shown in the ROC assay, the efficiency of TAT, PIC, tPAIC and TM discriminated well between overt- DIC with pre-DIC and non-overt DIC (AUROC, 0.64 (95% CI, 0.58 to 0.69); 0.63 (0.57 to 0.68); 0.63 (0.58 to 0.69);0.73 (0.68 to 0.78), respectively)(Table 2). In the combination assay, the AUROC rose up to 0.955 (0.94 to 0.97) when in addition with global coagulation tests (Fig.2). Moreover, the ISTH DIC scores showed significant correlation with these molecular markers' levels. The mortality of DIC, pre-DIC and non-DIC was 33.56%, 51.35% and 8.97%, respectively. Among the significant diagnostic markers for DIC, TAT, tPAIC and TM were also good predictors of 28-day mortality (AUROC, 0.65, 0,76 and 0.76, respectively), high levels of them were associated with poor outcome(Fig.3).Conclusion: These four biomarkers have good diagnostic performance and prognostic value in DIC patients with different underlying diseases. They can also be applied in classification and stages of DIC. Moreover, combination of four makers demonstrate better behavior than single one. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

164 Greater Light Exposure Is Associated with More Robust Rest-Activity Rhythms in Community-Dwelling Older Adults

Abstract Introduction Disrupted circadian rest-activity rhythms in older adults have been associated with an increased risk of cognitive decline and mortality. While light is one of the most potent synchronizing agents for the human circadian system, little is known about how light may influence rest-activity rhythms in older adults. We aimed to investigate the relationship between the amount of light exposure and rest-activity rhythm parameters using actigraphy data from a large cohort study. Methods 553 community-dwelling older adults (aged 72±5, 142 (25.5%) female) from the Chicago Healthy Aging Study cohort underwent recording of activity and ambient light exposure for a minimum of five 24-hour periods, using Actiwatch-L (Phillips Respironics). The average recording duration was 6.7±0.5 days. An extension to the traditional cosine model was used to compute circadian rest-activity rhythm parameters, including the amplitude (a measure of strength), the goodness of fit (pseudo F statistic; a measure of robustness), and acrophase (timing of peak activity). Light exposure was measured by time spent above light thresholds of 100, 200, 500, and 1000 lux per day (TAT100, TAT200, TAT500, TAT1000, respectively). Bivariate associations between rhythm parameters and TAT values were examined with Spearman’s correlation coefficients. Variables that met a significant threshold (p&amp;lt;0.05) were entered into multivariable models to adjust for potential confounders including age, sex, race, and season. Results Robustness of the rest-activity rhythm, measured by extended cosine pseudo-F statistics, was associated with TAT100 (partial Spearman’s correlation coefficient 0.12, p=0.008), TAT200 (coefficient 0.13, p=0.03), TAT500 (coefficient 0.16, p&amp;lt;0.001), and TAT 1000 (coefficient 0.18, p&amp;lt;0.001). TAT100/200/500/1000 were also associated with the strength of the rest-activity rhythm, measured by amplitude of the extended cosine fit (partial Spearman’s correlation coefficient vs. TAT100: 0.12, p=0.006, TAT200: 0.14, p=0.002, TAT500: 0.16, p&amp;lt;0.001, TAT1000: 0.18, p&amp;lt;0.001), after adjusting for age, sex, race, and season. Conclusion Across the seasons, greater daily light exposure is associated with more robust circadian rest-activity rhythm in community-dwelling older adults. Whether the enhancement of light exposure can improve the strength and robustness of rest-activity rhythm needs to be tested with future intervention studies. Support (if any):

Association of tumor size and internal echo pattern with coagulopathy associated with hepatic hemangioma.

Little is known concerning causal factors associated with the size and echogenicity of hepatic hemangiomas. The aim of the present study was to investigate the associations between tumor size and echo pattern and coagulation factors, and to elucidate the growth pattern of hemangiomas. In 214 consecutive patients with hepatic hemangiomas, ultrasonography was performed to determine total tumor number, size, echogenicity and location, and serum laboratory tests for liver function and coagulation factors were carried out. The ultrasonographic appearance of hemangiomas was homogeneous in 75.7% of cases and mixed in 24.3% of cases. A mixed echo pattern was seen in 1 out of 145 masses (0.7%) with a diameter <20 mm, in 30 out of 48 (62.5%) with a diameter of 20-40 mm, and in all of the 21 (100%) with a diameter >40 mm. Platelet counts (P<0.0001) and fibrinogen levels (P<0.01) were lower in patients with larger and mixed tumors. Levels of thrombin-antithrombin III complex (TAT), D-dimer, and fibrin and fibrinogen degradation products (FDP) were significantly elevated along with an increase in tumor size (all P<0.0001), and the number of patients with the abnormal values of TAT, D-dimer, and FDP was significantly higher in the mixed group than in the homogeneous group (all P<0.0001). Fibrinogen (P<0.01), platelet count (P<0.001), portal vein diameter (P<0.0001), splenic index (P<0.01), and levels of TAT, D-dimer and FDP (all P<0.0001) were significantly associated with tumor size. Multivariate analysis revealed TAT, D-dimer and FDP as independent predictors of tumor size. The internal echo pattern became mixed as size increased. The size and echogenicity of hemangiomas were closely associated with coagulation factors. Therefore, it was speculated that differences in size and echogenicity were caused by intratumoral thrombosis and subsequent hemorrhage.

Multipolar Porphyrin-Triazatruxene Arrays for Two-Photon Fluorescence Cell Imaging.

Two-photon excited fluorescent (TPEF) materials are highly desirable for bioimaging applications owing to their unique characteristics of deep-tissue penetration and high spatiotemporal resolution. Herein, by connecting one, two, or three electron-deficient zinc porphyrin units to an electron-rich triazatruxene core via ethynyl π-bridges, conjugated multipolar molecules TAT-(ZnP)n (n=1-3) were developed as TPEF materials for cell imaging. The three new dyes present high fluorescence quantum yields (0.40-0.47) and rationally improved two-photon absorption (TPA) properties. In particular, the peak TPA cross section of TAT-ZnP (436 GM) is significantly larger than that of the ZnP reference (59 GM). The δTPA values of TAT-(ZnP)2 and TAT-(ZnP)3 further increase to 1031 and up to 1496 GM, respectively, indicating the effect of incorporated ZnP units on the TPA properties. The substantial improvement of the TPEF properties is attributed to the formation of π-conjugated quadrapole/octupole molecules and the extension of D-π-A-D systems, which has been rationalized by density function theory (DFT) calculations. Moreover, all of the three new dyes display good biocompatibility and preferential targeting ability toward cytomembrane, thus can be superior candidates for TPEF imaging of living cells. Overall, this work demonstrated a promising strategy for the development of porphyrin-based TPEF materials by the construction and extension of D-π-A-D multipolar array.

Pengaruh penambahan sari nanas terhadap karakteristik kimia dan sensori minuman teh cascara

Cascara tea is a drink made from dry coffee skin from coffee beans stripping process result. The aim of this research is to study the effect of pineapple juice on chemical characteristics (Total Tated Acid (TAT), vitamin C, pH) and sensory test results of cascara tea drinks. The experimental design used was a complete randomized design with 3 treatment and 3 replications. The treatment used is T1: Control (without adding pineapple juice), T2: Add pineapple juice 25 %, T3: Add pineapple juice 35 %. The parameters observed are the chemical characteristics of TAT, vitamin C, and pH, also sensory test of color, taste, aroma, and overall appearance. The resulting data was analyzed by Variant Analysis (ANOVA) with a significance level of 5% and continue with the Duncan test. The results of experiments showed a addition of pineapple juice gave a significant value of TAT, vitamin C, and pH of cascara tea drinks (P &lt;0.05). Sensory test results showed that pineapple juice addition gave significant value (P &lt;0.05) for aroma, taste, and appearance overal and no significant effect (P&gt; 0.05) for the color. 35 % addition of cascara tea liked by panelis.

Value of TAT and PIC with D-dimer for cancer patients with metastasis.

The hypercoagulability of blood is related to the development and metastasis of cancer. High levels of D-dimer have been reported to be associated with the metastasis and poor prognoses of cancer. Here, we investigated the performance of biomarkers-TAT, PIC, TM, and tPAI·C by new method-for monitoring cancer patients with metastasis. A total of 197 cancer patients were enrolled. TM, TAT, PIC, and tPAI·C were detected by the chemiluminescence immunoassay. Results showed that the levels of TAT and PIC were higher in the metastasis group than those in the nonmetastasis group (P<.01). In the nonmetastasis group, there were 16 patients with elevated levels of D-dimer. But, TAT and PIC in these 16 patients were all at normal level (<0.55mg/L FEU). After dilution, D-dimer was also decreased to normal levels in these 16 patients. The ROC was used to show the performance of D-dimer, TAT, and PIC on indicating cancer with metastasis. The AUC of PIC was higher than that of D-dimer (0.825 vs. 0.770). The specificity and PPV of TAT and PIC were higher than those of D-dimer. Serial test of TAT, PIC, and D-dimer improved the specificity and positive predictive value to 90.91% [80.61%, 96.25%] and 89.29% [77.45%, 95.57%], respectively. Combining TAT and PIC with D-dimer could be useful surveillance biomarkers for cancer with metastasis.

Total Count of Lactic Acid Bacteria in Goats and Cows Milk Yoghurt using Starter S. thermophilus RRAM-01, L. bulgaricus RRAM-01 and L. acidophilus IIA-2B4

Yoghurt is a well-known fermented dairy product which produced using a combination of lactic acid bacteria (LAB) of Streptococcus thermophilus, Lactobacillus bulgaricus and L. acidophillus as fermentation starters. Cow milk is usually used as a raw ingredient. The LAB-based local yoghurt starter (S. thermophilus RRAM-01 (ST), L. bulgaricus RRAM-01 (LB) and L. acidophilus IIA-2B4 (LA)) were previously isolated from milk and meat, nevertheless had not been extensively attempted to be used in yoghurt production. This study aimed to evaluate the characteristics of cow and goat milk based yoghurt produced by using a single local strater of S. thermophilus RRAM-01 (ST) or L. bulgaricus RRAM-01 (LB) or L. acidophilus IIA-2B4 (LA). The yoghurts were produced through addition of the starter (3% v/v each) with 1010 CFU mL-1 of initial population, and then fermented at room temperature for 24 hr. The result revealed that initial population of LAB in goat’s milk yoghurt fermented by ST or LB were significantly higher than that of by LA. Yet, after 24-hour of storage at room temperature, the total population of LA increased and reached final population which was higher than LB or ST. Meanwhile, cow’s milk yoghurt fermented by LB had the highest population of at the initial day (D0), while after fermentation the highest population were observed on LB or LA cow’s milk yoghurt. Overall goat’s milk yoghurt had significantly lower pH values than the cow’s milk yoghurt. These were accompanied by higher the total titrated acid (TTA) of goat’s milk yoghurt than that of cow’s milk yoghurt. Based on pH and TAT values, it was found that ST bacteria produced significantly higher total acidity goat’s milk yoghurt, followed by LB and LA. However, the type of culture had no effect on total acidity of cow's milk yoghurt.

Evaluation the combined diagnostic value of TAT, PIC, tPAIC, and sTM in disseminated intravascular coagulation: A multi-center prospective observational study

BackgroundAccurate and early diagnosis is important in the management of disseminated intravascular coagulation (DIC). We employed new automation technology to detect plasma biomarkers, including thrombin-antithrombin complex (TAT), α2-plasmininhibitor-plasmin complex (PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator-inhibitor complex (tPAIC), and evaluated their diagnostic performance and prognostic value for DIC in Chinese population. MethodsThis prospective observational study included 444 patients with suspected DIC and 137 healthy people. The molecular markers were measured by qualitative chemiluminescence enzyme immunoassay performed on HISCL automated analyzers. All patients with suspected DIC were followed for 7 days to screen for the development of overt-DIC and 28 days for mortality. ResultsAccording to the International Society of Thrombosis and Haemostasis (ISTH) scoring system, 157 patients were diagnosed as overt-DIC and 36 were diagnosed as pre-DIC. All four biomarkers were significantly higher in DIC patients than in non-overt DIC patients; TAT, tPAIC, and sTM were significantly higher in pre-DIC patients than in non-overt DIC patients. Four molecular markers behaved differently among various underlying diseases. TAT, tPAIC, and sTM were also good predictors of 28-day mortality, high levels were associated with poor outcomes. ConclusionsTAT, PIC, tPAIC, and sTM demonstrated good diagnostic performance and prognostic value in DIC patients with different underlying diseases. Besides, TAT, tPAIC and sTM have certain implications in pre-DIC stage. Combination of four makers was demonstrated better behavior than single one.

Enoxaparin pretreatment effect on local and systemic inflammation biomarkers in the animal burn model.

Low-molecular weight heparins (LMWH) are anticoagulants that have shown anti-inflammatory activity in several experimental models. Hot water burn inflammatory model accurately simulates human clinical situations allowing its use for nociception test and evaluation of anti-inflammatory drugs. The present study aims to evaluate the enoxaparin pretreatment on local and systemic inflammation biomarkers in the animal burn model. Inflammation was induced by submersing the rat left hind paw in water at 60oC for 60s. C-reactive protein (CRP) and thrombin-antithrombin complex (TAT) were estimated by immunosorbent assay, fibrinogen (Fg) by the gravimetric method and paw oedema by orthogonal digital photography. Highest values of paw oedema, CRP and TAT were observed at 4h post-burn while Fg peak occurs at 12h post-burn; enoxaparin pretreatment decreased oedema (-32.1%), and concentration of TAT (-66.7%), PCR (-37.9%) and Fg (-8%). This study shows that enoxaparin has local and systemic anti-inflammatory effects and should be considered as a potential adjuvant drug for the treatment of burns.

Venous thromboembolism in hospitalized patients receiving chemotherapy for malignancies at Japanese community hospital: prospective observational study

BackgroundAlthough Asian population was recognized to have a lower risk of venous thromboembolism (VTE), its increasing prevalence and incidence remain unclear in patients with malignancies. We attempted to predict VTE development using activation markers of coagulation and fibrinolysis.MethodsWe enrolled patients with malignancy admitted to Tonan Hospital between April and December 2014 to receive a new-for-them chemotherapy regimen. All patients were examined for VTE by computed tomography and whole-leg compression ultrasonography before chemotherapy and three months later. We also examined plasma levels of thrombin-antithrombin complex (TAT) and plasmin α2-plasmin inhibitor complex (PIC) before chemotherapy. The cut off values of TAT and PIC were set at 2.1 ng/mL and 1.8 μg/mL, respectively.ResultsOf 97 patients, the majority (67%) had distant metastases. The most common malignancies were colorectal (26%), breast (23%), and stomach (19%) cancer. VTE was detected in 29 patients (31%); all were asymptomatic. VTE was newly developed in 12 patients in the three-month observation period, which means the incidence was 49 per 1000 person-years. Non-increased PIC with increased TAT was the only significant risk factor for both VTE prevalence and incidence in multivariate analysis, and the odds ratios were 3.0 (95% confidence interval, 1.1–8.2; P = 0.034) and 9.4 (95% confidence interval, 1.7–51.9; P = 0.011), respectively.ConclusionsThe prevalence and incidence of VTE were high in hospitalized Japanese patients receiving chemotherapy for malignancies. Non-increased PIC with increased levels of TAT may be an independent risk factor for VTE development.

Coagulation activation after discontinuation of VTE treatment with different oral anticoagulants and impact on 12-month clinical outcomes

Increasing D-dimer (DD) levels after discontinuation of vitamin K antagonist (VKA) therapy indicate an increased risk of recurrence of venous thromboembolism (VTE). However, after discontinuation of direct-acting non-VKA oral anticoagulants (DOACs or NOACs) the extent of coagulation activation and its clinical impact is unknown. Blood samples were collected from consenting patients with proximal VTE at the end of anticoagulation treatment with apixaban (n=37), dabigatran (n=17), rivaroxaban (n=9) or VKA (n=184) and 4weeks later. DD, prothrombin fragments F1+2 (F1+2) and thrombin–antithrombin complexes (TAT) were measured. All patients underwent follow-up at 12months to establish recurrent VTE or death from any cause. Irrespective of the treatment, DD and F1+2 but not TAT demonstrated a similar increase between baseline and week 4. At 12months, 18 patients (7.3%) had recurrent VTE and two (0.8%) had died. For all patients and subgroups of VKA and DOAC, positive likelihood ratios were numerically higher for baseline values but only TAT values at 4weeks were found to be related to a small increase of outcome event likelihood (2.6; 95%CI 1.23-5.50), which was driven by VKA patients (3.1; 95%CI 1.32-7.30) and not by DOAC patients (2.27; 95%CI 0.52-9.95). For all parameters, negative likelihood ratios were not predictive.In logistic regression analysis, only ΔTAT (optimal cut-off >178% from baseline demonstrated a significant risk increase for VTE/death (odds ratio 3.76; 95% confidence interval 1.46-9.68; p=0.006). In conclusion, the concept of testing coagulation activation parameters may also be transferred to VTE patients at the end of DOAC therapy. For patients with an increase of TAT levels within 4weeks after treatment discontinuation (>178% from baseline) is associated with an increased risk for VTE recurrence or death at 12months.

Application of Multilineal Regression Model for Measuring the Impact of Maintenance Service Providers’ Quality on Overall Healthcare Service Quality

This research was aimed at examining how transaction performance regarding medical equipment maintenance affected overall healthcare service quality, understood as healthcare input and/or process quality. A cross-sectional, retrospective, exploratory study was thus designed for examining 719 maintenance transactions. Such sample size guaranteed 0.8 statistical power, having 0.2 effect size at =0.05. Secondary source data were taken from databases kept at two hospitals in Bogota, Colombia. A multivariate linear regression model was used for analysing the effect of turnaround time (TAT, the independent variable) in terms of hours on healthcare institution service quality (decreased overall quality, the dependent variable), controlling for the type of service provider carrying out the maintenance transaction (i.e. in-house or outsourcing) and the maintenance type concerned (i.e. preventive or corrective) in healthcare service quality. The results provided sufficient statistically significant support (p<0.001), good CI precision (+ 1.156, + 1.432) and low standard error (standard error=0.070), as healthcare service quality became negatively affected as TAT value increased due to low maintenance service provider quality or performance (i.e. TAT=+1.473). KeywordsMultivariate Linear Regression Model; Quality Management; Healthcare Service Operation Research; Maintenance; Medical Engineering; Clinical Engineering