Journal of Clinical Laboratory Analysis最新文献

{"title":"Role of Macrophage TLR4 Expression in the Immunopathogenesis of Severe Aplastic Anemia","authors":"Mengran Gao,&nbsp;Xiaorui Meng,&nbsp;Yi Cui,&nbsp;Ling Deng,&nbsp;Xinrui Zhang,&nbsp;Chunyan Liu,&nbsp;Rong Fu","doi":"10.1002/jcla.70055","DOIUrl":"10.1002/jcla.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Severe aplastic anemia (SAA) is a life-threatening hematologic disorder characterized by bone marrow failure and impaired immunity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Investigating the role of Toll-like receptor 4 (TLR4) highly expressing macrophages in the immunopathogenesis of SAA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Macrophage TLR4 expression levels were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and western blotting (WB). Knocked down or inhibited macrophage TLR4 expression, detected the pyroptosis (IL-1β, IL-18, NLRP3, caspase-1, gasdermin D) levels by RT-qPCR and WB. Using RNA sequencing to find differential genes and pathways. Co-cultured CD8+ T cells with macrophages that knocked down or inhibited TLR4, and the levels of perforin and granzyme B expression in CD8+ T cells were detected by flow cytometry. CD8+ T cells were further co-cultured with K562, and the apoptosis rate of K562 was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The TLR4 in the bone marrow macrophages of patients with untreated SAA were significantly higher than those in the remission and control groups, and were negatively correlated with clinical indicators. RNA sequencing of macrophages with TLR4 knockdown showed that differentially expressed genes were enriched in the innate immune and inflammatory chemotaxis signaling pathways. After TLR4 knockout or TLR4 inhibitor addition in bone marrow macrophages of patients with untreated SAA, the mRNA and protein expression levels of pyroptosis markers interleukin (IL)-1β, IL-18, NLRP3, caspase-1, and gasdermin D were significantly lower than those in the control group. When CD8+ T cells were co-cultured with TLR4-knocked-down or inhibitor-added macrophages, the expression of perforin and granzyme B in CD8+ T cells was significantly reduced, and CD8+ T cell cytotoxicity decreased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Inhibition of macrophage TLR4 expression in SAA patients could alleviate the over-activated cellular immune response in SAA patients by decreasing the level of pyroptosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 12","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Game Changer for Acute Gastroenteritis in the Pediatric Emergency Department: Multiplex Stool PCR Test.","authors":"Dogan Barut, Caner Turan, Ezgi Boluk, Sohret Aydemir, Ali Yurtseven, Eylem Ulas Saz","doi":"10.1002/jcla.70067","DOIUrl":"https://doi.org/10.1002/jcla.70067","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the diagnostic performance of the FilmArray GI Panel multiplex polymerase chain reaction (PCR) compared to conventional stool culture (CSC) and microscopic stool analysis in children with bacterial acute infectious gastroenteritis (AIG) in the emergency department (ED). It also assessed the impact of PCR use on clinical decision-making, antibiotic stewardship, and ED workflow.</p><p><strong>Methods: </strong>A retrospective analysis was conducted in a tertiary pediatric ED. Children diagnosed with AIG who underwent CSC, microscopy, and multiplex PCR were included. Data on demographics, clinical findings, diagnostic results, antibiotic prescriptions, and patient outcomes were collected. Diagnostic performance metrics-sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)-were compared.</p><p><strong>Results: </strong>Among 257 pediatric patients, enteropathogens were detected in 31.9% via CSC and 39.3% via multiplex PCR. PCR showed superior sensitivity (96.2%) and NPV (97.4%) compared to CSC. The median turnaround time for PCR (7.9 h) was significantly shorter than for CSC (47.5 h, p < 0.001). Antibiotic use was significantly lower in PCR-negative cases (p < 0.001), and ED length of stay was also reduced.</p><p><strong>Conclusion: </strong>The FilmArray GI Panel offers improved sensitivity and faster results than conventional methods, enhancing diagnostic accuracy and reducing unnecessary antibiotic use. Its integration in ED protocols can support antimicrobial stewardship and streamline care.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e70067"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Analysis of afa Gene Prevalence in Uropathogenic Escherichia coli Isolates: A Global Perspective","authors":"Fatima Al-Zahraa Hamsho,&nbsp;Zaher Samman Tahan","doi":"10.1002/jcla.70060","DOIUrl":"10.1002/jcla.70060","url":null,"abstract":"&lt;p&gt;The human body hosts a diverse array of microorganisms, including commensal organisms and those that cause various diseases. Urinary tract infections (UTIs) are among the most prevalent infections worldwide, second only to respiratory tract infections. Uropathogenic &lt;i&gt;Escherichia coli&lt;/i&gt; (UPEC) is the primary causative agent of UTIs because of its numerous virulence factors that contribute to infection and penetration of the host's mucosal barrier [&lt;span&gt;1&lt;/span&gt;]. Among these virulence factors, the ability to adhere to host cells is crucial.&lt;/p&gt;&lt;p&gt;UPEC possesses a genome containing various genes carried on operons, including those responsible for adhesion and biofilm formation, such as &lt;i&gt;pap&lt;/i&gt; (prevalent in pyelonephritis-associated strains), &lt;i&gt;fim&lt;/i&gt; (found in nearly all UPEC isolates), &lt;i&gt;sfa&lt;/i&gt;, and &lt;i&gt;afa&lt;/i&gt; [&lt;span&gt;2&lt;/span&gt;]. The &lt;i&gt;afa&lt;/i&gt; gene is one such adhesion-related genes in UPEC, mediating afimbrial adhesion. It functions by producing adhesive polymeric substances on the bacterial cell surface and certain proteins that enhance bacterial binding to host cells [&lt;span&gt;3&lt;/span&gt;]. The &lt;i&gt;afa&lt;/i&gt; operon consists of &lt;i&gt;afaA&lt;/i&gt; through &lt;i&gt;afaF&lt;/i&gt;. The A and F segments are involved in encoding transcription systems, B segments correspond to proteins in the cytoplasmic space, C segments anchor the protein, D is responsible for invasion, and E is responsible for cell adhesion [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Adhesion to urinary tract epithelial cells provides a favorable environment for bacterial growth, leading to infection development and associated symptoms. The presence of the &lt;i&gt;afa&lt;/i&gt; gene in &lt;i&gt;E. coli&lt;/i&gt; is associated with pyelonephritis. Indeed, it concentrates in the most virulent isolates [&lt;span&gt;5&lt;/span&gt;]. In this letter, we sought to provide an overview of the prevalence of the &lt;i&gt;afa&lt;/i&gt; gene in UPEC causing UTIs worldwide as no previous study reported such data.&lt;/p&gt;&lt;p&gt;In the middle east region, Syria in particular, an &lt;i&gt;afa&lt;/i&gt; gene distribution rate of 18.3% was obtained. It turned out that most isolates were from pregnant women and exhibited resistance to multiple antibiotics. Similarly, an Iraqi study in 2024 reported a slightly higher prevalence of &lt;i&gt;afa&lt;/i&gt;-expressing isolates (14.28%), demonstrating its contribution to biofilm formation and increased infection severity, particularly in pyelonephritis [&lt;span&gt;6&lt;/span&gt;]. Additional studies from Iraq [&lt;span&gt;7&lt;/span&gt;] and Iran [&lt;span&gt;8&lt;/span&gt;] reported &lt;i&gt;afa&lt;/i&gt; gene prevalence rates of 12.7%, 15.6%, and 11%, respectively. The Iranian study noted a correlation between the gene's presence and antibiotic resistance, particularly in regions with indiscriminate antibiotic use, and a higher prevalence in females, especially pregnant women.&lt;/p&gt;&lt;p&gt;Highest prevalence rates were found in India and Southeast Asia where hygiene and medical care are insufficient. An Indian study [&lt;span&gt;9&lt;/span&gt;] identified a prevalence rate as high as 23.1%. Studies from Thailand [&lt;span&gt;10&lt;/span&gt;]","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 13","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of Inflammation Markers to Predict Curative Treatment for Prostate Cancer Patients on Active Surveillance","authors":"Yenigürbüz Serkan,&nbsp;Ediz Caner,&nbsp;Akan Serkan,&nbsp;Kati Bulent,&nbsp;Vural Yasin,&nbsp;Alcin Adem,&nbsp;Yilmaz Omer","doi":"10.1002/jcla.70059","DOIUrl":"10.1002/jcla.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Active surveillance (AS) strategy aims to avoid unnecessary or excessive early treatment in patients at a low risk for prostate cancer (PCa). However, a biomarker that can predict the need for early curative treatment in patients under AS has not been identified to date. In this study, we aimed to investigate the potential of inflammatory biomarkers in predicting the requirement of curative treatment in the early period in patients under AS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study included a total of 83 patients with the diagnosis of PCa and under AS. Patient age, prostate-specific antigen (PSA) level, prostate volume (PV), PSA density (PSAD), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and follow-up period were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant difference between the two groups in terms of PSAD, NLR, PLR and SII (<i>p</i> = 0.037, <i>p</i> = 0.046, <i>p</i> = 0.008, <i>p</i> = 0.004 and <i>p</i> = 0.005, respectively). The cut-off value determined by performing ROC analysis to evaluate the levels that predict the need for curative treatment before AS was 0.125 for PSAD (sensitivity: 61.8%, specificity: 61.2%), 2.01 for NLR (sensitivity: 67.6%, specificity: 55.1%), 115.49 for PLR (sensitivity: 73.5%, specificity: 59.2%) and 465.40 for SII (sensitivity: 70.6%, specificity: 59.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The analysis of PSAD, NLR, PLR and SII before making the decision to conduct AS can guide clinicians regarding curative treatment in the early period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 13","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Function and Biochemical Parameters of Platelet Concentrates (PCs) Prepared From Blood Donors With a History of COVID-19 During the Platelet Storage.","authors":"Fatemeh Arastehnazar, Mohammad Hessam Rafiee, Mohammad Reza Deyhim, Faezeh Ghasemi, Amir Teimourpour","doi":"10.1002/jcla.70062","DOIUrl":"https://doi.org/10.1002/jcla.70062","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 can affect hematological and biochemical parameters, potentially altering platelet function. This study aimed to evaluate the long-term effects of COVID-19 on the quality of platelet concentrates (PCs) collected from donors with a history of infection.</p><p><strong>Materials and methods: </strong>Twenty PCs were selected from male donors who had recovered from COVID-19. Donors were divided into two groups: control (recovered more than 6 months ago) and case (recovered between 1 and 3 months ago). Research variables, including metabolic and oxidative parameters, were evaluated. Platelet aggregation was also measured at various time points during PC storage.</p><p><strong>Results: </strong>Both groups showed significant decreases in glucose and pH, and increases in lactate, LDH activity, and ROS during storage (p < 0.001). Collagen-induced platelet aggregation declined over time in both groups without a significant difference between them (interaction p = 0.8). In contrast, arachidonate-induced aggregation showed a significant group-by-time interaction (p = 0.003), with a significant decrease over time in the case group but not in controls. Other parameters did not differ significantly between groups (p > 0.05).</p><p><strong>Conclusion: </strong>PC from donors recently recovered from COVID-19 exhibited a decline in aggregation in response to both collagen and arachidonic acid; however, the reduction in arachidonic acid-induced aggregation was particularly significant, indicating a selective impairment in platelet function following infection. Biochemical markers did not show significant differences between groups. Further studies with larger cohorts and clinical efficacy assessments are essential to comprehensively evaluate the safety and effectiveness of transfusing PC from donors recently recovered from COVID-19.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e70062"},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Factors Contributing to Infection Severity and High Levels of Drug Resistance in Clinical Enterococcus Isolates.","authors":"Maryam Koleini, Ahmad Mosadegh, Farzan Madadizadeh, Hamid Heidari","doi":"10.1002/jcla.70063","DOIUrl":"https://doi.org/10.1002/jcla.70063","url":null,"abstract":"<p><strong>Background: </strong>Various factors, including virulence determinants, biofilm formation, and antimicrobial resistance, contribute to the severity of infections caused by Enterococcus spp.</p><p><strong>Methods: </strong>Enterococcus isolates were obtained from hospitalized patients in Yazd, Iran, and identified using microbiological and molecular tests. High-level resistance, biofilm formation, and the genes encoding virulence factors and resistance were investigated following standard methods.</p><p><strong>Results: </strong>Enterococcus faecalis was the most prevalent species (60.7%), followed by Enterococcus faecium (30.4%). Linezolid was highly effective, with 94.6% of isolates being susceptible. However, more than 76% of isolates exhibited resistance to rifampin, erythromycin, tetracycline, and ciprofloxacin, and 94.6% were multidrug-resistant (MDR). Additionally, 39.3% of the isolates were vancomycin-resistant enterococci (VRE) with a MIC > 32 μg/mL, and the vanA gene was detected in 35.7% of the isolates. High-level resistance to gentamicin and streptomycin was seen in 60.7% and 50% of the isolates, respectively. The most prevalent aminoglycoside resistance gene was aph(3')-IIIa (62.5%) followed by ant(6')-Ia (58.9%), and aac(6')-Ie-aph(2″)-Ia (50%). The ant(3″)-Ia was found in only one isolate. Most of the isolates (87.5%) were biofilm producers, and the distribution of virulence-encoding genes was as follows: gelE (66.1%), efaA (57.1%), asa1 (51.8%), esp (25%), cylA (19.6%), and hyl (8.9%). Furthermore, the ace gene was present in 79.4% of E. faecalis isolates, while the fnm and acm genes were found in 76.5% and 23.5% of E. faecium isolates, respectively.</p><p><strong>Conclusion: </strong>The study highlights the significant role of notable drug resistance and the widespread presence of virulence traits in the development of enterococcal infections.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e70063"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference Intervals of Hematological Parameters Among Healthy Adults in Northern Sudan: A Community-Based Cross-Sectional Study","authors":"Mohamed F. Lutfi,&nbsp;Ahmed Ali Hassan,&nbsp;Ishag Adam","doi":"10.1002/jcla.70061","DOIUrl":"10.1002/jcla.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent studies from various countries, including those in Africa, have highlighted the importance of region-specific data in assessing hematological health. However, no study has established hematological reference intervals (RIs) in Northern Sudan. We aimed to investigate the normal hematological values among apparently healthy adults in Northern Sudan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in Northern Sudan. Standardized procedures measured participants' weight, height, and hematological parameters. The Mann–Whitney <i>U</i> test was used to compare the parameters between males and females. Mean, median, and RIs (2.5th–97.5th percentiles) were computed for the adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred fifty-three adults were enrolled (141 [55.7%] males and 112 [44.3%] females). The median (interquartile [IQR]) of the enrolled adults' age was 40.0 (29.7–50.0) years. The RIs for both genders, hemoglobin 9.71–16.10 g/dL, red blood cells (RBC) 3.66–5.79 × 10⁶/mm³, hematocrit (HCT) 28.02%–46.75%, mean corpuscular volume (MCV) 64.02–95.65 fL, mean corpuscular hemoglobin (MCH) 21.57–33.80 pg, mean corpuscular hemoglobin concentration (MCHC) 31.60–36.56 g/dL, platelet count 155.35–454.30 × 10³/mm³, and total white blood cells (WBCs) 2.90–10.76 × 10³/mm³. Significantly higher median values were observed in males compared to females for hemoglobin, RBC, HCT, MCH, MCHC, and platelet distribution width. In contrast, females demonstrated significantly higher red cell distribution width-coefficient of variation, WBC, platelet, mean platelet volume, and plateletcrit than males. MCV showed no significant difference between genders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study's findings underscore the importance of establishing RIs for each region and specific gender population. RIs should also be established in other regions of Sudan to enhance clinical relevance and accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 13","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Two Novel Indices for Evaluating Coronary Artery Stenosis: Athero-Inflammatory Index and Athero-Inflammatory Glucose Index","authors":"Rana Kolahi Ahari,&nbsp;Mohsen Moohebati,&nbsp;Mohammad Tajfard,&nbsp;Habibollah Esmaily,&nbsp;Gordon Ferns,&nbsp;Majid Ghayour-Mobarhan,&nbsp;Sara Saffar Soflaei","doi":"10.1002/jcla.70050","DOIUrl":"10.1002/jcla.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We investigated the association of two novel indices, the athero-inflammatory (AI) index and athero-inflammatory glucose (AIG) index, with coronary artery stenosis (CAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this case–control study, the cases were grouped as angiography (+) and angiography (−) according to the angiographic results. The control group comprised subjects who attended clinics for routine check-ups or pre-employment medical assessments. The AI index and AIG index were compared between the groups using ANOVA. Binary logistic regression (LR) was performed to find the association of the indices with angiography (+). Receiver operating characteristic (ROC) curve analysis was used to establish the cut-off values in differentiating angiography (+) from angiography (−) and healthy subjects. <i>p</i> &lt; 0.05 were considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among a total of 2326 participants (761 angiography (+), 406 angiography (−), and 1159 controls), the AI index and AIG index were significantly different between the groups (<i>p</i> &lt; 0.001). In LR analysis, after adjustment for potential confounders, the AI index and AIG index were independently associated with angiography (+). ROC curve analysis showed that the AI index (AUC: 0.895; 95% CI: 0.880, 0.908; <i>p</i> &lt; 0.0001) and AIG index (AUC: 0.918; 95% CI: 0.905, 0.930; <i>p</i> &lt; 0.0001) performed better diagnostic performance in differentiating angiography (+) from healthy subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI index demonstrated higher AUC compared to other biomarkers in differentiating angiography (+) from angiography (−) and healthy subjects. If it combines with fasting glucose (AIG index), it is a promising indicator for the identification of the CAS particularly from a healthy population, with a promising AUC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 12","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the National Genomic DNA Reference Materials to Evaluate the Performance of Nanopore Sequencing in Identifying Thalassemia Variants","authors":"Xingyu Wei,&nbsp;Xu Yang,&nbsp;Wanqing Han,&nbsp;Li Zhang,&nbsp;Guojun Ouyang,&nbsp;Shoufang Qu,&nbsp;Fang Yang,&nbsp;Xuexi Yang","doi":"10.1002/jcla.70044","DOIUrl":"10.1002/jcla.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Nanopore sequencing shows advantages in detecting single nucleotide variations (SNVs), deletions, and complex structural variants as a single test in thalassemia. However, the performance evaluation or verification of this method remains unestablished, which is essential before clinical utility and panel registration. Here, we developed a classification method for thalassemia mutations, enabling automated interpretation, visual representation, and identification of diverse mutation types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a total of 36 samples, comprising 32 reference materials and four clinical samples to assess the performance of nanopore sequencing in identifying variants in terms of concordance, precision, and the lower limits of detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis successfully identified 19 SNVs, six deletions, and two triplications using nanopore sequencing across all samples. Notably, these variants showed complete concordance of 100% with the genotypes of the reference materials and known results. The precision of nanopore sequencing for detecting thalassemia variants was consistently high, with neither false positive nor false negative observed. Furthermore, the lower limits of detection achieved in our study were 3 ng/μL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, our study proved that the reference materials can be used to evaluate the performance of nanopore sequencing in identifying thalassemia mutations, and it is necessary to incorporate triplications when utilizing reference materials for performance evaluation of long-read sequencing. The consistent and robust performance of nanopore sequencing in this study demonstrates its potential as a reliable method for comprehensive variant detection in thalassemia and other genetic diseases diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 11","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors for Augmented Renal Clearance in Neurocritical Ill Patients","authors":"Xiangru Ye,&nbsp;Qiang Yuan,&nbsp;Zhuoying Du,&nbsp;Haijun Yao,&nbsp;Lei Yang,&nbsp;Biwu Wu,&nbsp;Gang Wu,&nbsp;Weilin Shi,&nbsp;Yufeng Jin,&nbsp;Zhiping Liu,&nbsp;Caihua Xi,&nbsp;Jin Hu","doi":"10.1002/jcla.70047","DOIUrl":"10.1002/jcla.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Augmented renal clearance (ARC) refers to a phenomenon in critically ill patients characterized by increased creatinine clearance. Neurological patients seem to be at higher risk compared with other groups. The epidemiology study of ARC reported in critically ill neurological patients varies substantially with the definitions used and the population evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to describe the prevalence of ARC and to explore risk factors in critically ill neurological patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study was conducted in a university-affiliated neurocritical care unit (NCCU). Study participants had a serum creatinine concentration (Scr) &lt; 120 μmol/L. Kidney function was assessed by the 24-h creatinine clearance (CL_cr); ARC was defined as CLcr ≥ 120 mL/min/1.73m² in women and ≥ 130 mL/min/1.73m² in men. The prevalence and clinical characteristics of ARC were evaluated. Multivariate logistic regression analysis was used to assess variables associated with ARC occurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 137 patients, 56.2% were male, and the mean age was 50.2 (17.4) years. ARC was present in 55.5% of the NCCU patients, ranging from 50% in intracranial infection to 75% in patients with spinal lesions. ARC patients have a mean CL_cr159.3 (IQR:139.6–185.2) ml/min/1.73m². Age was the only factor independently associated with ARC (OR 0.996, 95% CI: 0.934–0.999, <i>p</i> = 0.043) in multivariable logistic analysis. Scr (Pearson correlation = −0.477) and cystatin C (Pearson correlation = −0.336) were found to have a negative correlation with ARC with statistically significant effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ARC is prevalent in critically neurological patients. Age is likely to significantly influence renal clearance in this population, especially as patients with low Scr and cystatin C levels should be given more attention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 11","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}