Microstrip isoelectric focusing with deep learning for simultaneous screening of diabetes, anemia, and thalassemia.

BACKGROUND: Hemoglobin (Hb) is an important protein in red blood cells and a crucial diagnostic indicator of diseases, e.g., diabetes, thalassemia, and anemia. However, there is a rare report on methods for the simultaneous screening of diabetes, anemia, and thalassemia. Isoelectric focusing (IEF) is a common separative tool for the separation and analysis of Hb. However, the current analysis of IEF images is time-consuming and cannot be used for simultaneous screening. Therefore, an artificial intelligence (AI) of IEF image recognition is desirable for accurate, sensitive, and low-cost screening. RESULTS: Herein, we proposed a novel comprehensive method based on microstrip isoelectric focusing (mIEF) for detecting the relative content of Hb species. There was a good coincidence between the quantitation of Hb via a conventional automated hematology analyzer and the one via mIEF with R2 = 0.9898. Nevertheless, our results showed that the accuracy of disease diagnosis based on the quantification of Hb species alone is as low as 69.33 %, especially for the simultaneous screening of multiple diseases of diabetes, anemia, alpha-thalassemia, and beta-thalassemia. Therefore, we introduced a ResNet1D-based diagnosis model for the improvement of screening accuracy of multiple diseases. The results showed that the proposed model could achieve a high accuracy of more than 90 % and a good sensitivity of more than 96 % for each disease, indicating the overwhelming advantage of the mIEF method combined with deep learning in contrast to the pure mIEF method. SIGNIFICANCE: Overall, the presented method of mIEF with deep learning enabled, for the first time, the absolute quantitative detection of Hb, relative quantitation of Hb species, and simultaneous screening of diabetes, anemia, alpha-thalassemia, and beta-thalassemia. The AI-based diagnosis assistant system combined with mIEF, we believe, will help doctors and specialists perform fast and precise disease screening in the future.

An efficient isoelectric focusing of microcolumn array chip for screening of adult Beta-Thalassemia.

Traditional capillary isoelectric focusing (cIEF), liquid chromatography (LC) and capillary zone electrophoresis (CZE) still suffered from low resolution for hemoglobinopathy screening. Herein, a 30-mm pH 5.2-7.8 microcolumn IEF (mIEF) array chip was developed for hemoglobinopathy screening. As a proof of concept, adult beta-thalassemia was chosen as a model disease. In the method, blood samples were hemolyzed via hemolysin solution and loaded into the microcolumn. The experiments showed that (i) the species of Hb A, F, A2 and variants were clearly separated in the chip, and the resolution was greatly higher than the ones of LC/CZE/cIEF; (ii) up to 24 samples could be simultaneously analyzed in 12-min run; (iii) the intraday and interday RSDs were respectively 3.32-4.91 % and 4.07-5.33 %. The assays of mIEF to total 634 samples were compared with the ones of LC (n = 327) and PCR (n = 307). The cutoff of 3.5 % HbA2 led to the sensitivity of 100 % and specificity of 89.1 % for the mIEF-based screening; and there was 96.7 % coincidence between the methods of mIEF and PCR if refer Hb A2 and F. The method had the merits of facility, efficiency, specificity and sensitivity in contrast to the currently-used methods, implying its potential to screening of beta-thalassemia and hemoglobinopathies.

Long Term Prognostic Value Of SYNTAX Score II Among Stemi Patients-A Comprehensive Result From Meta-Analysis.

PURPOSE: To assess the predictive value of SS II (SYNTAX score II) for long-term outcomes in ST-elevated myoarial infarction (STEMI) patients.  Source: PubMed, EMBASE and Cochrane databases were searched up until September 24, 2021. Two investigators extracted data independently from the relevant articles. A random-effects model was conducted to combine the pooled hazard ratio (HR) or risk ratio (RR) for association between SS II and long term outcomes.  Principal findings: A total of 12 articles (7,195 subjects) were included in the final meta-analyses. Analysis of nine of the articles showed that higher SS II predicted poor long term all-cause mortality among STEMI patients (pooled RRs=4.09,95%CI: 3.49-4.80). A similar association of SS II with poor long term mortality was observed when the crude HRs and adjusted HRs were pooled (crude HRs: pooled HR=1.07, 95%CI: 1.04-1.09; adjusted HRs: pooled HR=1.05, 95%CI:1.04-1.07). The STEMI patients with higher SS II also showed a higher associated with increased risk of long term major adverse cardiac events (pooled HR = 1.05, 95% CI: 1.02-1.07; pooled RR=2.28, 95%CI:2.02-2.57). A consistent association was found for heart failure among STEMI patients.  Conclusion: Higher SS II predicted poor long term all-cause mortality, major adverse cardia events and heart failure among STEMI patients.