One Case of Abnormal Decrease of Interferon Gamma Release Assay Result Caused by Melphalan.

BACKGROUND: Interferon gamma release assay (IGRA) is an important method to detect the specific antigen of tuberculosis, which is crucial to the diagnosis of tuberculosis or potential tuberculosis infection. METHODS: We report a case of myelosuppression caused by the use of Melphalan in the treatment of multiple myeloma, resulting in an abnormal decrease in interferon gamma release assay results. RESULTS: We collected blood samples from the patient for retesting and the result of the test did not differ significantly. Upon reviewing the case, it was found that the patient's use of Melphalan treatment resulted in bone marrow suppression and extreme reduction of peripheral blood lymphocytes. Therefore, it is speculated that the abnormal decrease of the interferon gamma release assay result is caused by bone marrow suppression, which is caused by the use of Melphalan. CONCLUSIONS: When patients with multiple myeloma are treated with Melphalan, it can lead to bone marrow suppression and result in false negative interference gamma release assay results. Laboratory staff should consider the existence of such interference and communicate with clinical doctors in a timely manner.

Severe Coagulation Dysfunction caused by Vitamin K Deficiency in an Elderly Patient.

BACKGROUND: Vitamin K deficiency can lead to severe coagulation dysfunction, which may be dangerous and fatal, especially in patients undergoing surgery. METHODS: We report an 84-year-old male patient with gallstones and cholecystitis who had a severe coagulation disorder without bleeding symptoms after endoscopic papillary balloon dilation for removal of bile duct stones. After vitamin K supplementation, the coagulation dysfunction was corrected the next day. RESULTS: In this case, long-term antibiotic treatment, inadequate diet, and abnormal liver function led to coagulation dysfunction. After vitamin K supplementation, the blood coagulation disorder was corrected and serious consequences were prevented. Significantly elevated coagulation function was considered to be caused by vitamin K deficiency. CONCLUSIONS: This case indicates that coagulation dysfunction caused by vitamin K deficiency may occur within a few days. Laboratory personnel should fully understand the risks of vitamin K deficiency in elderly patients undergoing surgery with severely restricted diet, impaired absorption, and long-term use of cephalosporin anti-inflammatory therapy, and promptly remind clinical doctors.

A Case of Pseudoelevation of Serum CA19-9 Level.

BACKGROUND: Carbohydrate antigen 19-9 (CA19-9) is usually synthesized by pancreatic and bile duct cells and is present in small amounts in serum. During the period of tumor disease, its serum level significantly increases, and it is the most widely used serum tumor marker for diagnosis and monitoring therapy of pancreatic cancer. METHODS: We reported a case of abnormal elevation of serum CA19-9. Considering the possibility of detection interference, we used heterophilic antibody blocking analysis, detection by different analysis systems, and polyethylene glycol (PEG) precipitation to evaluate the reliability of abnormally elevated CA19-9 concentration. RESULTS: Repeated measurements on the Roche Cobas 8000 system of another hospital significantly reduced the CA19-9 concentration, as did PEG precipitation. Therefore, the abnormally elevated level of CA19-9 in this patient is considered to be pseudoelevation caused by interferences. CONCLUSIONS: We suggest considering the presence of detection interference in cases with elevated CA19-9 levels but no related clinical manifestations to prevent false positives. PEG precipitation may be a simple and feasible solution to eliminate interference.

Two Cases of False Elevation of MCHC.

BACKGROUND: Mean corpuscular hemoglobin concentration (MCHC) is one of the parameters detected by blood cell analyzers, often used together with mean corpuscular volume (MCV) and mean corpuscular hemoglobin content (MCH) as diagnostic indicators for anemia classification. It has important clinical value in early detection of the cause of anemia and the underlying etiology of anemia. Therefore, the accuracy of MCHC results is of great significance for the diagnosis and treatment of diseases. METHODS: We reported two cases of false elevation of MCHC. Considering the possibility of cold agglutination and lipid blood interference detection, we used 37℃ water bath and plasma exchange to correct for interference on the sample. RESULTS: After correcting the interference, MCHC returned to normal, consistent with the patient's disease status. Therefore, the two cases of abnormal elevation of MCHC are considered to be pseudo elevation caused by interference. CONCLUSIONS: For specimens with abnormally elevated MCHC levels, experimenters should first analyze possible interfering factors and choose effective methods to correct different interferences, providing accurate testing reports for doctors and patients.

A Case of False Insulin Test Results Due to the Megaloblastic Anemia.

BACKGROUND: Megaloblastic anemia is a subtype of anemia with increased red blood cell volume. These megaloblastic cells can be easily destroyed in the bone marrow and spleen, leading to ineffective hematopoiesis. Insulin-degrading enzymes (IDE) in erythrocytes can break down the insulin into amino acid fragments; thus, when hemolysis occurs, IDE can be released into the blood, resulting in low insulin measurement values. METHODS: This article reports a case of false insulin test results due to the hemolysis resulting from megaloblastic anemia. RESULTS: The patient's first fasting glucose results indicated that the glucose and C-peptide levels were within the normal range while her insulin level was abnormally low. After hemolysis was corrected, the relevant indicators were re-evaluated and all the results were normal. CONCLUSIONS: This article reports a patient diagnosed with megaloblastic anemia, whose dysmorphic erythrocytes cause severe extravascular hemolysis. It was the occurrence of hemolysis that the IDE released into the blood, leading to the abnormal insulin test result.

A Case of Pseudoelevation of Prostate Specific Antigen Level.

BACKGROUND: Prostate specific antigen (PSA) is an important marker for the diagnosis, monitoring and efficacy evaluation of prostate cancer. Therefore, the accuracy of PSA detection results is of great significance for the diagnosis and treatment of prostate cancer. METHODS: We reported a case with abnormally elevated PSA. The patient's serum samples were subjected to investigations for suspected interference. Interference studies included measurement of PSA on different analytical platforms, serial dilutions, heterophilic blocking tube (HBT) analysis and polyethylene glycol (PEG) precipitation. RESULTS: In this case, the abnormal increases in the results of PSA detected by Abbott i2000SR immune analyzer were considered to be the pseudoelevation caused by interferences, resulting in unnecessary prostate puncture examination. CONCLUSIONS: When the patient's PSA level is abnormally elevated, which is not consistent with the clinical diagnosis, we should consider immunological interference in PSA assays. Pretreatment with PEG may be an economical, simple, and feasible scheme for removing interference.

A False Insulin Level in a Patient with Insulin Autoimmune Syndrome: a Case Report.

BACKGROUND: Insulin autoimmune syndrome (IAS) is a rare condition in which spontaneous severe hypoglycemia without previous exposure to exogenous insulin, and is characterized by hyperinsulinemia and high titers of insulin autoantibodies (IAA). METHODS: This paper reports a case of IAS with false insulin test results due to the hook effect. RESULTS: The patient's blood samples were collected at 0, 30, 60, 120, 180 minutes for measurement of serum insulin after a 3-hour oral glucose tolerance test (OGTT). The results of serum insulin levels were 1,698.6 pmol/L at fasting, 1,633.05 pmol/L at 30 minutes post load, 1,691.14 pmol/L at 60 minutes post load, 1,780.67 pmol/L at 120 minutes post load, and 1,807.93 pmol/L at 180 minutes post load. Dilution and re-analysis of the specimens revealed that the actual insulin concentrations were 217,516 pmol/L at fasting, 228,456 pmol/L at 30 minutes post load, 250,474 pmol/L at 60 minutes post load, 273,266 pmol/L at 120 minutes post load, and 291,232 pmol/L at 180 minutes post load. The insulin level results before and after the dilution had significant discrepancies. It was the hook effect caused by the high concentration of insulin in the serum that made the first test inaccurate. CONCLUSIONS: Serum insulin in patients with IAS is abnormally elevated, and extremely high concentrations of it may have a hook effect during assay resulting in inaccurate results. The laboratory should analyze and review the test results in combination with the patient's clinical case data, to detect interference in time and avoid erroneous diagnosis and treatment of patients.

Differentiating thymoma, thymic carcinoma and lymphoma based on collagen fibre patterns with T2- and diffusion-weighted magnetic resonance imaging.

OBJECTIVES: The amount and distribution of intratumoural collagen fibre vary among different thymic tumours, which can be clearly detected with T2- and diffusion-weighted MR images. To explore the incidences of collagen fibre patterns (CFPs) among thymomas, thymic carcinomas and lymphomas on imaging, and to evaluate the efficacy and reproducibility of CFPs in differential diagnosis of thymic tumours. MATERIALS AND METHODS: Three hundred and ninety-eight patients with pathologically diagnosed thymoma, thymic carcinoma and lymphoma who underwent T2- and diffusion-weighted MR imaging were retrospectively enrolled. CFPs were classified into four categories: septum sign, patchy pattern, mixed pattern and no septum sign. The incidences of CFPs were compared among different thymic tumours, and the efficacy and reproducibility in differentiating the defined tumour types were analysed. RESULTS: There were significant differences in CFPs among thymomas, thymic squamous cell carcinomas (TSCCs), other thymic carcinomas and neuroendocrine tumours (OTC&NTs) and thymic lymphomas. Septum signs were found in 209 (86%) thymomas, which differed between thymomas and any other thymic neoplasms (all p < 0.005). The patchy, mixed patterns and no septum sign were mainly seen in TSCCs (80.3%), OTC&NTs (78.9%) and thymic lymphomas (56.9%), respectively. The consistency of different CFP evaluation between two readers was either good or excellent. CFPs achieved high efficacy in identifying the thymic tumours. CONCLUSION: The CFPs based on T2- and diffusion-weighted MR imaging were of great value in the differential diagnosis of thymic tumours. KEY POINTS: • Significant differences are found in intratumoural collagen fibre patterns among thymomas, thymic squamous cell carcinomas, other thymic carcinomas and neuroendocrine tumours and thymic lymphomas. • The septum sign, patchy pattern, mixed pattern and no septum sign are mainly seen in thymomas (86%), thymic squamous cell carcinomas (80.3%), other thymic carcinomas and neuroendocrine tumours (79%) and thymic lymphomas (57%), respectively. • The collagen fibre patterns have high efficacy and reproducibility in differentiating thymomas, thymic squamous cell carcinomas and thymic lymphomas.

Distinguishing between COVID-19 and influenza during the early stages by measurement of peripheral blood parameters.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 infection. This study aims to examine the changes in peripheral blood parameters during the early stages of COVID-19 and influenza. We analyzed the peripheral blood parameters of 169 COVID-19 patients and 131 influenza patients during the early-onset stage. Results from the patients with COVID-19 were compared with those from healthy controls and influenza patients. In addition, results from patients with common and severe COVID-19 were further compared. There were significant differences between COVID-19 and influenza patients in terms of age, white blood cell count, platelet count, percentage of neutrophils, percentage of lymphocytes, percentage of monocytes, percentage of eosinophils, percentage of basophils, neutrophil, count and monocyte count. Two parameters (monocyte count and percentage of basophils) were combined to clarify the diagnostic efficacy of COVID-19 and influenza and the area under the curve was found to be 0.772. Comparison of peripheral blood parameters from common COVID-19, severe COVID-19, and influenza patients revealed many differences during the early disease stages. The diagnostic formula developed by this study will be of benefit for physicians in the differentiation of COVID-19 and influenza.

Can the low and high b-value distribution influence the pseudodiffusion parameter derived from IVIM DWI in normal brain?

BACKGROUND: Our study aims to reveal whether the low b-values distribution, high b-values upper limit, and the number of excitation (NEX) influence the accuracy of the intravoxel incoherent motion (IVIM) parameter derived from multi-b-value diffusion-weighted imaging (DWI) in the brain. METHODS: This prospective study was approved by the local Ethics Committee and informed consent was obtained from each participant. The five consecutive multi-b DWI with different b-value protocols (0-3500 s/mm2) were performed in 22 male healthy volunteers on a 3.0-T MRI system. The IVIM parameters from normal white matter (WM) and gray matter (GM) including slow diffusion coefficient (D), fast perfusion coefficient (D*) and perfusion fraction (f) were compared for differences among defined groups with different IVIM protocols by one-way ANOVA. RESULTS: The D* and f value of WM or GM in groups with less low b-values distribution (less than or equal to 5 b-values) were significantly lower than ones in any other group with more low b-values distribution (all P <  0.05), but no significant differences among groups with more low b-values distribution (P > 0.05). In addition, no significant differences in the D, D* and f value of WM or GM were found between group with one and more NEX of low b-values distribution (all P > 0.05). IVIM parameters in normal WM and GM strongly depended on the choice of the high b-value upper limit. CONCLUSIONS: Metrics of IVIM parameters can be affected by low and high b value distribution. Eight low b-values distribution with high b-value upper limit of 800-1000 s/mm2 may be the relatively proper set when performing brain IVIM studies.

Predicting pathological subtypes and stages of thymic epithelial tumors using DWI: value of combining ADC and texture parameters.

OBJECTIVES: To explore the value of combining apparent diffusion coefficients (ADC) and texture parameters from diffusion-weighted imaging (DWI) in predicting the pathological subtypes and stages of thymic epithelial tumors (TETs). METHODS: Fifty-seven patients with TETs confirmed by pathological analysis were retrospectively enrolled. ADC values and optimal texture feature parameters were compared for differences among low-risk thymoma (LRT), high-risk thymoma (HRT), and thymic carcinoma (TC) by one-way ANOVA, and between early and advanced stages of TETs were tested using the independent samples t test. Receiver operating characteristic (ROC) curve analysis was performed to determine the differentiating efficacy. RESULTS: The ADC values in LRT and HRT were significantly higher than the values in TC (p = 0.004 and 0.001, respectively), also in early stage, values were significantly higher than ones in advanced stage of TETs (p < 0.001). Among all texture parameters analyzed in order to differentiate LRT from HRT and TC, the V312 achieved higher diagnostic efficacy with an AUC of 0.875, and combination of ADC and V312 achieved the highest diagnostic efficacy with an AUC of 0.933, for differentiating the LRT from HRT and TC. Furthermore, combination of ADC and V1030 achieved a relatively high differentiating ability with an AUC of 0.772, for differentiating early from advanced stages of TETs. CONCLUSIONS: Combination of ADC and DWI texture parameters improved the differentiating ability of TET grades, which could potentially be useful in clinical practice regarding the TET evaluation before treatment. KEY POINTS: • DWI texture analysis is useful in differentiating TET subtypes and stages. • Combination of ADC and DWI texture parameters may improve the differentiating ability of TET grades. • DWI texture analysis could potentially be useful in clinical practice regarding the TET evaluation before treatment.

Fusion of near-infrared and fluorescence spectroscopy for untargeted fraud detection of Chinese tea seed oil using chemometric methods.

BACKGROUND: This paper investigated the feasibility of data fusion of near-infrared (NIR) and fluorescence spectroscopy for rapid analysis of cheap vegetable oils in Chinese Camellia oleifera Abel. (COA) oil. Because practical frauds usually involve adulterations of multiple known and unknown cheap oils, traditional analytical methods aimed at detecting one or more known adulterants are insufficient to identify adulterated COA oil. Therefore, untargeted analysis was performed by developing class models of pure COA oil using robust one-class partial least squares (OCPLS). RESULTS: The most accurate OCPLS model was obtained with fusion of standard normal variate (SNV)-NIR and SNV-fluorescence spectra with sensitivity of 0.954 and specificity of 0.91. Robust OCPLS could detect adulterations with 2% (w/w) or more cheap oils, including rapeseed oil, sunflower seed oil, corn oil and peanut oil. CONCLUSION: Fusion of NIR and fluorescence data and chemometrics provided enhanced capacity for rapid and untargeted analysis of multiple adulterations in Chinese COA oils. © 2018 Society of Chemical Industry.

Usefulness of Volume Perfusion Computed Tomography in Differentiating Histologic Subtypes of Thymic Epithelial Tumors.

PURPOSE: This study aimed to evaluate the usefulness of volume perfusion computed tomography (VPCT) parameters in differentiating the World Health Organization subtypes of thymic epithelial tumors. MATERIALS AND METHODS: This study was approved by the local ethics committee, and informed written consent was obtained. Fifty-one thymic epithelial tumor patients confirmed by histopathological analysis underwent conventional CT and a 48-second VPCT scan of the tumor bulk before any treatment. The VPCT parameters (blood volume [BV], blood flow [BF], mean transit time [MTT], and permeability [PMB]) based on volume of interest (VOI) or region of interest (ROI) were compared for differences among low-risk thymomas (LRTs; types A, AB, and B1), high-risk thymomas (HRTs; types B2 and B3) and thymic carcinomas (TCs) by one-way analysis of variance. RESULTS: The BVVOI, PMBVOI, BVROI, and PMBROI values in LRT were significantly higher than the values from HRT and thymic carcinoma (BVVOI: 13.75, 6.17, and 5.48 mL/100 mL; PMBVOI: 22.47, 9.56, and 13.37 mL/100 mL/min; BVROI: 14.75, 6.87, and 6.06 mL/100 mL; PMBROI: 24.05, 9.79, and 15.63 mL/100 mL/min, respectively; all P < 0.05/3). However, the BFVOI, MTTVOI, BFROI, and MTTROI values did not differ between LRT and HRT or thymic carcinoma groups (P > 0.05/3). CONCLUSIONS: These results suggest that VPCT could be useful in differentiating LRTs from HRTs and TCs preoperatively.

Iodine Quantification Using Dual-Energy Computed Tomography for Differentiating Thymic Tumors.

The aim of the study was to explore the efficacy of iodine quantification with dual-energy computed tomography (DECT) in differentiating thymoma, thymic carcinoma, and thymic lymphoma. MATERIALS AND METHODS: Fifty-seven patients with pathologically confirmed low-risk thymoma (n = 16), high-risk thymoma (n = 15), thymic carcinoma (n = 14), and thymic lymphoma (n = 12) underwent chest contrast-enhanced DECT scan were enrolled in this study. Tumor DECT parameters including iodine-related Hounsfield unit (IHU), iodine concentration (IC), mixed HU (MHU), and iodine ratio in dual phase, slope of energy spectral HU curve (λ), and virtual noncontrast (VNC) were compared for differences among 4 groups by one-way analysis of variance. Receiver operating characteristic curve was used to determine the efficacy for differentiating the low-risk thymoma from other thymic tumor by defined parameters. RESULTS: According to quantitative analysis, dual-phase IHU, IC, and MHU values in patients with low-risk thymoma were significantly increased compared with patients with high-risk thymoma, thymic carcinoma, and thymic lymphoma (P < 0.05/4).The venous phase IHU value yielded the highest performance with area under the curve of 0.893, 75.0% sensitivity, and 89.7% specificity for differentiating the low-risk thymomas from high-risk thymomas or thymic carcinoma at the cutoff value of 34.3 HU. When differentiating low-risk thymomas from thymic lymphoma, the venous phase IC value obtained the highest diagnostic efficacy with the area under the curve of 0.969, and sensitivity, specificity, and cutoff value were 87.5%, 100.0%, and 1.25 mg/mL, respectively. CONCLUSIONS: Iodine quantification with DECT may be useful for differentiating the low-risk thymomas from other thymic tumors.

Systematic review of the risk of urolithiasis following parathyroidectomy in patients with primary hyperparathyroidism.

OBJECTIVE: Parathyroidectomy (PTX) is the conclusive therapy for primary hyperparathyroidism (PHPT), but its effect on the risk of urolithiasis is inconclusive. We comprehensively reviewed the currently available research to investigate the impact of PTX on the likelihood of urolithiasis among individuals suffering PHPT. METHODS: Internet-based articles in English language released on Cochrane, PubMed, Scopus, Web of knowledge, and Embase up to September, 2023 were comprehensively reviewed. Each publication in contrast to the incidence, occurrence, or recurrence of urolithiasis after PTX versus medical treatment in PHPT patients was included. The outcome with pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) was examined employing DerSimonian and Laird's model of random effects. To determine the range of the real effect size of a future study in 95% of all populations, a prediction interval (PI) was also established. RESULTS: Finally, ten studies involving 74,190 patients were included. Results from randomized-controlled trials (RCTs) and observational studies (OSs) both revealed that PTX did not substantially lessen the vulnerability of urolithiasis among individuals with PHPT (RCTs: pooled relative risk [RR] 0.42, 95%CI 0.13-1.41, p = 0.163; OSs: pooled RR 1.37, 95%CI 0.96 to 1.97, p = 0.084). The PI (RCT: 0.03 to 5.96; OSs: 0.44-4.20) containing 1.0 suggested the possibility of consistent results in future studies. Subgroup and sensitivity analyses supported the above findings, and no evidence showed publication bias. CONCLUSION: Our analysis from the available RCTs or OSs did not give adequate or exact proof that the average effect of PTX lowers the incidence of urolithiasis among PHPT persons based on the random-effects model. Future research shall take into account the common effect of PTX as well as the prerequisites of preventive stone procedures, which will further help us assess the effectiveness of PTX in reducing kidney calculus comorbidity and develop techniques to avoid stone sequelae in these individuals.

A photo-modulated nitric oxide delivering hydrogel for the accelerated healing of biofilm infected chronic wounds.

Biofilm infection and impaired healing of chronic wounds are posing tremendous challenges in clinical practice. In this study, we presented a versatile antimicrobial hydrogel capable of delivering nitric oxide (NO) in a controllable manner to dissipate biofilms, eliminate microorganisms, and promote the healing of chronic wounds. This hydrogel was constructed by Schiff-base crosslinking of oxidized dextran and antimicrobial peptide ε-poly-lysine, further encapsulating photothermal nanoparticles bearing NO donor. This hydrogel could continuously and slowly release NO, effectively dissipating biofilms, and promoting the proliferation of mouse fibroblasts and the migration of endothelial cells. Upon exposure to NIR laser irradiation, the hydrogel generated hyperthermia and rapidly released NO, resulting in the efficient elimination of a broad spectrum of drug-resistant Gram-positive/negative bacterial and fungal biofilms through the synergistic effects of NO, photothermal therapy, and the antibacterial peptide. Notably, the hydrogel demonstrated exceptional in vivo therapeutic outcomes in accelerating the healing process of mice diabetic wounds infected with methicillin-resistant Staphylococcus aureus by successfully eliminating biofilm infection, regulating inflammation, and facilitating angiogenesis and collagen deposition. Overall, this proposed hydrogel shows great promise in accommodating the various demands of the complex repair process of chronic wounds infected with biofilms. STATEMENT OF SIGNIFICANCE: : The presence of biofilm infections and underlying dysfunctions in the healing process made chronic wound become stuck in the inflammation stage and difficult to heal. This work developed a NIR laser-modulated three-stage NO-releasing versatile antimicrobial hydrogel (DEPN) exhibiting good therapeutic efficacy for chronic wound. This DEPN hydrogel could inherently and slowly released NO to disperse biofilm. Upon NIR laser irradiation, the DEPN hydrogel generated hyperthermia and induced a rapid burst release of NO effectively eliminating a broad spectrum of drug-resistant bacterial and fungal biofilms. Subsequently, the DEPN hydrogel continually release NO slowly to promote the tissue remolding. This DEPN hydrogel displays great potential in treatment of chronic wounds infected with biofilm.

Interfacial delivery of carbon monoxide via smart titanium implant coating for enhanced soft tissue integration with switchable antibacterial and immunomodulatory properties.

Soft tissue integration around titanium (Ti) implants is weaker than that around natural teeth, compromising long-term success of Ti implants. Carbon monoxide (CO) possesses distinctive therapeutic properties, rendering it as a highly promising candidate for enhancing STI. However, achieving controlled CO generation at the STI interface remains challenging. Herein, a controlled CO-releasing dual-function coating was constructed on Ti surfaces. Under near-infrared (NIR) irradiation, the designed surface could actively accelerate CO generation for antibiosis against both aerobic and anaerobic bacteria. More importantly, in the absence of NIR, the slow release of CO induces macrophage polarization from pro-inflammatory phenotype towards pro-regenerative phenotype. In a rat implantation model with induced infection, the designed surface effectively controlled the bacterial infection, alleviates accompanying inflammation and modulated immune microenvironment, leading to enhanced STI. Single-cell sequencing revealed that the coating alters the cytokine profile within the soft tissue, thereby influencing cellular functions. Differentially expressed genes in macrophages are highly enriched in the PIK3-Akt pathway. Furthermore, the cellular communication between fibroblasts and macrophages was significantly enhanced through the CXCL12/CXCL14/CXCR4 and CSF1-CSF1R ligand-receptor pair. These findings indicate that our coating showed an appealing prospect for enhancing STI around Ti implants, which would ultimately contribute to the improved long-term success of Ti implants.

Integration of Hydrogels and 3D Bioprinting Technologies for Chronic Wound Healing Management.

The integration of hydrogel-based bioinks with 3D bioprinting technologies presents an innovative approach to chronic wound management, which is particularly challenging to treat because of its multifactorial nature and high risk of complications. Using precise deposition techniques, 3D bioprinting significantly alters traditional wound care paradigms by enabling the fabrication of patient-specific wound dressings that imitate natural tissue properties. Hydrogels are notably beneficial for these applications because of their abundant water content and mechanical properties, which promote cell viability and pathophysiological processes of wound healing, such as re-epithelialization and angiogenesis. This article reviews key 3D printing technologies and their significance in enhancing the structural and functional outcomes of wound-care solutions. Challenges in bioink viscosity, cell viability, and printability are addressed, along with discussions on the cross-linking and mechanical stability of the constructs. The potential of 3D bioprinting to revolutionize chronic wound management rests on its capacity to generate remedies that expedite healing and minimize infection risks. Nevertheless, further studies and clinical trials are necessary to advance these therapies from laboratory to clinical use.

Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis.

Background: Hypoglycaemia has been linked to an increased risk of cardiac arrhythmias by causing autonomic and metabolic alterations, which may be associated with detrimental outcomes in individuals with diabetes(IWD), such as cardiovascular diseases (CVDs) and mortality, especially in multimorbid or frail people. However, such relationships in this population have not been thoroughly investigated. For this reason, we conducted a systematic review and meta-analysis. Methods: Relevant papers published on PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL complete from inception to December 22, 2022 were routinely searched without regard for language. All of the selected articles included odds ratio, hazard ratio, or relative risk statistics, as well as data for estimating the connection of hypoglycaemia with cardiac arrhythmia, CVD-induced death, or total death in IWD. Regardless of the heterogeneity assessed by the I2 statistic, pooled relative risks (RRs) and 95% confidence intervals (CI) were obtained using random-effects models. Results: After deleting duplicates and closely evaluating all screened citations, we chose 60 studies with totally 5,960,224 participants for this analysis. Fourteen studies were included in the arrhythmia risk analysis, and 50 in the analysis of all-cause mortality. Hypoglycaemic patients had significantly higher risks of arrhythmia occurrence (RR 1.42, 95%CI 1.21-1.68), CVD-induced death (RR 1.59, 95% CI 1.24-2.04), and all-cause mortality (RR 1.68, 95% CI 1.49-1.90) compared to euglycaemic patients with significant heterogeneity. Conclusion: Hypoglycaemic individuals are more susceptible to develop cardiac arrhythmias and die, but evidence of potential causal linkages beyond statistical associations must await proof by additional specifically well planned research that controls for all potential remaining confounding factors.

Nanoporous electrode with stable polydimethylsiloxane coating for direct electrochemical analysis of bisphenol A in complex wine media.

Direct electrochemical analysis of bisphenol A (BPA) in alcoholic drinks without proper sample preparation is a major challenge. The current work reports a nanoporous electrode design with ultrathin polydimethylsiloxane (PDMS) coating grafted on the top of an indium tin oxide (ITO) electrode with silica nanochannels membrane and cetyltrimethylammonium bromide micelles (SNCM), using a facile contact heating step. The proposed PDMS@SNCM/ITO electrode was subjected to direct ultra-trace detection of BPA in the linear range of 1.0-100.0 µM and detection limit of 0.23 µM, under optimized pH 8 and an accumulation time of 9.0 min. The analytical utility of the proposed method was checked in real wine samples for BPA detection with successful recovery percentages in the range from 95.20 ± 8.53 to 96.22 ± 10.00. The intrinsic hydrophobic features, exceptional stability, and sensitivity of the proposed electrode show potential for food safety surveillance in complex food matrices.