Clinical response to nonsurgical periodontal therapy is associated with decreased serum leukocyte count and uric acid levels in kidney transplant recipients.

OBJECTIVE: This study sought to investigate the relationship between clinical response to nonsurgical periodontal therapy (NSPT) and serum changes in leukocyte count, fasting blood glucose, hemoglobin, hematocrit, creatinine, and uric acid in kidney transplant recipients (KTR). METHODOLOGY: A prospective study was performed on 20 KTRs. Periodontal and serum data were collected before and 90 days after NSPT, and delta values (Δ = after NSPT - before) were calculated. Periodontal assessment included periodontal probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP). Patients were classified based on the presence of periodontitis and then categorized into stages. RESULTS: Patients showed a reduction in the percentage of sites with PPD≥3mm, PPD≥4 mm and BOP, after NSPT. There was a direct correlation between the deltas of leukocyte count and CAL ≥3 mm (r=0.645, P=0.002) and BOP (r=0.663, P=0.001), and the deltas of uric acid and CAL ≥3 mm (r=0.562, P=0.010). CONCLUSION: A good clinical response to NSPT may affect the reduction of serum levels of leukocyte count and uric acid, suggesting a beneficial effect on systemic health in KTR.

Difference in hematocrit and plasma albumin levels as an early biomarker of severity and prognosis in patients with severe fever and thrombocytopenia syndrome.

Severe fever with thrombocytopenia syndrome (SFTS) is a widespread infectious disease with high mortality. Hence, identifying valuable biomarkers for detecting the early changes in SFTS is crucial. In this study, we investigated the relationship between the difference in hematocrit (HCT) and serum albumin (ALB) levels (HCT-ALB) and the prognosis of patients with SFTS virus infection. After excluding the patients who did not meet the SFTS diagnostic criteria, those with SFTS from the First Affiliated Hospital of Wannan Medical College were divided into a fatal and Nonfatal group based on their disease prognosis. A dynamic analysis of the daily laboratory data was conducted for 14 days following SFTS onset. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of HCT-ALB. Another sample of patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University was utilized to verify the study conclusions. A total of 158 patients with SFTS were included. Among them, 126 patients were categorized in the Nonfatal group and 32 in the fatal group, leading to a mortality rate of 20.25% (32/158). Univariate analysis of the laboratory test findings and ROC curve analysis showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), HCT-ALB, and lactate dehydrogenase (LDH) had a relatively better ability to discriminate the disease condition of the patients with SFTS. Moreover, HCT-ALB served as a predictor of SFTS prognosis. Additionally, an area under the ROC curve (AUC) of 0.777 and a critical HCT-ALB value of 4.75 on day 7 were associated with a sensitivity of 83.3% and a specificity of 73.9%. On day 8 (AUC = 0.882), the critical value of HCT-ALB was 9.25, while the sensitivity was 100% and specificity was 76.5%. Further verification based on the data of 91 patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University demonstrated a mortality rate of 51% (24/47) among those with HCT-ALB values >4.75 on day 7 of the disease course, highlighting the potential of the HCT-ALB value of >4.75 for predicting SFTS prognosis. High HCT-ALB values are closely related to the mortality of patients with SFTS. HCT-ALB is a sensitive and independent predictor of early disease in patients with SFTS.

Need to reconsider national quality standards for red cell components: Evidence from a retrospective observational analysis.

Background & objectives Red cell concentrates (RCCs) must comply with applicable quality control (QC) standards to achieve the desired therapeutic effect in the recipient. In this study, we assessed the effect of change in the component preparation process on the quality of RCCs and their compliance with different QC standards. Methods A retrospective analysis of data for QC testing of RCCs over a period of 10 years, (from 2009 to 2019), was undertaken. QC testing parameters [volume, haematocrit (Hct), haemoglobin (Hb) content, white blood cell (WBC) content and percentage (%) haemolysis] were used to assess compliance with three national and three international QC standards. Linear regression analysis was done to assess the influence of donor variables. Results Data from 5,218 RCC units was included in the analysis. A majority (>50%) of RCCs prepared did not meet the three national QC standards either for volume or for Hct. The criteria for volume, Hct and Hb content, as defined in different international standards, were fulfilled by a majority (>75%) of RCCs evaluated. RCCs prepared by the buffy coat method had overall better compliance with QC standards compared to the platelet-rich plasma (PRP) method. The method of component preparation was found to influence Hb content, WBC content and percentage haemolysis. Male gender was associated with better Hb content. Interpretation & conclusions RCC prepared at our centre was found to have better compliance with international QC criteria compared to national standards. There is a need to reconsider the current national QC criteria for red cells with due consideration to the volume of whole blood collected and the method used for RCC preparation.

Rate of glucose-6-phosphate dehydrogenase deficiency in neonatal indirect hyperbilirubinemia at a private tertiary centre.

OBJECTIVES: To investigate the rate of hospitalized neonates with glucose-6-phosphate dehydrogenase (G6PD) deficiency presented with indirect hyperbilirubinemia at a private tertiary center in Al-Ahsa, Saudi Arabia, over 4 years and to compare the characteristics of G6PD-deficient and normal neonates admitted for indirect hyperbilirubinemia. METHODS: The retrospective case control study was carried out at Almoosa Specialist Hospital, Al-Ahsa, Saudi Arabia. Data were collected from Yassasi Medical System from 2018-2021 and finalized in 2024. The study included 2 groups: G6PD-normal and G6PD-deficient neonates with indirect hyperbilirubinemia not having recognizable triggers of hemolysis. The analysis focused on serum bilirubin levels, direct bilirubin levels, hematocrit levels, hemoglobin levels, reticulocyte percentage, G6PD levels, duration of phototherapy, and the need for exchange transfusion. RESULTS: The study enrolled 3200 neonates with hyperbilirubinemia, of whom 274 met inclusion criteria. A total of 103 (37.6%) neonates were G6PD-deficient, with 77 (74.8%) being male and 26 (25.2%) female. Glucose-6-phosphate dehydrogenase-deficient neonates exhibited significantly higher initial total bilirubin levels and earlier sampling times. There was no significant correlation between G6PD deficiency and hematocrit or hemoglobin levels in hyperbilirubinemic neonates, but 4 neonates required exchange transfusion, demonstrating statistical significance (p=0.009). CONCLUSION: High rate of G6PD deficiency in neonates with indirect hyperbilirubinemia, requiring close monitoring to prevent exchange transfusions, with no significant differences in hematocrit or hemoglobin levels.

Effect of storage duration on outcome of patients receiving red blood cell in emergency department.

The effect of the duration of red blood cell (RBC) storage on the outcomes of transfused patients remains controversial, and studies on patients in the emergency department (ED) are limited. This study aimed to determine the association between RBC storage duration and outcomes of patients receiving transfusions in the ED. For RBCs issued to patients in the ED between 2017 and 2022, the storage period of the RBC and data on the transfused patient were obtained. Patients were divided into fresh (≤ 7 days) and old (> 7 days) RBC groups, and the associations between storage duration, outcomes, and laboratory changes were evaluated. There was no significant difference in outcomes between the two groups in the 28-day mortality (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.75-1.10, P = 0.320) and the length of stay (fresh 13.5 ± 18.1 vs. old 13.3 ± 19.8, P = 0.814). Regarding changes in laboratory test results, the increase in hemoglobin and hematocrit levels was not affected by the storage durations. The study revealed that transfusion of older RBCs is not associated with inferior outcomes or adverse clinical consequences when compared to that of fresh RBCs in patients in the ED.

Analysis of Erythrocyte Parameters in Multiple and Long-Term Blood Donors from Northern Pomerania (Poland).

BACKGROUND/AIMS: Assessment of the levels of vital blood parameters in donors is essential to evaluate their health status, ensure their suitability for donation, preserve the integrity of the circulatory system, and facilitate comprehensive health monitoring. The aim of our study was to analyse the levels of haemoglobin, haematocrit, erythrocyte count, MCV, MCH, and MCHC in 12 groups of first-time donors and experienced donors of both sexes at the John Paul II Regional Blood Donation and Treatment Centre in Slupsk, northern Poland. The donors were divided into three age groups (18-30 years, 31-45 years, and 46-65 years). METHODS: Using MANOVA multivariate significance tests, we examined the main effects of donor-related factors (age, sex, donor stage) on morphological blood parameters to evaluate different haematological parameters, such as Hb, Ht, RBC, MCV, MCH, and MCHC, and identified statistically significant relationships between all variables. RESULTS: The multivariate analysis of these three main factors showed that the variation in haemoglobin (Hb) levels accounted for 46% of the explained dependence in this statistical model. In particular, approximately half of the variability in the multivariate statistical analysis was attributed to the role of Hb and haematocrit (Ht). In addition, the ß-coefficient values for Hb and Ht were statistically higher in relation to donor sex and donor type (single versus repeat). These ß-coefficient values from our data represent the strength and direction of the relationship between the haematological parameters (Hb and Ht) and the specific donor characteristics. A higher ß-coefficient indicates a stronger influence of donor sex and donor type on these parameters, suggesting that these factors contribute significantly to the variation in the Hb and Ht levels. Based on our results, the comprehensive analysis of the entire statistical model of metabolic biomarkers revealed the following hierarchy: Hb > Ht > MCHC > MCV > RBC > MCH. The results obtained showed strong statistical relationships, as indicated by the high values of the key statistical indicators in our analysis. The coefficient of determination (R²) showed that the model explained a significant proportion of the variance in the data, while the F-test statistic confirmed the significance of the predictors. CONCLUSION: These strong statistical dependencies provided a clear justification for selecting this model over others, as it effectively represented the underlying relationships within the data. These statistics help to assess how well the model matches the actual data, thereby helping to reduce the risks associated with blood donation, optimise donor safety, and maintain the quality and efficiency of blood transfusion services.

Relapse Risk Factors for Immune-Mediated Hemolytic Anemia: A Retrospective Study of 163 Dogs.

Immune-mediated hemolytic anemia (IMHA) is defined as an immune-mediated destruction of erythrocytes. Relapses are recognized, but risk factors are poorly defined. We hypothesized that a lower packed cell volume (PCV) on presentation, more transfusions during hospitalization, or a higher total bilirubin would be associated with an increased risk of relapse. IMHA was defined as a PCV less than 30% at diagnosis with two of the following identified: spherocytes, positive Coombs test, elevated total bilirubin, hemoglobinemia, or positive slide agglutination. This was a retrospective study evaluating 163 dogs between January 2005 and December 2019 from one specialty hospital. There were 13 relapses. The probability (95% confidence interval [CI]) of relapse by 3 and 12 mo was 0.05 (0.02-0.13) and 0.11 (0.06-0.22). The probability (95% CI) of relapse by 12 mo in patients who required two or more transfusions was 0.20 (0.09-0.42) compared with 0.07 (0.02-0.19) in patients who did not (P = .191). A lower PCV at diagnosis was not associated with an increased risk of relapse (hazard ratio [95% CI] 0.95 [0.86-1.04], P = .238). A higher total bilirubin was associated with a significantly increased risk of relapse (P = .003). With each increase of 1 mg/dL of total bilirubin, there was a 0.17 (95% CI 0.06-0.28) increase in the probability of relapse. These patients would likely need closer monitoring.

Automatic characterization of capillary flow profile of liquid samples on µTADs based on capacitance measurement.

Capillary flow profile of liquid samples in porous media is closely related to the important properties of liquid samples, including the viscosity and the surface energy. Therefore, capillary flow profile can be used as an index to differentiate liquid samples with different properties. Fast and automatic characterization of capillary flow profile of liquid samples is necessary. In this work, we develop a portable and economical capacitance acquisition system (CASY) to easily obtain the capillary flow profile of liquid samples on microfluidic thread-based analytical devices (µTADs) by measuring the capacitance during the capillary flow. At first, we validate the accuracy of this method by comparing with the traditional method by video analysis in obtaining the capillary flow profiles in µTADs of cotton threads or glass fiber threads. Then we use it to differentiate liquid samples with different viscosity (mixture of water and glycerol). In addition, capillary flow profile on µTADs with chemical valves (chitosan or sucrose) can also be obtained on this device. Lastly, we show the potential of this device in measurement of hematocrit (HCT) of whole blood samples. This device can be used to catalog liquid biological samples with different properties in point-of-care diagnostics in the near future.

Genetically influenced tobacco and alcohol use behaviors impact erythroid trait variation.

Genome wide association studies (GWAS) have associated thousands of loci with quantitative human blood trait variation. Loci and related genes that impact blood trait variation may regulate blood cell-intrinsic biological processes, or alternatively impact blood cell development and function via systemic factors. Clinical observations have linked tobacco or alcohol use with altered blood traits, but these trait relationships have not been systematically explored at the genetic level. Applying a Mendelian randomization (MR) framework to GWAS summary statistics, we explore relationships between smoking and drinking behaviors with 15 quantitative blood traits. We find that the effects of smoking and drinking are confined to red blood cell traits. An instrumental variable (IV) comprised of 113 single nucleotide polymorphisms (SNPs) associated with smoking initiation is associated with decreased hemoglobin (HGB: Effect = -0.07 standard deviation units [95% confidence interval = -0.03 to -0.10 SD units], P = 1x10-4), hematocrit (HCT: Effect = -0.06 [-0.03 - -0.09] SD units, P = 4x10-4), and red blood cell count (RBC: Effect = -0.05 [-0.02 - -0.09] SD units, P = 5x10-3) without impacting platelet count (P = 0.9) or white blood cell count (P = 0.6). Similarly, an IV associated with an increased number of alcoholic drinks consumed per week is associated with decreased HGB (Effect = -0.22 [-0.42 - -0.02] SD units, P = 3x10-2) and RBC (Effect = -0.27 [-0.51 - -0.03] SD units, P = 3x10-2). Using multivariable MR and causal mediation analyses, we find that an increased genetic predisposition to smoking initiation is associated with increased alcohol intake, and that alcohol use mediates the genetic effect of smoking initiation on red blood cell traits. These findings demonstrate a novel role for genetically influenced behaviors on human blood traits, revealing opportunities to dissect related pathways and mechanisms that influence hematopoiesis and blood cell biology.

Performance in the Six-Minute Walking Test Does Not Discriminate Excessive Erythrocytosis Patients in a Severe Hypoxic Environment.

BACKGROUND: Chronic exposure to severe hypoxia causes an increase in hematocrit (Hct) and hemoglobin concentration ([Hb]), which can lead to excessive erythrocytosis (EE) and impact physical performance. This work aims to determine the differences in the six-minute walking test (6MWT) between EE and healthy subjects residing at more than 5000 m. METHODS: A prospective, cross-sectional study was performed on 71 men (36 healthy and 25 suffering from EE) living in La Rinconada, Peru (5100 m). Basal levels of [Hb] and Hct were obtained. All the subjects performed the 6MWT, and distance reached, vital signs, dyspnea, and fatigue (Borg scale) at the end of the test were recorded. RESULTS: The average [Hb] and Hct levels in the control group were 18.7 ± 1.2 g/dL and 60.4 ± 7.1%, respectively, contrasting with EE subjects, who showed 23.4 ± 1.6 g/dL and 73.6 ± 5.9% (p < 0.001). However, no statistically significant differences were observed in BMI or other anthropometric parameters. At the end of the 6MWT, the distance traveled and vital constants were similar between both groups, except for arterial oxygen saturation, which was consistently lower in subjects with EE throughout the test. CONCLUSION: EE does not significantly affect 6MWT performance at high altitudes, nor the hemodynamic control during moderate aerobic exercise of subjects who live permanently in a severely hypoxic environment.

The Influence of Environmental Conditions and Coinfection by Blood-Feeding Parasites on Red Blood Cell Physiology of an Ectothermic Host.

AbstractVector-borne blood parasites cause myriad sublethal effects and can even be deadly to endotherms, but far less is known about their impacts on ectothermic hosts. Moreover, the pathologies documented in endotherms are generally linked to infection by blood parasites rather than by their vectors. Here, we measured hematocrit, hemoglobin, and relative proportions of immature red blood cells to evaluate the physiological effects of two blood-feeding parasites and coinfection on ectothermic hosts, differentiating among pathological responses, extrinsic factors, and natural variations. We investigated a population of wild eastern hellbender salamanders (Cryptobranchus alleganiensis), which harbor leeches (Placobdella appalachiensis) that transmit blood parasites (Trypanosoma spp.) to their hosts, often resulting in coinfection. We observed seasonal changes in host hematology corresponding to water temperature and demonstrated their ability to modulate hematological parameters in response to acute stress. We reveal seasonal relationships between parasite dynamics and host physiology, in which peak parasitemia occurred when hosts had seasonally high hematocrit and hemoglobin concentrations. We found that coinfected individuals expressed symptoms of anemia, including a regenerative response to depletion of their red blood cells. We also documented a more pronounced pathological response to leech vectors than to the trypanosomes they transmit. Our research underscores the complex interactions between host physiology, multiple parasites, and environmental factors and highlights the pathologies associated with the vector in coinfections. Given the contributions of climate change and disease in the rapid global decline of ectotherms such as amphibians, our study provides timely foundational insights into multiple factors that influence their red blood cell physiology.

HEMATOLOGY AND BIOCHEMISTRY REFERENCE INTERVALS FOR FREE-LIVING ADULT LESSER KESTRELS (FALCO NAUMANNI) IN SOUTHERN ITALY.

The lesser kestrel (Falco naumanni) is a small falcon with a Euro-Central and Asian-Mediterranean range wintering in sub-Saharan Africa. In the second half of the 20th century, the European population experienced a steep decline and was classified as at risk; thus, its biological and ecological aspects have been widely investigated. Nonetheless, data on hematology and plasma chemistry are not yet available. Therefore, hematology and biochemistry parameters were investigated in a sampling population of clinically healthy lesser kestrels (21 female and 10 male adults) from an Italian rescue center during breeding season, estimating the 95% (2.5 - 97.5th percentile) reference intervals (RI) for standard tests based on either parametric or robust statistical methods. The effect of sex on the referenced parameters was also tested and showed no statically significant differences. The established 95% RI highlighted values comparable with those of other similar raptors such as American kestrel (Falco sparverius) and peregrine falcon (Falco peregrinus). As the first recorded hematology and serum chemistry RI, these clinical data could support conservation efforts and clarify the effects of various environmental and ecological factors on the clinical and health status of lesser kestrels, although they should be reinforced with further data from healthy wild animals.

HEMATOLOGY AND BIOCHEMISTRY REFERENCE VALUES IN NESTLING RED KITES (MILVUS MILVUS) IN SHORT-TERM HUMAN CARE IN ENGLAND.

Between the years 2022 and 2023, 62 red kite (Milvus milvus) nestlings were translocated from England to Spain to bolster declining populations in mainland Europe as part of a wider conservation initiative. Health examinations were undertaken by veterinarians ahead of translocation, including examination of hematology and biochemistry parameters from blood samples. This study aimed to establish reference values for these parameters in nestling red kites for use in future translocations or for other clinical purposes. All individuals included in the analysis were clinically healthy at the time of sampling. Biochemical reference intervals were comparable to published values for other Accipitridae, although differences in hematology were noted: PCV was generally lower; and WBC counts higher than (up to triple) those reported for related species of a similar age. It is hypothesized that these differences reflect species variations or the effects of the stress of recent capture on the immune system of the red kites. A Leucocytozoon species was identified on blood smears of six of the red kites. The reference intervals presented in this study are representative of free-living red kite nestlings in England that have recently been captured for conservation translocation purposes.

HEMATOLOGIC AND PLASMA BIOCHEMICAL REFERENCE VALUES FOR CAPTIVE LEOPARD SHARKS (TRIAKIS SEMIFASCIATA).

Leopard sharks (Triakis semifasciata) are temperate, Eastern Pacific elasmobranchs popular in public aquariums. Blood analysis is commonly used for assessing animal health, yet reference values have not been established for this species. This study analyzed T. semifasciata population data to characterize blood reference values for a collection of T. semifasciata housed at a public aquarium. Twenty-one captive leopard sharks were sampled. Blood was collected during annual health examinations from sedated animals. After collection, blood samples were anticoagulated with lithium heparin, and hematocrit and plasma biochemistry values were analyzed. The minimum-maximum ranges were hematocrit 11-31%, buffy coat 1-2%, glucose 4.94-9.38 mM/L, sodium 244-272 mM/L, potassium 3.7-5.5 mM/L, chloride 214-246 mM/L, aspartate aminotransferase 5-31 U/L, creatine kinase 36-1,136 U/L, calcium 3.65-3.95 mM/L, phosphorus 1.13-2.23 mM/L, total protein 21-38 g/L, and total CO2 12-18 mM/L. The values identified will contribute to a better understanding of captive leopard shark physiology and to improved veterinary care for captive leopard sharks. Further research can examine the validity of machines like the Vetscan VS2, which will expand the resources available to care professionals.

Polycythemia Prevalence and Risk Factors in Pilots.

INTRODUCTION: Pilots are frequently exposed to thrombotic risk as a result of immobility from air travel. As hypoxemia is associated with secondary polycythemia, and polycythemia increases the risk of thrombosis, intermittent exposure to high-altitude hypoxic environments could escalate the risk of thrombosis in pilots. Our objectives were to find the prevalence of polycythemia in airplane pilots (primary outcome) and to assess associated risk factors of polycythemia (secondary outcome).METHODS: This study is a cross-sectional descriptive study. Data was collected from paper-based and computerized medical records of airplane pilots who applied for Class 1 Aviation Medical Certificate renewal at the Institute of Aviation Medicine, Royal Thai Air Force, Bangkok, Thailand, in 2018. The data was sampled by a simple random sampling technique.RESULTS: A total of 386 paper-based records were sampled. Of those, 29 (7.5%) of the pilots met polycythemia criteria. Spearman's correlation analysis showed a significant positive correlation between Body Mass Index (BMI) and hemoglobin (correlation coefficient = 0.127) and between BMI and hematocrit (correlation coefficient = 0.105). In multivariate logistic regression of each variable on polycythemia as defined by hemoglobin alone, piloting a non-pressurized aircraft was found to be an independent predictor of polycythemia (odds ratio = 4.3).DISCUSSION: The prevalence of polycythemia in airplane pilots was 7.5%. Operating a non-pressurized aircraft was a significant risk factor of polycythemia, and pilots with higher BMI were more likely to have increased red blood cell parameters.Thanapaisan P, Plaingam M, Manyanont S. Polycythemia prevalence and risk factors in pilots. Aerosp Med Hum Perform. 2024; 95(9):683-687.

In vivo anthelmintic activity of Combretum mucronatum schumach & Thonn leaf extract against Haemonchus contortus in goats.

Parasitic infections with gastrointestinal nematodes are a serious problem for the health and welfare of domestic animals and negatively affect the economics of animal production. Haemonchus contortus is a haematophagous nematode of small ruminants responsible for significant mortality and morbidity. In addition, the widespread resistance to synthetic anthelmintic drugs emphasizes the urgent need of alternative treatment options against haemonchosis. This work aims to investigate the anthelmintic activity of an hydroethanolic Combretum mucronatum leaf extract (CMLE) against Haemonchus contortus in goats. Goats were artificially infected with 3500 third-stage larvae of H. contortus, and 21 days later, treated with CMLE (1000, 500, 250 mg/kg) for 4 consecutive days. Different parameters such as faecal egg count reduction, weight and haematocrit were monitored during the experimental period. The number of eggs per gram of faeces (EPG) was concentration-depended lower and significantly reduced compared to the untreated control (p < 0.0001). The effect of the highest CMLE dose (4 ×1000 mg/kg body weight) was similar to the effect of albendazole (1 ×5 mg/kg of body weight). The ED50 and ED90 values calculated were 189.17 and 392.33 mg/kg body weight respectively. ED50 and ED90 values were time-dependent. Moreover, CMLE improved haematocrit and weight of goats in dose-dependent and time-dependent manner. These results showed that CMLE could be used for haemonchosis treatment in small ruminants.

Relation between hematocrit partitioning and red blood cell lingering in a microfluidic network.

Despite increased interest in the effect of lingering red blood cells (LRBCs) on the heterogeneous hematocrit distribution in the microcirculation, quantitative data on LRBCs before and after the lingering event are still limited. The aim of the study was to investigate the relation between red blood cell (RBC) lingering and hematocrit partitioning in a microfluidic model of a microvascular bifurcation in the limit of low hematocrit conditions (tube hematocrit <10%). To this end, the classification of LRBCs was performed based on timing, position, and velocity of the RBCs. The investigation provided statistical information on the velocity, shape, and orientation of LRBCs as well as on their lateral distribution in the parent and daughter vessels. LRBCs traveled predominantly close to the centerline of the parent vessel, but they marginated close to the distal wall in the daughter vessels. Differently than the RBC flow observed in the smallest vessels, no influence of lingering events on the local hematocrit partitioning was observed in our experiments. However, importantly, we found that LRBCs flowing in the daughter vessel after lingering may be connected to reverse hematocrit partitioning in downstream bifurcations by influencing the skewness of the hematocrit distribution in the daughter vessel, which relates to the so-called network history effect.

Impact of hematocrit levels on the accuracy of specific blood glucose meters: A hospital-based study.

AIMS/INTRODUCTION: Blood glucose meters are commonly used at the bedside, but most of the meters used in Hung Vuong Hospital (Ho Chi Minh City, Vietnam) are built for self-monitoring and might not be suitable for determining glucose levels in patients. In this study, we aimed to validate the performance of six frequently used meters in our hospital using the Clinical & Laboratory Standards Institute (CLSI) standard, and investigate the hematocrit impact on the accuracy of these meters. MATERIALS AND METHODS: A total of 135 pregnant women who underwent a 75-g oral glucose tolerance test consented to participate in the study at Hung Vuong Hospital. Whole blood glucose levels were measured in duplicate using meters, and hematocrit levels were measured using an Alinity h-series analyzer. Within 5 min, plasma glucose levels were measured twice in a row using the Cobas c502 reference analyzer. For accuracy and precision, the hematocrit effect was assed using CLSI POCT12-A3. RESULTS: Out of six evaluated meters, three meters qualified. For CLSI criterion at glucose concentration of 5.55 mmol/L, Accu-Chek Inform II, Accu-Chek Performa and OneTouch VerioVue achieved 97.31%, 98.08% and 99.62%, respectively. For CLSI criterion at 4.17 mmol/L, these three achieved 100%. Accu-Chek Inform II and Accu-Chek Performa showed an inverse correlation between glucose level and hematocrit with slopes of -0.500 (95% confidence interval -0.678 to -0.322) and -0.396 (95% confidence interval -0.569 to -0.224), whereas OneTouch VerioVue was not affected by hematocrit, with a slope of 0.207 (95% confidence interval -0.026 to 0.440). CONCLUSIONS: Blood glucose meters' measurements can be affected by hematocrit, and might provide readings not within an acceptable bias. Medical organizations need to verify or validate before using on patients.

Paper-Based Microfluidic Analytical Device Patterned by Label Printer for Point-of-Care Blood Glucose and Hematocrit Detection Using 3D-Printed Smartphone Cassette.

This study presents a portable, low-cost, point-of-care (POC) system for the simultaneous detection of blood glucose and hematocrit. The system consists of a disposable origami microfluidic paper-based analytical device (µPAD) for plasma separation, filtration, and reaction functions and a 3D-printed cassette for hematocrit and blood glucose detection using a smartphone. The origami µPAD is patterned using a cost-effective label printing technique instead of the conventional wax printing method. The 3D-printed cassette incorporates an array of LED lights, which mitigates the effects of intensity variations in the ambient light and hence improves the accuracy of the blood glucose and hematocrit concentration measurements. The hematocrit concentration is determined quantitatively by measuring the distance of plasma wicking along the upper layer of the origami µPAD, which is pretreated with sodium chloride and Tween 20 to induce dehydration and aggregation of the red blood cells. The filtered plasma also penetrates to the lower layer of the origami µPAD, where it reacts with embedded colorimetric assay reagents to produce a yellowish-brown complex. A color image of the reaction complex is captured using a smartphone inserted into the 3D-printed cassette. The image is analyzed using self-written RGB software to quantify the blood glucose concentration. The calibration results indicate that the proposed detection platform provides an accurate assessment of the blood glucose level over the range of 45-630 mg/dL (R2 = 0.9958). The practical feasibility of the proposed platform is demonstrated by measuring the blood glucose and hematocrit concentrations in 13 human whole blood samples. Taking the measurements obtained from commercial glucose and hematocrit meters as a benchmark, the proposed system has a differential of no more than 6.4% for blood glucose detection and 9.1% for hematocrit detection. Overall, the results confirm that the proposed µPAD is a promising solution for cost-effective and reliable POC health monitoring.

Estimating synthetic hematocrit and extracellular volume from native blood pool T1 times at 3 Tesla CMR: Derivation of a conversion equation, accuracy and comparison with published formulas.

PURPOSE: Calculation of extracellular volume fraction (ECV), a marker of myocardial fibrosis in cardiac magnetic resonance imaging (CMR), requires hematocrit (Hct). We aimed to correlate Hct levels with native blood T1 times, to derive a formula for estimating synthetic Hct (Hctsyn) and synthetic ECV (ECVsyn), to assess accuracy of ECVsyn and to compare our model with published formulas. METHOD: In this retrospective study, a cohort of 250 CMR scans with T1 mapping (3T, MOLLI 5(3)3, endsystolic aquisition), was divided into a derivation and validation cohort. Native T1 times of the left ventricular blood pool (T1native,midLV) were correlated with Hct levels from blood sampling within 24 h (Hct24h) and a formula for calculation of Hctsyn was derived by linear regression. RESULTS: In the derivation cohort (n = 167), Hct24h showed a good association with T1native,midLV (r = -0.711, p < 0.001). The resulting regression equation was Hctsyn = 1/T1native,midLV * 1355.52-0.310. In the validation cohort (n = 83), Hctsyn and Hct24h showed good correlation (r = 0.726, p < 0.001), while ECVsyn, and ECV24h demonstrated excellent correlation (r = 0.940, p < 0.001). ECVsyn had a minimal bias of 0.28 % and the misclassification rate (8.8 %) was comparable to the variability introduced by repeated Hct measurements (misclassification in 7.5 %). Applying published formulas in our cohort resulted in incorrect classification in up to 60 %. CONCLUSION: We provide a formula for estimating Hctsyn from native blood T1 on a 3T scanner. The measurement error of ECVsyn is low and comparable to the error due to retest variability of conventional Hct. Scanner- and sequence-specific formulas should be used.