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AbstractMonoclonal gammopathy has been reported to interfere with several laboratory measurement results. We investigated potential interference in monoclonal gammopathy on immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) concentrations using three different routine chemistry instruments: Alinity (Abbott Laboratories), Cobas 8000 (Roche Diagnostics) and Optilite (Binding Site) at the Department of Clinical Biochemistry, Aalborg University Hospital, Denmark. Blood samples collected from 216 patients with known monoclonal gammopathy were analyzed on Alinity, Cobas and Optilite. Diagnoses were ascertained from clinical records. Scatter plots with Passing-Bablok regression were used to investigate associations between concentrations of IgA, IgG and IgM measured with each of the different instruments. Furthermore, comparison of IgG analyses on Alinity, Optilite and Cobas according to monoclonal IgM concentration was explored with Bland-Altman plots. A total of 81 patients were identified with IgM type monoclonal gammopathy and 8 of these patients (10%) had analytical interference as reflected by more than 25% decrease in the level of IgG measured on Alinity as compared to Optilite and Cobas. All blood samples with interference on IgG measurement using Alinity were from patients with lymphoplasmacytic lymphoma/Waldenströms macroglobulinemia and all of them had monoclonal IgM concentrations above 10 g/L. This study identified a source of interference from IgM monoclonal gammopathy on IgG measurement performed using Alinity. The interferences caused falsely low results of IgG which is important to recognize to ensure proper patient management. [ABSTRACT FROM AUTHOR]

A convenient and effective synthesis of imidazo[1,2-a]pyrimidine derivatives has been developed under microwave irradiations using Al2O3 as a catalyst in solvent-free conditions. The functionalized imidazo[1,2-a]pyrimidine derivatives are useful in biochemistry and medical science. In our investigation, the antimicrobial activity of the synthesized compounds was evaluated against 13 microorganisms, including 6 Gram-positive bacteria, 4 Gram-negative bacteria, and 3 pathogenic fungi. Bioactivity tests revealed that the majority of the compounds exhibited good antimicrobial activity. Finally, molecular docking simulations and ADME-T predictions were performed, showing that the most active compounds have good binding modes with microbial targets and promising pharmacokinetic safety profiles. [ABSTRACT FROM AUTHOR]

Background: Predicting mortality in emergency departments (EDs) using machine learning models presents challenges, particularly in balancing simplicity with performance. This study aims to develop models that are both simple and effective for predicting short- and long-term mortality in ED patients. Our approach uses a minimal set of variables derived from one single blood sample obtained at admission. Methods: Data from three cohorts at two large Danish university hospitals were analyzed, including one retrospective and two prospective cohorts where prognostic models were applied to predict individual mortality risk, spanning the years 2013–2022. Routine biochemistry analyzed in blood samples collected at admission was the primary data source for the prediction models. The outcomes were mortality at 10, 30, 90, and 365 days after admission to the ED. The models were developed using Light Gradient Boosting Machines. The evaluation of mortality predictions involved metrics such as Area Under the Receiver Operating Characteristic Curve (AUC), sensitivity, specificity, negative predictive values, positive predictive values, and Matthews correlation coefficient (MCC). Results: A total of 43,648 unique patients with 65,484 admissions were analyzed. The models showed high accuracy, with very good to excellent AUC values between 0.87 and 0.93 across different time intervals. Conclusions: This study demonstrates that a single assessment of routine clinical biochemistry upon admission can serve as a powerful predictor for both short-term and long-term mortality in ED admissions. [ABSTRACT FROM AUTHOR]

Objective: Acute or chronic exposure to excess iodine has detrimental effects on thyroid physiology; therefore, this study aimed to determine the prevalence of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) in an elderly population residing in geographical areas with chronic exposure to excess iodine intake and to analyse contributing risk factors. Design: This cross‐sectional study was conducted from 2016 to 2017 in areas of Jiangsu Province that have documented chronic exposure to high iodine intake. Patients: We enroled 2559 adult participants using a multistage, stratified sampling method. Measurements: Urinary iodine concentration (UIC), serum thyroid‐stimulating hormone (TSH) level and other relevant parameters were measured. Demographic information was recorded using a standardized questionnaire. The age‐specific TSH references were determined by the National Academy of Clinical Biochemistry guidelines. Univariate and multivariate logistic regression analyses were performed to identify risk factors for hypothyroidism in the study population. Results: The median UIC of participants was 307.3 µg/L (interquartile range: 200.7, 469.8 μg/L). The prevalence of OH in subjects ≥70 years using laboratory reference ranges was 2.37%; however, it decreased to 1.78% with the use of an age‐specific reference range. Similarly, the prevalence of SCH also declined drastically from 29.59% to 2.96% with the application of an age‐specific reference range. In both univariate and multivariate models, advanced age, female gender and high UIC were identified as risk factors for hypothyroidism. Conclusions: Usage of age‐specific TSH reference ranges led to a significantly lower prevalence of OH and SCH in the study population, thus preventing unnecessary over‐diagnosis and over‐treatment. [ABSTRACT FROM AUTHOR]

Background: Inter‐assay variation between different immunoassays and different mass spectrometry methods hampers the biochemical confirmation of male hypogonadism. Furthermore, some laboratories utilise assay manufacturer reference ranges that do not necessarily mirror assay performance characteristics, with the lower limit of normality ranging from 4.9 nmol/L to 11 nmol/L. The quality of the normative data underlying commercial immunoassay reference ranges is uncertain. Design: A working group reviewed published evidence and agreed upon standardised reporting guidance to augment total testosterone reports. Results: Evidence‐based guidance on appropriate blood sampling, clinical action limits, and other major factors likely to affect the interpretation of results are provided. Conclusions: This article aims to improve the quality of the interpretation of testosterone results by non‐specialist clinicians. It also discusses approaches for assay harmonisation which have been successful in some but not all healthcare systems. [ABSTRACT FROM AUTHOR]

Gamification is emerging as an active learning innovation in medical education to enhance student engagement and promote life‐long learning in a unique and collaborative environment. Clinical enzymology in biochemistry is one of the core topics in the medical curriculum. However, students face challenges in comprehension and retention of information. Hence, CARd & Board GAmes in Medical Education (CARBGAME) was introduced and evaluated for its effectiveness in enhancing learning, application, and retention of knowledge in clinical enzymology via gamification context. This mixed‐method study involved 150 first‐year undergraduate medical students. Before the game, students completed a pre‐test in clinical enzymology. Later they were divided into 25 small groups to compete in the board game designed for enzymology in biochemistry. The students took turns throwing the dice and answering the questions on the game board to continue moving forward. The first team to reach 100 and solve the case‐based question was deemed the winner. Following the board game, the students took up the post‐test to compare the educational impact of the innovation. Also, the subsequent internal assessment scores were compared with previous batch who were not implemented with this intervention. Then students evaluated the effectiveness of CARBGAME—Clinical Enzymology using a 32‐item questionnaire on 5‐point Likert scale. The feedback obtained on a 10‐point rating scale and for qualitative analysis, students' and faculty perceptions were recorded in small groups. CARBGAME received overwhelmingly positive feedback from both students and faculty. It was perceived well by students for being fun, relevant, consistent, motivating, collaborative, and promoting experiential learning. The game's low‐stakes approach, effective feedback, and sense of accomplishment were highly appreciated, making it a valuable tool for education. A significant improvement in knowledge was recorded, from a mean score of 8.37 ± 1.126 on a 20‐point scoring scale before the game to 16.53 ± 1.219 after with a p‐value of 0.0001. The comparison of the internal assessment scores between the intervention and non‐intervention group of students also showed a significant improvement among those implemented with CARBGAME (p < 0.0001). The CARBGAME innovation has achieved the intended outcome of promoting active learning and enhanced performance in clinical enzymology. Highly positive responses from faculty and students also indicate the exigent need to introduce innovative components like games into curricula to achieve student engagement and promote a meaningful learning experience. [ABSTRACT FROM AUTHOR]

Objective: This scoping review protocol describes the strategy for a scoping review that aims to provide a comprehensive overview of published guidelines for the prescription of standard laboratory tests performed in intensive care unit (ICU) patients. Background: The use of clinical laboratories is constantly increasing. However, there is evidence of inappropriate use. Inappropriate laboratory testing has the potential to harm patients, increase costs, burden staff, and has an environmental impact. Effective management can be achieved through demand managing strategies, such as providing guidelines on performing the appropriate test, for the right patient, at the right time. Although national and international guidelines exist for individual tests, a comprehensive summary of available recommendations for laboratory testing in the ICU is currently unavailable. Inclusion criteria: This scoping review will incorporate documents that provide explicit advice on which test to perform in ICU patients. We selected 34 tests routinely ordered in the ICU. This review will consider any document type that matches our concept and context. We will consider gray literature with appropriate adherence to guidelines methodology. We will not limit the review by geographical location, but will only include articles published in English. Search strategy: Our scoping review will follow the Joanna Brigg Institute (JBI) methodology. We will search Medline (PubMed), Embase, Scopus, Google Scholar, and Google. Our search strategy adheres to the JBI 3-step construction approach for systematic reviews. We will search for keywords related to guidelines, laboratory testing, and the 34 selected tests. We will report our study using the S1 Checklist. Review registration number: osf.io/yfs9z. [ABSTRACT FROM AUTHOR]

Summary To evaluate the relationship between serum gamma‐glutamyl transferase (GGT) levels and fatty pancreas in subjects with concurrent obesity, insulin resistance and metabolic dysfunction‐associated steatotic liver disease (MASLD) without a history of pancreatitis. From March 2019 to September 2021, 31 adult subjects with concurrent obesity and MASLD were recruited as part of the study investigating the biological impact of bariatric surgery and lifestyle modification on obesity. Chemical shift encoded MRI of the abdomen, LiverMultiScan, anthropometric, clinical and blood biochemistry analyses were performed prior to any intervention at baseline. GGT (p <.001) was significantly different between those ‘with fatty pancreas’ and ‘without fatty pancreas’ groups. GGT (p <.001) was significantly different between those ‘with both metabolic syndrome and fatty pancreas’ and those ‘with metabolic syndrome but without fatty pancreas.’ GGT (p <.001) was also significantly different between those ‘with both diabetes and fatty pancreas’ and those ‘with diabetes but without fatty pancreas’. Logistic regression analysis showed that abnormal GGT levels (p = .010) and Hypertension (p = .045) were significant independent predictors of fatty pancreas. GGT was associated with fatty pancreas by an odds ratio 7.333 (95% [CI]: 1.467–36.664), while the AUROC of GGT in determining fatty pancreas was 0.849. Elevation in serum GGT might be a potential marker to identify fatty pancreas. [ABSTRACT FROM AUTHOR]

"True" cobras (genus Naja) are among the venomous snakes most frequently involved in snakebite accidents in Africa and Asia. The Cape cobra (Naja nivea) is one of the African cobras of highest medical importance, but much remains to be learned about its venom. Here, we used a shotgun proteomics approach to better understand the qualitative composition of N. nivea venom and tested its cytotoxicity and protease activity as well as its effect on intracellular Ca2+ release and NO synthesis. We identified 156 venom components representing 17 protein families, with the dominant ones being three-finger toxins, mostly of the short-chain type. Two-thirds of the three-finger toxin entries identified were assigned as cytotoxins, while the remainder were categorized as neurotoxins, including short-chain, long-chain, and ancestral three-finger toxins. We also identified snake venom metalloproteinases and members of CRISP, l-amino acid oxidase, and other families. Protease activity and its effect on intracellular Ca2+ release and NO synthesis were low. Phospholipase A2 activity was surprisingly high, despite this toxin family being marginally recovered in the analyzed venom. Cytotoxicity was relevant only at higher venom concentrations, with macrophage and neuroblastoma cell lines showing the lowest viability. These results are in line with the predominantly neurotoxic envenomation symptoms caused by Cape cobra bites. The present overview of the qualitatively complex and functionally intriguing venom of N. nivea may provide insights into the pathobiochemistry of this species' venom. [ABSTRACT FROM AUTHOR]

AbstractThe cultivation of tilapias, the third most farmed fish group globally, has been rapidly growing, especially in Southeast Asia. This surge in tilapia farming intensification has led to increased use of antibiotics to control bacterial diseases. This study investigated the safety implications of administering graded doses of enrofloxacin (ENF) at 0 (control), 10, 30, 50 and 100 mg/kg biomass/day orally to Oreochromis niloticus. The 43-day study comprised 7 days of pre-dosing, 15 days of ENF-dosing, and a 21-day recovery period with a periodical assessment of the biological responses of fish. The results revealed that the overdosed groups experienced up to 21% reduction in feed consumption, 11% mortalities, and adverse impacts on hematology, including a decrease in erythrocytes, and monocytes and an increase in leukocytes, thrombocytes, lymphocytes, and neutrophils. Haematological indices like mean corpuscular volume and mean corpuscular hemoglobin decreased, while mean corpuscular hemoglobin concentration increased. The plasma biochemical parameters including glucose and liver and kidney enzymes unveiled a significant dose- and time-dependent increase, while calcium and chloride levels decreased. Erythrocytes displayed several erythrocyte cellular and nuclear abnormalities. The frequency of micronucleus increased with dose and time, suggesting potential genotoxicity of ENF. Additionally, a dose-dependent increase in residues in the tissues with the highest accumulation in muscle was documented. Nevertheless, the recovery of the measured parameters upon dose termination indicated that the ENF-induced alterations are reversible. The study affirmed the safety of ENF at the recommended dose (10 mg) in O. niloticus and their adoptive responses to higher doses. [ABSTRACT FROM AUTHOR]

Background: Myxomatous mitral valve degeneration (MMVD) is a prevalent canine heart condition often accompanied by pulmonary hypertension (PH). Echocardiography is a valuable diagnostic tool for MMVD, but its accessibility is limited in small veterinary clinics. Aim: This study aimed to identify clinical parameters and biochemistry and cardiac biomarkers as prognostic indicators for cardiac mortality in MMVD dogs with and without PH. Animals: Ninety-nine MMVD dogs and nineteen normal dogs. Methods: In a five-year longitudinal study, data including clinical and laboratory measurements as well as echocardiographic parameters were collected every 6 months. Dogs were monitored until death or loss to follow-up, and the cause of death was determined when possible. Statistical analysis was performed to identify factors that predicted death. Results: Alterations in body condition score, total protein, fractional shortening percentage, and mean corpuscular volume were predictive of impending cardiac mortality. High blood urea nitrogen-to-creatinine ratio, heart rate, and low hemoglobin levels were associated with an increased risk of death. N-terminal pro-B-type natriuretic peptide was also a significant predictor of cardiac-related mortality, with higher levels indicating increased risk. Moreover, MMVD dogs with PH had a significantly lower survival rate than those with MMVD without PH. However, no significant difference in survival was observed between MMVD stage C and D with PH and MMVD stage C and D without PH groups. Conclusion: These findings provide valuable insights into the monitoring of MMVD progression in dogs using clinical parameters and biomarkers, especially when echocardiography cannot be performed. [ABSTRACT FROM AUTHOR]

Pseudothrombocytopenia (PTCP) is defined by the occurence of spouriously low platelet count as a consequence of in vitro platelet aggregation. It is a rare and benign artifact, not associated with any specific disorder or therapy, that becomes clinically relevant when it is not timely and reliably recognized. Thus, it may result in inappropriate clinical decisions (i.e. unnecessary further testing, misdiagnoses and potential patients' mismanagement) unavoidably compromising patient safety. The most common form of PTCP is caused by ethylenediaminetetraacetic acid (EDTA). Several approaches for the management of samples with EDTA-induced PTCP have been described in the literature. However, expert recommendations are scarce. The scope of these recommendations is to assist in achieving national harmonisation in laboratory management (i.e. detecting and reporting platelet counts) of samples with EDTA-induced PTCP. These minimal recommendations were prepared by the members of the joint working group of the Croatian Chamber of Medical Biochemists and Working group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, and might be customized according to specific conditions (i.e. personnel and equipment) of each individual laboratory. These recommendations are primarily intended to all laboratory professionals involved in the management of samples with EDTA-induced PTCP, but also to other healthcare professionals involved in collecting samples and interpreting complete blood count results. [ABSTRACT FROM AUTHOR]

The translation of discoveries on extracellular vesicle (EV) based cancer biomarkers to personalised precision oncology requires the development of robust, sensitive and specific assays that are amenable to adoption in the clinical laboratory. Whilst a variety of elegant approaches for EV liquid biopsy have been developed, most of them remain as research prototypes due to the requirement of a high level of microfabrication and/or sophisticated instruments. Hence, this study is set to develop a simple DNA aptamer‐enabled and fluorescence polarisation‐based homogenous assay that eliminates the need to separate unbound detection ligands from the bound species for EV detection. High specificity is achieved by immobilising EVs with one set of antibodies and subsequently detecting them with a DNA aptamer targeting a distinct EV biomarker. This two‐pronged strategy ensures the removal of most, if not all, non‐EV substances in the input biofluids, including soluble proteins, protein aggregates or non‐vesicular particles, prior to quantifying biomarker‐positive EVs. A limit of detection of 5.0 × 106 EVs/mL was achieved with a linear quantification range of 5.0 × 108 to 2.0 × 1010 EVs/mL. Facilitated by a multiple parametric analysis strategy, this aptamer‐guided fluorescence polarisation assay was capable of distinguishing EVs from three different types of solid cancer cells based on quantitative differences in the levels of the same sets of biomarkers on EVs. Given the simplicity of the method and its ease of implementation in automated clinical biochemistry analysers, this assay could be exploited for future EV‐based continuous and real‐time monitoring of the emergence of new macro‐ or micro‐metastasis, cancer progression as well as the response to treatment throughout different stages of cancer management in the clinic. [ABSTRACT FROM AUTHOR]

Background: In our study, we aimed to compare the Friedewald, Martin/Hopkins, and Sampson formulae with direct LDL-cholesterol (d-LDL-C) measurement. Methods: The study was a retrospective investigation by the Department of Medical Biochemistry of the Ankara Training and Research Hospital between January 1, 2021, and December 31, 2022. Our study evaluated the results of 6297 patients aged 18–95 years who underwent cholesterol panel TC, TG, HDL-C, and direct LDL-C in our laboratory. The estimated LDL-C was calculated according to Friedewald, Martin/Hopkins, and Sampson formulae. Results: All three formulae showed a stronger positive correlation with d-LDL-C (0.905, 0.897, and 0.886, respectively, for all data, p<0.001). In addition, when we compared the total median difference (1st–3rd quartile) of all formulae, it was -0.69 (-1.62 to 0.39) for Friedewald, 0.034 (-0.74 to 1.14) for Martin/Hopkins and -0.40 (-1.19 to 0.55) for Sampson. According to Passing Bablok regression analyses, the intercept was determined as -0.97 (95% CI=-1.01 to -0.93), 0.41 (95%=0.37 to 0.44) and -0.05 (-0.08 to -0. 03) and slopes were calculated as 1.083 (95% CI=1.07–1.09), 0.88 (0.88 to 0.89) and 0. 90 (95%=0.89 to 0.90) for Friedewald, Martin/Hopkins and Sampson, respectively. Conclusions: Our findings suggest that the Martin/Hopkins formula performed better than the Friedewald and Sampson formulas. We figured out utilizing the Martin/ Hopkins formula as a good alternative for estimated LDL-C in Turkish adults. [ABSTRACT FROM AUTHOR]

Harmonization of the laboratory total testing process (TTP) is critical to improving patient outcome. In 2016, an EFLM survey on the harmonization of TTP underlined the serious shortcomings pertaining to the post-analytical phase. In 2023, the WG-H conducted a new survey aiming to update information in the 2016 harmonization report in order to ascertain whether countries that had declared they were keen to adopt SI units had continued with this program, the aim being to verify the state-of art in harmonization units in areas of laboratory medicine not included in the previous survey. Questionnaires were distributed to the Presidents and National Representatives of EFLM Full Member Societies and EFLM affiliate Members. The survey questions were grouped into three categories: measurement units, reference intervals, and nomenclature/terminology, and results were evaluated using Survey Monkey software and Excel. A total of 123 questionnaires from 31 countries were analyzed. A trend (+19.3 %) was observed toward a wider use of SI units for general clinical biochemistry parameters. The results for tests not included in the 2016 survey (i.e., endocrinology diagnostics and coagulation panels), demonstrated that for reports on hormones, responses were satisfactory, 70–90 % of the responders adopting the recommended units, whereas for coagulation test panels, a serious lack of harmonization was found, "seconds", which are inaccurate and not recommended, being widely used units (91 %). The findings made in the 2023 survey demonstrated a progressive, albeit slow, improvement in harmonization reports. However, further efforts at improvement are mandatory. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a common autoimmune disease marked by the formation of apoptotic debris and the presence of autoantibodies that target nuclear components. At this moment, the actual cause of SLE is uncertain. Genetic variables have been well proven to have a significant role in the propensity of SLE. This study aimed to investigate the effect of (ZNF76) rs (10947540) and (SCUBE) rs (1888822) gene polymorphism in patients with systemic lupus erythematosus. A case control study has been carried out at Medical Biochemistry & Molecular biology and Rheumatology unit of Internal Medicine Departments, Faculty of Medicine, Menoufia University, Egypt, for 1-year duration between 1 June 2022 and 1 June 2023. Sixty patients were females (75%) and twenty patients were males (25%). Their ages ranged from 19 to 53 years. Their disease durations ranged from 7 months to 20 years. The findings indicated that the TC genotype of the ZNF76 rs10947540 gene increases the risk of SLE by 2.274-fold, while the dominant TC + CC increases the risk by 2.472-fold, and the C allele increases the risk by 2.115-fold. Additionally, the results showed that the TT genotype of the SCUBE3 rs1888822 gene increases the risk of SLE by 3.702-fold, the dominant GT + TT increases the risk by 2.304-fold, and the T allele increases the risk by 2.089-fold, while the GT genotype increases the risk by 1.918-fold. The study revealed significant associations between the genotypes of these polymorphisms and certain clinical parameters in SLE patients. These findings highlight the potential genetic contributions to SLE susceptibility and its clinical manifestations, providing valuable insights for future research and potential personalized approaches to the management of this complex autoimmune disease. [ABSTRACT FROM AUTHOR]

Gastroesophageal reflux disease (GERD) represents one of the most prevalent foregut illnesses, affecting a large portion of individuals worldwide. Recent research has shown that inflammatory mediators such as cytokines, chemokines, and enzymes are crucial for causing esophageal mucosa alterations in GERD patients. It seems likely that the expression of various cytokines in the esophageal mucosa also induces oxidative stress by increasing the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS). As humoral agents and peptidergic neurotransmitters that may support the enterogastric axis, bombesin and its related bombesin-like peptide, GRP (gastrin releasing peptide), have not been fully investigated. Therefore, considering all these assumptions, this study aimed to evaluate the influence of bombesin in reestablishing biochemical markers linked with inflammation and oxidative/nitrosative stress in GERD pathological settings. C57BL/6 mice were alternatively overfed and fasted for 56 days to induce GERD and then treated with bombesin (0.1, 0.5, and 1 mg/kg intraperitoneally) once daily for 7 days, and omeprazole was used as the positive control. After 7 days of treatment, gastric pain and inflammatory markers were evaluated. Abdominal pain was significantly reduced following bombesin administration, which was also successful in diminishing inflammatory and oxidative/nitrosative stress markers in a manner overlapping with omeprazole. Moreover, bombesin was also able to appreciably modulate gastric pH as a result of the restoration of gastric homeostasis. Overall, these observations indicated that the upregulation of bombesin and interconnected peptides is a promising alternative approach to treat GERD patients. [ABSTRACT FROM AUTHOR]

Miranda’s donkey is an autochthonous asinine breed from northern Portugal classified as endangered by the Food and Agriculture Organization. Research on Miranda’s donkey in several scientific areas is important to standardize the breed and to assist the breed’s preservation. Reference values in clinical pathology are used to determine the health status of individuals and herds, and to control the evolution of diseases and their response to therapy. This review summarized the studies performed on Miranda’s donkey and evaluated the state of the art concerning studies performed in the clinical pathology field. Thirty-seven publications on Miranda’s donkey published between 2000-2023 in various scientific areas were found. In conclusion, research on Miranda’s donkey is scarce, and further studies are needed, especially in hematology and clinical biochemistry areas with respect to physiological and pathological changes that affect the breed, thus helping its conservation. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) exhibits variations in terms of patients’ clinical symptoms and levels of routinely employed biochemical markers. The aim of the current study was to determine the correlation between serum levels of the C-X-C chemokine ligand type 12 (CXCL12) and C-X-C chemokine receptor type 4 (CXCR4), one of its specific receptors, and disease severity in COVID-19 patients.

Background : Errors in pre analytical phase have a profound effect on test results.This study was taken up to recognize various preanalytical errors in Clinical Biochemistry Lab of a tertiary hospital, Anantapur. Methods : This was a retrospective study conducted in Clinical Biochemistry Lab of Government General Hospital, Anantapur. Data from the sample rejection register & requisition forms sent by the clinicians was evaluated for a period of 6 months from January 2024 to June 2024. Various errors in pre analytical phase were noted & the percentage of occurrence of each error was calculated. Results : The data obtained showed the following errors as percentage of total pre analytical errors. Improper labeling of the samples : 69%, insufficient quantity of sample 22%, hemolysis : 3%, delayed transport : 2.5%,wrong container 0.7%, clotted sample 1.5%, lipemic sample : 0.7% Conclusion : The study revealed burden of preanalytical errors and the necessity to focus on reducing the same as they have significant impact on test reports. [ABSTRACT FROM AUTHOR]

The teaching objectives of traditional approaches in higher education emphasize mostly students' mastery of knowledge and have insufficient directionality to social needs. In this study, we developed a BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory Learning, Post-assessment and Summary) teaching model combined with the OBE (Outcome Based Education) concept to enhance the teaching outcomes. Firstly, based on the graduation requirements and professional training objectives of students, we divided the course objectives into three dimensions (knowledge, ability and quality), and further specified into index points. Then, the teaching content of each chapter was set to correspond with the index points. Finally, the BOPPPS teaching model was used to meet each requirement. Clinical biochemistry testing course was used as a model to assess the effects of the teaching reform. After the class, the teaching effect was analyzed based on the questionnaire surveys from the students and their scores of both the chapter and final examinations. The results showed that compared with the traditional approach, the BOPPPS teaching model combined with the OBE concept has demonstrated a notable enhancement in student engagement, and significant improvement of their mastery of knowledge, application skills, and problem-solving abilities. The examination scores of the BOPPPS group were markedly higher than those of the traditional group. Moreover, the difference between the two groups diverse assessment scores was much bigger than that between the two group examination scores. Our study indicates that the BOPPPS teaching model combined with the OBE concept is a highly effective teaching model for enhancing the learning effectiveness of students. [ABSTRACT FROM AUTHOR]

Background: One method used selectively in medical education institutions is the Flipped Classroom Model. According to this paradigm, students receive their first material education at home by completing tasks instead of the typical, boring teacher-centric lectures. (minimum 48-72 h before the session), and spend class time in interactive sessions and group activities. Aim and Objectives: The objectives of the study were to introduce Flip classroom teaching in the subject of biochemistry, compare teaching-learning with the flip classroom method and interactive lecturing in biochemistry for 1st-year MBBS students, and assess the acceptability and feasibility of this method among undergraduates and faculty members. Materials and Methods: A cross-sectional interventional study was carried out and department faculties were introduced to this method. One hundred students of 1st-year MBBS class were included in the study. There were two Groups, A and B, each with 50 students. For Topic I, Group A was taught by the flip classroom method and Group B was taught by the interactive Lecture method. For Topic II, Group A will be taught by the interactive Lecture method while Group B will be taught by the flip classroom method. Pre- and post-tests were conducted for both sessions. Feedback was taken as questionnaires from the students and faculties at the end of the sessions. Results: We found statistically significant differences among both methods from feedback received from the students. Feedback received from the faculties was very positive. The average Likert score was above four in almost all questionnaires. Conclusion: Our research indicates that interactive lectures are not as effective as the flipped classroom approach for teaching and learning. Due to providing material ahead of the lecture, students are more interactive in flipped classrooms and perform well in post-session examinations. [ABSTRACT FROM AUTHOR]

A recent proof-of-concept pilot clinical study has demonstrated that consumption of CL18100F4, a proprietary herbal blend of Withania somnifera root and Abelmoschus esculentus fruit extracts, significantly relieved the participants from functional constipation and improved their quality of life. The objective of the present randomized, double-blind, placebo-controlled study was to reevaluate the efficacy and tolerability of CL18100F4 in a larger number of subjects. Male and female subjects (n = 135; age: 25–60 years), selected through Rome-IV criteria for functional constipation, were randomized into placebo and 300 or 500 mg of CL18100F4 groups and supplemented daily over 60 consecutive days. The primary efficacy outcome measure was Patient Assessment of Constipation-Symptoms (PAC-SYM), evaluated at baseline and on days 7, 30, and 60 of supplementation. The secondary efficacy parameters included Patient Assessment of Constipation-Quality of Life (PAC-QOL), Gastrointestinal Symptom Rating Scale (GSRS) scores, Gastrointestinal Transit Time (GIT), and Complete Spontaneous Bowel Movement (CSBM). Serum levels of Interleukin (IL)-6, IL-10, cortisol, gastrin, serotonin, Diamine oxidase (DAO), and Zonulin were measured. CL18100F4 supplementation significantly (p < 0.001) reduced the PAC-SYM, PAC-QOL, GSRS scores, and GIT and improved CSBM scores. CL18100F4 significantly improved (p < 0.001) sleep quality and decreased depression and anxiety symptoms in the participants. Notably, relief in constipation symptoms and improved gastrointestinal (GI) function were reported starting from day 7. Furthermore, CL18100F4 supplementation significantly (p < 0.001) increased the serum levels of IL-10, DAO, serotonin, gastrin, reduced IL-6, cortisol, and Zonulin. No major adverse events were observed. Participants' vital signs, hematology, clinical biochemistry, and urinalysis parameters were within the normal ranges. The present investigation demonstrates that CL18100F4 is tolerable and efficacious in relieving functional constipation, alleviating GI dysfunction, and improving associated non-GI factors in male and female adults. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Routine clinical biochemistry tests are crucial for clinical diagnostics and play a key role in enhancing outpatient turnover efficiency and patient satisfaction. This study aimed to implement Lean Six Sigma in the biochemistry laboratory of a hospital in China to improve efficiency and quality by reducing turnaround time.The study was conducted from January to December 2023, using the DMAIC (Define, Measure, Analyze, Improve, Control) framework, and employed tools such as the voice of the customer, Value Stream Mapping, ‘5 whys’ technique, Nominal Group Technique, and Pareto chart.The turnaround time for outpatient routine clinical biochemistry tests was reduced from 139 min to 58 min (p < 0.05), effectively increasing both patient and physician satisfaction.Lean Six Sigma aimed to reduce the turnaround time for biochemical tests have significant advantages. This study confirms the effectiveness of Lean Six Sigma in a Chinese clinical laboratory setting and provides guidance for optimizing efficiency in global clinical laboratories with limited implementation experience, constrained technical and equipment resources, and high demand for medical diagnostics. [ABSTRACT FROM AUTHOR]

This article discusses the potential use of microRNA-138 (miR-138) as a diagnostic tool for breast cancer. The study found that breast cancer patients had higher levels of miR-138 expression compared to healthy controls, and high miR-138 expression was associated with better overall survival. Additionally, miR-138 expression was inversely correlated with tumor markers CEA and CA15.3. The study also analyzed various factors and biomarkers in breast cancer patients and found that certain factors, including metastasis status and high levels of CEA and CA15.3, were associated with poor prognosis and increased risk of relapse. Further research is needed to confirm these findings and explore their clinical implications. [Extracted from the article]

The need to create safe materials for biomedical and pharmaceutical applications has become a significant driving force for the development of new systems. Therefore, a chitosan-coated copolymer of itaconic acid, acrylic acid, and N-vinyl caprolactam (IT-AA-NVC) was prepared by radical polymerization and subsequent coating via nanoprecipitation to give a system capable of sustained delivery of melatonin. Although melatonin brings undoubted benefits to the human body, aspects of the optimal dose, route, and time of administration for the obtaining of suitable treatment outcomes remain under discussion. The entrapment of melatonin in biocompatible polymeric systems can prevent its oxidation, decrease its toxicity, and provide an increased half-life, resulting in an enhanced pharmacokinetic profile with improved patient compliance. The structures of the biopolymer and conjugate were proven by FTIR, thermal properties were tested by DSC, and the morphologies were followed by SEM. The loading efficiency and in vitro release profile were studied by means of HPLC, and a delayed release profile with an initial burst was obtained. The potential systemic toxicity of the formulation was studied in vivo; a mild hepatotoxicity was observed following administration of the melatonin-loaded formulation to mice, both by histopathology and blood clinical biochemistry. Histopathology showed a mild nephrotoxicity as well; however, kidney clinical biochemistry did not support this. [ABSTRACT FROM AUTHOR]

Objective: Thyroid function tests are common biochemical analyses, and agreement between the routinely used immunoassays is important for diagnosis and monitoring of thyroid disease. Efforts are continuously made to align the biochemical assays, and we aimed to evaluate the agreement between immunoassays used in a clinical laboratory setting among non‐pregnant and pregnant adults. Design: Cross‐sectional study. Participants: Serum samples were obtained from 192 blood donors (non‐pregnant adults) and from 86 pregnant women in the North Denmark Region with no known thyroid disease. Measurements: Each sample was used for measurement of thyroid‐stimulating hormone (TSH) with the routinely used automatic immunoassays in the regional Departments of Clinical Biochemistry (Alinity, Abbott Laboratories, Cobas, Roche Diagnostics, and Atellica, Siemens Healthineers) and reported as the median with 95% confidence interval (95% CI). Results: In nonpregnant adults, the level of TSH was higher with Cobas and Atellica than with Alinity as reflected by median (Alinity: 1.39 mIU/L (95% CI: 1.30–1.51 mIU/L); Cobas: 1.57 mIU/L (95% CI: 1.48–1.75 mIU/L); Atellica: 1.74 mIU/L (95% CI: 1.61–1.83 mIU/L)). Similarly, a trend was seen towards higher median TSH with Cobas than with Alinity among pregnant women (Alinity: 1.90 mIU/L (95% CI: 1.37–2.82 mIU/L); Cobas: 2.33 mIU/L (95% CI: 1.69–3.62 mIU/L)). Conclusion: Results of thyroid function tests obtained with different immunoassays were not interchangeable when evaluated among pregnant and non‐pregnant adults. The distinct differences are relevant for clinical decision making and emphasize the necessity of clinical laboratory information when different assays are used for diagnosis and monitoring of patients with thyroid disease. [ABSTRACT FROM AUTHOR]

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An integrated and projected‐based laboratory course was described, integrating interconnected knowledge points and biochemistry and molecular biology techniques on a research project‐based system. The program, which served as an essential extension of theoretical courses to practice, was conducted with a sophomore of basic medical science who had completed the course in medical biochemistry and molecular biology. This course engaged students in learning "genetic manipulation" and "recombinant DNA technology" to understand the target gene's role in disease mechanics, thus altering evaluation and treatment for clinical disease. Students could master applied and advanced techniques, such as cell culture, transfection, inducing exogenous fusion protein expression, purifying protein and its concentration assay, quantitative polymerase chain reaction, and western bot analysis. This laboratory exercise links laboratory practices with the methods of current basic research. Students need to complete the experimental design report and laboratory report, which could be advantageous for improving their ability to write lab summaries and scientific papers in the future. The reliability and validity analyses were conducted on the questionnaire, and we examined students' satisfaction with the course and their gains from the course. The student feedback was generally positive, indicating that the exercise helped consolidate theoretical knowledge, increase scientific research enthusiasm, and provide a powerful tool to be a better person and make informed decisions. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a recessive inherited disorder caused by genetic mutations in the CF transmembrane conductance regulator (CFTR) gene. It is a multisystem condition that primarily induces abnormal mucus accumulation in the respiratory system and obstructs the intrapancreatic common bile duct, causing a reduction in the delivery of digestive enzymes to the small intestine. Thus, patients with CF are characterized by maldigestion, malabsorption, and recurrent airway bacterial infections. Clinical monitoring of the health status of patients with CF is mandatory for increasing the patients’ lifespan. To assess the feasibility of monitoring life quality (LQ) in pediatric patients with cystic fibrosis (CF) and to explore the relationship between biochemical parameters and clinical symptoms, our study analyzed inflammatory responses related to CF, medication, and pulmonary bacterial infections in 52 patients diagnosed with CF. Blood, hypo-pharyngeal exudate, and fecal samples were analyzed using clinical biochemistry, hematology, and microbiology techniques at the Alessandrescu-Rusescu National Institute for Mother and Child Health central laboratory in Bucharest, Romania. All the participants adhered to their prescribed outpatient CF regimens and appeared clinically stable. The overall clinical status of patients with CF was observed and compared with that of a healthy control group, which consisted of individuals similar in number and age. The screened patients with CF presented an impaired lipid status and chronic infections with various bacteria, iron, and vitamin (A, D, and E) deficiencies. Our findings provide insights into the pathophysiological mechanisms of CF and suggest that tailored monitoring and personalized therapeutic strategies could improve patient management. [ABSTRACT FROM AUTHOR]

p-Cymene, is a monocyclic monoterpene hydrocarbon, commonly used as a flavoring agent in food. A 90-day repeated oral toxicological study of p-cymene was conducted to examine the toxicological properties and determine the no-observed-adverse-effect level (NOAEL) of p-cymene in Crl:CD (SD) rats at the following doses: 0 (corn oil), 2.4, 12, and 60 mg/kg/day. No mortality or abnormal clinical signs were observed in the treatment groups. The body weight, food consumption, ophthalmoscopy, and gross pathology of the rats were also not affected by p-cymene treatment. However, in the 60 mg/kg group, certain parameters decreased in males, including hemoglobin and hematocrit, red blood cell count, triglyceride, total protein, and albumin. In females, urine volume and total potassium excretion increased, whereas specific gravity, and sodium, potassium, and chlorine concentrations decreased. Increased liver weight was observed in both males and females. Histopathological observations revealed centrilobular hepatocellular hypertrophy. In the 12 mg/kg group, no adverse effects of p-cymene treatment were observed in both sexes. In conclusion, the NOAEL of p-cymene was 12 mg/kg/day for both sexes under the present experimental conditions, considering the alterations in urinalysis, hematology, clinical biochemistry, and histopathology. [ABSTRACT FROM AUTHOR]

Background: the poor adherence to guidelines approved by scientific societies are widely described as a possible cause of criticisms in the management of several diseases. In the setting of dyslipidemia, a lack of compliance with clinical and biochemical recommendations defining the informations that should be included in the laboratory report, could be a relevant issue. Methods: in order to verify the state-of-the art of this specific topic, a survey containing 8 questions spanning from the pre-analitycal phase (panel of tests, nonfasting testing), to analytical (types of methods and equations) and to post-analytical phase (reference interval, desirable values, therapeutic goals) was sent to the laboratory professionals registered in the Italian Society of Clinical Biochemistry and Molecular Biology (SIBioC). Results: the most interesting results demonstrate that: about 40% of the laboratories add to the traditional lipid panels (total, LDL and HDL cholesterol, tryglicerides) the recommended measurement of apolipoproteins (Apo-A1, Apo-B and Lpa); 89% adopt the fasting testing; 73.6% use direct methods to measure HDL-C and 29% calculate LDL-C using Friedewald equation; 87.3% of the values are reported using the traditional (mg/dL) units; 64.5% use the reference interval as comparator, inadequate for the most part of lipid tests, 51.4% desirable levels, only 5.61% the recommended therapeutic goals. Discussion: on the basis of the obtained data, a shared improvement in the adoption and application of the recommendations published by SIBioC but poorly adopted until now, seems to be a fundamental activity that should be undertaken in the near future. [ABSTRACT FROM AUTHOR]

Introduction: Hyponatraemia is the most common electrolyte disorder in inpatients resulting mainly from an imbalance in water homeostasis. Intravascular fluid status assessment is pivotal but is often challenging given multimorbidity, polypharmacy and diuretics use. We evaluated the utility of point‐of‐care ultrasound (POCUS) as an adjunct tool to standard practice for fluid assessment in severe hyponatraemia patients. Methods: Patients presenting with severe hyponatremia (Serum Sodium [Na] < 120 mmol/L; Normal range: 135−145 mol/L), managed by standard care were included. Hyponatraemia biochemistry work‐up and POCUS examination were undertaken. Both clinician and POCUS independently assigned one of the three fluid status groups of hypovolaemia, hypervolaemia or euvolaemia. The final diagnosis of three fluid status groups at admission was made at the time of discharge by retrospective case review. Clinician's (standard of care) and POCUS fluid assessments were compared to that of the final diagnosis at the time of discharge. Results: n = 19 patients were included. Median Na on admission was 113 mmol/L (109‐116), improved to 129 ± 3 mmol/L on discharge. POCUS showed the higher degree of agreement with the final diagnosis (84%; n = 16/19), followed by the clinician (63%; n = 12/19). A trend towards higher accuracy of POCUS compared to clinician assessment of fluid status was noted (84% vs. 63%, p = 0.1611). Biochemistry was unreliable in 58% (n = 11/19) likely due to renal failure, polypharmacy or diuretic use. Inappropriate emergency fluid management was undertaken in 37% (n = 7/19) of cases based on initial clinician assessment. Thirst symptom correlated to hypovolaemia in 80% (4/5) cases. Conclusion: As subjective clinical and biochemistry assessments of fluid status are often unreliable due to co‐morbidities and concurrent use of medications, POCUS can be a rapid objective diagnostic tool to assess fluid status in patients with severe hyponatraemia, to guide accurate emergency fluid management. [ABSTRACT FROM AUTHOR]

Background: The application of the Six Sigma (σ) metric in biochemical laboratories is a powerful tool for reducing the occurrence of errors and prioritizing important improvements in laboratory quality control. The National Accreditation Board for Testing and Calibration Laboratories (NABL) is an accreditation body with an accreditation system established in accordance with ISO/IEC 17011, providing specialty- or scope-based certification based on the conformance of quality indices to medical laboratories. In this context, a study has been designed that considers the quality guidelines set by NABL as well as the sigma metric rule in the assessment of analytical performance. Aims and Objectives: The aims of this study were to identify the gaps and need for strategy modification for quality improvement by assessing the performance of two NABL-accredited medical testing laboratories on a Sigma metric scale. Materials and Methods: A retrospective analytical study was conducted over 6 months (January-June 2021). Internal quality control (IQC) and EQAS data were obtained from third-party QC providers (Bio-Rad, India) and analyzed by calculating sigma (σ) values based on the coefficient of variation, bias, and total error allowable in two NABL-accredited medical testing laboratories. To identify potential problems for analytes with poor sigma values, a quality goal index (QGI) analysis was performed. Results: By analyzing the sigma values obtained by both NABL-accredited laboratories, we can see that laboratory 2 performed better than laboratory 1. After calculating the QGI, there was a problem of inaccuracy and imprecision in laboratory 1, and laboratory 2 had QGI values that indicated only imprecision. Conclusion: Diagnostic laboratories should incorporate Six Sigma metrics to identify gaps in their performance to ensure better quality control and patient safety. [ABSTRACT FROM AUTHOR]

Abstract Albumin, a key protein in human blood plasma, has been linked to various health conditions. However, its association with malaria, particularly in assessing disease severity, remains inadequately understood. This comprehensive systematic review and meta-analysis aimed to elucidate the relationship between albumin levels and malaria severity. A comprehensive literature search was conducted across multiple databases, including Embase, Scopus, PubMed, MEDLINE, Ovid, and Google Scholar, to identify studies examining albumin levels in malaria patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were pooled using a random-effects model, and heterogeneity was assessed using I 2 statistics. Subgroup and meta-regression analyses were performed based on publication year, study location, and Plasmodium species. A total of 37 studies were included in this review. The thematic synthesis indicated that albumin levels in malaria patients varied significantly based on geographical location. A meta-analysis of 28 studies found that albumin levels were significantly lower in malaria patients compared with non-malarial controls (P

Margit Kriegbaum,1 Bent Struer Lind,2 Mia Klinten Grand,1 Christen Lykkegaard Andersen1,3 1The Copenhagen Primary Care Laboratory (CopLab) Database, Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 2Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; 3Department of Haematology, University Hospital Copenhagen, Rigshospitalet, Copenhagen, DenmarkCorrespondence: Margit Kriegbaum, Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 København K, Denmark, Tel +45 35337326, Fax +45 35327629, Email makr@sund.ku.dkBackground: The Copenhagen General Practice Laboratory (CGPL) was founded in 1922 to provide paraclinical analyses to the primary health-care sector in Copenhagen. At the end of 2015, CGPL was closed and the CopLab database was established to make CGPL data available for research.Methods: We isolated tests performed at the CGPL with clinically relevant test results. The database was linked to national registers containing health, social, and demographic information. Results are presented with descriptive statistics showing counts, percentages, medians, and interquartile ranges (IQR).Results: The CopLab database includes 1,373,643 unique individuals from primary care with test results from laboratory analyses of blood/urine/semen as well as cardiac and lung function tests collected by CGPL from greater Copenhagen from 2000 to 2015. The CopLab database holds nearly all test results requested by general practitioners throughout years 2000 to 2015 for residents in the greater Copenhagen area. The median age of the individuals was 51 years and 59.7% were females. Each individual has a median of 4 requisitions. More than 1 million participants are currently alive and living in Denmark and may be followed in national registries such as the Danish National Patient Registry, Laboratory Database, National Prescription Database etc.Keywords: laboratory database, population-based cohort, register studies, clinical biochemistry, epidemiology

The application of artificial intelligence (AI) in the analysis of molecular biology data is becoming increasingly widespread. The Western Blot (WB) technique, a cornerstone in proteomic research, facilitates the identification and analysis of proteins, such as the frameshift mutant of ubiquitin B (UBB+1). In our study, we attempted to assess the potential of four different AI models—Gemini, Gemini Advanced, Microsoft Copilot, and ChatGPT 4—in the analysis of WB imagery containing UBB+1, derived from peripheral blood studies of patients suffering from schizophrenia. Participants, all male and diagnosed with schizophrenia, were recruited from the Specialist Psychiatric Care Team of Babinski Hospital in Lodz. After obtaining their informed consent, blood samples were collected and transported to the laboratory of the Department of Medical Biochemistry at the Medical University of Lodz. The samples were processed, synthesis of Ub-48UBB+1 dimers was performed, and the WB technique was applied. The result of the WB analysis, in the form of a photograph with basic labels but without a legend (JPG format), was implemented into ChatGPT 4, Microsoft Copilot, Gemini and Gemini Advanced. Following the implementation of the image, the command 'Could you analyze the attached photo?' was added, along with the protocol from Sample Preparation and Synthesis of Ub-48UBB+1 Dimers. The AI models effectively analyzed and interpreted WB images, with variations in their approaches and depth. Gemini excelled in detailing the WB process and biological significance of bands, while Gemini Advanced focused on specific band identification, especially Ub-48UBB+1 dimers. Microsoft Copilot provided a basic overview with less technicality, and ChatGPT 4 offered comprehensive band interpretations, linking them to patient samples and standards, thus confirming the hypothesis about the differing capabilities of these models. This discovery demonstrates the advanced capabilities of ChatGPT 4 and highlights the growing role of AI in scientific research, including the interpretation of results. [ABSTRACT FROM AUTHOR]

Background: Lipoprotein(a) (Lp(a)) is now established as a causal risk factor for cardiovascular disease (CVD) and accurate laboratory measurement is of pivotal importance in reducing Lp(a) associated risk. The consensus statement by HEART UK in 2019 included recommendations to improve standardisation of clinical laboratory measurement and reporting of Lp(a). Methods: A 16 question, electronic audit survey was circulated to 190 accredited clinical biochemistry laboratories to assess the adoption of these recommendations in the UK. Results: Responses were received from 65 of 190 laboratories (34%). Only 5 (8%) did not offer Lp(a) measurement. Of those providing the test, 23% (n = 14) offered an in-house service (IHS), the remaining laboratories (77%; n = 46) used an external referral service (ERS). The majority (10 of 14 or 71%) of IHS laboratories responded with details of their method, stating whether it minimised sensitivity to the effect of Lp(a) isoform size and used calibrators certified for traceability to the WHO/IFCC reference material, however, only a minority ERS laboratories (13 of the 46 or 28%) were able to specify the method used by their referral laboratory. Of the laboratories who specified their reporting units, 6 of 10 IHS and 7 of 23 ERS laboratories reported in nmol/L. Among the 60 laboratories who responded, the HEART UK recommendations appear to have been adopted in full by only 3 IHS laboratories. Conclusions: Further efforts are needed to standardise the measurement and reporting of Lp(a) so that results and interpretation are comparable across clinical biochemistry laboratories in the UK. [ABSTRACT FROM AUTHOR]

Positron emission tomography (PET) and computed tomography (CT) have evolved as a pivotal diagnostic modality in the field of oncology. With its increasing application in staging and ready availability, it becomes imperative for committed radiation oncologists to possess a complete analysis and understanding of integration of molecular imaging, which can be helpful for radiation planning, while also acknowledging its possible limitations and challenges. A significant obstacle lies in the synthesis and design of tumor-specific bmolecules for diagnosing and treating cancer. The utilization of radiation in medical biochemistry and biotechnology, encompassing diagnosis, therapy, and control of biological systems, is encapsulated under the umbrella term "nuclear medicine". Notably, the application of various radioisotopes in pharmaceutics has garnered significant attention, particularly in the realm of delivery systems for drugs, DNA, and imaging agents. The present article provides a comprehensive review of use of novel techniques PET and CT with major positron-emitting radiopharmaceuticals currently in progress or utilized in clinical practice with their integration into imaging and radiation therapy. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to determine the level of compliance of venous blood sampling (VBS) in Lithuania with the joint recommendations of the European Federation of Clinical Chemistry and Laboratory Medicine and the Latin American Confederation of Clinical Biochemistry (EFLM-COLABIOCLI) and to analyse possible causes of errors. A survey was conducted between April and September 2022. Materials and methods: A self-designed questionnaire was distributed to the Lithuanian National Societies. Error frequencies and compliance score were computed. Differences between groups were analysed using Pearson's chi-square, Fisher's exact criterion, Mann-Whitney U (for two groups), or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The association between ordinal and discrete variables was assessed using Spearman's rank correlation coefficient. Statistical significance was determined at P < 0.05. Results: A total of 272 respondents completed the questionnaire. Median error rate and compliance score were 31.5% and 13/19, respectively. Significant differences were found among professional titles, standard operating procedures availability, training recency, and tourniquet purpose opinions. A negative correlation was noted between compliance and time since training (rs = - 0.28, P < 0.001). Conclusions: The findings of this study indicate that there is a significant need for improvement in compliance with the EFLM-COLABIOCLI recommendations on VBS among specialists in Lithuania. Essential measures include prioritizing ongoing phlebotomy training and establishing national guidelines. Harmonisation of blood collection practices across healthcare institutions is crucial. [ABSTRACT FROM AUTHOR]

The H 2 O 2 -assisted oxidation by a peroxidase enzyme takes place to help plants maintain the concentrations of organic compounds at physiological levels. Cells regulate the oxidation rate by inhibiting the action of this enzyme. The cells use two inhibitory processes to regulate the enzyme: a noncompetitive substrate inhibitory process and a competitive substrate inhibitory process. Numerous applications of peroxidase have been developed in clinical biochemistry, enzyme immunoassays, the treatment of waste water containing phenolic compounds, the synthesis of various aromatic chemicals, and the removal of peroxide from industrial wastes. The kinetic mechanism of the Spanish broom peroxidase enzyme is a Ping Pong Bi Bi mechanism with the presence of competitive inhibition by substrates. A mathematical model may help in identifying the key mechanism from amongst a set of competing mechanisms. In this study, we developed a fractional mathematical model to describe the H 2 O 2 -supported oxidation by the enzyme Spanish broom peroxidase. Numerical simulations of the model produced results that are consistent with the known behaviour of Spanish broom peroxidase. Finally, some future investigations of the study are briefly indicated as well. [ABSTRACT FROM AUTHOR]

Critical test results in clinical laboratories are crucial for timely patient care, serving as indicators of potentially life-threatening conditions. Despite their importance, a notable heterogeneity in management practices exists globally. This study investigates the current practices of managing critical results at Danish clinical biochemistry laboratories and identifies areas prone for improvement. A comprehensive online survey was distributed to all 21 Danish clinical biochemistry laboratories regarding their critical result management, including documentation practices, critical limit selection, and quality assurance measures. A total of 17 laboratories (81%) responded. The answers revealed a generally uniform approach to managing critical results, with all laboratories having 24-h reporting, local instructions and using the telephone as communication channel. However, variations were noted in documentation practices and critical limit selection. Notably, 23.5% of the laboratories reported that one out of every ten critical results was not reported, indicating a significant risk of delayed critical results. This is further complicated by the limited use of predefined timeframes for reporting and also, only few laboratories actively monitored response times. The findings emphasize the need for more standardized documentation and evaluation practices to align with international standards and to enhance patient safety. While the laboratories showed a commitment to standardized procedures, the study emphasizes the necessity of a National or Nordic guideline to supplement the ISO 15189:2022. This study is a step towards optimizing critical result management, not only in Danish clinical biochemistry laboratories but also across various laboratory specialties, thereby improving overall laboratory quality, efficiency, and patient safety. [ABSTRACT FROM AUTHOR]

The ability to connect key concepts of biochemistry with clinical presentations is essential for the development of clinical reasoning skills and adaptive expertise in medical trainees. To support the integration of foundational and clinical sciences in our undergraduate health science curricula, we developed a small group active learning exercise during which interprofessional groups of students use clinical cases to explore the biochemistry, diagnostic strategy, and evidence‐based treatment options of inborn errors of metabolism (IEM). We designed multistage learning modules consisting of (1.) low‐fidelity case simulations of pediatric patients presenting with IEMs, (2.) guided group discussions on clinical biochemistry, differential diagnoses, and diagnostic strategies, (3.) oral presentations of clinical reasoning strategies, and (4.) discussion of relevant evidence‐based medicine topics related to the cases. These modules Scientific Knowledge Integrated in Patient Presentations (SKIPPs) were added to a first‐semester foundational sciences course serving five health professions programs. The assessment of learning outcomes by students and faculty shows that SKIPPs sessions are well‐received activities that significantly improve trainees' ability to integrate foundational science concepts into clinical scenarios, to practice interprofessional teamwork and to develop clinical reasoning skills. [ABSTRACT FROM AUTHOR]

Background: We compared the performance of 21 different assays performed by the Wantai Wan200+ (Wantai BioPharm, Beijing, China) with respect to other methods in use at the University Hospital of Padova (AOPD), Italy. Methods: The plasma (P) or serum (S) of 5027 leftover samples, collected from May to Sept 2023, was either analyzed or frozen at −20 °C. Beckman DXI800 (DXI), Roche Cobas 8000 e801 (RC), Snibe Maglumi 4000 plus (SM), DiaSorin Liaison XL (DL) and Binding Site Optilite (BS) equipment were used at the AOPD. P-procalcitonin (PCT), DXI; P-Troponin I (TnI), DXI; S-CA125, DXI; S-free PSA (f-PSA), DXI; S-total PSA (t-PSA), DXI; S-IL6, SM; P-Troponin T (TnT), RC; P-NT-proBNP, RC; P-Neuron-Specific Enolase (NSE), RC; S-CA15-3, DL; S-CA19-9, DL; S-AFP, DL; and S-CEA, DL were tested in fresh samples. P-Myoglobin (Myo), DXI; P-Cyfra21-1, RC; S-β2 microglobulin (B2MIC), BS; S-HE4, SM; S-PGI, SM; S-PGII, SM; S-CA72-4, SM; and S-CA50, SM were analyzed in frozen and thawed samples. Bland–Altman (BA), Passing–Bablok (PB) and Cohen's Kappa (CKa) metrics were used as statistics. Results: An excellent comparability profile was found for 11 analytes. For example, the t-PSA CKa was 0.94 (95%CI: 0.90 to 0.98), and the PB slope and intercept were 1.02 (95%CI: 0.99 to 1.03) and 0.02 (95%CI: 0.01 to 0.03), respectively; the BA bias was 2.25 (95%CI: −0.43 to 4.93). Ten tested measurands demonstrated a suboptimal comparability profile. Biological variation in EFLM (EuBIVAS) performance specifications was evaluated to assess the clinical relevance of measured biases. Conclusions: Evaluation of the Wantai Wan200+'s performance suggests that between-method differences did not exceed the calculated bias. Metrological traceability may influence the comparisons obtained for some measurands. [ABSTRACT FROM AUTHOR]

Magnesium is one of the seven essential macro minerals in our human body and the 4th most abundant cation in the body. The role of serum magnesium in cardiovascular disease has been acknowledged extensively. The association between hypomagnesemia and acute myocardial infarction has been well recognized. A cross-sectional study was conducted at Chettinad Hospital and Research Institute, and the samples were recruited from the clinical laboratory of the Biochemistry department. Fifty patients diagnosed with acute MI for whom serum magnesium and troponin T levels were taken into the study. Statistical analysis was done in SPSS version 29. The mean age of study subjects is 65±13.78. The scatter plot illustrates the association between all study subjects' cardiac troponin I and serum Magnesium values. The association between troponin I and magnesium is negative. The Pearson correlation coefficient "r" is -0.05. It shows that the inverse correlation between serum magnesium and troponin I, as shown in the current study, could mean that low serum magnesium may have a higher area of infarction. [ABSTRACT FROM AUTHOR]

Introduction: Early Clinical Exposure (ECE) was incorporated into the Competency-based Medical Education (CBME) curriculum in 2019. ECE in a classroom setting is conducted through Clinical Case Discussion (CCD) using paper-based clinical case scenarios. The assessment pattern of CBME and Maharashtra University of Health Sciences (MUHS) includes clinical case-based questions. Therefore, assessing and developing clinical reasoning skills and critical thinking has become the need of the hour. Aim: To measure the effectiveness of the modified One-minute Preceptor (OMP) model as a teaching-learning tool for CCD to enhance the knowledge and reasoning skills of Phase I Bachelor of Medicine Bachelor of Surgery (MBBS) students and to assess the perception of students and faculty towards the modified OMP model. Materials and Methods: This prospective interventional study was conducted in the Department of Biochemistry at Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India from February 2020 to May 2020. Out of 250 Phase I MBBS students, 180 who had given consent and participated in all the sessions were included. Eight faculty members voluntarily participated in the study. The faculty involved in CCD for the control and study groups were different and selected through randomisation. After a didactic lecture, a pretest was administered, and then students were divided into Control group A (n=90) and Study group B (n=90). For CCD, the modified OMP model was used for the study group and the traditional unstructured method for the control group. A post-test was given after CCD, and feedback was collected from faculty and students. Quantitative analysis of the feedback was done using a 5-point Likert scale, and open-ended questions were qualitatively assessed. Pretest and post-test scores were analysed using an unpaired t-test. Learning gain was measured, and program evaluation was conducted using Kirkpatrick's model. Results: There was a statistically significant difference in the post-test scores obtained by the control group and study group (p-value <0.001). A higher normalised learning gain (0.83) was observed in the study group. The modified OMP model was perceived as an effective, interactive teaching-learning tool for CCD by both students and faculty. Conclusion: CCD using the modified OMP model significantly improved knowledge, critical thinking, and reasoning skills of students. Even after modifications to the original OMP model, the effectiveness of this model for preclinical subjects remains unaffected. [ABSTRACT FROM AUTHOR]

Aim: To develop an alternative drug molecule design to fludarabine which is commonly used in chronic lymphocytic leukemia. Methods: The molecular properties and biological activities of the drug molecules were determined using Molinspiration software. We investigated the biological activity and drug properties of fludarabine by changing the positions of bioisosteres on the molecular structure. Results: In our studies of derivatives of the fludarabine drug molecule, we obtained data by adding different structures to the Y part without changing the X structure (F) of fludarabine. We have used the abbreviation 'M' to refer to the molecules in these experiments. We predict that the M6 derivative of fludarabine will have higher ion channel modulator, kinase and protease activity compared to fludarabine. We predict that the M15 derivative of fludarabine will have higher G- protein coupled receptors, ion channel modulator, kinase, and protease and enzyme inhibition activity compared to fludarabine. In our experiments with fludarabine derivatives, we have experimented by binding different molecules to both the X and Y structures of fludarabine at the same time. We have used the abbreviation 'C' to refer to the molecules in these experiments. In these experiments, we did not achieve higher biological activity than fludarabine. Conclusions: The results suggest that this newly designed M15 derivative of fludarabine molecule may be a better antileukemic drug molecules in the future and may be useful for further drug molecule development research in medical biochemistry, chemistry and pharmacology. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to assess the safety of transgenic maize CC-2 through a 90-day feeding study in Sprague-Dawley rats. Methods Transgenic maize CC-2 and its parental counterpart maize Zhengdan 958 were respectively incorporated into diets at levels of 70%, 35% or 17.5% (w/w) and were administrated to rats (n = 10/sex/group) for 90 days. An additional control group of rats (n = 10/sex/group) were fed with the AIN93 breeding diet. All formulated diets were nutritionally balanced. Results There was no death and obvious toxic symptom in all rats. Food consumption, body weight, total food consumption rate, hematology, urinalysis, organ weight and organ coefficient were comparable between transgenic groups and the corresponding dose parental groups. There were significant differences of food consumption rate on some timepoint between high dose transgenic group and high dose parental group; male rats in high dose transgenic group showed significantly higher ALT/AST than high dose parental group on the middle or end of the experiment; but the differences showed no biological significance. There were no significant differences of other serum biochemistry parameters and pathological changes. Conclusion The results in this study demonstrated that the transgenic maize CC-2 didn't cause any related toxicity in rats. [ABSTRACT FROM AUTHOR]