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Adequate sleep is crucial for elite athletes' recovery, performance readiness, and immune response. Establishing reference ranges for elite athletes enables appropriate contextualization for designing and targeting sleep interventions. Purpose: To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Methods: Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Results: Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P =.006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P <.001). Winter Games participants had later bedtime (P =.036) and sleep offset time (P =.028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P <.001). Individual-sport athletes were more likely to have low (P =.005) and mild (P =.045) risk for reduced sleep duration than team-sport athletes. Conclusion: These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions. [ABSTRACT FROM AUTHOR]

Background Objectives Animals Methods Results Conclusions and Clinical Importance Reference intervals for simple body weight‐independent measurements of right heart size and function are limited.Generate reference intervals for measurements of right heart size indexed to the long‐axis aortic valve diameter (AoD) or corresponding left heart structure (right heart ratios) and describe the reproducibility of these indices.Ninety healthy adult dogs of variable body weight.Prospective study. All dogs underwent an echocardiogram performed by the same operator. Numerous linear 2‐dimensional measurements of right heart size and function from different imaging planes were performed. Eight dogs underwent repeated echocardiograms by the same operator on 3 different days, and 3 different operators performed repeated echocardiograms on the same day. Reference intervals were generated using the Clinical Laboratory Standards Institute method. Reproducibility was quantitated using coefficients of variation (CVs) and reproducibility coefficients.Reference intervals for right heart ratios were generated and allow simple assessments of right heart size and function that do not require a scaling exponent or body weight table. Right heart ratios did not show clinically relevant associations with body weight. All CVs were <22.6%. In general, CVs for right heart measurements indexed to AoD were lower compared with right heart measurements indexed to the corresponding left heart structure.Reference intervals for simple body weight‐independent right heart ratios are available to help detect abnormalities of right heart size and function. Reproducibility coefficients might be useful to help identify meaningful changes in right heart size during serial evaluations. [ABSTRACT FROM AUTHOR]

Purpose: The primary goal was to estimate reference values of parathyroid hormone (PTH) in very low birth weight infants without severe neonatal morbidity. A secondary objective was to assess the relationship between PTH serum levels and selected laboratory markers of bone metabolism. Methods: Ninety two infants with birth weight less than 1500 g met the inclusion criteria of the study. Serum levels of PTH, 25-hydroxyvitamin-D [25(OH)D], C3-epi-25(OH)D, total calcium, phosphorus, and alkaline phosphatase, and urinary levels of calcium, phosphorus, and creatinine were examined on day 14 and subsequently every 2 weeks until discharge. Results: Of the total 167 serum samples examined for PTH levels in infants without 25(OH)D deficiency the estimated range was 0.9–11.9 pmol/l (8.5–112.3 pg/mL). During the first month, no statistically significant correlation was observed between PTH level and that of 25(OH)D, C3-epimers of 25(OH)D, S-Ca, S-P, or ALP, nor with urinary excretion of calcium and phosphorus. From the second month of life, there was a moderately significant correlation between PTH and 25(OH)D (Rho = −0.40, P =<.001), between PTH and calcium/creatinine ratio (Rho = −0.56, P = <.001), and between PTH and phosphorus/creatinine ratio (Rho = 0.51, P = <.001). Conclusions: The physiological range for PTH levels for preterm neonates without 25(OH)D deficiency was estimated as 0.9–11.9 pmol/l (8.5–112.3 pg/mL). It seems that elevation of serum PTH above this range can be considered as hyperparathyroidism in very low birth weight infants. [ABSTRACT FROM AUTHOR]

Background: Serum thyroid-stimulating hormone (TSH) measurement is the diagnostic cornerstone for primary thyroid dysfunction. There is high inter-individual but limited intra-individual variation in TSH concentrations, largely due to genetic factors. The currently used wide population-based reference intervals may lead to inappropriate management decisions. Methods: A polygenic score (PGS) including 59 genetic variants was used to calculate genetically determined TSH reference ranges in a thyroid disease-free cohort (n = 6,834). Its effect on reclassification of diagnoses was investigated when compared to using population-based reference ranges. Next, results were validated in a second independent population-based thyroid disease-free cohort (n = 3,800). Potential clinical implications were assessed in a third independent population-based cohort including individuals without thyroid disease (n = 26,321) as well as individuals on levothyroxine (LT4) treatment (n = 1,132). Results: PGS was a much stronger predictor of individual TSH concentrations than FT4 (total variance in TSH concentrations explained 9.2–11.1% vs. 2.4–2.7%, respectively) or any other nongenetic factor (total variance in TSH concentrations explained 0.2–1.8%). Genetically determined TSH reference ranges differed significantly between PGS quartiles in all cohorts, while the differences in FT4 concentrations were absent or only minor. Up to 24.7–30.1% of individuals, previously classified as having subclinical hypo- and hyperthyroidism when using population-based TSH reference ranges, were reclassified as euthyroid when genetically determined TSH reference ranges were applied. Individuals in the higher PGS quartiles had a higher probability of being prescribed LT4 treatment compared to individuals from the lower PGS quartiles (3.3% in Q1 vs. 5.2% in Q4, Pfor trend =1.7 × 10−8). Conclusions: Individual genetic profiles have the potential to personalize TSH reference ranges, with large effects on reclassification of diagnosis and LT4 prescriptions. As the currently used PGS can only predict approximately 10% of inter-individual variation in TSH concentrations, it should be further improved when more genetic variants determining TSH concentrations are identified in future studies. [ABSTRACT FROM AUTHOR]

Purpose: Blood Lp(a) concentration is recognized as an independent risk factor for cardiovascular disease (CVD). Population-based lipoprotein(a) (Lp[a]) research in Saudi Arabia is rare. Thus, the primary goal of this pilot study was to identify age- and sex-specific reference ranges for Lp(a) levels, in addition to the associations between Lp(a) levels and other atherosclerotic markers in Saudi individuals. Patients and methods: A five-year retrospective study of Lp(a) and lipid markers in Saudi patients was conducted using the Al-Borg diagnostics database (2015– 2020). The population sample consisted of 361 Saudi individuals aged 18– 93 years (162 males, 199 females). An immunoturbidimetric technique was used to determine Lp(a) concentration. Results: The mean and median Lp(a) levels in the study population were 35 nmol/L and 50 nmol/L, respectively. Sex and age did not influence Lp(a) values. Lp(a) values showed a minor correlation with other atherosclerotic markers when the Pearson correlation coefficient was used. In Saudi Arabia, the distribution of Lp(a) concentrations is skewed to the left, favoring lower values. Conclusion: Lp(a) levels in individuals residing in Saudi Arabia were comparable to those observed in other ethnic groups. Additionally, standardizing Lp(a) measurements according to sex and age may enhance broader applicability and facilitate comparisons across different populations. However, larger studies are required to provide more comprehensive data for comparison. [ABSTRACT FROM AUTHOR]

Objectives: To investigate short‐term neonatal developmental outcomes in fetuses with an isolated wide or narrow cavum septi pellucidi (CSP) using new reference ranges. Methods: A cross‐sectional study on fetuses at 16 + 0 to 36 + 6 weeks of gestation between December 2020 and January 2022. CSP width reference ranges were constructed from low‐risk pregnancies. Wide and narrow CSPs were defined as measurements above the 95th percentile and below the 5th percentile, respectively. For the primary outcome fetuses with normal neurosonograms were included. Neonatal developmental outcomes were assessed using the Survey of Well‐being of Young Children (SWYC). Results: A total of 352 fetuses were included in this study, of whom 138 were healthy and had uncomplicated neonatal outcomes. These fetuses constituted the control group and were used to construct the CSP width reference ranges. Of 185 fetuses in the neurosonography group, 9.7% had wide and 7.6% had narrow CSPs, of whom 33.3% and 22.2%, respectively, scored below the SWYC threshold for expected developmental milestones, a rate similar to that reported in the general population. Conclusions: The presence of a prenatally isolated wide or narrow CSP does not appear to increase the risk of neonatal neurodevelopmental delay. [ABSTRACT FROM AUTHOR]

Background: Serum vitamin B12 plays a crucial role in cellular growth, DNA synthesis, and maintaining a healthy nervous system. Its deficiency can lead to various health issues, including cardiovascular problems. The reference range for vitamin B12 varies between populations due to cultural, genetic, and dietary differences. Methods: A cross-sectional study was conducted on 127 healthy An-Najah National University students aged between 18 and 25. Blood samples were collected, and a questionnaire assessed factors affecting vitamin B12 levels. Serum vitamin B12 levels were measured using ACCUBIND ELIZA microwells. Results: The study found a reference range for serum vitamin B12 of 136–640 pg/mL (5th to 95th percentile) among the studied population, which differed from the manufacturer’s claimed range of 200–835 pg/mL. Gender did not significantly affect the reference intervals. Conclusion: The study highlights the importance of establishing local reference values for laboratory tests like vitamin B12 due to variations in demographics. Further research in different Palestinian regions and age groups with larger sample sizes is recommended to refine these reference values.

Yuan Huang,1,&ast; Hong Yang,2,&ast; Rui Ding,1,&ast; Li Wang,3 Ji Li,2 Wenbo Li,4 Xuzhen Qin,1 Yingchun Xu,1 Jiaming Qian2 1Department of Laboratory Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Department of Gastroenterology, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Epidemiology and Health Statistics, Institute of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China; 4Department of Ultrasound, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xuzhen Qin; Jiaming Qian, Email qxz_01@163.com; qianjiaming1957@126.comObjective: Serum pepsinogen (PG) is a good indicator of atrophic changes in the gastric mucosa. Gastric mucosal atrophy is a high-risk factor for gastric cancer. Serological testing for PG combined with endoscopy can help to improve gastric cancer screening. In this study, we established the reference ranges of serum PG-I, PG-II, and the PG-I/II ratio (PGR) in the Chinese population by chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA). Besides, in the real world, doctors are often confused by the results of different testing platforms. Thus, a comparison of methods CLIA and ELISA was performed.Methods: 2904 individuals were enrolled from six regions in China as part of the Chinese Adult Digestive Diseases Surveillance (2016) program. The individuals completed questionnaires and volunteered to undergo examinations, including gastroscopy, urea breath test, abdominal ultrasound examination and routine serologic tests. Serum was collected to measure PGs (including PG-I, PG-II and PGR) by CLIA and ELISA. Participants who were found obvious abnormalities or absent from the examinations were excluded. Ultimately, 747 healthy individuals were enrolled in this study. The Kolmogorov–Smirnov test was used to assess the distribution of variables. The Kruskal–Wallis H or Mann–Whitney U-tests were used to compare different sex, age, and geographical groups. The 95% reference ranges of PGs obtained by the two methods were established according to document CLSI-EP28-A3, with covariates of sex, age, and region. Spearman correlation analysis, linear regression analysis and allowable total error (ATE) zone analysis were utilized for comparing the two methods.Results: On overall, the 95% reference ranges of PG-I, PG-II, and PGR measured by CLIA were 23.00– 110.64 ng/mL, 2.50– 19.13 ng/mL, and 3.87– 13.30, respectively. Meanwhile, the reference ranges of PG-I, PG-II, and PGR measured by ELISA were 36.93– 205.06 ng/mL, 1.65– 17.96 ng/mL, and 7.50– 33.60, respectively. Both PG-I and PG-II levels measured by the two platforms were found to be influenced by sex and age. PGR measured by CLIA was influenced by age but not by sex, while PGR measured by ELISA was not affected by either age or sex. Regional factors did not significantly impact the PG results, except for PG-I detected by ELISA. Ultimately, reference ranges for PGs were established based on age and sex stratification. Additionally, the Spearman correlation analysis revealed that the correlation coefficients for PG-I, PG-II, and PGR detected by the two methods were 0.899, 0.887, and 0.777, respectively, indicating a strong correlation between the two methods. The regression equation for the PG levels detected by two methods was obtained through linear regression analysis. The ATE analysis provided a visual depiction of the consistency between the two methods, clearly indicating the poor agreement between them.Conclusion: This study established the reference ranges of PGs by strict and intact enrollment standard. In addition, the results indicated a strong linear relationship between the two methods, yet with a clear bias, which was valuable for laboratory interpretation.Keywords: pepsinogen, reference range, gastric cancer

Abstract Background The study evaluated the performance of the Mindray N-terminal pro-B-type natriuretic peptide (NT-proBNP) in a healthy population in China, focusing on creating a reference range for future clinical applications adjusted according to different demographics. Methods The study measured NT-proBNP in 2277 healthy individuals. We analyzed age and sex-stratified data, performed precision, accuracy, linearitcvy, and detection limit studies, and evaluated method comparison and consistency between Roche and Mindray assays on 724 serum samples. We used Excel 2010, Medcalc, and GraphPad Prism 9. Results In males, the 97.5th centile NT-proBNP concentration at age

Abstract Background The recognition of pain is a major problem in cattle, as they are stoic animals which strongly mask their pain. Among objective parameters to assess pain in cattle is substance P (SP), a neurotransmitter which is involved in the pain pathways. Research about SP concentration in calves focus on painful procedures, such as castration and dehorning. Basic research work is lacking; evaluation of SP concentrations in healthy calves and possible differences between sexes have not been published yet. The objectives of this study were to (1) describe SP concentrations in healthy male and female calves of the German Simmental breed to establish benchmarks of orientation, (2) compare SP concentrations between male and female calves, and (3) assess differences in SP concentrations between calves and adult cows. A total of 44 male and 49 female calves aged 14 to 21 days (17.1 ± 2.2 days) were included in this study. Blood samples were taken at 06:00 a.m. from the jugular vein, followed by a clinical examination. SP concentrations were analyzed using a commercial ELISA kit. Differences in SP concentrations according to laboratory parameters, and correlation of SP concentrations with different parameters were assessed. Results Median SP concentrations in the blood plasma were 516 pg/ml (Interquartile Range 320 pg/ml, range 229–1615 pg/ml) in calves. Median SP concentrations differed significantly between male and female calves (554 pg/ml for male, and 489 pg/ml for female calves, respectively). There was no significant difference in animals with laboratory findings within reference ranges and those with mild deviations from reference ranges. There was a positive correlation between SP concentrations and leucocyte count, which was significant. SP concentrations were significantly lower in calves compared with a dataset of adult cows, which has been published previously. Conclusion Due to the high interindividual differences in SP concentrations, it is hard to establish benchmarks for orientation. Sex has a significant influence on SP concentrations. Research work should preferably be done in animals of the same sex. Also, animals should be within the same age range (adults or calves), as age seems to have an influence on SP concentrations.

Introduction: Nyctereutes procyonoides koreensis (Korean raccoon dog), a member of the Canidae family, is anatomically similar to dogs. Previous studies have used vertebral heart scale measurements to measure the cardiac size of Korean raccoon dogs on thoracic radiographs; however, the use of additional cardiac size indices, such as vertebral left arial score, intercostal space, cardiothoracic ratio, and echocardiographic indices, has not been reported. Therefore, this study aimed to establish normal reference ranges for various thoracic radiographic and echocardiographic indices in normal Korean raccoon dogs. Methods: Twenty-six Korean raccoon dogs (11 males and 15 females) were included in this study. The thoracic radiographic indices, vertebral heart scale score, and vertebral left atrial score were measured in the right lateral view. The intercostal space and cardiothoracic ratio were measured in the ventrodorsal view. The echocardiograms were evaluated in the right parasternal long and short axis view and left parasternal apical view. Results: The mean values for the thoracic radiographic and echocardiographic indices were as follows: vertebral heart scale, 9.12 ± 0.74; vertebral left atrial score, 1.5 ± 0.31; intercostal spaces, 3.17 ± 0.34; cardiothoracic ratio, 0.69 ± 0.07; left atrial to aortic root ratio, 1.22 ± 0.14; main pulmonary artery to aorta ratio, 1.22 ± 0.14; left ventricular end-diastolic internal diameter normalized for body weight, 1.36 ± 0.19; end-diastolic volume index, 51.07 ± 19.6; end-systolic volume index, 16.54 ± 7.45; the peak velocity of early diastolic transmitral flow, 73.13 ± 15.46 cm/s; and the ratio between the transmitral flow velocities and the peak early diastolic velocity, 1.77 ± 0.47. Only percent increase in the left ventricular end-systolic internal diameter was negatively correlated with body weight. The remaining indices showed no correlations with body weight. Conclusion: To the best of our knowledge, this is the first case report covering both thoracic radiographic and endocardiographic indices for Korean raccoon dogs. Thus, the thoracic radiographic and echocardiographic indices established in this study may be used to evaluate the cardiac condition of Korean raccoon dogs. [ABSTRACT FROM AUTHOR]

Background: The study evaluated the performance of the Mindray N-terminal pro-B-type natriuretic peptide (NT-proBNP) in a healthy population in China, focusing on creating a reference range for future clinical applications adjusted according to different demographics. Methods: The study measured NT-proBNP in 2277 healthy individuals. We analyzed age and sex-stratified data, performed precision, accuracy, linearitcvy, and detection limit studies, and evaluated method comparison and consistency between Roche and Mindray assays on 724 serum samples. We used Excel 2010, Medcalc, and GraphPad Prism 9. Results: In males, the 97.5th centile NT-proBNP concentration at age < 45, 45 to 54, 55 to 64, 65 to 74 and ≧ 75 were 89.4 ng/L, 126 ng/L, 206 ng/L, 386 ng/L and 522 ng/L, respectively. In females, the concentration of NT-proBNP at the same age was 132 ng/L, 229 ng/L, 262 ng/L, 297 ng/L and 807 ng/L, respectively. The repeatability precision coefficient of variation (CV%) for NT-proBNP was between 0.86 and 1.65 in analytical performance. In contrast, the reproducibility precision (CV%) for NT-proBNP was between 1.52 and 3.22, respectively. The study found a bias of accuracy of 3.73% in low-value samples (concentration: 148.69) and 7.31% in high-value samples (concentration: 1939.08). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 125 ng/L were 96.6%, 92.3%, 84.2%, and 98.5%, respectively. In contrast, those of 300 ng/L were 94.0%, 98.2%, 95.7% and 97.5%, respectively. Conclusions: The Mindray NT-proBNP assay showed increased levels in both males and females with age, with higher levels in women. It performs well and aligns with manufacturer specifications. We recommend adjusting cutoff values based on demographic factors. [ABSTRACT FROM AUTHOR]

Objective To establish the reference interval of thromboelastography(TEG)for healthy adults in Shaanxi province so as to serve clinical precision blood transfusion. Methods According to the standard method of “Establishment of Reference Interval for Clinical Laboratory Test Items”(WS/T 402-2012), peripheral venous blood was collected from 386 selected patients in Shaanxi. The conventional coagulation and fibrinolysis indexes(PT, APTT, TT, FiB, FDP, and DD)were detected by hemagglutinometer, and the following parameters(R, K, Angle, MA, LY30, CI)were determined by thrombolysis graph. The 95% confidence interval was used to determine the reference interval of each parameter of thrombolysis diagram. Results The routine coagulation and fibrinolysis indexes of the 386 healthy volunteers were normal. Compared with the reference intervals of various TEG indicators provided by the manufacturer of TEG, 7.2%(28/386)were diagnosed with coagulopathy, and the test specificity was only 44%(170/386). Furthermore, there was decreased R in 188 subjects(48.7%), increased K in 28 subjects(7.3%), and decreased Angle in 12 subjects(3.1%). The significant differences in R, MA and CI were found between males and females(P<0.05). The significantly different R and CI were revealed in different age ranges(P<0.05). Finally, the normal reference range of each parameter of thrombus elastigram in 386 cases was set for males(R: 2.7-8.6, K: 1.3-3.6, Angle: 46.2-72.5, MA: 49.5-69.3, LY30:0-8.0, CI: -3.2-3.6)and females(R: 2.7-9.2, K: 1.2-3.4, Angle: 46.2-72.5, MA: 49.5-69.3, LY30:0-8.0, CI: -3.2-3.6). Conclusion The reference interval of thrombolysis map of healthy people in Shaanxi is significantly different from that provided by the manufacturer. The thrombolysis map reference interval established in this study is more suitable for the clinical coagulation characteristics of the local population and can be better applied in clinical diagnosis and treatment services. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assessthe repeatability of infrared thermometertemperature readings and evaluate the correlation between digitai rectal temperature and infrared thermometer temperatures taken at different locations in healthy afebrile horses. ANIMALS 101 afebrile horses ≥ 1 year old. METHODS Digital rectal temperatures and infrared temperatures from the eye, gingiva, neck, axilla, and perineum were obtained in a climate-controlled environment and at 2 outdoor ambient temperatures (study period, November 1, 2021, to April 30,2023). RESULTS Infrared temperature measurements were well tolerated by horses, including those resistant to rectal temperature. There was significant correlation between rectal temperature and infrared temperature taken at the perineum (R = 0.57; P < .001) and eye (R = 0.37; P < .001). Infrared temperature measurements were highly repeatable, allowing for calculation of reference ranges for the perineum (36.0 to 37.8 °C) and eye (35.7 to 37.1 °C) in climate-controlled conditions. There was increased variance in outside temperatures compared to climate-controlled conditions for the eye (P = .002), gingiva (P = .047), and perineum (P = .005). CLINICAL RELEVANCE While infrared thermometer temperatures were not numerically the same as rectal temperature using a digital thermometer, measurements at the perineum and eye were correlated with rectal temperature readings. Further, the repeatability of infrared readings allows for computation of reference ranges that make the infrared thermometer a viable alternative for the practicing veterinarian when obtaining a temperature in uncooperative horses. The infrared thermometer was reliable outdoors for the eye, but not the perineum. Additional validation of infrared temperature reference ranges in febrile horses and warmer ambient temperatures is warranted. [ABSTRACT FROM AUTHOR]

Spinal muscular atrophy (SMA) is the leading genetic cause of infant mortality, characterized by progressive neuromuscular degeneration resulting from mutations in the survival motor neuron (SMN1) gene. The availability of disease-modifying therapies for SMA therapies highlights the pressing need for easily accessible and cost-effective blood biomarkers to monitor treatment response and for better disease management. Additionally, the wide implementation of newborn genetic screening programs in Western countries enables presymptomatic diagnosis of SMA and immediate treatment administration. However, the absence of monitoring and prognostic blood biomarkers for neurodegeneration in SMA hinders effective disease management. Neurofilament light protein (NfL) is a promising biomarker of neuroaxonal damage in SMA and reflects disease progression in children with SMA undergoing treatment. Recently, the European Medicines Agency issued a letter of support endorsing the potential utilization of NfL as a biomarker of pediatric neurological diseases, including SMA. Within this review, we comprehensively assess the potential applications of NfL as a monitoring biomarker for disease severity and treatment response in pediatric-onset SMA. We provide reference ranges for normal levels of serum based NfL in neurologically healthy children aged 0–18 years. These reference ranges enable accurate interpretation of NfL levels in children and can accelerate the implementation of NfL into clinical practice. [ABSTRACT FROM AUTHOR]

Objective To investigate the influencing factors and reference ranges for thyroid function in preterm infants at the age of 7 days, with the aim of avoiding unnecessary clinical reexamination and intervention. Methods A retrospective analysis was performed for the data of 685 preterm infants from January 2020 to January 2023. According to gestational age and birth weight, they were divided into a high-risk group (gestational age <34 weeks or birth weight <2 000 g; 228 infants) and a low-risk group (gestational age ≥34 weeks and birth weight ≥2 000 g;457 infants). The influencing factors for thyroid function were analyzed, and 95% reference range was calculated. Results Gestational age, birth weight, birth season, sex, and assisted reproduction were the influencing factors for thyroid function (P<0.05). For the preterm infants in the high-risk group, the reference ranges of free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid stimulating hormone (TSH) were 2.79-5.40 pmol/L, 8.80- 25.64 pmol/L, 0.80-2.15 nmol/L, 50.06-165.09 nmol/L, and 0.80-18.57 μIU/mL, respectively. For those in the low-risk group, the reference ranges of these indicators were 3.08-5.93 pmol/L, 11.17-26.24 pmol/L, 1.02-2.27 nmol/L, 62.90- 168.95 nmol/L, and 0.69-13.70 μIU/mL, respectively. FT3, FT4, TT3, and TT4 were positively correlated with gestational age (P<0.05); FT3, FT4, TT3, and TT4 were positively correlated with birth weight (P<0.05); TSH was negatively correlated with birth weight (P<0.05). Conclusions Thyroid function in preterm infants at the age of 7 days is affected by the factors such as gestational age and birth weight, and the reference ranges of thyroid function in preterm infants at the age of 7 days should be established based on gestational age and birth weight. [ABSTRACT FROM AUTHOR]

Background: The recognition of pain is a major problem in cattle, as they are stoic animals which strongly mask their pain. Among objective parameters to assess pain in cattle is substance P (SP), a neurotransmitter which is involved in the pain pathways. Research about SP concentration in calves focus on painful procedures, such as castration and dehorning. Basic research work is lacking; evaluation of SP concentrations in healthy calves and possible differences between sexes have not been published yet. The objectives of this study were to (1) describe SP concentrations in healthy male and female calves of the German Simmental breed to establish benchmarks of orientation, (2) compare SP concentrations between male and female calves, and (3) assess differences in SP concentrations between calves and adult cows. A total of 44 male and 49 female calves aged 14 to 21 days (17.1 ± 2.2 days) were included in this study. Blood samples were taken at 06:00 a.m. from the jugular vein, followed by a clinical examination. SP concentrations were analyzed using a commercial ELISA kit. Differences in SP concentrations according to laboratory parameters, and correlation of SP concentrations with different parameters were assessed. Results: Median SP concentrations in the blood plasma were 516 pg/ml (Interquartile Range 320 pg/ml, range 229–1615 pg/ml) in calves. Median SP concentrations differed significantly between male and female calves (554 pg/ml for male, and 489 pg/ml for female calves, respectively). There was no significant difference in animals with laboratory findings within reference ranges and those with mild deviations from reference ranges. There was a positive correlation between SP concentrations and leucocyte count, which was significant. SP concentrations were significantly lower in calves compared with a dataset of adult cows, which has been published previously. Conclusion: Due to the high interindividual differences in SP concentrations, it is hard to establish benchmarks for orientation. Sex has a significant influence on SP concentrations. Research work should preferably be done in animals of the same sex. Also, animals should be within the same age range (adults or calves), as age seems to have an influence on SP concentrations. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to examine whether the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) reference intervals for 19 commonly used biochemical assays (potassium, sodium, chloride, calcium, magnesium, inorganic phosphorous, glucose, urea, creatinine, direct and total bilirubin, C-reactive protein (CRP), total protein, albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and lactate dehydrogenase (LD)) could be applied to the newborn population of one Croatian clinical hospital. Materials and methods: Reference interval verification was performed according to the CLSI EP28-A3c guidelines. Samples of healthy newborns were selected using the direct a posteriori sampling method and analyzed on the Beckman Coulter AU680 biochemical analyzer. If verification wasn't satisfactory, further procedure included de novo determination of own reference intervals by analyzing 120 samples of healthy newborns. Results: After the first set of measurements, 14/19 tested reference intervals were adopted for use: calcium, inorganic phosphorous, glucose, urea, creatinine, total bilirubin, CRP, total protein, albumin, AST, ALT, GGT, ALP and LD. A second set of samples was tested for 5 analytes: potassium, sodium, chloride, magnesium and direct bilirubin. The verification results of the additional samples for sodium and chloride were satisfactory, while the results for potassium, magnesium and direct bilirubin remained unsatisfactory and new reference intervals were determined. Conclusions: The CALIPER reference intervals can be implemented into routine laboratory and clinical practice for the tested newborn population for most of the analyzed assays, while own reference intervals for potassium, magnesium and direct bilirubin have been determined. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aimed to establish the reference intervals for complete blood count (CBC) in healthy adults at very high altitudes.MethodsThis study recruited 4,863 healthy adults (3,598 males and 1,265 females) who received routine health check-ups at Ali District People’s Hospital from January 2019 to December 2021 through the LIS system. CBC was detected by the XT-4000i automatic cell analyzer and statistically analyzed by SPSS 23.0 software (between-groups comparison, diagnostic concordance comparison). In addition, 20 health check samples were collected in 2022 to validate the established reference intervals.ResultsThe CBC count showed a non-normal distribution in each item separately. The white blood cell (WBC), neutrophil (NEUT), lymphocyte (LYMPH), monocyte (MONO), eosinophil (EO), basophil (BASO), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean hemoglobin content (MCH), and mean erythrocyte hemoglobin concentration (MCHC) levels of healthy adults were significantly different from the national clinical reference range (p < 0.05). There were significant differences between males and females in RBC, HGB, and HCT levels (p < 0.05). The new reference intervals were less consistent with the expert consensus CBC reference intervals (p < 0.05). Compared with the other reference intervals, the diagnostic value of the reference screening interval established was significantly higher in this study (p < 0.05). The reference range established is verified by 20 independent samples from 2022, and the results are acceptable.ConclusionThis study preliminarily established reference intervals for complete blood counts of healthy adults at high altitudes in the Ali region of Tibet to provide a reference point for understanding routine blood markers in permanent residents of high-altitude environments and illustrate the need for regular establishment of laboratory reference intervals on a regular basis.

Abstract Background Wistar rats are extensively used as the model for assessing toxicity and efficacy in preclinical research. Hematological and biochemical laboratory data are essential for evaluating specific variations in the physiological and functional profile of a laboratory animal. Establishing hematological and biochemical reference values for Wistar (han) rats at various age intervals was the goal of this work. Male and female Wistar rats (n = 660) of ages 6–8 weeks, 10–14 weeks and > 6 months were used in the experiment. Blood and serum were collected from these rats under fasting conditions. Results We observed that the majority of hematological and biochemical parameters were significantly influenced by sex and age. Hematological changes were significantly correlated to aging were increased red blood cells, hemoglobin, hematocrit, neutrophils, monocytes and eosinophils in both sexes, as well as decreased platelet, mean corpuscular volume, mean corpuscular hemoglobin and lymphocytes in both sexes. White blood cells of male rats were considerably higher than those of female rats in all age ranges. For biochemistry, increase in glucose, total protein and creatinine were seen in both sexes, along with increases in urea in females and alanine aminotransferase in males. Age was significantly associated with decreased alkaline phosphatase in both sexes. Conclusions When using Wistar rats as a model, these reference values may be useful in evaluating the results.

Abstract Patients with chronic daily headaches (CDH) are often a diagnostic challenge and frequently undergo neuroimaging. One common underlying cause of CDH is idiopathic intracranial hypertension (IIH). However, certain neuroimaging abnormalities that suggest IIH, such as optic nerve sheath diameters (ONSD), pituitary gland height, and venous sinus diameter, require interpretation due to the absence of established normative values. Notably, intracranial pressure is known to varies with age, sex and weight, further complicating the determination of objectively abnormal findings within a specific patient group. This study aims to assist clinical neuroradiologists in differentiating neuroimaging results in CDH by providing weight-adjusted normative values for imaging characteristics of IIH. In addition to age and BMI we here assessed 1924 population-based T1-weighted MRI datasets of healthy participants for relevant MRI aspects of IIH. Association to BMI was analyzed using linear/logistic regression controlled for age and stratified for sex. ONSD was 4.3 mm [2.8; 5.9]/4.6 mm [3.6; 5.7] and diameter of transverse sinus was 4.67 mm [1.6; 6.5]/4.45 mm [3.0; 7.9]. Height of pituitary gland was 5.1 mm [2.2;8.1]/4.6 mm [1.9;7.1] for female and male respectively. Values generally varied with BMI with regression slopes spanning 0.0001 to 0.05 and were therefor presented as normative values stratified by BMI. Protrusion of ocular papilla, empty sella and transverse sinus occlusion were rare in total. Our data show an association between BMI and commonly used MRI features for diagnosing IIH. We provide categorized normative BMI values for ONSD, pituitary gland height, and transverse sinus diameter. This distinction helps objectively identify potential IIH indicators compared to regular population norms, enhancing diagnostic accuracy for suspected IIH patients. Notably, optic nerve head protrusion, empty sella, and transverse sinus occlusion are rare in healthy individuals, solidifying their importance as imaging markers regardless of BMI.

Najia Sherzay,1– 3 Ziauddin Azimi,1,2 Siti Hamimah Sheikh Abdul Kadir,1,4 Noor Shafina Mohd Nor1,4 1Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Cawangan Selangor, Sungai Buloh, Selangor, 47000, Malaysia; 2Department of Biochemistry, Faculty of Pharmacy, Kabul University, Karte Sakhi, Kabul, Afghanistan; 3Laboratory of Electrophiles and Genome Operation, Institute of Chemical Sciences and Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; 4Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, 47000, MalaysiaCorrespondence: Najia Sherzay; Siti Hamimah Sheikh Abdul Kadir, Email najia.sherzay@epfl.ch; sitih587@uitm.edu.myPurpose: This study was designed and conducted to validate the reference values of hematological parameters for healthy adult male and female residents of Kabul city, Afghanistan.Methodology: In this cross-sectional study, the samples were collected according to a non-random sampling method. Blood samples were collected from students and employees of Kabul University. The study included 166 males and 125 females, aged 18– 45 years. The selection and exclusion of participants were carried out according to a questionnaire and the assessment of serum ferritin and vitamin B12 levels. Candidates with lower serum ferritin and vitamin B12, a history of chronic disease, females with menstruation or pregnancy, and those with chronic abdominal pain were excluded.Results: Reference ranges for all blood parameters were determined by a non-parametric method. The determined reference values were compared between males and females by the Z-test. Reference intervals for hemoglobin (4.5– 6.3 g/dL for males and 3.66– 5.67 g/dL for females) and hematocrit (36.23– 55.93% for males and 30.20– 53.86% for females) were significantly (p< 0.05) higher in males. No significant (p< 0.05) differences were observed between the reference intervals for the red blood cell count.Conclusion: Therefore, we conclude that the commonly used reference intervals should be revised for the Afghan population, as our findings indicated higher reference values for the hemoglobin and hematocrit indices.Keywords: reference range, blood parameters, Afghan population

Reference regions are important in laboratory medicine to interpret the test results of patients, and usually given by tolerance regions. Tolerance regions of p (≥2)$$ p\;\left(\ge 2\right) $$ dimensions are highly desirable when the test results contains p$$ p $$ outcome measures. Nonparametric hyperrectangular tolerance regions are attractive in real problems due to their robustness with respect to the underlying distribution of the measurements and ease of intepretation, and methods to construct them have been recently provided by Young and Mathew [Stat Methods Med Res. 2020;29:3569‐3585]. However, their validity is supported by a simulation study only. In this paper, nonparametric hyperrectangular tolerance regions are constructed by using Tukey's [Ann Math Stat. 1947;18:529‐539; Ann Math Stat. 1948;19:30‐39] elegant results of equivalence blocks. The validity of these new tolerance regions is proven mathematically in [Ann Math Stat. 1947;18:529‐539; Ann Math Stat. 1948;19:30‐39] under the only assumption that the underlying distribution of the measurements is continuous. The methodology is applied to analyze the kidney function problem considered in Young and Mathew [Stat Methods Med Res. 2020;29:3569‐3585]. [ABSTRACT FROM AUTHOR]

Background: This study aims to explore the observable distribution of serum uric acid levels in healthy adults residing in China's coastal areas and to assess the suitability of current reference intervals. Methods: The study incorporated 20,786 participants. The overall uric acid level displayed a skewed distribution, leading to the division of subjects into six groups based on gender and age. The analysis was conducted to comprehend the distribution of UA in various groups and seasons, establish and validate the reference intervals for the surface healthy population in this region, and analyze the abnormality rates using different reference intervals. Results: Statistically significant differences were observed between the uric acid levels of males and females across all age groups (ALL p < 0.05). Furthermore, there were statistical differences in uric acid levels among different age groups for both genders (H = 69.593 and 326.348, all p < 0.001). The overall reference interval was determined as 238 - 488 µmol/L for males and 155 - 364 µmol/L for females, based on the 95% confidence interval (P2.5 - P97.5). The established reference intervals, grounded on gender and age group, were validated, showing statistically significant disparities in UA levels among groups. The abnormality rate in males decreased by 56.90% following the adjustment of the reference interval. Conclusions: The study revealed that UA levels at all ages exhibited varying degrees of "right shift". Additionally, the low-value population should not be overlooked in the clinical evaluation of UA test results. Setting a reasonable reference interval and clinical decision level is crucial for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

AbstractHuman red blood cell acetylcholinesterase (RBC-AChE) activity is valuable for detecting potential exposure to cholinesterase inhibiting substances (CIS). A reliable population-based RBC-AChE activity reference range is critical for early and massive clinical and occupational toxicology screening. Previous published studies were often limited to small numbers of subjects, various testing methods, and crude statistical data analyses. We tested 4818 adult subjects with a well-established 17-minute modified Michel method over a 2-year period. We conducted a retrospective data analysis and systematically investigated on the influences to testing values from gender, age, age group, and their combinations and interactions. No significant difference was observed in the testing values between males (mean, medium, interquartile range = 0.76, 0.76, 0.71–0.80 ΔpH/h, respectively) and females (mean, medium, interquartile range = 0.76, 0.76, 0.71–0.81 ΔpH/hour, respectively), when gender was the only factor considered (p = 0.7238). However, with age progression, male testing values exhibited a consistent upward trend, while females did not show any clear patterns. Linear regression analysis of the data revealed that gender, age, and age group more or less affected testing values either as independent variables or with their combinations and interactions. However, more potential factors need to be included to achieve better testing value predictions. We recommend the toxicological testing community to adopt a new set of age group specific RBC-AChE activity reference ranges for males (0.68–0.80, 0.69–0.81, 0.70–0.83, 0.71–0.84, and 0.73–0.87 ΔpH/h for 18–29, 30–39, 40–49, 50–59, and ≥60 years old, respectively) while keeping the current reference range (0.63–0.89 ΔpH/hour) for females. [ABSTRACT FROM AUTHOR]

Objective Procedure Results Conclusions To describe a repeatable method of measuring ocular structures and to establish ocular biometry reference ranges in adult domestic rabbits (Oryctolagus cuniculus) without medical history or imaging findings consistent with ophthalmic disease using a 64‐slice multidetector computed tomography scanner.In this retrospective and observational anatomic study, 100 eyes from 50 rabbits without medical history or imaging findings consistent with ophthalmic disease who received a head computed tomography scan were selected for measurement of globe length, width, and height using 3D multiplanar reconstruction. Lens width and length, the anteroposterior length of the anterior and vitreous chambers, and attenuation of the lens and vitreous chamber were collected. These parameters were compared against age, sex, weight, body condition, and ear conformation.A reference guide was established, with globe width being the largest dimension (18.03 ± 0.81 mm), followed by height (17.18 ± 0.69 mm) and then length (16.64 ± 0.66 mm). Increased weight was associated with an increase in globe height (p = 2.43 × 10−5), length (p = 1.63 × 10−4), and width (p = 7.0 × 10−3). Increased age was associated with increased lens attenuation (p = 1.28 × 10−7) and increased transverse lens width (p = 1.64 × 10−3). Inter‐ and intra‐observer agreement was excellent.CT is a reliable modality for measurement of ocular biometry dimensions in rabbits. These reference values can be applied to aid in identifying diseases that affect the dimensions of the ocular structures in rabbits over 18 months of age. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine whether clinical efficacy and reported adverse effects (AEs) of the newer antiseizure medications (ASMs) brivaracetam (BRV), lacosamide (LCM), and perampanel (PER) have been associated with plasma levels of these ASMs. We also investigated whether plasma levels outside the reference range has led to dose adjustments. Methods: Plasma levels of 300 people with epilepsy (PWE) seen at our tertiary epilepsy center were determined by liquid chromatography–tandem mass spectrometry. PWE received BRV (n = 100), LCM (n = 100), or PER (n = 100), in most cases in polytherapy. Demographic and clinical data were retrospectively analyzed and related to plasma levels. Clinical efficacy of BRV, LCM, or PER was assessed retrospectively by comparing seizure frequency at the time of current blood draw with seizure frequency at the time of first administration. AEs were also recorded and, if reported, compared retrospectively with the time of first administration. Results: No significant associations were found between plasma levels of BRV, LCM, or PER and seizure freedom (BRV, p = 1.000; LCM, p =.243; PER, p =.113) or responder status (BRV, p =.118; LCM, p =.478; PER, p =.069) at presentation. There was also no pattern between plasma levels and the occurrence of AEs. In the majority of cases, drug levels outside the reference ranges have not led to adjustments in the daily doses of BRV (93.5%), LCM (93.9%), or PER (89.1%). Significance: Plasma levels at a given time point did not allow conclusions to be drawn about seizure control or the occurrence of AEs. Our findings indicate that efficacy and tolerability cannot be predicted based on averaged data from a single plasma measurement due to high interindividual variability. Instead, individual reference values should be established when sufficient clinical data are available, in line with the 2008 International League Against Epilepsy position paper on therapeutic drug monitoring. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) reference ranges for ventricular morphology and function in the Chinese population are lacking. Purpose: To establish the MRI reference ranges of left and right ventricular (LV and RV) morphology and function based on a large multicenter cohort. Study Type: Prospective. Population: One thousand and twelve healthy Chinese Han adults. Field Strength/Sequence: Balanced steady‐state free procession cine sequence at 3.0 T. Assessment: Biventricular end‐diastolic, end‐systolic, stroke volume, and ejection fraction (EDV, ESV, SV, and EF), LV mass (LVM), end‐diastolic and end‐systolic dimension (LVEDD and LVESD), anteroseptal wall thickness (AS), and posterolateral wall thickness (PL) were measured. Body surface area (BSA) and height were used to index biventricular parameters. Parameters were compared between age groups and sex. Statistical Tests: Independent‐samples t‐tests or Mann–Whitney U test to compare mean values between sexes; ANOVA or Kruskal–Wallis test to compare mean values among age groups; linear regression to assess the relationships between cardiac parameters and age (correlation coefficient, r). A P value <0.05 was considered statistically significant. Results: The biventricular volumes, LVM, LVEDD, RVEDV/LVEDV ratio, LVESD, AS, and PL were significantly greater in males than in females, even after indexing to BSA or height, while LVEF and RVEF were significantly lower in males than in females. For both sexes, age was significantly negatively correlated with biventricular volumes (male and female: LVEDV [r = −0.491; r = −0.373], LVESV [r = −0.194; r = −0.184], RVEDV [r = −0.639; r = −0.506], RVESV [r = −0.270; r = −0.223]), with similar correlations after BSA normalization. LVEF (r = 0.043) and RVEF (r = 0.033) showed a significant correlation with age in females, but not in males (P = 0.889; P = 0.282). Data Conclusion: MRI reference ranges for biventricular morphology and function in Chinese adults are presented and show significant associations with age and sex. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Aims Cardiovascular magnetic resonance parametric mapping enables non-invasive quantitative myocardial tissue characterization. Human myocardium has normal ranges of T1 and T2 values, deviation from which may indicate disease or change in physiology. Normal myocardial T1 and T2 values are affected by biological sex. Consequently, normal ranges created with insufficient numbers of each sex may result in sampling biases, misclassification of healthy values vs. disease, and even misdiagnoses. In this study, we investigated the impact of using male normal ranges for classifying female cases as normal or abnormal (and vice versa). Methods and results One hundred and forty-two healthy volunteers (male and female) were scanned on two Siemens 3T MR systems, providing averaged global myocardial T1 and T2 values on a per-subject basis. The Monte Carlo method was used to generate simulated normal ranges from these values to estimate the statistical accuracy of classifying healthy female or male cases correctly as 'normal' when using sex-specific vs. mixed-sex normal ranges. The normal male and female T1- and T2-mapping values were significantly different by sex, after adjusting for age and heart rate. Conclusion Using 15 healthy volunteers who are not sex specific to establish a normal range resulted in a typical misclassification of up to 36% of healthy females and 37% of healthy males as having abnormal T1 values and up to 16% of healthy females and 12% of healthy males as having abnormal T2 values. This paper highlights the potential adverse impact on diagnostic accuracy that can occur when local normal ranges contain insufficient numbers of both sexes. Sex-specific reference ranges should thus be routinely adopted in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Wistar rats are extensively used as the model for assessing toxicity and efficacy in preclinical research. Hematological and biochemical laboratory data are essential for evaluating specific variations in the physiological and functional profile of a laboratory animal. Establishing hematological and biochemical reference values for Wistar (han) rats at various age intervals was the goal of this work. Male and female Wistar rats (n = 660) of ages 6–8 weeks, 10–14 weeks and > 6 months were used in the experiment. Blood and serum were collected from these rats under fasting conditions. Results: We observed that the majority of hematological and biochemical parameters were significantly influenced by sex and age. Hematological changes were significantly correlated to aging were increased red blood cells, hemoglobin, hematocrit, neutrophils, monocytes and eosinophils in both sexes, as well as decreased platelet, mean corpuscular volume, mean corpuscular hemoglobin and lymphocytes in both sexes. White blood cells of male rats were considerably higher than those of female rats in all age ranges. For biochemistry, increase in glucose, total protein and creatinine were seen in both sexes, along with increases in urea in females and alanine aminotransferase in males. Age was significantly associated with decreased alkaline phosphatase in both sexes. Conclusions: When using Wistar rats as a model, these reference values may be useful in evaluating the results. [ABSTRACT FROM AUTHOR]

Patients with chronic daily headaches (CDH) are often a diagnostic challenge and frequently undergo neuroimaging. One common underlying cause of CDH is idiopathic intracranial hypertension (IIH). However, certain neuroimaging abnormalities that suggest IIH, such as optic nerve sheath diameters (ONSD), pituitary gland height, and venous sinus diameter, require interpretation due to the absence of established normative values. Notably, intracranial pressure is known to varies with age, sex and weight, further complicating the determination of objectively abnormal findings within a specific patient group. This study aims to assist clinical neuroradiologists in differentiating neuroimaging results in CDH by providing weight-adjusted normative values for imaging characteristics of IIH. In addition to age and BMI we here assessed 1924 population-based T1-weighted MRI datasets of healthy participants for relevant MRI aspects of IIH. Association to BMI was analyzed using linear/logistic regression controlled for age and stratified for sex. ONSD was 4.3 mm [2.8; 5.9]/4.6 mm [3.6; 5.7] and diameter of transverse sinus was 4.67 mm [1.6; 6.5]/4.45 mm [3.0; 7.9]. Height of pituitary gland was 5.1 mm [2.2;8.1]/4.6 mm [1.9;7.1] for female and male respectively. Values generally varied with BMI with regression slopes spanning 0.0001 to 0.05 and were therefor presented as normative values stratified by BMI. Protrusion of ocular papilla, empty sella and transverse sinus occlusion were rare in total. Our data show an association between BMI and commonly used MRI features for diagnosing IIH. We provide categorized normative BMI values for ONSD, pituitary gland height, and transverse sinus diameter. This distinction helps objectively identify potential IIH indicators compared to regular population norms, enhancing diagnostic accuracy for suspected IIH patients. Notably, optic nerve head protrusion, empty sella, and transverse sinus occlusion are rare in healthy individuals, solidifying their importance as imaging markers regardless of BMI. [ABSTRACT FROM AUTHOR]

In this commentary, we address a paper published by Johnson et al. by assessing the robustness of their method to discover diagnostic biomarkers in Alzheimer's disease (AD). In addition, we examine how these newly discovered and previously discovered biomarkers, can play a role in assisting patients with AD and those at risk for developing AD, with an emphasis on the translational hurdles that accompany such discoveries. [ABSTRACT FROM AUTHOR]

Background: Leucine arylamidase (LAP) is a type of proteinase. During pregnancy, the LAP value of women will continue to rise, but there is currently no established normal range for this value. Methods: A total of 26,208 records of LAP information from pregnant women who visited Qingdao Municipal Hospital between 2016 and 2022 were selected, including 25,582 records of healthy pregnant women. The study used the AU5800 Series Clinical Chemistry Analyzer as the detection equipment. The Wilcoxon method was appropriate for calculating confidence intervals in this study since LAP values in pregnant women have a skewed distribution. Results: The reference ranges obtained were 64.00 - 70.50 U/L, 161.00 - 166.00 U/L, and 174.50 - 182.50 U/L for the first trimester, second trimester, and third trimester, respectively. Conclusions: LAP can rise significantly during pregnancy, so it is essential to establish an appropriate reference range for pregnant women. Abnormal values of LAP carry a risk of developing various pregnancy disorders. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplantation is still a curative treatment for many haematological cancers. Many factors, such as age, sex, ethnic background, smoking status, and body mass index, affect average reference values in different populations. This study aimed to establish a reference range for the absolute numbers and percentages of healthy individuals' hematopoietic stem cells and immune cells in the bone marrow. Seventy-one healthy donors (32 males and 39 females) were enrolled in the study. Following bone marrow harvesting, using flow cytometry, immunophenotyping was performed to determine the absolute number and percentage of CD34+ stem cells and various immune subsets. We found no statistically significant difference in the absolute count of HSCs or immune cell subsets in the bone marrow between males and females. Regarding age, the younger group had more significant CD34+ and immune cell subsets. Donors with healthier body weights tend to have richer bone marrow cellularity. Establishing a reference value for hematopoietic stem cells and immune cells in the bone marrow based on various influential factors is pivotal for defining bone marrow status and donor selection.

Background: Detecting subtle changes in the parotid gland size can be difficult when there are no established reference values in a specific area. This can affect patient management and delay early detection of diseases. Therefore, the objective of this study was to describe the size of the parotid gland of adult Nigerian people. Methods: This cross-sectional study included apparently healthy adults. The parotid glands were scanned in various sections using a 7.5 MHz probe after applying ultrasound gel. Each dimension was measured twice, and the mean value was calculat-ed. The 95% reference rages (mean ± 1.96 standard deviation) were described for various dimensions of the parotid glands. Results: Four hundred healthy adults participated in the survey. Their mean (standard deviation) age was 38.6 (14.6) years. The mean (95% reference range) of both parotid lengths was 4.7 (4.1 – 5.3) cm. The right and left parotid transverse sizes were 3.8 (3.4 – 4.2) and 3.7 (2.9 – 4.5) respectively. The right and left parotid depths lateral to the mandible were 0.8 (0.4 – 1.2) and 0.9 (0.3 – 1.5), parotid depths dorsal to the mandible were 2.3 (1.7 – 2.9) and 2.2 (1.8 – 2.6), and parotid volume were 20.3 (13.3 – 27.1) and 19.8 (14.3 – 25.3) cm3. No significant difference was seen between the right and left parotid glands in men and women. Conclusion: This study delineates the mean and reference range values of parotid glands among healthy adults of Nigeria which can be used for clinical decision making.

Abstract Background Maternal lipid metabolism fluctuations have been shown to increase the risk of adverse pregnancy outcomes. However, there is no consensus over what constitutes normal maternal lipid values during twin pregnancy. Therefore, the aim of this study was to establish a serum lipid reference range for a twin pregnancy. Methods A retrospective survey was conducted, from 2011 to 2021, at the Peking University Third Hospital. A total of 881 twin pregnancies, with lipid data from early and middle pregnancies, were included. After excluding those with adverse pregnancy outcomes, we performed a descriptive analysis of total cholesterol (TC), triglycerides (TG), high-density lipid cholesterol (HDL-C), and low-density lipid cholesterol (LDL-C) levels, using the mean and standard deviation to determine appropriate percentiles. We later determined the lipid reference range in early and middle pregnancy based on the initial results. We evaluated Inappropriate lipid levels associations with pregnancy outcomes, including gestational diabetes, pregnancy-induced hypertension, small for gestational age. Results (1) Serum levels of TC, TG, LDL-C, and HDL-C increased significantly from early to late pregnancy, where the greatest increase was observed in TG. (2) Based on the results, we recommend that TC, TG, and LDL-C serum reference values during early and middle pregnancy should be less than the 95th percentile. On the other hand, HDL-C should be greater than the 5th percentile. During early pregnancy, the values recommended are TC 1.02 mmol/L and LDL 1.25 mmol/L and LDL 1.10 mmol/L and LDL

Background: Maternal lipid metabolism fluctuations have been shown to increase the risk of adverse pregnancy outcomes. However, there is no consensus over what constitutes normal maternal lipid values during twin pregnancy. Therefore, the aim of this study was to establish a serum lipid reference range for a twin pregnancy. Methods: A retrospective survey was conducted, from 2011 to 2021, at the Peking University Third Hospital. A total of 881 twin pregnancies, with lipid data from early and middle pregnancies, were included. After excluding those with adverse pregnancy outcomes, we performed a descriptive analysis of total cholesterol (TC), triglycerides (TG), high-density lipid cholesterol (HDL-C), and low-density lipid cholesterol (LDL-C) levels, using the mean and standard deviation to determine appropriate percentiles. We later determined the lipid reference range in early and middle pregnancy based on the initial results. We evaluated Inappropriate lipid levels associations with pregnancy outcomes, including gestational diabetes, pregnancy-induced hypertension, small for gestational age. Results: (1) Serum levels of TC, TG, LDL-C, and HDL-C increased significantly from early to late pregnancy, where the greatest increase was observed in TG. (2) Based on the results, we recommend that TC, TG, and LDL-C serum reference values during early and middle pregnancy should be less than the 95th percentile. On the other hand, HDL-C should be greater than the 5th percentile. During early pregnancy, the values recommended are TC < 5.31 mmol/L, TG < 2.25 mmol/L, HDL > 1.02 mmol/L and LDL < 3.27 mmol/L, and those during middle pregnancy are TC < 8.74 mmol/L, TG < 4.89 mmol/L, HDL > 1.25 mmol/L and LDL < 5.49 mmol/L, while the values during late pregnancy are TC < 9.11 mmol/L, TG < 6.70 mmol/L, HDL > 1.10 mmol/L and LDL < 5.81 mmol/L. Higher levels of blood lipids were associated with GDM, PE, SGA. Conclusions: We suggested a reference ranges for blood lipids during the twin pregnancy in a Chinese population. The reference ranges recommended by this study can be used to identify women with twin pregnancies using unfavorable lipid values. Higher levels of blood lipids were associated with adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study intends to assess the reference range of lamotrigine concentration for treating childhood epilepsy. Methods: PubMed, Ovid-Embase, The Cochrane Library, CNKI, WanFang data and VIP databases were searched from database inception to January 2022. RCT, cohort study, case–control study, cross-sectional study that estimated the reference range of lamotrigine for children epilepsy treatment were included. The data extracted included basic information, statistical methods, data type, and results of reference range. Descriptive analysis was performed for them. Results: 8 studies were included and estimated the reference range, and all of them were calculated based on efficacy data and/or concentration data. Statistical methods including ROC curve, concentration-effect curve, mean ± standard deviation, 95% confidence interval and percentile interval were utilized. For lamotrigine monotherapy, the lower limits ranged from 2.06 mg/L to 3.99 mg/L, and the upper limits ranged from 8.43 mg/L to 9.08 mg/L, showing basic consistency. However, for lamotrigine concomitant with valproate, the lower limits ranged from 2.00 mg/L to 8.00 mg/L, and the upper limit was 11.50 mg/L, for lamotrigine concomitant with other antiepileptics, the lower limits ranged from 1.00 mg/L to 3.09 mg/L, and the upper limits varied from 5.90 mg/L to 16.24 mg/L, indicating inconsistency. Conclusion: Several studies have estimated the reference range of lamotrigine for childhood epilepsy, while controversy exist and no studies have determined the upper limit of the range based on safety data. To establish the optimal reference range, further high-quality studies are necessary that consider both efficacy and safety data. [ABSTRACT FROM AUTHOR]

Background: Acylcarnitine is one of the crucial markers of fatty acid metabolism, and examination of their level in infants can reveal several Inherited Metabolic Disorders (IDM) or Inborn errors of Metabolism (IEM). Because of the great importance of hereditary, metabolic, and other inherited disorders early diagnosis before the appearance of clinical symptoms, this study was carried out to establish a reference range for carnitine analytes and to identify acylcarnitine profiles in normal weight neonatal dried blood spots (DBS) specimens. Methods: By using liquid chromatography tandem mass spectrometry (LC-MS/MS) for neonatal screening and eventually the examination and analysis of LC-MS/MS results, 34 acylcarnitine derivatives were identified. Results: The normal range for acylcarnitine analytes with carbon numbers ranging from zero to 18, both main and the branched ones, were ultimately measured. Afterward, they were compared with the results of some other diagnostic laboratories to be verified. Conclusion: This study differed from the other findings, which could be due to diversity in population and work methods. However, the reference range of most acylcarnitine derivatives in Tehran closely aligned with this study's findings. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Background: Although reference ranges of T1 and T2 mapping are well established for cardiovascular magnetic resonance (CMR) at 1.5T, data for 3T are still lacking. The objective of this study is to establish reference ranges of myocardial T1 and T2 based on a large multicenter cohort of healthy Chinese adults at 3T CMR. Methods: A total of 1015 healthy Chinese adults (515 men, age range: 19–87 years) from 11 medical centers who underwent CMR using 3T Siemens scanners were prospectively enrolled. T1 mapping was performed with a motion-corrected modified Look–Locker inversion recovery sequence using a 5(3)3 scheme. T2 mapping images were acquired using T2-prepared fast low-angle shot sequence. T1 and T2 relaxation times were quantified for each slice and each myocardial segment. The T1 mapping and extracellular volume standardization (T1MES) phantom was used for quality assurance at each center prior to subject scanning. Results: The phantom analysis showed strong consistency of spin echo, T1 mapping, and T2 mapping among centers. In the entire cohort, global T1 and T2 reference values were 1193 ± 34 ms and 36 ± 2.5 ms. Global T1 and T2 values were higher in females than in males (T1: 1211 ± 29 ms vs. 1176 ± 30 ms, p < 0.001; T2: 37 ± 2.3 ms vs. 35 ± 2.5 ms, p < 0.001). There were statistical differences in global T2 across age groups (p < 0.001), but not in global T1. Linear regression showed no correlation between age and global T1 or T2 values. In males, positive correlation was found between heart rate and global T1 (r = 0.479, p < 0.001). Conclusions: Using phantom-validated imaging sequences, we provide reference ranges for myocardial T1 and T2 values on 3T scanners in healthy Chinese adults, which can be applied across participating sites. Trial registration URL: http://www.chictr.org.cn/index.aspx. Unique identifier: ChiCTR1900025518. Registration name: 3T magnetic resonance myocardial quantitative imaging standardization and reference value study: a multi-center clinical study. [ABSTRACT FROM AUTHOR]

Abstract Background Cattle strongly mask their pain, making the recognition and assessment of pain difficult. Different subjective and objective parameters to assess pain have been described. Substance P (SP), which is a neurotransmitter, is used to objectively evaluate nociception in cattle. However, SP concentrations have mainly been described in diseased animals, or animals subjected to painful procedures. To this day, no evaluation of SP in healthy adult cattle has been published. The objectives of this pilot study were to 1) assess the SP concentrations in healthy adult German Simmental cattle in the blood plasma, 2) compare the concentrations between the blood of the jugular and the tail vein, and 3) assess the concentrations in the blood of the tail vein every 6 h over a period of 24 h. A total of 52 healthy cattle of the German Simmental breed were included in this study. Animals were 5.0 ± 1.3 (mean ± SD) years old and between 117 and 239 (175.0 ± 34.1) days in milk. Blood samples were taken from the jugular vein (BJV, 07:45 a.m.) and the tail vein (TV1, 08:00 a.m.) each. Additional blood samples were taken every 6 h over the course of 24 h from the tail vein (TV2 – TV5). SP concentrations were analyzed using a commercial ELISA kit. Results Mean (± SD) and median SP concentrations were 1.087 ± 436 pg/ml and 984 pg/ml for BJV (range 502 – 2,337 pg/ml), and 920 ± 402 pg/ml and 818 pg/ml for TV1 (range 192 – 2,531 pg/ml), respectively. There was a significantly positive correlation between SP concentrations of BJV and TV1. SP concentrations between BJV and TV1 were significantly different, as were SP concentrations in the tail vein between sampling times over the course of 24 h. Conclusions The results of this study show that blood samples to assess SP concentrations in cattle can be taken from the jugular as well as from the tail vein. There are high variations in concentrations between animals, and it is hard to define reference ranges for SP in healthy animals. Repeated blood samples should not be taken by repeated punctation of a vein but by use of a jugular vein catheter, which is a major limitation of the present study.

Veterinarians rely on the measurement of canine body temperature to define the health status of dogs, but no studies exist defining a reference range for rectal temperature on a large group of dogs. The aim of this study was to define the rectal body temperature of dogs based on a large data set of diseased and healthy animals and to evaluate the capability of the employed algorithm to calculate reference intervals of numerical clinical data. Out of 24,013 recorded measurements, statistical analysis was applied to data from 9782 adult dogs that underwent clinical examination at a university clinic between 2008 and 2017. The reference interval was calculated using an algorithm developed by the Deutsche Gesellschaft für Klinische Chemie und Laboratoriumsmedizin e.V. as part of its Reference Limit Estimator software (version 1.40.36.07). The following values were excluded: multiple measurements in a given dog, samples without assigned age or dogs younger than one year, and values 43.0 °C. Out of 9782 adult dogs, 665 temperature measurements were identified as outliers, and 9117 were used for further statistical analysis. The mean rectal temperature was 38.6 °C (90% CI: 38.6–38.6 °C) with a reference interval of 37.7 °C (90% CI: 37.7–37.7 °C) to 39.5 °C (90% CI: 39.5–39.5 °C). Validation according to CLSI guidelines showed the results to be valid. The determination of a reference interval for rectal temperatures in dogs using an algorithm for mixed datasets yielded results comparable to the existing reference intervals. This demonstrates that the calculation of reference intervals from mixed datasets of clinical numerical data can be used to confirm existing reference intervals or establish such de novo.

Objective To explore the distribution of T lymphocyte subsets in peripheral blood of healthy adults from Chashan Town of Dongguan in Guangdong Province. Methods The venous whole blood samples were collected from 827 healthy adults. The percentage of CD3+ T cells， CD4+ T cells， CD8+ T cells， CD4+CD8+ double positive （DP） T cells， and regulatory T（Treg） cells and CD4+/CD8+ ratio were determined by flow cytometry. Results The percentage of CD3+ T cells， CD4+ T cells， CD8+ T cells， CD4+/CD8+ ratio， DP T cells and Treg cells were determined as 40.5%-75.2%， 35.4%-68.9%， 27.4%-61.8%， 0.6-2.4， 0.2%-2.7% and 2.4%-6.0%， respectively. Significant differences were observed in the distribution of lymphocyte subsets regarding age and gender （all P < 0.05）. Conclusion The distribution of T lymphocyte subsets in healthy adults from Chashan Town of Dongguan in Guangdong Province was successfully analyzed， providing valuable reference for clinicians in this region.

Background The common reference intervals (RIs) for thyroid hormones currently used in China are provided by equipment manufacturers. This study aimed to establish thyroid hormone RIs in the population of Lanzhou, a city in the subplateau region of northwest China, and compare them with previous reports and manufacturer-provided values. Methods In total, 3,123 individuals (1,680 men, 1,443 women) from Lanzhou, an iodine-adequate area of China, perceived as healthy were selected. The Abbott Architect analyzer was used to determine the serum concentration of thyroid hormones. The 95% RI was estimated using the 2.5th and 97.5th percentiles as the lower and upper reference limits, respectively. Results The serum levels of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), antithyroglobulin (ATG) antibody, and antithyroid peroxidase (ATPO) antibody levels were significantly correlated with sex (P0.05). The established RIs of TSH, ATG, and ATPO in this study differed between sexes (P

Background: Cattle strongly mask their pain, making the recognition and assessment of pain difficult. Different subjective and objective parameters to assess pain have been described. Substance P (SP), which is a neurotransmitter, is used to objectively evaluate nociception in cattle. However, SP concentrations have mainly been described in diseased animals, or animals subjected to painful procedures. To this day, no evaluation of SP in healthy adult cattle has been published. The objectives of this pilot study were to 1) assess the SP concentrations in healthy adult German Simmental cattle in the blood plasma, 2) compare the concentrations between the blood of the jugular and the tail vein, and 3) assess the concentrations in the blood of the tail vein every 6 h over a period of 24 h. A total of 52 healthy cattle of the German Simmental breed were included in this study. Animals were 5.0 ± 1.3 (mean ± SD) years old and between 117 and 239 (175.0 ± 34.1) days in milk. Blood samples were taken from the jugular vein (BJV, 07:45 a.m.) and the tail vein (TV1, 08:00 a.m.) each. Additional blood samples were taken every 6 h over the course of 24 h from the tail vein (TV2 – TV5). SP concentrations were analyzed using a commercial ELISA kit. Results: Mean (± SD) and median SP concentrations were 1.087 ± 436 pg/ml and 984 pg/ml for BJV (range 502 – 2,337 pg/ml), and 920 ± 402 pg/ml and 818 pg/ml for TV1 (range 192 – 2,531 pg/ml), respectively. There was a significantly positive correlation between SP concentrations of BJV and TV1. SP concentrations between BJV and TV1 were significantly different, as were SP concentrations in the tail vein between sampling times over the course of 24 h. Conclusions: The results of this study show that blood samples to assess SP concentrations in cattle can be taken from the jugular as well as from the tail vein. There are high variations in concentrations between animals, and it is hard to define reference ranges for SP in healthy animals. Repeated blood samples should not be taken by repeated punctation of a vein but by use of a jugular vein catheter, which is a major limitation of the present study. [ABSTRACT FROM AUTHOR]

Objective: To establish a reference range for fetal ductus venosus pulsatility index for veins (DV PIV) and investigate the efficacy of the abnormal ductus venosus (DV) Doppler assessment to diagnose the chromosomal abnormalities of the fetus during first-trimester screening. Material and Methods: We retrospectively evaluated a total of 3,243 singleton pregnancies at 11+0 to 13+6 weeks of gestation in a 12-year period and assigned the patients into 2 groups to compare the efficacy of DV PIV in predicting chromosome abnormalities. The first group consisted of pregnancies involving fetuses with chromosomal abnormalities and the second group consisted of uncomplicated singleton fetuses with available DV Doppler measurements. We determined a cut-off value for DV PIV measurements to predict chromosomal abnormalities, and analyzed the relationship between chromosome abnormalities, and abnormal DV Doppler measurements. Results: A total of 644 fetuses (104 fetuses with an abnormal karyotype (pregnancies involving fetuses with chromosomal abnormalities) and 540 fetuses phenotypically normal or euploid in neonates after birth (pregnancies with normal fetuses) met the study criteria. The 5th and 95th percentiles of DV PIV were 0.78 and 1.21 in pregnancies with normal fetuses. We calculated with 63.6% sensitivity and 60.3% specificity, (95% confidence interval 0.72-0.83) for DV PIV to diagnose chromosomal abnormalities. Abnormal DV blood flow was related to all trisomies. The lowest DV PIV was observed in cases with trisomy 21, while the highest DV PIV values were found in cases with trisomy 18 and 13 in the abnormal karyotype group. Conclusion: Routinely monitoring DIV PIV as a first-trimester screening tool may be beneficial to predict fetal chromosomal abnormalities. [ABSTRACT FROM AUTHOR]

Fluoxetine is the recommended first-line antidepressant in many therapeutic guidelines for children and adolescents. However, little is known about the relationships between drug dose and serum level as well as the therapeutic serum reference range in this age group. Within a large naturalistic observational prospective multicenter clinical trial ("TDM-VIGIL"), a transdiagnostic sample of children and adolescents (n = 138; mean age, 15; range, 7–18 years; 24.6% males) was treated with fluoxetine (10–40 mg/day). Analyses of both the last timepoint and all timepoints (n = 292 observations), utilizing (multiple) linear regressions, linear mixed-effect models, and cumulative link (mixed) models, were used to test the associations between dose, serum concentration, outcome, and potential predictors. The receiver operating curve and first to third interquartile methods, respectively, were used to examine concentration cutoff and reference values for responders. A strong positive relationship was found between dose and serum concentration of fluoxetine and its metabolite. Higher body weight was associated with lower serum concentrations, and female sex was associated with lower therapeutic response. The preliminary reference ranges for the active moiety (fluoxetine+norfluoxetine) were 208–328 ng/mL (transdiagnostically) and 201.5–306 ng/mL (depression). Most patients showed marked (45.6%) or minimal (43.5%) improvements and reported no adverse effects (64.9%). This study demonstrated a clear linear dose–serum level relationship for fluoxetine in youth, with the identified reference range being within that established for adults. [ABSTRACT FROM AUTHOR]

Evaluation of the inclination direction and degree of the Sylvian fissure plateau has not been reported. We aimed to evaluate the Sylvian fissure plateau by Sylvian fissure plateau angle (SFPA) in axial views at 23–28 wk gestation. A prospective ultrasound evaluation of 180 normal and 3 abnormal singleton pregnant women was conducted at 23–28 wk gestation. All cases were assessed in three axial planes of the fetal brain (the transthalamic, transventricular and transcerebellar plane) using transabdominal 2-D images. The SFPAs of all cases were measured between the brain midline and a line drawn along the Sylvian fissure plateau. Intraclass correlation coefficients (ICCs) were used to assess the intra- and inter-observer repeatability of SFPA measurements. The SFPAs in normal cases in the transthalamic, transventricular and transcerebellar planes were all above y = 0, while in abnormal cases were below y = 0. However, there was no major difference between the angles measured on the transthalamic and transventricular planes (p = 0.365). There was a major difference between the SFPAs on the transcerebellar plane and transthalamic/transventricular plane (p < 0.05). The intra- and inter-observer ICCs were excellent at 0.971 (95% confidence interval [CI]: 0.945–0.984) and 0.936 (95% CI: 0.819–0.979), respectively. The SFPAs of the normal cases in three axial views were stable at 23–28 wk gestation, suggesting that 0° may be a good cut-off value for evaluating abnormal SFPA. Findings offer a potential method by which the SFPA < 0°, as shown in three abnormal cases described herein, can be evaluated prenatally and thus serve as another tool for malformations of cortical development assessment, especially for frontoobitalopercula dysplasia. We recommend use of SFPA of the transthalamic plane to evaluate the Sylvian fissure in clinical work. [ABSTRACT FROM AUTHOR]