Journal of Clinical Laboratory Analysis最新文献

{"title":"The Association of VDR FokI T>C (rs2228570) Gene Variants With T2DM, and Its Complications: Influence on BMI, Oxidative Stress, and Dyslipidemia","authors":"Armin Sharifi,&nbsp;Mahsa Nouri,&nbsp;Ebrahim Shakiba,&nbsp;Zahra Ghorbani,&nbsp;Zohreh Rahimi","doi":"10.1002/jcla.70090","DOIUrl":"10.1002/jcla.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The present study aimed to investigate the association between vitamin D receptor (VDR) <i>FokI</i> gene variants and the risk of type 2 diabetes mellitus (T2DM) and its complications, as well as with oxidative stress parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated 300 individuals with diabetes with and without neuropathy and retinopathy, and 100 individuals without diabetes. The PCR-RFLP technique was used to determine the genotypes of VDR <i>FokI</i> T&gt;C (rs2228570). The oxidative stress parameters were measured using chemical methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In individuals with diabetes, there were significantly higher levels of body mass index (BMI) and oxidative stress than in controls. The presence of the FokI CC genotype and the C allele were associated with 2.46 times and 1.6-fold increased risk of T2DM, respectively, and enhanced diabetic neuropathy risk by 3.41- and 3.68-fold, respectively, and elevated diabetic retinopathy risk by 2.45 and 1.59 times, respectively. The presence of FokI TC + CC compared to the TT genotype resulted in higher triglycerides, total oxidative status, and BMI levels in individuals with diabetes. We found significantly higher BMI, oxidative stress index, and significantly lower levels of total antioxidant capacity in females than in males among individuals with diabetes and controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that the <i>FokI</i> CC genotype and the <i>FokI</i> C allele are associated with an increased risk of T2DM and its complications. We observed the influence of VDR <i>FokI</i> variants on dyslipidemia, oxidative stress, and BMI. It seems the risk factors of developing T2DM, obesity, and oxidative stress among women are more prevalent than in men.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 19","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonlinear Relationship Between Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio and Non-Alcoholic Fatty Liver Disease: A Secondary Retrospective Analysis Based on a Japanese Longitudinal Study","authors":"Lingde Shen,&nbsp;Yuanfang Lin,&nbsp;Weifeng Chen,&nbsp;Dan Zhou,&nbsp;Hui Peng","doi":"10.1002/jcla.70107","DOIUrl":"10.1002/jcla.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this research is to investigate the particular connection between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and non-alcoholic fatty liver disease (NAFLD) to offer a more precise foundation for evaluating NAFLD risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study involves a secondary analysis of a retrospective cohort study conducted from 2004 to 2015 in a Japanese population, which included 14,106 participants. The TG/HDL-C ratio was determined by the levels of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Participants were grouped according to the quartiles of TG/HDL-C. We analyzed the relationship between TG/HDL-C and NAFLD using Cox proportional hazards regression, smooth curve fitting, and sensitivity analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average age of the study participants was 43.51 ± 8.89 years, with 7275 (51.57%) being male. After considering potential confounding factors, the study found a positive correlation between TG/HDL-C and NAFLD (OR: 1.37, 95% CI: 1.31–1.43, <i>p</i> &lt; 0.001). Moreover, a nonlinear relationship between TG/HDL-C and NAFLD was found, with a turning point at 1.42. The odds ratio (OR) on either side of this inflection point were 3.71 (95% CI: 2.87–4.79) on the left and 1.23 (95% CI: 1.17–1.29) on the right, indicating a stronger correlation when TG/HDL-C is below 1.42, particularly in younger individuals, females, and those with a BMI under 25 kg/m².</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The TG/HDL-C index shows a nonlinear positive correlation with NAFLD risk, particularly when the TG/HDL-C ratio is below 1.42, with a stronger association observed in younger individuals, females, and lower-BMI populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 20","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference Intervals for Lead, Arsenic, Mercury, and Cadmium in the Population of Southwest China: A Comparative Study of Direct and Indirect Sampling Techniques","authors":"Manqing Nie,&nbsp;Hang Du,&nbsp;Tiancheng Xie,&nbsp;Bo Zheng,&nbsp;Xiaoli Zou,&nbsp;Guokang Sun,&nbsp;Qiurong He,&nbsp;Ling Wu,&nbsp;Jing Zhang,&nbsp;Dingzi Zhou","doi":"10.1002/jcla.70096","DOIUrl":"10.1002/jcla.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Environmental metal pollution poses a potential threat to public health, and reference intervals (RIs) are crucial tools for assessing exposure levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Our study was the first to systematically establish RIs for lead, arsenic, mercury, and cadmium in a population in southwest China, examining differences across genders and ages. The study also compared the differences between RIs obtained by two sampling techniques, including direct and indirect sampling, to assess the substitutability and limitations between the two techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Direct sampling employed atomic absorption spectrometry (AAS) and inductively coupled plasma-mass spectrometry (ICP-MS) on human biomonitoring (HBM) data, while indirect sampling utilized a Gaussian Mixture Model (GMM) applied to a local Laboratory Information System (LIS) database. RIs were determined using the nonparametric method for both approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RIs were established for each metal, with variations observed across age groups for cadmium and lead, and across genders for lead in certain age groups. Most of the RIs established by the direct sampling technique had a narrower range compared to that established by GMM, and the RIs established by the two techniques were partially biased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>These RIs offer a vital baseline for assessing environmental metal exposure and identifying metal poisoning in Southwest China. Additionally, this study highlights the potential of the GMM-based indirect sampling technique as a viable alternative to the traditional direct sampling technique, with the dual-technique comparison enhancing our understanding of their substitutability and limitations, thus opening new avenues for environmental health research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 19","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic, Targeted Genotypic, and Antimicrobial Susceptibility Profiling of Extended-Spectrum β-Lactamase Production and Exclusive blaOXA−48 Gene Detection in Escherichia coli and Klebsiella pneumoniae Isolates From a South Lebanese Hospital","authors":"Aya Kahil,&nbsp;Elie Salem Sokhn","doi":"10.1002/jcla.70108","DOIUrl":"10.1002/jcla.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Globally, multidrug resistance (MDR), including extended-spectrum β-lactamase (ESBL) and carbapenemase production in <i>Enterobacteriaceae</i>, is increasing. Data concerning their presence in South Lebanon are scarce. This study aimed to determine the prevalence of ESBL and carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) in <i>Escherichia coli</i> (<i>E. coli</i>) and <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>) isolates from the Saida region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In Hammoud Hospital University Medical Center (HHUMC), and over a period of 9 months, identification and susceptibility testing of the isolates using the Kirby–Bauer method were performed and then confirmed as recommended by the Clinical and Laboratory Standards Institute (CLSI). Molecular analysis of the genes encoding ESBL and carbapenemases was investigated by polymerase chain reaction (PCR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 isolates (171 <i>E. coli</i> and 29 <i>K. pneumoniae</i>) were obtained from different clinical specimens (urine, rectal swabs, blood, sputum, pus, wound/tissue, nasal swabs, vaginal swabs) and were subsequently studied. Nearly 89.5% (179/200) and 10.5% (21/200) of the isolates were producers of ESBL and carbapenemase, respectively. The ESBL isolates showed high sensitivity toward carbapenem drugs, whereas the CRE isolates were most sensitive to tigecycline. Of 67 studied ESBL isolates, <i>bla</i>_CTX-M (44.8%) was the most prevalent gene, followed by <i>bla</i>_TEM (37.3%) and <i>bla</i>_SHV (13.4%). Among the CRE isolates, only two of 21 collected isolates were positive for the <i>bla</i>_OXA-48 gene.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This type of scenario highlights the necessity of using antibiotics sparingly and putting stringent measures in place to prevent infections.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 20","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Regional Proadrenomedullin in Cerebrospinal Fluid Is a Reliable Diagnostic and Prognostic Marker for Acute Meningoencephalitis and Neurological Disorders","authors":"Francesco Janes,&nbsp;Paola Dalla Siega,&nbsp;Marco Comar,&nbsp;Matteo Furlani,&nbsp;Agnese Zanus Fortes,&nbsp;Daniela Visentini,&nbsp;Andrea Ripoli,&nbsp;Francesco Sbrana,&nbsp;Novella Carannante,&nbsp;Silvia Leonardi,&nbsp;Francesco Curcio,&nbsp;Mariarosaria Valente,&nbsp;Martina Fabris,&nbsp;Carlo Tascini","doi":"10.1002/jcla.70110","DOIUrl":"10.1002/jcla.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Despite numerous pieces of evidence of its important role as a diagnostic and prognostic biomarker in infectious diseases and sepsis, adrenomedullin (ADM) was only poorly investigated in cerebrospinal fluid (CSF) in central nervous system (CNS) infections. In this multicentre retrospective study, we investigated ADM CSF concentrations in acute meningitis compared to other noninfectious neurological disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Since ADM is rapidly metabolised in vivo, the available diagnostic methods are designed to measure its cognate metabolite called mid-regional proADM (MR-proADM). We collected detailed clinical and laboratory data about 293 patients in whom MR-proADM was measured in CSF and plasma as part of the diagnostic workup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients were finally classified in CNS infection (<i>n</i> = 59), other CNS disorders (<i>n</i> = 190) and 14 disease controls, in which CNS infections and other definite disorders were excluded. Both cerebrospinal MR-proADM levels and their CSF/blood ratio were significantly higher in CNS infections compared to the other two groups (<i>p</i> &lt; 0.001 and <i>p</i> &lt; 0.037 respectively). CSF MR-proADM resulted informative for patients' classification, furnishing a volume under the ROC surface of 0.513 [0.414–0.613], overcoming the 1/6 threshold value for undecidability. Threshold values of &lt; 0.807 and &gt; 1.590 nmol/L can differentiate controls from neurological disorders and neurological disorders from CNS infections respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We demonstrated significant upregulation of Adrenomedullin in CSF during infections compared to other neurological diseases and proposed preliminary thresholds of CSF MR-proADM to be used in the diagnostic workup of acute CNS infections, to help with differential diagnosis and possibly guide targeted therapeutic interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 20","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Infection Confirmed by Bronchoalveolar Lavage Fluid Metagenomics -Next-Generation Sequencing Instead of Pharyngeal Swabs in Follicular Lymphoma: Three-Case Report and Literature Review","authors":"Can Liu,&nbsp;Yupeng Song,&nbsp;Siyan Niu,&nbsp;Yili Jiang,&nbsp;Tingting Zhu,&nbsp;Xin Li,&nbsp;Rui Cui,&nbsp;Qi Deng","doi":"10.1002/jcla.70103","DOIUrl":"10.1002/jcla.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hematologic malignancy patients with B lymphocytopenia after anti-CD20 monoclonal antibody or anti-CD19 chimeric antigen receptor (CAR) T cell therapy often face prolonged SARS-CoV-2 positivity on pharyngeal swabs and persistent or recurrent COVID-19 infection, resulting in high mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Here, we describe three follicular lymphoma (FL) patients with persistent fever, cough, and hypoxemia, but they were ruled out for bacterial, viral, fungal, and other pathogen infections, and the throat swabs were consistently SARS-CoV-2 negative. These FL patients with B lymphocyte deficiency who were diagnosed with COVID-19 infection confirmed by bronchoalveolar lavage fluid (BALF) metagenomics next-generation sequencing (mNGS). Their COVID-19 infection was characterized by differences in viral load in the upper and lower respiratory tracts. When this particular COVID-19 infection occurred, although their percentages and absolute values of CD8⁺ T cells and CD4⁺ T cells were normal, they all had B lymphocyte deficiency and hypogammaglobulinemia. They all had low expression of interleukin (IL)-6 in peripheral blood inconsistent with clinical infection symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients received a combination therapy of molnupiravir and methylprednisolone; then their symptoms were relieved over the next 2 weeks–2 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Therefore, for immunocompromised patients, especially those with B lymphocyte deficiency, hypogammaglobulinemia, and low expression of IL-6 in peripheral blood inconsistent with clinical infection symptoms, mNGS for BALF should be performed as soon as possible in this particular condition to confirm the diagnosis of COVID-19 infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 20","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Characteristics and Prognosis of IgA Nephropathy Combined With Malignant Hypertension Kidney Injury","authors":"Zhong Zhong,&nbsp;Wenzhuo Yang,&nbsp;Zefang Dai,&nbsp;Jianbo Li,&nbsp;Zhijian Li","doi":"10.1002/jcla.70105","DOIUrl":"10.1002/jcla.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>IgA nephropathy (IgAN), a major cause of primary glomerulonephritis, is closely associated with malignant hypertension (MHT). This study aimed to explore the clinicopathological characteristics and renal prognosis of patients with IgAN combined with malignant hypertension kidney injury (IgAN-MHT) and investigate the associations of clinicopathological indicators with prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center retrospective cohort study, patients diagnosed with IgAN-MHT through kidney biopsy between January 1, 2008, and June 30, 2023, in our hospital were enrolled. Cox regression models were used to assess the associations between clinical indicators and renal prognosis in IgAN-MHT patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 70 patients were included in the analysis of renal function improvement. During a median follow-up time of 9.4 months, 26 patients (37.1%) achieved renal function improvement. Patients in the improved renal function group had higher hemoglobin levels (<i>p</i> = 0.003), lower serum creatinine levels (<i>p</i> = 0.006), a higher proportion of patients using sulodexide (<i>p</i> = 0.018), and a lower proportion of glomerulosclerosis (<i>p</i> &lt; 0.001). Multivariable Cox regression analysis indicated that a higher proportion of glomerulosclerosis was independently associated with a lower likelihood of renal function improvement (HR = 0.97, 95% CI = 0.96–0.99, <i>p</i> = 0.003), while sulodexide administration was independently associated with a higher likelihood of improvement (HR = 2.75, 95% CI = 1.18–6.41, <i>p</i> = 0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study revealed that in IgAN-MHT patients, a higher proportion of glomerulosclerosis was independently associated with poorer renal outcomes, while the use of sulodexide showed a significant independent association with improved renal function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 20","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Set of Rapid Diagnostic Tool for Babesia microti Infection","authors":"Yanan Bai,&nbsp;Shangdi Zhang,&nbsp;Qindong Liang,&nbsp;Xinxin Zhang,&nbsp;Zeen Liu,&nbsp;Yuxin Ye,&nbsp;Jianxun Luo,&nbsp;Hong Yin,&nbsp;Chongge You,&nbsp;Guiquan Guan,&nbsp;Jinming Wang","doi":"10.1002/jcla.70102","DOIUrl":"10.1002/jcla.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Human babesiosis caused by <i>Babesia microti</i> is an emerging tick-borne zoonosis, with a global pooled prevalence of 2.23% and regional peaks in Europe (4.17%) and North America (1.54%). Traditional diagnostics like microscopy and polymerase chain reaction (PCR) suffer from low sensitivity in low-parasitemia cases or high costs ($230/test), necessitating accessible, rapid assays for resource-limited regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-priming amplification combined with vertical flow visualization (CPA-VF) assay, a straightforward molecular method targeting the 18S rRNA gene of <i>B. microti</i>, requires minimal equipment and facilitates rapid detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sensitivity/Specificity: The CPA-VF assay detected 2.56 fg/reaction (equivalent to 0.000004% parasitic red blood cells), with a sensitivity of 95.5% matching that of RT-PCR but at a 60-fold lower cost ($3.8/test). It showed no cross-reactivity with <i>B. duncani, B</i><i>. divergens</i><i>, or Plasmodium</i>. Clinical Validation: Testing 49 positive samples (19 experimentally infected mice +30 artificially spiked) and 492 field samples, CPA-VF demonstrated 95.5% sensitivity (95% CI: 88.2–98.7) and 95.5% specificity compared to nested PCR (nPCR). Intra-assay coefficients of variation (CV) was 2.1%–7.2% and inter-assay kappa coefficient was 0.94, confirming reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CPA-VF is a rapid, low-cost ($3.8/test), and instrument-free diagnostic tool for <i>B. microti</i>, particularly suitable for endemic regions where timely diagnosis reduces mortality risks from misdiagnosis as malaria. Its portability and visual readout address critical gaps in resource-constrained settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 20","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Serum 3-Epi-25-Hydroxyvitamin D3, 25-Hydroxyvitamin D3 and 25-Hydroxyvitamin D2 in the Korean Population With UPLC–MS/MS","authors":"Sung-Eun Cho,&nbsp;Jungsun Han,&nbsp;Gayoung Chun,&nbsp;Rihwa Choi,&nbsp;Sang Gon Lee,&nbsp;Hyung-Doo Park","doi":"10.1002/jcla.70098","DOIUrl":"10.1002/jcla.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The liquid chromatography–tandem mass spectrometry method (LC–MS/MS) identified an epimeric form of 25-hydroxyvitamin D₃ (3-epi-25-OH-D₃) concentrations. For the first time, the 3-epi-25-OH-D₃ was included in the Korea National Health and Nutrition Examination Survey (KNHANES) IX (from 2022 to 2024). In this study, we evaluated the results of 3-epi-25-OH-D₃ in KNHANES IX to determine its clinical status in Korea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We measured 3-epi-OH-D₃, 25-OH-D₃, and 25-OH-D₂ concentrations using an Ultra Performance (UP) LC–MS/MS, and assessed the differences in concentration ranges based on gender and age among participants in this national project.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The concentration range of 3-epi-25-OH-D₃ among 11,744 Korean participants (5193 male and 6551 female, aged 10–80 with a median age of 53) was 0.50 (lower limit of quantification) to 15.66 ng/mL, with a mean ± SD of 1.15 ± 0.85 ng/mL. The 3-epi-25-OH-D₃ concentration was not significantly different between genders. The concentrations of 25-OH-D metabolites were different across age groups. There was a highly significant correlation between 3-epi-25-OH-D₃ and 25-OH-D₃ concentrations (<i>r</i> = 0.77, <i>R</i>² = 0.5911, slope = 0.0579, <i>p</i> &lt; 0.0001). The minimum and maximum of % 3-epi-25-OH-D₃ were 1.33% and 23.94%, respectively. The % 3-epi-25-OH-D₃ was highest in the highest quartile (Q4) of the total 25-OH-D₃ concentration (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first large-scale study of 3-epi-25-OH-D₃ concentrations in the Korean population. Accurate measurement of 3-epi-25-OH-D₃ is necessary for the reliable results of vitamin D metabolites in KNHANES.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 19","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Cell Population Data With Hematology Analyzer Messages for Improved Detection of Immature White Blood Cells and Laboratory Efficiency","authors":"Lin-Chen Hsu,&nbsp;Tsung-Han Tsai,&nbsp;Yu-Hua Lin,&nbsp;Kai-Yun Lu,&nbsp;Wen-Chun Liu","doi":"10.1002/jcla.70099","DOIUrl":"10.1002/jcla.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Improving efficiency and reducing turnaround time are crucial in clinical laboratories. While automated analyzers such as the Beckman Coulter DxH 900 streamline workflow, subtle abnormalities like blasts and immature granulocytes (IGs) may be missed, especially in the absence of WBC-related suspect messages. This study evaluated whether integrating cell population data (CPD) with instrument messages could enhance detection accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 587 blood samples were analyzed and classified with (Group A) or without (Group N) WBC-related suspect messages. Manual slide review (MSR) and digital morphology (DM) served as reference standards. CPD parameters were evaluated using receiver operating characteristic (ROC) analysis and Youden's index to establish optimal detection rules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 587 samples, 55.3% were in Group A and 44.7% in Group N, with Group A showing significantly lower red blood cell, hemoglobin, and platelet counts (<i>p</i> &lt; 0.001). The DxH 900 flagged 37.7% and 55.4% of samples with blast- and IG-related messages, respectively. However, it failed to detect blasts in 20.6% of cases confirmed by MSR and 21.3% by DM, and missed IGs in 16.2% of MSR-confirmed and 18.7% of DM-confirmed positive samples. CPD parameters (e.g., SD_V_NE, MN_V_NE) identified additional true positives, with area under the curve (AUC) values &gt; 0.9. Integrating CPD rules with WBC-related suspect messages improved sensitivity/specificity to 91.9%/99.0% for blasts and 91.5%/96.7% for IGs, using MSR as the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Integrating CPD parameters with WBC-related suspect messages provides a sensitive, automated secondary screening strategy that reduces false negatives and enhances hematologic diagnostics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 19","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}