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Context and ObjectiveIn vitro labelling of leukocytes with 99mTc-HMPAO is a haematological test performed and optimised in specialised radiopharmacies in some university hospitals. It is used to differentiate between infection on implanted devices and inflammation in cases of pain. However, it requires high-quality biological samples. Several factors, including those related to the patient and healthcare professionals, affect the outcome. This study aims to establish a link between sample quality and image quality to improve our practices and patient care.Materials and MethodsWe first established criteria to assess blood sample quality, such as the duration of collection, the type of equipment used, the puncture site, sedimentation time, hemolysis, and cell viability tests, alongside an associated score (≤2: excellent, 3≤ score ≤5: average, ≥6: poor). We then defined image quality criteria in the early phase, based on spleen/liver (S/L) activity ratios measured during imaging (a ratio <130% indicating good image quality, 130%–150% moderate quality, and >150% poor quality). Lastly, we statistically compared S/L ratios between two groups: good vs. average/poor samples.ResultsOut of 23 samples, 18 were rated ‘excellent,’ two ‘average,’ and three ‘poor.’ Among the ‘excellent’ samples, 17 had S/L ratios <130%, corresponding to good image quality, while one had a ratio >150%. Among the five ‘average/poor’ samples, one had an S/L ratio <130%, one between 130%–150%, and three >150%. A significant difference (P<0.05) was found between the good and average/poor sample groups.Conclusion/DiscussionOur results suggest that sample quality affects image quality. However, certain biases, such as the small sample size and the low proportion of ‘average/poor’ samples (5/23), should be considered. The choice of quality criteria and scoring system may need refinement. Additionally, the patient’s cell condition at the time of testing and the proximity of the suspected infection to organs like the liver and spleen may influence the results. A larger, long-term study could help develop optimal sampling recommendations.

Objective Early readmission following total hip arthroplasty (THA) is not uncommon and impacts patient outcomes and healthcare costs. However, easily accessible biomarkers for early identification of high‐risk patients remain limited. This study aims to evaluate the association between various blood component‐derived ratios and 14‐day readmission after THA. Methods Data from the Chang Gung Medical Research Database (CGRD) from 2014 to 2022 were retrospectively analyzed. Patients ≥ 20 years old who underwent primary THA by a single surgeon were included. The primary outcome was 14‐day readmission. Five hematologic markers were evaluated: monocyte‐to‐albumin ratio (MAR), red cell distribution width (RDW)‐to‐albumin ratio (RAR), hemoglobin‐to‐albumin ratio (HAR), leukocyte‐to‐albumin ratio (LAR), and RDW‐to‐platelet ratio (RPR). Ratios were calculated from blood collected within 1 month before to 1 week after surgery. Receiver operating characteristic (ROC) Curve analysis was used to determine their optimal thresholds, and multivariable logistic regression assessed associations between these markers and readmission risk. Results A total of 307 patients were included in the analysis. Among the ratios evaluated, only high RPR (≥ 0.10; aOR = 5.92, 95% CI: 2.19–16.00, p = 0.001) was significantly associated with increased risk of 14‐day readmission after adjustment in the multivariable analysis. Conclusion RPR is independently associated with 14‐day readmission following THA in this exploratory study. As an easily obtainable marker, it may aid postoperative risk stratification, and the findings provide a foundation for future multicenter prospective investigations incorporating more granular perioperative factors and additional biomarkers before clinical application. RDW‐to‐platelet ratio (RPR) is strongly associated with 14‐day readmission following total hip arthroplasty. RPR could serve as a marker for patients at increased risk of early readmission.

Systemic inflammatory cell ratio, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) are used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory markers for pathological response and prognosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC). In this study, we collected data of 203 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. The effects of NLR, PLR, and LMR on the disease-free survival (DFS) of patients with breast cancer were analyzed by test and Cox regression analyses. We found that 27 of the 203 patients (13.3%) had local or distant metastases. The peripheral blood NLR, PLR, and LMR areas under the curve (AUC) were 0.674 (0.555-0.793), 0.630 (0.508-0.753), and 0.773 (0.673-0.874), respectively. The optimal cutoff values were 3.0, 135, and 6.2, respectively. Univariate and multivariate analyses revealed that LMR was related to the pathological complete response (pCR) rates and breast cancer DFS ( < 0.05). Among all patients, those with low LMR, HER-2 positive, and lymph node status (N2-3) demonstrated poor DFS. Our study thus demonstrated that LMR can act as a potential marker for predicting the efficacy and prognosis of patients with breast cancer.

We present a new methodology of computing incremental contribution for performance ratios for portfolio like Sharpe, Treynor, Calmar or Sterling ratios. Using Euler’s homogeneous function theorem, we are able to decompose these performance ratios as a linear combination of individual modified performance ratios. This allows understanding the drivers of these performance ratios as well as deriving a condition for a new asset to provide incremental performance for the portfolio. We provide various numerical examples of this performance ratio decomposition. Mathematics Subject Classification: C12; G11

Abstract Background The utility of neutrophil-to-lymphocyte ratio (NLR), platelet to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) as prognostic indicators has not been investigated in canine parvovirosis (CPV). Hypothesis To evaluate whether these hematological ratios obtained at hospital admission in CPV are associated with outcome or duration of hospitalization. Animals Four hundred one client-owned dogs presented with CPV. Methods-Retrospective multicenter cohort study. Medical records were reviewed to identify dogs with CPV. Data regarding signalment, complete blood count at admission, duration of hospitalization and outcome were collected. Results Of the 401 dogs included in the study, 336 (83.8%) survived to discharge. The median (25th and 75th percentiles) PLR in nonsurvivors (336.56 [159.84-635.77]) was significantly higher than in survivors (217.65 [117.67-389.65]) (P = .003). The area under the receiver-operating characteristic curve for nonsurvival was 0.615 (95% CI [0.593-0.691], P = .003). A cut off of 700 showed a 21.5% sensitivity and 90% specificity for nonsurvival. No association was observed between hospitalization duration and either hematological ratios or total WBC counts. The median (25th and 75th percentiles) lymphocyte count was below reference interval in all dogs and was significantly lower in the dogs which died (0.82 × 109/L [0.5-1.87]) than in survivors (1.27 × 109/L [0.73-2.22]) (P = .005). The median (25th and 75th percentiles) monocyte count however was lower in survivors (0.38 × 109/L [0.29-1.59]), than in nonsurvivors (0.73 × 109/L [0.1-2]) (P = .002). Conclusions Evaluation of PLR at hospital admission might be a useful marker of disease severity and could have prognostic value in dogs with CPV.

BackgroundSmall airways dysfunction (SAD) is an important treatable trait in persistent asthma but remains poorly captured by conventional spirometry. The (FEV3-FEV1)/FVC and FEV3/FEV6 ratios have been proposed as novel markers of peripheral airflow limitation.ObjectiveWe investigated the relationship between (FEV3-FEV1)/FVC and FEV3/FEV6 with severe exacerbation frequency and symptom control in patients with moderate-to-severe asthma.MethodsClinical, physiological and biomarker data were collected from adults with GINA-defined moderate-to-severe asthma visiting a specialist severe asthma centre in Scotland. Associations between spirometric and oscillometric parameters with clinically relevant outcomes were retrospectively analysed using multivariate models.Results294 patients were included in the analysis. The (FEV3-FEV1)/FVC and FEV3/FEV6 ratios were not significantly associated with asthma symptoms or severe exacerbation rate. Conversely, traditional measures such as FEV1/FVC [adjusted odds ratio (95%CI) 2.11 (1.27,3.50) p<0.01], FEF25–75/FVC [2.11 (1.27,3.50) p<0.01], and oscillometric Rrs5–20 [OR 1.90 (1.14,3.16) p<0.05] were significantly associated with ≥2 exacerbations in the previous year (figure 1). High coefficient of determination (r2) values were observed between FEV1/FVC with (a) (FEV3-FEV1)/FVC r2=0.61 and (b) FEV3/FEV6 r2=0.83, suggesting overlapping aspects of lung function being measured. There was a weak correlation between FEV1/FVC and Rrs5–20 values (r2=0.08) indicating that these parameters assess unique aspects of lung function and mechanics.Abstract M19 Figure 1Adjusted odds ratios (95%CI) between spirometry and oscillometry parameters in relation to exacerbation frequency[Image Omitted. See PDF.]ConclusionIn moderate-to-severe asthma, (FEV3-FEV1)/FVC does not independently predict clinical outcomes and offers no advantage over conventional lung function assessments.

The clinical value of the Syntax score in patients with non-ST segment elevation myocardial infarction (NSTEMI) has been well established. The neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the high sensitivity C-reactive protein (hsCRP)-albumin ratio (hsCAR), and systemic immune-inflammatory (SII) index are promising systemic inflammation (SI) biomarkers in coronary artery diseases. However, studies which compare the predicting value of these SI indicators with the Syntax score in NSTEMI patients are limited. NSTEMI patients who underwent coronary angiography (CAG) in our department were retrospectively enrolled. Both univariable and multivariable logistic regression analyses were performed to evaluate the clinical value between SI biomarkers and Syntax score in these patients. The area under the receiver operating characteristic curve (ROC) was used to compare the clinical values of these parameters in predicting 6-month major cardiovascular events (MACE) and over-all mortality. A total of 429 NSTEMI patients were finally enrolled in this study. The level of NLR, PLR, as well as hsCAR, and SII in patients with high Syntax scores, are significantly higher than patients with the low Syntax score. Multivariable logistic regression analysis demonstrated that all of the SI indicators but not the Syntax score were the independent risk factors of 6-month MACE in NSTEMI patients. ROC showed that all of the SI indicators had better predictive value than the Syntax score in these patients (0.637, 0.592, 0.631, 0.590, 0.559, respectively) in predicting MACE and similar predictive value in over-all mortality (0.530, 0.524, 0.761, 0.553, 0.620, respectively). Novel SI biomarkers including NLR, PLR, hsCAR, and SII have better predictive value in MACE and similar predictive value in over-all mortality compared with Syntax score in NSTEMI patients.

The present research work aimed to examine the vital factors that affect the solvency of the Indian construction sector. The two different parameters of solvency, namely, debt to total assets (DTA) and cash flow to total liabilities (CFTL), were used in the present study. These two solvency indicators were categorized using zero and one numerical values. One indicates financially sound companies, and zero indicates weak companies with poor solvency ratios. The different financial ratios, namely, profitability, liquidity, leverages, and turnovers, were used as predictors or explanatory variables of insolvency of Indian construction companies. The study employs multivariate discriminant analysis (MDA) and binary logistic regression to predict the factors accountable for the insolvency of the Indian construction sector. The empirical findings of MDA and logistic regression show significant discrimination in the solvency position of construction companies according to their different financial performance parameters, namely, profitability, liquidity, and leverage. The empirical findings suggest that in the first case, the critical indicators predicting solvency are turnover, liquidity, and leverage ratios. In the second measure of solvency (CFTL), profitability significantly discriminates solvency of companies. Overall, the findings of MDA and logistic regression are consistent with each other. The outcomes of the study will be helpful to policymakers' different stakeholders.

Accumulating evidence suggested that immune system activation might be involved in the pathophysiology of schizophrenia. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) can measure inflammation. This study aimed to investigate the inflammatory state in patients with schizophrenia by using these indicators. In this study, the complete blood count data for 187 continuing hospitalized patients with schizophrenia and 187 age- and sex-matched healthy participants was collected annually from 2017 to 2019. Platelet (PLT), lymphocyte (LYM), monocyte (MON) and neutrophil (NEU) counts were aggregated and NLR, MLR, PLR, and SII were calculated. Using a generalized linear mixed model, we assessed the impact of age, sex, diagnosis, and sampling year on the above indicators and evaluated the interaction between the factors. According to the estimation results of the generalized linear mixed model, the NLR increased by 0.319 (p = 0.004), the MLR increased by 0.037 (p < 0.001), and the SII increased by 57.858 (p = 0.018) in patients with schizophrenia. Data after two years of continuous antipsychotic treatment showed that the NLR and MLR were higher in patients with schizophrenia than those in healthy controls, while the PLT and LYM counts were decreased in patients with schizophrenia. The schizophrenia diagnosis was correlated to the MON and LYM count, NLR, MLR, and SII ( < 0.05). The differences in these markers were stable and cannot be eliminated by a full course of treatment. This study provides impetus for the inflammatory hypothesis of schizophrenia.

Abstract Disclosure: S. Lee: None. L. Needleman: None. J. Park: None. R. Schugar: None. J.P. Annes: None. Pathogenic mutations in the succinate dehydrogenase complex, particularly in the SDHB gene, predispose individuals to hereditary pheochromocytoma and paraganglioma (hPPGL). However, more than 80% of missense SDHB variants are classified as variants of uncertain significance (VUS) in ClinVar. Consequently, numerous families harboring an SDHB VUS are at elevated oncologic risk, but do not benefit from early detection protocols. As SDHB pathogenicity is caused by impaired SDH enzymatic activity, functional evaluation may help resolve VUS classification. Hence, we developed a functional biochemical assay using CRISPR/Cas9-engineered SDHB-knockout HEK293 cells to assess succinate/fumarate ratios by LC-MS/MS as a proxy for SDH enzymatic activity. Loss of SDHB led to a marked elevation in the succinate/fumarate ratio, which was restored by transfection of wild-type SDHB. Expression of 35 classified variants (9 benign, 26 pathogenic) clustered into low and high succinate/fumarate ratio groups, validating the assay’s ability to resolve SDHB variant functionality. To improve interpretability, we converted succinate/fumarate ratios into SDH % activity, which was used for the logistic regression modeling of known variants. Using the trained model, P(path) and OddsPath values were calculated to assign ACMG/AMP functional evidence strength (BS3/PS3). Compared to the computational predictor REVEL, our assay provided superior discrimination between benign and pathogenic variants. This model was applied to 33 VUSs, including 16 Stanford patient alleles and three causative of Leigh syndrome. Twenty-three VUSs demonstrated wild-type-like activity (BS3), while 10 exhibited marked SDH dysfunction and were assigned PS3strong. Following ACMG/AMP guidelines, mock clinical interpretation that included our functional assay recategorized 78% of SDHB VUSs (16 likely benign and 10 likely pathogenic). Notably, all SDHB VUSs affecting highly conserved cysteine residues responsible for Fe-S cluster coordination showed complete enzymatic loss, confirming the critical function of these domains. Interestingly, recessive mitochondrial disease-associated SDHB variants (Leighs) were not reliably distinguished from wild-type-like variants, indicating these variants are not causative for hPPGL. Finally, pathogenic variants with relatively lower succinate/fumarate ratios than PPGL-predominant variants were associated with increased occurrence of head and neck paragangliomas (HNPGL; r2=0.45; p=0.0001). Logistic modeling identified a metabolic threshold predictive of tumor location; hence, SDH dysfunction severity influences location-specific tumor risk. Together, these data establish a robust, quantitative platform for SDHB variant classification with immediate clinical implications for risk assessment and tumor surveillance. Presentation: Saturday, July 12, 2025