Circulating Endothelial Cells: A New Possible Marker of Endothelial Damage in Kawasaki Disease, Multisystem Inflammatory Syndrome in Children and Acute SARS-CoV-2 Infection.

BACKGROUND: Kawasaki Disease (KD) and Multisystem Inflammatory Syndrome in Children (MIS-C) are pediatric diseases characterized by systemic inflammation and vascular injury, potentially leading to coronary artery lesions (CALs). Data on vascular injury occurring during acute COVID-19 (AC19) in children are still lacking. The aim of our study was to investigate endothelial injury in KD-, MIS-C- and AC19-dosing circulating endothelial cells (CECs). METHODS: We conducted a multicenter prospective study. CECs were enumerated by CellSearch technology through the immunomagnetic capture of CD146-positive cells from whole blood. RESULTS: We enrolled 9 KD, 20 MIS-C and 10 AC19. During the acute stage, the AC19 and KD patients had higher CECs levels than the MIS-C patients. From the acute to subacute phase, a significant CEC increase was observed in the KD patients, while a mild decrease was detected in the MIS-C patients. Cellular clusters/syncytia were more common in the KD patients. No correlation between CECs and CALs were found in the MIS-C patients. The incidence of CALs in the KD group was too low to investigate this correlation. CONCLUSIONS: Our study suggests a possible role of CECs as biomarkers of systemic inflammation and endothelial dysfunction in KD and MIS-C and different mechanisms of vascular injury in these diseases. Further larger studies are needed.

INVESTMENT REASONS FOR USING STANDARDS COMPLIANCE IN AUTONOMOUS VEHICLES

The possibility of a quick return on investment - ROI, is reflected in the application of clear research studies on the actors involved in production processes, with an emphasis on investment and the application of compliance. Tendencies to ensure the stability, reliability and compliance of software require the application of certain standards. By understanding the application of standardization and digitalization, companies can identify themselves as leaders in investing in innovation. The main element of the research is reflected in the identification of the reasons for the cooperation of software companies, suppliers, manufacturers. Research studies rely on supplier segmentation, through the study of decision-making methods. The analysis of the accompanying literature ensures the application of harmonization of standards in business practice with the aim of defining research issues. The scope and structure are limited in the review of the sources of connection of the processes that take place during production from the physical parts to the software itself. The application of the methodological approach considers the degree of innovation in order to provide a secure and reliable integration solution. Performance is measured through the constant presentation of acquired software knowledge and verification of compliance. Relying on intelligent data collection techniques can accelerate development and enable a higher degree of definition writing by harmonization between companies.