Association between phase angle and level of independence in daily living among institutionalized super older females requiring nursing care.

[Purpose] This study aimed to clarify the association between phase angle (PhA) and the level of independence in daily living among institutionalized super older females requiring nursing care. [Participants and Methods] This three-facility cross-sectional study enrolled 173 nursing home residents (mean age 91.0 years, standard deviation 4.9 years) divided into five groups, from 80+ to 100+ years of age, in 5-year increments. PhA, skeletal muscle mass index, body fat percentage, body mass index, and Barthel Index were measured in the five groups. We measured the relationship between age and PhA and analyzed partial correlation coefficients using these items. The adjusted variables differed significantly among the five groups. [Results] The overall PhA was 2.91 degrees, with a 2.36-degree PhA in patients aged >100 years. Age differences were found between the PhA and the Barthel Index. A significant correlation (0.66) was identified between the PhA and the Barthel Index. The age-adjusted partial correlation coefficient between the PhA and the Barthel Index was 0.56, indicating a moderately significant positive correlation. [Conclusion] This study identified an association between PhA and independence in daily living among female nursing home residents aged 80-107 years, indicating that the PhA is an excellent indicator of physical condition.

Elevated serum cholesterol levels during pregnancy as predictors for postpartum hypercholesterolemia: A prospective cohort study.

OBJECTIVE: To identify the associations between gestational cholesterol levels and the risk of postpartum hypercholesterolemia, and to establish trimester-specific reference values. METHODS: Serum lipids at gestational weeks 6-8, 16, 24, and 36, and 42 days postpartum were derived from 905 pregnant women of a prospective cohort. The major outcome was postpartum hypercholesterolemia. Logistic regression and restricted cubic splines were conducted to estimate the associations between cholesterol levels at specific gestational ages and postpartum hypercholesterolemia. Associations of the trend of changes in cholesterol levels during pregnancy with postpartum hypercholesterolemia were evaluated by linear mixed-effect model and linear or logistic regression. Reference values were computed by the receiver operating characteristic curves. RESULTS: Serum concentrations of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and the ratios of TC/HDL-C and LDL-C/HDL-C all increased during pregnancy and decreased at 42 days postpartum. The elevated levels of TC and LDL-C, decreased levels of HDL-C in pregnancy, and their rapid change rates were positively associated with higher risks of postpartum hypercholesterolemia. The established reference values from the first to the third trimester were below 5.47, 6.35, and 7.22 mmol/L for TC; below 2.83, 3.82, and 4.21 mmol/L for LDL-C; and more than 1.50, 1.55, and 1.50 mmol/L for HDL-C, respectively. CONCLUSION: Maternal cholesterol levels and their trend of change during pregnancy were predictors of postpartum hypercholesterolemia. Trimester-specific reference values were established in a Chinese population.

A New Design for Reference Values Assignment in Proficiency Testing for Fat and Crude Protein in Raw Milk for a Limited Number of Participants.

Proficiency testing (PT) allows food laboratories to endorse their competency to provide food safety guarantees to producers and consumers. One of the recommended methods for assigning reference values in PT with a small number of participants consists in considering the results that a laboratory obtains by means of a calibration test based on certified reference material (CRM). The present study delves into the results from eight PT rounds on the determination of fat and crude protein from raw milk, with modifications in the number of samples and the analysis sessions from that required by the ISO 13528:2022. The uncertainty criterion of the assigned value established by the ISO 13528:2022 standard was met by 93% of the participating laboratories, which allowed most participants to be evaluated through z-score. The assigned values were generally compatible with the results obtained by the participants. Thus, it can be concluded that the design for the assignment of the reference value is appropriate for PT with a limited number of participants. It is recommended for future PT to limit the uncertainty of the CRM according to their availability and to update the standard deviation of the proficiency assessment for the Mid-Infrared Spectroscopy method (MIR).

Three-Dimensional Geometry Values and Clinical Determinants for the Annulus of the Tricuspid Valve in a Japanese Population.

The tricuspid annulus (TA) is the primary target of tricuspid valve (TV) surgery for tricuspid regurgitation (TR). However, the reference values for TA geometry in the Japanese population is currently unavailable. We aimed to elucidate the geometric reference values of the TA in Japanese individuals using 3-dimensional (3D) echocardiography.We conducted a prospective study using transthoracic 3D echocardiography on 142 healthy Japanese subjects aged between 20 and 79 years. The tricuspid geometric parameters in the late-diastole and the mid-systole were analyzed using custom 3D software (Realview™).After excluding 46 subjects with poor images, data from 96 subjects (67.6%) were analyzed. TA area and circumference showed strong correlations with body surface area (BSA) (P < 0.001 for all), while some of these parameters exhibited weak correlations with age. Gender differences in TV geometry were assessed across 3 age groups: 20-39 years (42 subjects), 40-59 years (28 subjects), and 60-79 years (26 subjects). In the youngest subjects (20-39 years), males had a significantly larger TA area and smaller anterior-posterior and medial-lateral diameters (P < 0.001 for all), even after adjusting for BSA, indicating gender differences of TA geometry. These differences diminished with age.We present reference values for TA geometry by age and gender in a Japanese cohort. BSA may be a suitable metric for indexing the TA parameters. While age-related changes in TA parameters may not be significant, gender differences, particularly in younger individuals, persist even after adjusting for BSA.

Reliability, Objectivity, Validity, and Reference Levels of the Austrian Pole Climbing Test (APCT)-A Novel Monitoring Tool for Assessing General Fitness in Children, Adolescents, and Young Adults.

Climbing is an activity involving many major muscle groups and, therefore, it is suitable for assessing general physical fitness. The Austrian pole climbing test (APCT) was developed as a reliable and valid test for the assessment of general fitness levels in children, adolescents, and young adults. In this cross-sectional pilot study, 677 participants (aged 6 to 19 years) were assessed via the APCT. Subsequently, test quality criteria (reliability and objectivity) were assessed, and the test's validity was evaluated through comparisons with other established fitness tests (hand grip strength, standing long jump, and pull- and push-ups). Additionally, age- and gender-specific reference values were generated. The reliability (ICC2.1 = 0.97, 95%CI 0.95 to 0.98) and objectivity (ICC2.1 = 0.99, 95%CI 0.99 to 0.99) of the APCT were found to be excellent. The APCT results correlated strongly with the hand strength per kilogram of body weight (right: r = 0.58; left: r = 0.53), number of pull-ups (with upper grip: r = 0.74; with lower grip: r = 0.69) and standing long jump (r = 0.61); a moderate correlation with the push-up test was observed (r = 0.44). The APCT is reliable, objective, and suitable for children, adolescents, and young adults with an affinity for sports. It offers a novel opportunity to assess fitness without time pressure, considering the anthropometric requirements.

Establishing and Validating Refractive Error Reference Values for Myopia Prediction Among Children Aged 6-12 Years - Jiangsu Province, China, 2018-2023.

What is already known about this topic?: Previously, it has been proved that a simplified model that uses refraction error value provides a robust and efficient means of predicting myopia for non-myopic students. Intervention targeting non-myopic children with alert refraction errors (or insufficient hyperopia reserve) holds significant importance in reducing the incidence rate of myopia. What is added by this report?: This study, comprising two phases (surveillance and cohort studies), was aiming to pinpoint the precise refractive error value for the onset of myopia prediction among non-myopic children in Jiangsu Province. What are the implications for public health practice?: First, when conducting myopia screenings using pupil dilation for non-myopic populations: the cycloplegic 50th percentile refractive error emerges as a more precise predictive indicator. Second, when conducting myopia screenings without pupil dilation: this study advocates for the incorporation of axial length (AL) and corneal curvature (CC) values as supplementary indicators in screenings.

A Nationwide Nepalese Study to Establish Reference Intervals for Major Biochemical Analytes with Elucidation of Nepalese Features of Reference Values.

Despite immense importance of reference intervals (RIs) for clinical diagnosis, there have been no reliable RIs available for Nepalese. Hence, this nationwide study was organized to establish RIs for 30 common biochemical parameters. This study was conducted following the harmonized protocol provided by IFCC Committee on Reference Interval and Decision Limits (C-RIDL) with recruitment of 617 apparently healthy volunteers (18 - 65 years) by near-equal gender balance from 5 major cities. Fasting blood were collected, serum was separated and measured collectively using Beckman-Coulter/Olympus AU480 chemistry analyzer. The sources of variations of reference values (RVs) were evaluated by multiple regression analysis and nested ANOVA. Latent abnormal values exclusion (LAVE) method was applied to reduce influence of latent diseases. RIs were standardized based on a value-assigned serum panel provided by C-RIDL. By ANOVA, no between-city differences were observed, while sex-related changes were typically noted for urate, creatinine, iron, γ-glutamyl transferase (GGT), immunoglobulin M, and transferrin, but not for high-density lipoprotein cholesterol. Age-related changes were observed for total cholesterol (TC), triglyceride, low-density lipoprotein cholesterol, and C-reactive protein (CRP). RIs were successfully derived all parametrically. The LAVE procedure was effective in lowering upper limits for aspartate aminotransferase, alanine aminotransferase (ALT), and CRP. Compared to other collaborating countries, Nepalese RIs were low for urea, cholesterols, ALT, and high for triglyceride, GGT, CRP, immunoglobulin G, and complements. The RIs for major chemistry analytes were derived and standardized for nationwide use in Nepal. This study distinctly elucidated sources of variation and international features of Nepalese RIs. Supplementary Information: The online version supplementary material available at 10.1007/s12291-023-01123-6.

Serum amino acid profiles in clinically normal Noma horses.

Plasma or serum amino acids are used to evaluate nutritional status and metabolic disorders. In this study, we aimed to set reference values of serum amino acid concentrations in the Noma horse, a Japanese native horse. Thirty-one horses were classified into six age groups: neonatal foal (0-4 days), foal (0.5-1 years), youth (5 years), middle age (10 years), old (15 years), and extra-old (>20 years). Horses >5 years of age were analyzed together as the adult group. In the adult horses, there were no significant differences among the serum amino acid concentrations of each age group. The foal group had higher concentrations of alanine, aspartic acid, glutamic acid, α-aminoadipic acid, and 3-methyl-histidine than the adult group. The neonatal foal group had higher serum concentrations of phenylalanine, lysine, alanine, proline, aspartic acid, glutamic acid, ß-alanine, and ß-amino-iso-butyric acid and lower tryptophan concentrations and Fischer's ratios than the adult group. The neonatal foal group had higher ß-amino-iso-butyric acid concentrations and lower tryptophan and 3-methyl-histidine concentrations than the foal group. Therefore, reference values might be set separately in neonatal foals, foals, and adult horses. The data for the serum amino acid concentrations can be used for health care through physiological and pathological evaluations in Noma horses.

Reciprocity models revisited: intention factors and reference values.

We present a test of the two most established reciprocity models, an intention factor model and a reference value model. We test characteristic elements of each model in a series of twelve mini-ultimatum games. Results from online experiments show major differences between actual behavior and predictions of both models: the distance of actual offers to the proposed reference value provides a poor measure for the kindness of offers, while a comparison of offers with extreme offers as suggested by the intention factor model makes offers indiscriminable in richer settings. We discuss possible combinations of both models better describing our observations.

Gender-specific reference values of dynamometric and non-dynamometric trunk performance in individuals with different body fat percentages: A preliminary study.

Trunk muscles maintain steady effort with adequate strength and endurance. When the muscle performance is subpar, it might cause lower back discomfort. No reference for trunk strength and endurance has been established previously. The aim of this study was to determine the normative reference values for dynamometric and non-dynamometric tests in people with various body fat percentages. Two hundred sixty-four participants aged 19-40 years old were recruited in this cross-sectional study. The Siri equation was used to calculate the individuals body fat proportions, which were divided into normal, high, and very high body fat for men and women. The Modified Sorenson's and the Back-Leg-Chest Dynamometric tests were utilized to measure muscular performance. The means of strength in females with normal, high, and very high body fat percentages were 27.39, 25.75, and 25.37 N/m2, respectively. The males in the same category had the means of 56.48, 51.79, and 60.17 N/m2, respectively. The highest mean of endurance in females was in those with normal body fat percentage (42.28), so did males (71.02). Our findings suggest that males had higher trunk muscle strength and endurance than females, and normal-body-fat individuals had the greatest endurance regardless of gender.

Reference intervals for knee functions specific to outpatients with knee osteoarthritis: a cross-sectional study.

BACKGROUND: Reference values (RVs) for knee function tests have been reported in perioperative patients with knee osteoarthritis (KOA); however, such values for practical use in outpatient setting has yet to be determined. Therefore, we aimed to establish the reference intervals (RIs) for outpatients with mild to moderate KOA. METHODS: This cross-sectional study enrolled 202 outpatients with KOA from 8 Japanese orthopedic clinics and measured knee extensor/flexor muscle strength (MS) and knee extension/flexion range of motion (ROM). We used multiple regression analysis to evaluate the sources of variation, including sex, age, body mass index, Kellgren-Lawrence (K-L) classification, bilateral KOA, and exercise habits. Magnitude of between-subgroup differences is expressed as standard deviation ratio (SDR) based on a three-level nested analysis of variance, with SDR ≥ 0.4 as the threshold for requiring RIs specific for subgroups. RIs were calculated parametrically using two-parameter Box-Cox formula if Gaussian transformation of RVs was successful, otherwise calculated nonparametrically. RESULTS: Partitioning was required by sex for extensor and flexor MS (SDR = 0.65, 0.57, respectively) and by K-L classification for flexion ROM (SDR = 0.54). RIs were determined parametrically for extensor MS as 0.27-2.09 (male) and 0.27-1.54 (female) Nm/kg and for flexor MS 0.18-1.20 (male) and 0.13-0.79 (female) Nm/kg. On the other hand, RIs for extension and flexion ROM were determined nonparametrically due to discrete nature of their RVs. The RIs determined for extension ROM were -15°-0° and for flexion ROM were 105°-150° (for K-L grade I/II) and 95°-140° (for K-L grade III/IV). CONCLUSIONS: The ranges of RIs determined specifically for patients with mild to moderate KOA were in-between those of age-matched healthy controls and pre-surgical KOA patients, both of which we had reported for use in physiotherapeutic management of KOA patients undergone total knee arthroplasty. The newly derived RIs will provide an objective benchmark for physiotherapy targeting outpatients with mild to moderate KOA.

Intracranial pressure following surgery of an unruptured intracranial aneurysm-a model for normal intracranial pressure in humans.

OBJECTIVE: Optimizing the treatment of several neurosurgical and neurological disorders relies on knowledge of the intracranial pressure (ICP). However, exploration of normal ICP and intracranial pressure pulse wave amplitude (PWA) values in healthy individuals poses ethical challenges, and thus the current documentation remains scarce. This study explores ICP and PWA values for healthy adults without intracranial pathology expected to influence ICP. METHODS: Adult patients (age > 18 years) undergoing surgery for an unruptured intracranial aneurysm without any other neurological co-morbidities were included. Patients had a telemetric ICP sensor inserted, and ICP was measured in four different positions: supine, lateral recumbent, standing upright, and 45-degree sitting, at day 1, 14, 30, and 90 following the surgery. RESULTS: ICP in each position did not change with time after surgery. Median ICP was 6.7 mmHg and median PWA 2.1 mmHg in the supine position, while in the upright standing position median ICP was - 3.4 mmHg and median PWA was 1.9 mmHg. After standardization of the measurements from the transducer site to the external acoustic meatus, the median ICPmidbrain was 8.3 mmHg in the supine position and 1.2 mmHg in the upright standing position. CONCLUSION: Our study provides insights into normal ICP dynamics in healthy adults following a uncomplicated surgery for an unruptured aneurysm. These results suggest a slightly wider normal reference range for invasive intracranial pressure than previously suggested, and present the first normal values for PWA in different positions. Further studies are, however, essential to enhance our understanding of normal ICP. Trial registration The study was preregistered at www. CLINICALTRIALS: gov (NCT03594136) (11 July 2018).

Reference Value Fibrin Monomer in Healthy Children: A Cross-Sectional Study.

The objective of this study is to determine the fibrin monomer reference intervals in healthy children. This cross-sectional study was conducted in the Hematology Department at Vietnam National Children's Hospital (April 2023 to March 2024). Children without prior history of clotting disorders or anticoagulants use hospitalized in preparation for orthopedic surgery or inguinal hernia surgery were enrolled in the study. The fibrin monomer test method was the quantitative fibrin monomer test on the STA-R system (Diagnostica Stago™, France). Eighty-six children (58 males and 28 females) were enrolled in the study. The median (interquartile range, 2.5th-97.5th) fibrin monomer value of the study subjects was 2.56 (0.11-5.93) µg/mL, with no statistically significant difference in fibrin monomer values among the age groups of 1 month to 3 years, 3 years to 13 years, and 13 years to 18 years. This is the first study conducted in Vietnam to determine reference values of fibrin monomer in children. This information can help in the diagnosis and treatment of early hypercoagulation stage and disseminated intravascular coagulation in children.

Cut-off value for a normal posterior tibial nerve to diagnose tarsal tunnel syndrome amongst people of different race in Pretoria, South Africa.

INTRODUCTION: Posterior tibial nerve (PTN) cross-sectional area (CSA) reference values for the diagnosis of tarsal tunnel syndrome (TTS) using ultrasound imaging exist in several countries but not in South Africa (SA). Therefore, the objective was to measure the CSA reference values for PTN in SA. METHODS: Ultrasound CSA measurements of PTN in both ankles on 112 participants were performed, the mean measurement was recorded, and the effect of race, age, gender, and body mass index (BMI) were recorded. RESULTS: In this study, the primary variables age and BMI affect the CSA measurement of the PTN. A positive correlation was found between PTN asymptomatic size and age (r = 0.196, P < 0.05), size and BMI (r = 0.200, P < 0.05). Age (categories) had a mean value of 3.17 for the age group 36-45 years (95% confidence interval (CI) 2.9-3.4). The mean BMI was 30.0 kg/m2 (CI 28.57-31.08). As for the asymptomatic PTN, a mean CSA reference value of 0.10 cm2 was obtained. CONCLUSION: With increase in age and BMI, a greater PTN measurement will occur. Race appears to be a contributing factor, but further research is needed in this regard. The reference CSA value for normal PTN should be set at 0.10 cm2 for all racial groups for a basic musculoskeletal ultrasound exam protocol in South Africa.

Alpha-fetoprotein level in fetuses, infants, and children with ovarian masses: a literature review.

Alpha-fetoprotein (AFP) is a serum protein highly produced during the fetal period. It is also known as a biomarker of various pathologies. Commonly, tumors requiring diagnosis and monitoring through AFP determination appear during the first year of life, with poorer outcomes when presenting in fetal life. Due to advancements in imaging technology, the detectability of ovarian masses in infants is higher. However, the use of AFP as a biomarker could improve diagnosis in cases when imaging and histological examinations are not sensitive enough to detect tumors. From the outcome of our investigation, it is possible to conclude that there is evidence of an association between increased AFP levels and ovarian masses. However, previous studies have presented contradictory and unverified results, with the authors emphasizing that future research is needed. In this article, an analysis of the available literature on AFP as a biomarker of ovarian masses in children was performed. Two types of literature were reviewed: guidance and published studies (clinical trials, reviews, and systematic reviews). We searched the Embase, PubMed, ScienceDirect, and Web of Science databases to collect essential data.

Characterization of nickel levels considering seasonal and intra-individual variation using three biological matrices.

Nickel compounds are classified as group 1 carcinogens by the International Agency for Research on Cancer. However, only a few exposure assessment studies have been conducted on such compounds to date. In this study, we investigated the distribution of nickel in three biological types of samples (blood, serum, and urine) and its temporal variability through repeated measurements. From 2020 to 2021, blood and urine samples were collected for four times from 50 healthy participants. Nickel concentrations were determined using inductively coupled plasma mass spectrometry, and inter-individual correlation was calculated from linear mixed model. The overall geometric mean of nickel was 1.028 µg/L in blood, 0.687 µg/L in serum, and 1.464 µg/L in urine. Blood nickel was the highest in November (blood: 1.197 µg/L), and the geometric mean of nickel concentrations in the serum and urine were the highest in March (serum: 1.146 µg/L; urine: 1.893 µg/L). This matched seasonal trends for fine particulate matter concentrations from 2020 to 2021. Thus, seasonal effects significantly affect nickel levels in blood, serum, and urine. The inter-individual correlations were low as 0.081 for blood and 0.064 for urine. In addition, the correlation of nickel levels between each biological sample was low. It was also found that age, gender, commuting time, and different matrices affect concentrations. Blood and serum nickel levels were high in this study compared to other nationwide data, with urinary nickel ranking the second highest among the six countries examined. Therefore, biomonitoring study in the general population should be conducted, and finding a suitable matrix that can reflect nickel exposure to set exposure guideline levels is imperative.

Can TBS reference values be a valid indicator for clinical vertebral fracture? A cross-sectional study.

INTRODUCTION: Trabecular bone score (TBS) is partially independent of fracture risk. Reference values for TBS have not been established in official guidelines, and thus clinicians often have difficulty interpreting TBS results. This study aimed to investigate whether reference values for TBS could be a valid indicator for clinical vertebral fracture (CVF). MATERIALS AND METHODS: This cross-sectional study involved 231 women with CVF and 563 women without CVF aged 60-90 years who underwent dual-energy X-ray absorptiometry during 2019-2023. They were divided into osteoporosis, osteopenia, and normal groups according to bone mineral density of the lumbar spine. Reference values for TBS were defined as low (≤ 1.23), intermediate (1.23-1.31), and high (≥ 1.31). RESULTS: Among patients without anti-osteoporosis treatment (n = 476), the proportion with low TBS was 36.7% in the CVF group and 10.7% in the control group. The proportion with CVF was higher in the low TBS group than in the intermediate and high TBS groups, especially in the osteoporosis group (p < 0.001). The odds ratio for CVF was higher in the low TBS group than in the intermediate and high especially in patients with normal BMD and osteoporosis. The TBS cut-off values for incidence of CVF in the osteoporosis, osteopenia, and normal groups were 1.224, 1.319, and 1.322, respectively. CONCLUSIONS: The reference value for low TBS (≤ 1.23) was useful as an indicator for CVF, especially in patients with osteoporosis. It is expected that reference values for TBS will be established in official guidelines in the future.

Determination of cystatin C reference interval for children in Croatia.

Introduction: Cystatin C is considered an early marker of kidney damage. The aim was to determine the reference interval in children since this information was not available from the test manufacturer. Materials and methods: Included were children aged 0 to 18 years undergoing routine check without history of any renal disease. Cystatin C was measured by the immunoturbidimetric method, and creatinine by the enzymatic method on a Cobas c501 analyzer (Roche Diagnostics, Manheim, Germany). Reference intervals were determined according to the CLSI C28-A3 guidelines using a robust method and a nonparametric percentile method, depending on the sample size. The Schwartz's formula was applied to estimate glomerular filtration (eGFR) from cystatin C. Results: The cystatin C reference interval for children aged 1-18 years (N = 204, median 8 years) was from 0.61 mg/L (90% CI: 0.53 to 0.64) to 1.08 mg/L (90% CI: 1.07 to 1.14). Differences according to sex were not found. For children aged 0-1 years (N = 29, median 5 months), the reference interval was from 0.60 mg/L (90% CI: 0.48 to 0.72) to 1.49 mg/L (90% CI: 1.36 to 1.61). The sample size was too small to test the difference according to sex. The eGFR was 76 (70-88) mL/min/1.73m2 for males and 83 (74-92) mL/min/1.73m2 for females. Conclusion: The cystatin C reference intervals for Croatian pediatric population according to age were determined. The cystatin C concentrations in children reach adulthood values after the first year. The cystatin C Schwartz's formula is applicable for eGFR calculation in children.

Reference values of serum total IgE in Uppsala - comparison over four decades.

Background: Total immunoglobulin E (IgE) analysis is a common tool in allergy diagnosis. Suggested reference values for IgE are divergent and sometimes based on outdated assay methods. We aimed to validate the published reference values (geometric mean [GM]: 13.2 kU/L, upper limit of normal [ULN], 114 kU/L) shown in an Uppsala cohort from 1974 using Phadebas IgE PRIST, and the suggested clinical threshold of 100 kU/L (Zetterström and Johansson 1981). Methods: Immunoglobulin E was measured in two Uppsala cohorts from 1997 (Blood bank) and 2011 to 2013 (the European community respiratory health survey part III [ECRHS III]) using ImmunoCAP™ Total IgE. For the reference value calculations, exclusion criteria were atopy (both cohorts), doctor's diagnosis of asthma and self-reported allergy (hay fever, rhinitis, rash) (only ECRHS III). Upper limit of normal was defined as mean + 2 standard deviations (SD) calculated using log-transformed values and back-transformation of the ULN prior to presentation. Common imputation methods for results below the assay range were evaluated. Results: The average GM was 14.2 kU/L (Blood bank, n = 63; imputation method range: 16.9-17.4 kU/L; ECRHS III, n = 113: 10.7-11.6 kU/L) and the overall mean ULN was 118 kU/L (Blood bank: 113-130 kU/L; ECRHS III: 104-128 kU/L). The clinical sensitivity and specificity of the 100 kU/L IgE threshold were 37.8 and 94.3% for atopy, 34.9 and 89.5% for doctor's diagnosis of asthma, and 24.5 and 97.3% for any self-reported allergy (ECRHS III). Conclusion: The calculated ULN values were similar between the cohorts. We conclude that the total IgE reference values shown for Uppsala subjects from 1974 are still valid and suitable also for the ImmunoCAP Total IgE assay. The 100 kU/L threshold for total IgE had a low sensitivity but high specificity for atopy, asthma, and allergy.

Human biomonitoring and reference values of urinary 1-hydroxypyrene among Iranian adults population.

Polycyclic aromatic hydrocarbons (PAHs) are one of the most important environmental pollutants. Urinary concentrations of 1-hydropyren metabolites of PAHs have been used as biomarkers of these chemicals' exposure in humans. This cross-sectional study was conducted on 468 healthy Iranian adults over 25 years old and non-smokers in six provinces who were selected based on the clustering method. Fasting urine sampling and body composition and demographic measurements were performed. Urine samples were analyzed by GC-MS. The analysis included descriptive statistics and analytical statistics using multiple linear regression by Python software. 1-Hydroxypyrene was found in 100% of samples, and the mean (Reference Value 95%) concentration of 1-hydroxypyrene was 6.12 (RV 95%: 20) µg/L and 5.95 (21) µg/gcrt. There was a direct relationship between the amount of body composition (body fat, visceral fat), BMI, and age with the urinary concentrations of 1-hydropyren metabolites, and this relationship was significant for BMI with urinary concentrations of 1-hydropyren metabolites (P = 0.045). The amount of 1-hydroxypyrene in healthy Iranian adults has been higher than in similar studies in other countries. These results provide helpful information regarding the exposure of Iranian adults to 1-hydroxypyrene, and these data can be used to supplement the national reference values of human biomonitoring for the interpretation of biomonitoring results.