Acute and subacute toxicity profile of ethanolic stem bark extract of Albizia coriaria Welw. ex Oliv. in Wistar albino rats

Albizia coriaria (Fabaceae) crude extracts are key ingredients of several licensed and unlicensed herbal products in East Africa. However, there is limited and often contradicting information regarding its toxicity. We therefore evaluated the acute and subacute toxicity of the ethanolic stem bark extract of A. coriaria in mature healthy Wistar albino rats following Lorke's method and OECD guidelines 407. The LD50 of the ethanolic stem bark extract of A. coriaria was 2000 mg/kg. The acute toxicity signs observed included piloerection, hyperventilation, lethargy, and loss of righting reflex. There was a significant increase in aspartate aminotransferase, alkaline phosphatase, red blood cells and haemoglobin in rats after 28 days at the dose of 500 mg/kg. Histological analyses revealed multifocal random parenchymal necrosis and scattered periportal mononuclear inflammatory cells infiltration in the liver, interstitial nephritis in the kidney and multifocal lymphoid accumulation in the peribronchiolar and perivascular lung tissue at 500 mg/kg. The ethanolic stem bark of A. coriaria was therefore moderately toxic to the rats when administered in a single high oral dose within 24 h. The extract caused a dose dependent toxicity with significant damage to the kidney, liver and lung tissues at a dose of 500 mg/kg after 28 days. Herbal medicines containing A. coriaria extracts should be consumed cautiously due to likelihood of toxicity particularly at higher doses greater than 500 mg/kg.

Biomedical students' self-efficacy and academic performance by gender in a flipped learning haematology course

INTRODUCTION

This study investigated the impact of flipped learning versus traditional instruction on medical students' academic performance and self-efficacy in a haematology course, and examined gender differences. Flipped learning is an instructional approach where students review pre-recorded lecture content at home, and active learning occurs in the classroom. Self-efficacy refers to students' beliefs in their ability to succeed and accomplish learning goals.

METHODS

A quasi-experimental study was conducted with 86 third-year Saudi medical students (46 males, 40 females) in a 10-week haematology course. Students were assigned to flipped learning group (n = 41) or traditional lecture group (n = 45). Both groups completed pre- and post-intervention academic tests and self-efficacy surveys. Data were analyzed using descriptive statistics and t-tests.

RESULTS

The flipped learning group showed an increase in academic scores (p <.05) and self-efficacy scores (p <.05) compared to the traditional group, but between group differences were not statistically significant. Female students in the flipped learning group showed the greatest increase in academic scores and self-efficacy. Most students perceived flipped learning positively for enhancing learning and preparation for class.

CONCLUSION

Flipped learning promoted self-efficacy compared to traditional lectures in medical students. Gender-specific benefits were observed, highlighting the need to design instruction to meet diverse student needs.

Innate immune response of snakehead fish to Indian strain of snakehead rhabdovirus (SHRV-In) infection and the infectivity potential of the virus to other freshwater fishes

A new virus known as snakehead rhabdovirus (SHRV-In) was discovered in South India in striped snakehead (Channa striata) that had hemorrhagic patches and cutaneous ulcerations. The virus is the most potentially harmful pathogen of snakehead because it could cause 100% mortality within 5 days. The goal of the current investigation was to evaluate the infectivity of rhabdovirus in freshwater fishes and to analyze the immune response in snakehead fish after challenge with SHRV-In. The infectivity study of SHRV-In against three freshwater fish such as tilapia, grass carp and loach showed that the virus could not induce mortality in any of them. Snakehead fish challenged with SHRV-In showed significant (p < 0.05) changes in haematological parameters such as red blood cell (RBC), haemoglobin (HGB), haematocrit (HCT), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), white blood cell (WBC), total platelet (PLT) counts, mean platelet volume (MPV) and immunological markers such as respiratory burst, superoxide dismutase, catalase activity and myeloperoxidase activity at 6, 12, 24 and 48 hpi. Real time PCR was executed to examine the expression profile of innate immune genes such as IRF-7, IL-8 and IL-12 in Snakehead fish at 6, 12, 24 and 48 h post SHRV-In infection. Immune gene expression of IRF-7, IL-8 and IL-12 were up-regulated in the spleen when compared to kidney at 6 and 12 hpi. However, the expression level of all the genes was down-regulated at 24 and 48 hpi. The down regulation of innate immune genes after 24 hpi in these tissues may be the result of increased multiplication of SHRV-In by interfering with the immune signaling pathway.

Mitigation of haemato-genotoxic and stress response effects in Cyprinus carpio via silymarin dietary supplementation following deltamethrin exposure

The study examined the potential of Silymarin, a blend of bioactive flavonolignans extracted from the milk thistle Silybum marianum, to mitigate Deltamethrin-induced toxicity in the blood of Cyprinus carpio. Fish were exposed to Deltamethrin (0.66 μg/L), the plant extract, or a combination of both for a duration of thirty days. Various parameters, including serum biochemical markers, erythrocytic abnormalities, and genotoxicity endpoints, were assessed. Results indicated a significant (p < 0.05) increase in the levels of AST, ALT, ALP, blood urea nitrogen, creatinine, glucose, cholesterol, and TLC in the fish exposed to the pesticide. Conversely, total protein, TEC, and Hb showed a notable decrease. There was also a notable rise in micronuclei and erythrocytic abnormalities such as acanthocytes, microcytes, and notched cells. Under ultrastructural examination, phenotypic deformities like spherocytosis, discocytes, and clumped erythrocytes were observed. However, dietary supplementation of silymarin (1 g/kg) significantly restored the biochemical, genetic, and cellular parameters, resembling those of the control group. This suggests the potential of this plant extract in protecting the common carp, Cyprinus carpio, from Deltamethrin-induced damage by scavenging free radicals and reducing DNA oxidative stress.

Dietary zinc requirement of juvenile stinging catfish Heteropneustes fossilis based on growth performance, haematology, and tissue mineral composition

This investigation was done to determine how much zinc (Zn) the stinging catfish, Heteropneustes fossilis, needs in its diet. Five isonitrogenous (34.5% protein) and isolipidic (6.0% lipid) diets were prepared to contain graded levels of Zn (0, 10, 20, 30, and 40 mg kg-1), supplied as zinc sulfate (ZnSO4·7H2O), and referred to as Zn0, Zn10, Zn20, Zn30, and Zn40, respectively. A total of 600 fish (initial body weight: 1.41 ± 0.02 g) were stocked in 15 glass aquaria (40 fish/aquarium), each with 180 L water capacity. For ten weeks, each diet was hand fed to three groups of fish twice daily until they appeared satisfied. The highest weight gain and specific growth rate, and lowest feed conversion ratio were recorded in fish fed with a 30 mg Zn kg-1 diet. Zn contents in bone and muscle linearly increased up to 30 mg kg-1 Zn and then remained stable, while iron (Fe) and copper (Cu) contents in bone and muscle had an inverse pattern with the inclusion level of dietary Zn. Increasing dietary Zn levels up to 30 mg kg-1 was found to improve values of hematological parameters such as red blood cell (RBC), white blood cell (WBC), haemoglobin (Hb), and haematocrit (HCT). These values, however, decreased when the dietary Zn level was further increased. The serum alkaline phosphatase level was the highest in fish fed a diet containing 30 mg kg-1 of Zn. Regression analyses based on weight gain, specific growth rate, and bone and muscle Zn concentrations indicated that the optimum dietary Zn requirement for stinging catfish was in a range of 27.4-36.5 mg kg-1.

Photoperiod manipulation improves growth performance, haematological indices and economic returns of Indian butter catfish, Ompok bimaculatus (Bloch, 1794)

Photoperiod manipulation is emerging as an effective approach for regulating physiological functions in fish. This study aimed to assess the impact of photoperiod on the growth performance, haematological responses, and economic returns of the endangered and highly valued Indian butter catfish, Ompok bimaculatus. Fish with an average body weight of 28.60 ± 4.78 g were randomly placed in six FRP tanks, each measuring 120 × 45 × 60 cm3. Each tank contained 20 fish exposed to a light intensity of 1500 lx under different photoperiods [24:0 light: dark (L: D), 15 L: 9D, 12 L: 12D, 9 L: 15D, 0 L: 24D and a natural photoperiod (control)], and fed at a daily rate of 2% of their body weight twice daily for 60 days. The fish in the 15 L: 9D photoperiod exhibited the highest final weight (g), percentage weight gain, specific growth rate (SGR) and survival rate, while the lowest was displayed in 24 L: 0D photoperiod group. The feed conversion ratio (FCR) was at its lowest in the catfish subjected to the 15 L: 9D photoperiod. Regarding haematological parameters, the 15 L: 9D photoperiod group showed higher total erythrocyte count, total leukocyte count, haemoglobin levels, and haematocrit values compared to the other groups. Conversely, the 0 L: 24D group, which experienced prolonged darkness, exhibited the lowest values in these parameters. Moreover, the 24 L: 0D, 9 L: 15D, and 0 L: 24D groups displayed a lower mean corpuscular volume (MCV) but higher mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) when compared to the control group. The economic analysis revealed that O. bimaculatus reared in a moderate photoperiod (15 L: 9D) displayed better growth, feed utilization, and overall health. This finding suggests that adopting a 15 L: 9D photoperiod can lead to enhanced production and improved economic returns for farmers culturing this high-value catfish in the future.

Analysis of real-world data demonstrating the efficacy of current management of polycythaemia vera in attaining and maintaining therapeutic haematocrit

BACKGROUND

Polycythaemia vera (PV) is a Philadelphia-negative myeloproliferative neoplasm, typically driven by acquired JAK2 mutation and characterised by elevated red cell mass and increased risk of thrombotic events. Patients are managed with phlebotomy to maintain haematocrit (Hct) < 0.45, and patients stratified as 'high risk' for thrombosis are additionally treated with cytoreductive agents to attain this target.

STUDY

This analysis of newly diagnosed JAK2 mutant PV patients (n = 50) over 2 years aimed to determine how effectively patients attained and maintained target Hct according to recommended practice.

CONCLUSIONS

We found that patients spent the majority of time in target Hct range. Findings are supportive of current management guidelines.

Anaemia in South American camelids - an overview of clinical and laboratory diagnostics

South American camelids (SACs) play an increasing role in veterinary care in Europe. Many alpacas or llamas presented to veterinarians suffer from anaemia, regularly with a packed cell volume (PCV) below 0.10 l/l, which is a life-threatening condition for the animals. This review article presents clinical and laboratory diagnostic tools for the diagnosis of anaemia in SACs. Clinical identification of anaemic animals can be performed by assessing the FAMACHA© score and the Body Condition Score (BCS), since anaemia in alpacas and llamas correlates with pale mucous membranes and a lowered BCS. Haematological examination of a blood sample can provide a more differentiated diagnosis of anaemia in SACs. A common finding is regenerative anaemia with an increased number of reticulocytes that is often caused by blood loss due to Haemonchus contortus. Changes in a blood smear from an alpaca or llama with regenerative anaemia may include normoblasts (nucleated red blood cells), anisocytosis, poikilocytosis, polychromasia, Howell-Jolly bodies or basophilic stippling. Furthermore, non-regenerative anaemia, often caused by trace element deficiency or cachexia, can also occur.

Haematology and biochemistry in healthy llamas at sea level

In the last years, there has been an increasing interest in llamas, not only as part of a productive system, but mostly as companion animals. Most reports regarding clinical biochemistry and haematology include few llamas and details about their health status are not available. The present study aims to provide haematological and biochemical parameters for llamas of known health status. Twenty-three non-pregnant females and seven males that live in Buenos Aires, Argentina (34°36'S, 58°22'W, at sea level) were studied. Llamas were clinically healthy, in good nutritional status. Animals were kept at grass and were fed hay bale or pellets and water ad libitum. Blood samples were collected by jugular venipuncture in spring. Packed cell volume, leucocyte count, differential white cell count, platelets count, urea, creatinine, total proteins, albumin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, glucose, calcium and phosphate were assessed. No significant differences were observed between males and females, except for platelet count and calcium, which was greater in males (P˂0.01). Values obtained for the different parameters were similar to those previously reported, except for monocytes, alkaline phosphatase, glucose and calcium, that were lower and lymphocytes and platelets count, that were higher in this study. In conclusion, different ambient and methodological conditions might affect some parameters. The parameters hereby presented are representative of llama's population living at sea level in South America.

Observational longitudinal study on Toxoplasma gondii infection in fattening beef cattle: serology and associated haematological findings

Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is a globally distributed zoonotic infection with significant implications for human and animal health. This study investigated the prevalence of T. gondii infection in a population of beef cattle at three different stages of their productive lifespan and examined the impact of T. gondii serological status on blood parameters. A commercial beef fattening unit in Italy was the setting for this research, which involved a biosecurity assessment upon cattle arrival, blood sampling at three time points and Toxoplasma-specific serological testing using indirect fluorescent antibody tests (IFAT). Results revealed a dynamic pattern of T. gondii seropositivity in cattle, with an initial prevalence of 30.6% at arrival (T0) that increased to 44.6% at 14 days (T1) and then decreased slightly to 39.3% at slaughter after 5 months (T2). Interestingly, seroconversion was observed during the study, indicating ongoing infections, and antibody waning occurred in some animals. In terms of blood parameters, seropositive cattle exhibited significantly lower mean corpuscular volume (MCV) and a higher neutrophil-lymphocyte (N/L) ratio, suggesting an activation of the innate immune response. Furthermore, cattle with higher antibody titres displayed higher neutrophil counts. However, all blood parameters with a statistical significance were within the reference range. This study provides for the first time a longitudinal investigation on the serological status for T. gondii in naturally exposed beef cattle. These findings provide valuable insights into the clinico-pathological aspects of natural T. gondii exposure in cattle and underscore the importance of monitoring and managing T. gondii infection in livestock production systems.

Healthcare migration in Italian paediatric haematology-oncology centres belonging to AIEOP

BACKGROUND

In Italy, there is a network of centres headed by the Italian Association of Pediatric Hematology and Oncology (AIEOP) for the diagnosis and treatment of paediatric cancers on almost the entire national territory. Nevertheless, migration of patients in a hospital located in a region different from that of residence is a widespread habit, sometimes motivated by several reasons. The aim of this paper is to assess the impact of migration of children with cancer to AIEOP centres in order to verify their optimal distribution throughout the national territory.

METHODS

To this purpose, we used information on 41,205 registered cancer cases in the database of Mod.1.01 Registry from AIEOP centres, with age of less than 20 years old at diagnosis, diagnosed from 1988 to 2017. Patients' characteristics were analysed and compared using the X2 or Fisher's exact test or Mann-Whitney test, when appropriate. Survival distributions were estimated using the method of Kaplan and Meier, and the log-rank test was used to examine differences among subgroups.

RESULTS

Extra-regional migration involved overall 19.5% of cases, ranging from 23.3% (1988-1997) to 16.4% (2008-2017) (p < 0.001). In leukaemias and lymphomas we observed a mean migration of 8.8% overall, lower in the North (1.2%) and Centre (7.8%) compared to the South & Isles (32.3%). In the case of solid tumours, overall migration was 25.7%, with 4.2% in the North, 17.2% in the Centre and 59.6% in the South & Isles. For regions with overall levels of migration higher than the national average, most migration cases opted for AIEOP centres of close or even neighbouring regions. Overall survival at 10 years from diagnosis results 69.9% in migrants vs 78.3% in no migrants (p < 0.001).

CONCLUSIONS

There is still a certain amount of domestic migration, the causes of which can be easily identified: migration motivated by a search for high specialization, migration due to lack of local facilities, or regions in which no AIEOP centres are present, which makes migration obligatory. Better coordination between AIEOP centres could help to reduce so-called avoidable migration, but technical and political choices will have to be considered, with the active participation of sector technicians.

A cross-sectional study on performance evaluation in Italian standardbred horses' real-time PCR-positive for Theileria equi

BACKGROUND

Inflammatory myopathy and perivasculitis have been recently described in horses with chronic equine piroplasmosis (EP). These alterations may be linked to poor performances. The aims of this study were to evaluate the prevalence for EP in clinically healthy Italian Standardbred (IS) racehorses and to compare laboratory parameters and performance metrics between positive and negative horses. Real-time PCR was applied for the detection of T. equi and B. caballi positivity. Haematology parameters, blood chemistry results, subjective muscle mass scores, and performance metrics were compared between PCR-positive and -negative horses.

RESULTS

This cross-sectional study included 120 well-trained IS racehorses and was performed over a two-years period. The prevalence of T. equi was 36.3%, whereas all samples were negative for B. caballi. Red blood cells count, haemoglobin concentration, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase activities were significantly higher in PCR-positive horses, whereas blood urea nitrogen, globulin concentration and globulin-to-albumin ratio were significantly lower in PCR-positive horses compared to PCR-negative ones. Nonetheless, all values fell within the physiological range. The best racing time, which was selected as the most representative of the performance metrics at the principal component analysis, was not affected by PCR positivity, the muscle mass score or the training yard. The best racing time was significantly better in horses with a mild or no signs of muscular atrophy, within the PCR-positive group. The muscle mass score was associated with the training yard in PCR-negative horses.

CONCLUSIONS

Prevalence of T. equi was high in IS racehorses in southern Italy. The absence of obvious changes in haematological and biochemical parameters, as well as performance metrics in positive horses, highlights the need for specific diagnostic tests to identify chronically infected horses.

From microscope to micropixels: A rapid review of artificial intelligence for the peripheral blood film

Artificial intelligence (AI) and its application in classification of blood cells in the peripheral blood film is an evolving field in haematology. We performed a rapid review of the literature on AI and peripheral blood films, evaluating the condition studied, image datasets, machine learning models, training set size, testing set size and accuracy. A total of 283 studies were identified, encompassing 6 broad domains: malaria (n = 95), leukemia (n = 81), leukocytes (n = 72), mixed (n = 25), erythrocytes (n = 15) or Myelodysplastic syndrome (MDS) (n = 1). These publications have demonstrated high self-reported mean accuracy rates across various studies (95.5% for malaria, 96.0% for leukemia, 94.4% for leukocytes, 95.2% for mixed studies and 91.2% for erythrocytes), with an overall mean accuracy of 95.1%. Despite the high accuracy, the challenges toward real world translational usage of these AI trained models include the need for well-validated multicentre data, data standardisation, and studies on less common cell types and non-malarial blood-borne parasites.

Perceptions and experiences of onco-haematology professionals in relation to advance care planning: a qualitative study

PURPOSE

The objective of this study is to identify the beliefs, values, perceptions, and experiences of medical oncology, radiation oncology, and clinical haematology professionals about the advance care planning process.

METHODS

Qualitative exploratory study. There were four focus groups with 14 nurses and 12 physicians (eight medical oncology, one radiation oncology, three haematology). A reflexive thematic analysis of the data obtained was performed.

RESULTS

We identified 20 thematic categories, which we grouped into four themes: lack of knowledge about advance care planning; perception of the advance care planning process: knowledge acquired from practice; barriers and facilitators for the implementation of advance care planning; and communication as a key aspect of advance care planning.

CONCLUSIONS

The participants valued advance care planning as an early intervention tool that promotes autonomy. They perceived difficulties in approaching planning due to lack of knowledge, training, and time. They identified the therapeutic relationship with the person, the participation of the person's loved ones, teamwork, and communication skills as essential to ensuring the quality of the process. Finally, they recognised that palliative care professionals provide added value in supporting planning processes.

Percutaneous infraclavicular subclavian vein catheters in paediatric cancer patients in comparison with critically ill children: a one-year experience from a Tunisian hospital

BACKGROUND

Paediatric cancer and critically ill patients frequently require central venous catheters for prolonged intravenous therapy. The aim of this study is to compare the difficulty of catheter insertion and the morbidity related to this procedure in these two populations and to investigate risk factors for complications.

METHODS

This prospective observational study was conducted at the Hedi Chaker University Hospital in Sfax, Tunisia, from July 2021 to July 2022. We included all patients aged three months to 14 years who required an infraclavicular subclavian vein catheterization. Patients were divided into two groups: Group 1 included children with malignancies; and Group 2 included critically ill paediatric patients. Then, we compared the demographic data, the difficulty of the catheterization procedure, and catheter-related complications. We also investigated risk factors for complications using a logistic regression model. The significance level was P<0.05.

RESULTS

We included 65 infants and children requiring central venous access, 28 of whom suffered from malignancies. The demographic parameters were comparable. However, the time for the procedure and the number of attempts were higher in the malignancy group with P<0.001. Central venous catheter complications were present 46.4% of the time in Group 1 compared to 21.6% in Group 2 (P=0.032). Malignancies were associated with an increased risk of complications (aOR = 2.95; 95%CI: 0.63-13.8).

CONCLUSIONS

This study showed increased difficulty and higher morbidity related to infraclavicular subclavian vein catheterization among infants and children suffering from cancer.

Mitochondrial-mediated apoptosis as a therapeutic target for FNC (2'-deoxy-2'-b-fluoro-4'-azidocytidine)-induced inhibition of Dalton's lymphoma growth and proliferation

PURPOSE

T-cell lymphomas, refer to a diverse set of lymphomas that originate from T-cells, a type of white blood cell, with limited treatment options. This investigation aimed to assess the efficacy and mechanism of a novel fluorinated nucleoside analogue (FNA), 2'-deoxy-2'-β-fluoro-4'-azidocytidine (FNC), against T-cell lymphoma using Dalton's lymphoma (DL)-bearing mice as a model.

METHODS

Balb/c mice transplanted with the DL tumor model received FNC treatment to study therapeutic efficacy against T-cell lymphoma. Behavioral monitoring, physiological measurements, and various analyses were conducted to evaluate treatment effects for mechanistic investigations.

RESULTS

The results of study indicated that FNC prevented DL-altered behavior parameters, weight gain and alteration in organ structure, hematological parameters, and liver enzyme levels. Moreover, FNC treatment restored organ structures, attenuated angiogenesis, reduced DL cell viability and proliferation through apoptosis. The mechanism investigation revealed FNC diminished MMP levels, induced apoptosis through ROS induction, and activated mitochondrial-mediated pathways leading to increase in mean survival time of DL mice. These findings suggest that FNC has potential therapeutic effects in mitigating DL-induced adverse effects.

CONCLUSION

FNC represents an efficient and targeted treatment strategy against T-cell lymphoma. FNC's proficient ability to induce apoptosis through ROS generation and MMP reduction makes it a promising candidate for developing newer and more effective anticancer therapies. Continued research could unveil FNC's potential role in designing a better therapeutic approach against NHL.

Advances and challenges of immunotherapies in NK/T cell lymphomas

Natural killer (NK)/T cell lymphoma (NKTCL) is a rare subtype of Epstein-Barr virus (EBV)-associated non-Hodgkin lymphoma characterized by poor clinical outcomes. It is more common in East Asian and Latin American countries. Despite the introduction of asparaginase/pegaspargase-based chemotherapy, the prognosis of patients with advanced NKTCL needs to be improved, and few salvage treatment options are available for relapsed/refractory patients who fail chemotherapy. Although many unknowns remain, novel treatment strategies to further improve outcomes are urgently needed. Immunotherapy has emerged and shown favorable antitumor activity in NKTCL, including monoclonal antibodies targeting immune checkpoint inhibitors, other receptors on the cellular membrane, and cellular immunotherapy, which could enhance immune cells attack on tumor cells. In this review, we provide an overview of recent immunotherapy in NKTCL, focusing on programmed cell death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1), cytotoxic T lymphocyte-associated protein 4 (CTLA-4), chimeric antigen receptor (CAR) T cells, EBV-specific cytotoxic T lymphocytes, immunomodulatory agents, and other targeted agents, as well as the current progress and challenges in the field.

Anti-malarial and haematological evaluation of the ethanolic, ethyl acetate and aqueous fractions of Chromolaena odorata

Malaria is a global health challenge with endemicity in sub-Saharan Africa, where there are multiple drug-resistant strains and limited access to modern health care facilities, especially in rural areas. Studies indicate that African traditional medicine could make a substantial contribution to the reduction of malaria-related deaths and achievement of universal health coverage (UHC), particularly in these regions. Thus, this study evaluated the curative antimalarial effects of Chromolaena odorata leaf extract using mouse model. Forty-five (45) albino mice weighing between 18 and 22 g were grouped into nine groups of 5 animals each. Animals in groups 2-9 were infected with the chloroquine-resistant strain of Plasmodium berghei, while animals in groups 3-9 were subsequently treated with 10 mg/kg chloroquine, a combination of 1.4 mg/kg artemether and 8.75 mg/kg lumefantrine (Coartem), and varying concentrations of the fraction from the aqueous leaf extract of C. odorata at day 3 post-infection. The findings from this study indicate that treatment with 400 mg/kg of the ethanolic fraction of the crude extract resulted in a significant decrease in parasite load (97.6%), which was comparable to the activities of the conventional drugs chloroquine (98.6%) and Coartem (98.8%). The ethyl acetate and ethanolic fractions at 400 mg/kg also ameliorated the significant alterations in the red blood cells, white blood cells, and platelets of the infected animals. The high antimalarial activity displayed by the ethanolic fraction could be due to the presence of quercetin and kaempferol, as detected by high performance liquid chromatography (HPLC) analysis. The findings suggest that the fractions from C. odorata could serve as an alternative source of malaria therapy, particularly in sub-Saharan Africa.

Assessment of textile industry effluent (untreated and microbially treated) induced genotoxic, haematological, biochemical, histopathological and ultrastructural alterations in fresh water fish Channa punctata

The unregulated expulsion of untreated textile water into water bodies is a major hazard to aquatic ecosystems. The present investigation was contrived to estimate the impact of textile dye bath effluent (untreated and microbially treated) on fish Channa punctata. Untreated effluent-exposed fish showed extremely altered behaviour (air gulping, erratic and speedy movements, increased opercular activity) and morphology (deposition of dyes on skin and scales, high pigmentation, mucus exudation). Significantly increased micronuclei (1.61-, 1.28-, 1.38-fold) and aberrant cell frequency (1.37-, 1.45-, 1.28-fold) was observed in untreated group as compared to treated group after 15, 30, and 45 days of exposure. Tail length, % tail intensity, tail moment and olive tail moment were also enhanced in all the exposed tissues. However, maximum damage was noticed in gill tissues showing 1.19-, 1.37-, 1.34- and 1.50-fold increased TL, %TI, TM and OTM in untreated group as compared to treated group after 45 days of exposure. On comparing untreated and treated groups, increased blood parameters and significantly reduced white blood cell count (WBC) were noticed in treated group. Significantly enhanced alterations in biochemical parameters were also analysed in untreated group. Reduced alterations in enzymological levels of fishes exposed to treated effluent indicate lesser toxic nature of the degraded metabolites of dye. Histological analysis in fishes exposed to untreated effluent showed several deformities in liver (necrosis, congestion, fusion of cells and melanomacrophage infiltration) and gill tissues (necrosis, bending of lamellae and severe aneurysm). Scanning electron microscopy (SEM) analysis further reaffirmed the pathologies observed in histological analysis. Fewer structural alterations were noticed in treated effluent fishes. The results concluded that untreated effluent inflicted toxicity potential on morphology as well as physiological defects in fish, and the severity increased with increasing duration of exposure, whereas reduction in toxicity in microbially treated groups can be analysed for aquacultural purposes owing to their lesser toxic nature.

Evaluation of the effect of soaked false yam (Icacina oliviformis) tuber meal on the haematological indices and serum biochemistry of rabbits

Background

The exploitations of non-conventional feeds for livestock have sparked great interest due to human-animal competition for conventional feedstuffs. The majority of animal feedstuffs are formulated with grains as the major ingredient, resulting in tautness and an increase in the costs of conventional feeds. This practice has underscored the necessity for an alternatively cheap and sustainable non-conventional feedstuff to salvage the feeding restraint to animal production. With this, the present study aimed at evaluating the effect of soaked false yam tuber meal (SFYTM) on the haematological indices and serum biochemical profile of weaner rabbits.

Methods

Sixteen local weaned rabbits of diversified breeds and sexes were randomly apportioned to dietary treatments containing 0, 10, 15, and 20 % of soaked false yam tuber in replacement for maize in a maize-fishmeal-based diet. Following feeding trials, blood samples from the rabbits were taken and analyzed using haematology and chemistry analyzers.

Results

The haematological assay revealed significant differences (P < 0.05) among treatments for red blood cells (RBCs), total white blood cells (TWBCs), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and monocytes. For haemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), platelet, lymphocytes, neutrophils, esoniphiles, and basophils, no significant differences (P > 0.05) were achieved. With the serum biochemical tests, significantly higher values were obtained for alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and sodium relative to the control. Despite some of the evaluated parameters having relatively high values, they tumbled within the normal range of values for a healthy weaned rabbit.

Conclusion

False yam tuber can therefore be exploited as a substitute for maize in rabbits' diets without detrimental effects on the haematological and biochemical markers of the farm animals.

Haemato-biochemical characterization of equine piroplasmosis asymptomatic carriers and seropositive, real-time PCR negative horses

Equine piroplasmosis (EP) is caused by Theileria equi and Babesia caballi, transmitted by tick vectors. Horses can suffer an acute, subacute, and chronic forms of the disease, with clinical signs such as poor performance, fever, pale mucosal membranes, and jaundice. The diagnosis of EP subclinical cases is complex due to the sensitivity of real-time PCR and the limited parasite load in some carriers, making it challenging to differentiate them from seropositive, PCR negative (S+PCR-) individuals. This study aimed to describe haematological and biochemical changes in asymptomatic EP carriers, EP S+PCR- horses and control horses (EP seronegative and PCR negative). It also investigated potential haemato-biochemical markers to aid in distinguishing true EP carriers alongside molecular and serological tests. A comprehensive haematology and biochemistry profile was conducted on 410 sera and EDTA blood samples, comprising 130 EP positives by real-time PCR and competitive ELISA (cELISA) (carriers), 130 EP negatives by real-time PCR but positive to cELISA (S+PCR-) and 150 EP negative horses to real-time PCR and c-ELISA (controls). Our study confirmed that a haematological and biochemistry profile could help to differentiate between EP carriers/S+PCR- from healthy horses. Carriers and S+PCR- horses showed significant increases in the white blood cell count (WBC), high total proteins (TP) and total globulins (GLOB) concentration, and liver function markers compared to controls. Additionally, the evaluation of uric acid (UA) suggested oxidative stress in carrier horses. However, no useful haemato-biochemical diagnostic markers were identified to aid the challenging differentiation of EP carriers and S+PCR- horses, highlighting the need for improvement in molecular/serological diagnosis for these horses.

Molnupiravir compared to nirmatrelvir/ritonavir for COVID-19 in high-risk patients with haematological malignancy in Europe. A matched-paired analysis from the EPICOVIDEHA registry

INTRODUCTION

Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections and decrease hospitalisation and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, whereas molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir because it is associated with fewer drug-drug interactions and contraindications. A caveat for molnupiravir is the mode of action induces viral mutations. Mortality rate reduction with molnupiravir was less pronounced than that with nirmatrelvir/ritonavir in patients without haematological malignancy. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, molnupiravir and nirmatrelvir/ritonavir were compared in a cohort of patients with haematological malignancies.

METHODS

Clinical data from patients treated with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and severity of baseline haematological malignancy to controls treated with nirmatrelvir/ritonavir.

RESULTS

A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (interquartile range [IQR] 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 56.9% (n=66) of the patients had controlled baseline haematological malignancy, 12.9% (n=15) had stable disease, and 30.2% (n=35) had active disease at COVID-19 onset in each group. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of patients in the two groups were vaccinated (molnupiravir n=77, 66% vs. nirmatrelvir/ritonavir n=87, 75%), more of those treated with nirmatrelvir/ritonavir had received four vaccine doses (n=27, 23%) compared with those treated with molnupiravir (n=5, 4%) (P<0.001). No differences were detected in COVID-19 severity (P=0.39) or hospitalisation (P=1.0). No statistically significant differences were identified in overall mortality rate (P=0.78) or survival probability (d30 P=0.19, d60 P=0.67, d90 P=0.68, last day of follow up P=0.68). Deaths were either attributed to COVID-19, or the infection was judged by the treating physician to have contributed to death.

CONCLUSIONS

Hospitalisation and mortality rates with molnupiravir were comparable to those with nirmatrelvir/ritonavir in high-risk patients with haematological malignancies and COVID-19. Molnupiravir is a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy.

Developing a partnership to improve health care delivery to children <18 years with cancer and blood disorders in the English-speaking Caribbean: lessons from the SickKids-Caribbean Initiative (SCI)

In 2013, the SickKids-Caribbean Initiative (SCI) was formalised among The Hospital for Sick Children in Toronto, Canada, the University of the West Indies, and Ministries of Health in six Caribbean countries (Barbados, The Bahamas, Jamaica, St. Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago). The aim was to improve the outcomes and quality of life of children (<18 years) with cancer and blood disorders in the partner countries. Core activities included filling a human resource gap by training paediatric haematologists/oncologists and specialised registered nurses; improving capacity to diagnose and treat diverse haematology/oncology cases; developing and maintaining paediatric oncology databases; creating ongoing advocacy activities with international agencies, decision makers, and civil society; and establishing an integrated administration, management, and funding structure. We describe core program components, successes, and challenges to inform others seeking to improve health service delivery in a multidisciplinary and complex partnership.

Access to the World Health Organization-recommended essential diagnostics for invasive fungal infections in critical care and cancer patients in Africa: A diagnostic survey

BACKGROUND

Invasive fungal infections (IFIs) contribute to significant morbidity and mortality among patients with haemato-oncological conditions, seriously ill hospitalised patients and those in intensive care (ICU). We surveyed for the World Health Organization-recommended essential diagnostic tests for IFIs in these risk groups in Africa.

METHODS

The Global Action For Fungal Infections (GAFFI) evaluated the different levels of access to both diagnostics for IFIs for populations in Africa, with the aim of building a comparative dataset and a publicly available interactive map. Data was collected through a validated questionnaire administered to a country leader in relevant topics (i.e., HIV, laboratory coordination) and/or Ministry of Health representatives and followed up with 2 rounds of validation by video calls, and later confirmation by email of findings.

RESULTS

Initial data was collected from 48 African countries covering 99.65 % of the population. Conventional diagnostics such as blood cultures, direct microscopy and histopathology were often used for diagnosis of IFIs in more than half of the facilities. Bronchoscopy was rarely done or not done in 20 countries (population 649 million). In over 40 African countries (population >850 million), Aspergillus antigen testing was never performed in either the public or private sectors. Computed tomography (CT) imaging is routinely used in 27 (56 %) of countries in the public sector and 21 44 %) in the private sector. However, magnetic resonance imaging remains relatively uncommon in most African countries.

CONCLUSIONS

There are critical gaps in the availability of essential diagnostics for IFIs in Africa, particularly Aspergillus antigen testing and modern medical imaging modalities. Early diagnosis and commencement of targeted therapy of IFIs are critical for optimal outcomes from complex cancer therapies.

Blood and carcass characteristics of grower rabbits fed diets containing pawpaw (Carica papaya L.) leaf protein concentrate

The aim of this study was to investigate the effect of partial replacement of soybean meal with pawpaw (Carica papaya L.) leaf protein concentrate on blood and carcass characteristics of grower rabbits in Benin City, Nigeria. Five dietary treatments were formulated such that soybean meal was replaced at 0, 15, 30, 45, and 60% with pawpaw leaf protein concentrate (PLPC) on weight-for-weight basis. Twenty-five composite grower rabbits of mixed sex and approximately seven weeks of age (736 ± 90 g) were randomly allocated to five dietary treatments of five replicates in a completely randomized design. Feed and water were provided ad libitum for 12 weeks of feeding experiment. Data obtained from the study showed that white blood cells (WBC) was significantly (p < 0.05) increased by 60% PLPC inclusion. Pack cell volume (PCV), red blood cells (RBC), and haemoglobin concentration (Hgb) were not significantly (p > 0.05) affected by PLPC inclusion in the rabbit diets. However, PCV (28.90-37.43%), WBC (3.67-9.4 103/μL), and RBC (4.36-5.22 106/μL) were within the normal physiological range. Glucose and total protein concentration were significantly (p < 0.05) reduced and increased, respectively by 15% PLPC inclusion but did not follow any particular trend for higher replacement levels. Carcass measurements indicated that dressing percentage and heart, kidney, and liver weights were not significantly (p > 0.05) affected by dietary treatments. Caecum length was significantly increased (p < 0.05) by 60% PLPC inclusion. In conclusion, PLPC can be used to partially replace soybean meal without causing any adverse effect on blood and carcass characteristics of grower rabbits.

Population pharmacokinetic modelling of fibrinogen in patients with congenital or acquired-chronic or acute-hypofibrinogenaemia

AIMS

Fibrinogen is the key substrate for coagulation. Fibrinogen pharmacokinetics (PK) after single doses of fibrinogen concentrate (FC), using modelling approaches, has only been evaluated in congenital afibrinogenaemic patients. The aims of this study are to characterize the fibrinogen PK in patients with acquired-chronic (cirrhosis) or acute-hypofibrinogenaemia (critical haemorrhage), showing endogenous production. Influencing factors of differences on the fibrinogen PK between subpopulations will be identified.

METHODS

A total of 428 time-concentration values from 132 patients were recorded. Eighty-two out of 428 values were from 41 cirrhotic patients administered with placebo and 90 out of 428 were from 45 cirrhotic patients that were given FC, 161 out of 428 values were from 14 afibrinogenaemic patients and 95 out of 428 values were from 32 severe acute trauma haemorrhagic patients. A turnover model that accounted for endogenous production and exogenous dose was fitted using NONMEM74. The production rate (Ksyn), distribution volume (V), plasma clearance (CL) and concentration yielding to 50% of maximal fibrinogen production (EC50) were estimated.

RESULTS

Fibrinogen disposition was described by a one-compartment model with CL and V values of 0.0456 L·h-1 and 4.34 L·70 kg-1 , respectively. Body weight was statistically significant in V. Three different Ksyn values were identified that increased from 0.00439 g·h-1 (afibrinogenaemia), to 0.0768 g·h-1 (cirrhotics) and 0.1160 g·h-1 (acute severe trauma). EC50 was of 0.460 g·L-1 .

CONCLUSIONS

This model will be key as a support tool for dose calculation to achieve specified target fibrinogen concentrations, in each of the studied populations.

Comparative pathogenicity of single and mixed drug-resistant Trypanosoma brucei brucei and Trypanosoma congolense infections in rats

Drug-resistant trypanosomes are widespread in sub-Saharan Africa and in conjunction with the drug-sensitive phenotypes cause a serious endemic wasting disease in animals. We evaluated the pathogenicity of single and mixed drug-resistant Trypanosoma brucei brucei and T. congolense isolates in 35 female rats, randomly divided into seven groups (1-7) of five rats. Group 1 was the uninfected control. Groups 2 and 3 were infected with drug-sensitive T. brucei brucei and T. congolense, respectively, whereas groups 4 and 5 were infected with multidrug-resistant T. brucei brucei and T. congolense respectively. Group 6 were infected with drug-sensitive T. brucei brucei and T. congolense while group 7 were infected with multidrug-resistant T. brucei brucei and T. congolense. Parasitaemia kinetics, haematological parameters, body weight, clinical signs, survival time, gross and histopathological changes in the spleen were evaluated. Parasitaemia occurred between day 3-9 post-infection in all the infected groups. Rats in groups 4 and 7 had markedly prolonged (p < 0.05) pre-patent period, days to first peak parasitaemia, survival time, and lower (p < 0.05) parasitaemia level than groups 2 and 6 rats while these parameters were comparable for groups 3 and 5 rats. Anaemia was noted in the infected groups but the severity did not vary amongst the infected groups. Severe clinical signs and splenic lesions were noted in rats infected with drug-sensitive trypanosome species compared to the multidrug-resistant species. Therefore, we conclude that the trypanosome isolates were pathogenic. However, the drug-sensitive T. brucei brucei and mixed drug-sensitive trypanosome infections were more pathogenic than their multidrug-resistant counterparts.

Migratory songbirds exhibit seasonal modulation of the oxygen cascade

Migratory flight requires birds to maintain intensive aerobic exercise for many hours or days. Maintaining O2 supply to flight muscles is therefore important during migration, especially since migratory songbirds have been documented flying at altitudes greater than 5000 m above sea level, where O2 is limited. Whether songbirds exhibit seasonal plasticity of the O2 cascade to maintain O2 uptake and transport during migratory flight is not well understood. We investigated changes in the hypoxic ventilatory response, haematology and pectoralis (flight) muscle phenotype of 6 songbird species from 3 families during migratory and non-migratory conditions. Songbirds were captured during southbound migration in southern Ontario, Canada. Half of the birds were assessed during migration, and the rest were transitioned onto a winter photoperiod to induce a non-migratory phenotype and measured. All species exhibited seasonal plasticity at various stages along the O2 cascade, but not all species exhibited the same responses. Songbirds tended to be more hypoxia tolerant during migration, withstanding 5 kPa O2 and breathed more effectively through slower, deeper breaths. Warblers had a stronger haemoglobin-O2 affinity during autumn migration (decrease of ∼4.7 Torr), while the opposite was observed in thrushes (increase of ∼2.6 Torr). In the flight muscle there was an ∼1.2-fold increase in the abundance of muscle fibres with smaller fibre transverse areas during autumn migration, but no changes in capillary:fibre ratio. These adjustments would enhance O2 uptake and transport to the flight muscle. Our findings demonstrate that in the O2 cascade there is no ideal migratory phenotype for all songbirds.

Effects of nickel supplementation on nutrient utilization, mineral balance, haematology and antioxidant status of crossbred dairy calves

BACKGROUND

Nickel has been identified as an important newer trace mineral playing essential role in animals however, its precise mechanism of action in the body is yet to be determined. Interaction of Ni with other essential minerals is suggested in reports limited to lab animals and needs to be explored further in large animals.

AIM

This study was conducted to study the influence of Ni supplementation at different levels, on minerals and health status of crossbred dairy calves.

METHOD

Twenty-four Karan Fries crossbred (Tharparkar × Holstein Friesian) male dairy calves were selected based on body weight (137.09 ± 5.68) and age (10.78 ± 0.61) and were divided into 4 treatment groups (n = 6) given basal diet supplemented with 0 (Ni0), 5 (Ni5), 7.5 (Ni7.5) and 10 (Ni10) ppm Ni/kg of DM. Nickel was supplemented in the form of nickel sulphate hexahydrate (NiSO₄.6 H₂O) solution. To ensure the intake of the required amount of nickel by each animal, the calculated quantity of solution was mixed with 250 g concentrate mixture and offered individually to the calves. The calves were fed total mixed ration (TMR) consisting of green fodder, wheat straw and concentrate mixture in the ratio of 40:20:40 and the nutritional requirements were met according to NRC (2001) guidelines. Growth performance was recorded at fortnightly interval whereas, plasma minerals, haematology, antioxidant and immunity parameters were studied at monthly interval during the 150-day experimental period. Nutrient utilization and mineral balances were estimated with the help of a metabolism trial conducted at the end of feeding trial.

RESULTS

Supplementation of Ni exhibited no influence on dry matter intake (DMI), body weight, average daily gain (ADG) and nutrient digestibility of dairy calves. However, the absorption and balance of minerals such as Ni, Fe, Cu, Zn and their respective plasma concentration increased (P < 0.05) with Ni supplementation and highest values were observed in calves fed 10 mg Ni/kg DM. The red blood cell (RBC) count, haemoglobin (Hb) concentration, haematocrit (HCT) and activity of superoxide dismutase (SOD) and catalase antioxidant enzymes showed highest increase (P < 0.05) in calves supplemented with Ni at level of 10 mg/kg DM as compared to other treatment groups. However, white blood cell (WBC) count, glutathione peroxidase (GPx), total antioxidant status (TAS), total immunoglobulins and IgG plasma concentration remained unaltered with addition of different levels of Ni in the diet of calves.

CONCLUSIONS

The supplementation of Ni at level of 10 mg/kg DM shows a positive effect on status of trace minerals such as Fe, Cu, Zn and improves the physiological conditions and health status of crossbred dairy calves indicated by improved haematology and antioxidant parameters.

Worldwide sources of data in haematology: Importance of clinician-biostatistician collaboration

The field of haematology has benefitted greatly from registry-based observational research. Medical and technical advances, changes in regulations and events such as the global pandemic is changing the landscape for registries. This review describes features of high-quality registries, statistical approaches and study design needed, an overview of worldwide hematologic registries, and how registries are evolving and expanding. The importance of collaborations between biostatisticians and haematologists in designing and conducting registry-related research is highlighted.

Can haematological changes constitute a surrogate diagnostic parameter to detect schistosomiasis in migrants and travellers? - A retrospective analysis

Background

Earlier studies found characteristic haematological changes in African patients with active schistosomiasis. If consistently present, full blood counts (FBC) may be helpful to diagnose schistosomiasis also in migrants and returning travellers.

Methods

A retrospective patient record review was conducted on data from seven European travel clinics, comparing FBC of Schistosoma egg-positive travellers and migrants to reference values. Sub-analyses were performed for children, returned travellers, migrants and different Schistosoma species.

Results

Data analysis included 382 subjects (median age 21.0 years [range 2-73]). In returned travellers, decreases in means of haemoglobin particularly in females (β = -0.82 g/dL, p = 0.005), MCV (β = -1.6 fL, p = 0.009), basophils, neutrophils, lymphocytes and monocytes (β = -0.07, p < 0.001; -0.57, p = 0.012; -0.57, p < 0.001 and -0.13 10³/μL, p < 0.001, respectively) were observed. As expected, eosinophils were increased (β = +0.45 10³/μL, p < 0.001). In migrants, a similar FBC profile was observed, yet thrombocytes and leukocytes were significantly lower in migrants (β = -48 10³/μL p < 0.001 and β = -2.35 10³/μL, p < 0.001, respectively).

Conclusions

Active egg-producing Schistosoma infections are associated with haematological alterations in returned travellers and migrants. However, these differences are discrete and seem to vary among disease stage and Schistosoma species. Therefore, the FBC is unsuitable as a surrogate diagnostic parameter to detect schistosomiasis.

Haematological and biochemical blood reference values for Canary Island camels (Camelus dromedarius), an endangered dromedary species

The purpose of this research was to develop reference values for haematological and biochemical variables in the Canary camel breed (Camelus dromedarius). 114 clinically healthy dromedary camels were assessed. Age, sex, and pregnancy status was also recorded. The reference range for red blood cells (RBCs) was 8.45 - 13.65 X10⁶/µL, haemoglobin (HGB) was 10.61 - 15.29 g/dL, packed cell volume (PCV) was 19.93 - 32.51 %, and white blood cells (WBCs) 7.35 - 18.36 X10³/µL. A correlation was established between the haemoglobin concentration (HGB) (g/dl) and packed cell volume (PCV) obtaining a linear regression (HGB = 0.31 PCV + 4.67). Young animals had higher RBC and WBC values than adult animals. Additionally, blood urea nitrogen (BUN), phosphorus, calcium, albumin/globulin (A/G) ratio, alkaline phosphatase, cholesterol, and lipase were higher in young animals compared with adults. Female dromedary camels showed higher values for the three main variables: RBC, HGB and PCV, but no differences between sexes were detected in the biochemical variables results. The WBC count was higher in non-pregnant females than in pregnant animals. These results provide references values for the Canary camel breed and may contribute to the understanding of differences in 18 haematological and biochemical parameters in dromedary camels with a potential impact in health and welfare for this species.

Artificial intelligence to assist specialists in the detection of haematological diseases

Artificial intelligence, particularly the growth of neural network research and development, has become an invaluable tool for data analysis, offering unrivalled solutions for image generation, natural language processing, and personalised suggestions. In the meantime, biomedicine has been presented as one of the pressing challenges of the 21st century. The inversion of the age pyramid, the increase in longevity, and the negative environment due to pollution and bad habits of the population have led to a necessity of research in the methodologies that can help to mitigate and fight against these changes. The combination of both fields has already achieved remarkable results in drug discovery, cancer prediction or gene activation. However, challenges such as data labelling, architecture improvements, interpretability of the models and translational implementation of the proposals still remain. In haematology, conventional protocols follow a stepwise approach that includes several tests and doctor-patient interactions to make a diagnosis. This procedure results in significant costs and workload for hospitals. In this paper, we present an artificial intelligence model based on neural networks to support practitioners in the identification of different haematological diseases using only rutinary and inexpensive blood count tests. In particular, we present both binary and multiclass classification of haematological diseases using a specialised neural network architecture where data is studied and combined along it, taking into account the clinical knowledge of the problem, obtaining results up to 96% accuracy for the binary classification experiment. Furthermore, we compare this method against traditional machine learning algorithms such as gradient boosting decision trees and transformers for tabular data. The use of these machine learning techniques could reduce the cost and decision time and improve the quality of life for both specialists and patients while producing more precise diagnoses.

Impact of repeated micro and macro blood sampling on clinical chemistry and haematology in rats for toxicokinetic studies

Non-clinical rodent safety studies are essential in the development of new medicines to assess for potential adverse effects. Typically, toxicokinetic samples are collected from a satellite group. AstraZeneca implemented repeated microsampling of main study animals as standard in the one-month small molecule regulatory toxicology studies. A retrospective analysis of the clinical chemistry and haematology data collected in 52 independent studies from the adult rat controls explored the impact of micro and macro sampling of main study animals. For the majority of variables, the blood sampling technique had no significant impact on the mean or range. For microsampling, a few variables had statistically significant effects on the mean signal but these were considered to have limited biological relevance and would therefore not introduce a meaningful bias to any toxicological evaluation. The macrosampling had the expected effects on the red cell parameters of haemoglobin, haematocrit and red blood count due to the larger blood volume draw. In contrast, microsampling showed no such changes. In conclusion, this large-scale retrospective analysis supports the use of microsampling, for toxicokinetics, of main study animals and enables us to conduct rodent toxicology studies without satellite animals and further reduce the number of animals used in toxicological assessments.

Health and welfare assessment of beef cattle during the adaptation period in a specialized commercial fattening unit

Beef cattle welfare and health status are influenced by housing and management systems. The present study aimed to assess the welfare and health status in the first 15 days after arrival of Limousine bulls imported from France and fattened in a commercial fattening unit in Italy. A total of 264 bulls were included in the study. Welfare, biosecurity, and major hazard and warning system were assessed on days 2 (T1) and 15 (T2) after arrival to the unit. At T1 and T2 an inspective clinical examination was performed on all bulls. At T1 and T2 blood samples were collected from 88 bulls for haematological analysis. Both at T1 and T2, the welfare, biosecurity, and major hazards and warning systems were classified with a general score of medium but with a decrease on animal-based measurements in T2. At T1 and T2 the clinical examination revealed a significant increase (p-value≤0.05) of skin lesions and lameness in T2. A high incidence of respiratory disease was noticed in both assessed times. Leucocytes and all differentials count, and platelets were significantly increased (p-value≤0.05) at T2, while the fibrinogen was significantly decreased. The haematological changes suggest that the bulls were under higher stress in T2 when compared with T1 linked with a difficult adaptation response to the fattening unit. A multi-factorial approach that integrates the indicators of the checklist and the clinical and haematological findings of animals can be a useful method to deepen the assessment of welfare in beef cattle.

Effects of metacercariae of Prosorhynchoides sp. (Trematoda: Bucephalidae) on the swimming ability and blood parameters of the intertidal fish Girella laevifrons (Osteichthyes: Kyphosidae)

Parasites may have various effects on their host's health. It is important to determine the type of the effects but also to decipher the physiological mechanisms underlying a parasitic infection. In this study, swimming ability (by a fixed swim speed test) and haematological analyses (by blood parameters) were compared between juvenile fish Girella laevifrons non-parasitised and parasitised with metacercariae of Prosorhynchoides sp. Fish were infested in the laboratory using natural parasitised mussels. Aerobic swimming time, total erythrocyte and leukocyte counts were compared among four groups of fish: non-parasitised (NP), non-parasitised but manipulated (NPM), parasitised 3 days (PT1), and 10 days (PT2) post-infection. Differentiated haematological components were also compared among NP, PT1 and PT2 fish groups. Parasitised fish (PT1 and PT2) swam between 32% and 55% less time than unparasitised fish. Erythrocyte counts were lower in PT1, indicating anemia, and total leukocyte counts were higher in PT1, showing immune action. Macrophages and basophils were observed only in parasitised fish, independent of the post-infection time. There was a negative correlation between swimming time and leukocyte counts. Increased leukocytes in the blood indicate activation of the innate cellular immune response, which may be metabolically costly for the host. Moreover, the anemia in parasitised fish would reduce the oxygen transport necessary to carry out aerobic exercise, reducing the swimming capacity. In fish several days post-infection (PT2), the erythrocytes count reached normal values, and some kinds of leukocytes decreased in comparison to fish PT1. This suggests that parasitised fish with metacercariae were recovering.

Effect of increasing valine level in the diet on performance, egg quality, and serum components in laying quails

This research was conducted to determine the effect of increasing dietary valine level on performance parameters, egg quality criteria, and blood and serum components. In the study, 120 female Japanese quails at the age of 10 weeks (241.4 ± 8.6 g) did randomly allocate to six experimental groups contained five subgroups. Treatment diets were prepared to contain 0.93% (control), 1.00%, 1.10%, 1.20%, 1.30%, or 1.40% valine. The egg mass decreased linearly with the increasing level of valine in the diet, while egg weight decreased in both linear and quadratic manner (P < 0.05). Increased levels of dietary valine increased eggshell breaking strength in cubic manner (P < 0.05). The administration of the valine to the diet caused a linear decrease in the albumin index and Haugh unit (P < 0.05). Other egg quality parameters were not affected (P > 0.05). Serum glucose and triglyceride concentrations of laying quails were reduced by the increasing dietary valine levels; the effect on serum glucose was linear, while both linear and quadratic effects were significant on triglyceride concentration (P < 0.05). White blood cell, lymphocyte, and neutrophil counts increased with the increasing dietary levels of valine (P < 0.05). Both linear and quadratic effects were significant on white blood cells and lymphocytes, while the effect on neutrophil counts was linear. However, erythrocyte and haematocrit (P < 0.05) decreased quadratically with increment in the dietary levels of valine. In conclusion, the increased valine levels in the diet adversely affected the egg weight, egg mass, and Haugh unit. but it reduced the serum triglyceride and glucose. Results may suggest that dietary valine at 0.93% level is sufficient for egg production and egg quality in laying quails, but positive effects of increased dietary valine levels on white blood cells may worth to investigate further.

VEXAS syndrome: a new paradigm for adult-onset monogenic autoinflammatory diseases

VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome is a recently described pathological entity. It is an acquired monogenic autoinflammatory disease caused by somatic mutations of the UBA1 gene in blood cells precursors; the gene encodes one of the two E1 enzyme isoforms that initiates ubiquitylation in cell's cytoplasm. VEXAS syndrome leads to systemic inflammation, with all organs and tissues potentially involved. The clinical picture may be extremely heterogenous, mimicking different other systemic rheumatologic entities coexisting with haematological disorders, especially myelodysplastic syndrome. This new disease represents a very intriguing clinical condition in several respects: it accounts for the paradigm of adult-onset monogenic autoinflammatory diseases determined by a genetic mosaicism resulting in the development of a challenging multiorgan inflammatory condition. Moreover, VEXAS syndrome is perhaps not an exceptionally rare condition and represents an example of a systemic genetic autoinflammatory disease drawing its origin in bone marrow disorders. VEXAS syndrome should be strongly considered in each adult patient with an unexplained systemic inflammatory condition, especially when recurrent fevers, neutrophilic dermatosis, relapsing polychondritis, ocular inflammation and other systemic inflammatory symptoms accompanying myelodysplastic syndrome or other haematological disorders. The syndrome deserves a multidisciplinary approach to reach the diagnosis and ensure the best management of a potentially very challenging condition. To quickly describe the clinical course, long-term outcomes, and the optimal management of this new syndrome it is essential to join forces internationally. To this end, the international AutoInflammatory Disease Alliance (AIDA) registry dedicated to VEXAS syndrome has been developed and is already active.

Effects of chronic exposure to toxic metals on haematological parameters in free-ranging small mammals

Blood circulates through the vascular system to carry oxygen, nutrients and metabolites to and away from tissues, and as such is a key-component of animal physiology. The impacts of metal pollution on blood, however, are poorly documented in free-ranging vertebrates. While the counteracting effect of selenium on mercury toxicity is well known in marine mammals, its potential role against the toxicity of other metals is less studied, especially on terrestrial wildlife. We explored the consequences of chronic exposure to two non-essential metals (cadmium and lead) along a pollution gradient in Northern France, on eleven haematological parameters in two free ranging small mammals, the wood mouse Apodemus sylvaticus and the bank vole Myodes glareolus. We hypothesized that haematology was related to metal concentrations in tissues, and that selenium might exert modulating effects. Concentrations of cadmium and lead in the tissues indicated an increased chronic exposure to and accumulation of metals along the gradient. Some haematological parameters were not explained by any measured variables while some others varied only with gender or age. Red blood cells, red blood cells distribution width, and blood iron concentration, however, decreased with increasing cadmium in the tissues in wood mice. Red blood cells and haemoglobin decreased with increasing renal lead and hepatic cadmium, respectively, in bank voles. Red blood cells distribution width in wood mice increased with cadmium concentrations in the liver but this was counteracted by high selenium levels in the same organ. An interaction of selenium and lead on red blood cells was also observed in bank voles. Further, selenium concentrations were associated with an increase of monocytes in wood mice. The present results show that toxic metals were related to haematology changes, particularly erythrocyte indicators, and that some essential elements like selenium should be measured as well since they may counteract toxic effects.

Efficacy of licorice extract on the growth performance, carcass characteristics, blood indices and antioxidants capacity in broilers

Some studies have suggested that dietary medicinal plants or herbs may have a variety of biological functions such as anti-inflammatory, antiallergic, antifungal, antioxidative stress, and anticarcinogenic activities. The present study was undertaken to assess the incorporation of the extract of licorice supplementation on the growth performance, carcass yield, blood indices, and antioxidative capacity in broilers. Three hundred twenty unsexed one-day-old Ross 308 broiler chicks were allocated randomly into four groups. Chicks in each group were randomly subdivided into eight replicates of ten chicks. The first group received a basal diet and was considered a control. The respective groups received a basal diet supplemented with 1, 2, and 3 g licorice extract/kg diet. The obtained results indicated that supplementation of licorice extract to broiler chicks resulted in heavier BW and weight gain and a better feed conversion ratio during the experimental periods compared with the control group. However, feed consumption increased during the entire growing period. Supplementing the broiler's diet with licorice extract led to a higher value of erythrocytes, leukocytes, haemoglobin, plasma total protein, albumin, and antioxidant concentration and a low value in plasma cholesterol, triglycerides, uric acid, urea, and total cholesterol. It could be concluded that the dietary addition of licorice extracts 2 and 3 g licorice extract/kg diet improved broiler chicks' growth performance and physiological status.

Ginkgo biloba Supplement Reverses Lead (II) Acetate-Induced Haematological Imbalances, Hepatic and Renal Dysfunctions in Male Wistar Rat

Lead is a heavy metal abundant in nature that causes haematological imbalances, and hepatic and renal dysfunction, and this imbalance has been linked to oxidative stress. Several reports have shown that natural products are implicated in ameliorating metal poisonings. Ginkgo biloba is a flavonoid-rich natural herbal supplement with several pharmacological properties. The present study investigated effect of Ginkgo biloba supplement (GBS) on lead-induced toxicity. Animals were given a lead dose of 25 mg/kg for 14 days orally and then given Ginkgo biloba supplements of 50 mg/kg and 100 mg/kg orally for 14 days. Animals given GBS had significantly improved haematological and rheological parameters. GBS showed a protective impact in terms of improved kidney and liver histology, anti-oxidant enzyme activity (CAT, SOD, GSH, and MDA), organ function indices, and a lower rate of erythrocyte osmotic fragility. Conclusively, Ginkgo biloba supplementation attenuated lead toxicity by normalization of haematological imbalances, and hepatic and renal dysfunction as well as maintaining erythrocyte membrane integrity.

The basics of blood and associated disorders

The blood and its components are involved in a wide range of processes to support life, including fighting infection and providing the body's tissues with oxygen and nutrients. If any stage in the development of blood cells is disrupted, for example by genetic abnormalities or a lack of nutrients, disease may result. This article provides an overview of some of the blood's key components, blood cells and their formation and functions, blood groups and some of the problems that can arise from malfunctions. A case study on haemophilia A as a blood disorder is presented to consolidate knowledge.

Skewed fate and hematopoiesis of CD34(+) HSPCs in umbilical cord blood amid the COVID-19 pandemic

Umbilical cord blood (UCB) is an irreplaceable source for hematopoietic stem progenitor cells (HSPCs). However, the effects of SARS-CoV-2 infection and COVID-19 vaccination on UCB phenotype, specifically the HSPCs therein, are currently unknown. We thus evaluated any effects of SARS-CoV-2 infection and/or COVID-19 vaccination from the mother on the fate and functionalities of HSPCs in the UCB. The numbers and frequencies of HSPCs in the UCB decreased significantly in donors with previous SARS-CoV-2 infection and more so with COVID-19 vaccination via the induction of apoptosis, likely mediated by IFN-γ-dependent pathways. Two independent hematopoiesis assays, a colony forming unit assay and a mouse humanization assay, revealed skewed hematopoiesis of HSPCs obtained from donors delivered from mothers with SARS-CoV-2 infection history. These results indicate that SARS-CoV-2 infection and COVID-19 vaccination impair the functionalities and survivability of HSPCs in the UCB, which would make unprecedented concerns on the future of HSPC-based therapies.

Does Hypoxia and Stress Erythropoiesis Compromise Cardiac Function in Healthy Adults? A Randomized Trial

OBJECTIVES

To investigate whether recombinant human erythropoietin (rHuEPO) injections during an altitude training camp impact heart function.

METHODS

Thirty (12 women) moderately trained subjects stayed at 2320 m altitude for 4 weeks while training. Subjects were randomized to placebo (isotonic saline) or rHuEPO (20 IU/kg body weight) i.v. injections. Transthoracic echocardiography imaging was acquired 3 days after arrival to altitude and prior to the first placebo or rHuEPO injection as well as one day after the last rHuEPO injection three weeks later.

RESULTS

rHuEPO did not alter cardiovascular morphology parameters, systolic or diastolic function. In the placebo group, altitude exposure improved left ventricle (LV) systolic function due to an increased twist angle but rHuEPO had no additional effects. Pulmonary arterial systolic pressure was unaffected in either group. Notably, rHuEPO hampered LV untwist rate without affecting LV early filling.

CONCLUSION

rHuEPO provided during mild altitude exposure does not cause any major effects on heart function. The observed alteration in LV untwist induced by rHuEPO is unlikely to have a meaningful clinical effect. Trial Registration Registered on www.

CLINICALTRIALS

gov (NCT04227665).

Integrated biomarker approach strongly explaining in vivo sub-lethal acute toxicity of butachlor on Labeo rohita

Butachlor herbicide belongs to the family of chloroacetanilide group, widely used for control of grass and broadleaf weeds in paddy fields however, its repeated application may result in aquatic pollution. Butachlor residue has been detected in aquatic environments, which may produce toxic effects on non-target organisms including fish. Keeping this in mind, the present study was designed to estimate the LC₅₀ of butachlor (Shaktiman®), and to evaluate the sub-lethal toxicity at two concentrations (12.42 μg L^-1 and 62.10 μg L^-1) in Labeo rohita for a period of 24, 48, and 72 h. Fish exposed to butachlor reduced the counts of red blood cells (RBC), haemoglobin (HGB), hematocrit (HCT), and white blood cells (WBC). A significant (p < 0.05) increase in the antioxidant enzyme (superoxide dismutase-SOD, glutathione-s-transferase-GST), and hepatic enzyme (glutamate-oxaloacetate transaminase-GOT, glutamate-pyruvate transaminase-GPT) were noticed in butachlor exposed fish. Heat shock protein 70 (HSP70) and HSP90 in gill; cortisol, protein, albumin, globulin, and triglyceride in serum were increased upon exposure of butachlor. On the contrary, complement 3 (C3) and immunoglobulin (IgM) in serum was found to be decreased compared to control fish. The findings thus suggest that the fish upon exposure to butachlor disrupts the biomarkers which ultimately leads to growth retardation in fish.

Impact of sublethal phenol in freshwater fish Labeo rohita on biochemical and haematological parameters

Phenol, an aromatic chemical commonly found in domestic and industrial effluents, upon its introduction into aquatic ecosystems adversely affects the indigenous biota, the invertebrates and the vertebrates. With the increased demand for agrochemicals, a large amount of phenol is released directly into the environment as a byproduct. Phenol and its derivatives tend to persist in the environment for longer periods which in turn poses a threat to both humans and the aquatic ecosystem. In our current study, the response of Labeo rohita to sublethal concentrations of phenol was observed and the results did show a regular decrease in biochemical constituents of the targeted organs. Exposure of Labeo rohita to sublethal concentration of phenol (22.32 mg/L) for an epoch of 7, 21 and 28 days shows a decline in lipid, protein, carbohydrate content and phosphatase activity in target organs such as the gills, muscle, intestine, liver and kidney of the fish. The present study also aims to investigate the toxic effects of phenol with special reference to the haematological parameters of Labeo rohita. At the end of the exposure period, the blood of the fish was collected by cutting the caudal peduncle with a surgical scalpel. And it was observed that the red blood corpuscle count (RBC), white blood corpuscle (WBC), haemoglobin count (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) values showed a decline after exposure to phenol for 7 days, while white blood corpuscle (WBC) shows an increased count. At 21 days and 28 days, all the haematological parameters showed a significant decrease.

Use of black soldier fly (Hermetia illucens) prepupae reared on organic waste as feed or as an ingredient in a pellet-feed formulation for Nile tilapia (Oreochromis niloticus)

The growth and sustainability of freshwater aquaculture are highly dependent on economic feed which is the major running cost. Fish feed industries depend on the high-priced fish meal (FM) as protein source in feed formulations. In this context, a nutrient-rich, and palatable insect meal-based fish feed was developed incorporating the black soldier fly (BSF) (Hermetia illucens) prepupae meal (BSFPM) reared on organic waste imparting additional benefit of waste bioremediation to make cost-effective feed. Feeding trial was conducted to evaluate growth performance on monosex Nile tilapia (Oreochromis niloticus). The different treatments were (1) dried BSF prepupae, (2) BSF prepupae and BSFPM-based feed in 1:1 proportion, (3) BSFPM feed, and (4) control feed with FM. The survival, growth, feed efficiency, and haematological parameters were not significantly different between BSFPM and control feed. Fish fed with control feed and BSFPM feed showed significantly higher (P ≤ 0.05) weight gain, specific growth rate, and percentage weight gain. Lowest food conversion ratio (P ≤ 0.05) was recorded for fish fed control feed with a significantly higher feed efficiency ratio (0.65^d ± 0.034) and protein efficiency ratio (2.11^a ± 0.063). The mean corpuscular volume of blood in fish fed BSF prepupae (128.5^a ± 3.2) is significantly higher. The good growth of fish fed BSFPM feed may be attributed to the essential amino acids which are not limiting in feed. Absence of microbes and safe level heavy metals in BSFPM feed ensures safety of the ingredient. Hence, it can be used as a suitable protein source in feed formulations.