Originator: Computational Framework Separating Single-Cell RNA-Seq by Genetic and Contextual Information

Single-cell RNA sequencing data from complex human tissues are prone to blood contamination in sample preparation, and some comprise cells of different genetic makeups, necessitating rigorous preprocessing and cell filtering prior to the downstream functional analysis. Our proposed new computational framework, Originator, deciphers single cells by genetic origin and separates blood cells from tissue-resident cells. It improves the quality of data analysis, exemplified by pancreatic ductal adenocarcinoma and placenta tissues.

Effectiveness of Chinese Herbal Medicine as a Complementary Treatment for Neutropenia Prevention and Immunity Modulation During Chemotherapy in Patients With Breast Cancer: Protocol for a Real-World Pragmatic Clinical Trial

BACKGROUND

In recent years, advancements in cancer treatment have enabled cancer cell inhibition, leading to improved patient outcomes. However, the side effects of chemotherapy, especially leukopenia, impact patients' ability to tolerate their treatments and affect their quality of life. Traditional Chinese medicine is thought to provide complementary cancer treatment to improve the quality of life and prolong survival time among patients with cancer.

OBJECTIVE

This study aims to evaluate the effectiveness of Chinese herbal medicine (CHM) as a complementary treatment for neutropenia prevention and immunity modulation during chemotherapy in patients with breast cancer.

METHODS

We will conduct a real-world pragmatic clinical trial to evaluate the effectiveness of CHM as a supplementary therapy to prevent neutropenia in patients with breast cancer undergoing chemotherapy. Patients will be classified into CHM or non-CHM groups based on whether they received CHM during chemotherapy. Using generalized estimating equations or repeated measures ANOVA, we will assess differences in white blood cell counts, absolute neutrophil counts, immune cells, and programmed cell death protein 1 (PD-1) expression levels between the 2 groups.

RESULTS

This study was approved by the research ethics committee of Hualien Tzu Chi Hospital (IRB 110-168-A). The enrollment process began in September 2021 and will stop in December 2024. A total of 140 patients will be recruited. Data cleaning and analysis are expected to finish in the middle of 2025.

CONCLUSIONS

Traditional Chinese medicine is the most commonly used complementary medicine, and it has been reported to significantly alleviate chemotherapy-related side effects. This study's findings may contribute to developing effective interventions targeting chemotherapy-related neutropenia among patients with breast cancer in clinical practice.

TRIAL REGISTRATION

International Traditional Medicine Clinical Trial Registry ITMCTR2023000054; https://tinyurl.com/yc353hes.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/55662.

Diagnosing periprosthetic joint infection

Aims

The diagnosis of periprosthetic joint infection (PJI) can be challenging as the symptoms are similar to other conditions, and the markers used for diagnosis have limited sensitivity and specificity. Recent research has suggested using blood cell ratios, such as platelet-to-volume ratio (PVR) and platelet-to-lymphocyte ratio (PLR), to improve diagnostic accuracy. The aim of the study was to further validate the effectiveness of PVR and PLR in diagnosing PJI.

Methods

A retrospective review was conducted to assess the accuracy of different marker combinations for diagnosing chronic PJI. A total of 573 patients were included in the study, of which 124 knees and 122 hips had a diagnosis of chronic PJI. Complete blood count and synovial fluid analysis were collected. Recently published blood cell ratio cut-off points were applied to receiver operating characteristic curves for all markers and combinations. The area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated.

Results

The results of the analysis showed that the combination of ESR, CRP, synovial white blood cell count (Syn. WBC), and polymorphonuclear neutrophil percentage (PMN%) with PVR had the highest AUC of 0.99 for knees, with sensitivity of 97.73% and specificity of 100%. Similarly, for hips, this combination had an AUC of 0.98, sensitivity of 96.15%, and specificity of 100.00%.

Conclusion

This study supports the use of PVR calculated from readily available complete blood counts, combined with established markers, to improve the accuracy in diagnosing chronic PJI in both total hip and knee arthroplasties.

Determination of the Assigned Values of Blood Cells by an Impedance Method for Hematological Reference Samples Used in Hematology External Quality Assessment (EQA) Programs

The research into and production of hematological reference samples used to implement an external quality assessment (EQA) to check the quality of hematology tests are necessary for hematology laboratories in Vietnam. In this research, the study team determined the assessment values of blood cell count (human RBCs, pseudo-leucocytes, and pseudo-platelets) by the impedance method used in hematology EQA programs. The hematological reference samples were controlled at three concentration levels: low, normal, and high. Determination of the assigned value (mean ± 2SD) was performed for the following hematology analyzer series by impedance method: ABX Micros 60, Celldyn 1700, and Mindray BC 2000. Each device was sent to 10 different laboratories for evaluation. Research results for assigned values of each model (ABX Micros 60, Celldyn 1700, and Mindray BC 2000) were determined at the three concentrations. For the ABX Micros 60 and Celldyn 1700 series, 80% of laboratories had analytical results within assigned values. For the Mindray BC 2000 series, 100% of laboratories had analytical results within assigned values. The measurement results for the number of human RBCs, pseudo-leucocytes, and pseudo-platelets on each analyzer were similar between the 10 laboratories; the results of the three hematology analyzer series using the impedance method were different and the difference was statistically significant (p < 0.05). Thus, hematological reference samples for measuring the number of blood cells meeting the standards so that they can evaluate the results of laboratories using the impedance method: ABX, Celldyn 1700, Mindray BC 2000.

BCNet: A Deep Learning Computer-Aided Diagnosis Framework for Human Peripheral Blood Cell Identification

Blood cells carry important information that can be used to represent a person's current state of health. The identification of different types of blood cells in a timely and precise manner is essential to cutting the infection risks that people face on a daily basis. The BCNet is an artificial intelligence (AI)-based deep learning (DL) framework that was proposed based on the capability of transfer learning with a convolutional neural network to rapidly and automatically identify the blood cells in an eight-class identification scenario: Basophil, Eosinophil, Erythroblast, Immature Granulocytes, Lymphocyte, Monocyte, Neutrophil, and Platelet. For the purpose of establishing the dependability and viability of BCNet, exhaustive experiments consisting of five-fold cross-validation tests are carried out. Using the transfer learning strategy, we conducted in-depth comprehensive experiments on the proposed BCNet's architecture and test it with three optimizers of ADAM, RMSprop (RMSP), and stochastic gradient descent (SGD). Meanwhile, the performance of the proposed BCNet is directly compared using the same dataset with the state-of-the-art deep learning models of DensNet, ResNet, Inception, and MobileNet. When employing the different optimizers, the BCNet framework demonstrated better classification performance with ADAM and RMSP optimizers. The best evaluation performance was achieved using the RMSP optimizer in terms of 98.51% accuracy and 96.24% F1-score. Compared with the baseline model, the BCNet clearly improved the prediction accuracy performance 1.94%, 3.33%, and 1.65% using the optimizers of ADAM, RMSP, and SGD, respectively. The proposed BCNet model outperformed the AI models of DenseNet, ResNet, Inception, and MobileNet in terms of the testing time of a single blood cell image by 10.98, 4.26, 2.03, and 0.21 msec. In comparison to the most recent deep learning models, the BCNet model could be able to generate encouraging outcomes. It is essential for the advancement of healthcare facilities to have such a recognition rate improving the detection performance of the blood cells.

Hematology, Ultrastructure and Morphology of Blood Cells in Rufous-Winged Buzzards (Butastur liventer) from Thailand

In attempt to treat injured raptors and promote conservation awareness, the Kasetsart University Raptor Rehabilitation Unit (KURRU) was established in 2007. The complete blood counts (CBCs) are a manual tool used for the screening of raptor health. These tests require knowledge of blood cell morphology. This study aimed to describe the preliminary information of the hematology, ultrastructure, and morphology of blood cells in rufous-winged buzzards (RWB). There were 17 RWBs admitted into the KURRU. CBCs were manually performed by veterinary technicians. The morphology and morphometry of blood cells were observed from Wright-stained blood smears. Ultrastructure was observed from uranyl acetate and lead citrate-stained sections. The hematologic values were analyzed and described from individual RWBs that were clinically healthy, negative for blood parasites, and had PCV > 0.30 L/L. Consequently, CBCs of 12 out of 17 RWBs were included for descriptive hematologic values. Heterophils were the most prevalent white blood cells in RWBs. Of these 17 RWBs, 1 non-parasitized RWB showed hypochromic erythrocytes with PCV 0.18 L/L, which indicated that anemia in RWBs resulted from non-parasitic causes. The morphology of blood cells in RWBs was similar to those in other diurnal raptors, except that the lymphocytes showed pale or colorless cytoplasm. The electron micrographs highlighted that the basophil contained two types of granules: homogeneous electron-dense granules and reticulated electron-dense granules. The photomicrographs in this report are the scientific reference for identification of blood cells in RWBs. The CBCs from non-parasitized RWBs (clinically healthy) can be used as a cage mate reference in the KURRU. Additionally, we found evidence that evaluations of blood smears together with CBC examination were important in raptors.

Application of machine learning in predicting blood flow and red cell distribution in capillary vessel networks

Capillary blood vessels in the body partake in the exchange of gas and nutrients with tissues. They are interconnected via multiple vascular junctions forming the microvascular network. Distributions of blood flow and red cells (RBCs) in such networks are spatially uneven and vary in time. Since they dictate the pathophysiology of tissues, their knowledge is important. Theoretical models used to obtain flow and RBC distribution in large networks have limitations as they treat each vessel as a one-dimensional segment and do not explicitly consider cell-cell and cell-vessel interactions. High-fidelity computational models that accurately model each individual RBC are computationally too expensive to predict haemodynamics in large vascular networks and over a long time. Here we investigate the applicability of machine learning (ML) techniques to predict blood flow and RBC distributions in physiologically realistic vascular networks. We acquire data from high-fidelity simulations of deformable RBC suspension flowing in the networks. With the flow and haematocrit specified at an inlet of vasculature, the ML models predict the time-averaged flow rate and RBC distributions in the entire network, time-dependent flow rate and haematocrit in each vessel and vascular bifurcation in isolation over a long time, and finally, simultaneous spatially and temporally evolving quantities through the vessel hierarchy in the networks.

Transfusion in orthopaedic surgery : a retrospective multicentre cohort study

Aims

Orthopaedic surgeries are complex, frequently performed procedures associated with significant haemorrhage and perioperative blood transfusion. Given refinements in surgical techniques and changes to transfusion practices, we aim to describe contemporary transfusion practices in orthopaedic surgery in order to inform perioperative planning and blood banking requirements.

Methods

We performed a retrospective cohort study of adult patients who underwent orthopaedic surgery at four Canadian hospitals between 2014 and 2016. We studied all patients admitted to hospital for nonarthroscopic joint surgeries, amputations, and fracture surgeries. For each surgery and surgical subgroup, we characterized the proportion of patients who received red blood cell (RBC) transfusion, the mean/median number of RBC units transfused, and exposure to platelets and plasma.

Results

Of the 14,584 included patients, the most commonly performed surgeries were knee arthroplasty (24.8%), hip arthroplasty (24.6%), and hip fracture surgery (17.4%). A total of 10.3% of patients received RBC transfusion; the proportion of patients receiving RBC transfusions varied widely based on the surgical subgroup (0.0% to 33.1%). Primary knee arthroplasty and hip arthroplasty, the two most common surgeries, were associated with in-hospital transfusion frequencies of 2.8% and 4.5%, respectively. RBC transfusion occurred in 25.0% of hip fracture surgeries, accounting for the greatest total number of RBC units transfused in our cohort (38.0% of all transfused RBC units). Platelet and plasma transfusions were uncommon.

Conclusion

Orthopaedic surgeries were associated with variable rates of transfusion. The rate of RBC transfusion is highly dependent on the surgery type. Identifying surgeries with the highest transfusion rates, and further evaluation of factors that contribute to transfusion in identified at-risk populations, can serve to inform perioperative planning and blood bank requirements, and facilitate pre-emptive transfusion mitigation strategies.

Cite this article: Bone Jt Open 2021;2(10):850–857.

Cell therapies in the clinic

Cell therapies have emerged as a promising therapeutic modality with the potential to treat and even cure a diverse array of diseases. Cell therapies offer unique clinical and therapeutic advantages over conventional small molecules and the growing number of biologics. Particularly, living cells can simultaneously and dynamically perform complex biological functions in ways that conventional drugs cannot; cell therapies have expanded the spectrum of available therapeutic options to include key cellular functions and processes. As such, cell therapies are currently one of the most investigated therapeutic modalities in both preclinical and clinical settings, with many products having been approved and many more under active clinical investigation. Here, we highlight the diversity and key advantages of cell therapies and discuss their current clinical advances. In particular, we review 28 globally approved cell therapy products and their clinical use. We also analyze >1700 current active clinical trials of cell therapies, with an emphasis on discussing their therapeutic applications. Finally, we critically discuss the major biological, manufacturing, and regulatory challenges associated with the clinical translation of cell therapies.

High-lethality of suicide attempts associated with platelet to lymphocyte ratio and mean platelet volume in psychiatric inpatient setting

OBJECTIVES

A wide range of potential psychosocial, biological, genetic and environmental factors may interact with each other in determining suicidal behaviours. The aim of this study was to evaluate several biological parameters referred to the complete blood count values in 259 suicide attempters (SA) and 164 non-suicide attempters (control group), according to the lethality of suicidal behaviour.

METHODS

After attempting suicide, subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the section of Psychiatry from 1 January 2014 to 31 June 2019. Socio-demographic and clinical characteristics, as well as blood cells, were collected.

RESULTS

Individuals with high-lethality suicide attempts had a higher number of neutrophils, mean platelet volume, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lower number of lymphocytes relative to both those with low-lethality suicide attempts and control group. After regression analysis, only the mean platelet volume and platelet to lymphocyte ratio resulted associated with a high-lethality suicide attempt (HLSA).

CONCLUSIONS

Our findings provide potential and useful peripheral biological markers able to help clinicians in understanding the complex phenomenon of suicide. However, further studies are needed to confirm the present findings.

The blood cells in NSCLC and the changes after RFA

Lung cancer has attracted a lot of attention because of its high morbidity and mortality. The emergence of RFA provides a new treatment for unresectable NSCLC patients. In addition to killing in situ lung tumors, RFA also provides new immuno-activated antigens, for the treatment of lung cancer. It changes the tumor microenvironment and activates the entire immune system of patients. The peripheral blood cell count is easy to achieve and the blood cells are important in tumor immunity, which changes after RFA. On the one hand, the changes in blood cells identify the immune changes of NSCLC; on the other hand, it provides support and suspicion for the treatment of RFA.

Do Blood Cell Parameters have a Predictive Role in the Etiology and Severity Pediatric Antrochoanal Polyp Cases?

Introduction  There are no definitive parameters to guide the etiology and severity of pediatric antrochoanal polyps.

Objective  The aim of our study is to compare the values of blood cell distribution parameters in cases of pediatric antrochoanal polyps (ACPs) with those of the control group. These values may be guiding parameters in determining the etiology of ACPs and evaluating the severity of the disease and the risk of recurrence.

Methods  Blood count values of patients operated for pediatric ACPs were retrospectively analyzed and compared with the data of the control group with the same age and gender distribution. The ACPs group was divided into subgroups in terms of inflammation, severity, and recurrence, and these subgroups were statistically compared as well.

Results  When the ACP patient group and the control group were compared, there was no statistically significant difference between the two groups. When we compared the patients considering the CT findings, there was a statistically significant difference between the stage III patients and the control group in terms of mean platelet volume (MPV) and platelet-to-lymphocyte ratio (PLR) values ( p  < 0.05 in both). Similarly, the MPV and PLR values were significantly higher in the recurrence patient group than in the control group. ( p  < 0.05 in both).

Conclusion  As a result of the data obtained, it can be suggested that inflammatory parameters in pediatric cases of ACPs vary in terms of recurrence and the severity of the disease.

Identification of Potential Biomarkers of Radiation Exposure in Blood Cells by Capillary Electrophoresis Time-of-Flight Mass Spectrometry

Biodosimetry is a useful method for estimating personal exposure doses to ionizing radiation. Studies have identified metabolites in non-cellular biofluids that can be used as markers in biodosimetry. Levels of metabolites in blood cells may reflect health status or environmental stresses differentially. Here, we report changes in the levels of murine blood cell metabolites following exposure to X-rays in vivo. Levels of blood cell metabolites were measured by capillary electrophoresis time-of-flight mass spectrometry. The levels of 100 metabolites were altered substantially following exposure. We identified 2-aminobutyric acid, 2'-deoxycytidine, and choline as potentially useful markers of radiation exposure and established a potential prediction panel of the exposure dose using stepwise regression. Levels of blood cell metabolites may be useful biomarkers in estimating exposure doses during unexpected radiation incidents.

Clonal Hematopoiesis: Somatic Mutations in Blood Cells and Atherosclerosis

The most important prognostic factor for atherosclerotic cardiovascular disease is age, independent of all other recognized risk factors. Recently, exome sequence analyses showed that somatic mutations in blood cells, a process termed clonal hematopoiesis, are common and increase in prevalence with age, with at least 1 in 10 adults older than 70 years affected. Carriers of clonal hematopoiesis have been shown to be not only at heightened risk for hematologic malignancy but also at increased risk for atherosclerotic cardiovascular disease. Here, we review the prior literature of clonal selection and expansion of hematopoietic stem cells and the evidence supporting its causal association with atherosclerotic cardiovascular disease.

Headcase is a Repressor of Lamellocyte Fate in Drosophila melanogaster

Due to the evolutionary conservation of the regulation of hematopoiesis, Drosophila provides an excellent model organism to study blood cell differentiation and hematopoietic stem cell (HSC) maintenance. The larvae of Drosophila melanogaster respond to immune induction with the production of special effector blood cells, the lamellocytes, which encapsulate and subsequently kill the invader. Lamellocytes differentiate as a result of a concerted action of all three hematopoietic compartments of the larva: the lymph gland, the circulating hemocytes, and the sessile tissue. Within the lymph gland, the communication of the functional zones, the maintenance of HSC fate, and the differentiation of effector blood cells are regulated by a complex network of signaling pathways. Applying gene conversion, mutational analysis, and a candidate based genetic interaction screen, we investigated the role of Headcase (Hdc), the homolog of the tumor suppressor HECA in the hematopoiesis of Drosophila. We found that naive loss-of-function hdc mutant larvae produce lamellocytes, showing that Hdc has a repressive role in effector blood cell differentiation. We demonstrate that hdc genetically interacts with the Hedgehog and the Decapentaplegic pathways in the hematopoietic niche of the lymph gland. By adding further details to the model of blood cell fate regulation in the lymph gland of the larva, our findings contribute to the better understanding of HSC maintenance.

Blood Cell Parameters and Predicting Coronary In-Stent Restenosis

Major advances in coronary interventional techniques and pharmacotherapy as well as the use of drug-eluting stents (DESs) have considerably reduced the risk of in-stent restenosis (ISR). However, ISR remains a major clinical challenge. Inflammation and platelet activation are important processes that underlie the pathophysiology of ISR. Parameters related to blood cells, entailing both cell count and morphology, are useful markers of the inflammatory response and platelet activation in clinical practice. Recent studies have highlighted several new combined or derived parameters related to blood cells that independently predict ISR after DES implantation. The neutrophil/lymphocyte ratio, an inflammatory marker, is regarded as a predictor of the risk of ISR and the stability of atherosclerotic plaques. The mean platelet volume, a widely used platelet activation parameter, has been shown to be a predictor of the risk of ISR and the efficacy of antiplatelet therapy. Other markers considered include the platelet/lymphocyte ratio, red blood cell distribution width, and platelet distribution width. This review provides an overview of these parameters that may help stratify the risk of coronary angiographic and clinical outcomes related to ISR.

Transglutaminase inhibition stimulates hematopoiesis and reduces aggressive behavior of crayfish, Pacifastacus leniusculus

Transglutaminase (TGase) is a Ca²⁺-dependent cross-linking enzyme, which has both enzymatic and nonenzymatic properties. TGase is involved in several cellular activities, including adhesion, migration, survival, apoptosis, and extracellular matrix (ECM) organization. In this study, we focused on the role of the TGase enzyme in controlling hematopoiesis in the crayfish, Pacifastacus leniusculus We hypothesized that a high TGase activity could mediate an interaction of progenitor cells with the ECM to maintain cells in an undifferentiated stage in the hematopoietic tissue (HPT). We found here that the reversible inhibitor cystamine decreases the enzymatic activity of TGase from crayfish HPT, as well as from guinea pig, in a concentration-dependent manner. Cystamine injection decreased TGase activity in HPT without affecting production of reactive oxygen species. Moreover, the decrease in TGase activity in the HPT increased the number of circulating hemocytes. Interestingly the cystamine-mediated TGase inhibition reduced aggressive behavior and movement in crayfish. In conclusion, we show that cystamine-mediated TGase inhibition directly releases HPT progenitor cells from the HPT into the peripheral circulation in the hemolymph and strongly reduces aggressive behavior in crayfish.

Cytochemical characterization of peripheral blood cell populations of two Cyprinidae, Carassius auratus and Ctenopharyngodon idellus

Fish are the most diverse species of all vertebrate groups, and their blood cells have shown variable characteristics in terms of morphology. Cytochemical staining for enzyme activity in blood leukocytes will help assess the immune function of fish. We characterize blood cells from crucian carp (Carassius auratus) and grass carp (Ctenopharyngodon idellus) by using a Diff-Quick stain as well as different cytochemical methods. Blood specimens obtained from crucian carp and grass carp were evaluated after cytochemical staining for acid phosphatase (ACP), alkaline phosphatase (ALP), naphthol AS chloroacetate esterase (AS-DNCE), naphthyl acetate esterase (NAE), α-naphthyl butyrate esterase (NBE), peroxidase (MPO) and periodic acid-Schiff's reaction (PAS) using commercial kits. Blood cell types were evaluated based on their morphological characteristics and the presence or absence of specific chromogen. The expression pattern of enzymes was similar between the two Cyprinidae and was also broadly consistent with other fish species. However, there were some interesting differences detected between crucian carp and grass carp, including naphthol AS chloroacetate esterase activity in monocytes, peroxidase activity and location in thrombocytes. The ACP, ALP and MPO expressions of different leukocytes of the two Cyprinidae were evaluated by Image Pro Plus and were analysed for statistical significant differences. This investigation provides basic haematology and enzyme activity analyses for crucian carp and grass carp and serves as an approach to evaluating the immune response of fish.

The association of hemocyte profile and obstructive sleep apnea

BACKGROUND

The hemocyte profile is one of the most frequently requested clinical laboratory tests. However, the analysis of blood cell indexes of obstructive sleep apnea (OSA) patients in previous studies was not comprehensive. And, this study aimed to fully analyze the blood routine in OSA patients.

METHODS

A retrospective study was conducted on 1087 male patients, who were admitted to the sleep center of Nanfang Hospital from May 2013 to February 2018. According to the apnea hypopnea index (AHI), patients were divided into four groups: control group (AHI < 5, n = 135), mild OSA (5 ≦ AHI < 15, n = 185), moderate OSA (15 ≦ AHI < 30, n = 171), and severe OSA (AHI ≧ 30, n = 596). Data collected included sleep parameters, complete blood routine, body mass index (BMI), age, and comorbidities.

RESULTS

In our study, leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, erythrocytes, hemoglobin, hematocrit, platelets, MPV, and PDW-SD were statistically significant among the four groups based on AHI (P < 0.05), but no significant differences were found in MCV, RDW-SD, N/L, and P/L ratio (P > 0.05). Neutrophils, lymphocytes, monocytes, eosinophils, basophils, hemoglobin, hematocrit, platelets, and MPV were significantly correlated with AHI. Moreover, multiple linear regression analysis demonstrated that hematocrit (β = 73.254, P = 0.001), neutrophils (β = 1.414, P = 0.012), and lymphocytes (β = 4.228, P < 0.001) were independently associated with AHI.

CONCLUSION

Neutrophils, lymphocytes, and hematocrit were independently associated with OSA severity. And combining these three blood cell indicators could contribute to the diagnosis of OSA.

Pretreatment hematologic markers as prognostic predictors of gastroenteropancreatic neuroendocrine tumors: a systematic review and meta-analysis

Background

Systemic inflammation can be reflected by peripheral hematologic parameters and combined index like the lymphocyte count, neutrophil count, platelet count, neutrophil-to-lymphocyte (NLR), and platelet-to-lymphocyte ratio (PLR). This systematic review and meta-analysis aimed to summarize the association between the hematologic markers and prognosis of gastroenteropancreatic neuroendocrine tumors (GEP–NETs).

Methods

A computerized systematic search of PubMed, Embase, and Web of Science was conducted up to August 2016. Studies evaluating prognosis value of hematologic parameters in patients with GEP–NETs were retrieved. For meta-analysis, hazard ratios (HRs) with 95% confidence intervals (95% CIs) were extracted and synthesized using Review Manager software.

Results

We identified eight retrospective cohort studies comprising a total of 724 cases. The majority of included studies focused on pancreatic neuroendocrine tumors (PNETs). The prognostic values of NLR, PLR, and platelet count were reported in six studies, two studies, and one study, respectively. All the parameters were associated with prognostic outcomes in patients with GEP–NETs. A high NLR was significantly associated with poor prognosis in GEP–NETs (pooled HR 3.05, 95% CI 1.96–4.76, I² = 0%, P < 0.00001 for overall survival (OS); pooled HR 3.30, 95% CI 2.04–5.32, I² = 0%, P < 0.00001 for recurrence-free survival [RFS]). In PNETs, pooled-analyses also showed significant superiority of a low NLR on OS (pooled HR 4.21, 95% CI 1.95–9.13, I² = 0%, P = 0.0003) and RFS (pooled HR 5.37, 95% CI 2.14–13.47, I² = 0%, P = 0.003).

Conclusions

These findings suggest that the elevated NLR could be an adverse prognosis factor for GEP–NETs. The conclusion should be mainly limited to PNETs as the majority of included cases were PNET patients. The prognostic value of other hematologic parameters deserves further investigation. We recommend that further studies should use a continuous NLR variable and adopt a prospective and matched study design.

Low MT-CO1 in Monocytes and Microvesicles Is Associated With Outcome in Patients With Coronary Artery Disease

BACKGROUND

Cytochrome oxidase (COX) IV complex regulates energy production in mitochondria. Impaired COX gene expression is related to obesity and type 2 diabetes mellitus, but whether it is directly related to the incidence of cardiovascular events is unknown. We investigated whether COX gene expression in monocytes is predictive for cardiovascular events in coronary artery disease patients. To avoid monocyte isolation from fresh blood, we then aimed to validate our findings in monocyte-derived microvesicles isolated from plasma.

METHODS AND RESULTS

We enrolled 142 consecutive patients undergoing diagnostic coronary angiography between June 2010 and January 2011 and followed 67 patients with stable coronary artery disease prospectively for at least 3 years. Twenty-two patients experienced a new cardiovascular event (32.8%). Circulating CD14⁺ monocytes and microvesicles were isolated with magnetic beads, and COX mRNA levels were measured with quantitative polymerase chain reaction, after normalization with 5 validated house-keeping genes. Patients in the lowest tertile of mitochondrial cytochrome oxidase, subunit I (MT-COI) in monocytes at baseline had a higher risk for developing a new event after adjusting for age, sex, (ex)smoking, body mass index, blood pressure, diabetes mellitus, low-density lipoprotein- and high-density lipoprotein-cholesterol, triglycerides, high-sensitivity C-reactive protein, interleukin-6, and number of diseased vessels (harzard ratio [HR], 3.95; 95% CI, 1.63-9.57). Patients in the lowest tertile of MT-COI in monocyte-specific microvesicles had also a higher risk of developing a new event (adjusted HR, 5.00; 95% CI, 1.77-14).

CONCLUSIONS

In the current blinded study, low MT-COI in monocytes of coronary artery disease patients identifies a population at risk for new cardiovascular events. For the first time, we show that signatures in monocyte-specific microvesicles in plasma have similar predictive properties.

Detection of cyprinid herpesvirus 2 in peripheral blood cells of silver crucian carp, Carassius auratus gibelio (Bloch), suggests its potential in viral diagnosis

Epidemics caused by cyprinid herpesvirus 2 (CyHV-2) in domestic cyprinid species have been reported in both European and Asian countries. Although the mechanisms remain unknown, acute CyHV-2 infections generally result in high mortality, and the surviving carps become chronic carriers displaying no external clinical signs. In this study, in situ hybridization analysis showed that CyHV-2 tended to infect peripheral blood cells during either acute or chronic infections in silver crucian carp, Carassius auratus gibelio (Bloch). Laboratory challenge experiments coupled with real-time PCR quantification assays further indicated that steady-state levels of the viral genomic copy number in fish serum exhibited a typical 'one-step' growth curve post-viral challenge. Transcriptional expression of open reading frames (ORF) 121, which was selected due to its highest transcriptional levels in almost all tested tissues, was monitored to represent the replication kinetics of CyHV-2 in peripheral blood cells. Similar kinetic curve of active viral gene transcription in blood cells was obtained as that of serum viral load, indicating that CyHV-2 replicated in peripheral blood cells as well as in other well-characterized tissues. This study should pave the way for designing non-invasive and cost-effective serum diagnostic methods for quick detection of CyHV-2 infection.

Effects of New Dietary Ingredients Used in Artificial Diet for Screwworm Larvae (Diptera: Calliphoridae)

Spray-dried whole bovine blood, dry poultry egg, and a dry milk substitute are the constituents of the artificial diet currently used for mass rearing screwworm larvae, Cochliomyia hominivorax (Coquerel) (Diptera: Calliphoridae). Due to high cost and uncertainty of the commercial supply of spray-dried blood, research was conducted to identify alternative, locally available, inexpensive, dietary ingredients which could reduce cost of rearing and eliminate concerns of short supply. Experimental diets were prepared without blood component and with various ratios of bovine blood or blood cell product and defatted soy flour. Results indicate that spray-dried bovine blood can be replaced by a readily available and less expensive blood cell product. When the quantity of whole dried blood or blood cell component was reduced or removed completely from the diet, the larvae did not feed adequately, resulting in high mortality. Those larvae that survived produced pupae that were of unacceptable quality. When the milk product was replaced by soy flour, pupae were slightly smaller than those reared using the current diet; however, replacement of egg product with soy flour produced even smaller pupae. Longevity of adult flies that emerged from these small pupae was short and the females deposited few eggs. These results indicate that soy flour cannot replace the blood component from the diet, but can replace the milk product successfully. It is likely that some factor or a combination of factors in the blood act as feeding stimulants, without which larvae are unable to feed normally, resulting in high larval mortality.

Emerging microengineered tools for functional analysis and phenotyping of blood cells

The available techniques for assessing blood cell functions are limited considering the various types of blood cell and their diverse functions. In the past decade, rapid advances in microengineering have enabled an array of blood cell functional measurements that are difficult or impossible to achieve using conventional bulk platforms. Such miniaturized blood cell assay platforms also provide the attractive capabilities of reducing chemical consumption, cost, and assay time, as well as exciting opportunities for device integration, automation, and assay standardization. This review summarizes these contemporary microengineered tools and discusses their promising potential for constructing accurate in vitro models and rapid clinical diagnosis using minimal amounts of whole-blood samples.

Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-response randomized controlled trial

Background

The erythrocyte membrane content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which constitutes the omega‐3 index (O3I), predicts cardiovascular disease mortality. The amount of EPA+DHA needed to achieve a target O3I is poorly defined, as are the determinants of the O3I response to a change in EPA+DHA intake. The objective of this study was to develop a predictive model of the O3I response to EPA+DHA supplementation in healthy adults, specifically identifying factors that determine the response.

Methods and Results

A randomized, placebo‐controlled, double‐blind, parallel‐group study was conducted in 115 healthy men and women. One of 5 doses (0, 300, 600, 900, 1800 mg) of EPA+DHA was given daily as placebo or fish oil supplements for ≈5 months. The O3I was measured at baseline and at the end of the study. There were no significant differences in the clinical characteristics between the groups at baseline. The O3I increased in a dose‐dependent manner (P<0.0001), with the dose of EPA+DHA alone accounting for 68% (quadratic, P<0.0001) of the variability in the O3I response. Dose adjusted per unit body weight (g/kg) accounted for 70% (linear, P<0.0001). Additional factors that improved prediction of treatment response were baseline O3I, age, sex, and physical activity. Collectively, these explained 78% of the response variability (P<0.0001).

Conclusions

Our findings validate the O3I as a biomarker of EPA+DHA consumption and identify additional factors, particularly body weight, that can be used to tailor EPA+DHA recommendations to achieve a target O3I.

The family experience following bone marrow or blood cell transplantation

AIM

To explore how families with children at home managed 4-12 months after an adult family member was discharged from the hospital to home following bone marrow or blood cell transplantation.

BACKGROUND

Studies of these families have been limited in number. The Family Management Style Framework offers a conceptual framework relevant to families with children who have an adult member who has undergone a bone marrow or blood cell transplant.

DESIGN

This was a descriptive, qualitative, one-point-in-time study.

METHOD

Content analysis in relation to the three conceptual components of the Family Management Style Framework was employed; inductive thematic analysis determined the emergent conceptual dimensions present in the data. The sample was composed of 29 participants: 15 transplant recipients and 14 significant others who met the study criteria in 2008 and 2009. Each patient and his or her significant other were interviewed; the audio-recorded interviews were analysed after transcription.

FINDINGS

The three conceptual components of the Family Management Style Framework: (1) definition of the situation; (2) management behaviours; and (3) perceived consequences, were validated as relevant for this sample across all participants. New conceptual dimensions were also present, inclusive of recovery view, support base, financial picture, management domains, perceived consequences to the whole family, and perceived consequences to the dyad relationships.

CONCLUSION

There are several overarching findings in this study, notably that recovery at home is a family experience. Implications for nursing practice include the need for effective transitional care for the patient and family.

THF-gamma 2, a thymic hormone, increases immunocompetence and survival in 5-fluorouracil-treated mice bearing MOPC-315 plasmacytoma

The effect of the thymic hormone, THF-gamma 2, on the immunocompetence of 5-fluorouracil (5-FU)-treated BALB/c mice, bearing MOPC-315 tumor, was examined. Treatment of noninoculated or tumor-bearing mice with THF-gamma 2 after 5-FU injection, resulted in an increase in the antibody response to sheep red blood cells and in the allogeneic response in spleen cell cultures and had no effect on the concanavalin-A-induced interleukin-2 secretion beyond that caused by 5-FU alone. Treatment with either 5-FU alone or 5-FU and THF-gamma 2 resulted in restoration to normal values of Lyt1- and L3T4-positive populations in tumor-bearing mice. THF-gamma 2 prolonged the survival time of mice bearing MOPC-315 tumor beyond that observed in mice treated with 5-FU alone.

Antitumor effect of intrapleural administration of Lactobacillus casei in mice

The antitumor effect of intrapleural (i.pl.) administration of Lactobacillus casei YIT 9018 (LC 9018) on Meth A sarcoma in BALB/c mice was examined. Inoculation of Meth A cells into the thoracic cavity of BALB/c mice caused growth of the cells and the mice died from the tumor with an increased amount of pleural fluid. LC 9018 was given i.pl. to BALB/c mice before or after i.pl. inoculation of Meth A cells and the survival of the mice was determined. The i.pl. administration of LC 9018 was effective in prolonging the survival of the mice after i.pl. inoculation of Meth A tumor, and pretreatment with LC 9018 i.pl. also prolonged survival. Moreover, i.pl. administration of LC 9018 not only increased the number of thoracic exudate cells (TEC) but also augmented both cytolytic activity of thoracic macrophages and natural killer cell activity of TEC. Furthermore, phagocytic activity of thoracic macrophages against sheep red blood cells was enhanced and Ia antigen-positive cells in TEC were increased by the i.pl. treatment with LC 9018. These results showed that TEC induced by i.pl. administration of LC 9018 had antitumor activity against Meth A tumor inoculated i.pl. into BALB/c mice.

Decreased monocyte antibody-dependent cell-mediated toxicity in stage I-II malignant melanoma. Augmentation by subcutaneous Corynebacterium parvum

Lymphocyte and monocyte antibody-dependent cell-mediated cytotoxicity (ADCC) against human red blood cells was examined in 28 stage-I-II malignant melanoma patients. Eighteen were studied at various time intervals after receiving SC Corynebacterium parvum (C. parvum); 10 were untreated. Fifteen normal age-matched controls were also studied. Monocyte ADCC was significantly decreased in untreated patients compared with controls (P less than 0.005) and was significantly increased above controls and untreated patients in individuals treated with C. parvum (P less than 0.008). No significant differences in lymphocyte ADCC were seen. Optimal enhancement of monocyte ADCC by C. parvum occurred from 2 weeks to 1 month after treatment. Significant decreases in ADCC to baseline levels occurred in patients studied from 3 to 6 months beyond treatment.

Complete remission in a patient with acute myelogenous leukemia treated with leukocyte alpha-interferon and cimetidine

A 76-year-old woman with acute myelogenous leukemia with approximately 65% myeloblasts on bone marrow examination was treated daily with a combination of 4 megaU of leukocyte interferon IM and 1,000 mg cimetidine PO. During therapy there was a gradual decrease of bone marrow myeloblasts down to 9% and a normalization of peripheral white blood cells. The treatment was discontinued after 6 weeks because of increasing fatigue and anorexia. The general condition improved greatly during the following weeks and the patient entered complete remission, which has continued for 6 months so far. In the course of therapy there was a gradual appearance of antibodies showing a selective binding capacity to autochthonous leukemic cells with no tendency to increased binding to remission cells. The aim of this report is to stimulate a further evaluation of this form of therapy in additional AML patients whenever this might be justified as an alternative to conventional chemotherapy.

Hemagglutination and structural polypeptides of a new coronavirus associated with diarrhea in infant mice

The hemagglutination (HA) and receptor destroying enzyme (RDE) activities of a newly isolated mouse enteric coronavirus (designated as DVIM) are described. DVIM agglutinates mouse or rat red blood cells (RBC) at 4 degrees C. At 37 degrees C the agglutination was rapidly reversed. The optimal pH for HA and for RDE activities using mouse red cells were shown to be 6.5 and 7.3 respectively. Hemagglutination by DVIM was not inhibited by pretreatment of RBCs with Vibrio cholerae filtrate or by pretreatment with Influenza-A neuraminidase. Therefore, the DVIM receptors on RBCs differ from the receptors of Influenza-A, and the RDE activity of DVIM acts specifically on this receptor. In addition, an analysis of the DVIM polypeptides showed that the virions contain five major, VP1 (M.W. 139,000), VP2 (68,000), VP3 (53,000), VP4 (38,000), VP5 (22,000) and two minor, VP1a (110,000), VP1b (100,000) polypeptides. VP1 and VP1b were digested by bromelain, suggesting that they constitute the surface glycoproteins.