Red cell exchange for rapid leukoreduction in adults with hyperleukocytosis and leukostasis.

ABSTRACT: We show that red cell exchange (RCE) treats hyperleukocytosis in acute leukemia. RCE provided similar leukoreduction to standard therapeutic leukoreduction and could be superior in patients with severe anemia or monocytic leukemias or when requiring rapid treatment.

More efficient exchange of sickle red blood cells can be achieved by exchanging the densest red blood cells: An ex vivo proof of concept study.

BACKGROUND: In sickle cell disease (SCD), red blood cells (RBCs) containing hemoglobin S can be denser than RBCs containing wild-type hemoglobin, especially when dehydrated. We hypothesize that targeting denser RBCs during red blood cell (RBC) exchange for SCD could result in more efficient removal of dehydrated, sickled RBCs and preservation of non-sickled RBCs. STUDY DESIGN AND METHODS: Waste products from RBC exchanges for SCD were used as "simulated patients". One RBC volume was exchanged using ABO-compatible blood. The apheresis instrument was programmed to exchange the entire RBC layer by indicating the hematocrit (control), or the bottom half by indicating the hematocrit was half the hematocrit (experimental), with or without subsequent transfusion. Hemoglobin S levels, and complete blood counts were measured. RESULTS: Hemoglobin S levels were lower after the modified versus control RBC exchange (post-RBC exchange mean 4.96% and 11.27%); total hemoglobin S amounts were also lower (mean 19.27 and 58.29 mL of RBCs). Mean RBC density decreased after the modified RBC exchange by 8.86%. Hematocrit decreased in the modified RBC exchange by 36.37%, with partial correction by direct transfusion following a truncated RBC exchange. CONCLUSIONS: Targeting denser RBCs in RBC exchange enhanced hemoglobin S removal and decreased RBC density. Further development of this ex vivo model could potentially allow for: 1) improved reduction in hemoglobin S levels (allowing for longer periods between RBC exchange or maintained lower levels), or 2) achievement of previous goal hemoglobin S levels with fewer donor units (reducing alloimmunization risk and improving blood utilization).

Compact solar autoclave based on steam generation using broadband light-harvesting nanoparticles.

The lack of readily available sterilization processes for medicine and dentistry practices in the developing world is a major risk factor for the propagation of disease. Modern medical facilities in the developed world often use autoclave systems to sterilize medical instruments and equipment and process waste that could contain harmful contagions. Here, we show the use of broadband light-absorbing nanoparticles as solar photothermal heaters, which generate high-temperature steam for a standalone, efficient solar autoclave useful for sanitation of instruments or materials in resource-limited, remote locations. Sterilization was verified using a standard Geobacillus stearothermophilus-based biological indicator.

The influence of linguistic content on the Lombard effect.

PURPOSE: The Lombard effect describes the tendency for speakers to increase pitch, intensity, and duration in the presence of noise. It is unclear whether these modifications are uniformly applied across all words within an utterance or whether information-bearing content words are further enhanced compared with function words. In the present study, the authors investigated the influence of linguistic content on acoustic modifications made to speech in noise. METHOD: Sixteen speaker-listener pairs engaged in an interactive cooperative game in quiet, 60 dB of multitalker noise, and 90 dB of multitalker noise. Speaker productions were analyzed to examine differences in fundamental frequency (F(0)), intensity, and duration of target words in sentences across noise conditions. RESULTS: Proportional increases in F(0,) intensity, and duration were noted for all word types as noise increased from quiet to 60 dB. From quiet to 90 dB, content words that referred to agents, objects, and locations were disproportionately elongated compared with function words. Additionally, agents were further enhanced by increased F(0). CONCLUSIONS: At moderate noise levels, most word types appear to be uniformly boosted in F(0), intensity, and duration. As noise increases, linguistic content shapes the extent of the Lombard effect, with F(0) and duration serving as primary cues for marking information-bearing word types.