Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes.

BACKGROUND: The Molecular International Prognostic Scoring System (IPSS-M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow-up. METHODS: We retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS-M cohort. Time-dependent erythrocyte transfusion dependency (E-TD) was added to IPSS-M features and analyzed regarding overall survival and leukemic transformation (acute myeloid leukemia). A multistate Markov model was applied to assess the prognostic value of early changes in transfusion patterns. RESULTS: Specific clinical and genetic features were predicted for diagnostic and time-dependent transfusion patterns. Importantly, transfusion state both at diagnosis and within the first year strongly predicts outcomes in both lower (LR) and higher-risk (HR) MDSs. In multivariable analysis, 8-month landmark E-TD predicted shorter survival independently of IPSS-M (p < 0.001). A predictive model based on IPSS-M and 8-month landmark E-TD performed significantly better than a model including only IPSS-M. Similar trends were observed in an independent validation cohort (n = 218). Early transfusion patterns impacted both future transfusion requirements and outcomes in a multistate Markov model. CONCLUSION: The transfusion requirement is a robust and available clinical parameter incorporating the effects of first-line management. In MDS, it provides dynamic risk information independently of diagnostic IPSS-M and, in particular, clinical guidance to LR MDS patients eligible for potentially curative therapeutic intervention.

Neutrophils cultured ex vivo from CD34+ stem cells are immature and genetically tractable.

BACKGROUND: Neutrophils are granulocytes with essential antimicrobial effector functions and short lifespans. During infection or sterile inflammation, emergency granulopoiesis leads to release of immature neutrophils from the bone marrow, serving to boost circulating neutrophil counts. Steady state and emergency granulopoiesis are incompletely understood, partly due to a lack of genetically amenable models of neutrophil development. METHODS: We optimised a method for ex vivo production of human neutrophils from CD34+ haematopoietic progenitors. Using flow cytometry, we phenotypically compared cultured neutrophils with native neutrophils from donors experiencing emergency granulopoiesis, and steady state neutrophils from non-challenged donors. We carry out functional and proteomic characterisation of cultured neutrophils and establish genome editing of progenitors. RESULTS: We obtain high yields of ex vivo cultured neutrophils, which phenotypically resemble immature neutrophils released into the circulation during emergency granulopoiesis. Cultured neutrophils have similar rates of ROS production and bacterial killing but altered degranulation, cytokine release and antifungal activity compared to mature neutrophils isolated from peripheral blood. These differences are likely due to incomplete synthesis of granule proteins, as demonstrated by proteomic analysis. CONCLUSION: Ex vivo cultured neutrophils are genetically tractable via genome editing of precursors and provide a powerful model system for investigating the properties and behaviour of immature neutrophils.

Ammonia Detection by Electronic Noses for a Safer Work Environment.

Providing employees with proper work conditions should be one of the main concerns of any employer. Even so, in many cases, work shifts chronically expose the workers to a wide range of potentially harmful compounds, such as ammonia. Ammonia has been present in the composition of products commonly used in a wide range of industries, namely production in lines, and also laboratories, schools, hospitals, and others. Chronic exposure to ammonia can yield several diseases, such as irritation and pruritus, as well as inflammation of ocular, cutaneous, and respiratory tissues. In more extreme cases, exposure to ammonia is also related to dyspnea, progressive cyanosis, and pulmonary edema. As such, the use of ammonia needs to be properly regulated and monitored to ensure safer work environments. The Occupational Safety and Health Administration and the European Agency for Safety and Health at Work have already commissioned regulations on the acceptable limits of exposure to ammonia. Nevertheless, the monitoring of ammonia gas is still not normalized because appropriate sensors can be difficult to find as commercially available products. To help promote promising methods of developing ammonia sensors, this work will compile and compare the results published so far.

Defining the proteomic landscape of cultured macrophages and their polarization continuum.

Macrophages have previously been characterized based on phenotypical and functional differences into suggested simplified subtypes of MØ, M1, M2a and M2c. These macrophage subtypes can be generated in a well-established primary monocyte culture model that produces cells expressing accepted subtype surface markers. To determine how these subtypes retain functional similarities and better understand their formation, we generated all four subtypes from the same donors. Comparative whole-cell proteomics confirmed that four distinct macrophage subtypes could be induced from the same donor material, with > 50% of 5435 identified proteins being significantly altered in abundance between subtypes. Functional assessment highlighted that these distinct protein expression profiles are primed to enable specific cell functions, indicating that this shifting proteome is predictive of meaningful changes in cell characteristics. Importantly, the 2552 proteins remained consistent in abundance across all macrophage subtypes examined, demonstrating maintenance of a stable core proteome that likely enables swift polarity changes. We next explored the cross-polarization capabilities of preactivated M1 macrophages treated with dexamethasone. Importantly, these treated cells undergo a partial repolarization toward the M2c surface markers but still retain the M1 functional phenotype. Our investigation of polarized macrophage subtypes therefore provides evidence of a sliding scale of macrophage functionality, with these data sets providing a valuable benchmark resource for further studies of macrophage polarity, with relevance for cell therapy development and drug discovery.

Graphene Oxide Thin Films for Detection and Quantification of Industrially Relevant Alcohols and Acetic Acid.

Industrial environments are frequently composed of potentially toxic and hazardous compounds. Volatile organic compounds (VOCs) are one of the most concerning categories of analytes commonly existent in the indoor air of factories' facilities. The sources of VOCs in the industrial context are abundant and a vast range of human health conditions and pathologies are known to be caused by both short- and long-term exposures. Hence, accurate and rapid detection, identification, and quantification of VOCs in industrial environments are mandatory issues. This work demonstrates that graphene oxide (GO) thin films can be used to distinguish acetic acid, ethanol, isopropanol, and methanol, major analytes for the field of industrial air quality, using the electronic nose concept based on impedance spectra measurements. The data were treated by principal component analysis. The sensor consists of polyethyleneimine (PEI) and GO layer-by-layer films deposited on ceramic supports coated with gold interdigitated electrodes. The electrical characterization of this sensor in the presence of the VOCs allows the identification of acetic acid in the concentration range from 24 to 120 ppm, and of ethanol, isopropanol, and methanol in a concentration range from 18 to 90 ppm, respectively. Moreover, the results allows the quantification of acetic acid, ethanol, and isopropanol concentrations with sensitivity values of (3.03±0.12)∗104, (-1.15±0.19)∗104, and (-1.1±0.50)∗104 mL-1, respectively. The resolution of this sensor to detect the different analytes is lower than 0.04 ppm, which means it is an interesting sensor for use as an electronic nose for the detection of VOCs.

The State of the Art on Graphene-Based Sensors for Human Health Monitoring through Breath Biomarkers.

The field of organic-borne biomarkers has been gaining relevance due to its suitability for diagnosing pathologies and health conditions in a rapid, accurate, non-invasive, painless and low-cost way. Due to the lack of analytical techniques with features capable of analysing such a complex matrix as the human breath, the academic community has focused on developing electronic noses based on arrays of gas sensors. These sensors are assembled considering the excitability, sensitivity and sensing capacities of a specific nanocomposite, graphene. In this way, graphene-based sensors can be employed for a vast range of applications that vary from environmental to medical applications. This review work aims to gather the most relevant published papers under the scope of "Graphene sensors" and "Biomarkers" in order to assess the state of the art in the field of graphene sensors for the purposes of biomarker identification. During the bibliographic search, a total of six pathologies were identified as the focus of the work. They were lung cancer, gastric cancer, chronic kidney diseases, respiratory diseases that involve inflammatory processes of the airways, like asthma and chronic obstructive pulmonary disease, sleep apnoea and diabetes. The achieved results, current development of the sensing sensors, and main limitations or challenges of the field of graphene sensors are discussed throughout the paper, as well as the features of the experiments addressed.

Energy access during and post-COVID-19 pandemic in sub-Saharan countries: the case of Ethiopia.

The global COVID-19 pandemic causes hundreds of thousands of deaths and has created a catastrophic economic and health crisis around the World. Transportation, manufacturing industries, business and people's movement came to almost a halt and sharp oil and gas prices reduction were observed. The impact of the pandemic for sub-Saharan countries like Ethiopia, which was already struggling with many economic and social welfare problems, is more evident than in other wealthy nations around the World. In Ethiopia, the general energy access rate is 44% and in healthcare facilities is only about 10%. Therefore, the response for the COVID-19 pandemic is challenging, since activities such as information sharing, communication with health centers, diagnosis and medical treatment require electricity access. This paper aims to assess the impact of the pandemic on energy access plans during and post-pandemic. The paper analyzed, the status of the current COVID-19 outbreak in Ethiopia, the energy access situation in health facilities, and the impacts of COVID-19 on energy access during and post-pandemic periods. Data related to the universal energy access plan of Ethiopia, the impact of energy access on healthcare services and the impact of the pandemic were reviewed for the assessment. The analysis indicates that the impact of the COVID-19 pandemic in Ethiopian healthcare facilities and on the overall universal energy access plan is immense and to minimize the global impact short and long-term policy responses are identified and urgently recommended. Furthermore, powering healthcare facilities with microgrids composed of solar panels and battery storage systems could be one cost-effective and sustainable solution for the speedy and effective response of the pandemic challenges.

Multiple Roles of Alkanethiolate-Ligands in Direct Formation of H2 O2 over Pd Nanoparticles.

Coadsorbed organic species including thiolates can promote direct synthesis of hydrogen peroxide from H2 and O2 over Pd particles. Here, density functional theory based kinetic modeling, augmented with activity measurements and vibrational spectroscopy are used to provide atomistic understanding of direct H2 O2 formation over alkylthiolate(RS) Pd. We find that the RS species are oxidized during reaction conditions yielding RSO2 as the effective ligand. The RSO2 ligand shows superior ability for proton transfer to the intermediate surface species OOH, which accelerates the formation of H2 O2 . The ligands promote the selectivity also by blocking sites for unselective water formation and by modifying the electronic structure of Pd. The work rationalizes observations of enhanced selectivity of direct H2 O2 formation over ligand-funtionalized Pd nanoparticles and shows that engineering of organic surface modifiers can be used to promote desired hydrogen transfer routes.

A new genus of fossil frog (Anura) from lower Cretaceous deposits in South America.

The frog clade Neobatrachia or "advanced frogs" represents more than 95% of the diversity within Anura. The neobatrachian fossil record is incomplete due to the small size and fragile nature of their bones but provides some clues on the time and rate of the current diversification of modern-day amphibians. The Crato Formation (Aptian) of northeastern Brazil is known for the presence of, at least, five species of neobatrachian fossils. Herein, we describe a well-preserved fossil that represents a new neobatrachian taxon from the Crato Formation (Cretaceous) in the Araripe Basin, northeastern Brazil, and perform phylogenetic analysis to assess its higher-level relationships. The new specimen is an almost complete and articulated skeleton with soft tissue preservation. Phylogenetic analysis recovered the specimen nested in the clade Hyloidea and our results highlight the remarkable value of the Crato Formation as a Laggerstätte.

IoT Platform for Energy Sustainability in University Campuses.

University campuses are normally constituted of large buildings responsible for high energy demand, and are also important as demonstration sites for new technologies and systems. This paper presents the results of achieving energy sustainability in a testbed composed of a set of four buildings that constitute the Telecommunications Engineering School of the Universidad Politécnica de Madrid. In the paper, after characterizing the consumption of university buildings for a complete year, different options to achieve more sustainable use of energy are presented, considering the integration of renewable generation sources, namely photovoltaic generation, and monitoring and controlling electricity demand. To ensure the implementation of the desired monitoring and control, an internet of things (IoT) platform based on wireless sensor network (WSN) infrastructure was designed and installed. Such a platform supports a smart system to control the heating, ventilation, and air conditioning (HVAC) and lighting systems in buildings. Furthermore, the paper presents the developed IoT-based platform, as well as the implemented services. As a result, the paper illustrates how providing old existing buildings with the appropriate technology can contribute to the objective of transforming such buildings into nearly zero-energy buildings (nZEB) at a low cost.

Non-muscle myosin II drives vesicle loss during human reticulocyte maturation.

The process of maturation of reticulocytes into fully mature erythrocytes that occurs in the circulation is known to be characterized by a complex interplay between loss of cell surface area and volume, removal of remnant cell organelles and redundant proteins, and highly selective membrane and cytoskeletal remodeling. However, the mechanisms that underlie and drive these maturational processes in vivo are currently poorly understood and, at present, reticulocytes derived through in vitro culture fail to undergo the final transition to erythrocytes. Here, we used high-throughput proteomic methods to highlight differences between erythrocytes, cultured reticulocytes and endogenous reticulocytes. We identify a cytoskeletal protein, non-muscle myosin IIA (NMIIA) whose abundance and phosphorylation status differs between reticulocytes and erythrocytes and localized it in the proximity of autophagosomal vesicles. An ex vivo circulation system was developed to simulate the mechanical shear component of circulation and demonstrated that mechanical stimulus is necessary, but insufficient for reticulocyte maturation. Using this system in concurrence with non-muscle myosin II inhibition, we demonstrate the involvement of non-muscle myosin IIA in reticulocyte remodeling and propose a previously undescribed mechanism of shear stress-responsive vesicle clearance that is crucial for reticulocyte maturation.

Spirituality in palliative care: experiences of an interdisciplinary team. / Espiritualidade nos cuidados paliativos: experiência vivida de uma equipe interdisciplinar.

Objective To understand the experience of spirituality in the daily routine of a palliative care interdisciplinary team. Method A qualitative study was conducted with an oncological palliative care team in southern Brazil. The data was collected through phenomenological interviews in 2014, and interpreted using a hermeneutic phenomenological approach. Results Six professionals participated in the study. Spiritually-related activities, such as prayer and providing comprehensive care, were useful therapeutic resources for offering comfort, survival with dignity and humanization of death, in addition to helping the team and patients understand the end-of-life process and search for meaning in the suffering caused by illness. Conclusion Spirituality on the part of professionals with patients imparted meaning to their palliative care work and facilitated the formation of bonds between teams, patients, and family members.

Psychosocial risks in Psychiatry and Anaesthesiology residents in a Portuguese General and University Hospital.

BACKGROUND: Medical Doctors (MD), although at the front line of response to patients and their families, are seldom study subjects for occupational psychosocial risks and work related stress. OBJECTIVES: Assess psychiatry and anaesthesiology residents in a central and university Portuguese Hospital for the presence of psychosocial risks at work. METHODS: We used the Copenhagen Psychosocial Questionnaire version 2 (COPSOQ), which was applied face-to-face in two group settings, in April 2014. It comprised a sample of 19 Psychiatry residents and 20 Anaesthesiology residents. Statistical analysis was done by correlational analysis using Pearson's coefficient (r) and the t-student test for categorical variables. RESULTS: An occupational health risk (red flag) was found for residents in the "Cognitive demands" dimension of COPSOQ and a health risk (red flag) in the "Work influence" dimension for the female Anaesthesiology sub-group. A possible risk (yellow flag) was found in 17 dimensions. Results also showed moderate correlations between various COPSOQ dimensions and the emergency department workload, workload, home study, number of children, year of training and the medical specialty variables. CONCLUSIONS: These results suggest that residents have a health risk which derives from the cognitive demands of their work and that it increases with the workload.  This implicates the need for occupational health measures to be taken to manage and reduce these psychological risks.

Breath biomarkers in Non-Carcinogenic diseases.

The analysis of volatile organic compounds (VOCs) from human matrices like breath, perspiration, and urine has received increasing attention from academic and medical researchers worldwide. These biological-borne VOCs molecules have characteristics that can be directly related to physiologic and pathophysiologic metabolic processes. In this work, gathers a total of 292 analytes that have been identified as potential biomarkers for the diagnosis of various non-carcinogenic diseases. Herein we review the advances in VOCs with a focus on breath biomarkers and their potential role as minimally invasive tools to improve diagnosis prognosis and therapeutic monitoring.

Why Foot-and-Mouth Disease-Free with Vaccination Should Be Equivalent to Foot-and-Mouth Disease-Free without Vaccination.

Foot-and-Mouth Disease (FMD) is still one of the most relevant animal diseases and remains of global concern. The World Organization for Animal Health (WOAH) has specified two sanitary statuses that assure freedom from FMD: a country or zone can be free from FMD either with or without vaccination. To obtain either of the two statuses, absence of virus circulation must be shown. The standards set by WOAH are used for trade negotiations. During recent decades, different tools and approaches were developed to control FMD, including vaccines, diagnostics, and the Progressive Control Pathway for FMD. These tools improved over time, and nowadays high-quality, reliable vaccines and specific diagnostics are available to efficiently control and detect the infection, even in vaccinated populations. Due to these improvements, it is no longer justifiable to treat the two FMD-free statuses differently. The distinction between the statuses provides wrong incentives and tempts countries to take increased risks by stopping vaccination to improve their trade conditions, which can have potentially devastating consequences. The decision to stop vaccination should only be made on the basis of a careful and comprehensive analysis of the local and regional epidemiological situation. This paper presents the perspective that member countries and WOAH should recognize the two FMD-free statuses as equivalent.

Complete absence of GLUT1 does not impair human terminal erythroid differentiation.

The Glucose transporter 1 (GLUT1) is one of the most abundant proteins within the erythrocyte membrane and is required for glucose and dehydroascorbic acid (Vitamin C precursor) transport. It is widely recognized as a key protein for red cell structure, function, and metabolism. Previous reports highlighted the importance of GLUT1 activity within these uniquely glycolysis-dependent cells, in particular for increasing antioxidant capacity needed to avoid irreversible damage from oxidative stress in humans. However, studies of glucose transporter roles in erythroid cells are complicated by species-specific differences between humans and mice. Here, using CRISPR-mediated gene editing of immortalized erythroblasts and adult CD34+ hematopoietic progenitor cells, we generate committed human erythroid cells completely deficient in expression of GLUT1. We show that absence of GLUT1 does not impede human erythroblast proliferation, differentiation, or enucleation. This work demonstrates for the first-time generation of enucleated human reticulocytes lacking GLUT1. The GLUT1-deficient reticulocytes possess no tangible alterations to membrane composition or deformability in reticulocytes. Metabolomic analyses of GLUT1-deficient reticulocytes reveal hallmarks of reduced glucose import, downregulated metabolic processes and upregulated AMPK-signalling, alongside alterations in antioxidant metabolism, resulting in increased osmotic fragility and metabolic shifts indicative of higher oxidant stress. Despite detectable metabolic changes in GLUT1 deficient reticulocytes, the absence of developmental phenotype, detectable proteomic compensation or impaired deformability comprehensively alters our understanding of the role of GLUT1 in red blood cell structure, function and metabolism. It also provides cell biological evidence supporting clinical consensus that reduced GLUT1 expression does not cause anaemia in GLUT1 deficiency syndrome.