Gemtuzumab-Ozogamicin-Related Impaired Hemoglobin-Haptoglobin Scavenging as On-Target/Off-Tumor Toxicity of Anti-CD33 AML Therapy : A Report of Two Cases

Gemtuzumab-ozogamicin (GO) is a humanized anti-CD33 antibody, which is conjugated to a cytotoxic calicheamicin. It is used to treat acute myeloid leukemia (AML) in combination with chemotherapy. We describe here two GO-treated acute myeloid leukemia (AML) cases: both patients suffered from a toxic syndrome, which manifested as impaired hemoglobin-haptoglobin scavenging and accumulation of hemolysis-related products. Our observations and earlier reports indicated that the reaction was caused by GO-targeted destruction of CD33 + CD163+ monocytes/macrophages, which are responsible for the clearance of hemoglobin-haptoglobin complexes. The rise of plasma lactate dehydrogenase was an early sign of the reaction, and both patients had high levels of free plasma hemoglobin, but plasma haptoglobin and bilirubin levels were paradoxically normal. Symptoms included septic fever and abnormalities in cardiac tests and in the case of the first patient, severe neurological symptoms which required intensive care unit admittance. Therapeutic plasma exchanges supported the patients until the recovery of normal hematopoiesis. The symptoms may be easily confounded with infectious complications-related organ damage. Regarding the increasing use of gemtuzumab-ozogamicin and other emerging CD33-targeted cell therapies, we want to highlight this mostly unknown and probably underdiagnosed toxicity.Peer reviewe

Kasvoja seuraavan näköjärjestelmän toteutus robottipäähän

Tiivistelmä. Työssä kehitettiin robottiin kytketty koneoppimisjärjestelmä, joka käsittelee reaaliajassa kameralta tulevaa videosyötettä. Järjestelmää käytettiin havaitsemaan, jäljittämään ja tunnistamaan ihmisten kasvoja, sekä hallitsemaan kameraa (pään ja silmien suuntaus) tarpeenmukaisella tavalla. Kasvojentunnistukseen hyödynnettiin OpenCV:n Haar-ominaisuuksiin pohjautuvaa kaskadiluokittelijaa. Tunnistettua henkilöä seurattiin suhteessa robotin sijaintiin koordinaatistossa, joka helpottaa tunnistuksien käyttöä ja käsittelyä. Henkilön tunnistamiseen koulutettiin Tensorflow-kirjastoa käyttäen autoenkooderityyppinen neuroverkko, jolla enkoodataan kasvoista helposti muistettava ja matemaattisesti vertailtavissa oleva vektori. Tuotettu kokonaisuus onnistui kohtuullisella tarkkuudella ihmisen silmänliikkeitä imitoiden tunnistamaan ja seuraamaan kasvoja. Kyseessä oli usean kandidaattivaiheen opiskelijan laajempi yhteistyöprojekti, jossa eri ryhmät toteuttavat robotille eri toiminnallisuuksia. Ryhmien tuottamat ominaisuudet yhdistettiin käyttäen ROS (Robot Operating System) -nimistä järjestelmää.Abstract. In this work we developed a machine learning system for a robot used to process real time video feed of a camera. The system is used to detect, track and recognize faces and control a camera accordingly (head and eye movement). We used OpenCV cascade classifier which uses Haar-features for facial recognition. Recognitions are mapped to a coordinate system relative to the robot which helps the usage and processing of the detections. An autoencoder based solution was trained using Tensorflow-library for facial recognition by encoding an easily mathematically comparable vector from the faces. The produced system was able to imitate human eye movement with reasonable accuracy and track faces. The project was a part of larger collaboration between other bachelor’s degree students on this project course. Each group developed a specific functionality for the robot. All of the functionalities developed by each group were combined using Robot Operating System

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English summaryPeer reviewe

Infiltration of CD163-, PD-L1-and FoxP3-positive cells adversely affects outcome in patients with mantle cell lymphoma independent of established risk factors

We characterised patients with mantle cell lymphoma (MCL) with poor prognosis based on differences in immune infiltration. Different expressions of the tumour cell markers Cyclin D1 and sex-determining region Y-box transcription factor 11 (SOX11), and the immune markers cluster of differentiation 3 (CD3), CD4, CD8, CD25, forkhead box protein P3 (FoxP3), T-box transcription factor TBX21 (T-bet), programmed cell death protein 1 (PD-1), programmed-death ligand 1 (PD-L1) and CD163 were investigated for all-cause mortality in 282 patients with MCL and time-to-progression (TTP) in 106 clinical trial patients. With increasing age, a significantly lower infiltration of CD3(+) T lymphocytes was seen. T-cell infiltration was independent of cellular tumour antigen p53 (p53) expression, Ki-67, morphology and frequency of tumour cells. The all-cause mortality was higher in patients with PD-L1-expression above cut-off [hazard ratio (HR) 1 center dot 97, 95% confidence interval (CI) 1 center dot 18-3 center dot 25, adjusted for sex and MCL International Prognostic Index (MIPI)] and a higher frequency of CD163(+) cells (continuously, HR 1 center dot 51, 95% CI 1 center dot 03-2 center dot 23, adjusting for age, sex, morphology, Ki-67 and p53). In patients treated within the Nordic Lymphoma Group MCL2/3 trials, TTP was shorter in patients with a higher frequency of FoxP3(+) cells (HR 3 center dot 22, 95% CI 1 center dot 40-7 center dot 43) and CD163(+) cells (HR 6 center dot 09, 95% CI 1 center dot 84-20 center dot 21), independent of sex and MIPI. When combined a higher frequency of CD163(+) macrophages and PD-L1(+) cells or high CD163(+) macrophages and FoxP3(+) regulatory T cells indicated worse outcome independent of established risk factors. The T-cell infiltrate was in turn independent of molecular characteristics of the malignant cells and decreased with age.Peer reviewe

Eight years of sub-micrometre organic aerosol composition data from the boreal forest characterized using a machine-learning approach

The Station for Measuring Ecosystem-Atmosphere Relations (SMEAR) II, located within the boreal forest of Finland, is a unique station in the world due to the wide range of long-term measurements tracking the Earth-atmosphere interface. In this study, we characterize the composition of organic aerosol (OA) at SMEAR II by quantifying its driving constituents. We utilize a multi-year data set of OA mass spectra measured in situ with an Aerosol Chemical Speciation Monitor (ACSM) at the station. To our knowledge, this mass spectral time series is the longest of its kind published to date. Similarly to other previously reported efforts in OA source apportionment from multi-seasonal or multi-annual data sets, we approached the OA characterization challenge through positive matrix factorization (PMF) using a rolling window approach. However, the existing methods for extracting minor OA components were found to be insufficient for our rather remote site. To overcome this issue, we tested a new statistical analysis framework. This included unsupervised feature extraction and classification stages to explore a large number of unconstrained PMF runs conducted on the measured OA mass spectra. Anchored by these results, we finally constructed a relaxed chemical mass balance (CMB) run that resolved different OA components from our observations. The presented combination of statistical tools provided a data-driven analysis methodology, which in our case achieved robust solutions with minimal subjectivity. Following the extensive statistical analyses, we were able to divide the 2012-2019 SMEAR II OA data (mass concentration interquartile range (IQR): 0.7, 1.3, and 2.6 mu gm(-3)) into three sub-categories - low-volatility oxygenated OA (LV-OOA), semi-volatile oxygenated OA (SV-OOA), and primary OA (POA) - proving that the tested methodology was able to provide results consistent with literature. LV-OOA was the most dominant OA type (organic mass fraction IQR: 49 %, 62 %, and 73 %). The seasonal cycle of LV-OOA was bimodal, with peaks both in summer and in February. We associated the wintertime LV-OOA with anthropogenic sources and assumed biogenic influence in LV-OOA formation in summer. Through a brief trajectory analysis, we estimated summertime natural LV-OOA formation of tens of ngm 3 h 1 over the boreal forest. SV-OOA was the second highest contributor to OA mass (organic mass fraction IQR: 19 %, 31 %, and 43 %). Due to SV-OOA's clear peak in summer, we estimate biogenic processes as the main drivers in its formation. Unlike for LV-OOA, the highest SV-OOA concentrations were detected in stable summertime nocturnal surface layers. Two nearby sawmills also played a significant role in SV-OOA production as also exemplified by previous studies at SMEAR II. POA, taken as a mix of two different OA types reported previously, hydrocarbon-like OA (HOA) and biomass burning OA (BBOA), made up a minimal OA mass fraction (IQR: 2 %, 6 %, and 13 %). Notably, the quantification of POA at SMEAR II using ACSM data was not possible following existing rolling PMF methodologies. Both POA organic mass fraction and mass concentration peaked in winter. Its appearance at SMEAR II was linked to strong southerly winds. Similar wind direction and speed dependence was not observed among other OA types. The high wind speeds probably enabled the POA transport to SMEAR II from faraway sources in a relatively fresh state. In the event of slower wind speeds, POA likely evaporated and/or aged into oxidized organic aerosol before detection. The POA organic mass fraction was significantly lower than reported by aerosol mass spectrometer (AMS) measurements 2 to 4 years prior to the ACSM measurements. While the co-located long-term measurements of black carbon supported the hypothesis of higher POA loadings prior to year 2012, it is also possible that short-term (POA) pollution plumes were averaged out due to the slow time resolution of the ACSM combined with the further 3 h data averaging needed to ensure good signal-to-noise ratios (SNRs). Despite the length of the ACSM data set, we did not focus on quantifying long-term trends of POA (nor other components) due to the high sensitivity of OA composition to meteorological anomalies, the occurrence of which is likely not normally distributed over the 8-year measurement period. Due to the unique and realistic seasonal cycles and meteorology dependences of the independent OA subtypes complemented by the reasonably low degree of unexplained OA variability, we believe that the presented data analysis approach performs well. Therefore, we hope that these results encourage also other researchers possessing several-yearlong time series of similar data to tackle the data analysis via similar semi- or unsupervised machine-learning approaches. This way the presented method could be further optimized and its usability explored and evaluated also in other environments.Peer reviewe

Non-invasive electrical brain stimulation for vision restoration after stroke : An exploratory randomized trial (REVIS)

Background: Occipital strokes often cause permanent homonymous hemianopia leading to significant disability. In previous studies, non-invasive electrical brain stimulation (NIBS) has improved vision after optic nerve damage and in combination with training after stroke. Objective: We explored different NIBS modalities for rehabilitation of hemianopia after chronic stroke. Methods: In a randomized, double-blinded, sham-controlled, three-armed trial, altogether 56 patients with homonymous hemianopia were recruited. The three experiments were: i) repetitive transorbital alternating current stimulation (rtACS, n=8) vs. rtACS with prior cathodal transcranial direct current stimulation over the intact visual cortex (tDCS/rtACS, n=8) vs. sham (n = 8); ii) rtACS (n = 9) vs. sham (n = 9); and iii) tDCS of the visual cortex (n = 7) vs. sham (n = 7). Visual functions were evaluated before and after the intervention, and after eight weeks follow-up. The primary outcome was change in visual field assessed by high-resolution and standard perimetries. The individual modalities were compared within each experimental arm. Results: Primary outcomes in Experiments 1 and 2 were negative. Only significant between-group change was observed in Experiment 3, where tDCS increased visual field of the contralesional eye compared to sham. tDCS/rtACS improved dynamic vision, reading, and visual field of the contralesional eye, but was not superior to other groups. rtACS alone increased foveal sensitivity, but was otherwise ineffective. All trial-related procedures were tolerated well. Conclusions: This exploratory trial showed safety but no main effect of NIBS on vision restoration after stroke. However, tDCS and combined tDCS/rtACS induced improvements in visually guided performance that need to be confirmed in larger-sample trials.Peer reviewe

A minor role of asparaginase in predisposing to cerebral venous thromboses in adult acute lymphoblastic leukemia patients

Cerebral venous thrombosis (CVT) covers up to a third of all venous thromboses (VTs) detected in patients with acute lymphoblastic leukemia (ALL). It usually hampers patients' lives and may also endanger efficient leukemia treatment. Although many factors have been suggested to account for an elevated risk of VTs in patients with ALL, there still is a lack of studies focusing on CVTs and especially in the setting of adult ALL patients. We studied in our retrospective population-based cohort the occurrence, characteristics, as well as risk factors for VTs in 186 consecutively diagnosed Finnish adult ALL patients treated with a national pediatric-inspired treatment protocol ALL2000. In the risk factor analyses for VTs we found a distinction of the characteristics of the patients acquiring CVT from those with other kinds of VTs or without thrombosis. In contrast to previous studies we were also able to compare the effects of asparaginase in relation to CVT occurrence. Notably, more than half of the CVTs were diagnosed prior the administration of asparaginase which accentuates the role of other risk factors on the pathophysiology of CVT compared to truncal or central venous line (CVL) VTs in adult ALL patients