Acute leukaemia: no reason to panic

Acute leukaemia is characterised by uncontrolled expansion of immature leukocytes, either myeloid or lymphoid progenitors, leading to acute myeloid leukaemia (AML) and acute lymphoid leukaemia (ALL), respectively. If left untreated, it is life-threatening and can lead to death within weeks. When acute leukaemia is suspected, urgent haematology input should be sought. Appropriate investigations are needed promptly to confirm diagnosis and start treatment. A multidisciplinary approach is vital to ensure appropriate management

Lymphocytosis and chronic lymphocytic leukaemia: investigation and management

Lymphocytosis is a common blood-test finding. Establishing whether the cause of lymphocytosis is benign or malignant is key to managing patients appropriately. A lymphocytosis should always prompt clinical review including a thorough history, examination and appropriate preliminary investigations (blood tests, blood film). The majority of patients with chronic lymphocytic leukaemia (CLL) present incidentally due to a lymphocytosis found on routine blood tests. Patient outcomes vary considerably based on genetic pre-disposition and various prognostic markers (age, Binet or Rai staging, and B2-microglobulin). Although not curative, chemo-immunotherapy is an effective treatment strategy for the majority of CLL patients with progressive disease. More recently, novel oral therapies have been developed that target key signalling and apoptosis pathways and that are being used in relapse settings and as first-line treatments for certain patients

Von Willebrand Factor (vWF): marker of endothelial damage and thrombotic risk in COVID-19?

Background COVID-19 infection is characterised, among other features, by a prothrombotic state with high rate of venous thromboembolism (VTE), D-dimer, and fibrinogen levels. Clinical observations have also highlighted that these patients have elevated von Willebrand factor (vWF) and factor VIIIc. Methods 24 consecutive COVID-19 positive patients were selected from the intensive care unit (ICU) or the high acuity ward of Brighton and Sussex University Hospitals NHS Trust. Results The rate of VTE was 25% and mortality rate was 16.7%. Fibrinogen and D-Dimers were elevated, 7.9 (1.6) g/L and 2.4 (2.02) ug/ml respectively. Factor VIIIc and von vWF antigen levels were both extremely elevated at 279 (148) u/dL and 350 (131) % respectively, which are comparable to levels seen in ICU patients with severe sepsis. vWF levels were significantly higher in patients that died (p=0.017) and showed a positive correlation with age. There was a statistically significant association between COVID-19 disease and non-O blood group (p=0.02); 80% (4/5) of COVID-19 patients with VTE were blood group A. Conclusion Very high levels of vWF and factor VIIIc are common in COVID-19 patients, comparable to levels in severely septic non-COVID ICU patients. This could contribute to the hypercoagulable state and increased VTE rate in COVID-19. Further studies are needed to evaluate the use of vWF for stratifying thrombotic risk in COVID-19 and to determine if elevated vWF is contributing to disease pathogenesis

Thrombotic risk in COVID-19: a case series and case-control study

Background: A possible association between COVID-19 infection and thrombosis, either as a direct consequence of the virus or as a complication of inflammation, is emerging in the literature. Data on the incidence of venous thromboembolism (VTE) is extremely limited. Methods: We describe 3 cases of thromboembolism refractory to heparin treatment, the incidence of VTE in an inpatient cohort, and a case-control study to identify risk factors associated with VTE. Results: We identified 274 confirmed (208) or probable (66) COVID-19 patients. 21 (7.7%) were diagnosed with VTE. D-dimer was elevated in both cases (confirmed VTE) and controls (no confirmed VTE) but higher levels were seen in confirmed VTE cases (4.1vs 1.2 µg/mL P <0.001). Conclusion: Incidence of VTE is high in patients hospitalised with COVID-19. Urgent clinical trials are needed to evaluate the role of anticoagulation in COVID-19. Monitoring of D-dimer and anti-factor Xa levels may be beneficial in guiding management

Effect of Sorghum bicolor mycorrhizae on development of tomato in nursery

Tomato is one of the most important vegetable crops in Burkina Faso. Nevertheless, tomato production is confronted with numerous biotic and abiotic constraints. So, it is essential to find ways of boosting its production, starting at the nursery. In nurseries, the use of mycorrhizal fungi can be an effective means of obtaining vigorous and healthy seedlings. This study was carried out with the aim of assessing the impact of endogenous mycorrhizal fungi on the growth and biomass of tomato in nursery. To do so, sorghum (Sorghum bicolor L.), known as a hypermycotrophic plant, was used for inoculum production of mycorrhizal fungi. In addition, the effect of direct association of sorghum and tomato was studied. The results showed that the application of mycorrhizal fungi from the inoculum significantly improved the emergence, growth and leafing of tomato in the nursery during experimentation. A height of 5.75 cm was observed in mycorrhizal plants as compared to 3.23 cm for non-mycorrhizal control plants. It was also shown that adding mycorrhizal inoculum to the seeds was much more effective than the direct association in the field with the sorghum plant and tomato. The results showed that endogenous mycorrhizal fungi significantly improved the emergence, plant height, leaf formation and biomass production of tomato plants

The emerging role of estrogen in B cell malignancies

Increasing evidence implicates a role of estrogens in hematological malignancies. We reviewed current knowledge on the emerging role of estrogens and estrogen receptors in normal B-cell function, chronic lymphocytic leukemia, and B-cell lymphoma. Data support that (1) normal human peripheral blood cells (mononuclear cells, total lymphocytes, T as well as B lymphocytes, and NK cells) express both estrogen receptor subtypes (ERα and ERβ), (2) B-cell malignancies express mainly ERβ while selective ERβ agonists inhibit cell growth and induce apoptosis, (3) estrogens regulate, via an ER-mediated pathway, gene expression of cyclins, kinases, bcl-2 proto-oncogene, activation-induced deaminase (AID), and transcription factors, associated with changes in BCR signaling and B cell tumorigenesis. In conclusion, estrogen receptors play an important role in normal B-cell function and B-cell tumorigenesis; however, further investigations are required to delineate the role of estrogens and estrogen receptors in the etiopathogenesis and therapy of B-cell malignancies. © 2016 Informa UK Limited, trading as Taylor &amp; Francis Group

COVID-19 mortality in patients on anticoagulants and antiplatelet agents

Coagulopathy (Tang, et al 2020) and a prothrombotic diathesis with high D-dimer and fibrinogen levels (Al-Samkari, et al 2020) are associated with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Extensive thrombosis in small vessels and the microvasculature in lungs and extrapulmonary organs has been confirmed histologically (Zhang, et al 2020). Early studies showed that the venous thromboembolism (VTE) incidence in hospitalised COVID-19 patients can be as high as 25% (Songping, et al 2020), and more recent studies have indicated this can be expanded to other macrovascular thrombotic complications, such as a higher than expected prevalence of pulmonary emboli in patients with COVID-19 (Klok, et al 2020, Stoneham, et al). The term “diffuse pulmonary intravascular coagulopathy” has been proposed to describe the lung-restricted vascular immunopathology associated with COVID-19. This is distinct from disseminated intravascular coagulation in its early stages and is characterised by increased D-dimer with normal platelet count and normal/elevated fibrinogen (McGonagle, et al 2020). Increased VTE rate has been associated with higher D-dimer level, and in the same study, an association between VTE and death was found (Middeldorp, et al 2020). Another study has shown a D-dimer greater than 1 μg/mL was associated with a poorer prognosis (Zhou, et al 2020). Patients requiring mechanical ventilation who were treated with therapeutic anticoagulation had an in-hospital mortality of 29.1% compared to 62.7% in patients who did not receive anticoagulation. Longer duration of anticoagulation was associated with a reduced risk of mortality (Paranjpe, et al 2020)

Exploring the Impact of Potassium on Growth, Photosynthetic Performance, and Nutritional Status of Lemon Trees (cv. <i>Adamopoulou</i>) Grafted onto Sour Orange and Volkamer Lemon Rootstocks

(1) Background: This study investigates the effects of potassium (K) and rootstock on the growth, photosynthetic activity, and mineral nutrition of lemon trees; (2) Methods: Lemon trees (cv. Adamopoulou) grafted onto sour orange (Citrus aurantium) (SO) or Volkamer lemon (Citrus volkameriana) (VL) rootstock were cultivated hydroponically under 0.00, 0.75, 1.50, 3.00, and 6.00 mM K. Plant growth and nutrition parameters, as well as leaf photosynthetic rate, stomatal conductance, transpiration rate, intracellular CO2, chlorophyll, and carotenoid concentration were assessed; (3) Results: Under K deficiency (0 mM K), plants exhibited chlorotic and necrotic symptoms, more pronounced in older leaves. Potassium deficiency adversely affected various physiological processes in lemon leaves, including a decrease in photosynthesis rate, stomatal conductance, transpiration rate, intercellular CO2 concentration, water use efficiency, CO2 utilization efficiency, chlorophyll a/b ratio, and carotenoid concentrations (some effects were rootstock-dependent). Low photosynthetic rates under K deficiency were due to both stomatal- and non-stomatal limitations. Elevated K in the nutrient solution consistently reduced the total plant uptake of P, Ca, Mg, B, Mn, and Zn, resulting in nutrient imbalances, as evidenced by the significant decrease in P, Ca, Mg, and Zn concentrations found in scion tissues (especially at the 6 mM K treatment). Rootstock-dependent responses were also observed in scion leaf and stem growth and in mineral nutrient concentrations, uptake, and distribution across plant parts; (4) Conclusions: Our study reveals interesting aspects on how to optimize K fertilization in lemon trees in the context of sustainable agriculture by considering nutrient interactions and rootstock-dependent effects. Understanding these complex interactions and improving K fertilization practices is expected to improve lemon tree performance, yield, and fruit quality

Semantic Modeling of Trustworthy IoT Entities in Energy-Efficient Cultural Spaces

Part 5: Energy Efficiency and Artificial Intelligence (ΕΕΑΙ 2021) WorkshopInternational audienceIn this paper, an ontology related to energy-efficient cultural spaces is presented. Specifically, this research work concerns ongoing efforts towards engineering the Museum Energy-Saving Ontology (MESO) towards meeting the following objectives: a) to represent knowledge related to the trustworthy IoT entities that are deployed in a museum i.e., things (e.g., exhibits, spaces), sensors, actuators, people, data, applications; b) to deal with entities’ heterogeneity via semantic interoperability and integration, especially for ’smart’ museum applications and generated data; c) to represent knowledge related to saving energy e.g., lights, air-conditioning; d) to represent knowledge related to museum visits and visitors towards enhancing visiting experience while preserving comfort; e) to represent knowledge related to environmental conditions towards protecting and preserving museum artwork via continuous monitoring. The human-centered collaborative, agile and iterative methodology is followed, namely HCOME, towards the development of an evolved, ‘live’ and modular ontology, while SWRL rules and SPARQL queries are used for its preliminary evaluation

Salinity alters plant's allometry and sugar metabolism, and impairs the photosynthetic process and photosystem II efficiency in Eriobotrya japonica plants

Hydroponically-grown loquat Eriobotrya japonica Lindl.) seedlings were subjected to salinity (80 mM NaCl) for 82 days. Salinity sensibly impaired the photosynthetic performances of loquat due to both stomatal and biochemical limitations. NaCl treatment altered the light partitioning in photosystem II, sensibly increasing the dissipation of excess excitation energy via non-regulated mechanisms (Omo)-In addition, NaCl altered sugar patterns in loquat leaves, stimulating glucose and fructose accumulation which might reduce the leaf lifespan by promoting events of early senescence in mature leaves. Conversely, the observed impairment of translocating sugars might seriously compromise the development of sink organs, such as young leaves, inflorescences and fruits. Overall, these results pose serious concerns about the possible effect of salinity to the yield of this economical fruit crop and highlight the need for future research to investigate the effect on plant productivity and fruit quality in loquat trees grown under high saline conditions