ABSTRACT
Introduction: Covid-19 patients may have unusual arrangements of their blood count, compared to most viral infections. Neutrophilia can be associated with lymphopenia within the first few days. Therefore, an increasing neutrophil to lymphocyte ratio on admission has been considered an indicator of the disease severity Among the qualitative anomalies associated with the quantitative ones, reactive lymphocytes and nucleocytoplasmic morphological changes of the neutrophil granulocytes have been reported.Our study aimed to evaluate whether these leukocyte abnormalities modify the morphology of the instrumental cytograms of the Mindray BC6800plus haematological analyser resulting in diagnostic utility. Method(s): We evaluated the instrumental scattergrams provided by the Mindray BC6800plus analyser in 61patients admitted to the Monaldi and SS Trinita Hospitals (Naples and Borgomanero, Italy) with clinical evidence of SARSCoV- 2 infection confirmed with PCR research of viral RNA, comparing them with 61 healthy subjects. We used the 3D-Cube function - which allows a three-dimensional observation - to evaluate the lymphocyte and neutrophil cluster morphology in the DIFF scattergram. Blood cell morphology was assessed by microscopy. A prolonged microscopic review was performed in case of relevant lymphopenia. Result(s): Covid-19 samples showed evocative anomalies of the lymphocyte clusters in 47 out 61 samples (77%) related to the peripheral blood's morphological findings. Cytographic abnormalities concern the presence of an additional high fluorescence lymphocyte cluster - always well separated from the main one - with numerical consistency ranging between a few units to a few dozen (range 7.0 - 126) (Figure 1). Interestingly, the rotation of the 3D-Cube shows a widening of the high fluorescence cells along the FS axis attributable to the heterogeneity of cellular size (Figure 2). The microscopic review showed activated lymphocytes ranging between plasmacytoid and type III Downey morphologies. Positional indices of the neutrophil clusters showed significant differences from normal. Conclusion(s): Further studies need to associate positional indices with cytographic and microscopic anomalies of the neutrophils. The morphology of the lymphocyte clusters resulting from the 3D projections makes possible an accurate activated lymphocytes quantification, especially in severe lymphopenia thus evocative for Covid-19 infection and helpful for diagnostic and prognostic purposes.
ABSTRACT
The Tropospheric Monitoring Instrument (TROPOMI) on the Sentinel-5 Precursor (S5P) satellite is a valuable source of information to monitor the NOx emissions that adversely affect air quality. We conduct a series of experiments using a 4×4 km2 Comprehensive Air Quality Model with Extensions (CAMx) simulation during April–September 2019 in eastern Texas to evaluate the multiple challenges that arise from reconciling the NOx emissions in model simulations with TROPOMI. We find an increase in NO2 (+17 % in urban areas) when transitioning from the TROPOMI NO2 version 1.3 algorithm to the version 2.3.1 algorithm in eastern Texas, with the greatest difference (+25 %) in the city centers and smaller differences (+5 %) in less polluted areas. We find that lightningNOx emissions in the model simulation contribute up to 24 % of the column NO2 in the areas over the Gulf of Mexico and 8% in Texas urban areas. NOx emissions inventories, when using locally resolved inputs, agree with NOx emissions derived from TROPOMI NO2 version 2.3.1 to within 20 % in most circumstances, with a small NOx underestimate in Dallas–Fort Worth (-13 %) and Houston (-20 %). In the vicinity of large power plant plumes (e.g., Martin Lake and Limestone) we find larger disagreements, i.e., the satellite NO2 is consistently smaller by 40 %–60 % than the modeled NO2, which incorporates measured stack emissions. We find that TROPOMI is having difficulty distinguishingNO2 attributed to power plants from the background NO2 concentrations in Texas – an area with atmospheric conditions that cause short NO2 lifetimes. Second, the NOx/NO2 ratio in the model may be underestimated due to the 4 km grid cell size. To understand ozone formation regimes in the area, we combine NO2 column information with formaldehyde (HCHO) column information. We find modest low biases in the model relative to TROPOMI HCHO, with -9 % underestimate in eastern Texas and -21 % in areas of central Texas with lower biogenic volatile organic compound (VOC) emissions. Ozone formation regimes at the time of the early afternoon overpass are NOx limited almost everywhere in the domain, except along the Houston Ship Channel, near the Dallas/Fort Worth International airport, and in the presence of undiluted power plant plumes. There are likely NOx-saturated ozone formation conditions in the early morning hours that TROPOMI cannot observe and would be well-suited for analysis with NO2 and HCHO from the upcoming TEMPO (Tropospheric Emissions: Monitoring Pollution) mission. This study highlights that TROPOMI measurements offer a valuable means to validate emissions inventories and ozone formation regimes, with important limitations.
ABSTRACT
The disruption of routine cancer screening during the COVID-19 pandemic is a public health priority given documented delays in the diagnosis and treatment of screening-eligible cancers, and future impacts on cancer mortality. Furthermore, COVID-19 has disproportionately affected historically underrepresented populations such as the Hispanic community, who already experience lower cancer screening rates compared to non-Hispanic whites. The purpose of this study was to examine inquiries about cancer screening among Spanish-speaking general public users before and during COVID-19, using data from the National Cancer Institute's Cancer Information Service (CIS). For this analysis, we examined cancer screening inquiries before (February 2019-March 2020) and during (March 2020-January 2021) COVID-19 among Spanish-speaking general public users. We analyzed CIS point of access (email, LiveHelp, social media, telephone), subjects of interaction, and referrals. Cancer sites with low cell sizes (e.g., lung) were combined into the category “other.” We conducted Chi-squared tests to compare counts for cancer screening inquiries before and during COVID-19 across these variables. There were 47.3% (n=691) cancer screening inquiries among English-speaking users before COVID-19 and 52.7% (n=770) during COVID-19. In comparison, among the 300 cancer screening inquiries from Spanish speakers, there were 57% (n=171) before COVID-19 compared to 43% (n=129) during COVID-19. There was a significant difference in patterns between these two groups (p<.002). Cancer site inquiries among Spanish speakers included breast (n=66), general (n=108), and 17 other cancers combined (n=126). The proportion of breast and general cancer inquiries from Spanish speakers increased during COVID-19 compared to pre-COVID (p<.001), whereas other cancer inquiries decreased. Additionally, Spanish-speaking telephone-based inquiries increased during COVID-19 whereas all other points of access decreased (p<.001);subjects of interaction regarding general cancer questions increased, but those on finding healthcare services, screening tests, and other subjects decreased (p<.01);and there was an increase in referrals to national/community organizations and to the CDC National Breast and Cervical Cancer Early Detection Program, although referrals to healthcare providers and other sources decreased during COVID-19 (p<.001). We found that COVID-19 was associated with a significant decrease in cancer screening inquiries among Spanish speakers compared to English speakers using the CIS, with changes in point of access, referrals, subject of interaction, and cancer site for Spanish-speaking CIS users. It is critical to evaluate how these changes in information-seeking may affect screening behaviors post-COVID in Hispanic communities and may potentially widen existing disparities that have worsened during COVID-19. Despite overall inquiry reductions, there was an increase in some cancer screening referrals, hopefully resulting in increased screening behavior among Spanish-speaking CIS users.