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Purpose: There are few studies in Japan evaluating informationalmaterials about passive smoking prevention with respect to health literacy. This study applied a range of health literacy assessment tools to assess the understandability of public-sector leaflets about passive smoking prevention. Methods: We collected 26 anti-passive smoking leaflets published online by Japanese prefectural governments. We used three internationally recognized health literacy assessment tools to evaluate their understandability: the Clear Communication Index (CCI), the Suitability Assessment of Materials (SAM), and the Patient Education Materials Assessment Tool (PEMAT, further divided into scales for understandability and actionability). Results: Although none of the assessed materials met the CCI's scoring threshold for "easy to understand," the highest-scoring leaflet, which received a top-two ranking in three of the four scales (excluding the PEMAT understandability scale), was characterized by its conciseness and its easy-to-understand structure, including the use of checklists and flowcharts to engage reader interest. There was a significant correlation between CCI and SAM, and between SAM and the PEMAT understandability scale. However, the PEMAT actionability scale did not significantly associate with the other assessment scales. Conclusions: The understandability of written informational materials about passive smoking prevention in Japan could be improved by referring to multiple assessment scales. [ABSTRACT FROM AUTHOR]

Chimerism analysis after allogeneic hematopoietic stem cell transplantation serves to confirm engraftment, indicate relapse of hematologic malignancy, and attribute graft failure to either immune rejection or poor graft function. Short tandem repeat PCR (STR-PCR) is the prevailing method, followed by quantitative real-time PCR (qPCR), with detection limits of 1–5% and 0.1%, respectively. Chimerism assays using digital PCR or next-generation sequencing, both of which are more sensitive than STR-PCR, are increasingly used. Stable mixed chimerism is usually not associated with poor outcomes in non-malignant diseases, but recipient chimerism may foretell relapse of hematologic malignancies, so higher detection sensitivity may be beneficial in such cases. Thus, the need for and the type of intervention, e.g., immunosuppression regimen, donor lymphocyte infusion, and/or salvage second transplantation, should be guided by donor chimerism in the context of the feature and/or residual malignant cells of the disease to be treated. [ABSTRACT FROM AUTHOR]

Background: The DEL phenotype is the D variant expressing the least amounts of D antigen per red cell. Asian‐type DEL (RHD:c:1227G > A) is the most prevalent DEL in East Asia without any anti‐D alloimmunization reported before. We investigated the first observation of an anti‐D in any DEL phenotype, reported in the Japanese language at a 1987 conference, only 3 years after the discovery of DEL. Methods: We contacted the proband 35 years after the initial report. Standard hemagglutination, adsorption/elution, and flow cytometry tests were performed, as was nucleotide sequencing for the RHD, RHCE, and HLA class I and class II genes. Results: The healthy multiparous Japanese woman, a regular blood donor, still had the anti‐D of titer 8 representing an alloantibody by standard serologic methods. Unexpectedly, she carried an Asian‐type DEL without any additional RHD gene variation. All 12 HLA alleles identified were known in the Japanese population. Interestingly, one of her HLA‐DRB1 and a variant of her HLA‐DQB1 alleles had previously been associated with anti‐D immunization. Conclusion: We described an allo‐anti‐D, maintained for more than three decades, in an Asian‐type DEL. The combination of two implicated HLA alleles were rare and could have contributed to the anti‐D immunization. Continued monitoring of anti‐D immunization events in patients with DEL is warranted, and we discuss possible mechanisms for further study. As only this single observation has been recognized in the last 35 years, the current recommendation is affirmed: Individuals with Asian‐type DEL should be treated as Rh D‐positive for transfusion and Rh immune prophylaxis purposes. [ABSTRACT FROM AUTHOR]

Background: Breast milk, nature's optimum source of nutrition for infants, can contain undesirable microorganisms that cause severe morbidity. After an outbreak of multidrug‐resistant Escherichia coli among neonates receiving breast milk donated by another mother in our neonatal intensive care unit (NICU), we were motivated to develop a high‐grade breast milk pasteurizer (BMP) designed to thaw and pasteurize breast milk at 63°C for 30 min in a sealed bag without having to open the bag or immerse it in water. Methods: Pre‐existing bacteria and spiked cytomegalovirus (CMV) were measured pre‐ and post‐pasteurization in frozen breast milk donated by mothers of children admitted to the NICU. Results: Among 48 breast milk samples (mean ± standard deviation [SD]), pre‐existing bacterial counts of 5.1±1.1 × 104 colony forming units (cfu)/mL decreased to less than 10 cfu/mL (below detection level) in 45 samples after pasteurization for 30 min. In three samples, 10–110 cfu/mL persisted. As no CMV was detected in any of the 48 samples, CMV at ≥5 × 104 pfu/mL was spiked into 11 breast milk samples. After just 10 min of pasteurization, infectious CMV was not detected (threshold <50 pfu/mL) in any sample. Conclusion: A new BMP was shown to pasteurize milk effectively with more than a 3‐log reduction of microorganisms. Compared to conventional pasteurizers, this device reduces the effort involved in pasteurizing breast milk, avoids various contamination risks, and may reduce the risk of infectious disease transmission via breast milk. [ABSTRACT FROM AUTHOR]

Background: Anti‐M is frequently observed as a naturally occurring antibody of little clinical significance. Naturally occurring anti‐M is often found in children although the specific triggers of production, persistence, and evanescence of anti‐M have yet to be elucidated. Methods: In a retrospective, multicenter, nationwide cohort survey conducted from 2001 to 2015, alloantibody screening was performed before and after transfusion in 18,944 recipients younger than 20 years. Recipients were categorized into six cohorts based on their age at transfusion; within and among these cohorts, allo‐anti‐M was analyzed in regard to its production, persistence, and evanescence. Results: In 44 patients, anti‐M detected before and/or after transfusion was an age‐related phenomenon, with a median age of 2 years and an interquartile range of 1–3 years; anti‐M was most frequently detected in a cohort of children 1 to <5 years (0.77%, 31 of 4035). At least five patients were presumed to have concurrent infections. Among 1575 adolescents/young adults (15 to <20 years), no anti‐M was detected. Of 29 patients with anti‐M prior to transfusion, the antibody fell to undetectable levels in 17 recipients (89.5%, of whom at least 13 received only M‐negative red cells) after anywhere from 5 days to 5.8 years; anti‐M persisted in 2, and was not tested in 10. Only 15 recipients (0.08%) produced new anti‐M after transfusion. Conclusion: Naturally occurring anti‐M is a phenomenon of younger ages, predominantly between 1 and 3 years. After transfusion, it often falls to undetectable levels. [ABSTRACT FROM AUTHOR]

Platelets parameters including platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) are associated with various physiological and pathological functions in various disease. However, few studies have addressed whether perinatal factors may be associated with platelet parameters at birth in a large cohort of late preterm and term neonates. The aim of this study to investigate perinatal factors affecting platelet parameters in late preterm and term neonates. We retrospectively investigated platelet parameters including PLT, PCT, MPV, and PDW on the first day of life in 142 late preterm and 258 term neonates admitted to our NICU from 2006 through 2020. PLT, MPV, PCT, PDW on Day 0 did not significantly differ between the two groups. In term neonates, multivariate analysis revealed that PCT correlated with being small for gestational age (SGA) (β = -0.168, P = 0.006), pregnancy induced hypertension (PIH) (β = -0.135, P = 0.026) and male sex (β = -0.185, P = 0.002). PLT was associated with SGA (β = -0.186, P = 0.002), PIH (β = -0.137, P = 0.024) and male sex (β = -0.166, P = 0.006). In late preterm neonates, multivariate analysis revealed that PLT were associated with PIH, whereas no factors associated with PDW and MPV were found. In all patients studied, chorioamnionitis (CAM) was significantly associated with MPV (CAM = 10.3 fL vs. no CAM = 9.7 fL, P<0.001). Multivariate analysis showed that SGA, male sex and PIH were associated with PCT and PLT. This study demonstrates that different maternal and neonatal complications affect platelet parameters in late preterm and term neonates. [ABSTRACT FROM AUTHOR]

Background: During storage, the potassium level of red blood cell (RBC) components increases, especially after irradiation. Neonates are prone to hyperkalemia, for example, non‐oliguric hyperkalemia, so using potassium adsorption filters during transfusion may be helpful. To overcome dilution of RBC components caused by saline priming of existing potassium adsorption filters, a downsized potassium adsorption filter for neonates (PAF‐n, Kawasumi Laboratories Inc., Tokyo, Japan) was developed. Study Design and Methods: To assess the performance of PAF‐n, its adsorption efficiency and RBC recovery rate were evaluated by testing pre‐filtration and serial post‐filtration (0‐30 mL, 30‐60 mL, 60‐90 mL, and 90‐120 mL) samples from 8 RBC components. Results: The average potassium adsorption rate of the PAF‐n was 90.5% ± 0.78%, and never less than 89.0% in any of 8 RBC components. RBC recovery rates were 99.3% ± 1.12%. Conclusion: The PAF‐n showed an effective potassium ability with negligible RBC dilution. [ABSTRACT FROM AUTHOR]

The success of bone marrow or peripheral blood stem cell (PBSC) transplants is associated not only with phenotypic compatibility between donor and patient but also with the number of [CD34.sup.+] [...], Context.--An increasing number of medical centers can collect bone marrow, peripheral blood, or umbilical cord stem cells. Pathology laboratories should accommodate this trend, but investment in additional equipment may be impractical. Objectives.--To compare [CD34.sup.+] cell counting results by using 2 widely available flow cytometry systems, with and without the use of a separate hematology analyzer (ie, single-platform versus dual-platform methodologies). Design.--Whole blood and peripheral blood stem cell (PBSC) samples were analyzed from 13 healthy allogeneic PBSC donors and 46 autologous PBSC donors with various malignancies. The Cytomics FC500 (Beckman Coulter, Fullerton, California) was compared with the FACSCalibur (BD Biosciences, San Jose, California). Dual-platform [CD34.sup.+] cell counting incorporated data from a KX-21 hematology analyzer (Sysmex, Kobe, Japan). Results.--Subtle differences in [CD34.sup.+] cell counting between 2 systems and 2 methods did not achieve statistical significance. Conclusion.--Different systems and methods for [CD34.sup.+] cell enumeration, properly validated, can support care for patients undergoing transplants and provide meaningful data for multicenter studies or meta-analyses. (Arch Pathol Lab Med. 2011;135:909-914)

To the Editor.--Just hours before opening the September 2010 Archives of Pathology & Laboratory Medicine, was editing the English-language abstract of a Japanese manuscript. This put me in a suitable [...]