Search

This study examined the relationship between exposure to adverse childhood experiences (ACEs) and health in adolescents with high or low levels of resilience. Data came from the 2020 Bangkok Behaviour Surveillance Survey (BBSS). Multivariate logistic regression analyses examined associations between ACEs and health conditions overall, and for adolescents with low versus high resilience on the Grotberg's Resilience Scale. Overall, 54.9% of adolescents reported 0 ACEs. Compared to adolescents with no ACEs, it was found that those with [greater than or equal to] 1 ACE were more likely to experience insomnia, sadness, suicide attempt, depression, and excess alcohol consumption. Those with a history of four or more ACEs had worse mental health, higher total undesirable behaviour, and lower academic achievement. When the sample was divided into high resilience (60.2%) and low resilience (39.8%), having at least 1 ACEs (vs. 0 ACEs) was associated with worse mental health and undesirable behaviour in adolescents with low resilience. History of ACEs can predict adverse health conditions and undesirable behaviour among adolescents, and the strongest correlation is among adolescents with low resilience. Future studies are needed to develop strategies and interventions to increase adolescent resilience, and test whether improvements in resilience reduce the adverse impact of ACEs on adolescent mental/behavioural health.

Genetic transformation is a critical tool for gene manipulation and functional analyses in plants, enabling the exploration of key phenotypes and agronomic traits at the genetic level. While dicotyledonous plants offer various tissues for in vitro culture and transformation, monocotyledonous plants, such as rice, have limited options. This study presents an efficient method for genetically transforming rice (Oryza sativa L.) using seed-derived embryogenic calli as explants. Two target genes were utilized to assess regeneration efficiency: green fluorescent protein (eGFP) and the apple FLOWERING LOCUS T (FT)-like gene (MdFT1). Antisense MdFT1 was cloned into a vector controlled by the rice α-amylase 3D (Ramy3D) promoter, while eGFP was fused to Cas9 under the Ubi promoter. These vectors were introduced separately into rice embryogenic calli from two Korean cultivars using Agrobacterium-mediated transformation. Transgenic seedlings were successfully regenerated via hygromycin selection using an in vitro cultivation system. PCR confirmed stable transgene integration in the transgenic calli and their progeny. Fluorescence microscopy revealed eGFP expression, and antisense MdFT1-expressing lines exhibited notable phenotypic changes, including variations in plant height and grain quality. High transformation efficiency and regeneration frequency were achieved for both tested cultivars. This study demonstrated the effective use of seed-derived embryogenic calli for rice transformation, offering a promising approach for developing transgenic plants in monocot species. [ABSTRACT FROM AUTHOR]

Fruit skin color and physical quality are important for customer acceptability and market value. Therefore, this study aimed to evaluate the effect of pneumatic defoliation on the fruit quality, coloration, and anthocyanin content of 'Fuji' apples. Apple trees were subjected to no defoliation (control) and defoliation at low (0.6 bar) and high (0.9 bar) air pressure 20 days before harvest at 1 km/h of tractor speed. High-defoliation treatment increased the leaf damage rate but did not significantly affect the defoliation rate compared to low-defoliation treatment. Additionally, photosynthetically active radiation and solar irradiance inside the tree canopies were highest in the high-defoliation group, followed by the low-defoliation and control groups. With the exception of higher firmness in the high-defoliation treatment, pneumatic defoliation treatments had little effect on fruit size and weight, titratable acidity, soluble solids content, the starch pattern index, and the sunburn incidence of fruit. Compared with that of the control group, both defoliation treatments significantly increased the a* and C values and decreased the ho values of the fruit color. Moreover, both defoliation treatments significantly increased anthocyanin content and upregulated the anthocyanin biosynthesis genes (MdPAL, MdCHS, MdCHI, MdF3H, MdANS, MdANS, MdUFGT) and the transcription factor (MdMYB10). A Pearson′s correlation analysis also showed that anthocyanin production was strongly correlated with each of the anthocyanin biosynthesis genes, especially in the pneumatic defoliation treatments. Conclusively, the results show that pneumatic defoliation at low pressure bars could be an effective strategy for improving the red coloration of 'Fuji' apples. [ABSTRACT FROM AUTHOR]

In this study, we describe the genetic characteristics of influenza A(H1N1)pdm09 strains detected in Myanmar from 2015 to 2019. Whole genomes from 60 A(H1N1)pdm09 virus isolates were amplified using real-time polymerase chain reaction and successfully sequenced using the Illumina iSeq100 platforms. Eight individual phylogenetic trees were retrieved for each segment along with those of the World Health Organization (WHO)-recommended Southern Hemisphere vaccine strains for the respective years. A(H1N1)pdm09 viruses from 2015 were found to belong to clade 6B, those from 2016 to 6B.1, 2017 to 6B.1A, and 2019 to 6B.1A.5a, and were genetically distinct from the Southern Hemisphere vaccine strains for the respective seasons, A/California/7/2009 and A/Michigan/45/2015. We observed one virus with intra-subtype reassortment, collected in the 2015 season. Importantly, three viruses possessed the H275Y substitution in the neuraminidase protein, appearing to be community-acquired without the prior administration of neuraminidase inhibitors. These viruses exhibited highly reduced susceptibility to oseltamivir and peramivir. This study demonstrates the importance of monitoring genetic variations in influenza viruses that will contribute to the selection of global influenza vaccines. [ABSTRACT FROM AUTHOR]

Increasing fruit crop production sustainability under climate change, particularly increasing temperatures, is a major challenge in modern agriculture. High temperatures affect apple fruit quality and decrease its color. Herein, we constructed an experimental field under temperature simulation to evaluate climate change mitigation strategies for apples. 'Hongro' apples were subjected to three treatments: (1) cultivation inside a vinyl house for heat treatment (heat induction), (2) cultivation under water irrigation (heat reduction), and (3) cultivation under normal atmospheric temperature (control). At harvest, the fruits of the heat treatment group exhibited poor coloration, with a lower gene expression and pigment accumulation than those of the water irrigation and control groups. Furthermore, the fruit quality of the heat treatment group decreased, with a lower soluble solid content (SSC) and titratable acidity (TA), and smaller fruits. Additionally, a higher fruit disorder (cracking and spots) ratio was observed in the heat treatment group than in the water irrigation and control groups. However, the fruits of the water irrigation group exhibited higher quality indexes (flesh firmness, SSC, and TA) and less cracking than those of the heat treatment and control groups. Heat reduction, including water irrigation, may be used for orchard management to prevent climate change-induced increasing temperatures. [ABSTRACT FROM AUTHOR]

Coloration, a major factor contributing to apple quality, attracts consumer attraction, thereby increasing the sale of fruits in the market. Among the fruit pigments, anthocyanins and carotenoids are the most important pigments that impart coloration to apples. Pigment accumulation, which is regulated by transcriptional factors in the anthocyanin and carotenoid biosynthesis pathways, varies according to genetics, transcription, and developmental stage. To understand the regulation of color development in apples, we evaluated the expression of the genes in the anthocyanin and carotenoid biosynthetic pathways and analyzed the accumulation of pigment, including anthocyanin and carotenoid in the skin and flesh of the red-fleshed apple 'Enbu' cultivar at different fruit development stages (30, 60, 90, 120, and 150 days after full bloom, and ripe). Color development increased according to the developmental stage, with considerable variation in both the transcript levels and pigment concentrations observed in tissues, skin, and flesh. Moreover, we identified key transcription factors among the anthocyanin and carotenoid biosynthesis genes that regulated pigment accumulation. Pearson's correlation analysis showed a strong correlation between the coloration patterns and the expression levels of anthocyanin biosynthesis-related genes (MdPAL, MdCHI, and MdF3H) and carotenoid biosynthesis-related genes (MdGGPPS, MdPSY, MdZDS, MdCRTISO, MdCRHβ, and MdZEP). This study provides insight into the molecular mechanisms underlying pigment biosynthesis for breeding high-quality red-fleshed apple varieties to cater to consumer attention and preference. [ABSTRACT FROM AUTHOR]

Anthocyanin accumulation is responsible for the coloration of apple fruit, and their accumulation depends on the expression of anthocyanin biosynthesis-related genes. Light is an environmental stimulus that induces fruit color by regulating genes involved in the anthocyanin biosynthesis pathway. In this study, the roles of light and genetic factors on fruit coloration and anthocyanin accumulation in apple fruit were investigated. Three genes in the anthocyanin biosynthesis pathway, MdCHS, MdANS, and MdUFGT1, were synthesized and cloned into a viral-based expression vector system for transient expression in 'Ruby S' apple fruits. Apple fruits were agroinfiltrated with expression vectors harboring MdCHS, MdANS, and MdUFGT1. Agroinfiltrated apple fruits were then either kept in the dark (bagged fruits) or exposed to light (exposed fruits). The agroinfiltrated fruits showed significantly different coloration patterns, transcript expression levels, and anthocyanin accumulation compared to the control fruits. Moreover, these parameters were higher in exposed fruits than in bagged fruits. For stable expression, MdCHS was introduced into a binary vector under the control of the rice α-amylase 3D (RAmy3D) promoter. The ectopic overexpression of MdCHS in transgenic rice calli showed a high accumulation of anthocyanin content. Taken together, our findings suggest that light, together with the overexpression of anthocyanin biosynthesis genes, induced the coloration and accumulation of anthocyanin content in apple fruits by upregulating the expression of the genes involved in the anthocyanin biosynthesis pathway. [ABSTRACT FROM AUTHOR]

Apple skin color is essential for market value. Therefore, this study evaluated the efficiency of pneumatic defoliation (PD) on the enhancement of red skin color and anthocyanin pigments in 'Picnic' apples. Three weeks before harvesting, apple trees were treated with PD with low- (0.7 bar) and high- (0.9 bar) air pressure at a tractor driving speed of 2 km/h. Undefoliated trees served as controls. Higher leaf defoliation and leaf damage rates were observed in the high-PD treatment than those in the low-PD treatment. Photosynthetically active radiation inside the canopies was the highest in trees subjected to high-pressure PD than in those that underwent low-pressure PD and the controls. At harvest, the fruit color (a*) value, red-colored area, and anthocyanin content in the fruit skin were the highest in the high-PD treatment, intermediate in the low-PD treatment, and the lowest in the control treatments. Additionally, a higher expression of anthocyanin biosynthetic genes was observed in both defoliation treatments, especially under high PD. However, except for higher flesh firmness under low PD, the L* and b* values and fruit quality indices (fruit weight, starch pattern index, titratable acidity, soluble solids content, and sunburn occurrence) were not significantly affected by either PD treatment. In conclusion, PD can be used to enhance skin coloration and anthocyanin pigments in apples; further PD with high air pressure achieved optimum red skin coloration in 'Picnic' apples. [ABSTRACT FROM AUTHOR]

Parechovirus‐A (PeV‐A) causes emerging infection in children, and clinical presentation depends on genotype. The virus has been investigated mainly in developed countries; however, data from developing countries, especially in Asia, are sparse. This study investigated whether PeV‐A circulated in children in Myanmar. This retrospective study evaluated PeV‐A in nasopharyngeal samples from children aged 1 month to 12 years who were hospitalized with acute lower respiratory infection at Yankin Children Hospital, Yangon, Myanmar, during the period from May 2017 to April 2019. Real‐time polymerase chain reaction (PCR) was used to detect PeV‐A, and PCR‐positive samples were used for genotyping and phylogenetic analysis. In total, 11/570 (1.9%) of samples were positive for PeV‐A; 7 were successfully genotyped by sequencing the VP3/VP1 region, as follows: PeV‐A1 (n = 4), PeV‐A5 (n = 1), PeV‐A6 (n = 1), and PeV‐A14 (n = 1). Median age was 10.0 months (interquartile range 4.0–12.0 months), and other respiratory viruses were detected in all cases. Phylogenetic analysis showed that all detected PeV‐A1 strains were in clade 1 A, which was a minor clade worldwide. Four PeV‐A genotypes were detected in Myanmar. The clinical impact of PeV‐A in children should be evaluated in future studies. [ABSTRACT FROM AUTHOR]

An influenza circulation was observed in Myanmar between October and November in 2021. Patients with symptoms of influenza-like illness were screened using rapid diagnostic test (RDT) kits, and 147/414 (35.5%) upper respiratory tract specimens presented positive results. All RDT-positive samples were screened by a commercial multiplex real-time polymerase chain reaction (RT-PCR) assay, and 30 samples positive for influenza A(H3N2) or B underwent further typing/subtyping for cycle threshold (Ct) value determination based on cycling probe RT-PCR. The majority of subtyped samples (n = 13) were influenza A(H3N2), while only three were B/Victoria. Clinical samples with low Ct values obtained by RT-PCR were used for whole-genome sequencing via next-generation sequencing technology. All collected viruses were distinct from the Southern Hemisphere vaccine strains of the corresponding season but matched with vaccines of the following season. Influenza A(H3N2) strains from Myanmar belonged to clade 2a.3 and shared the highest genetic proximity with Bahraini strains. B/Victoria viruses belonged to clade V1A.3a.2 and were genetically similar to Bangladeshi strains. This study highlights the importance of performing influenza virus surveillance with genetic characterization of the influenza virus in Myanmar, to contribute to global influenza surveillance during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the genetic and evolutionary characteristics of the influenza A/H3N2 viruses circulating in Myanmar from 2015 to 2019. Whole genomes from 79 virus isolates were amplified using real-time polymerase chain reaction and successfully sequenced using the Illumina iSeq100 platforms. Eight individual phylogenetic trees were retrieved for each segment along with those of the World Health Organization (WHO)-recommended Southern Hemisphere vaccine strains for the respective years. Based on the WHO clades classification, the A/H3N2 strains in Myanmar from 2015 to 2019 collectively belonged to clade 3c.2. These strains were further defined based on hemagglutinin substitutions as follows: clade 3C.2a (n = 39), 3C.2a1 (n = 2), and 3C.2a1b (n = 38). Genetic analysis revealed that the Myanmar strains differed from the Southern Hemisphere vaccine strains each year, indicating that the vaccine strains did not match the circulating strains. The highest rates of nucleotide substitution were estimated for hemagglutinin (3.37 × 10−3 substitutions/site/year) and neuraminidase (2.89 × 10−3 substitutions/site/year). The lowest rate was for non-structural protein segments (4.19 × 10−5 substitutions/site/year). The substantial genetic diversity that was revealed improved phylogenetic classification. This information will be particularly relevant for improving vaccine strain selection. [ABSTRACT FROM AUTHOR]

Salvage of refractory post-transfusion hyperhaemolysis by targeting hyperinflammation and macrophage activation with tocilizumab He was not on a regular transfusion programme and had not received further transfusion since the last operation in 2018. Treatment of post-transfusion hyperhaemolysis syndrome in sickle cell disease with the anti-IL6R humanised monoclonal antibody tocilizumab. Hyperhaemolysis syndrome (HHS) is a severe post-transfusion complication that can develop rapidly and cause life-threatening anaemia and death unless recognised and treated promptly.1,2 It is mostly, but not exclusively, seen in sickle cell patients, often after multiple previous transfusions. [Extracted from the article]

Background: Posttransfusion hyperhemolysis syndrome is a rare but life‐threatening form of delayed hemolytic transfusion reaction with lysis of both transfused and autologous red cells, seen predominantly in patients with sickle cell disease. Macrophage activation is thought to play a major role in its pathophysiology. Standard treatment is with intravenous immunoglobulin and steroids but refractory cases pose a major clinical problem. Tocilizumab is a humanized monoclonal antibody against the IL‐6 receptor that can inhibit IL‐6 induced macrophage activation. Methods and materials: We describe the case of a 33‐year‐old woman with sickle cell anemia and posttransfusion hyper hemolysis syndrome refractory to standard therapy, treated with Tocilizumab. We also review all cases reported in the literature where Tocilizumab was used for posttransfusion hyperhemolysis. Results: Treatment with Tocilizumab was well tolerated with no observed adverse events. There was no further drop in Hb after day 2 of treatment with subsequent continuous gradual improvement. Her bilirubin dropped significantly after the first dose and continued to improve, while ferritin and LDH reduced significantly after day 2 of treatment with Tocilizumab and continued to drop thereafter. Like in our case, all other cases in the literature where Tocilizumab was used for posttransfusion hyperhemolysis led to rapid clinical responses and no adverse events. Discussion: Even though the number of cases of posttransfusion hyper hemolysis syndrome treated with Tocilizumab are few, they have all been associated with rapid clinical responses with no observed adverse events suggesting that the role of Tocilizumab in this context needs to be further explored. [ABSTRACT FROM AUTHOR]

A community outbreak of human influenza A(H1N1)pdm09 virus strains was observed in Myanmar in 2017. We investigated the circulation patterns, antigenicity, and drug resistance of 2017 influenza A(H1N1)pdm09 viruses from Myanmar and characterized the full genome of influenza virus strains in Myanmar from in-patients and out-patients to assess the pathogenicity of the viruses. Nasopharyngeal swabs were collected from out-patients and in-patients with acute respiratory tract infections in Yangon and Pyinmana City in Myanmar during January-December 2017. A total of 215 out-patients and 18 in-patients infected with A(H1N1)pdm09 were detected by virus isolation and real-time RT-PCR. Among the positive patients, 90.6% were less than 14 years old. Hemagglutination inhibition (HI) antibody titers against A(H1N1)pdm09 viruses in Myanmar were similar to the recommended Japanese influenza vaccine strain for 2017–2018 seasons (A/Singapore/GP1908/2015) and WHO recommended 2017 southern hemisphere vaccine component (A/Michigan/45/2015). Phylogenetic analysis of the hemagglutinin sequence showed that the Myanmar strains belonged to the genetic subclade 6B.1, possessing mutations of S162N and S164T at potential antigenic sites. However, the amino acid mutation at position 222, which may enhance the severity of disease and mortality, was not found. One case with no prior history of oseltamivir treatment possessed H275Y mutated virus in neuraminidase (NA), which confers resistance to oseltamivir and peramivir with elevated IC50 values. The full genome sequence of Myanmar strains showed no difference between samples from in-patients and out-patients, suggesting no additional viral mutations associated with patient severity. Several amino acid changes were observed in PB2, PB1, and M2 of Myanmar strains when compared to the vaccine strain and other Asian strains. However, no mutations associated with pathogenicity were found in the Myanmar strains, suggesting that viral factors cannot explain the underlying reasons of the massive outbreak in Myanmar. This study reported the first detection of an oseltamivir-resistant influenza virus in Myanmar, highlighting the importance of continuous antiviral monitoring and genetic characterization of the influenza virus in Myanmar. [ABSTRACT FROM AUTHOR]

Background: Hyperhemolysis syndrome (HHS) is a posttransfusion complication most frequently seen in sickle cell disease (SCD), characterized by rapid destruction of transfused and autologous red blood cells (RBCs), resulting in reticulocytopenia and a decrease in hemoglobin to below pretransfusion levels. Additional RBC transfusion can be life threatening. Most patients improve with intravenous immune globulin and steroids, but in refractory cases, hyperhemolysis may result in multiorgan failure and death in the absence of salvage therapy. The exact pathophysiology of HHS remains uncertain, yet new insights suggest that RBC destruction is driven by activated macrophages. Therefore, we propose that antimacrophage therapy may represent an effective treatment.Case Report: A case of life-threatening HHS, refractory to intravenous immune globulin and steroids, in a patient with SCD is presented. Marked elevation in ferritin, an indirect marker of macrophage activation, a negative direct antiglobulin test, and the absence of RBC alloantibodies was noted. A hemoglobin nadir of 2.1 g/dL and resultant hypoxemia-induced organ failure prompted the use of tocilizumab, an interleukin-6 receptor monoclonal antibody. Hemoglobin-based oxygen carrier-201, a cell-free polymerized bovine hemoglobin, was used to support the patient during critical anemia.Results: Hemolysis resolved and ferritin dramatically decreased after administration of tocilizumab, which was well tolerated. A full recovery was achieved.Conclusion: This case highlights both a novel and successful approach to managing refractory transfusion-induced hyperhemolysis with tocilizumab and provides further evidence supporting the role for macrophage activation in the destruction of RBCs in antibody-negative HHS. We propose that tocilizumab is an effective and rapid salvage therapy for refractory HHS. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate whether 1-methylcyclopropene (1-MCP) treatment delays the fruit softening mechanism associated with the fruit quality of the newly released apple cultivars "Summer King" and "Green Ball" during cold storage. For both cultivars, the fruit treated with 1-MCP exhibited lower internal ethylene concentration, higher firmness, and higher titratable acidity relative to the control fruit, in association with less fruit softening. In addition, the treated fruit significantly delayed fresh weight loss and reduction of soluble solids content, especially in "Green Ball." Moreover, slower degradation of cell wall components (water-soluble pectin, sodium carbonate-soluble pectin, hemicellulose, and cellulose) was also observed in the treated fruit in comparison to the control fruit. Similarly, the enzymatic activities (of polygalacturonase, pectin methylesterase, cellulase, β-galactosidase, and α-L-arabinofuranosidase) that cause cell wall degradation were relatively lower in the treated fruit than in the control fruit for both cultivars, which was further proved by transcriptional analysis of the genes encoding the enzymes. Overall, the results suggested that the usage of 1-MCP is useful to delay fruit softening of the two cultivars during cold storage by delaying the degradation of cell wall components and enzymatic activities of cell wall hydrolysis. [ABSTRACT FROM AUTHOR]

Summary: Post‐transfusion hyperhaemolysis syndrome (PTHS) is a rare life‐threatening transfusion complication reported mainly in sickle cell patients. Its pathogenesis is poorly understood. Antibody‐mediated haemolysis and bystander effect have been proposed as putative mechanisms, but in half of cases, red cell antibodies are undetectable, and PTHS develops despite transfusion of cross‐matched compatible RBC. An alternate hypothesis proposes activated macrophages as the main drivers of red cell destruction through direct phagocytosis. We report the histopathological findings of two patients with PTHS showing extensive macrophage expansion and erythrophagocytosis, supportive of macrophage activation driving PTHS. This supports a possible role for novel therapies that target macrophage activation. [ABSTRACT FROM AUTHOR]

Background: The U- phenotype is extremely rare and is found predominantly in black African populations at a frequency of between 0.2 and 1.7%. In European populations, U- units are therefore rare, with limited availability in the United Kingdom. Anti-U is clinically significant and is known to cause hemolytic transfusion reactions (HTRs) and hemolytic disease of the fetus and newborn. It has been suggested that intravenous immunoglobulin (IVIG) may be considered as an option among supportive therapy for urgent transfusion when clinically significant antigen-matched units are not available. We report three cases with anti-U transfused with least-incompatible RBC units, their outcomes, and their clinical management.Study Design and Methods: Intravenous immunoglobulin was prescribed when least-incompatible units must be issued in patients with anti-U to ameliorate acute HTR and prevent the development of delayed HTR. We report the outcome of these cases.Results: Of the case reports described, one patient with weak anti-U developed a delayed HTR after transfusion with incompatible units due to an anamnestic response. Two additional patients are described, with the use of IVIG as a precautionary measure to prevent the development of HTRs when transfused with antigen-positive incompatible units. No acute HTRs or delayed HTRs were noted upon follow-up.Conclusion: U- units are not always readily available and transfusion support requires close collaborative working among a multidisciplinary team. Transfusion with antigen-positive incompatible units with IVIG cover both ameliorates acute HTRs and prevents the development of delayed HTRs. [ABSTRACT FROM AUTHOR]

Amiodarone is commonly used to instantly reverse potentially fatal myocardial arrhythmias, but may also potentiate arrhythmic adverse effects, such as QT prolongation and torsades de pointes. This case describes a 56-year-old male patient who, after experiencing a myocardial infarction, had undergone temporary pacemaker (TPM) insertion for bradycardia-induced ventricular tachycardia (VT); however, his VT persisted post-insertion and intravenous amiodarone was administered. Within a few minutes, monomorphic VT occurred, which progressed to polymorphic VT arrest (i.e. torsades de pointes). The polymorphic VT induced by amiodarone resolved on withdrawal of amiodarone and a subsequent switch to lignocaine. In view of suspected TPM dislodgement, a new TPM was inserted and paced at a higher rate. The patient did not show further ventricular arrhythmia and, prior to discharge, had a permanent pacemaker implanted and was hemodynamically stable. [ABSTRACT FROM AUTHOR]

Background: Antenatal cases of Bombay-phenotype (Oh ) individuals and hemolytic disease of the fetus and newborn (HDFN) are not well described in the literature. We present two case reports of high-titer anti-H in pregnant Oh individuals and their serologic investigation, clinical management, and subsequent outcomes. We describe current published cases detailing pregnancy in Oh individuals, to add to the evidence base for clinical decision making and management of pregnancy.Study Design and Methods: We describe two case reports of high-titer anti-H in pregnancy in Oh individuals. We summarize published cases to date, to inform clinical decision making and antenatal management in individuals with the Bombay phenotype.Results: Of the case reports described, neither were affected by HDFN due to anti-H. Antibody titers were high in both cases (immunoglobulin G titer scores, 512 and 4000, respectively) and would be expected to cause some degree of HDFN, a surprising finding. Regular mean cerebral artery Doppler ultrasound was normal. Patient blood management (PBM) techniques ensured that the patient's hemoglobin (Hb) levels were monitored and maintained. Transfusion intervention was not required, with minimal blood loss recorded at birth in both cases.Conclusion: High-titer anti-H in Oh pregnancies may, in rare cases, cause HDFN, but evidence suggests that this may not be the case in all pregnancies. We recommend a multidisciplinary approach, with prompt referral to a fetomaternal medicine unit, combined with PBM strategies, and a planned delivery with the provision of rare-phenotype units (if available and if indicated) on standby. [ABSTRACT FROM AUTHOR]

Background: The therapeutic value of the use of intravenous immunoglobulin (IVIG) to correct anemia and thrombocytopenia as a result of immunologic causes (hemolytic disease of the fetus and newborn and fetal or neonatal alloimmune thrombocytopenia) have been well established. Few published papers exist regarding the use of IVIG in adult settings. We report two patients with clinically significant antibodies against high-incidence antigens, who were successfully transfused with incompatible red blood cells (RBCs), in conjunction with IVIG plus steroids and IVIG.Case Reports: Case 1 was a 25-year-old patient (Hb SC) who was admitted with low hemoglobin (Hb) and low reticulocyte count. A diagnosis of parvovirus-induced RBC hypoplasia was made. The patient's sample contained anti-E, anti-N, and anti-U. The Hb decreased to 37 g/dL and urgent transfusion was provided with E-, N-, "least-incompatible" RBC units covered by IVIG and hydrocortisone. Case 2 was a 54-year-old patient who was admitted after a road traffic accident. Nonspecific weak antibody was detected. She received 6 units of least-incompatible RBCs. She was transferred to another hospital and received 2 least-incompatible units. Hb level decreased further and an additional unit was transfused. Samples were referred to the reference laboratory and strong anti-Jra detected. As there was clinical and laboratory evidence of hemolysis and Jr(a-) units were not available, IVIG was prescribed and least-incompatible units were transfused.Results: There were no hemolytic transfusion reactions, hemolysis ceased, and anemia improved in both cases.Conclusion: Prophylaxis with IVIG plus steroids and IVIG should be considered as a therapeutic option when transfusion of incompatible units is necessary. [ABSTRACT FROM AUTHOR]

We investigated the role of nano-silver (NAg) and the bacterial strain Enterobacter cloacae in increasing the vase life of cut carnation flowers 'Omea.' NAg treatment extended vase life of the flowers by increasing relative fresh weight, antioxidant activities, and expression level of the cysteine proteinase inhibitor gene (DcCPi), and by suppressing bacterial blockage in stem segments, ethylene production and expression of ethylene biosynthesis genes and DcCP1 gene, compared with the control. Out of all the treatments, administration of 25 mg L-1 NAg gave the best results for all the analyzed parameters. Interestingly, application of E. cloacae also extended the vase life of cut flowers by 3 days in comparison with control flowers, and overall, showed better results than the control for all the analyzed parameters. Taken together, these results demonstrate the positive role of NAg and E. cloacae in increasing the longevity of cut carnation flowers, and indicate that this effect is brought about through multiple modes of action. [ABSTRACT FROM AUTHOR]

Treatment of post-transfusion hyperhaemolysis syndrome in Sickle Cell Disease with the anti-IL6R humanised monoclonal antibody Tocilizumab It is characterised by brisk haemolysis of both transfused and recipient red cells, also known as "By-stander" haemolysis, with a haemoglobin (Hb) drop below pre-transfusion levels, marked increase in serum ferritin (SF) and a fall in reticulocyte count. 1 Hb, haemoglobin, LDH, lactate dehydrogenase; PTHS, post-transfusion hyperhaemolysis syndrome; RTC, reticulocytes; SF, serum ferritin. [Extracted from the article]

Hyperhemolytic transfusion reaction (HHTR) is a serious and potentially life-threatening complication of red blood cell (RBC) transfusion and has been well described in patients with sickle cell disease (SCD) and non-SCD patients. Awareness of this condition is important because subsequent transfusion may exacerbate hemolysis and may lead to a chronic protracted course or even death. If hemolysis is rapid and severe, subsequent transfusion may be necessary. Additional transfusion has been given together with intravenous immunoglobulin (IVIG) and steroids. We report a patient with SCD presented with severe HHTR whose serum contained multiple RBC alloantibodies. On day 2 of admission, the hemoglobin level dropped to 47 g/L. Intravenous immunoglobulin and steroid therapy was commenced. The patient responded and further transfusion was avoided. Review of the literature identified 5 HHTR cases in which transfusion was withheld and IVIG/steroids prescribed. In all of these cases, anemia was corrected and hemolysis resolved without blood transfusion. The reasons why transfusion was withheld and IVIG/steroids treatment prescribed were explored. There is no indication for IVIG in the routine treatment of hemolytic transfusion reactions, but IVIG should be considered as an option for treatment of serious, life-threatening HHTR both in SCD and non-SCD patients. [Copyright &y& Elsevier]

We aimed to analyze the situation of the first two epidemic waves in Myanmar using the publicly available daily situation of COVID-19 and whole-genome sequencing data of SARS-CoV-2. From March 23 to December 31, 2020, there were 33,917 confirmed cases and 741 deaths in Myanmar (case fatality rate of 2.18%). The first wave in Myanmar from March to July was linked to overseas travel, and then a second wave started from Rakhine State, a western border state, leading to the second wave spreading countrywide in Myanmar from August to December 2020. The estimated effective reproductive number (Rt) nationwide reached 6–8 at the beginning of each wave and gradually decreased as the epidemic spread to the community. The whole-genome analysis of 10 Myanmar SARS-CoV-2 strains together with 31 previously registered strains showed that the first wave was caused by GISAID clade O or PANGOLIN lineage B.6 and the second wave was changed to clade GH or lineage B.1.36.16 with a close genetic relationship with other South Asian strains. Constant monitoring of epidemiological situations combined with SARS-CoV-2 genome analysis is important for adjusting public health measures to mitigate the community transmissions of COVID-19. [ABSTRACT FROM AUTHOR]

Transfusion related acute lung injury (TRALI) is one of the complications of blood transfusion and can result in major morbidity or mortality. The diagnosis depends upon the application of strict clinical criteria defining acute lung injury (ALI) and a temporal relationship to blood transfusion. We present the clinical and immunogenetic findings of 96 suspected TRALI cases investigated between 1996 and 2004. During this time period the national haemovigilance scheme (UK) defined TRALI as a reaction occurring either during or within 24 h of blood transfusion. Using clinical, laboratory and post mortem evidence, 64/96 cases could be defined as TRALI in our series. Sensitive techniques were employed to screen for HLA class I, class II and granulocyte specific antibodies in donor serum. Donor derived antibodies were detected in 58/64 (90%) of cases. Recipient derived DNA or cells were not always available but incompatibility was confirmed by the presence of the cognate antigen on recipient leucocytes or by crossmatching in 47/64 (73%) of cases. Cases referred prior to 2001 were not tested for HLA class II antibodies. By applying strict clinical criteria and using sensitive techniques a white blood cell antibody mediated immunological pathophysiology can be implicated in the majority TRALI cases. [ABSTRACT FROM AUTHOR]