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This experiment aimed to study the effects of guanidine acetic acid (GAA) on reproductive performance, lactation performance and blood biochemical indices of sows, as well as the performance of offspring piglets. A total of 20 sows (Landrace × Yorkshire, parity 4) were used. Half of the sows in each parity were fed a control diet (CG; basic diet, n = 10) or GAA diet (basic diet +1 g/kg GAA, n = 10) from the 85th day of gestation until weaning. The study results are presented as follows: Supplementation of GAA from late gestation to lactation did not adversely affect sow feed intake, backfat thickness, or blood routine indexes (p > 0.05). GAA supplementation showed a tendency to increase the number of healthy piglets and their birth activity (p = 0.06; p = 0.08), while significantly increasing the IUGR score of piglets (p < 0.05). GAA supplementation significantly increased colostrum protein content (p < 0.05) and tended to increase daily milk yield in sows (p = 0.07). GAA supplementation increased the level of immunoglobulin A in sow colostrum (p < 0.05) and showed a tendency to increase proline content (p = 0.10). GAA supplementation significantly decreased triglyceride content in sow cord blood (p < 0.05), with no significant effects observed on HDL-C, LDL-C, TC, and GLU (p > 0.05). GAA supplementation significantly increased eNOS levels in sow cord blood (p < 0.05), while showing no significant effects on IL-6 and IL-10 (p > 0.05). GAA supplementation did not significantly affect the α diversity of sow intestinal flora (ACE, Shannon, Chao1, Simpson, observed_otus, pielou_e, and good_cover), but PCoA analysis revealed differences in intestinal flora structure between groups. Additionally, GAA decreased the relative abundance of Sarciha and unidentified_ruminococcaceae and increased the relative abundance of Lactobacillus , Parabacteroides , and Pedobacter in the gut. GAA boosts nitric oxide synthase in sows' umbilical cord blood, enhancing placental blood vessel development. This improves piglet health and vitality, increases beneficial gut bacteria (Lactobacillus , Parabacteroides , Pedobacter), and raises colostrum protein levels and lactation volume, leading to better piglet growth and performance. [ABSTRACT FROM AUTHOR]

Objective Methods Results Significance This study was undertaken to develop a machine learning (ML) model to forecast initial seizure onset in neonatal hypoxic–ischemic encephalopathy (HIE) utilizing clinical and quantitative electroencephalogram (QEEG) features.We developed a gradient boosting ML model (Neo‐GB) that utilizes clinical features and QEEG to forecast time‐dependent seizure risk. Clinical variables included cord blood gas values, Apgar scores, gestational age at birth, postmenstrual age (PMA), postnatal age, and birth weight. QEEG features included statistical moments, spectral power, and recurrence quantification analysis (RQA) features. We trained and evaluated Neo‐GB on a University of California, San Francisco (UCSF) neonatal HIE dataset, augmenting training with publicly available neonatal electroencephalogram (EEG) datasets from Cork University and Helsinki University Hospitals. We assessed the performance of Neo‐GB at providing dynamic and static forecasts with diagnostic performance metrics and incident/dynamic area under the receiver operating characteristic curve (iAUC) analyses. Model explanations were performed to assess contributions of QEEG features and channels to model predictions.The UCSF dataset included 60 neonates with HIE (30 with seizures). In subject‐level static forecasting at 30 min after EEG initiation, baseline Neo‐GB without time‐dependent features had an area under the receiver operating characteristic curve (AUROC) of .76 and Neo‐GB with time‐dependent features had an AUROC of .89. In time‐dependent evaluation of the initial seizure onset within a 24‐h seizure occurrence period, dynamic forecast with Neo‐GB demonstrated median iAUC = .79 (interquartile range [IQR] .75–.82) and concordance index (C‐index) = .82, whereas baseline static forecast at 30 min demonstrated median iAUC = .75 (IQR .72–.76) and C‐index = .69. Model explanation analysis revealed that spectral power, PMA, RQA, and cord blood gas values made the strongest contributions in driving Neo‐GB predictions. Within the most influential EEG channels, as the preictal period advanced toward eventual seizure, there was an upward trend in broadband spectral power.This study demonstrates an ML model that combines QEEG with clinical features to forecast time‐dependent risk of initial seizure onset in neonatal HIE. Spectral power evolution is an early EEG marker of seizure risk in neonatal HIE. [ABSTRACT FROM AUTHOR]

Background: The hormonal shift occurring in pregnant women is crucial for the outcome of pregnancy. We conducted a study in pregnant women living in a malaria endemic area to determine the potential effect of gestational age on the modulation of the endocrine system by cortisol and prolactin production during pregnancy. Methods: Primigravidae and multigravidae with a gestational age between 16–20 weeks were included in the study and followed up to delivery and 6–7 weeks thereafter. Venous blood was collected at scheduled visit: Visit 1 (V1; 16–20 weeks of amenorrhea), Visit 2 (V2; 28 ±1 weeks of pregnancy), Visit 3 (V3; 32 ±1 weeks of pregnancy), Visit4 (V4; delivery) and Visit5 (V5; 6–7 weeks after delivery). In addition, a cord blood sample was also collected during labour at delivery. Nulliparous and primiparous/multiparous non-pregnant women were enrolled in the control group. Cortisol and prolactin plasma concentrations were measured using ichroma II and i-chamber apparatus. Light microscopy was used to detect Plasmodium falciparum infections. A linear mixed-effects regression (LMER) model was used to assess the association between the variation of cortisol titres and prolactin levels during the pregnancy and the post-partum. Results: Results showed that cortisol and prolactin levels in the peripheral blood were globally up-regulated during pregnancy. Concentrations of cortisol during follow-up was significantly higher in primigravidae than in multigravidae during the whole pregnancy (p<0.024). Moreover, the level of prolactin which was higher before delivery in primigravidae reversed at delivery and postpartum visit, but the difference was not statistically significant during the follow-up (V1 to V5) (p = 0.60). The cortisol level in peripheral blood at delivery was higher than that in the cord blood, and conversely for prolactin. Cortisol and prolactin levels decreased after delivery, though the level of prolactin was still higher than that at enrolment. An increase of one unit of prolactin was associated with the decrease of the average concentration of cortisol by 0.04 ng/ml (p = 0.009). However, when cortisol increases with one unit, the average concentration of prolactin decreases by 1.16 ng/ml (p = 0.013). Conclusion: These results showed that the up-regulation effects of cortisol and prolactin are related to gestational age. A The downward regulation effect that both hormones have on each other during the pregnancy when each increase to 1 unit (1.0 ng/ml) was also reported. [ABSTRACT FROM AUTHOR]

Objective • To report the efficacy and safety of combination therapy with selinexor, palbociclib, pembrolizumab, and umbilical cord blood NK cells for advanced hepatocellular carcinoma (HCC).Advanced HCC has a poor prognosis and limited effective treatment options. Exploring personalized combination treatment strategies is critically important for improving outcomes in patients with advanced HCC. This study aims to provide preliminary evaluation of the clinical effectiveness and safety of this combination regimen in this high-risk population, and lay the groundwork for larger studies to bring more treatment choices to patients with advanced HCC. Methods • A 67-year-old male patient with advanced HCC and multiple metastases was treated with palbociclib 75mg on days 1-14 of a 28-day cycle, pembrolizumab 200mg intravenous infusion, selinexor 40mg weekly, and umbilical cord blood NK cell (12×109 cells) infusion on days 1, 14, 28 and 42. Imaging examinations and tumor marker detection were performed before and after two cycles of treatment to evaluate response. Results • After two cycles of combination treatment, follow-up PET-CT showed partial response with the liver tumors reduced in size by approximately 60%, lung metastases reduced by approximately 90%, and FDG uptake decreased more than 90% in lymph nodes and bone metastases. The AFP level decreased compared to baseline. Liver function tests including albumin, bilirubin and prothrombin time improved. The patient's performance status also improved from ECOG 2 to ECOG 1. Conclusions • This case report describes preliminary signals that the combination of selinexor, palbociclib, pembrolizumab, and umbilical cord blood NK cells may warrant further investigation for the treatment of advanced HCC. Objective response was observed based on standardized response criteria. However, due to the limitations of a single-arm case study design, definitive conclusions cannot be drawn regarding the efficacy or safety profile of this personalized combination approach. Larger and more robust clinical trials are needed to fully validate if this treatment strategy can achieve clinical benefit for advanced HCC. Future studies should aim to elucidate potential biomarkers that may help identify patients most likely to respond to this combination regimen. Exploring optimal patient selection criteria could also help maximize clinical benefit. Further research is warranted to continue exploring precision medicine combinations involving immunotherapy, targeted agents and cellular therapies for advanced HCC. [ABSTRACT FROM AUTHOR]

Introduction: Our aim was to investigate the incidence, comorbidities, and outcomes of fetuses with an elevated middle cerebral artery peak systolic velocity (MCA-PSV) >1.5 multiples of median (MoM), despite normal hemoglobin (Hgb) levels on fetal blood sampling (FBS). Methods: A single-center observational retrospective cohort study of all fetuses undergoing FBS and MCA-PSV >1.5 MoM. Only those fetuses with no or mild anemia were included. Indications for Doppler assessment, associated anomalies, and neonatal outcomes were collected. Results: Overall, 383 fetuses had an MCA-PSV >1.5 MoM and underwent FBS. Twenty-three (6%) fetuses met our inclusion criteria and had no or only mild anemia. Associations with elevated MCA-PSV were elucidated in 12 of the 23 cases (52.2%) and included mild anemia (n = 2), intracranial hemorrhage (n = 3), genetic disease (n = 1), idiopathic nonimmune hydrops (NIH, n = 1), hypoxic-ischemic encephalopathy (n = 1), maternal and or fetal acidosis (n = 3), and fetal growth restriction (n = 1). Favorable perinatal outcomes were observed in truly unexplained 11 cases with no additional anomalies (47.8%). Conclusion: Elevated MCA-PSV >1.5 MoM with normal Hgb levels is seen in 6% of pregnancies undergoing FBS and is often associated with other significant maternal or fetal problems. Those with unexplained and isolated MCA-PSV elevation have normal outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to identify predictive values of the soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio and interleukin (IL)-6, assessed with a clinically available method in a large-volume biochemistry laboratory, in maternal blood, amniotic fluid, and umbilical cord blood for the presence of the placental lesions consistent with maternal vascular malperfusion (MVM) and acute histological chorioamnionitis (HCA), respectively. Methods: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays. Results: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL. Conclusion: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days. [ABSTRACT FROM AUTHOR]

Aim and objective: Is to conduct a comparative analysis of Cord Blood and Whole Blood transfusions on clinical parameters and evaluate their effects on morbidity and mortality outcomes in neonatal sepsis, utilizing the Neonatal Sequential Organ Failure Assessment (N-SOFA) score as a clinical evaluation tool. Methodology: This prospective, comparative study was conducted at Gandhi Memorial Hospital, Rewa, from September 2022 to June 2024, involving 184 neonates with confirmed sepsis and hemoglobin < 7 g/dL requiring transfusion. Neonates were randomly assigned to two groups: Group 1 received umbilical cord blood transfusions, and Group 2 received adult human blood transfusions. The Neonatal Sequential Organ Failure Assessment (N-SOFA) score was utilized to evaluate organ dysfunction pre- and post-transfusion at 12 and 24 hours. Clinical assessments included blood indices and the need for inotropic support, with statistical analyses determining changes in N-SOFA scores and their significance. Results: The study included 184 neonates, equally divided into two groups: 92 receiving cord blood transfusions and 92 receiving whole blood transfusions. The demographic analysis showed no significant differences between groups in sex distribution (p = 0.880), mode of delivery (p = 0.673), or gestational age (p = 0.657). Notably, cord blood transfusions resulted in a significant reduction in the N-SOFA score > 4 from 67.3% pre-transfusion to 53.2% post-transfusion (p = 0.05), indicating an improvement in organ function. Additionally, cord blood transfusions significantly reduced the need for inotropic support (from 34.8% to 12.0%, p < 0.001), increased culture negativity (from 29.3% to 10.9%, p = 0.002), decreased procalcitonin levels (from 21.7% to 5.4%, p = 0.001), and reduced Creactive protein levels (from 27.2% to 10.9%, p = 0.005). In contrast, the whole blood group did not demonstrate significant improvements in these parameters. Conclusion: This study demonstrates that cord blood transfusions significantly improve outcomes in neonatal sepsis compared to whole blood transfusions. Key findings include reduced N-SOFA scores, decreased inotropic support needs, and lower inflammatory markers in the cord blood group, indicating enhanced organ function and immune modulation. These results support the use of cord blood transfusions as a promising therapeutic option for critically ill neonates, warranting further exploration and clinical implementation. [ABSTRACT FROM AUTHOR]

Background: Intrapartum hypoxia causes fetal suffocation, acidosis, newborn brain damage, long-term morbidity, and mortality.1 As a result, intrapartum fetal monitoring is performed to detect early indicators of fetal hypoxia and to take appropriate action as soon as possible to avoid fetal hypoxia complications. Objectives: 1. To study the correlation between fetal Doppler ultrasound and umbilical cord blood gas analysis in detecting fetal academia. 2. To identify the maternal and obstetric determinants associated with fetal acidemia. MATERIAL & METHODS: Study Design: Hospital-based prospective observational study. Study area: The study was conducted in the Department of Obstetrics and Gynaecology. Study Period: 1 year. Sample size: Using a sample size calculator, expecting a correlation coefficient of r=0.300, the required sample size was calculated to be 85. Study population: During the study period, a total of 92 pregnant women with abnormal fetal Doppler ultrasound findings, meeting the below-mentioned inclusion and exclusion criteria were eventually recruited into this study. Sampling Technique: Simple Random technique. Study tools and Data collection procedure: The institutional ethical committee clearance was obtained. The design and nature of the clinical study were explained to the patients and significant relatives of the patients. Informed consent was obtained from patients. The sociodemographic data was collected and recorded in the specially designed proforma. The socioeconomic class was assessed using the Socio-Economic Status Schedule. The obstetric history data was gathered and recorded in the proforma. All the patients in the sample group (n=92) were subjected to thorough clinical examination which included general physical, systemic examination and pelvic examination. Maternal blood samples for routine laboratory investigations (including tests for acidosis) were sent. Results: There was a significant correlation between gestational age and fetal acidemia (p value=0.0096). A gestational age of 41 weeks or more has a lesser incidence of fetal acidemia. Middle cerebral artery pulsatility index (MCAPI) was significantly associated with fetal academia (p-value of <0.0001). The umbilical artery pulsatility index (UAPI) had a highly significant correlation (p <0.0001) with the umbilical cord blood gas analysis. Conclusion: Based on the statistical analysis of the data, it is safe to assume that fetal Doppler ultrasound can predict the development of fetal acidemia. Two indicators, the Middle cerebral artery pulsatility index and the Umbilical artery pulsatility index, are strong predictors of fetal acidemia. Similarly, determinants like obstetric score, medical comorbidity, general physical examination and status of labour per vaginal examination were also not found to be significantly associated with fetal acidemia. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to characterize and investigate the safety and efficacy of Plonmarlimab, a novel anti‐granulocyte‐macrophage colony‐stimulating factor (anti‐GM‐CSF) neutralizing antibody, on the treatment of macrophage activation syndrome (MAS), a life‐threatening systemic inflammatory disease, in pre‐clinical models. Methods: The binding affinity was evaluated using Biacore. The neutralizing activity was measured through the blockade of ligand–receptor interaction, inhibition of STAT5 phosphorylation and suppression of TF‐1 cell proliferation. The efficacy of Plonmarlimab was evaluated in a humanized MAS model, which was established by engrafting human umbilical cord blood (UCB) cells into NOG‐EXL mice. Additionally, the safety profile of Plonmarlimab was investigated in cynomolgus monkeys. Results: At the molecular level, Plonmarlimab showed sub‐nanomolar binding affinity with human GM‐CSF and effectively blocked the binding of GM‐CSF to its receptor. At the cellular level, Plonmarlimab dose‐dependently inhibited intracellular STAT5 phosphorylation and suppressed GM‐CSF‐induced TF‐1 proliferation. In the UCB‐engrafted NOG‐EXL MAS mouse model, Plonmarlimab treatment significantly ameliorated disease progression, demonstrated by the improvements in body weight loss, anaemia and some histopathological features. Furthermore, Plonmarlimab was well tolerated up to 150 mg/kg weekly in monkeys with no reported adverse effects. Conclusions: Plonmarlimab is a highly potent GM‐CSF blocking antibody and has demonstrated promising efficacy in a pre‐clinical MAS model with a favourable safety profile, supporting its clinical development. [ABSTRACT FROM AUTHOR]

Fetal bovine serum (FBS) accounts for the largest portion of the cost of cultured meat production or cell culture experiments and is highly controversial in terms of animal welfare because it is taken from the fetus of a pregnant cow during slaughtering. Nevertheless, FBS is the most important supplement in the cell culture manufacturing process. This study aimed to develop an FBS substitute from slaughterhouse waste blood to reduce the cost of FBS in cultured meat production through various experiments. Our study successfully demonstrated that adult livestock blood obtained from slaughterhouses can effectively replace FBS. Our substitute, when cultured with bovine myosatellite cells, demonstrated cell growth that was either equivalent to or superior to that of commercial FBS. In the process of muscle generation through differentiation, the substitutes from bovine and chicken formed 70%–75% more bovine muscle compared to the control group using FBS. Furthermore, using the FBS substitute can reduce cell culture costs by approximately 61% compared to using commercial FBS. Therefore, the groundbreaking FBS substitute will not only contribute to the development of technology to mass‐produce cultured meat using livestock byproducts but will also lower the production cost of media for experimental cell culture or vaccine production. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between maternal blood pressure (BP) and neonatal cord blood telomere length (TL) during pregnancy, and to clarify the sensitive period. Methods: We conducted a prospective cohort study with 621 mother‐newborn pairs from the Guangxi Zhuang Birth Cohort (GZBC) in China. Multiple informant models, restricted cubic spline regression (RCS) models, and quantile regression models were conducted to analyze the correlation between maternal BP and neonatal TL. Results: Maternal diastolic blood pressure (DBP) was inversely related to neonatal cord blood TL in the second trimester (P = 0.015) and the third trimester (P = 0.011). There was a male‐specific relationship between maternal BP and neonatal TL. A 1 mmHg increment in maternal systolic blood pressure (SBP) and DBP during the second trimester was related with 0.42% (95% CI: −0.80%, −0.04%) and 0.61% (95% CI: −1.13%, −0.09%) shorter TL in male newborns, respectively. Per unit increase of maternal DBP during the third trimester was related with 0.54% (95% CI: −1.03%, −0.05%) shorter TL in male newborns. Pregnant women with hypertensive disease of pregnancy (HDP) had male offspring with shorter TL (P = 0.003). However, no significant relationships were found in female newborns (P = 0.570). Conclusion: Maternal BP during pregnancy is inversely correlated with male neonatal TL and the second and third trimesters are sensitive windows. Synopsis: Maternal blood pressure during pregnancy is inversely correlated with male neonatal telomere length and the second and third trimesters are sensitive windows. [ABSTRACT FROM AUTHOR]

Aims: Sertraline is frequently prescribed for mental health conditions in both pregnant and breastfeeding women. According to the limited available data, only small amounts of sertraline are transferred into human milk, yet with a large amount of unexplained interindividual variability. This study aimed to develop a population pharmacokinetic (popPK) model to describe the pharmacokinetics of sertraline during the perinatal period and explain interindividual variability. Methods: Pregnant women treated with sertraline were enrolled in the multicenter prospective cohort SSRI‐Breast Milk study. A popPK model for sertraline maternal plasma and breast milk concentrations was developed and allowed estimating the milk‐to‐plasma ratio (MPR). An additional fetal compartment allowed cord blood concentrations to be described. Several covariates were tested for significance. Ultimately, model‐based simulations allowed infant drug exposure through placenta and breast milk under various conditions to be predicted. Results: Thirty‐eight women treated with sertraline were included in the study and provided 89 maternal plasma, 29 cord blood and 107 breast milk samples. Sertraline clearance was reduced by 42% in CYP2C19 poor metabolizers compared to other phenotypes. Doubling milk fat content increased the MPR by 95%. Simulations suggested a median daily infant dosage of 6.9 μg kg−1 after a 50 mg maternal daily dose, representing 0.95% of the weight‐adjusted maternal dose. Median cord blood concentrations could range from 3.29 to 33.23 ng mL−1 after maternal daily doses between 25 and 150 mg. Conclusions: Infant exposure to sertraline, influenced by CYP2C19 phenotype and breast milk fat content, remains low, providing reassurance regarding the use of sertraline during pregnancy and breastfeeding. [ABSTRACT FROM AUTHOR]

Objectives: Impaired B‐cell reconstitution after allogeneic hematopoietic cell transplantation (allo‐HCT) contributes to the pathogenesis of chronic graft‐versus‐host disease (cGVHD). Therefore, methods to consistently achieve effective B cell lymphogenesis are required. We assessed the long‐term effects of posttransplantation cyclophosphamide (PTCy) use on immune reconstitution in clinical settings, an emerging strategy to suppress allogeneic immunological inflammation early after allo‐HCT and prevent subsequent GVHD. Methods: We comprehensively analyzed peripheral immune cell subsets and measured serum immunoglobulin G (IgG) or cytokine levels in 39 patients who survived for >1 year after allo‐HCT. Results: The absolute counts of B1 and IgM memory B cells were significantly lower in patients with severe cGVHD than in those without. The absolute count and percentage (among total CD19+ B cells) of switched memory B cells and serum IgG levels were significantly higher in patients transplanted with PTCy than in those transplanted with conventional GVHD prophylaxis. Interestingly, increased percentages of switched memory B cells and serum IgG levels were observed only in patients transplanted with PTCy and not in those transplanted with umbilical cord blood. Conclusions: PTCy administration can mediate favorable memory B‐cell reconstitution long after allo‐HCT and may therefore suppress cGVHD. [ABSTRACT FROM AUTHOR]

Background: The therapeutic effect of mesenchymal stem cells (MSCs) in liver cirrhosis is limited by their entrapment in the pulmonary vessels. Thus, the use of MSC-derived exosomes has become a promising strategy. The current work aimed to compare the role of human umbilical cord blood-MSCs (hUCB-MSCs) and their derived exosomes in the alleviation of liver cirrhosis focusing on the role of miR-23b and miR-221 and their direct effectors in inflammatory and autophagic pathways. Methods: Rats were divided into six groups: normal controls (negative control), liver cirrhosis group (positive control), liver cirrhotic rats that received conditioned media, liver cirrhotic rats that received hUCB-MSCs, cirrhotic rats that received exosomes, and cirrhotic rats that received both hUCB-MSCs and exosomes. The messenger RNA expression of transforming growth factor-β (TGF-β), Matrix metalloproteinase 9 (MMP 9), fibronectin, collagen type-1 (col1), alpha-smooth muscle actin (α-SMA), Suppressor of Mothers Against Decapentaplegic (SMAD) 2 and 7, Beclin, P62, and light chain 3 (LC3) were evaluated by quantitative real-time polymerase chain reaction. Immunohistochemical staining for Beclin, P62, and LC3 was performed. Results: The treatment of cirrhotic rats with hUCB-MSCs, exosomes, or the combination of them significantly downregulated miRNA-221, fibronectin, collagen I, α-SMA, Smad2 (P<0.001, for each), and P62 (P=0.032, P<0.001, P<0.001, respectively). Additionally, the treatment of cirrhotic rats with hUCB-MSCs, exosomes, or the combination of them significantly upregulated mTOR, Beclin, LC3, and Smad7 (P<0.001, for each) and miRNA-23 (P=0.021, P<0.001, P<0.001, respectively). Conclusion: hUCB-MSCs and their derived exosomes ameliorated liver cirrhosis by anti-inflammatory and anti-fibrotic effects besides modulation of autophagy. The exosomes had a better improvement effect either alone or combined with hUCB-MSCs, as proved by improvement in liver function tests, and molecular, histopathological, and immunohistochemical profiles. [ABSTRACT FROM AUTHOR]

Malaria blood‐stage parasite is a critical pathogenic stage responsible for serious adverse outcomes in pregnant women and their neonates. Immunoglobulin G (IgG) antibody responses specific to various asexual blood‐stage antigens were well reported in non‐pregnant individuals. However, little is still known during placental malaria. To assess the antibody responses specific to Plasmodium falciparum‐derived MSP3 and UB05 malaria vaccine candidates in mother‐neonate couples, mother's peripheral blood and neonate's cord blood samples were collected at delivery. After malaria diagnostic, plasma levels of IgG and IgG subclass responses specific to UB05, MSP3 and UB05‐MSP3 were determined using ELISA. As outcomes, both mothers and neonates had significantly higher IgG responses to UB05 and UB05‐MSP3 compared to anti‐MSP3 IgG (p < 0.05), irrespective of malaria status. Significant negative correlations were observed between IgG levels specific to the three antigens and parasitaemia (p < 0.01). Anti‐UB05 and anti‐UB05‐MSP3 IgG levels in neonates showed a significant positive correlation with the corresponding mothers' antibodies (rs = 0.25 with p = 0.04; rs = 0.31 with p = 0.01, respectively). UB05MSP3‐specific IgG3 and IgG1 subclass responses were significantly higher than the IgG4 subclass (p < 0.01). The neonates IgG1 and IgG3 levels positively correlated with the corresponding antibody subclasses of mothers. These findings suggest an association between UB05 and UB05‐MSP3‐specific antibody responses and malaria control during pregnancy. Maternal–foetal transfer of MSP3 and UB05‐specific IgG occurs during pregnancy, suggesting the interest in the future malaria vaccination strategies in pregnant women to generate early protective immunity in baby against malaria. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to evaluate the relationship between the level of improvement in blood gas parameters in the first hours of age and normal and diffusion-restriction brain magnetic resonance imaging (MRI). Materials and Methods: The study is a retrospective cohort study. Cases of the diagnosis of hypoxic-ischemic encephalopathy (HIE) who received therapeutic hypothermia in our unit between January 2022 and January 2024 were included in the study. Clinical findings, blood gas values (first, cord; second, first hours of age; third, 24th hour of age), and MRI results were recorded from the case files and compared between normal and diffusion-restricted brain MRI groups. Results: Diffusion-restricted brain MRI was detected in 10 out of a total of 19 cases. The 5-minute Apgar score was lower (p=0.038) and mechanical ventilator support was higher (P=.003) in the diffusion-restricted MRI group than in the normal MRI group. The relationship was shown between high base excess (P=.022) in cord blood gas, low HCO3 (p=0.025) in the 24th hour blood gas, and convulsion (P=.033) in the diffusion-restricted MRI group. Additionally, it was found that only the improvement level of the pH value in the first hour of age was significant (P=.025) in the diffusion-restricted brain MRI group than in the normal MRI group. Conclusion: We showed that there was a relationship between diffusion-restricted brain MRI and the improvement level in the pH value in the first hours of age of patients diagnosed with HIE who received treatment for therapeutic hypothermia [ABSTRACT FROM AUTHOR]

Background/Objectives: Chronic skin wounds (CSWs) are a worldwide healthcare problem with relevant impacts on both patients and healthcare systems. In this context, innovative treatments are needed to improve tissue repair and patient recovery and quality of life. Cord blood platelet lysate (CB-PL) holds great promise in CSW treatment thanks to its high growth factors and signal molecule content. In this work, thermo-sensitive hydrogels based on an amphiphilic poly(ether urethane) (PEU) were developed as CB-PL carriers for CSW treatment. Methods: A Poloxamer 407®-based PEU was solubilized in aqueous medium (10 and 15% w/v) and added with CB-PL at a final concentration of 20% v/v. Hydrogels were characterized for their gelation potential, rheological properties, and swelling/dissolution behavior in a watery environment. CB-PL release was also tested, and the bioactivity of released CB-PL was evaluated through cell viability, proliferation, and migration assays. Results: PEU aqueous solutions with concentrations in the range 10–15% w/v exhibited quick (within a few minutes) sol-to-gel transition at around 30–37 °C and rheological properties modulated by the PEU concentration. Moreover, CB-PL loading within the gels did not affect the overall gel properties. Stability in aqueous media was dependent on the PEU concentration, and payload release was completed between 7 and 14 days depending on the polymer content. The CB-PL-loaded hydrogels also showed biocompatibility and released CB-PL induced keratinocyte migration and proliferation, with scratch wound recovery similar to the positive control (i.e., CB-PL alone). Conclusions: The developed hydrogels represent promising tools for CSW treatment, with tunable gelation properties and residence time and the ability to encapsulate and deliver active biomolecules with sustained and controlled kinetics. [ABSTRACT FROM AUTHOR]

This report describes a positive outcome of topical exosome therapy for toxic epidermal necrolysis (TEN) in a dog. Enrofloxacin was administered subcutaneously one day before and for 7 days after the surgery for urolithiasis. Fourteen days after discontinuing the treatment, the dog was presented to the clinic for disseminated superficial tissue loss in the dorsal region which is associated with adverse drug reaction based on the scores for assessment of drug causality for epidermal necrolysis. Bovine-derived cord blood exosome was applied in the dose of 1 million/kg, twice a day, with intradermal and spraying routes to multiple points around the wound. The dog was monitored weekly, and complete recovery was observed 58 days after treatment. This report shows that topical xenogeneic exosome may be an alternative treatment approach for wound healing in dogs. [ABSTRACT FROM AUTHOR]

Preterm birth (PTB) forms a heterogeneous group with possible genetic predisposition. 25(OH)-vitamin D3 plays a significant role during implantation, placentation, and the maintenance of normal pregnancy. The aim of our research was to examine whether FokI, Cdx2, and ApaI VDR gene variants, as well as serum concentrations of 25-hydroxy25(OH)-vitamin D3 in women and their newborns, might be predisposing factors for idiopathic spontaneous preterm birth. The patient group consisted of 44 pairs of women with ISPTB and their children, and the control group consisted of 44 pairs of women who delivered at term and their children. At the time of delivery, peripheral blood was collected from every woman, and after newborn delivery, umbilical cord blood was collected. For genotyping of the rs2228570 C/T, rs11568820 G/A, and rs7975232 T/G SNPs, a combination of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) was used. Serum concentrations of 25(OH)-vitamin D3 were determined using high-performance liquid chromatography (HPLC). There were no statistically significant differences in the frequencies of VDR genotypes and alleles between women with ISPTB and control women. There was a statistically significant difference in the distribution of VDR Cdx-2 (rs11568820) genotypes between preterm-born children and controls, with the GG genotype and G allele being more prevalent among patients than controls (p < 0.001). There were no statistically significant differences in mean values between women with ISPTB and control women, nor between preterm and full-term newborns, although the 25(OH)-vitamin D3 concentrations in preterm-born children were lower than in controls. Furthermore, there was a statistically significant correlation in 25(OH)-vitamin D3 concentrations between mothers and children both in the patient and in the control groups (b = 0.771, p < 0.001). The results of our study demonstrate a notable association between the VDR Cdx2 gene polymorphism and idiopathic spontaneous preterm birth (ISPTB) in a Caucasian population, but because of the small number of participants, further research is needed. [ABSTRACT FROM AUTHOR]

Reduced/deficient expression of Protein Kinase C (PKC)ζ in Cord blood (CB) T cells is associated with allergy development in children and a propensity to maintain an immature T-helper (Th)2 cytokine profile. In addition, other PKC isozymes are also low in CBTCs. Since previous studies have reported that cord blood/neonatal monocyte and neutrophil functions are significantly lower than cells from adults, it was of interest to see if the CBTC PKC levels were reflected in CB monocytes and neutrophils. Compared to adult blood, CB expresses low levels of PKCα, β2, ε, θ, μ, ζ and λ/ι in monocytes and PKCα, β2, η, θ, μ, ζ and λ/ι in neutrophils. The T-cell PKCζ levels were positively correlated with levels in CB monocytes but not in neutrophils. However, neither the monocytes nor the neutrophil PKCζ were associated with T-cell development towards a Th1 or Th2 cytokine propensity, based on the production of interferon-gamma and interleukin-4 in response to phytohemagglutinin and phorbol myristate acetate. The results demonstrate that some newborn babies display a deficiency in PKC isozymes in monocytes and neutrophils, as reported for T cells. However, unlike T cells, the PKCζ levels of the phagocytes did not correlate with regulation of development towards a Th1 or Th2 cytokine phenotype. [ABSTRACT FROM AUTHOR]

Background: Fetal heart rate (FHR) monitoring has caused a clinical dilemma due to widespread misinterpretation of the physiology influencing various FHR patterns and the development of cerebral palsy. This study aimed to correlate various category II FHR patterns with maternal risk factors and birth outcomes. Methods: This prospective observational study was conducted at SRM Medical College Hospital and Research Center, Kattankulathur, Chennai, from December 2020 to March 2022. A total of 150 parturients with category II cardiotocography (CTG) were studied, and all were followed up through delivery and in the neonatal period. Results: Of the pregnant mothers, 79.9% were aged between 21 and 29 years. Most patients were primigravida 113 (75.3%), and 97 (64.7%) were in the early term (37w-38w 6d). On studying the association between maternal risk factors and category II CTG, 68% had an associated risk factor. In our study, intrauterine resuscitation maneuvers did not help in improving the abnormal fetal heart pattern. Variable deceleration was the most commonly encountered CTG abnormality (50.7%). Common category II CTG abnormalities with risk factors were variable deceleration followed by tachycardia, minimal beat-to-beat variability, and bradycardia. The most common category II CTG abnormality associated with induced labor was tachycardia, and with spontaneous labor, it was variable deceleration with good beat-to-beat variability which was statistically significant. The difference in the mode of delivery between the different CTGs was statistically significant. The difference in the APGAR score and cord blood pH between CTG abnormalities was statistically significant. Conclusion: In our study, there was higher correlation seen between minimal beat-to-beat variability, tachycardia, and variable decelerations with adverse neonatal outcomes and when present should be carefully monitored and decision to be taken accordingly. [ABSTRACT FROM AUTHOR]

Summary: TMEM56, a gene coding a transmembrane protein, is abundantly expressed in erythroid cells. Despite this, its role in erythropoiesis has not been well characterized. In this study, we sought to clarify the function of TMEM56 in erythroid development, focusing specifically on its involvement in haem biosynthesis and cell cycle progression. To do this, we used CD34+ haematopoietic stem cells derived from umbilical cord blood and differentiated them into erythroid cells in an ex vivo model. Our results indicate that the loss of TMEM56 disrupts haem biosynthesis and impairs erythroid differentiation. Furthermore, deletion of Tmem56 in the erythroid lineage in murine models using erythropoietin receptor (EpoR)‐Cre revealed defects in erythroid progenitors within the bone marrow under both normal conditions and during haemolytic anaemia. These observations underscore the regulatory role of TMEM56 in maintaining erythroid lineage homeostasis. Taken together, our results unveil a previously unrecognized function of TMEM56 in erythroid differentiation and suggest its potential as an unfounded target for therapeutic strategies in the treatment of erythropoietic disorders. [ABSTRACT FROM AUTHOR]

Summary: Rearrangement of NUTM1 gene (NUTM1r) is one of the most frequent aberrations occurring in infants (younger than 1 year at diagnosis) with B‐cell precursor Acute Lymphoblastic Leukaemia (BCP‐ALL). In this study we had the unique opportunity to analyze the umbilical cord blood (UCB) sample from one infant patient with NUTM1r BCP‐ALL. Herein we reported for the first time that NUTM1r infant ALL arise prenatally, as both the patient‐specific CUX1::NUTM1 fusion gene, as well as two IG/TR leukaemic markers were already present and detectable in the patient's UCB at birth. Our results clearly demonstrate the prenatal origin of NUTM1r infant BCP‐ALL. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of sortilin in the pathogenesis of fetal growth restriction (FGR) by examining serum sortilin levels in fetal cord blood. Methods: This prospective case-control study was conducted at Ankara Etlik City Hospital between July 2023 and January 2024. Group 1 included 44 pregnant women with late FGR; Group 2 included 44 healthy pregnant women as controls. Results: Umbilical cord blood sortilin levels were significantly higher in the FGR group [2.96 (2.43–4.01)] compared to the control group [2.12 (1.74–3.18)] (p = 0.001). Sortilin levels negatively correlated with APGAR scores at 1 min (r=-0.281, p = 0.008) and 5 min (r=-0.292, p = 0.006). A sortilin threshold of 2.58 ng/ml predicted composite adverse neonatal outcomes with 66.7% sensitivity, 53.1% specificity, and an AUC of 0.652 (95% CI: 0.529–0.775, p = 0.031). Conclusion: This study showed that sortilin levels, which are indicators of oxidation, were higher in the cord blood of newborns with late FGR. [ABSTRACT FROM AUTHOR]

Aim: Prenatal maternal depression is known to affect the neurodevelopment of offspring. This study aimed to investigate the profile of umbilical cord serum in mothers with major depressive disorder (MDD). Methods: Liquid chromatography–tandem mass spectrometry (LC–MS) was conducted using umbilical cord serum from mothers with MDD (n = 5) and controls (control, n = 5). The levels of several differentially expressed proteins in umbilical cord serum were compared between the MDD (n = 10) and control groups (n = 10) by enzyme‐linked immunosorbent assay. Results: The proteomic profiles in the umbilical cord serum were different between the MDD and control groups, including the pathways of regulation of plasma lipoprotein particle levels, and synapse organization. Only apolipoprotein A4 (APOA4) was significantly higher in the cord blood of MDD group. APOA4 levels in maternal serum were also significantly higher in the MDD group than those in the control group. The APOA4 levels in the umbilical cord serum were higher than that in the maternal serum. Conclusions: The levels of APOA4, a biomarker of depression, in the umbilical cord serum at birth were elevated in the neonates of MDD mothers. It is, therefore, likely that fetuses of MDD mothers were exposed to higher APOA4 levels in utero and this could have developmental and mental health implications for the offspring. [ABSTRACT FROM AUTHOR]

Heavy metals like arsenic, mercury, cadmium, and lead are harmful pollutants that can change how our genes are regulated without altering the DNA sequence, specifically through a process called DNA methylation (DNAm) at 5-methylcytosine, an epigenetic mark that we will focus on in this review. These changes in DNAm are most sensitive during pregnancy, a critical time for development when these modifications can affect how traits are expressed. Historically, most research on these environmental effects has focused on adults, but now there is more emphasis on studying the impacts during early development and childhood. The placenta acts as a protective barrier between the mother and the baby, and by examining it, scientists can identify changes in key genes that might affect long-term health. This review looks at how exposure to heavy metals during pregnancy can cause changes in the gene regulation by DNAm in newborns, as seen in their umbilical cord blood. These changes reflect the baby's genetic state during pregnancy and can be influenced by the mother's environment and genetics, as well as the baby's own genetics. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) is a debilitating monogenic disease originating from mutations in the hemoglobin beta chain gene producing an abnormal hemoglobin HbS. The polymerization of HbS is responsible for the sickling of erythrocytes leading to anemia and vaso-occlusive events. Gene therapy is a promising treatment of SCD, and two different gene therapy drugs, using gene editing or gene transfer, have already reached the marketing stage. There is still a need to improve the efficacy of gene therapy in SCD, particularly when using anti-sickling beta-globin gene transfer strategies, which must outcompete the pathological HbS. One possibility is to increase transduction by inhibiting lentiviral restriction factors such as interferon-induced transmembrane proteins (IFITMs). This can be achieved by the addition of cyclosporin H (CsH) during the transduction process. This strategy was applied here in CD34+ hematopoietic progenitor and stem cells obtained from cord blood (CB). A first series of experiments with lentiviral vector coding for a green fluorescent protein (GFP) gene confirmed that the addition of CsH enhanced transgene expression levels and vector copy number per cell (VCN), while CD34+ cells remained viable and functional. Notably, the production of colony-forming cells (CFC) remained unaffected unless very high VCN values were reached. In a second step, CD34+ cells obtained from the CB of newborns with homozygous (n = 2) or heterozygous (n = 1) SCD mutations were transduced with the GLOBE-AS3 lentiviral vector coding for the HbAS3 anti-sickling beta globin. As with GFP, GLOBE-AS3 lentiviral transduction was clearly enhanced by CsH, leading to VCN > 2 and therapeutic levels of expression of the HbAS3. Moreover, the process did not affect the viability or functions of CFC. The combination of CB progenitors, the GLOBE-AS3 vector, and CsH is thus shown here to be a promising approach for the treatment of SCD. [ABSTRACT FROM AUTHOR]

For patients with hematologic malignancies requiring allogeneic stem cell transplantation, alternative donor sources are needed when lacking access to a matched related or unrelated donor. Umbilical cord blood (UCB) has been an important alternative allograft donor source for these patients; however, several limitations exist. Omidubicel is a nicotinamide modified allogeneic hematopoietic progenitor cell therapy derived from UCB. Omidubicel was approved in May 2023 by the United States Food and Drug Administration based on the results of a Phase III trial comparing it to UCB transplantation in patients with high-risk hematologic malignancies. Median time to neutrophil engraftment was faster with omidubicel compared to UCB transplantation (12 days vs 22 days; p< 0.001). There was also a lower incidence of grade 2/3 bacterial or invasive fungal infections with omidubicel compared to UCB transplantation (37% vs 57%; p=0.027). From a safety perspective, omidubicel has a boxed warning due to the risk of life-threatening infusion reactions, graft-versus-host disease, graft failure, and engraftment syndrome. Omidubicel represents an important advancement in developing novel alternative allograft donor sources. This also has important implications in ensuring access to alternative donor sources for ethnic and minority populations. [ABSTRACT FROM AUTHOR]

Streptococcus agalactiae, or Group B Streptococcus (GBS), is a leading cause of neonatal sepsis. Materno-fetal transmission of the microorganisms present in the lower genital tract/perineum is considered to be the most frequent mode for acquisition of infection. It has also been proposed that, in a subset of cases, GBS causes acute chorioamnionitis, intraamniotic infection, and fetal/neonatal sepsis. However, the evidence to support this ascending pathway is derived from microbiologic studies that rely on cultivation methods, which do not have the resolution to determine if the microorganisms causing neonatal sepsis are the same as those found in the amniotic fluid and the vaginal ecosystem. We used whole genome sequencing of the microorganisms isolated from the vagina, amniotic fluid, chorioamniotic membranes, and neonatal blood (four isolates) in a case of early neonatal sepsis. Using hybrid genome assembly, we characterized the genomic features including virulence factors and antimicrobial resistance in four isolates from the same mother, placenta, and newborn. Whole genome sequencing revealed that the microorganisms in the four clinical isolates corresponded to S. agalactiae sequence type 1, clonal complexes 1, and serotype Ib. Comparative genomic analysis illustrated similar DNA sequences of the four genomes. This study presents the first evidence of the genomic similarity of microorganisms in the vaginal ecosystem, the space between the chorioamniotic membranes of the placenta, amniotic fluid, and neonatal blood. [ABSTRACT FROM AUTHOR]

Background: Currently, few literature reports document cases of decoy cells in the urine of umbilical cord blood transplant patients. The majority of the literature indicates that decoy cells are frequently identified in the urine of kidney transplant recipients. Case presentation: This case report describes a patient with Myelodysplastic Neoplasms featuring a complex karyotype who underwent umbilical cord blood transplantation. Postoperative urinary cytology revealed decoy cells, and subsequent BK virus nucleic acid testing was positive. However, the routine use of antiviral drugs by the physicians led to insufficient attention to the decoy cells and BK virus, culminating in hemorrhagic cystitis. Conclusions: Urine cytology is a simple, intuitive, rapid, and cost-effective analytical method. The presence of decoy cells in the urine can serve as an indicator for infection screening and provide a clue for clinical doctors: Detection of decoy cells in urine should prompt a more vigorous antiviral response to mitigate the risk of complications like hemorrhagic cystitis. [ABSTRACT FROM AUTHOR]

Background Iron deficiency (ID) is a common micronutrient problem, especially in pregnant women in developing countries such as Indonesia. Moreover, vitamin D deficiency is also a major concern in worldwide public health. A correlation between anemia, ID, and vitamin D deficiency in children has been identified, but investigations in pregnant women and their newborn babies are still limited. Objective To assess association between iron status and vitamin D levels in umbilical cord blood and maternal anemia. Methods This cross-sectional study involved 109 pregnant women and their newborns. They were divided into two groups, with and without maternal anemia. Collected cord blood (2 mL) was placed in tubes with ethylenediaminetetraacetic acid (EDTA). Plasma ferritin and vitamin D (25-hydroxyvitamin D, 25(OH)D) levels were measured by enzyme-linked immunosorbent assay (ELISA). Results Maternal anemia was found in 60 mothers (55% subjects). The mean cord blood hemoglobin levels for the anemic and nonanemic groups were 15.19 (SD 2.25) g/dL and 15.12 (SD 1.98) g/dL, respectively (P=0.87). Median cord blood ferritin levels were slightly lower in anemic [12.95 (range 0.42-17.69) µg/L] than in non-anemic mothers[13.45 (range 7.10-22.12) µg/L], but were not significantly different (P=0.555). Median cord blood 25(OH)D levels were lower in the anemic group [12.24 (range 8.53-32.99) ng/dL] than in the non-anemic group [14.26 (range 9.84-61.44) ng/dL], but the difference was not significant (P=0.964). Conclusion Maternal anemia was not significantly associated with cord blood hemoglobin, ferritin, or 25(OH)D levels. [ABSTRACT FROM AUTHOR]

Objectives: Environmental exposure may affect the telomere length (TL) of newborns, which is considered as an early biomarker indicating susceptibility for later life diseases. However, the effects of prenatal organochlorine pesticide (OCP) exposure on newborn TL remain unclear. This study aimed to investigate the association between prenatal exposure levels of OCPs during pregnancy and TL in neonatal cord blood. Methods: A total of 168 mother–infant pairs from a birth cohort in Wuhan, China, were included this study. The concentrations of hexachlorocyclohexanes (HCHs, including β-HCH, α-HCH, and γ-HCH), p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT) and its metabolites (p,p'-dichlorodiphenyldichloroethane, p,p'-DDD; p,p'-dichlorodiphenyldichloroethylene, p,p'-DDE) were measured in cord blood. The associations between the OCPs and the TL in newborns were analyzed by a generalized linear regression model. Stratified analyses by newborn sex, maternal gestational weight gain, and pregnancy body mass index (BMI) were performed to evaluate if the associations were modified by these factors. Results: The detection rates of various OCPs ranged from 50.9% to 100.0%. The median concentration of p,p'-DDE was the highest (33.90 ng/g lipid), followed by β-HCH (8.67 ng/g lipid), and the median concentrations of the other OCPs were between 0.12 and 0.33 ng/g lipid. Among the all newborns, a two-fold increase in the γ-HCH concentration in the cord blood was significantly associated with a 0.024 (95% CI: −0.041, −0.007) decrease in the TL. After stratification by newborn sex, the inverse association between γ-HCH and the TL was only statistically significant in boys, but not in girls (P for interaction <0.05). In addition, after stratification by pre-pregnancy BMI, β-HCH and p,p'-DDT concentrations were significantly associated with a decreased TL in the overweight pre-pregnancy BMI group [−0.111 (95% CI: −0.203, −0.018) and −0.036 (95% CI: −0.049, −0.023), respectively]. Conclusions: Prenatal exposure to OCPs during pregnancy was associated with a decreased neonatal telomere length, which may be affected by the newborn sex and pre-pregnancy BMI. These findings may provide new insights into the mechanisms underlying OCP-induced adverse health effects. [ABSTRACT FROM AUTHOR]

Introduction: Graft failure (GF) or poor graft function (PGF) remain critical obstacles in haploidentical hematopoietic stem cell transplantation (haplo-HSCT), especially in recipients with HLA antibodies. Here, we performed a retrospective cohort study to investigate the efficacy and safety of the use of unrelated umbilical cord blood stem cells (UCBs) as a third-party adjuvant infusion in patients with HLA-antibodies undergoing haplo-HSCT. Methods: A total of 90 patients were divided into three groups: 17 patients in Group A (with positive HLA antibodies and who received UCB infusion), 36 patients in Group B (with positive HLA antibodies without UCB infusion), and 37 patients in Group C (without HLA antibody or UCB infusion). Results: The median age of patients included in Groups A, B, and C was 43 (IQR, 27 - 49.5), 33 (IQR, 20 - 48.75), and 30 (IQR, 18 - 46.5) years, respectively. All but one patient in Group B achieved granulocyte recovery within 28 days after transplantation. The median time to granulocyte engraftment were all 12 days for patients in Groups A, B, and C, respectively. All the patients in Group A achieved 100% donor chimerism without UCB engraftment. There were no significant differences in granulocyte or platelet engraftment time between the three groups. There were 1, 5, and 0 patients in Groups A, B, and C, respectively, who developed PGF. The cumulative incidence rates for any grade of acute graftversus-host disease (aGVHD) were comparable among the three groups. Patients in Group B presented a greater incidence of cGVHD than did those in Group A (P = 0.002) and Group C (P = 0.006). Patients in Group A presented more limited and milder cGVHD than those in Group C (P < 0.0001). The 1-year relapse-free survival (RFS) was 70.6% (95% CI, 0.47 - 0.87), 55.6% (95% CI, 0.40 - 0.70), and 77.9% (95% CI, 0.63 - 0.89) in Groups A, B, and C, respectively. Discussion: Our results indicated that patients who were positive for HLA antibodies were at a greater risk of developing GF/PGF. Co-infusion with UCBs was safe and improved engraftment, cGVHD, and improved the 1-year RFS to some extent. [ABSTRACT FROM AUTHOR]

Background: Placental maternal vascular malperfusion (MVM) is characterized by accelerated villous maturation and has been associated with a decrease in the antiaging protein, alpha-klotho (AK). Our aim was to characterize AK protein and gene expression in the placenta and fetal organs. Methods: We utilized 2 cohorts. First, we characterized AK protein expression in an autopsy cohort where cases were defined as MVM as the cause of fetal death compared to a stillborn control population. Second, we characterized placental and umbilical cord blood AK gene expression in a liveborn population with and without MVM. Results: We found decreased protein expression in the villous trophoblastic cells of placentas exposed to severe MVM and decreased AK gene expression in placental tissue exposed to MVM. We did not see any statistically significant differences in fetal organ or umbilical cord blood AK expression based on the presence or absence of MVM. Furthermore, in liveborn infants, we also found increased odds of preterm birth with lower placental AK expression. Conclusions: Decreased AK gene and protein expression in the placenta in the setting of MVM is consistent with the theory of placental aging in MVM and is associated with increased odds of preterm birth. [ABSTRACT FROM AUTHOR]

Objectives: To determine the proportion of latent iron deficiency (LID) in neonates delivered at more than 34 weeks gestation with and without risk factors for in-utero iron deficiency. Methods: This observational study enrolled neonates delivered at more than 34 weeks gestation. Maternal antenatal history, risk factors for placental insufficiency, hemoglobin, and serum ferritin levels were collected upon admission for confinement. Neonates were categorized based on the presence of risk factors, and further categorized based on ferritin concentrations (cord blood or venous blood < 72 hours) into those with ferritin > 75 ng/mL (normal iron status) and those with ferritin between 11–75 ng/mL (LID). Results: Among 559 neonates, 295 had underlying risk factors for poor in-utero iron status. Overall, 45 (9.8%) neonates had LID with an incidence of 10.5% in those with risk factors and 5.3% in those without risk factors [Odds Ratio (95% CI) 2.09 (1.08, 4.03); P value = 0.02]. Maternal anemia and gestational hypertension were found to be significant independent risk factors for LID. Conclusion: This study highlights the higher LID in at-risk neonates, emphasizing the need for targeted interventions to prevent iron deficiency. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this study is to assess the knowledge, attitudes, and practices of pregnant women and hospital staff regarding umbilical cord blood (UCB) donation and storage to understand its limitations in clinical practice. Methods: MEDLINE, Scopus, LILACS, EMBASE, Scielo.br, and PROSPERO were searched from inception to 30 November 2023 with no geographic or language restrictions. The study eligibility criteria included cross-sectional studies that interviewed pregnant women and/or hospital staff about their knowledge, attitudes, and practices regarding private or public storage. A random-effects restricted maximum-likelihood model with Freeman–Tukey Double arcsine transformation meta-analysis was carried out to calculate the pooled estimates. MOOSE guidelines were followed. STATA 14.1 was used for statistical analysis. The Newcastle–Ottawa Scale and ROBINS-I tool were used for quality and risk of bias assessments. Results: In total, 19 studies providing data for 19,904 pregnant women and 1245 hospital staff members were included. Pooled pregnant women awareness was 61% ((95% CI 0.60 to 0.62), I2 = 0%, τ2 = 0.00, Q = 11.0 (p = 0.950)), and 61% for hospital staff (95% CI 0.58 to 0.64), I2 = 0%, τ2 = 0.00, Q = 4.00 (p = 0.310)). In total, 57% ((95% CI 0.56 to 0.58), I2 = 0, τ2 = 0.00, Q = 4.00 (p = 0.320)) of pregnant women had a positive attitude about UCB, while 34% ((95% CI 0.32 to 0.36), I2 = 0%, τ2 = 0.00, Q = 4.00 (p = 0.310)) were in favor of donating UCB for research and 65% ((95% CI 0.63 to 0.66), I2 = 0%, τ2 = 0.00, Q = 4.0 (p = 0.350)) were planning UCB storage. A significant (p < 0.001) preference for public relative to private banking (51% ([95% CI 0.49 to 0.54], I2 = 0%, τ2 = 0.00, Q = 4.0 (p = 0.310)) vs. 12% ([95% CI 0.10 to 0.13], I2 = 0%, τ2 = 0.00, Q = 4.0 (p = 0.300))) was noted for pregnant women. The same was retrievable for professionals (84% ([95% CI 0.79 to 0.88], I2 = 0%, τ2 = 0.00, Q = 2.0 (p = 0.110)) vs. 6% ([95% CI 0.03 to 0.09], I2 = 0%, τ2 = 0.00, Q = 1.0 (p = 0.070); p < 0.001)). Conclusions: Despite these efforts, lack of knowledge and positive attitudes about UCB banking remain, emphasizing the need for increasing educational programs on the subject. [ABSTRACT FROM AUTHOR]

Background and Objectives: Human umbilical cord blood serum (HUCBS) stands out as a potent adjunct to conventional therapies for ocular surface disorders (OSDs) caused by, among many, autoimmune systemic syndromes. By expediting ocular surface regeneration and fostering epithelial integrity, HUCBS not only enhances subjective patient experiences but also improves objective clinical indicators. This makes it particularly useful in patients with corneal ulcers through ocular surface regeneration and anti-inflammatory activity. This study aims to explore the efficacy of HUCBS in patients who had previously received other treatments unsuccessfully. Materials and Methods: This study was a prospective, non-comparative, interventional case series study involving 49 patients (30 females and 19 males) aged 15–82 years with severe OSDs who were unresponsive to standard treatments. The study was conducted at the San Marco Hospital, Catania, Italy. Patients were categorized into four groups based on the etiology of their severe OSDs: Group I consisted of twenty four patients with filamentary keratitis and corneal ulcers associated with rheumatologic diseases such as Sjogren's syndrome and systemic sclerosis; Group II comprised thirteen patients with graft-versus-host disease; Group III consisted of nine patients with corneal neurotrophic ulcers; and Group IV included three patients with Steven–Johnson syndrome. The outcomes were evaluated before and after treatment using the following assessments: OSDI (Ocular Surface Disease Index) and SANDE (Symptom Assessment in Dry Eye) questionnaires, VAS (Visual Analog Scale), Slit Lamp Examination, Esthesiometry, Lissamine Green Staining, NIBUT (Non-Invasive Break-Up Time), BUT (Break-Up Time), Fluorescein Staining with Photography and Oxford Classification, The Schirmer Test, Best-Corrected Visual Acuity (BCVA), and Meibography. Results: We observed a significant improvement in the outcomes from the SANDE, VAS, and OSDI questionnaires, The Schirmer Test, BUT, BCVA, and Oxford Classification, after treatment with UCBS. Clinical variables, such as corneal inflammation, conjunctivalization, corneal neovascularization, and pain, were also considered individually. Nevertheless, pain and inflammation reduced markedly over time until complete healing was achieved in all cases. Conclusions: Our pilot study highlights the substantial efficacy of HUCBS in patients with systemic autoimmune diseases who have shown inadequate responses to prior treatments for dry eye. This underscores the need for further comprehensive investigations in this field. [ABSTRACT FROM AUTHOR]

Background: The differentiation of hematopoietic cells is significantly affected by cell metabolic activity. However, despite increasing interest in this field, there has been no comprehensive investigation of the metabolic functions of human hematopoietic cells during specific phases of differentiation. Thus, this study was conducted to develop a method for comparing hematopoietic cell lineage differentiation based on the metabolic functions of the cell. The metabolic activity of human umbilical cord-derived hematopoietic cells was examined during various phases of differentiation, specifically, hematopoietic stem cells (HSCs), hematopoietic progenitor cells, and differentiated blood cells. This approach was used to develop comprehensive metabolic maps corresponding to the different stages. Results: HSCs were found to have robust fatty acid (FA) synthesis, FA oxidation, pentose phosphate pathway (PPP) activity, and glucose uptake, shown by their significantly higher expression of ACAC, CPT1A, G6PD, and GLUT1 as compared to differentiated pluripotent progenitor cells, common myeloid progenitors, megakaryocyte erythroid progenitors, lympho-myeloid primed progenitors, and granulocyte-macrophage progenitor cell populations. In monocytic differentiation, higher levels of ACAC, ASS1, ATP5A, CPT1A, G6PD, GLUT1, IDH2, PRDX2, and HK1 protein expression were evident in classical and intermediate monocytes relative to non-classical monocytes, consistent with high anabolic and catabolic levels. Compared with myelocytes and mature cells, the meta-myelocyte and pro-myelocyte populations of granulocytes show significantly elevated levels of ACAC, ASS1, ATP5A, CPT1A, G6PD, IDH2, PRDX2, and HK. In contrast to naïve and regulatory B cells, pro-B cells had higher levels of oxidative phosphorylation, while regulatory B cells showed greater PPP activity, glucose uptake, and tricarboxylic acid cycle activity. The analyses of T cells also indicated significantly higher ACAC, ASS1, ATP5A, CPT1A, G6PD, GLUT1, IDH2, PRDX2, and HK1 expression levels in CD4+ populations compared with CD8+ populations. Conclusions: The results provide comprehensive analytical methods and reference values for future systematic studies into the metabolic functions of various cord blood-derived hematopoietic cell populations in different pathological or physiological conditions. These findings could also contribute to research on the connection between cellular metabolism and cancer or aging. [ABSTRACT FROM AUTHOR]

Erythroid cells are the most abundant cells in the human body. In addition to their established function in gas-transportation, erythroid cells at various stages of differentiation have recently been shown to have immunomodulatory roles. Red blood cells may serve as modulators of innate and adaptive immunity, while their immature counterparts, CD71+ erythroid cells (CECs) have important immunomodulatory functions in various contexts. CECs are abundant in human cord blood and placenta, where they contribute to fetomaternal tolerance. CECs also accumulate in patients with infections, tumors, and anemia, and effectively suppress T cells by producing high levels of arginase, reactive oxygen species, programmed death-ligand 1, transforming growth factor b, and/or interleukin-10. Here, we systematically summarize the immunomodulatory functions of erythroid cells and propose some potential therapeutic applications based on their characteristics. [ABSTRACT FROM AUTHOR]

To compare the cord blood alarin levels of infants in different birth weight groups with those of infants born to mothers diagnosed with gestational diabetes mellitus (GDM) who were not subgrouped according to birth weight.This prospective study was conducted between September 2023 and January 2024. Healthy term babies whose families agreed to participate in the study were divided into four groups according to their birth weight (small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA)) and whether their mothers had GDM.There was a significant difference between the cord blood alarin levels of the AGA and SGA groups (p=0.014). There was also a significant difference between the cord blood alarin levels of the AGA and GDM groups (p=0.012). However, the cord blood alarin levels of the LGA group (whose mothers did not have GDM) were similar to those of the AGA group (p=0.394).We found evidence that alarin levels in umbilical cord blood are associated with low birth weight and GDM. [ABSTRACT FROM AUTHOR]

Introduction: Fetal microchimerism could be involved in the regulation of breast cancer oncogenesis. CD34+ cells could be of a particular interest as up to 12% of the CD34+ population in maternal blood are of fetal origin. The aim of this research was to analyze the impact of umbilical cord blood (UCB) CD34+ on MCF-7 and MDA-MB-231 breast cancer cell lines, in order to uncover novel biological mechanisms and suggest novel treatment options for breast cancer. Methods: UCB CD34+ cells were obtained from healthy women at full-term delivery. Direct cultures were grown with MCF-7 and MDA-MB-231 cells. Proliferation, migration, invasion, and transcriptomic analysis of breast cancer cell lines were compared between cultures exposed and nonexposed to UCB CD34+ cells. Interactions between UCB CD34+ and breast cancer cells were analyzed under fluorescent microscopy. Functional analyses were generated with QIAGEN’s Ingenuity Pathway Analysis (IPA) and Gene Set Enrichment Analysis (GSEA). Results: Direct contact between UCB CD34+ and breast cancer cell lines induced a reduction in the proliferative capacities of MCF-7 and MDA-MB-231 and diminished the migration abilities of MDA-MB-231 cells. In 3D coculture, UCB CD34+ cells were attracted by tumor spheroids and incorporated into tumor cells. These cell-to-cell interactions were responsible for transcriptome modifications coherent with observed functional modifications. Among the cytokines secreted by UCB CD34+, IFN-γ was identified as a potential upstream regulator responsible for the molecular modifications observed in transcriptomic analysis of MCF-7 breast cancer cells exposed to UCB CD34+ cells, as was IL-17A in MDA-MB-231 cells. Conclusion: Direct cell-to-cell contact induced functional modifications in breast cancer cells. Interactions between UCB CD34+ and breast cancer cells could induce cell fusion and signal transmission via cytokines. Further analysis of direct cell-to-cell interactions should be performed at a molecular level to further understand the potential role of fetal CD34+ cells in breast cancer. [ABSTRACT FROM AUTHOR]

Background: Aquatic activities are becoming increasingly popular as a form of exercise during pregnancy. However, the effects of these activities on the physical and mental health outcomes of pregnant women during and after pregnancy as well as fetal outcomes remain unclear. This meta-analysis evaluated the current evidence regarding the effects of aquatic activities during pregnancy on neonatal and maternal outcomes. Methods: Three databases (PubMed, Cochrane Central electronic database, Embase) were searched from inception to July 17, 2024 for randomized controlled trials (RCTs) comparing the effects of aquatic activities versus standard prenatal care or no exercise on neonatal and maternal outcomes. Pooled outcome measures were determined using random-effects models. Results: Ten RCTs including 1949 patients met the criteria for inclusion in this meta-analysis. The results showed that prenatal aquatic activities could significantly improve maternal weight control (mean difference [MD]= -0.91, 95% confidence interval [CI]= -1.64 to -0.18, P = 0.01, I2 = 0.00%), improve maternal quality of life (standard mean difference [SMD] = 0.16, 95%CI = 0.03 to 0.28, P = 0.01, I2 = 0.00%), and extend fetal birth length (MD = 0.48, 95%CI = 0.10 to 0.87, P = 0.01, I2 = 0.00%) compared with standard prenatal care or no exercise, while no significant differences were observed in fetal birth weight, Apgar score at 1 min, Apgar score at 5 min, pH of umbilical cord blood, gestational age, rate of preterm delivery, incidence of postnatal depression and mode of delivery. Conclusions: Prenatal aquatic activities can significantly improve maternal weight control and quality of life during pregnancy, and may promote longer birth length. However, additional studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: maternal health during pregnancy can affect the intestinal microbial community of offspring, but currently the impact of intrauterine environmental changes resulting from gestational diabetes mellitus (GDM) on the microbiota of offspring as well as its interaction with the immune system remains unclear. Aims: to explore the impact of intrauterine microbial exposure during pregnancy of gestational diabetes mellitus on the development of neonate's intestinal microbiota and activation of immune responses. Methods: Levels of lipopolysaccharides in cord blood from GDM and expression of microbial recognition-related proteins in the placenta were measured. To evaluate embryonic intestinal colonization, pregnant mice with GDM were administered with labeled Escherichia coli or Lactobacillus. The intestinal colonization of pups was analyzed through 16S rRNA gene sequencing and labeled microbial culture. Additionally, memory T lymphocyte and dendritic cell co-culture experiments were conducted to elucidate the immune memory of intestinal microbes during the embryonic stages. Result: Gestational diabetes mellitus led to elevated umbilical cord blood LPS level and increased GFP labeled Escherichia coli in the offspring's intestine after gestational microbial exposure. The mouse model of GDM exhibited increased immune markers including TLR4, TLR5, IL-22 and IL-23 in the placenta and a recall response from memory T cells in offspring's intestines, with similar observations found in human experiments. Furthermore, reduced intestinal microbiome diversity and an increased ratio of Firmicutes/Bacteroidetes was found in GDM progeny, with the stability of bacterial colonization been interfered. Conclusions: Our investigation has revealed a noteworthy correlation between gestational diabetes and intrauterine microbial exposure, as well as alterations in the neonatal microbiota and activation of immune responses. These findings highlight the gestational diabetes's role on offspring's gut microbiota and immune system interactions with early-life pathogen exposure. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia (PE) is a condition in pregnancy characterized by hypertension and proteinuria, thus leading to severe complications for both mother and fetus, including fetal growth restriction (FGR). However, there are still unclear aspects regarding the pathogenesis, prevention, and treatments. This study aimed to elucidate the characteristics of lipid metabolism in maternal and umbilical cord plasma complicated with PE using liquid chromatography-mass spectrometry (LC-MS). Method: The study included singleton pregnant women at Osaka Metropolitan University Hospital from March 2023 to February 2024. PE was diagnosed based on new-onset hypertension after 20 weeks of gestation and other symptoms such as proteinuria and organ dysfunction. FGR was defined by ultrasound measurements below -1.5 standard deviation (SD). Plasma samples were collected from maternal and umbilical cord blood within 24 hours before delivery. Lipid metabolites were comprehensively analyzed using LC-MS, and the lipokine 12,13-diHOME, identified as elevated in the comprehensive analysis, was quantified. Immunohistochemistry was conducted on placental samples to assess soluble epoxide hydrolase (sEH) expression. Results: The study involved 31 participants, with 20 in the control group and 11 in the PE group. A comprehensive analysis of maternal plasma samples identified a significant increase in 12,13-diHOME levels in the PE group compared to the control group. Quantification of 12,13-diHOME showed a significant increase in maternal plasma, umbilical venous plasma, and umbilical arterial plasma in the PE group compared to the control group (p = 0.007, p = 0.008, p = 0.005). PE with FGR showed significantly higher 12,13-diHOME concentrations in the umbilical arterial/venous ratio compared to the PE without FGR group (p = 0.03). Negative correlations were observed between 12,13-diHOME levels and birth weight in the PE group. Immunohistochemistry did not show significant differences in the sEH expression between the groups. Conclusion: This study demonstrated that 12,13-diHOME levels were significantly elevated in maternal and umbilical cord blood in PE patients, particularly in PE with FGR. Elevated 12,13-diHOME may reflect the progression of placental ischemia due to PE pathogenesis. This lipid metabolite could serve as a marker for the severity of preeclampsia, thus providing new insights into perinatal lipidomics and the potential role of 12,13-diHOME in PE. [ABSTRACT FROM AUTHOR]

Maternal hyperhomocysteinemia (HHcy) is a risk factor for intrauterine growth restriction presumably caused by a decrease in the placental transport of nutrients. We investigated the effect of experimental HHcy induced by daily methionine administration to pregnant rats on the free amino acid levels in the maternal and fetal blood, as well as on morphological and biochemical parameters associated with the amino acid transport through the placenta. HHcy caused an increase in the levels of most free amino acids in the maternal blood on gestational day 20, while the levels of some amino acids in the fetal blood were decreased. In rats with HHcy, the maternal sinusoids in the placental labyrinth were narrowed, which was accompanied by aggregation of red blood cells. We also observed an increase in the neutral amino acid transporters (LAT1, SNAT2) protein levels and activation of 4E-BP1, a downstream effector of mTORC1 complex, in the labyrinth zone. Maternal HHcy affected the placental barrier permeability, as evidenced by intensification of the mother-to-fetus transfer of Evans Blue dye. The imbalance in the free amino acid levels in the maternal and fetal blood in HHcy may be due to the competition of homocysteine with other amino acids for common transporters, as well as a decrease in the area of exchange zone between maternal and fetal circulations in the placental labyrinth. Upregulation of the neutral amino acid transporter expression in the labyrinth zone may be a compensatory response to an insufficient intrauterine amino acid supply and fetal growth restriction. [ABSTRACT FROM AUTHOR]

Background: Placental pathological changes can occur in both normal and high-risk pregnancies, leading to adverse maternal and neonatal outcomes. Objective: This study aimed to investigate the relationship between placental histopathological findings and maternal and fetal clinical outcomes, as well as to determine if there is an association between maternal comorbidities and placental pathologies. Materials and Methods: In this study, 250 placenta samples were evaluated. The slides and paraffin blocks were retrieved from the archive of the pathology department of Shariati and Yas hospitals, Tehran, Iran. The placental histopathological findings were analyzed in relation to maternal and fetal clinical data. Results: The average age of pregnant women was 31.84 yr. The average gestational age at birth was 28 wk. The most prevalent pathological finding was maternal vascular malperfusion, observed in 59.6% of cases. The presence of nucleated red blood cells (NRBC) in umbilical cord blood vessels was observed in 16.4% of cases. Fetal vascular malperfusion was significantly associated with intrauterine fetal demise. Maternal inflammatory response was associated with premature rupture of membranes. Maternal vascular malperfusion and the presence of NRBC in umbilical cord blood vessels was significantly associated with pre-eclampsia and preterm labor. Furthermore, a history of maternal malignancy was associated with placental infarction and the presence of NRBC in umbilical cord blood vessels. Conclusion: The findings of this study underscore the importance of evaluating placental histopathological findings in relation to maternal and fetal clinical outcomes. Therefore, understanding these placental pathological changes will be crucial in predicting and preventing complications in subsequent pregnancies. [ABSTRACT FROM AUTHOR]

The article in the Journal of Travel Medicine discusses new insights into the Oropouche virus (OROV), an arbovirus belonging to the Simbu serogroup. OROV has been associated with outbreaks in various countries in the Americas, causing Oropouche fever characterized by fever, headache, and other symptoms. The virus has been linked to cases of vertical transmission, birth defects, and mortality, with cases reported in pregnant women and newborns. The spread of OROV has been observed in travelers returning from affected regions, highlighting the importance of monitoring and prevention strategies to address this emerging public health concern. [Extracted from the article]

Objectives: ABO hemolytic disease of the newborn (ABO HDN) is the most common cause of neonatal jaundice due to feto-maternal incompatibility. The objective of this study is to evaluate early predictors of ABO HDN using immuno-hematological and biochemical tests. Materials and method: Newborns with blood group A/B born to group O mothers were prospectively enrolled in the present study. Direct antiglobulin test (DAT) and cord blood bilirubin (CBB) were performed. Total serum bilirubin (TSB) was measured at 72 hours of life. Serum anti-A/B IgG titers of maternal samples were measured. For the statistical analysis, Microsoft Excel 2013 (Microsoft Corporation, NY, USA) and SPSS statistical computer software (version 22) were used. To find the efficacy and cut-off values for various predictors of neonatal jaundice, receiver operating characteristic (ROC) curve analysis was performed. To evaluate the relative importance of predictors for phototherapy (PT), logistic regression was used. Results: A total of 200 ABO incompatible mother-neonate pairs were included in the present study. The incidence of ABO HDN was 10% (n=20). The number of DAT positive cases was 38 (19%). Regression analysis showed a significant influence of antibody titre, CBB and DAT on probability of phototherapy. Antibody titers =512 predicted severe hyperbilirubinemia with 80% sensitivity and 83% specificity; CBB = 2.75 mg/dL had 85% sensitivity and 83% specificity. Conclusion: High risk ABO-incompatible neonates could be identified at birth using maternal antibody titers, DAT and CBB. Early diagnosis with enhanced surveillance will help in optimum utilization of healthcare. [ABSTRACT FROM AUTHOR]

Background: Neonatal jaundice is a commonly seen clinical condition globally, including in India seen in nearly 60% of subjects born at term and 80% of neonates born pre-term in their first week of life and is the most common cause of readmission in neonates. Aim: The present study aimed to assess the predictive value of umbilical cord blood albumin level for developing neonatal jaundice in healthy neonates born at term and the usefulness of cord blood albumin for predicting subsequent significant neonatal jaundice development. Materials and Methods: The present study assessed 200 healthy term neonates where cord blood albumin level was estimated at birth. Estimation of total serum bilirubin was done for all the neonates at birth. Estimation of total serum bilirubin was done in all the neonates with clinically suspected jaundice at the age of 72-96 hours. The neonates were divided into three groups I, II, and III depending on cord albumin levels of <2.8g/dL, 2.8-3.3 g/dL, and >3.3 g/dL respectively. The main outcome assessed was concerning serum bilirubin =17 mg/dL, exchange transfusion, and the need for phototherapy. Results: Groups I, II, and III had 42, 70, and 88 newborns respectively. In Group I, 85.7% (n=36) neonates had total bilirubin of >17 mg/dL, among which 76.19% (n=32) needed phototherapy, and 9.52% (n=4) subjects required exchange transfusion. In Group II. 65.7% (n=46) neonates developed jaundice whereas phototherapy was needed in 34.2% (n=24) neonates and no subjects needed exchange transfusion. In Group III, 34.09% (n=30) neonates developed jaundice here 2.2% (n=2) subjects needed phototherapy, and no subjects needed exchange transfusion which depicted a statistically significant difference with p<0.001. Conclusion: The present study concludes that cord blood albumin level of =2.8g/dL is a significant risk factor for the development of neonatal hyperbilirubinemia that needs early intervention, whereas, cord blood albumin >3.3 g/dL is usually the safe criteria for early discharge. [ABSTRACT FROM AUTHOR]

Background: Neuraxial anesthesia remains the preferred choice for Caesarean deliveries across the world. Hypotension is the physiologic consequence and perhaps the most common complication of neuraxial anesthesia in obstetric patients. In this study, we compared the effectiveness of vasopressors, ephedrine versus phenylephrine in the treatment of hypotension after spinal anesthesia and also the fetal outcome. Materials and Methods: Patients aged group between 18-and 35 years posted for elective cesarean section with term pregnancy were allocated randomly to the two groups, Group-1 (E) Ephedrine and Group-II (P) Phenylephrine. Changes in maternal blood pressure, heart rate, and saturation were monitored and noted till the end of the surgery. The total dose of vasopressor and number of boluses used, total volume of fluids infused, the time of spinal anesthesia given, the delivery of the fetus, and the duration of the procedure were documented. Umbilical artery cord blood for determination of the acid-base status of the fetus. APGAR scores 1 min and 5 min of delivery of all newborns were noted and a score of <8 was considered low. Results: In our study, all patients in the two groups were comparable concerning age, height, weight, gestational age, and ASA status. The differences observed in baseline values of mean arterial blood pressure and saturation between the two groups were statistically insignificant. Also, there was a statistically insignificant difference between the duration of surgery, the total volume of fluid used intra-operatively, and the time of spinal to the delivery of the fetus in both groups. Further in my study, it was observed that there was a statistically significant difference in mean arterial blood pressure between the two groups up to 20 minutes post spinal anesthesia, but beyond the 25th minute, there was no statistical difference in mean arterial blood pressure between the two groups till the end of the surgery. Conclusion: The use of phenylephrine or ephedrine to correct maternal hemodynamic changes during spinal block for cesarean section does not show any marked difference in the outcome. The effect on fetal pH fetal acid-base status is comparable with both groups. The results of my study show that phenylephrine and ephedrine are both efficient and suitable vasopressors for the treatment of hypotension following spinal block in patients undergoing cesarean section. [ABSTRACT FROM AUTHOR]