Blood Screening Research Articles

PREVALENCE AND INCIDENCE OF CONGENITAL HYPOTHYROIDISM IN NEONATES IN TERTIARY CARE CENTRE IN CENTRAL INDIA

Background: Congenital hypothyroidism is one of the most common disrupters of endocrine and metabolism, that is most important preventable cause of mental and physical disabilities. Clinical features are often lacking at birth even up to the rst few weeks or months of life. Diagnosis based on clinical features is difcult at birth without biochemical screening, resulting in delayed initiation of therapy and irreversible brain damage in the affected children. Screening during birth can help in early diagnosis and treatment. Knowledge of the country-specic prevalence of the disease can guide in establishing a universal screening program, thus improving the outcomes of affected children by timely intervention. This study aimed to describe and investigate the prevalence and incidence of CH in Central India by Cord blood screening method. A prospective observational study was conducte Material & Methods: d for a period of 9 months in the Department of Paediatrics, Index Medical College Hospital & Research Center, Indore after valid approval from Institutional ethics committee on neonates who qualied the inclusion criteria. The screening was conducted on 200 babies delivered at a tertiary care hospital, at Index Medical College Hospital & Research Center, Indore, both by normal vaginal delivery or Caesarean section were included in the study. Cord blood samples was collected on Post neonatal day 1 of these new born and sent for serum thyroid Stimulating hormone (TSH) estimation by IRMA method and followed up. Prevalence was calculated by percentage. Out of 200 ne Results: onates assessed 6 newborns detected to have serum TSH more than 20 µIU/ml, were further investigated with complete thyroid prole and out of these only one newborn detected to have congenital hypothyroidism eventually with incidence rate of 1:200. Early diagnosis of CH Conclusion: with an efcient and accurate screening method which can decrease the risks of developmental delay, mental retardation, and delayed physiological development

Effects of selenium oxide nanoparticles on the morphofunctional state of the liver: Experimental data

Copper smelters are the sources of emission of complex aerosols containing, inter alia, selenium-containing nanoparticles (NPs). It is very difficult to adequately estimate the hazard posed by such particles since available data on them are scarce and have been obtained in comparatively few experimental studies with rather contradicting results. The aim of our study was to determine toxic health effects of selenium-containing nanoparticles more precisely with a focus on liver as a target organ. Liver toxicity following exposure to suspended selenium oxide nanoparticles was investigated in a sub-chronic experiment on outbred male albino rats. The suspension was prepared by laser ablation of 99%-pure selenium plates. We examined ultrastructural changes by electron microscopy, did cytological and histological analyses of the liver, biochemical blood testing and metabolomic blood screening. We observed lesions in the liver and inhibited secretory functions at various levels, from molecular to organismic, in the exposed animals. The microscopic examination showed that the number of normal and normal-vesicular mitochondria in liver cells went down by 7.78 %, p < 0.05; the metabolomic screening established lower levels of glycocholic acid in blood serum, р < 0.001; levels of alanine aminotransferase in blood serum grew by 30 %, p < 0.05; the number of acaryotic hepatocytes demonstrated a 3.1-fold increase, p < 0.05, according to the results of histological assessment of liver specimens. The touch smears of the liver examined showed a 2.2-fold increase in the number of degenerated hepatocytes (p < 0.05). These experimental data can be used to estimate a potential hazard of selenium-containing nanoparticles within social-hygienic monitoring and biomedical predictions of health damage caused by exposure to such NPs. Altered levels of lysophos-phatidylinositol can be a marker of exposure to the examined NPs and necessitate the search for early diagnostic predictors of associated health disorders.

The infection rates of HBV and HCV decreased significantly in Zhejiang Province, China: A comparative study based on the data of two sero-epidemiological surveys in 1992 and 2020.

In 2020, China conducted a nationwide, sero-epidemiological, cross-sectional survey of viral hepatitis. The stratified multi-stage cluster random sampling method was used to select the permanent population aged 1-69 years, followed by questionnaire survey and sample collection and detection of the serological markers of hepatitis B (HBV) and hepatitis C viruses (HCV). A total of 4747 individuals aged 1-69 years were investigated in Zhejiang Province. The positive rates of hepatitis B surface antigen and anti-HCV were 4.3% and 0%, respectively. Compared to a similar sero-epidemiological survey in 1992, the 2020 survey showed that the HBV infection rate in Zhejiang Province decreased by 56.5%. In both surveys, HBV infection rate increased with age (in 1992, χ2 =185.866, p=.000; in 2020, χ2 =1383.836, p=.000). Compared with 1992, the positive anti-HCV rate in those aged 1-69 years in 2020 decreased by 100.0%. This result showed that the HBV vaccine and blood screening to prevent HBV and HCV infection significantly decreased the infection rate of HBV and HCV in the younger generation of Zhejiang province. However, the rate of HBV carriers aged 30-69 years was still high, which underscores the need to strengthen the management and treatment of chronic HBV infection. Hence, Zhejiang province can eliminate the public health threat of viral hepatitis.

Оценка влияния наночастиц оксида селена на морфофункциональное состояние печени (Экспериментальные данные)

Copper smelters are the sources of emission of complex aerosols containing, inter alia, selenium-containing nanoparticles (NPs). It is very difficult to adequately estimate the hazard posed by such particles since available data on them are scarce and have been obtained in comparatively few experimental studies with rather contradicting results. The aim of our study was to determine toxic health effects of selenium-containing nanoparticles more precisely with a focus on liver as a target organ. Liver toxicity following exposure to suspended selenium oxide nanoparticles was investigated in a sub-chronic experiment on outbred male albino rats. The suspension was prepared by laser ablation of 99%-pure selenium plates. We examined ultrastructural changes by electron microscopy, did cytological and histological analyses of the liver, biochemical blood testing and metabolomic blood screening. We observed lesions in the liver and inhibited secretory functions at various levels, from molecular to organismic, in the exposed animals. The microscopic examination showed that the number of normal and normal-vesicular mitochondria in liver cells went down by 7.78 %, p < 0.05; the metabolomic screening established lower levels of glycocholic acid in blood serum, р < 0.001; levels of alanine aminotransferase in blood serum grew by 30 %, p < 0.05; the number of acaryotic hepatocytes demonstrated a 3.1-fold increase, p < 0.05, according to the results of histological assessment of liver specimens. The touch smears of the liver examined showed a 2.2-fold increase in the number of degenerated hepatocytes (p < 0.05). These experimental data can be used to estimate a potential hazard of selenium-containing nanoparticles within social-hygienic monitoring and biomedical predictions of health damage caused by exposure to such NPs. Altered levels of lysophos-phatidylinositol can be a marker of exposure to the examined NPs and necessitate the search for early diagnostic predictors of associated health disorders.

The Impact of Health Coverage, Race and Ethnicity on Utilization of Preventive Medical Care during the First Year of the Covid-19 Pandemic: Findings from the National Health Interview Survey 2019-2020.

This study examined COVID-19's impact in the 2020 compared to 2019 survey years on preventive medical care utilization. Using a cross-sectional sample of adults aged 18years and over (2019; n = 31,997; 2020; n = 31,568), from the National Health Interview Survey, multivariable models compared 2020 to 2019 survey years for receiving diabetes screening blood tests, well-care visits, and physical therapy. An additional multivariable model predicted not having medical care due to the COVID-19 pandemic in the 2020 2020 survey year. In the 2020 versus 2019 survey years, the likelihood lowered for receiving a blood test for diabetes screening (aOR .83 CI = .76, .90). There was a lowered likelihood for a well care visits (aOR = .98 CI = .84, 1.1) and physical therapy (aOR = .97 CI = .89, 1.0). Black (aOR = .62 CI = .51, .75), Hispanic (aOR = .62 CI = .51, .75) and Asian (aOR .67 CI = .53, .86) adults had a lowered likelihood of having physical therapy compared to White adults. Having no insurance coverage lowered the likelihood of getting all three indicators of preventive medical care. There was a higher likelihood of not getting medical care due to COVID-19 in the 2020 survey year (aOR = 1.7 CI = 1.3, 2.1) with Medicaid compared to private coverage. Use of preventive medical care lowered in the pandemic. Race and ethnicity and not having any coverage contributed to not receiving preventive care. Medicaid appeared to increase utilization of preventive medical care but not acute medical care.

Common Clinical signs and symptoms observed in Patients diagnosed with Thyrotoxicosis in Gujranwala, Pakistan

Aim: To assess the common clinical sign and symptoms in Patients of Thyrotoxicosis in Gujranwala, Pakistan. This study was conducted at the Civil Hospital and Salamat Hospital & Healthcare Center, Gujranwala from July 2019 to February 2020. Methods: This was a prospective study consisted of 120, male and female patients of different age groups, diagnosed with thyroid gland disorder. The Clinical features and history related to thyroid disorders was taken. Complete thyroid profile was checked in initial screening of Thyrotoxicosis.The bloodscreening for various thyroid hormonal levels,Thyroid imaging for the patients with neck swelling and clinically various thyroid function tests were done by using Radiation Imaging (Radiotracers) techniques. Aninformed consent of all patients was taken before tests and study. The data was recorded on designed Performa. Results: In this study the prevalence of Thyrotoxicosis patients was higher in females (78) than male (42) and majority of patients belonged to 31-50 years of age range. Various typical clinical sign and symptoms of Thyrotoxicosis like Goiter, sweating, heat intolerance, Hoarseness, Tremors, Diarrhoea, anxiety, hair loss, Menstrual irregularities in females, Exophthlmus, increased appetite and poly urea were observed in patients diagnosed with Thyrotoxicosis.While in blood screening, marked mean ±SD of BMI, free T3ng/dL, T4(ng/dL) and TSH(mlU/L) were found in male & female patients (table 2). Conclusion and practical implication: Thyroid casesare found high in our population. This high prevalence rate is affecting the health and quality of life of affected persons. So it is deeply felt that awareness to use dietary iodineand other remedies isa need of hour for our communities to decrease high prevalence of the thyroid dysfunctions and improve health and quality of life of the community. Keywords: Thyrotoxicosis, Radiotracers, Radiation Imaging Technique, Signs and Symptoms, TSH, T3 and T4, Prevalence.

REASONS OF DONOR DEFERRAL FOR A SINGLE DONOR PLATELETPHERESIS IN A PUBLIC SECTOR BLOOD TRANSFUSION CENTRE OF LAHORE: A CROSS-SECTIONAL STUDY

Background and Objective: Plateletpheresis is a process by which platelets are extracted from the donor. Donor selection is critical since donors are the sole supply of blood available to satisfy demand. The goal of this study is to investigate the causes behind plateletpheresis donor deferral in order to ensure safe blood donation. Materials and Methods: The research was carried out at the department of Haematology and Transfusion Medicine University of Child Health Sciences, The Children Hospital Lahore. 50 plateletpheresis donors who voluntarily came for donation were considered for the procedure as per guidelines and departmental standard operating procedure. The details of the procedure of plateletpheresis were explained to each donor. Donor questionnaire was filled including brief history, general physical examination, Haematological parameters such as haemoglobin and the donor blood screening was done to be considered fit for procedure. The reasons for deferral of donors were noted after all work up was done. Informed consent was taken before the procedure. Plateletpheresis was done using COM.TEC Cell Separator instrument. Results: In this study 50 donors were included. Out of 50 donors 34 were approved for procedure and 16 were deferred due to different temporary and permanent reasons. The age of the donors were in between 18 to 50 years. Major reason for temporary deferral was poor venous access (n=7, 14%) followed by the low haemoglobin value (n=4, 8%). Other reasons for temporary deferral were history of medication (n=3, 6%), low platelet count (n=4,8%), history of blood transfusion (n=1, 2%), history of vaccination n=2, 4%), leucocytosis (n=1, 2%), underweight (n=4, 8%), fever (n=1, 2%), refusal after questionnaire (n=1, 2%), seropositive for malaria and VDRL (n=3, 6%), high blood pressure (n=1, 2%), and anxiety (n=1, 2%). Permanent reasons for deferral were seropositive for HbsAg (n=2, 4%), seropositive for HCV (n=4, 8%) and tattoo (n=1, 2%). Conclusion: This study found a pattern of donor deferral in single donor platelet apheresis that was our experience in single centre. In conclusion during the selection of donors, Transfusion services should be very careful related to donor safety measures and these causes of deferral should be kept in mind.

Change in Antinuclear Antibody Titers during Biologic Treatment for Psoriasis.

We previously evaluated blood screening data, including antinuclear antibodies (ANA), before initiating biologic treatment for patients with psoriasis in a real-world setting. However, we did not analyze change in ANA titers after the start of biologics. No previous study has comprehensively investigated change in ANA titers over time in individual patients or the effectiveness of certolizumab pegol or tildrakizumab. This study evaluated change in ANA titers in individual patients during treatment with biologics, including certolizumab pegol and tildrakizumab. 111 patients were included in this study. Change in ANA was regarded as significant when the ANA titer was ×80 or more in patients with a previously undetectable ANA titer or when it increased by fourfold or more in those with a detectable ANA titer before treatment. The ratios of patients with a significant change in ANA titer who were treated with a tumor necrosis factor (TNF) inhibitor, interleukin (IL) -17 inhibitor, or IL-23 inhibitor were 34.9% (15/43), 0.0% (0/32), and 0.0% (0/36), respectively. There were 4 patterns of significant change in ANA titer: (i) an increase (n=8), (ii) a decrease after an increase (n=4), (iii) a decrease after an increase with a drug change (n=2), and (iv) an increase after a decrease after an increase (n=1). No symptom suggesting lupus syndrome was noted. ANA titers must be carefully monitored throughout treatment with biologics, especially TNF inhibitors, and the possibility of lupus-like syndrome should be excluded.

Screening for possible hypopituitarism following mild traumatic brain injury: The first all-female study. Who do we need to evaluate further?

Studies on hypopituitarism (HP) following mild traumatic brain injury (mTBI) have focused on male populations although women may be more susceptible to the sequelae of mTBI. This is, to the best of our knowledge, the first all-female study screening for HP following mTBI. Screening for possible HP in female athletes reporting a history of one or more mTBI. Pituitary hormone screening blood tests (SBT) were performed in 133 of the 151 female athletes included. Repeated results outside the reference value (O-RV) were considered abnormal necessitating further endocrinological evaluation. Repeated SBT were O-RV in 88 women (66.2%). Decreased levels of serum insulin growth factor 1 (S-IGF1) were found in 55.6% of participants and elevated levels of serum prolactin (S-prolactin) in 22.6%. Serum cortisol levels were below the RV in 6.0% and thyroid hormonal levels in 11.3%. Lower age and increased number of mTBI symptoms correlated significantly with the risk of hormonal results O-RV. The majority of the study population had SBT O-RV, warranting further workup of possible HP. Decreased levels of S-IGF1 were most commonly observed followed by elevated S-prolactin possibly indicating hypothalamic-pituitary impairment. Lower age and increased number of symptoms of mTBI may indicate the need to screen for HP.

Risk of Target Organ Damage in Children With Primary Ambulatory Hypertension: A Systematic Review and Meta-Analysis.

Target organ damage (TOD) such as left ventricular hypertrophy (LVH), abnormal pulse wave velocity, and elevated carotid intima-media thickness are common among adults with hypertension and are associated with overt cardiovascular events. The risk of TOD among children and adolescents with hypertension confirmed by ambulatory blood pressure monitoring is poorly understood. In this systematic review, we compare the risks of TOD among children and adolescents with ambulatory hypertension to normotensive individuals. A literature search was conducted to include all relevant English-language publications from January 1974 to March 2021. Studies were included if patients underwent 24-hour ambulatory blood pressure monitoring and ≥1 TOD was reported. Ambulatory hypertension was defined by society guidelines. Primary outcome was the risk of TOD, including LVH, left ventricular mass index, pulse wave velocity, and carotid intima-media thickness among children with ambulatory hypertension compared with those with ambulatory normotension. Meta-regression calculated the effect of body mass index on TOD. Of 12 252 studies, 38 (n=3609 individuals) were included for analysis. Children with ambulatory hypertension had an increased risk of LVH (odds ratio, 4.69 [95% CI, 2.69-8.19]), elevated left ventricular mass index (pooled difference, 5.13 g/m2.7; [95% CI, 3.78-6.49]), elevated pulse wave velocity (pooled difference, 0.39 m/s [95% CI, 0.20-0.58]), and elevated carotid intima-media thickness (pooled difference, 0.04 mm [95% CI, 0.02-0.05]), compared with normotensive children. Meta-regression showed a significant positive effect of body mass index on left ventricular mass index and carotid intima-media thickness. Children with ambulatory hypertension have adverse TOD profiles, which may increase their risk for future cardiovascular disease. This review highlights the importance of optimizing blood pressure control and screening for TOD in children with ambulatory hypertension. URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42020189359.

A Novel Approach on the Use of Samples from Faecal Occult Blood Screening Kits for Metabolomics Analysis: Application in Colorectal Cancer Population.

The incidence of colorectal cancer (CRC) is increasing, and currently it is the third most common cancer. Early CRC diagnosis is still difficult and relies on an invasive colonoscopy and tissue biopsy. The globally observed tendency demands non-invasive, specific, and accurate diagnostic tools for early diagnosis and prognosis. In this work, the main aim was to evaluate for the first time the feasibility of using extracts from the non-invasive sample collection from faecal occult blood (FOB) kits for its use in metabolomics studies taking advantage in this way of the high sensitivity of this technology. Then, a cohort of 131 samples from control individuals (CTL), adenoma (AD) and CRC patients were analysed using a semitargeted approach by ultra-high-performance liquid chromatography-time-of-flight-mass spectrometry (UHPLC-ToF-MS). Multivariate and univariate statistical analysis revealed that cholesteryl esters (ChoE) with polyunsaturated fatty acids (PUFAs) together with FOB were relevant metabolites that could clearly separate CRC patients from AD and CTL individuals, whereas the metabolic profiles of CTL and AD were very similar. These results are in agreement with previous findings and reveal the advantage of using the same FOBT samples for several analyses, which would facilitate sample collection and improve direct connection between FOB measurements and metabolomics analysis. Although the sample size and the number of metabolites should be enhanced to cover a wider range of metabolites, alterations in lipid metabolism clearly point out for future perspectives.

A mathematical and exploratory data analysis of malaria disease transmission through blood transfusion

Malaria is a mosquito-borne disease spread by an infected vector (infected female Anopheles mosquito) or through transfusion of plasmodium-infected blood to susceptible individuals. The disease burden has resulted in high global mortality, particularly among children under the age of five. Many intervention responses have been implemented to control malaria disease transmission, including blood screening, Long-Lasting Insecticide Bed Nets (LLIN), treatment with an anti-malaria drug, spraying chemicals/pesticides on mosquito breeding sites, and indoor residual spray, among others. As a result, the SIR (Susceptible—Infected—Recovered) model was developed to study the impact of various malaria control and mitigation strategies. The associated basic reproduction number and stability theory is used to investigate the stability analysis of the model equilibrium points. By constructing an appropriate Lyapunov function, the global stability of the malaria-free equilibrium is investigated. By determining the direction of bifurcation, the implicit function theorem is used to investigate the stability of the model endemic equilibrium. The model is fitted to malaria data from Benue State, Nigeria, using R and MATLAB. Estimates of parameters were made. Following that, an optimal control model is developed and analyzed using Pontryaging's Maximum Principle. The malaria-free equilibrium point is locally and globally stable if the basic reproduction number (R0) and the blood transfusion reproduction number (Rα) are both less or equal to unity. The study of the sensitive parameters of the model revealed that the transmission rate of malaria from mosquito-to-human (βmh), transmission rate from humans-to-mosquito (βhm), blood transfusion reproduction number (Rα) and recruitment rate of mosquitoes (bm) are all sensitive parameters capable of increasing the basic reproduction number (R0) thereby increasing the risk in spreading malaria disease. The result of the optimal control shows that five possible controls are effective in reducing the transmission of malaria. The study recommended the combination of five controls, followed by the combination of four and three controls is effective in mitigating malaria transmission. The result of the optimal simulation also revealed that for communities or areas where resources are scarce, the combination of Long Lasting Insecticide Treated Bednets (u2), Treatment (u3), and Indoor insecticide spray (u5) is recommended. Numerical simulations are performed to validate the model's analytical results.

Rhesus (Rh) blood group antigens in multiparous women attending antenatal clinic in tertiary hospital, port harcourt, Nigeria

The routine blood screening test carried out for pregnant women attending antenatal clinic in Tertiary Hospital Port Harcourt, Nigeria especially with regards to blood group system is limited to ABO/Rh D antigen screening. This cross-sectional, hospital-based study was aimed at determining the prevalence of the Rh C, c, E and e blood group antigens in multiparous women attending antenatal clinic in Tertiary Hospital Port Harcourt, Nigeria. A total of one hundred and twenty (120) pregnant females within the age range of 18-40years were recruited randomly into the study between February-June, 2022. Blood samples were aseptically collected by venipuncture into EDTA sample bottle; Rh C, c, E and e blood group antigens were assay for using microwell agglutination technique. Data generated was statistically analyzed by simple percentage calculation and defining the percentage frequency of Rh antigens. Results obtained showed the percentage distribution of 17.5% for Rh C, 89.2% for Rh c, 39.2% for Rh E and 90.8% for Rh-e. Percentage distribution of Rh antigens amongst studied population based on parity showed that G3P2 group had the highest percentage positivity of 8(6.7%) for Rh-C antigen while those carrying their first pregnancy (prime) had the highest percentage positivity of 33(27.5%), 15(12.5%) and 36(30.0%) for Rh-c, Rh-E and Rh-e respectively. Distribution of Rh antigens with respect to previous transfusion history in studied participants showed 6 (5.0%), 15 (12.5%), 6 (5.0%) and 17 (14.2%) percentage positivity for Rh-C, Rh-c, Rh-E and Rh-e respectively. This study revealed a percentage positivity of 17.5%, 89.2%, 39.2 % and 90.8% for Rh-C, Rh-c, Rh-E and Rh-e respectively with high percentage expression for Rh-c, E and e antigens found on the red cells of Antennal Women carrying their first pregnancy. Furthermore, there is a high percentage expression of Rh antigens in previously transfused pregnant women in this study. Although routine phenotyping of these blood group antigens will be a financial burden in a resource limited country like Nigeria. It is expedient and needful to take into cognizance the fact that the presence of Rh C, c, E and e antigens may likely be the cause of some delayed transfusion reactions and haemolytic disease of the foetus and new born. Therefore, there is need for the inclusion of Rh C, c, E and e in routine antigen typing for pregnant women in other to help ameliorate red blood cell alloimmunization and delayed haemolytic transfusion reaction during pregnancy. Furthermore, there is need to promulgate policies that promote the optimum stocking of Rh-e, c antigen negative blood in blood banks in the area for emergency use.

ПРЕНАТАЛЬНЫЙ И НЕОНАТАЛЬНЫЙ СКРИНИНГ НОВОРОЖДЕННЫХ

Thorough observation after childbirth and additional examination of newborns based on prenatal and neonatal screening, including the screening of blood, hearing, congenital heart defects and other organs and systems, and in case of indications for hereditary diseases - the genetic examination, does allow not only at the clinical, but also at the pre-clinical stage the planning of preventive and therapeutic measures for newborns and early-age children. This read offers a working algorithm for prenatal and neonatal screening of newborns.

The Evolution of the Safety of Plasma Products from Pathogen Transmission-A Continuing Narrative.

Chronic recipients of plasma products are at risk of infection from blood-borne pathogens as a result of their inevitable exposure to agents which will contaminate a plasma manufacturing pool made up of thousands of individual donations. The generation of such a pool is an essential part of the large-scale manufacture of these products and is required for good manufacturing practice (GMP). Early observations of the transmission of hepatitis by pooled plasma and serum led to the incorporation of heat treatment of the albumin solution produced by industrial Cohn fractionation of plasma. This led to an absence of pathogen transmission by albumin over decades, during which hepatitis continued to be transmitted by other early plasma fractions, as well as through mainstream blood transfusions. This risk was decreased greatly over the 1960s as an understanding of the epidemiology and viral aetiology of transfusion-transmitted hepatitis led to the exclusion of high-risk groups from the donor population and the development of a blood screening test for hepatitis B. Despite these measures, the first plasma concentrates to treat haemophilia transmitted hepatitis B and other, poorly understood, forms of parenterally transmitted hepatitis. These risks were considered to be acceptable given the life-saving nature of the haemophilia treatment products. The emergence of the human immunodeficiency virus (HIV) as a transfusion-transmitted infection in the early 1980s shifted the focus of attention to this virus, which proved to be vulnerable to a number of inactivation methods introduced during manufacture. Further developments in the field obviated the risk of hepatitis C virus (HCV) which had also infected chronic recipients of plasma products, including haemophilia patients and immunodeficient patients receiving immunoglobulin. The convergence of appropriate donor selection driven by knowledge of viral epidemiology, the development of blood screening now based on molecular diagnostics, and the incorporation of viral inactivation techniques in the manufacturing process are now recognised as constituting a "safety tripod" of measures contributing to safety from pathogen transmission. Of these three components, viral inactivation during manufacture is the major contributor and has proven to be the bulwark securing the safety of plasma derivatives over the past thirty years. Concurrently, the safety of banked blood and components continues to depend on donor selection and screening, in the absence of universally adopted pathogen reduction technology. This has resulted in an inversion in the relative safety of the products of blood banking compared to plasma products. Overall, the experience gained in the past decades has resulted in an absence of pathogen transmission from the current generation of plasma derivatives, but maintaining vigilance, and the surveillance of the emergence of infectious agents, is vital to ensure the continued efficacy of the measures in place and the development of further interventions aimed at obviating safety threats.

Analysis of clinical features, biochemical indices and genetic variants among children with Short/branched-chain acyl-CoA dehydrogenase deficiency detected by neonatal screening

To investigate the clinical manifestations, biochemical abnormalities and pathogenic variants among children with Short/branched-chain acyl-CoA dehydrogenase (SBCAD) deficiency detected by neonatal screening. A total of 2 730 852 newborns were screened from January 2016 to December 2021 with liquid chromatography tandem mass spectrometry. Suspected SBCAD deficiency patients were diagnosed by urine organic acid analysis and high-throughput gene sequencing analysis. The clinical, biochemical and genetic changes of the confirmed cases were analyzed, in addition with guidance for diet and life management, L-carnitine supplement, and survey of growth and intellectual development. Twelve cases of SBCAD deficiency were diagnosed, which yielded a prevalence of 1/227 571. The lsovaleryl carnitine (C5) of primary screening blood samples was between 0.6 and 2.1 µmol/L, all exceeded the normal range. C5/acety1 carnitine (C2) was between 0.02 and 0.12, with 6 cases exceeding the normal range. C5/propionyl carnitine (C3) was between 0.1 and 1.16, with 5 cases exceeding the normal range. Free carnitine (C0) was between 18.89 and 58.12 µmol, with 1 case exceeding the normal range. Three neonates with abnormal screening results were recommended to have appropriate restriction for protein intake and two were given L-carnitine. During follow-up, their C5 has ranged from 0.22 to 2.32 µmol/L, C5/C2 has ranged from 0.01 to 0.31, C5/C3 has ranged from 0.14 to 1.7. C5 or C5/C2 and C5/C3 were transiently normal in all patients except for case 8 during the neonatal screening and follow-up. C0 was 17.42 ∼ 76.83 µmol/L Urine organic acid analysis was carried out in 9 of the 12 cases, and 2-methylbutyroglycine was elevated in 8 cases. Urine organic acid analysis was carried out in 9 cases, and 2-methylbutyrylglycine was increased in 8 cases. Genetic analysis was carried out for 11 children, and in total 6 ACADSB gene variants were identified, which included 4 missense variants (c.655G>A, c.923G>A, c.461G>A, c.1165A>G), 1 frameshift variant (c.746del) and 1 nonsense variant (c.275C>G). Among these, the C.461G>A variant was unreported previously. The most common variants were c.1165A>G (40.9%) and C.275C>G (22.7%). The patients were followed up for 18 days to 55 months. Only one patient had mental retardation, with the remainders having normal physical and mental development. SBCAD deficiency is a rare disease. The detection rate of newborn screening in this study was 1/227 571. Early intervention can be attained in most asymptomatic patients through neonatal screening. In this study, the common gene variants are c.1165A>G and c.275C>G.

Voles, shrews and red squirrels as sources of tick blood meals and tick-borne pathogens on an island in southwestern Finland

Molecular identification of the previous blood meal source of a questing tick (Acari: Ixodidae) from blood meal fragments was proposed a few decades ago. Following this, several blood meal assays have been developed and published, but none of them have been taken into widespread use. Recently, novel retrotransposon-based qPCR assays designed for detecting blood meal fragments of North American host species were published. We wanted to assess their function with host species present in Finland.Questing ticks were collected by cloth dragging in August-September 2021 from an island in southwestern Finland. DNA was extracted from Ixodes ricinus nymphs (n=438) and qPCR assays applied to identify larval blood meal sources (voles, shrews and red squirrels) and screen for several tick-borne human pathogens and other microbes with pathogenic potential [Borrelia spp. (including specific assays for Borrelia afzelii, Borrelia garinii, Borrelia valaisiana), Anaplasma phagocytophilum, Babesia spp., Rickettsia spp., and Neoehrlichia mikurensis].The probability of a nymph having fed as larva on either a vole, shrew or red squirrel was 0.34 (0.30 – 0.38; 95% confidence interval). Bacteria of the genus Borrelia were the most common pathogens detected, with host-specific probabilities of carrying Borrelia of 0.30 (0.18 – 0.44) for nymphs that had fed on voles, 0.23 (0.14 – 0.35) for nymphs that had fed on shrews, and 0.42 (0.28 – 0.58) for nymphs that had fed on red squirrels. Other microbes were rarely acquired from these hosts, apart from N. mikurensis from voles.This study highlights that shrews and red squirrels may equal voles as blood meal sources for I. ricinus larvae. Overall, variation in proportions of blood meals provided by these animals may be high across even proximate study areas. All studied host species appeared to be important sources for particularly Borrelia afzelii, and voles also for N. mikurensis.

Parasite detection and quantification in avian blood is dependent on storage medium and duration.

Studies of parasites in wild animal populations often rely on molecular methods to both detect and quantify infections. However, method accuracy is likely to be influenced by the sampling approach taken prior to nucleic acid extraction. Avian Haemosporidia are studied primarily through the screening of host blood, and a range of storage mediums are available for the short- to long-term preservation of samples. Previous research has suggested that storage medium choice may impact the accuracy of PCR-based parasite detection, however, this relationship has never been explicitly tested and may be exacerbated by the duration of sample storage. These considerations could also be especially critical for sensitive molecular methods used to quantify infection (qPCR). To test the effect of storage medium and duration on Plasmodium detection and quantification, we split blood samples collected from wild birds across three medium types (filter paper, Queen's lysis buffer, and 96% ethanol) and carried out DNA extractions at five time points (1, 6, 12, 24, and 36 months post-sampling). First, we found variation in DNA yield obtained from blood samples dependent on theirstorage medium which had subsequent negative impacts on both detection and estimates of Plasmodium copy number. Second, we found that detection accuracy (incidence of true positives) was highest for filter-paper-stored samples (97%), while accuracy for ethanol and Queen's lysis buffer-stored samples was influenced by either storage duration or extraction yield, respectively. Lastly, longer storage durations were associated with decreased copy number estimates across all storage mediums; equating to a 58% reduction between the first- and third-year post-sampling for lysis-stored samples. These results raise questions regarding the utility of standardizing samples by dilution, while also illustrating the critical importance of considering storage approaches in studies of Haemosporidia comparing samples subjected to different storage regimes and/or stored for varying lengths of time.

A rare case of clinically significant naturally occurring anti-Cw reported in a healthy male donor.

Anti-Cw antibody is an immunoglobulin against the red cell antigen Cw which is a low frequency red cell antigen that belongs to the Rh antigen system. It is a clinically significant antibody and may cause haemolysis on exposure to antigen positive red cells. Due to its low frequency, it is not included in routine antibody screening panels. A 32years healthy male donor with no history of transfusion donated whole blood at the department of Transfusion Medicine & Blood Centre of our institute. As a part of routine pre-transfusion testing, the donor's samples were subjected to automated blood grouping and screening for unexpected red cell antibodies using 3 cells panel on solid-phase red-cell adherence (SPRCA) (Galileo Neo, Immucor, Norcross, USA). The antibody screening came out to be positive with a reaction in cell I of the antibody screening panel. Further the antibody was identified as anti Cw in using 16 cells panel, select cells and phenotyping. In the present case, the anti-Cw antibody was found to be reactive at 37°C and AHG phase which could lead to haemolytic transfusion reaction. The fact that the male donor had no history of transfusion or transplant led us to the conclusion that it was a naturally occurring, but a clinically significant antibody. This case highlights the importance of performing an antibody screening for healthy donors as well and urges transfusion services to procure screening cells which incorporate Cw positive cells.

Modeling the Risk of HIV Transfusion Transmission.

Blood donations are routinely screened for HIV to prevent an infectious unit from being released to the blood supply. Despite improvements to blood screening assays, donations from infected donors remain undetectable during the window period (WP), when the virus has not yet replicated above the lower limit of detection (LOD) of a screening assay. To aid in the quantitative risk assessments of WP donations, a dose-response model describing the probability of transfusion-transmission of HIV over a range of viral RNA copies was developed. An exponential model was chosen based on data fit and parsimony. A data set from a HIV challenge study using a nonhuman primate model and another data set from reported human blood transfusions associated with HIV infected donors were separately fit to the model to generate parameter estimates. A Bayesian framework using No-U-Turn Sampling (NUTS) and Monte Carlo simulations was performed to generate posterior distributions quantifying uncertainty in parameter estimation and model predictions. The parameters of the exponential model for both nonhuman primate and human data were estimated with a mean (95% credible intervals) of 2.70 × 10 -2 (7.74 × 10 -3 , 6.06 × 10 -2 ) and 7.56 × 10 -4 (3.68 × 10 -4 , 1.31 × 10 -3 ), respectively. The predicted ID 50 for the animal and human models was 26 (12, 90) and 918 (529, 1886) RNA copies transfused, respectively. This dose-response model can be used in a quantitative framework to estimate the probability of transfusion-transmission of HIV through WP donations. These models can be especially informative when assessing risk from blood components with low viral load.