Meeting the transfusion needs of a patient with anti-Ena requires an international effort.

This extraordinary case showcases the identification of a rare anti-Ena specificity that was assisted by DNA-based red blood cell antigen typing and collaboration between the hospital blood bank in the United States, the home blood center in Qatar, the blood center Immunohematology Reference Laboratory, as well as the American Rare Donor Program (ARDP) and the International Society for Blood Transfusion (ISBT) International Rare Donor Panel. Ena is a high-prevalence antigen, and blood samples from over 200 individuals of the extended family in Qatar were crossmatched against the patient's plasma with one compatible En(a-) individual identified. The ISBT International Rare Donor Panel identified an additional donor in Canada, resulting in a total of two En(a-) individuals available to donate blood for the patient.

Evaluating the TaqMan Jra-Genotyping Method for Rapidly Predicting the Presence of Anti-Jra Antibodies.

Background: The Jra antigen is a high-prevalence red blood cell (RBC) antigen. Reports on cases of fatal hemolytic disease of the fetus and newborn and acute hemolytic transfusion reactions suggest that antibodies against Jra (anti-Jra) have potential clinical significance. Identifying anti-Jra is challenging owing to a lack of commercially available antisera. We developed an alternative approach to rapidly predict the presence of anti-Jra using the TaqMan single-nucleotide polymorphism (SNP)-genotyping method. Methods: Residual peripheral blood samples from 10 patients suspected of having the anti-Jra were collected. Two samples with confirmed Jr(a-) RBCs and anti-Jra were used to validate the TaqMan genotyping assay by comparing the genotyping results with direct sequencing. The accuracy of the assay in predicting the presence of anti-Jra was verified through crossmatching with in-house Jr(a-) O+ RBCs. Results: The TaqMan-genotyping method was validated with two Jr(a-) RBC- and anti-Jra-confirmed samples that showed concordant Jra genotyping and direct sequencing results. Jra genotyping for the remaining samples and crossmatching the serum samples with inhouse Jr(a-) O+ RBCs showed consistent results. Conclusions: We validated a rapid, simple, accurate, and cost-effective method for predicting the presence of anti-Jra using a TaqMan-based SNP-genotyping assay. Implementing this method in routine practice in clinical laboratories will assist in solving difficult problems regarding alloantibodies to high-prevalence RBC antigens and ultimately aid in providing safe and timely transfusions and proper patient care.

Risk Factors for Neural-Tube Defects Detected in Utero: A Prospective Community-Based Study from Addis Ababa.

BACKGROUND: A recent community-based study from Addis Ababa identifying Neural Tube Defect (NTD) cases by ultrasound examination of pregnant women showed a higher prevalence of 17 per 1000 fetuses. The risk factors behind the high prevalence remain unclear. METHODS: Altogether 891 of the 958 women participated in the ultrasound examination. Thirteen with unaffected twin pregnancies were excluded. Among 878 singleton pregnancies, 15 NTD cases were identified. Serum Folate, vitamin B12, and homocysteine levels were measured in case-mothers and a sub-set of 28 noncase mothers. Because of the modest sample size, exact logistic regression analysis was used to estimate associations between risk factors and NTDs. RESULTS: Serum vitamin status was generally poor for participants in the study. Still, relatively higher values of folate or vitamin B12 in serum, appeared to be protective for NTD (odds ratio [OR] = 0.61 per ng/ml, 95% Confidence interval [CI]: 0.42-0.85 and OR = 0.67 per 100 pg/ml, 95% CI: 0.41-1.02, respectively). High serum homocysteine was associated with higher risk of NTD (OR = 1.3 per µmol/l, 95% CI: 1.02-1.8). Women aged 30 years or more had an OR of 3.5 (95% CI: 1.1-12) for having a NTD child, and families with NTD children had lower household income. Women in the NTD group also had more spontaneous abortions or stillbirths in previous pregnancies. Self-reported intake of folate did not appear to protect against NTDs. CONCLUSIONS: Within this high-prevalence community, poor vitamin status was identified as a risk factor for NTDs detected at ultrasound examination. Improving food security and fortification of foods or food ingredients could be alternative measures.

Canine circovirus among dogs and cats in China: first identification in cats.

Canine circovirus (CanineCV) is a virus associated with respiratory and digestive diseases in dogs and often occurs in coinfections with other pathogens, thereby aggravating the symptoms of infected dogs. CanineCV was first reported in the United States in 2012. Subsequently, it was reported among dogs in Europe, Asia, and South America. To investigate the prevalence of CanineCV in dogs in China, 331 dog samples were collected in this study. The PCR results showed that 9.06% (30/331, 95% CI = 6.2% ~ 12.7%) of the dog samples were CanineCV positive. CanineCV has also been detected in some carnivorous wild animals, indicating the potential risk of cross-species transmission of this virus. And, cats are also one of the most common pets in our daily lives, who is close contact with dogs. Thus, this study first investigated the prevalence of CanineCV in cats. The PCR results showed that 3.42% (14/409, 95% CI = 1.9% ~ 5.7%) of the cat samples were CanineCV positive. Moreover, 14 canine-derived CanineCV whole genomes and the first cat-derived CanineCV whole genome were obtained in this study. Rep and Cap are the major nonstructural proteins and structural proteins of CanineCV, respectively. In nucleic acid homology analyses, these 15 CanineCV strains showed a high degree of variation in Rep (85.9 ~ 99%) and Cap (85.6 ~ 100%). In phylogenetic analyses, the 15 CanineCV strains clustered into 3 different genotypes (genotypes 1, 3, and 4). Among them, the first cat-derived CanineCV belonged to CanineCV-3. In addition, 4 genetic recombination events were predicted in these 15 CanineCV strains, occurring in multiple regions of the genome. In conclusion, this study is the first to provide evidence of CanineCV infection in cats and successfully obtained the first whole genome of cat-derived CanineCV. The complex circulation and high prevalence of CanineCV among dogs and cats emphasize the importance of continuous monitoring of this virus in various animal species.

The evolving paradigm and current perception of hypertrophic cardiomyopathy: Implications for management.

Recent evidence from imaging and genetic screening studies has clearly shown that hypertrophic cardiomyopathy (HCM) is more common than initially perceived, emphasizing the need to reassess its associated clinical and social burden. While clinical and academic efforts have long been focused on stratification of arrhythmic risk and management of intraventricular obstruction, progression of cardiac dysfunction and heart failure-related complications have emerged as most relevant from the epidemiological standpoint, delineating a major unmet need. Furthermore, a broader perspective of our patients' needs has become central in the care of individuals with HCM, addressing issues that are not strictly clinical but equally important to their wellbeing, such as quality of life, athletic participation, lifestyle and reproductive choices and psychological adaptation to a chronic condition often detected at a young age. The appropriate evaluation and objective assessment of disease burden associated with HCM are increasingly relevant not only to management but also to trial design and evaluation of the efficacy of emerging, targeted treatments. In this review, we discuss the evolving perception of HCM prevalence and natural history, as well as recent acquisitions regarding its true, often under-appreciated socio-economic and clinical burden.

Transfusion of incompatible blood to a patient with alloanti-Sc1.

Sc1 is a high-prevalence blood group antigen that is part of the Scianna blood group system. The clinical significance of Scianna antibodies is not well understood because of their rarity; there are only a handful of cases in the literature. This scarcity of information can make it difficult to decide on the best course of action when transfusing a patient with alloantibodies to Scianna blood group antigens. We describe a case of an 85-year-old woman presenting with melena and a hemoglobin of 66 g/L. Upon request for crossmatched blood, a panreactive antibody was found, later elucidated to be alloanti-Sc1. Because of the urgent nature of the transfusion, the patient was transfused with 2 incompatible, presumed Sc1+, red blood cell units with no evidence of an acute or delayed transfusion reaction. This case has been shared with the International Society of Blood Transfusion Rare Donor Working Party, via their Outcome of Incompatible Transfusion form, and adds to the body of evidence on clinical significance of antibodies to the antigens of the Scianna blood group system.

Sociodemographic characteristics of children born to HIV-infected mothers in Western French Guiana.

BACKGROUND: French Guiana is the French department most affected by HIV. The situation in Western French Guiana is complicated by the transborder context and isolation of many patients. This study aims to describe the epidemiological characteristics of children born to mothers living with HIV followed in Western French Guiana. METHODS: This was a retrospective and descriptive study. All children born to HIV-infected mothers between 2014 and 2018 were included. Data were collected using a survey sheet to generate an Excel database. RESULTS: We recorded 177 newborns exposed to maternal HIV, four of whom (2.26 %) were infected. The majority of women (87 %) were of foreign origin, and only 7 % had conventional health insurance coverage. The infection was discovered during pregnancy in 20 % of women. Overall 21.71 % of newborns were preterm and 22.5 % hypotrophic. All neonates had received antiretroviral prophylaxis for four weeks, either as monotherapy (AZT) (67.43 %) or triple therapy (AZT/3TC/NVP) (25.71 %). Twenty-two neonates had at least one neonatal illness: transient respiratory distress (9 cases), asphyxia (3 cases), hyaline membrane disease (8 cases), and there were two cases with birth defects: clubfoot (1 case) and heart disease (1 case). The follow-up rate at 24 months was 65 % and 35 % of cases were lost to follow-up. The most common biological anomalies were anemia (69.14 %), hyperlacticaemia (23 %), and neutropenia (9.14 %). CONCLUSION: The prevalence of mother-to child transmission of HIV was high; a quarter of maternal infections were discovered during pregnancy. The mother's socio-economic situation was often precarious and follow-up interruptions common.

Incompatible red blood cell transfusion for hemolytic disease of the fetus and newborn secondary to anti-U: A case report.

BACKGROUND: Hemolytic disease of the fetus and newborn (HDFN) is a challenging condition that may necessitate the need for intrauterine or neonatal transfusion. The ability to provide compatible blood depends on antibody identification and antigen prevalence. We describe the case of a newborn that was affected by HDFN secondary to a high-prevalence antigen of unknown specificity. STUDY DESIGN AND METHODS: A 29-year-old mother underwent emergency cesarean section for fetal distress. The newborn had severe anemia and hyperbilirubinemia. Antibody screening and identification on maternal plasma revealed pan reactivity with negative autocontrol. The cord sample had the same pattern with positive Direct Antiglobulin Test. Incompatible group O red blood cells were transfused to the newborn with no complications. RESULTS: Testing the maternal sample at a reference laboratory revealed the presence of anti-U at a high titer. DISCUSSION: In life-threatening conditions, it may be necessary to transfuse incompatible units. In patients who require transfusion in the presence of an identified antibody against a high-prevalence antigen, sources for rare blood should be explored. These include autologous donations for adults, collecting blood from relatives (including mothers), and fresh or frozen units from rare donors through rare donor registries.

Identification of antibody against highly prevalent antigen through serological test and molecular biology technology / 中国输血杂志

【Objective】 To identify a case of antibody against highly prevalent antigen through molecular biology technology. 【Methods】 Blood group typing, unexpected antibody identification and cross matching were performed by serological test, and genetic testing of Diego blood group was performed by molecular biology technology. 【Results】 Serological test showed that there was a high prevalence of anti-Dib in the serum of the patient. Gene sequencing showed that the genotype of the patient was Di(a+b-) . Two cases with Di(a+b-) matched with the patient were screened from 856 blood donors. 【Conclusion】 The combined detection method based on serological test supplemented by molecular biology technology is beneficial to the detection of antibody against highly prevalent antigens, and is of great significance for ensuring the safety of clinical blood transfusion.

Risk factors of chronic kidney disease among type 2 diabetic patients with longer duration of diabetes.

Background: Chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM) is the major cause of end stage renal disease, characterized by proteinuria with a subsequent decline in glomerular filtration rate. Although hyperglycemia is the major risk factor for the development and progression of kidney disease among diabetic patients, many other risk factors also contribute to structural and functional changes in the kidneys. As recommended by Kidney Disease Improving Global Outcomes (KDIGO), CKD classification based on cause and severity, links to risk of adverse outcomes including mortality and kidney outcomes. Objective: The aim of this study is to investigate the involvement of risk factors associated with the severity of CKD among participants with longer duration of diabetes. This study also aims to find whether number of risk factors vary among risk of CKD progression categories based on KDIGO classification. Material and methods: This cross-sectional study retrospectively selected 424 participants from type 2 diabetic cohort and categorized them based on the classifications for the diagnosis of kidney diseases in patients with diabetes, according to the KDIGO guidelines. Odds ratios and 95% CI of each risk factors according to severity of renal disease were determined. Results: Based on KDIGO classification, participants with type 2 diabetes (T2D) were categorized in to low risk (n=174); moderately increased risk (n=98); and high/very high risk (n=152). Type 2 diabetic participants with risk factors such as, hyperlipidemia, hypertension, DM duration ≥15 years and diabetic retinopathy showed a high/very high risk of CKD progression when compared with low-risk category. While T2D participants with risk factors such as, lack of exercise, hypertension, and diabetic retinopathy showed a moderately increased risk of CKD progression. In addition, participants with highest number of risk factors were significantly distributed among high/very high risk of CKD progression category. Conclusion: This study findings conclude that patients with T2DM and duration of ≥15 years, hyperlipidemia, hypertension and diabetic retinopathy have an increased prevalence of advanced CKD. In addition to this, increased number of risk factors could be an indicator of the severity of CKD in T2D.

High prevalence of spotted fever group rickettsiae in ticks collected from yaks (Bos grunniens) in Shiqu county, eastern Tibetan Plateau, China.

Tick-borne diseases have become a global health concern in recent decades. Spotted fever group (SFG) rickettsiae have been recognized as important pathogens of human tick-borne diseases worldwide. In this study, Dermacentor everestianus (n = 646) and Haemaphysalis qinghaiensis (n = 172) ticks were collected from yaks (Bos grunniens) in Shiqu county, eastern Tibetan Plateau, China. SFG rickettsiae were identified and characterized in these ticks. A total of 49.9% (408/818) ticks were infected by Rickettsia spp. with infection rates of 58.1% (100/172) and 46.7% (308/646) detected in H. qinghaiensis and D. everestianus ticks, respectively. Furthermore, 95% of Rickettsia spp. were Rickettsia raoultii-like bacteria, and 5% were related to Candidatus Rickettsia longicornii. To the best of our knowledge, this is the first time that SFG rickettsiae infections were firstly reported in Shiqu county for these tick species. Our results indicated that H. qinghaiensis and D. everestianus ticks from Shiqu county became highly infected with a R. raoultii-like bacteria during their feeding process. This observation is alarming because of the zoonotic potentiality of these species. Overall, the present study detected a widespread of R. raoultii-like bacteria in ticks that are considered a serious threat to domestic animals and humans in Shiqu county. The prevalence of R. raoultii-like bacteria in human and wildlife hosts should be further investigated in the future.

Prevalence of gaming disorder in East Asia: A comprehensive meta-analysis.

Background and aims: Asian countries are deemed to be high prevalence areas for gaming disorder (GD). This meta-analysis is the first to synthesize the overall prevalence of GD in East Asia and investigate characteristics that influence prevalence estimates. Methods: Systematic and independent searches were conducted across PubMed, Web of Science, Embase, PsycINFO, and the Cochrane Library since their inception to January 27, 2021. The Agency for Healthcare Research and Quality scale was used for quality assessment. A random effect model was used to calculate the overall GD prevalence and 95% confidence intervals (CIs). Results: In total, 22 articles (26 studies) comprising 51,525 participants were included in this meta-analysis. The overall pooled prevalence of GD in East Asia was 12%, 95% CI (10%-15%); this figure was adjusted to 6%, 95% CI (3%-9%) for a representative sample. Higher prevalence was observed in males than in females (16% vs. 8%, respectively, P < 0.05). Subgroup and meta-regression analyses revealed that studies among gamers or those without random sampling reported significantly higher prevalence rates. There were no significant differences between countries/regions, sample size, quality score, proportion of males, and scale used. Discussion and conclusions: The prevalence of GD in East Asia is higher than that in other world regions. Future studies should extend such epidemiological research to other regions to calculate the accurate prevalence of GD to benefit the local identification, prevention, policy formulation, and treatment efforts. Considering its negative effects, effective preventive and treatment measures for GD in East Asia need greater attention.

Unexpected antibody against the high-prevalence P antigen before cardiac surgery.

P is a high-prevalence antigen present in 99.9 percent of the population and is fully developed at birth. P- individuals form naturally occurring antibodies against P, which are often of immunoglobulin (Ig)M and/or IgG type, very potent in complement activation, and able to cause serious intravascular hemolytic transfusion reactions. Some people with anti-P have the rare P1 k phenotype, which lacks P in the presence of P1 and Pk. Blood transfusion in patients with anti-P is challenging, as is described here. A male patient without a history of blood transfusion was admitted for a planned cardiac surgery. The preoperative ABO blood group could not be determined because of unexpected reactions in the reverse grouping, and all red blood cells (RBCs) in the antibody detection test were positive, except for the autocontrol. Further analysis of the patient's sample confirmed the presence of the P1 k phenotype, and anti-P was identified. If transfusion was needed, P- blood would be required, and the only P- RBCs available were at the national Sanquin Bank of Frozen Blood. These units are limited, expensive, and only available for 48 hours after thawing. In the case of massive blood loss, first ABO and Rh-compatible units should be transfused, followed by P- units after the bleeding stops. In our case, the surgery was conducted without transfusion. This case illustrates the importance of preoperative ABO blood group testing and antibody screening in cases where blood loss can be expected. In recent years, more focus has been put on patient blood management. A good collaboration between the local laboratory, surgery department, and dedicated blood transfusion laboratory is critical to prevent unnecessary incompatible blood transfusions with potentially serious outcomes.

A new high-prevalence LW antigen detected by an antibody in an Indigenous Australian homozygous for LW*A c.309C>A variant.

BACKGROUND AND OBJECTIVES: The LW gene encodes the LW glycoprotein that carries the antigens of the LW blood group system. LW antigens are distinct from D antigen, however, they are phenotypically related and anti-LW antibodies are often mistaken as anti-D. An antibody was detected in an Australian patient of Aboriginal descent who consistently typed as LW(a+b-). This study aimed to describe the antibody recognizing a high-prevalence antigen on the LW glycoprotein. STUDY DESIGN AND METHODS: Samples from the patient and her four siblings were investigated. DNA was genotyped by single nucleotide polymorphism (SNP)-microarray and massively parallel sequencing (MPS) platforms. Red blood cells (RBCs) were phenotyped using standard haemagglutination techniques. Antibody investigations were performed using a panel of phenotyped RBCs from adults and cord blood cells. RESULTS: SNP-microarray and MPS genotyped all family members as LW*A/A, (c.299A), predicting LW(a+b-). In addition, a novel LW*A c.309C>A single nucleotide variant was detected in all family members. The patient and one of her siblings (M4) were LW c.309C>A homozygous. Antibody from the patient reacted positive to all reagent panel RBCs and cord blood cells but negative with RBCs from LW(a-b-), Rhnull and sibling M4. Antibody failed to react with RBCs treated with dithiothreitol. CONCLUSION: Antibody detected in the patient recognized a novel high-prevalence antigen, LWEM, in the LW blood group system. LWEM-negative patients who developed anti-LWEM can be safely transfused with D+ RBCs, however, D- is preferred. Accurate antibody identification can help better manage allocation of blood products especially when D- RBCs are in short supply.

Yes, MAM: how the cancer-related EMP3 protein became a regulator of erythropoiesis and the key protein underlying a new blood group system.

The MAM blood group system (International Society of Blood Transfusion [ISBT] 041) consists of one high-prevalence antigen to date, first detected in a 31-year-old woman during her third pregnancy. Epithelial membrane protein 3 (EMP3) was recently identified as the gene coding the MAM antigen. Six unique genetic variants have been described in EMP3 in 11 MAM- individuals. EMP3 is an 18-kDa glycoprotein with a large extracellular domain containing at least one N-glycosylation site. The normal function of EMP3 is still unclear, but ex vivo culture of erythropoietic progenitor cells from MAM- individuals shows an increased yield of reticulocytes, suggesting that EMP3 acts as a brake during normal erythropoiesis. EMP3 is abundant on different cell types, including many epithelial tissues and blood cells. Interestingly, EMP3 expression has been suggested as a prognostic marker for a number of cancer types, both for good and poor prognoses. EMP3 may act as a tumor suppressor or an oncogene in different cancer contexts. The protein appears to interact with other cell surface receptors and affects the downstream signaling and function of these proteins. MAM- red blood cells express low levels of CD44 and, consequently, the antigens of the Indian blood group system are only weakly expressed. Clinically, the MAM blood group antigen is important with regard to blood transfusion and pregnancy. Anti-MAM can cause severe hemolytic disease of the fetus and newborn in some pregnancies but have little to no effect in other pregnancies. Cases are typically not detected until problems occur during pregnancy, making the availability of compatible blood a challenge.

Awareness, acceptability, and intention to initiate HIV pre-exposure prophylaxis among pregnant women.

HIV prevention is critically important during pregnancy, however, pre-exposure prophylaxis (PrEP) is underutilized. We conducted a survey of pregnant and non-pregnant women in a high HIV prevalence community in Washington D.C. to evaluate determinants of PrEP initiation during pregnancy. 201 pregnant women and a reference population of 1103 non-pregnant women completed the survey. Among pregnant women, mean age was 26.9 years; the majority were Black with household-incomes below the federal poverty level. Despite low perceived risk of HIV acquisition and low prior awareness of PrEP, 10.5% of respondents planned to initiate PrEP during pregnancy. Pregnant women identified safety, efficacy, and social network and medical provider support as key factors in PrEP uptake intention. The belief that PrEP will "protect (their) baby from HIV" was associated with PrEP uptake intention during pregnancy. Concerns regarding maternal/fetal side effects, and safety in pregnancy or while breastfeeding were not identified as deterrents to uptake intention. When compared to a nonpregnant sample, there were no significant differences in uptake intention between the two samples. These findings support the need for prenatal educational interventions to promote HIV prevention during pregnancy, as well as interventions that center on the role of providers in the provision of PrEP.

HDFN Resulting from Anti-U: Alternatives to Allogeneic Intrauterine Transfusion.

Hemolytic disease of the fetus and newborn (HDFN) carries significant fetal mortality risks. Although anti-D as a source of HDFN has been prevented for decades using D-specific immunoglobulin to prevent alloimmunization between fetus and mother, minor blood groups may still result in disease, with potentially disastrous consequences if left untreated. Strategies such as intrauterine transfusion, early delivery, and vigilant serologic monitoring of fetal anemia have been the standards of care for alloimmunized patients, but beyond this not much more is possible. Mothers with rare phenotypes who are alloimmunized against extremely common red blood cell antigens may find access to rare antigen-negative blood units limited. This case study presents a healthy G10P6 woman with known anti-U presenting for treatment via intrauterine transfusion in the second trimester and follows the patient through successful delivery. Difficulties in obtaining rare blood for the patient because of concomitant delivery events involving 2 patients with anti-U at the facility opened discussions about the difficulties of and alternatives to intrauterine transfusion where rare blood phenotypes are involved.

Orofacial Clefts in High Prevalence Area of Birth Defects - Five Counties, Shanxi Province, China, 2000-2020.

WHAT IS ALREADY KNOWN ON THIS TOPIC?: The prevalence of structural birth defects, especially neural tube defects, decreased after national folic acid (FA) supplementation initiation. WHAT IS ADDED BY THIS REPORT?: The prevalence of orofacial clefts (OFCs) in five counties of Shanxi Province in northern China, including most subtypes except cleft palate, showed a downward trend in the past two decades. In this study, pre-perinatal prevalence increased due to earlier detection. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Periconceptional supplementation with FA may contribute to the decline in OFCs prevalence, while the effect on the OFCs subtype needs further investigation. Continuing to advocate for earlier supplementation (3 months before conception) and increased supplementation frequency (daily consumption) could promote further reduction in the prevalence of OFCs. Specific surveillance of this effect in the era of universal three-child policy is warranted.

Identification and Virulence of Cordyceps javanica Strain wf GA17 Isolated From a Natural Fungal Population in Sweetpotato Whiteflies (Hemiptera: Aleyrodidae).

A new strain of the entomopathogenic fungus, identified as Cordyceps javanica (Frieder. & Bally) Kepler, B. Shrestha & Spatafora (Hypocreales: Cordycipitaceae) wf GA17, was found naturally infecting the sweetpotato whitefly, Bemisia tabaci (Gennadius) MEAM1 in southern Georgia, US, in September 2017. The fungus was tested for pathogenicity and virulence in comparison with commercially available entomopathogenic fungal strains against several insect species in the laboratory. In specific, it was compared with Cordyceps fumosorosea (Wize) Kepler, B. Shrestha & Spatafora (Hypocreales: Cordycipitaceae) Apopka 97, Beauveria bassiana (Bals.-Criv.) Vuill. (Hypocreales: Cordycipitaceae) strain GHA, and Metarhizium brunneum Petch (Hypocreales: Clavicipitaceae) strain F52 for virulence against B. tabaci (4th instars) and cotton aphid, Aphis gossypii Glover (Hemiptera: Aphididae) (4th instars with or without wingbuds), on leaf-discs, and against last instars of pecan weevil Curculio caryae (Horn) (Coleoptera: Curculionidae) and citrus root weevil Diaprepes abbreviatus (L.) (Coleoptera: Curculionidae) in soil cups. Against B. tabaci, C. javanica exhibited higher mortality and mycosis development at 5 d post inoculation than other fungi. In assays against A. gossypii with and without wingbuds, C. javanica and C. fumosorosea had the highest mortality and mycosis levels and B. bassiana had the lowest; nymphs with wingbuds were more susceptible to some fungal infection than those without. Against C. caryae, B. bassiana was more effective than other fungi. For D. abbreviatus, B. bassiana also caused the highest mortality while M. brunneum had the lowest, with Cordyceps spp. being intermediate. Overall, the findings suggest high potential of the new strain, C. javanica wf GA17, for managing whiteflies and aphids, while it was not as effective as B. bassiana against the curculionids.

Maternal red blood cell alloimmunisation Working Party, literature review. RH blood group system: Rare specificities.

This report is part of a series reporting the GRADE review performed by the 2018-2020 French Working Party on maternal red blood cell alloimmunisation. This report focusses on the clinical significance in obstetrics, as published in the scientific literature, of the rare RH antibodies, variants and antigens (i.e. excluding conventional RH1 trough RH8 antigens, RH12, RH22 and RH27, which are discussed in other reports of this series). Extremely severe or severe haemolytic disease of the fetus and the newborn (HDFN), leading to death or requiring transfusions, have been reported for: anti-RH1 (-D) associated with DVI, DBT and DIVb phenotypes, RHD*12.04 (DOL4), RHD*03.03 (DIIIc), RHD*D-CE(2-5)-D, RHD*01EL.31 (RHD*148+1T), anti-RH9 (-CX), anti-RH11 (-EW), anti-RH17 (-Hr0), anti-RH18 (-Hr), anti-RH19 (-hrS), anti-RH23 (-DW), anti-RH29 ("total" Rh), anti-RH30 (-Goa), anti-RH32, anti-RH34 (-HrB), anti-RH36 (-Bea), anti-RH40 (-Tar), anti-RH46 (-Sec), anti-RH48 (-JAL), anti-RH54 (DAK), and antibodies to high prevalence antigens such as those associated with RHCE*02.08.02 (RHCE*CW-RHD(6-10)), RHCE*03N.01 (RHCE*cEMI). HDFN of moderate, mild or undetailed severity have been reported for: anti-RH1 associated with DHar, DIIIa and DIVa phenotypes, RHD*01EL.08 (RHD*486+1A),RHD*01EL.44 (RHD*D-CE(4-9)-D),RHD*25 (DNB), anti-RH20 (-VS), anti-RH31 (-hrB), anti-RH37 (-Evans), ani-RH42, anti-RH49 (-STEM), anti-RH51 (-MAR), anti-RH55 (-LOCR), anti-RH58 (-CELO). Positive direct antiglobulin test in the newborn but no clinically significant HDFN has been reported for anti-RH1 (-D) associated with RHD*10.05 (DAU5), RHD*12.02 (DOL2). Because so many specificities are associated with severe HDFN in the RH system, all RH antibodies should be considered as potentially able to cause HDFN, even if none has been reported yet.