Simulation of non-inherited maternal antigens acceptable HLA mismatches to increase the chance of matched cord blood units: Hong Kong’s experience

In Cord blood transplantation (CBT), the non-inherited maternal antigen (NIMA) virtual six HLA matched CB is found to have similar outcomes to six HLA inherited matched CB. Such virtual HLA matched CB units can be generated by substituting the inherited alleles with one to three NIMAs. In Hong Kong Cord Blood Bank, CB units have no NIMA defined. 100 CB samples were collected with NIMA defined. Retrospective searches of Hong Kong patients (n?=?520) were matched against the inherited and virtual HLA phenotypes of NIMA CB file. One to three NIMA matches was analyzed, virtual six HLA matches were identified for 31.7% patients, 29.4% from CB units with 5/6 HLA match with 1 NIMA match and 1.7% CB units with a 4/6 HLA match and 2 NIMA matches. However, searches in the 167,201 Bone Marrow Donors Worldwide CB units with defined NIMA did not yield similar increases, possibly due to the ethnicity differences between populations. The match performance rises from 26% to 60% after including the NIMA match. Comparing the match performance of 32% in a previous Dutch study, we calculated with 60% matching in this smaller size study. This provides a solid ground to considering NIMA in stem cell donor selection which was adopted in some centers, to be extended to Asian and local CB registries to increase the chance for matches and also to improve patient outcomes, increase the utilization of CB units, enhance clinical flexibility and signify economic intelligence.     

Using the Edinburgh postnatal depression scale to screen for perinatal anxiety

We replicated the factor structure of the anxiety subscale of the Edinburgh Postnatal Depression Scale (EPDS) in a large convenience sample of Western Australian women who participated in the beyondblue National Postnatal Depression Program. In addition, we determined an appropriate cut-off score for the anxiety subscale. Factor analyses conducted on the EPDS responses yielded depression and anxiety factors as identified in previous research. Two-factor solutions accounted for over 50% of the variance at two time frames: antenatally (N = 4,706) and at postnatal follow-up (N = 3,853). The anxiety and depression factors had similar factor structures antenatally and postnatally and were consistent with previous published findings. The concurrent validity of the anxiety subscale was demonstrated by its significant relationship to anxiety-related items on a psychosocial risk factors questionnaire. Anxiety dropped significantly from the antenatal to the postnatal time period. These findings confirm the anxiety subscale of the EPDS and point to its utility in screening for anxiety symptoms using a cut-off score ≥4 which captured the top quartile of the antenatal sample.     

Coordination of Noble Metals in Poly(vinyl mercaptoethanol) Particles Prepared by Precipitation/Emulsion Polymerization

S-Vinyl monomers react readily in radical polymerizations resulting in polymers with interesting features such as enhanced refractive indices, increased thermal stability, or the ability to coordinate various metals. Among them, vinyl mercaptoethanol (VME) can be produced in industrial scale, but the poor solubility of the resulting homopolymer limits its application. In this contribution, polymerizations of the monomer are investigated in water forming a heterogeneous system. The good solubility of the monomer in water imparts the system with mixed characteristics between a precipitation and an emulsion polymerization. Evaluating various surfactants, only polyvinyl alcohol (PVA) is found to create stable dispersions, although micrometer-sized particles are formed with a broad size distribution. Nevertheless, the particles are able to coordinate silver or gold ions. Attempts to reduce the noble metal ions by commercial reducing agents fail. However, exposure to sunlight unexpectedly results in a controlled reduction of the metal ions and the formation of composite particles. Silver ion-containing dispersions demonstrate strong antibacterial properties, while the effect is diminished in the corresponding composite. Overall, the precipitation/emulsion polymerization of VME represents a promising pathway to stable sulfur-rich polymer dispersions with the ability to coordinate metal ions or form reactive metal composites.     

Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis

To determine the accuracy of computed tomographic intravenous cholangiography (CT-IVC) for detection of choledocholithiasis. Sixty-five patients undergoing endoscopic retrograde cholangiography (ERC) underwent CT-IVC prior to ERC, using a single detector helical CT following intravenous infusion of 100 ml iotroxate. Patients with bilirubin levels >3 times normal were excluded. ERC was indeterminate in three patients (4.7%) and CT-IVC in four (6.3%). Twenty-three patients had ductal calculi at ERC, and CT-IVC was positive in 22, with two false positives and one false negative: sensitivity 95.6%, specificity 94.3%. Stones were multiple in nine and solitary in 14. Of the 14 solitary stones, ten were 5 mm and eight were 4 mm. The bilirubin level in positive cases was within normal in 20. Maximum intensity projection (MIP) reformats showed stones in only 27% of cases and surface rendered (SR) reformats in none. CT-IVC is highly accurate for detection of ductal calculi, including single small calculi, with a normal or near normal serum bilirubin. Axial images should be used for interpretation rather than MIP or SR reformats.     

Refractive errors in infancy predict reduced performance on the movement assessment battery for children at 3 1/2 and 5 1/2 years

We have previously reported that significant hyperopia at 9 months predicts mild deficits on visuocognitive and visuomotor measures between 2 years and 5 years 6 months. Here we compare the motor skills of children who had been hyperopic in infancy (hyperopic group) with those who had been emmetropic (control group), using the Movement Assessment Battery for Children (Movement ABC). Children were tested at 3 years 6 months (hyperopic group: 47 males, 63 females, mean age 3 y 7 mo, SD 1.6 mo; control group: 61 males, 70 females, mean age 3 y 7 mo, SD 1.2 mo) and at 5 years 6 months (hyperopic group: 43 males, 56 females, mean age 5 y 4 mo, SD 1.7 mo; control group: 51 males, 62 females, mean age 5 y 3 mo, SD 1.6 mo). The hyperopic group performed significantly worse at both ages, overall and on at least one test from each category of motor skill (manual dexterity, balance, and ball skills). Distributions of scores showed that these differences were not due to poor performance by a minority but to a widespread mild deficit in the hyperopic group. This study also provides the first normative data on the Movement ABC for children below 4 years of age, and shows that it provides a useful measure of motor development at this young age.