Monitoring and Management of Hemolytic Disease of the Fetus and Newborn Based on an International Expert Delphi Consensus

: The study aimed to develop structured, expert-based clinical guidance on the prenatal and postnatal management of hemolytic disease of the fetus and newborn. A Delphi procedure was conducted among an international panel of experts in fetal medicine, neonatology, and hematology. Experts were selected based on their expertise, relevant publications, and affiliations. The domains were (i) prenatal workup, (ii) prenatal monitoring and management, (iii) intrauterine transfusion, (iv) delivery, and (v) postnatal management. The pre-defined cut-off for consensus was ≥70% agreement. One hundred-seven experts representing 25 countries across six continents completed the first round, and 100 (93.5%) completed the subsequent rounds. 75.3% agreed on using cfDNA to determine fetal antigen status, particularly for RhD, Kell, and Rhc antigens. The critical titer, requiring fetal monitoring via ultrasound, is considered when the threshold of ≥16 is for non-Kell antigens. 70.0% agreed on the use of maternal IVIg in pregnancies with prior intrauterine transfusion (IUT) <24 weeks or fetal/neonatal death due to HDFN. The minimum GA for IUT is 16 to 18 weeks, and the maximum is 350/7 to 356/7 weeks. Postnatal management consensus was reached for the following: anemia labs should be investigated in the affected neonates before hospital discharge (92.0% agreement), and if they received IUT, the labs should be repeated within one week of discharge (84.0% agreement). 96.0% agreed that exchange transfusions should be centralized in hospitals with sufficient exposure and experience, and 92.0% agreed that the hemoglobin cut-off level to consider transfusion following hospital discharge is 7g/dL, and the newborns need to be monitored until 2-3 months of age (96.0% agreement)

Effects of Olive Oil and Tween 80 on Production of Lipase by Yarrowia Yeast Strains

Lipase is one of the most commonly used biocatalysts in the food, pharmaceutical and cosmetic industries, and can be produced by Yarrowia lipolytica yeast. Despite the intensive studies of lipase from Yarrowia, there are still many open questions regarding the enzyme secretion process, especially by new isolates of this genus as well as the effect of substrates or surfactants, or both on the production of lipase. This research focused on the effect of olive oil and surfactant Tween 80 including the optimisation of the concentration of these compounds on the production of lipase by some novel Yarrowia isolates. Moreover, the optimal environmental parameters (pH, temperature) of crude enzyme synthetised by Yarrowia strains were determined. All investigated strains were able to produce lipase in both intracellular and extracellular fractions. The extracellular lipase activities were higher than the intracellular ones (Y. divulgata Y.02062 and Yarrowia lipolytica 854/4 147 U/L, 80 U/L and 474 U/L, 122 U/L, respectively). In the case of extracellular lipase, supplementing olive oil and Tween 80 enhanced significantly the synthesis and secretion of the enzyme. The lipase activity can even be enhanced by 20 times higher from 25 U/L to 474 U/L in the case of Yarrowia lipolytica 854/4 strain. In the case of intracellular, supplementation of Tween 80 generally reduces lipase activity except for the Y. lipolytica 1/4 strain, which was affected by two times the increase. The optimised concentration of olive oil and Tween 80 were determined for Y. divulgata Y.02062, Y. divulgata 5257, Y. lipolytica 1/4, and Yarrowia lipolytica 854/4 strains as 1.6% olive oil and 0.09% Tween 80, 1.6% olive oil and 0.06% Tween 80, 1.4% olive oil and 0.09% Tween 80 as well as 1.6% olive oil and 0.065% Tween 80, respectively. The optimum pH and temperature of crude lipases (intra and extracellular) synthetised by the tested Yarrowia lipolytica and Y. divulgata yeast strains were found to be pH 7.2 and 37 &deg;C, respectively. Our results confirmed that the new isolate Y. divulgata is a very promising species for further development for industrial use as Y. lipolytica

Metabolic and Microbial Characterizations for the Gastrointestinal Digesta of the Zoo Colobus guereza

Abyssinian black-and-white colobus (Colobus guereza) inhabits west, central, and east Africa and lives in social groups in the rain forests. Colobus guereza has a unique foregut digestive system similar to that of ruminants and absorbs organic acids, including Short-Chain Fatty Acids (SCFAs), as energy sources derived from microbial fermentation of plant materials in the gastrointestinal tract. In this study, the gastrointestinal metabolic and microbial features of a male Colobus guereza singly housed in a zoo were characterized, and each digesta from each segment of the digestive tract was collected and subjected to biochemical, microbiome, and metagenome analyses. In this case report, high levels of acetate and propionate were observed in the foregut, while a relatively high level of lactate was detected in the small intestine. Moreover, in the hindgut and the feces, acetate was dominant compared to the other SCFAs. SCFAs analysis indicated that Colobus guereza obtains energy via SCFAs, especially acetate, fermentation in the foregut and hindgut. A metagenome analysis revealed that each part of the digestive tract of Colobus guereza has a unique microbiota. Similar to ruminants, Prevotella and Selenomonas were the dominant genera in the foregut, which may indicate microbial fermentation of plant materials in the foregut of Colobus guereza.</jats:p