Premature Loss Research Articles

Destinul unei cărți, oglindit în presa vremii. Elena Niculiță-Voronca, Datinele și credințele poporului român adunate și așezate în ordine mitologică (1903)

In the main table of contents that “Junimea literară” (Chernivtsi, the first series, 1904–1914) publishes in the first years, there is a section entitled “Folcloristică” (1905), then “Folclor” (1906) and “Folklor” (1907), where there are mentioned well-known names at the time: Sim. Fl. Marian, Dimitrie Dan, I. G. Sbiera, Elena Niculiță-Voronca, Artur Gorovei, but also many unknown people in this field of folklore. Since 1908, this section hadn’t been in the contents anymore and the explanation for giving it up is, undoubtedly, related to the premature loss of Sim. Fl. Marian, the editorial board of the magazine thus recognizing that he was the only one who, by his own signature and valuable folklore materials, actually gave meaning to this section. Changing its entitlings through numerous and valuable published writings that it comprised, the section offered its readers (between 1904 and 1907) an appropriate image about the folkloristic activity of the time in Bukovina. In 1903, in Chernivtsi appears the volume Datinile și credințele poporului român adunate și așezate în ordine mitologică written by Elena Niculiță-Voronca. Surprinsingly, there is almost nothing written about it in the pages of “Junimea literară”. It is only at the beginning of 1905 that it is mentioned, in fact, as a literature volume for youth, Zece povești scoase din cartea Datinile și credințele poporului român in the author’s publishing house (Mihalcea, Chernivtsi, 1905, p. 75). The distinguished folklorist is worth being recognized rather for continuing writing didactic literature for youth. What are the possible explanations for this ignorance/misunderstanding in her native town, in Chernivtsi, of the editorial appearance of an author considered “one of the most important leaders and most prolific authors when speaking about folklore?” Especially when the author desired to be awarded with an Academy prize? Her very writing in the only literary magazine of the moment in Bukovina is “discreet” in comparison with the above assessment. I also asked myself to what extend the press of the time (from Bukovina and from Romania too, in which Elena Niculiță-Voronca published more constantly) could clear up through possible articles about the book and on how the appearance of this monumental volume was received, or on the contrary, if by not by promoting the book she did not contribute to the unfortunate fate that until recently had followed the collection of the author from Bukovina.

Millennium-old pathogenic Mendelian mutation discovery for multiple osteochondromas from a Gaelic Medieval graveyard.

Only a limited number of genetic diseases are diagnosable in archaeological individuals and none have had causal mutations identified in genome-wide screens. Two individuals from the Gaelic Irish Medieval burial ground of Ballyhanna, Co. Donegal, showed evidence of bone tumours consistent with the autosomal dominant condition multiple osteochondromas. Genome sequencing of the earlier individual uncovered a missense mutation in the second exon of EXT1, a specific lesion that has been identified in several modern patients. The later individual lacked this but displayed a novel frameshift mutation leading to a premature stop codon and loss of function in the same gene. These molecular confirmations of a paleopathological diagnosis within a single rural ancient context are surprisingly disjunct, given the observation of clusters of this disease in modern isolated populations and a de novo mutation rate of only 10%.

Beneficial Effects of Traditional Chinese Medicine in the Treatment of Premature Ovarian Failure.

Premature ovarian failure (POF) is characterized by hormonal disorders, amenorrhea, and premature loss of fertility potential in women of reproductive age. Several studies have been conducted on the effectiveness of traditional Chinese medicine (TCM) in treating POF. TCM relied primarily on apoptosis, immunity, and aging to treat POF based on the studies of domestic and foreign literature. Zuogui pills inhibited mitochondrial-dependent apoptosis in the treatment of POF. Huyang Yangkun formula regulated the downstream of the Bcl-2 family to resist apoptosis through the aquaporin-1 protein. Modified Bazhen decoction regulated apoptosis in POF by regulating X-linked inhibitors of apoptosis protein. Bushen Tianjing recipe was effective in treating POF by promoting angiogenesis and preventing apoptosis. As for immunity, Bushen Jianpi prescription and Er-Xian decoction cured autoimmunity POF models and increased follicular development-related protein expression. Bushen Huoxue Tang improved ovarian function and reduced ovarian inflammation by regulating the Nrf2/Keap1 signaling pathway and T lymphocytes. Taohong Siwu decoction promoted the proliferation and differentiation of granulosa cells of POF mice by regulating the TGF-β1/Smads signaling pathway. In addition, ginsenoside Rg1 and Jiajian Guisheng formula treated POF by regulating cell aging-related mechanisms. Si Wu Tang treated POF by activating the angiogenesis-related proteins. The goal of this review is to serve as a reference for in-depth research into the treatment of POF with TCM and provide inspiration for new diagnostic methods and treatment options.

Bone mineral density among virologically suppressed Asians older than 50 years old living with and without HIV: A cross-sectional study.

There are limited data regarding bone health in older people living with HIV (PWH), especially those of Asian ethnicity. We aimed to determine whether BMD in well-suppressed HIV-infected men and women aged ≥ 50 years are different from HIV-uninfected controls. In a cross-sectional study, BMD by dual-energy X-ray absorptiometry and calciotropic hormones were measured. A total of 481 participants were consecutively enrolled (209 HIV+ men, 88 HIV- men, 126 HIV+ women and 58 HIV- women). PWH were on average 2.5 years younger [men: 55.0 vs. 57.5 yr; women: 54.0 vs. 58.0 yr] and had lower body mass index (BMI) [men: 23.2 vs. 25.1 kg/m2; women: 23.1 vs. 24.7 kg/m2] compared to the controls. The median duration since HIV diagnosis was 19 (IQR 15-21) years in men and 18 (IQR 15-21) years in women. Three-quarters of PWH had been treated with tenofovir disoproxil fumarate-containing antiretroviral therapy for a median time of 7.4 (IQR 4.5-8.9) years in men and 8.2 (IQR 6.1-10) years in women. In an unadjusted model, HIV+men had significantly lower BMD (g/cm2) at the total hip and femoral neck whereas there was a tend toward lower BMD in HIV+women. After adjusting for age, BMI, and other traditional osteoporotic risk factors, BMD of virologically suppressed older PWH did not differ from participants without HIV (P>0.1). PWH had lower serum 25(OH)D levels but this was not correlated with BMD. In conclusion, BMD in well-suppressed PWH is not different from non-HIV people, therefore, effective control of HIV infection and minimization of other traditional osteoporosis risk factors may help maintain good skeletal health and prevent premature bone loss in Asian PWH. Clinical trial registration: Clinicaltrials.gov # NCT00411983.

3-D Printed space maintainers - A review

Although the idea of a digital workflow is not new in dentistry, it has just recently started to be applied in pediatric dentistry. Fabrication of space maintainer is a time-consuming procedure that needs constant communication with the laboratory to be receive and provide patients the best outcomes. These devices maintain space created by premature tooth loss so that the erupting permanent teeth will not experience any kind of malocclusion As a result of clinician's natural curiosity 3-D printed space maintainer have been developed. The advanced CAD/CAM technology used for fabricating digital space maintainers improves patient experience and compliance. The current paper provides an insight on available conventional space maintainers and various aspects of technologically advanced digitainers.

The Molecular Pathophysiology of Ineffective Erythropoiesis at Single Cell Resolution

The anemias of myelodysplastic syndrome (MDS) and Diamond Blackfan anemia (DBA) are generally macrocytic, always reflect ineffective erythropoiesis, and yet result from diverse genetic mutations. To delineate the shared mechanisms that lead to the death of maturing erythroid cells, we studied single marrow cells from MDS-5q patients, DBA patients, and normal individuals with CITE-seq (antibody barcoding of cell surface proteins) and RNA sequencing. After testing several approaches, we opted to align transcriptomes with SCVelo pseudotime analysis, which includes incompletely processed mRNAs, since these are highly prevalent and regulated during erythropoiesis. We identified 38,296 erythroid lineage cells then plotted CITE-seq protein quantitation data versus the velocity pseudotime to identify BFU-E through orthochromatic erythroblasts based upon the sequential CD117, CD36, CD71, and GlyA expression levels, using well-established criteria. The analysis identified two distinct transcriptional trajectories. These diverge during the CFU-E stage, following upregulation of the transferrin receptor, CD71, and initiation of iron import, and right after upregulation of ALAS2, the first and rate-limiting step of heme synthesis. The normal (healthy) trajectory (trajectory A) contains cells at all stages, including the late stages of erythroid maturation, and there is high expression of mitochondrial oxidative metabolism and erythroid differentiation pathway genes. In contrast, the second trajectory (trajectory B) ends abruptly near the start of terminal erythroid differentiation as defined by cell surface proteins, and highly expresses gene pathways associated with excess heme and with apoptosis. There is loss of mitochondrial gene expression, premature loss of nuclear gene expression (increased % mitochondrial genes), and elevated levels of BAX and other apoptosis markers, implying that this is a death pathway. The significant increase in expression of genes in the heme-responsive dataset defined by Liao et al (Cell Rep. 2020. 31:107832) in trajectory B cells along with the pathway analysis, suggests that DBA and MDS-5q erythroid cells died from heme toxicity, a finding supportive of our earlier work (Yang et al. Sci Transl Med 2016. 8:338ra67). Cells along each trajectory were present in all samples but at different frequencies: 57±4% of MDS-5q, 73±2% of DBA, and 24±12% of normal cells followed trajectory B. That 24±12% of normal cells followed trajectory B was an unexpected finding, and indicated that heme might regulate the ineffective vs. effective differentiation of normal, as well as DBA and MDS-5q cells. As a corollary, drugs or interventions decreasing heme synthesis might modulate trajectory choice and be therapeutically beneficial. Also notably, fate decisions occur well before cell death, allowing time for therapeutic intervention. In addition, since we can independently track the fate and transcriptomes of cells with an intact chromosome 5q vs. cells with chromosome 5q deletion, these experiments provide insight into why anemia occurs early in MDS-5q (i.e., at presentation) often only 50-75% of the marrow is replaced by neoplastic cells. The analysis revealed both 5q- and 5q+ cells show early upregulation of HIF1A targets, ROS response, cell cycle regulation and spliceosome pathways and down regulation of erythroid differentiation and mTOR signaling pathways, indicating both 5q- and 5q+ cells share common pathologies. Additionally, the 5q- cells upregulate p53 pathways. The fact that the 5q+ cells are not normal implies that the presence of neoplastic 5q- cells influence the erythroid differentiation of the 5q+ cells. That they too have transcriptomic findings attributable to excessive heme may suggest a cell-extrinsic role for heme toxicity, which has led us to study heme processing by the central macrophage of erythroblastic islands (EBIs). Initial studies suggest EBI macrophage dysfunction contributes to the poor differentiation of 5q+ cells. This abstract includes data available on the medRxiv preprint server. https://doi.org/10.1101/2022.08.01.22278133

Rhees and the distinction between religion and science

AbstractA sharp distinction between religion and science is, it is argued here, implicit in Rush Rhees's thought. This distinction is, moreover, underpinned by a view of philosophy as purely descriptive, which Rhees shares with Wittgenstein. The first half of this paper criticises both the distinction and this view of philosophy. The second half is constructive rather than critical. A pattern of reasoning in religion is explored, which offers a possibility of insight to those afflicted by the tragic and premature loss of loved ones; a pattern of a kind which is effectively denied by Rhees. Logical relations between this reasoning in religion and reasoning in physics are then discussed, which lend further support to the earlier critical arguments. These relations also exhibit aspects of the coherence of the conception of the world as a divinely created Cosmos, which is consistent with classical theism.

ODP629 A Case of Juvenile Onset Hypophosphatasia Diagnosed In An Elderly Patient With Recurrent Fractures.

Abstract Background Hypophosphatasia (HPP) is a rare genetic disorder characterized by defective bone mineralization. Here we report a case of juvenile onset HPP in an elderly man. CASE A 77-year-old man presented for management of osteoporosis. He complained of joint pains and trouble walking. He had recurrent non-traumatic fractures since his teenage years and he and his sister were diagnosed with childhood rickets. He sustained fractures of both forearms, right ankle, right hip and left femoral neck, and had undergone right hip replacement and left femoral neck internal fixation. In his 20's, following a MVA he had several tooth extractions and eventually required dentures. He was misdiagnosed with osteogenesis imperfecta, vitamin D deficient osteomalacia and pseudogout, and had been treated with cholecalciferol and alendronate in the past. On exam, we noted a waddling gait, short stature and bowing of his knees. Labs revealed normal vitamin D 25-OH 48 ng/mL (30-100), and PTH 18 pg/mL (14-64), borderline corrected calcium 10.5 mg/dL (8.4-10.6) and elevated phosphorous 4.4 mg/dL (2.2-4.3). ALP was notably low 30 U/L (40-150) and had ranged between 15-46 U/L since 2009. These findings caught our attention and we ordered Vitamin B6 levels which were elevated >250. 0 ng/mL (2.1-21.7). Genetic testing identified two ALPL gene variants, a rare C.340G>A variant and a c.571G>A variant which has been found to be causative of HPP. His DXA scan showed normal L-spine (T-score 3.3) and significantly decreased BMD of the proximal 1/3 of the left forearm (T-score -4.4). Hip and femur were not assessed due to presence of hardware. He is scheduled to start treatment with Asfotase alfa. Conclusion HPP is caused by ALPL gene mutations, which lead to loss of function of the enzyme tissue nonspecific alkaline phosphatase (TSNALP). Clinical manifestations such as seizures, recurrent fractures and premature dental loss are observed. Pseudogout may occur due to intraarticular calcium pyrophosphate deposition, as in our patient. Characteristic lab findings are elevated metabolites of TNSALP, including urine inorganic pyrophosphate (PPi) and serum pyridoxal 5'phosphate (PLP) (biologically active metabolite of vitamin B-6). A persistently low ALP is most suggestive and may be a clue for early referral. Genetic testing is confirmatory, but novel mutations may be missed. Delayed diagnosis in our patient led to increased morbidity, potentially avoidable surgeries and inappropriate treatment with bisphosphonate which are contraindicated as they may increase risk for atypical fractures. Asfotase alfa is a TNSALP enzyme replacement therapy designed to address the underlying cause of HPP and studies show improvement in bone mineralization, fracture healing, decreased concentration of PLP and PPi, and improved physical function and quality of life. Cost and availability remain a barrier to many patients. Presentation: No date and time listed

ODP057 The Unusual Case of Hypercortisolism in a Patient with Juvenile Onset Hypophosphatasia

Abstract Juvenile onset hypophosphatasia is a rare, genetic disease that is caused by inactivating mutations in the ALPL gene which encodes tissue non-specific alkaline phosphatase (TNSALP). This leads to decreased activity of the TNSALP enzyme in target tissues and accumulation of TNSALP substrates, including inorganic pyrophosphate, an inhibitor of mineralization. This disease is characterized by low levels of alkaline phosphatase in serum and bone, osteomalacia, and periodontal disease. Patients with juvenile onset hypophosphatasia present with premature loss of primary teeth, delayed walking, and a waddling gait. These symptoms may improve spontaneously after puberty and recur later in life. Here we report the case of a 51 year old male who presented initially to endocrinology clinic with a metatarsal stress fracture with subsequent diagnosis of osteoporosis, periodontal infections, and associated myopathy and joint calcifications. The patient also had a prior history of a low alkaline phosphatase level as a child. Genetic testing showed a single variant of undetermined significance found in the ALPA gene. Of note, recent lab work for the patient showed AM cortisol 27.7 mcg/dL (reference range 4. 0-22. 0 mcg/dL) with ACTH 60 pg/mL (reference range 6 - 50 pg/mL). Prior 24 hour urine free cortisol measurements with LC/MS have demonstrated elevated values 159 mcg/24 hr and 256 mcg/24 hr (reference range 4. 0 - 50. 0 mcg/24 hr) . However, most recent testing demonstrated 24 hour urine free cortisol 3.6 mcg/24 hr, and the majority of midnight salivary cortisol tests were within normal. Pituitary MRI demonstrated no abnormalities. The patient has in the past reported findings of a dorsocervical fat pad, abdominal striae, and weight gain. There is no history of diabetes mellitus or hypertension, and the patient at this time reports stable weight without current presence of a fat pad or striae. There are no clinical features of Cushing's syndrome on exam. To our knowledge, this is the second case in the literature detailing hypercortisolism in a patient with hypophosphatasia. The etiology of the hypercortisolism is likely multifactorial, with unknown association with hypophosphatasia. Based on the clinical data it appears that the patient's chronic stress, pain, and anxiety are contributing to the hypercortisolism, and that this is not a true Cushing's or cyclical Cushing's case. Repeated midnight salivary cortisol tests have excluded the possibility of Cushing's as well. Presentation: No date and time listed

Children’s satisfaction and survival rate of fiber-reinforced space maintainer versus band and loop space maintainer in children with premature loss of maxillary primary first molar

Background: Band and loop space maintainer (BLSM) are well tolerated and long-lasting appliances, but it comes with several drawbacks, including longer lab times, more frequent cement loss dislodgements, longer visits, and the inability to avoid the rotation or tilting of neighboring teeth. These limitations motivate the search for alternative appliance such as fiber-reinforced space maintainers. Aim of the study: Evaluation of children’s satisfaction and survival rate of fiber-reinforced space maintainer versus band and loop space maintainer in children with premature loss of maxillary primary 1st molar. Materials and Methods: Thirty patients, randomly divided into two groups (n=15). BLSM group: which included (15) patients who receive band and loop space maintainer. FRSM group: which included (15) patients who were received fiber-reinforced space maintainer. The patients were evaluated for satisfaction based on Likert -type scale and survival rate. Results: The FRSM group showed a higher satisfaction score than BLSM group. For survival rate the fiber-reinforced space maintainers showed a greater success rate than band and loop space maintainers. Conclusions: The FRSM can be used as an alternative to BLSM regarding clinical performance and patient’s satisfaction in children with premature loss of maxillary 1st primary molars.

Donor-derived cell-free DNA as a diagnostic tool in transplantation.

There is a need to improve personalized immunosuppression in organ transplantation to reduce premature graft loss. Biomarkers are needed to better detect rejection, asymptomatic graft injury, and under-immunosuppression. Assessment of minimal necessary exposure to guide tapering and prevent immune activation is also important. There is robust clinical evidence from a large number of published studies supporting the role of dd-cfDNA for monitoring graft integrity and detection or exclusion of rejection. Dd-cfDNA indicates graft cell death without being rejection specific. It can be determined in plasma through droplet digital PCR using preselected SNPs or next generation sequencing. Changes in recipient cfDNA (e.g., by infection) can affect the results of dd-cfDNA fractional determination. This limitation can be overcome using absolute dd-cfDNA quantification. The combination of fractional and absolute determination including total cfDNA is recommended for meaningful interpretation of the results. The value proposition for the patient includes earlier transplant injury detection and intervention, less full blown rejection risk, an alternative to invasive biopsies, and personalized immunosuppression with potential for improved long-term outcome. Transplant physicians benefit from better immunosuppressive guidance and having an alternative when biopsies are refused or contraindicated. Further advantages are improved biopsy interpretation, less trial and error changes in immunosuppression, and less time dealing with complications. The laboratory medicine specialist can provide more effective services. Hospital management and insurance companies could benefit from more cost-effective surveillance of transplant recipients. Potential cost savings would result from fewer biopsies as a result of the tests' high negative predictive value, fewer re-transplantations, and less organ failure with return to dialysis. A pathway to implementation and metrics is suggested to measure the effectiveness of dd-cfDNA testing.

Mammalian oocytes store mRNAs in a mitochondria-associated membraneless compartment.

Full-grown oocytes are transcriptionally silent and must stably maintain the messenger RNAs (mRNAs) needed for oocyte meiotic maturation and early embryonic development. However, where and how mammalian oocytes store maternal mRNAs is unclear. Here, we report that mammalian oocytes accumulate mRNAs in a mitochondria-associated ribonucleoprotein domain (MARDO). MARDO assembly around mitochondria was promoted by the RNA-binding protein ZAR1 and directed by an increase in mitochondrial membrane potential during oocyte growth. MARDO foci coalesced into hydrogel-like matrices that clustered mitochondria. Maternal mRNAs stored in the MARDO were translationally repressed. Loss of ZAR1 disrupted the MARDO, dispersed mitochondria, and caused a premature loss of MARDO-localized mRNAs. Thus, a mitochondria-associated membraneless compartment controls mitochondrial distribution and regulates maternal mRNA storage, translation, and decay to ensure fertility in mammals.

Prevalence of premature loss of deciduous teeth and its relationship with gender among children from Acapulco, Guerrero: a cross-sectional study.

Premature loss of deciduous teeth is the exfoliation or extraction before physiological replacement with < 50% or < 75% of the root of the substitute tooth formed or if there is > 1 mm of alveolar bone covering the permanent successor tooth organ. This study aimed to estimate the prevalence of premature tooth loss in children and identify associated factors in a health center in Acapulco, Guerrero. We conducted a cross-sectional study in which we collected information from 109 clinical records of children examined from January 2019 to August 2021. Sociodemographic data of the children and parents were collected: socioeconomic level, non-pathological personal history, and the history of premature deciduous tooth loss. Multivariate analysis to identify factors associated with premature deciduous tooth loss was performed with CIETmap statistical software. Odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the strength of the association. The prevalence of premature loss of primary teeth was 40% (43/109). The leading cause was caries (84%, 36/43). The tooth organ with the highest loss occurrence was the lower right second molar (33%, 14/43). Gender was identified as an associated factor, with males having a higher risk of loss (ORa = 2.97; CI95% = 1.33-6.65). Our results were similar to those reported in other studies. Strategies aimed at health promotion directed at parents and children should be reinforced.

FP.25 Contracture management in ambulant boys with Duchenne muscular dystrophy (DMD)

Ankle contractures are a common feature in DMD, often developing in young boys as early as 4 or 5 years of age. This can contribute to premature loss of ambulation or at least some degree of impaired motor function. Preserving mobility by preserving ankle range of movement (ROM) can have positive effects on activity and participation as well as health related benefits related to respiratory function, scoliosis, and bone density. Traditional Physiotherapy techniques aim to reduce and prevent contractures occurring at the ankle by daily stretching regimes and night time splints (AFOs). In Newcastle, physiotherapy clinical experience has found issues with compliance with night time AFOs, limiting the benefit of these splints. The use of Contracture Control Devices (CCDs) has been explored as a novel alternative to these. To date there are no studies investigating the efficacy of CCDs or comparing these orthotic devices in contracture management in the DMD population. This pilot study aims to explore feasibility for a larger scale study comparing AFOs and CCDs in ambulant boys with DMD. It will explore intra-rater reliability of ROM and North Star Ambulatory Assessment (NSAA) evaluations and examine patient satisfaction and compliance. In an on-going pilot study, two ambulant boys were recruited to a single centre, single blinded Randomised Controlled Trial comparing standard night time AFO intervention (control arm) with the CCD group. Efficacy measures were ankle ROM and specific items from the NSAA. Intra-rater reliability was calculated using ICC. Patient adherence and satisfaction was measured using a self-completed diary and a validated satisfaction questionnaire, the OPUS. Currently N=2, with one boy randomised into each group. Intra-rater reliability was high for ankle ROM and NSAA items. Compliance was satisfactory for both individuals and the OPUS questionnaire informed patient satisfaction. Recruitment is ongoing, and updated results will be reported.

Premature Primary Tooth Loss and Oral Health-Related Quality of Life in Preschool Children.

The present study aimed to evaluate the association between premature primary tooth loss and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted in 769 5-year-old preschool children. The children and their parents or guardians answered the Brazilian version of the Scale of Oral Health Outcomes for 5-Year-Old Children for the assessment of OHRQoL. Meanwhile, clinical examinations were performed for the assessment of premature primary tooth loss. Unadjusted and adjusted multilevel Poisson regression models were utilized to investigate the associations between the variables. In the parental version of the scale, premature posterior primary tooth loss (rate ratio [RR] = 2.65; 95% confidence interval [CI] = 1.51–4.68), weak sense of coherence (RR = 2.25; 95% CI = 1.62–3.11), and visit to a dentist (RR = 1.61; 95% CI = 1.04–2.52) were associated with OHRQoL. Based on the children’s perceptions, only the preschool type was associated with OHRQoL (RR = 1.92; 95% CI = 1.21–3.05). Premature posterior primary tooth loss had a greater impact on OHRQoL based on the parents’ perception, whereas only the preschool type was associated with OHRQoL based on the children’s perception.

MCPggaac haplotype is associated with poor graft survival in kidney transplant recipients with de novo thrombotic microangiopathy.

De novo thrombotic microangiopathy (TMA) is associated with poor kidney graft survival, and as we previously described, it is a recipient driven process with suspected genetic background. Direct Sanger sequencing was performed in 90 KTR with de novo TMA and 90 corresponding donors on selected regions in CFH, CD46, C3, and CFB genes that involve variations with a functional effect or confer a risk for aHUS. Additionally, 37 recipients of paired kidneys who did not develop TMA were analyzed for the MCPggaac haplotype. Three-years death-censored graft survival was assessed using Kaplan-Meier and Cox regression models. The distribution of haplotypes in all groups was in the Hardy-Weinberg equilibrium and there was no clustering of haplotypes in any group. In the TMA group, we found that MCPggaac haplotype carriers were at a significantly higher risk of graft loss compared to individuals with the wild-type genotype. Worse 3-year death-censored graft survival was associated with longer cold ischemia time (HR 1.20, 95% CI 1.06, 1.36) and recipients’ MCPggaac haplotype (HR 3.83, 95% CI 1.42, 10.4) in the multivariable Cox regression model. There was no association between donor haplotypes and kidney graft survival. Similarly, there was no effect of the MCPggaac haplotype on 3-year graft survival in recipients of paired kidneys without de novo TMA. Kidney transplant recipients carrying the MCPggaac haplotype with de novo TMA are at an increased risk of premature graft loss. These patients might benefit from therapeutic strategies based on complement inhibition.

Assessment of Polyethylene Geomembrane Properties after Accelerated Thermal Ageing

Application temperatures and exposure environments are among the causes of premature antioxidant loss in polymer geomembranes. Therefore, over the long term, polymer degradation takes place which is reflected in geomembrane properties. In this work, accelerated thermal ageing of polyethylene geomembrane was carried out in a climatic chamber at 70℃ with 21% oxygen. The evolution of tensile properties, puncture resistance, and shore D hardness with exposure time was assessed. Changes in chemical and crystalline structure and melt flow index were made. According to the findings, geomembrane surface oxidation takes place in the polyethylene matrix after 9 months of exposure. This fact is confirmed by evaluating carbonyl, vinyl, and hydroxyl indexes. Uniaxial tensile properties, puncture resistance, and shore D hardness indicated slight changes after one year of exposure. While the crystallinity index, determined by XRD measurement, has shown an increase with exposure. Further, melt flow index measurements confirmed the absence of chain scission during the early exposure periods. However, for longer periods, chain scission reactions occurred and MI values increased moderately after five months of accelerated aging. All results indicated no significant bulk degradation while maintaining a certain mechanical resistance with applications under a temperature of 70℃. This temperature value is relevant in a waste storage center, but the studied geomembrane is not recommended for this case.

Eruption Guidance of Distally Displaced Mandibular Second Premolar by the Hemisection of Primary Second Molar: Two Case Reports

Distal displacement of the tooth germ of the mandibular second premolar (MnP2) leads to its impaction and obturation of the eruption path of the mandibular first molar delaying its eruption. The present case report describes the treatment of 2 cases of eruption guidance for distally displaced developing MnP2 that caused delayed eruption of the mandibular first molar. Intentional extraction of primary predecessor results in the mesial shift of the displaced MnP2. However, unfavorable distal ectopic eruption of the mandibular first premolar after the premature loss of primary second molar has been previously reported. Hemisection and sequential extraction of the mandibular primary second molar were performed to mesially shift the distally displaced MnP2, while preventing unfavorable distal ectopic eruption of the mandibular first premolar.

Intelligent Control of the Energy Storage System for Reliable Operation of Gas-Fired Reciprocating Engine Plants in Systems of Power Supply to Industrial Facilities

Gas-fired reciprocating engine plants (GREPs) are widely used in power supply systems of industrial facilities, which allows for ensuring the operation of electrical loads in case of accidents in the power system. Operating experience attests to the fact that during islanded operations, GREPs are shut down by process protections or protective relays in the event of severe disturbances. This leads to complete load shedding, which is accompanied by losses and damage to industrial facilities. Severe disturbances include the following ones: large load surges on GREPs due to one of them being switched off, the group starting of electric motors, and load shedding (more than 50%) during short circuits or disconnection of process lines. Energy storage systems (ESS) have the ability to compensate for instantaneous power imbalances to prevent GREPs from switching off. The authors of this study have developed methods for intelligent control of the ESS that allow one to solve two problems: prevention of GREPs shutdowns under short-term frequency and voltage deviations as well as preservation of the calendar and cycling lifetime of battery storage (BS) of the GREP. The first method does not require performing the calculation of adjustments of control actions for active and reactive power on the ESS online but rather determines them by the value of frequency deviations and the voltage sag configuration, which greatly simplifies the system of automatic control of the ESS. The second method, which consists in dividing the steady-state power/frequency characteristic into sections with different droops that are chosen depending on the current load of the ESS and the battery state of charge, and offsetting it according to a specified pattern, allows for preventing the premature loss of power capacity of the ESS BS.

ANALYSIS OF BONE DENSITY OF THE RABBIT LOWER JAW ACCORDING TO RADIOVIZIOGRAPHIYA

Nowadays, the premature loss of teeth is a serious problem not only dental but also a general medical.The results of dental prosthetics are largely determined by the condition of the bone tissue o f the jaw. Modern radiological examination methods make it possible to determine the quality of bone tissue, the biomarker of which is the mineral density indicator. Experimental methods play an important role in understanding the processes occurring in the body during the development of pathological conditions. The aim of our research was to fi nd out the peculiarities of mineral density of bone tissue in diff erent parts of the lower jaw of the intact rabbit. 10 lower jaws of sexually mature intact rabbits aged 6-7 months, weighing 2.5-3 kg were used for the study. It was established that the bone tissue density indicators of diff erent parts of the body of the lower jaw of an intact rabbit are characterized by features peculiar to each of the studied parts and caused, obviously, by diff erent loads on the bone tissue during articulatory movements. The alveolar part of the body of the lower jaw at the level of the molars has the highest density of bone tissue, the lowest one is the main part of the body o the lower jaw at the level of the incisors. The density of the bone tissue of the alveolar part of the body of the lower jaw gradually increases in the direction from the incisors to the molars, the density of the main part of the body of the lower jaw is the lowest at the incisors level of the, the highest – between the incisors and the molars. At the level of the incisors and molars, the density of the bone tissue of the alveolar part of the lower jaw body is higher, and between the incisors and the molars, it is lower than the density of the bone tissue of its main part.