Rh Blood Research Articles

Cell-Mediated Immune Responses May Play Roles in Osteochondral Allograft Transplantation Osteointegration Failures.

Prolonged and incomplete osteochondral allograft (OCA) osteointegration is consistently cited as a major mechanism for OCA treatment failure. Subrejection immune responses may play roles in this mode of failure. Preimplantation OCA preparation techniques, including subchondral bone drilling, thorough irrigation, and autogenous bone marrow aspirate concentrate saturation, may dampen immune responses and improve OCA osteointegration. This study sought to further characterize potential immune system contributions to OCA transplantation treatment failures by analyzing donor-recipient ABO and Rh-factor mismatches and histological and immunohistochemical assessments of transplanted OCA tissues recovered from revision surgeries. Using a dedicated registry, OCA transplant recipients with documented treatment failures who met inclusion criteria (n = 33) as well as age-, body mass index-, and joint-matched patients with successful outcomes (n = 70) were analyzed to compare matched cohorts of patients with successful versus failed OCA transplantation outcomes. Tissues recovered from 18 failed OCA transplants and portions of 7 nonimplanted OCA controls were further analyzed to provide contributing evidence for potential immune response mechanisms. For patients analyzed, no statistically significant differences in proportions for treatment success versus failure based on mismatches for ABO type, Rh factor, or both were noted. Further, no statistically significant differences in proportions for histological immune response presence or absence based on mismatches for ABO type, Rh factor, or both were noted. Twelve (67%) of the failed OCA tissues contained lymphocyte aggregations in the subchondral bone, which were comprised of combinations of CD3 + , CD4 + , CD8 + , and CD20+ lymphocytes. The mechanisms of failure for these 12 OCA transplants involved insufficient OCA osteointegration. Results of this study suggest that T- and B-cell-mediated subrejection immune responses may play roles in OCA transplant treatment failures independent of donor-recipient blood type mismatch effects.

Prevalence of principal abo and rhesus blood group systems over the entire Lebanese population

Prevalence of principal abo and rhesus blood group systems over the entire Lebanese population

Management of Fetal Hemolytic Disease Due to Anti-Rh17 With the D−Phenotype [ID 2683500

INTRODUCTION: The rare blood D− haplotype produces multiple Rh antibodies against red blood cell antigens such as anti-Rh17 or anti-Hr0 antibodies if a patient is sensitized to Rh antigens. METHODS: This report discusses successful management of a pregnancy in a 28-year-old woman with high anti-Rh17 titers leading to hemolytic disease of the fetus (HDFN). The combination of a D− allele and the weak D 45 allele has not been reported previously, and it may be that the hybrid allele expresses D antigen epitopes such that the D antigen is not weakened. During the studied pregnancy, the patient received plasmapheresis and intravenous immunoglobulin (IVIG) infusions along with intrauterine transfusions (IUTs) when absolutely necessary. She underwent uncomplicated repeat cesarean delivery at 32 5/7 weeks of gestation resulting in a female infant weighing 2,020 g. Patient informed consent was obtained for this case report. CONCLUSION: This patient with the D−/D− blood phenotype leading to anti-Rh17 antibodies after her first pregnancy was managed successfully. Her baby with HDFN and several instances of hydrops fetalis, was successfully managed and treated. The patient’s blood donations for IUTs and maternal plasma exchange therapies promoted efficiency and favorable outcomes for the baby, but did put the mother in an anemic blood range.

A cold case of hemolytic disease of the fetus and newborn resolved by genomic sequencing and population studies to define a new antigen in the Rh system.

We report an obstetric case involving an RhD-positive woman who had developed a red blood cell (RBC) antibody that was not detected until after delivery of a newborn, who presented with a positive direct antiglobulin test result. Immunohematology studies suggested that the maternal antibody was directed against a low-prevalence antigen on the paternal and newborn RBCs. Comprehensive blood group profiling by targeted exome sequencing revealed a novel nonsynonymous single nucleotide variant (SNV) RHCE c.486C>G (GenBank MZ326705) on the RHCE*Ce allele, for both the father and newborn. A subsequent genomic-based study to profile blood groups in an Indigenous Australian population revealed the same SNV in 2 of 247 individuals. Serology testing showed that the maternal antibody reacted specifically with RBCs from these two individuals. The maternal antibody was directed against a novel antigen in the Rh blood group system arising from an RHCE c.486C>G variant on the RHCE*Ce allele linked to RHD*01. The variant predicts a p.Asn162Lys change on the RhCE protein and has been registered as the 56th antigen in the Rh system, ISBT RH 004063. This antibody was of clinical significance, resulting in a mild to moderate hemolytic disease of the fetus and newborn (HDFN). In the past, the cause of such HDFN cases may have remained unresolved. Genomic sequencing combined with population studies now assists in resolving such cases. Further population studies have potential to inform the need to design population-specific red cell antibody typing panels for antibody screening in the Australian population.

Erythrocyte Alloimmunization and Autoimmunization in the Pediatric Population: A Multicenter, Cross-Sectional Study in Central China

Background: Erythrocyte alloantibodies and autoantibodies complicate transfusion. However, the prevalence of erythrocyte alloimmunization and autoimmunization has not been estimated in the Chinese pediatric population. Therefore, we investigated the prevalence of erythrocyte alloimmunization and autoimmunization in the Chinese pediatric population with the aim of developing a reasonable transfusion management policy in children from China. Methods: This study included 30,603 pediatric inpatients who were admitted to three tertiary hospitals in central China from May 2020 to October 2022. Antibody screening was carried out with a three-cell panel by column agglutination technology, and samples with positive screening were analyzed for antibody specificity with a 16-cell identification panel. Clinical details of the patients were collected to identify associations with antibody formation. Results: The alloimmunization rate was 0.55% (169/30,603), and the autoimmunization rate was 0.14% (43/30,603). Alloantibodies comprised 80.09% of the antibodies. The most frequent alloantibodies were anti-M (58.77%), anti-E (9.48%), and anti-P1 (4.27%). Autoantibodies comprised 19.91% of antibodies. Age (p = 0.000), sex (p = 0.016), geographical area (p = 0.000), ABO blood group (p = 0.008), and diagnosis (p = 0.000) were independent risk factors for antibody formation. The risk of antibody formation at the ages of 0–28 days and 1–3 months was zero (odds ratio = 0.000). The antibody distribution was significantly different by age (p = 0.000) and diagnosis (p = 0.000). Conclusion: Repeat pre-transfusion testing for infants less than 4 months of age can be omitted for no risk of antibody formation. MNS system antibodies, especially anti-M, are prominent in younger children, and this decreases with age. Provision of extended phenotype-matched transfusion for Rh system antigens, especially antigen E, is necessary in children to control erythrocyte alloimmunization. The presence of antibodies with high evanescence rates in the pediatric population suggests the pressing need for nationwide shared transfusion records to avoid hemolytic transfusion reactions in children.

Cognitive Effects of Toxoplasma and CMV Infections: A Cross-Sectional Study of 557 Young Adults Considering Modulation by Sex and Rh Factor.

One-third of humanity harbors a lifelong infection with Toxoplasma gondii, and probably about 80% are infected with human cytomegalovirus (CMV). This study aims to delineate the associations between toxoplasmosis and cognitive abilities and compare these to the associations with CMV. We evaluated the cognitive performance of 557 students, who had been examined for Toxoplasma and CMV infections, using intelligence, memory, and psychomotor tests. The results indicated cognitive impairments in seropositive individuals for both pathogens, with variations in cognitive impact related to sex and the Rh factor. Specifically, Toxoplasma infection was associated with lower IQ in men, whereas CMV was predominantly associated with worse performance by women when testing memory and reaction speeds. Analysis of the antibody concentrations indicated that certain Toxoplasma-associated cognitive detrimental effects may wane (impaired intelligence) or worsen (impaired reaction times) over time following infection. The findings imply that the cognitive impairments caused by both neurotropic pathogens are likely due to pathological changes in the brain rather than from direct manipulative action by the parasites.

Association of Vitiligo with ABO/Rh System and its Influence on Thyroid Stimulating Hormone and Vitamin D

This study was conducted to determine if there is a relationship between vitiligo and ABO blood groups, the Rhesus (Rh) factor, thyroid stimulating hormone (TSH) and vitamin D. For vitiligo analysis, two hundred subjects participated in this study, 100 vitiligo patients and 100 control cases (without vitiligo). ABO blood grouping and Rh typing were tested by a slide method. TSH testing involved 80 vitiligo patients and 80 controls (without vitiligo) and the hormone was analyzed by separating the serum in a centrifuge for two minutes and the results were obtained by Beckman fully automatic analyzer. For vitamin D, 50 vitiligo patients and 50 healthy people (without vitiligo) were included. The data on vitamin D were obtained from private laboratory services. Statistical analysis was performed using IBM SPSS version 26. P<0.05 was considered significant. Most patients with vitiligo had a significantly lower level of serum vitamin D compared with controls (p-value < 0.05), while no statistically significant difference in TSH serum levels between vitiligo cases and controls, was found (p-value > 0.05). Furthermore, despite showing that subjects with blood group O are more susceptible to vitiligo as compared to other groups, there was no significant association of vitiligo with ABO blood groups (p-value > 0.05). Similarly, the incidence of Rh positive and Rh negative was not statistically different between the two groups (p-value > 0.05). This study showed that vitiligo patients are often vitamin D deficient. This study highlights the need to evaluate vitamin D status in vitiligo patients to improve the level of skin pigment loss. It remains unknown whether vitamin D deficiency causes vitiligo. However, a collection of larger sample sizes of different ethnicities should be required to achieve a precise conclusion.

Blood groups and Rhesus status as potential predictors of outcomes in patients with cardiac resynchronisation therapy

Cardiac resynchronisation therapy (CRT) improves prognosis in patients with heart failure (HF) however the role of ABO blood groups and Rhesus factor are poorly understood. We hypothesise that blood groups may influence clinical and survival outcomes in HF patients undergoing CRT. A total of 499 patients with HF who fulfilled the criteria for CRT implantation were included. Primary outcome of all-cause mortality and/or heart transplant/left ventricular assist device was assessed over a median follow-up of 4.6 years (IQR 2.3–7.5). Online repositories were searched to provide biological context to the identified associations. Patients were divided into blood (O, A, B, and AB) and Rhesus factor (Rh-positive and Rh-negative) groups. Mean patient age was 66.4 ± 12.8 years with a left ventricular ejection fraction of 29 ± 11%. There were no baseline differences in age, gender, and cardioprotective medication. In a Cox proportional hazard multivariate model, only Rh-negative blood group was associated with a significant survival benefit (HR 0.68 [0.47–0.98], p = 0.040). No association was observed for the ABO blood group (HR 0.97 [0.76–1.23], p = 0.778). No significant interaction was observed with prevention, disease aetiology, and presence of defibrillator. Rhesus-related genes were associated with erythrocyte and platelet function, and cholesterol and glycated haemoglobin levels. Four drugs under development targeting RHD were identified (Rozrolimupab, Roledumab, Atorolimumab, and Morolimumab). Rhesus blood type was associated with better survival in HF patients with CRT. Further research into Rhesus-associated pathways and related drugs, namely whether there is a cardiac signal, is required.

Impact of human leucocyte antigen class II polymorphism on anti-red blood cell antibody development: Correlations and indications.

Blood transfusion therapy is vital for many patient groups. They can cause many complications, and the development of anti-red blood cell (RBC) antibodies is of significant importance. Molecules of class II human leucocyte antigens (HLA) are one of the several factors that influence antibody development in patients. In this study, we investigated 108 patients who developed antibodies against different erythrocyte antigens and 115 patients on multiple transfusion therapies who did not develop anti-RBC antibodies. The HLA loci HLA-DRB1 and HLA-DQB1 were typed using commercial molecular assays routinely used in HLA laboratories. An increased frequency of the HLA-DRB1*04 allele group was observed in patients who developed antibodies. Additionally, HLA-DRB1*09 was also significant for anti-E development and in patients with multi-specific alloimmunization. It was found that the HLA-DRB1*07 allele group is associated with antibodies to antigents of the Rh and MNS systems but also lacks an association with anti-K development. The HLA-DRB1*11 and -DRB1*01 allele groups displayed a protective mechanism for anti-E development, similar to that of HLA-DQB1*02 for anti-K. There is an association between various HLA class II alleles and anti-RBC development.

Correlation of Age, Gender, ABO Blood Group and Rh Factor in COVID-19 Infection: A Cross-Sectional Study in Udaipur, Rajasthan, India.

The ABO blood group has long been recognized as a significant factor influencing susceptibility to infectious diseases. Numerous studies have explored the links between ABO blood types and both the likelihood of contracting COVID-19 and the severity of the infection, yielding conflicting results. This study intends to determine the influence of age, gender, the ABO blood group, and Rh factor on the potential development of COVID-19 infection. A cross-sectional, observational study collected data including age, gender, the ABO blood group, and Rh factor from 80 healthcare professionals at R. R. Dental College and Hospital in Udaipur with a positive history of COVID-19 infection via Google Forms (Google LLC, Mountain View, California, United States). Chi-square statistics assessed the distribution of blood types and antibodies within the samples. Odds ratio (OR) assays were used to assess the probability of a certain blood type or Rh factor with version 21.0 of the IBM Statistical Package for Social Sciences (SPSS) for Windows (IBM Corp, Armonk, NY). In this study, the blood group type O was 45.2% (n = 33), type A was 21.9% (n = 16), type B was 24.7% (n = 18), and type AB was 8.2% (n = 6). Rh-positive samples were 87.7% (n = 64) and Rh-negative samples were 12.3% (n = 9). There was a statistically significant correlation between Type A (p = 0.001) and Type O (p = 0.049). Thirty-one participants (42.5%) were aged 20-30 years, 26 (35.6%) were aged 31-40 years, and 16 (21.9%) were aged 41-50 years. The statistical analysis revealed no statistically significant distinction among the age groups (p > 0.05). The patients' gender, age, and concurrent disorders are crucial risk variables that determine the severity of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. There is growing data indicating that the ABO blood group has a significant role in disease biology at physiological and biochemical levels. Hence, this study adds valuable information to strengthen and establish the potential role of factors, such as age and gender, in the possible pathogenicity of COVID-19 infection.

Trx4, a novel thioredoxin protein, is important for Toxoplasma gondii fitness

BackgroundTo successfully replicate within the host cell, Toxoplasma gondii employs several mechanisms to overcome the host cell defenses and mitigate the harmful effects of the free radicals resulting from its own metabolic processes using effectors such as thioredoxin proteins. In this study, we characterize the location and functions of a newly identified thioredoxin in T. gondii, which was named Trx4.MethodsWe characterized the functional role of Trx4 in T. gondii Type I RH and Type II Pru strains by gene knockout and studied its subcellular localization by endogenous protein HA tagging using CRISPR-Cas9 gene editing. The enzyme-catalyzed proximity labeling technique, the TurboID system, was employed to identify the proteins in proximity to Trx4.ResultsTrx4 was identified as a dense granule protein of T. gondii predominantly expressed in the parasitophorous vacuole (PV) and was partially co-localized with GRA1 and GRA5. Functional analysis showed that deletion of trx4 markedly influenced the parasite lytic cycle, resulting in impaired host cell invasion capacity in both RH and Pru strains. Mutation of Trx domains in Trx4 in RH strain revealed that two Trx domains were important for the parasite invasion. By utilizing the TurboID system to biotinylate proteins in proximity to Trx4, we identified a substantial number of proteins, some of which are novel, and others are previously characterized, predominantly distributed in the dense granules. In addition, we uncovered three novel proteins co-localized with Trx4. Intriguingly, deletion of trx4 did not affect the localization of these three proteins. Finally, a virulence assay demonstrated that knockout of trx4 resulted in a significant attenuation of virulence and a significant reduction in brain cyst loads in mice.ConclusionsTrx4 plays an important role in T. gondii invasion and virulence in Type I RH strain and Type II Pru strain. Combining the TurboID system with CRISPR-Cas9 technique revealed many PV-localized proximity proteins associated with Trx4. These findings suggest a versatile role of Trx4 in mediating the processes that occur in this distinctive intracellular membrane-bound vacuolar compartment.Graphical

A novel frameshift mutation in RHAG leads to Rhnull phenotype in a Chinese individual.

We recently encountered a Rhnull phenotype proband within one family in the Chinese population. Rhnull is a rare autosomal recessive disorder characterized by the absence of the Rh antigens on the erythrocyte membrane, resulting in chronic hemolytic anemia. This study described the serological and molecular analysis of a Chinese Rhnull proband and his immediate family. Red blood cells antigen phenotyping and antibody screening/identification were conducted. RHD, RHCE, and RHAG were analyzed using genomic DNA by polymerase chain reaction and sequence analysis. Serologic tests showed a D-C-E-c-e- phenotype in the proband associated with the suspicion of anti-Rh29 (titer 16). Molecular analyses showed a new mutation (c.406dupA) in exon 3 of RHAG. This duplication introduced a reading frameshift (p.Thr136AsnfsTer21). The RHAG mutation was found in the homozygous state for the proband and heterozygous state for his parents. We identified a novel RHAG mutation resulting in the Rhnull phenotype of the regulator type. Inheritance of the novel allele was shown by family study.

Risk factors for nonresponse to 2 years of denosumab administration in patients with osteoporosis: A retrospective single-center cohorts study.

To investigate the factors associated with changes in bone mineral density (BMD) and the incidence of fractures in osteoporotic patients treated with denosumab. This retrospective study included 162 osteoporotic patients treated with denosumab for 24 months between 2013 and 2019. Patients were divided according to the changes in BMD as nonresponders (NL group: <3% increase in lumbar spine BMD [LBMD], NH group: <0% increase in femoral neck BMD [FNBMD])or responders (RL group: ≥3% increase in LBMD, RH group: ≥0% increase in FNBMD). The respective changes in the LBMD and FNBMD after 24 months of denosumab treatment were 9.3% (95% confidence interval [CI]: 8.1-10.6) and 3.3% (95% CI: 2.1-4.5). Twenty-eight (17.3%) patients were in the NL group, and 134 (82.7%) were in the RL group. A history of bisphosphonate treatment was a risk factor for being in the NL group (odds ratio [OR]: 3.84, 95% CI: 1.38-10.71, p = 0.007; adjusted OR: 3.21, 95% CI: 1.01-10.19, p = 0.048). Although the NH (n = 48; 30.8%) and RH (n = 108; 69.2%) groups had similar baseline characteristics, the NH group had a significantly higher baseline FNBMD than the RH group (p = 0.003). The change in FNBMD was negatively associated with the FNBMD at baseline (r = -0.34, p < 0.001). No new osteoporotic fractures occurred in either group during follow-up. In osteoporotic patients receiving denosumab treatment, a history of bisphosphonate treatment was a risk factor for a lack of increase in LBMD, and a higher FNBMD at baseline was negatively associated with the change in FNBMD.

COVID-19 Susceptibility among ABO/RH Blood Groups in Tamil Nadu Population: A Retrospective Case–Control Study

Background: COVID-19 is a world pandemic with clinical manifestation from mild subclinical infection to severe illness. Literature suggests an evident correlation between the ABO blood group, Rhesus blood group, and COVID-19 in the recent past. The role of blood group in disease susceptibility and severity of COVID-19 varies in different geographical locations, as ABO blood group distribution varies among the human population with the impact of migration. Although various research have been done globally, scientific evidence with respect to the south Indian population remains limited, emphasizing the need for the present study to analyze the association of COVID-19 and blood groups in Tamil Nadu. Aim: The aim of this study was to analyze the potential susceptibility of COVID-19 among the blood groups (ABO and Rh type) in Tamil Nadu population. Materials and Methods: This was a noninterventional retrospective case–control study, with 500 patients who tested positive for COVID-19 being taken as the “cases,” while another 500 who tested negative were taken as the “controls.” The medical records, including the blood group and Rh factor, were collected from the government-recognized testing centers (Government Medical Hospital and Primary Health Centers, Tiruvallur, and Frontier Lifeline Hospital, Chennai) in Tamil Nadu, who came for COVID-19 screening by reverse transcriptase–polymerase chain reaction. The data were analyzed to associate its correlation with different blood groups. Results: Blood Group A showed significantly higher distribution among the cases (P = 0.030), and blood Groups O and B were significant among the controls (P = 0.026 and P = 0.000, respectively). Blood Group AB did not show any significant differences between the groups (P = 0.374). The odds ratio for AB, A, O, and B Groups for Rh (positive and negative) were shown to be 0.659, 0.591, 0.472, and 0.262, respectively, suggesting increased susceptibility toward Rh positive factor. Conclusion: In our study, blood Group A was found to be the most susceptible and blood Group O to be the least susceptible to COVID-19 in the Tamil Nadu population. In addition, the Rh positive factor showed more inclination toward COVID susceptibility than the Rh negative factor. ABO blood group may be considered a potential nonmodifiable and secondary risk factor for COVID-19 contributing to the disease pathobiology at immunological, biochemical, and physiological levels. Still, the intensity of their role and their exact mechanism in its association requires further exploration to validate the current findings.

Antenatal RHD screening to guide antenatal anti-D immunoprophylaxis in non-immunized D- pregnant women.

In pregnancy, D- pregnant women may be at risk of becoming immunized against D when carrying a D+ fetus, which may eventually lead to hemolytic disease of the fetus and newborn. Administrating antenatal and postnatal anti-D immunoglobulin prophylaxis decreases the risk of immunization substantially. Noninvasive fetal RHD genotyping, based on testing cell-free DNA extracted from maternal plasma, offers a reliable tool to predict the fetal RhD phenotype during pregnancy. Used as a screening program, antenatal RHD screening can guide the administration of antenatal prophylaxis in non-immunized D- pregnant women so that unnecessary prophylaxis is avoided in those women who carry a D- fetus. In Europe, antenatal RHD screening programs have been running since 2009, demonstrating high test accuracies and program feasibility. In this review, an overview is provided of current state-of-the-art antenatal RHD screening, which includes discussions on the rationale for its implementation, methodology, detection strategies, and test performance. The performance of antenatal RHD screening in a routine setting is characterized by high accuracy, with a high diagnostic sensitivity of ≥99.9 percent. The result of using antenatal RHD screening is that 97-99 percent of the women who carry a D- fetus avoid unnecessary prophylaxis. As such, this activity contributes to avoiding unnecessary treatment and saves valuable anti-D immunoglobulin, which has a shortage worldwide. The main challenges for a reliable noninvasive fetal RHD genotyping assay are low cell-free DNA levels, the genetics of the Rh blood group system, and choosing an appropriate detection strategy for an admixed population. In many parts of the world, however, the main challenge is to improve the basic care for D- pregnant women.

IJCM_99A: Risk Factors Associated with Polyhydramnios among Pregnant Women in Mangalore: A Case Control Study

Background: The amniotic fluid volume is maintained by a balance between production (fetal urine and fetal lung fluid) and resorption (swallowing and intramembranous flow). Any imbalance in this process could lead to either oligohydramnios or polyhydramnios. The incidence of polyhydramnios varies from 1-2%. It is a significant obstetric condition, the etiology of which is still largely unknown. The underlying maternal factors include diabetes mellitus, pregnancy induced hypertension, twin pregnancy, negative Rh factor, cardiac and renal diseases. The study aims to study the risk factors associated with polyhydramnios among the women seeking maternal health care in the study hospitals and to assess the socio-demographic correlates of polyhydramnios among the study population. Methodology: The study was conducted in the Government Lady Goschen Hospital and Kasturba Medical College Attavar, among 66 cases (Pregnant women admitted with polyhydramnios) and 132 controls(age matched pregnant women admitted to the study hospitals during the study period). Odds ratio was calculated, Chi square test was used to compare the groups. Results: Proportion of anemia among our cases was 20% and control was 25.6%. 7.6% of the cases were associated with hypertensive disorders of pregnancy and 0.8% of controls had hypertensive disorders. 12.1% of polyhydramnios cases with Gestational Diabetes Mellitus Conclusion: Majority of the polyhydramnios cases were in the age group 20-29 years. The proportion of Diabetes Mellitus, hypertension, Rh negative pregnancies, malpresentation were higher among polyhydramnios cases. The association was significant for hypertension.

Risk of Transfusion Complication: A Systematic Review of Iranian Literature

Background and aims: Injecting healthy blood on time can save patients’ lives; on the other hand, delaying the start of transfusion or injecting unhealthy and wrong blood can cause fatal risks. This study aimed to survey the risks of transfusion events as a systematic review. Methods: In this systematic review, the data associated with transfusion complications were collected by reviewing the literature published from 2001 to 2023 and indexed in various databases using related keywords. Then, the articles were included according to the inclusion and exclusion criteria. The collected data were recorded in Excel, and conclusions were drawn based on the available data. Results: The findings of this study revealed that the most important complications in patients who had blood transfusion are alloimmunization against Rh antigens (mainly anti-E, anti-D, anti-C, and anti-c) and anti-Kell alloantibodies, especially in patients with thalassemia. Although some cases of ABO antigens and anti-human leukocyte antigen (HLA) were also reported, allergic and febrile non-hemolytic transfusion reactions (FNHTRs) occurred mainly in the Iranian population. Conclusion: The results showed that the risks of blood transfusion generally include complications that may be preventable by better pretransfusion assessment and monitoring, and many of them can be prevented by strengthening the hemovigilance system and improving the equipment and skills of the staff. Consequently, most transfusion reactions can be prevented and reduced.

Breaking linear scaling relationships in NRR with hydrogen bonding in confined space: A case study of g-C3N4 covered Ru(001) system

The electrochemical nitrogen reduction reaction (NRR) is a very efficient method for sustainable NH3 production under mild conditions, but it requires effective catalysts to expedite the NRR kinetics. However, the linear scaling relationships between the energies of elementary steps in NRR severely limit the rates of thermally catalysis reactions. Using density functional theory calculations, we demonstrate that these scaling relations can be circumvented by introducing hydrogen bonding and confinement field in g-C3N4/Ru(Rh) catalysis. Specially, the adsorption strength of key intermediate *N2H can be enhanced on the g-C3N4/Ru(Rh) own to the formation of H···N hydrogen bonding, while the adsorption of N2 is weakened due to the steric confinement field of the covered g-C3N4, resulting a significantly decrease of the energy barrier for the potential-limiting step in g-C3N4/Ru(Rh) system compared that in pure Ru(Rh) surface. Moreover, the hydrogen bonding strength between g-C3N4 and *NxHy increases with increasing of H atoms, which lower the energy barrier for the following protonation steps. Our results provide guidance for optimizing catalysts for application with hydrogen bonding and steric confinement.

Analysis of human ABO Blood Group as a risk factor with knee osteoarthritis at tertiary care hospital in Pakistan.

To investigate the association and risk estimation of ABO blood group distribution and clinical attributes in patients with Knee Osteoarthritis. This was a hospital-based study conducted at, Liaquat University Hospital Hyderabad from December, 2019 to December, 2022 to investigate this least researched area of highly prevalent musculoskeletal disease in Pakistan. Non-Probability Convenience Sampling was used for selecting 190 cases of confirm Knee Osteoarthritis patients diagnosed by Orthopedic surgeon based on standard clinical and radiographic criteria. Data were analyzed using IBM-SPSS version 23.0. Percentages and frequencies were counted for categorical data. Pearson Chi Square test and fisher's exact test were used to check the association and Multinomial Logistic Regression was used to estimate the risk for moderate and severe kellgren grading Knee Osteoarthritis (KOA) cases with ABO blood grouping in comparison of mild Kellgren grading. A total of 190 cases of Knee Osteoarthritis (KOA) were included in the study. Females (61.6%) and patients with age 50 and above were 40.5 % were found in greater proportion. Majority (41.6%) were classified radiologically as mild cases with O group (39.5%) and positive Rh antigen (95.8%). Strong association (p = <0.01) was found between gender, age group and ABO blood group with KOA radiological Kellgren and Lawrence score. There is strong relation in between radiological grading of knee osteoarthritis severity and A blood group, gender and age.

Molecular dynamics of the human RhD and RhAG blood group proteins.

Introduction: Blood group antigens of the RH system (formerly known as "Rhesus") play an important role in transfusion medicine because of the severe haemolytic consequences of antibodies to these antigens. No crystal structure is available for RhD proteins with its partner RhAG, and the precise stoichiometry of the trimer complex remains unknown. Methods: To analyse their structural properties, the trimers formed by RhD and/or RhAG subunits were generated by protein modelling and molecular dynamics simulations were performed. Results: No major differences in structural behaviour were found between trimers of different compositions. The conformation of the subunits is relatively constant during molecular dynamics simulations, except for three large disordered loops. Discussion: This work makes it possible to propose a reasonable stoichiometry and demonstrates the potential of studying the structural behaviour of these proteins to investigate the hundreds of genetic variants relevant to transfusion medicine.