Preventing maternal phenylketonuria (PKU) syndrome: important factors to achieve good metabolic control throughout pregnancy

Background Insufficient metabolic control during pregnancy of mothers with phenylketonuria (PKU) leads to maternal PKU syndrome, a severe embryo-/fetopathy. Since maintaining or reintroducing the strict phenylalanine (Phe) limited diet in adults with PKU is challenging, we evaluated the most important dietary and psychosocial factors to gain and sustain good metabolic control in phenylketonuric women throughout pregnancy by a questionnaire survey with 38 questions concerning therapy feasibility. Among them, the key questions covered 5 essential items of PKU care as follows: General information about maternal PKU, PKU training, diet implementation, individual metabolic care, personal support. In addition, all participating PKU mothers were asked to estimate the quality of their personal metabolic control of the concluded pregnancies. 54 PKU mothers with 81 pregnancies were approached at 12 metabolic centers in Germany and Austria were included. According to metabolic control, pregnancies of PKU women were divided in two groups: group “ideal” (not more than 5% of all blood Phe concentrations during pregnancy > 360 µmol/l; n = 23) and group “suboptimal” (all others; n = 51). Results The demand for support was equally distributed among groups, concerning both amount and content. Personal support by the direct social environment (partner, family and friends) (“suboptimal” 71% vs “ideal” 78%) as well as individual metabolic care by the specialized metabolic center (both groups around 60%) were rated as most important factors. The groups differed significantly with respect to the estimation of the quality of their metabolic situation (p < 0.001). Group “ideal” presented a 100% realistic self-assessment. In contrast, group “suboptimal” overestimated their metabolic control in 53% of the pregnancies. Offspring of group “suboptimal” showed clinical signs of maternal PKU-syndrome in 27%. Conclusion The development of training programs by specialized metabolic centers for females with PKU in child bearing age is crucial, especially since those mothers at risk of giving birth to a child with maternal PKU syndrome are not aware of their suboptimal metabolic control. Such programs should provide specific awareness training for the own metabolic situation and should include partners and families.

Evaluation of Vertical Bone Augmentation Using a Titanium Ring Retained in Simultaneous Implants With Early Exposure: A Pilot Study in Dogs

To evaluate the performance of titanium rings retained in implants placed simultaneously for vertical bone augmentation with early exposure. Twenty-four bone level tapered dental implants were inserted in the premolar areas of the mandible with standardized, 3.5 mm deep, vertical bone defects in four beagle dogs, and titanium rings containing a mixture of autogenous bone chips and Bio-oss were retained in the implants for vertical bone augmentation. Three weeks after the operation, all titanium rings were exposed, one titanium ring from each mandible of each dog was removed, and the other titanium ring was left in place with daily flushing. After 2 months, the dogs were sacrificed, the height of vertical bone augmentation was measured, and bone samples containing the implants were harvested and analyzed. The median (minimum-maximum) bone augmentation height (BAH) was 2.46 (2.18-2.62) mm on the buccal side and 2.80 (2.66-3.02) mm on the lingual side in the removal group; however, the BAH was 0.64 (0.32-0.92) mm and 0.70 (0.22-1.22) mm in the holding group. The bone volume/total volume (BV/TV) of the increased bone was 80.07% (72.64%-87.89%) with micro-CT analysis in the removal group, ideal bone osseointegration formed, and new bone was observed in the hard tissue sections. Within its limitations, the use of titanium rings retained in implants was found to be a reliable alternative method for vertical bone augmentation, and removing titanium rings is better for bone augmentation when early exposure occurs.

Γ-(,δ)-Derivation on Semi-Group Ideals in Prime Γ-Near-Ring

The main purpose of this paper is to investigate some results. When h is  -( ,δ) – Derivation on prime Γ-near-ring G and K is a nonzero semi-group ideal of G, then G is commutative .

Tackling Complexity in Green Contractor Selection for Mega Infrastructure Projects: A Hesitant Fuzzy Linguistic MADM Approach with considering Group Attitudinal Character and Attributes’ Interdependency

Continuous environmental concerns regarding construction industry have been driving general constructors of mega infrastructure projects to incorporate green contractors. Although conventional multiple attributes decision-making (MADM) methodologies have provided feasible ways to select contractor, high complexity in scenarios of megaprojects still challenges existing MADM methods in concurrently accommodating three key issues of decision hesitancy, attributes interdependency, and group attitudinal character. To elicit decision-makers’ hesitant fuzzy assessments more objectively and comprehensively, we define an expression tool called interval-valued dual hesitant fuzzy uncertain unbalanced linguistic set (IVDHF_UUBLS) and develop aggregation operators through its operations. To exploit attributes interdependency, we establish a synthesized attributes’ weighting model to fuse an attributes interdependency-based weighting vector and an argument-dependent weighting vector, which are, respectively, derived through Decision-Making and Trial Evaluation Laboratory (DEMATEL) technique and maximizing deviation method. To effectively utilize decision-makers’ group attitudinal characters, we also develop a TOPSIS-based method to rationally transform group ideal attitudes into order-inducing vectors. On the strength of the above methods, an integrated MADM approach is then constructed. Finally, illustrative case study and experiments are conducted to validate our approach.

A single origin of extreme matrotrophy in African mabuyine skinks

Most mammals and approximately 20% of squamates (lizards and snakes) are viviparous, whereas all crocodilians, birds and turtles are oviparous. Viviparity evolved greater than 100 times in squamates, including multiple times in Mabuyinae (Reptilia: Scincidae), making this group ideal for studying the evolution of nutritional patterns associated with viviparity. Previous studies suggest that extreme matrotrophy, the support of virtually all of embryonic development by maternal nutrients, evolved as many as three times in Mabuyinae: in Neotropical Mabuyinae (63 species), Eumecia (2 species; Africa) and Trachylepis ivensii (Africa). However, no explicit phylogenetic hypotheses exist for understanding the evolution of extreme matrotrophy. Using multilocus DNA data, we inferred a species tree for Mabuyinae that implies that T. ivensii (here assigned to the resurrected genus Lubuya ) is sister to Eumecia , suggesting that extreme matrotrophy evolved only once in African mabuyine skinks.

Gambaran indeks Bolton pada pasien yang dirawat dengan piranti ortodontik lepasan di Rumah Sakit Gigi Mulut Universitas Hasanuddin Overview of Bolton index on patients treated with removable orthodontic appliance in Dental Hospital of Hasanuddin University

Orthodontic treatment requires complete planning. Various analyzes is needed to determine the treatment plan; one ofthem is analysis of tooth size differences or Bolton analysis. Orthodontic treatments in Dental Hospital of HasanuddinUniversity do not apply Bolton analysis, so it is necessary to know the overview of Bolton index of the cases that have beentreated. This observational descriptive study was conducted in Department of Orthodontics, Dental Hospital ofHasanuddin University in March-May 2012. The samples were patients who completed treatment in 2010-2011. A total of156 samples consisting of 117 females and 39 males. The result showed that the non-intervention group Ideal AnteriorBolton Ratios and group Overall Bolton Ratio <93.21% have a tendency orthodontic treatment success rate, higher thanthe other groups. While the group Overall Bolton Ratio <89.39% showed the lowest successful rate of orthodontictreatment. The conclusion is the case with interventions of extraction, slicing, and expansion showed inconsistenciestendency of the three categories of orthodontic treatment outcome assessment, namely canine position, overjet, andoverbite.