20th Week Research Articles

Pregnancy maintenance and fetal loss assessment in Holstein cows through analyzing pregnancy-associated glycoproteins in milk

Fetal loss (FL) from the 45th day of gestation until calving can impose a significant economic burden on dairy farmers, resulting in lost profits and increased production costs. Pregnancy-associated glycoprotein (PAG) is commonly used for detecting pregnancy in cows. PAG is secreted by binucleated trophoblast cells of the placenta and regulated by more than 24 genes. The purpose of this study was to determine the PAG threshold for FL and a probability of pregnancy maintenance until calving based on milk PAG levels. Our results reveal that primiparous and multiparous cows that maintained pregnancy until the 40th week exhibited higher PAG sample-negative (SN) values in their milk in the 6th week of gestation than did those that experienced FL later in gestation. Pregnant cows with higher PAG SN values in the 6th week of gestation were more likely to maintain their pregnancies. The area under the receiver operating characteristic curve for predicting the probability of pregnancy maintenance was 0.722 for our prediction model. On the other hand, a milk PAG SN value of <0.192 indicated 95 % confidence that FL would occur between the 7th and 40th weeks of gestation. Milk PAG testing is a noninvasive sampling technique that does not induce additional stress in lactating cows. The study reveals that PAG SN values increase significantly in Holstein cows during the 6th week of gestation. The predictive model developed was effective in forecasting pregnancy outcomes up to the 40th week of gestation or calving. The model's performance is moderately good for field application and could be a useful tool for dairy producers.

Hsa-Mir-1 and Hsa-Mir-1229 expression levels in recurrent miscarriage patients before and after lymphocyte therapy in comparison to control groups

Background. Recurrent pregnancy loss is defined as at least two consecutive clinical pregnancy losses before 20th week of gestation. In this study, we investigated microRNA-1 and microRNA-1229 in recurrent miscarriage patients before and after lymphocyte therapy in comparison to control group. Methods. First, a written and informed consent will be obtained from the target population of this study, who are people with RPL referring to Waliasr International Hospital. According to the standard protocol, the number of 2×107 is injected subcutaneously to patients. Real-time PCR technique will be used to check the expression level of microRNA-1 and microRNA-1229. Results. The gene expression level of micro-RNA 1 in RPL women before of lymphocyte therapy was 2.030±1.445 and the gene expression level of the same micro-RNA after the lymphocyte therapy of the mother was 1.101±0.4780. Also, the expression level of micro-RNA 1229 in these women was reported to be 2.100±0.6296 before treatment and 1.247±0.9631 after treatment with lymphocytes. This level of gene expression in control group, for micro-RNA 1 and micro-RNA 1229 genes is 1.000±0.08334 and 1.000±0.08091, respectively. Conclusion. The results of our study showed a noticeable decrease in the gene expression of microRNAs under study, both microRNAs 1 and 1229, in women with a history of three consecutive injections of the father's subcutaneous lymphocytes. Practical Implications. This study can show the therapeutic effect of lymphocyte for patients with recurrent miscarriage so that this treatment can be used along with other treatment methods.

Evaluation of a school-based health education program on hepatitis B virus infection prevention practice in rural South-Western, Nigeria.

Hepatitis B virus (HBV) infection prevention is most effective early in childhood with vaccination programme. However, where this is missed, primary prevention modes of intervention become an alternative recommendation to be considered before the occurrence of risk exposure to the virus. This study sought to evaluate outcomes of a theory-based HBV infection prevention educational intervention among students from four selected secondary schools in Ogun state, Nigeria. A quasi-experimental design enrolling 256 consenting secondary school students from four schools in Ogun state randomized into three intervention schools consisting teacher-instructed (E1), peer-directed (E2) and combination of the two (E3) respectively with a control group ( C) was implemented. The theory-based educational intervention was for six weeks with follow-up period of 8 weeks. A 66-item validated instrument was used to collect data at three reference points and response items for variables in the study were transformed into weighted-aggregate scores of mean and standard deviation of HBV infection prevention practice of participants. Statistical analysis of ANOVA, paired-sample t-test and Cohen's D Effect Size (ES) was used to quantify the changes produced by the intervention on the outcome variable at 5% level of significance. At baseline, there was no significant difference (p > 0.05) in the mean HBV infection prevention practice scores between the four groups E1 (17.21 ± 3.03), E2 (15.57 ± 1.90), E3 (17.90 ± 3.10), and C (15.20 ± 2.44). However, at 14th week follow up, there was observed significant differences in mean scores of HBV infection prevention practices between all four groups E1 (23.09 ± 2.4), E2 (22.6 ± 3.6), E3 (23.82 ± 2.3), and C (15.25 ± 2.4). Paired-sample t-test conducted demonstrated significant differences between baseline and 14th week follow up for E1 (17.21 ± 3.07 and 23.18 ± 2.9; p = 0.001), E2(15.57 ± 1.90 and 23.53 ± 3.12; p = 0.001), E3(17.90 ± 3.10 and 25.1 ± 2.6; p < 0.001), but not for C (15.20 ± 2.44 and 15.25 ± 2.4; p = 0.92), with most significant impact (ES(95%CI) on HBV infection prevention practices observed for E2(3.106 95%CI: [2.66 to 3.55; p = 0.001]). Importantly, the participants in E2 showed more improvement in prevention practices than their counterparts from E1, E3, and control. Therefore, the intervention demonstrated proof-of-concept in facilitating behavior modification expected. Peer education can be utilized as a strategy to promote Hepatitis B infection prevention practices among adolescents.

Prebiotics modulate the microbiota–gut–brain axis and ameliorate anxiety and depression-like behavior in HFD-fed mice

Previous research has demonstrated that Prebiotics can influence the composition of the gut microbiota, consequently impacting mood regulation. This study aimed to assess the effects of Prebiotics, specifically Fructooligosaccharides (FOS) and Galactooligosaccharides (GOS) on neuroinflammation, depression, and anxiety-like behavior in a mouse model fed a high-fat diet (HFD). Initially, mice were divided into two groups: a control group on a standard diet (n = 15) and a group on an HFD for 18 weeks (n = 45). By the 13th week, the HFD group was further divided into experimental groups: Control (n = 15), HFD (n = 15), HFD receiving Prebiotics (n = 15), and HFD receiving Fluoxetine (n = 15). From the 13th week onward, the HFD + Prebiotics group received both the high-fat diet and a combination of FOS and GOS, while the HFD + Fluoxetine group received Fluoxetine in their drinking water. In the 18th week, all mice underwent tests to evaluate behavior, including the Tail Suspension Test (TST), Forced Swimming Test (FST), Sucrose Preference Test (SPT), and the Plus Maze Test (PMT), after which they were euthanized. Mice on the HFD exhibited increased body weight, abdominal size, blood glucose, triglyceride levels, cholesterol, insulin, HOMA index, and higher serum IL-1β. These obese mice also displayed an increased number of microglia and astrocytes, activation of the TLR4 pathway, and elevated levels of neuroinflammatory markers like TNF-α, IL-1β, and COX-2. Moreover, obese mice showed increased activation of the IDO pathway and decreased levels of NMDA receptors. Additionally, markers of neurogenesis and synaptic plasticity, such as PSD, SAP 102, CREB-p, and BDNF, were lower. Treatment with FOS and GOS reversed symptoms of depression and anxiety in mice subjected to HD. This improvement in behavior resulted from a reduction in dysbiosis with an increase in acetate-producing bacteria (B. acidifaciens and B. dorei) and intestinal permeability, leading to a decrease in chronic peripheral and central inflammation. Furthermore, the modulation of the gut-brain axis by FOS and GOS promoted elevated acetate and GPR43 levels in the brain and a reduction in the levels of pro-inflammatory cytokines, positively impacting signaling pathways of neuronal proliferation and survival in the hippocampus and prefrontal cortex.

ACACA reduces lipid accumulation through dual regulation of lipid metabolism and mitochondrial function via AMPK- PPARα- CPT1A axis

BackgroundNon-alcoholic fatty liver disease (NAFLD) is a multifaceted metabolic disorder, whose global prevalence is rapidly increasing. Acetyl CoA carboxylases 1 (ACACA) is the key enzyme that controls the rate of fatty acid synthesis. Hence, it is crucial to investigate the function of ACACA in regulating lipid metabolism during the progress of NAFLD.MethodsFirstly, a fatty liver mouse model was established by high-fat diet at 2nd, 12th, and 20th week, respectively. Then, transcriptome analysis was performed on liver samples to investigate the underlying mechanisms and identify the target gene of the occurrence and development of NAFLD. Afterwards, lipid accumulation cell model was induced by palmitic acid and oleic acid (PA ∶ OA molar ratio = 1∶2). Next, we silenced the target gene ACACA using small interfering RNAs (siRNAs) or the CMS-121 inhibitor. Subsequently, experiments were performed comprehensively the effects of inhibiting ACACA on mitochondrial function and lipid metabolism, as well as on AMPK- PPARα- CPT1A pathway.ResultsThis data indicated that the pathways significantly affected by high-fat diet include lipid metabolism and mitochondrial function. Then, we focus on the target gene ACACA. In addition, the in vitro results suggested that inhibiting of ACACA in vitro reduces intracellular lipid accumulation, specifically the content of TG and TC. Furthermore, ACACA ameliorated mitochondrial dysfunction and alleviate oxidative stress, including MMP complete, ATP and ROS production, as well as the expression of mitochondria respiratory chain complex (MRC) and AMPK proteins. Meanwhile, ACACA inhibition enhances lipid metabolism through activation of PPARα/CPT1A, leading to a decrease in intracellular lipid accumulation.ConclusionTargeting ACACA can reduce lipid accumulation by mediating the AMPK- PPARα- CPT1A pathway, which regulates lipid metabolism and alleviates mitochondrial dysfunction.

Current aspects of the pathogenesis and prevention of preeclampsia

One of the most dangerous complications of pregnancy is preeclampsia. For effective prevention of preeclampsia, it is necessary to understand its mechanisms of development clearly. The analysis of modern patterns of preeclampsia cause and development are reviewed in this article. There are also the evidences of more effective strategies of prevention preeclampsia in our review, which have proven themselves most of all. The generalized endothelial mother’s disfunction is in the base of preeclampsia pathogenesis and caused by placental factors, genetical susceptibility and the lack of arterial invasion in trophoblast’s cell hereupon it increases the oxidative stress and inflammatory process, leading to complications of mother and fetus. More accurate understanding of preeclampsia mechanisms allows us to correct the adverse of lifestyle of patients and highlight those who are in the group of PE risk and need the prophylaxis to be prescribed. Nowadays, acetylsalicylic acid is a commonly accepted therapeutic medication and reliably effective (optimal dose from 75 to 162 mg). It is prescribed as the prevention from 11th to 14th week.

Impact of Abiotic Factors on Occurrence of Capsule Borer and Sucking Pests in Sesamum

A field experiment was conducted at Agricultural college, Naira, Srikakulam, Andhra Pradesh, India during early summer (January–April) of 2021 to know about the incidence of leaf webber and sucking pests viz., leafhopper (Hishimonus phycitis Distant) and whitefly (Bemisia tabaci Gennadius) its relation with main weather factors. Results revealed that a peak incidence of mean capsule borer population per plant were recorded in 9th and 11th standard weeks, respectively. The correlation study revealed that the Antigastra larvae had significantly positive correlation with maximum temperature (r=0.48) and significantly negative correlation with relative humidity (r=- 0.71). The regression analysis revealed that these factors accounted for approximately 59.8% of the variation in the capsule borer population (R2=0.598). The incidence of leafhopper (Hishimonus phycitis Distant) and whitefly (Bemisia tabaci Gennadius) were started during 5th and 4th SMW attained their peaks during 11th an 12th SMW respectively. The correlation study revealed that the leafhopper showed significant positive correlation with maximum temperature (r=0.623) and minimum temperature (r=0.283) and significantly negatively correlated with morning and evening relative humidity (r=-0.165, r=-0.122) respectively. While the correlation study between whitefly population and weather parameters revealed that the it showed positive correlation with maximum (r=0.821) and minimum (r=0.120) temperature and negatively correlated with morning and evening relative humidity (r=-0.097, r=-0.182) respectively whereas, rainfall showed non-significant correlation (r=0.00) with the both sucking pests.

Reassuring pregnancy outcomes in women with mild COL4A3-5–related disease (Alport syndrome) and genetic type of disease can aid personalized counseling

Individualized pre-pregnancy counseling and antenatal care for women with chronic kidney disease (CKD) require disease-specific data. Here, we investigated pregnancy outcomes and long-term kidney function in women with COL4A3-5 related disease (Alport Syndrome, (AS)) in a large multicenter cohort. The ALPART-network (mAternaL and fetal PregnAncy outcomes of women with AlpoRT syndrome), an international collaboration of 17 centers, retrospectively investigated COL4A3-5 related disease pregnancies after the 20th week. Outcomes were stratified per inheritance pattern (X-Linked AS (XLAS)), Autosomal Dominant AS (ADAS), or Autosomal Recessive AS (ARAS)). The influence of pregnancy on estimated glomerular filtration rate (eGFR)-slope was assessed in 192 pregnancies encompassing 116 women (121 with XLAS, 47 with ADAS, and 12 with ARAS). Median eGFR pre-pregnancy was over 90ml/min/1.73m2. Neonatal outcomes were favorable: 100% live births, median gestational age 39.0 weeks and mean birth weight 3135 grams. Gestational hypertension occurred during 23% of pregnancies (reference: 'general' CKD G1-G2 pregnancies incidence is 4-20%) and preeclampsia in 20%. The mean eGFR declined after pregnancy but remained within normal range (over 90ml/min/1.73m2). Pregnancy did not significantly affect eGFR-slope (pre-pregnancy β=-1.030, post-pregnancy β=-1.349). ARAS-pregnancies demonstrated less favorable outcomes (early preterm birth incidence 3/11 (27%)). ARAS was a significant independent predictor for lower birth weight and shorter duration of pregnancy, next to the classic predictors (pre-pregnancy kidney function, proteinuria, and chronic hypertension) though missing proteinuria values and the small ARAS-sample hindered analysis. This is the largest study to date on AS and pregnancy with reassuring results for mild AS, though inheritance patterns could be considered in counseling next to classic risk factors. Thus, our findings support personalized reproductive care and highlight the importance of investigating kidney disease-specific pregnancy outcomes.

The effect of caponization on tibia bone histomorphometric properties of crossbred roosters

The negative effect of caponization on the structural, geometric and mechanical parameters of femur and tibia has been shown in a few studies. Nevertheless, its influence on tibia bone microarchitecture is still largely unknown. Therefore, this study aimed to assess the effect of castration on the microstructural parameters of the trabecular and compact bone of tibia bone in crossbred chickens. The experiment involved 96 roosters derived from crossing Yellowleg Partridge hens (Z˙\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\dot{\ ext{Z}}}$$\\end{document}-33) and Rhode Island Red cockerels (R-11) fattened until the 16th, 20th and 24th week of life. Animals were randomly divided into 2 groups of 48 each. Group I (control) consisted of intact roosters and group II (experimental) consisted of birds subjected to caponization at the 8th week of age. The castration surgery had no influence on some properties within compact bone such as osteon diameter On.Dm, osteon perimeter On.Pm, osteon area On.Ar, osteocyte lacunar number Ot.Lc.N, osteon bone area On.B.Ar, osteon wall thickness On.W.Th as well as thick-mature collagen content in all analyzed age groups of animals. Nevertheless, our results demonstrate that castration caused a decrease of Haversian canal area Hc.Ar, osteocyte lacunar area Ot.Lc.Ar and osteocyte lacunar porosity Ot.Lc.Po among the 16-week-old birds, decrease of Haversian canal perimeter Hc.Pm and increase of fraction of bone area On.B.Ar/On.Ar among 16- and 24-week-old individuals and also an increase of osteocyte lacunar density Ot.Lc.Dn in the osteons of the oldest roosters. Additionally, some microstructural parameters of trabecular bone show the negative effect of caponization. The youngest 16-week-old capons were characterized by thinnin the trabecular in the epiphysis part of tibia. Moreover, in the case of 24-week-old, there is an increase in the trabecular separation Tb.Sp with simultaneous decrease of trabecular number Tb.N compared to roosters, which may suggest the increase of the bone resorption among the oldest individuals. The increased bone turnover in the epiphysis part of the tibia bone also indicates changes in the collagen fibers distribution, where among 20-week-old animals there is a decrease in the content of immature thin collagen fibers with simultaneous increase in the content of mature thick collagen fibers. Furthermore, among the oldest 24-week-old individuals we can observe the increased thick-to-thin collagen ratio, which may be a sign of slowing down in bone formation.

Effects of structured exercise program on severity of dizziness, kinesiophobia, balance, quality of sleep, activities of daily living and quality of life in bilateral vestibular hypofunction: case study

Background and Purpose. The vestibular rehabilitation is an exercise-based method, aiming to maximize central nervous system(CNS) compensation at vestibular nuclear and other CNS levels for vestibular pathology. A minimal number of studies have documented the impact of Vestibular rehabilitation on the recovery rate of patients with Bilateral Vestibular Hypofunction(BVH). The purpose of this study was to investigate the effectiveness of structured vestibular rehabilitation (VR) programs on severity of dizziness, kinesiophobia, balance, quality of sleep, activities of daily living(ADL) and quality of life(QoL) in subjects with chronic BVH. Case Description. Three participants diagnosed with BVH who suffered from severity of dizziness, kinesiophobia, balance, quality of sleep, ADL and QoL were included in the study. Intervention. A structured VR program was applied in 50-minute sessions once a week and as a home exercise program 3 days a week over 8 weeks. Outcomes. Participants were evaluated for severity of dizziness with the Visual Analog Scale (VAS), for kinesiophobia with the Tampa Scale of Kinesiophobia (TSK), for balance with the Semitandem, tandem, and standing tests, for quality of sleep with the Pittsburgh Sleep Quality Index (PSQI), for ADL with the Vestibular Disorders Activities of Daily Life (VADL) and for QoL with Dizziness Handicap Inventory (DHI) at the baseline (T0), at 4th week (T1), 8th week (T2), and 20th week (T3) after study started. Conclusion. In conclusion, a twelve-week structured VR program may enhance severity of dizziness, kinesiophobia, balance, quality of sleep, ADL and QoL in participants with chronic BVH.

Investigating the conception of collaborative learning (CL) and student engagement in the acquisition of practical skills (SEPSA) among prospective physical education and sports students.

The study aims to explore the association between collaborative learning and practical skills acquisition (SEPSA) among 310 students from second-year, third-year, and fourth-year (First stage of higher education) from the Institute of Arts, Culture, and Sports- Abai Kazakh National Pedagogical University. The data was collected using the time-lag approach at three intervals; 3rd week, 7th week, and 14th week. The mediation analysis suggests that collaborative learning (CL) has a positive mediating association with self-efficacy, and student engagement in practical skills acquisition (SEPSA). Additionally, collaborative learning (CL) has a positive mediating association with value-benefits, and practical skills acquisition (SEPSA). Furthermore, Collaborative learning (CL) has a positive significant association with practical skills acquisition (SEPSA). Our findings highlight the important potential of CL for increasing SEPSA. The finding of the study has implications for higher education teachers, students, administrators, and policymakers for developing more effective teaching and learning approaches using the concept of sharing and discussion with a specific focus on students' engagement.

Assessment of serum markers in preeclampsia: A prospective study

Preeclampsia is a disease characterized by hypertension, proteinuria, and edema that occurs after the 20th gestational week. It is among the most important reasons for maternal/perinatal morbidity and mortality. Although many studies have been carried out, the pathophysiology of the disease is not fully known. Many methods have been proposed for evaluating risk factors leading to preeclampsia. In the past, the methods used to predict preeclampsia have usually been focused on non-biochemical markers, but nowadays there is a shift towards biochemical markers. Recently, many biochemical agents have been started to be used in the prediction of preeclampsia. In this study, the evaluation of some serum biomarkers in the follow-up preeclampsia was aimed. Serum nesfatin, ezrin, placental protein 13, hypoxia-inducible factor 1-α subunit (HIF1A), and neuropilin 1 levels were examined with the ELISA method. In the study, 90 samples taken from subjects, including pre-treatment preeclampsia (n =35), post-treatment preeclampsia (n = 35), and healthy control (n = 20) groups were evaluated. The data obtained from the study was analyzed with SPSS 22.0. As a result of the statistical analysis, pre-treatment nesfatin-1, and ezrin levels were found significantly lower than post-treatment and the healthy control group and HIF-1A levels were found significantly higher. As a result of these analyses, pre-treatment and post-treatment PP13 levels were found to be significantly higher than the healthy control group.Considering the results obtained from the study, we can say that nestin, ezrin, HIF1A, PP13, and NRP1 are important biomarkers for predicting preeclampsia.

The role of second trimester uterine artery Doppler in predicting obstetric and neonatal outcomes in abnormal first trimester maternal serum pregnancy-associated plasma protein-A and free β-human chorionic gonadotropin values.

This study aims to determine whether second-trimester uterine artery (UtA) Doppler combined with first-trimester abnormal pregnancy-associated plasma protein-A (PAPP-A) and β-human chorionic gonadotropin (β-Hcg) levels predicts adverse obstetric and neonatal outcomes. This study of 289 pregnant women included 196 with normal PAPP-A and free β-HCG values (control group) and 93 with abnormal values (study group) in the first-trimester screening test. Second-trimester UtA Doppler sonography was done in these pregnancies. The perinatal prediction and screening potential of UtA Doppler pulsatility index (PI) parameters were examined in the study group. UtA PI >95 percentile increased birth before the 37th week by 4.46 times, birth before the 34th week by 7.44 times, preeclampsia risk by 3.25 times, fetal growth restriction (FGR) risk by 4.89 times, and neonatal intensive care unit (NICU) admission rates by 3.66 times in the study group (p < 0.05 for all). UtA PI >95 percentile had 49.2% sensitivity and 82.1% specificity for birth before 37 weeks. For birth before 34 weeks, sensitivity was 80.0% and specificity 65.0%. FGR has 70.5% sensitivity and 67.1% specificity. Screening for preeclampsia has 66.6% sensitivity and 61.9% specificity. Adding UtA Doppler in the second trimester to pregnancies with abnormal PAPP-A and/or free β-Hcg values in the first trimester may be a useful screening method for adverse outcomes.

A241 CORRELATION BETWEEN PLASMA IGA LEVEL AND BIOLOGICAL THERAPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract Background IgA is the predominant antibody class secreted by intestinal immune cells. However, the level of plasma IgA in Inflammatory Bowel Disease (IBD) patients under medical treatment remains unknown. Therefore, our study aimed to investigate the relationship between plasma IgA concentration in IBD patients under biological therapy. Aims To assess the correlation between plasma IgA level in IBD patients under biological therapy. Methods We collected data from outpatient clinics at our hospital, including 12 IBD patients, comprising 4 patients with Crohn's disease (CD) and 8 patients with Ulcerative Colitis (UC). Data was collected between 2020 and 2023. We measured plasma IgA concentrations both before initiating biologic therapy and at the 14th week of biological treatment (4 under Adalimumab and 8 under Vedolizumab). Additionally, we compared baseline plasma IgA levels between 24 IBD patients (7 CD and 17 UC) and 24 healthy individuals. Student T test was used for statistical analyze. Results The average baseline plasma IgA level was significantly higher in IBD patients (2134±187.2 ug/ml, mean ± standard error) when compared to healthy individuals (1346± 114.8 ug/ml, p=0.0008). In the view of CD and UC, the baseline plasma IgA level was 2179±439.4 ug/ml and 2116±203.1 ug/ml, respectively. Baseline plasma IgA level also showed statistical significantly higher in CD and UC compared to healthy individuals (p=0.0063, p=0.0005, respectively), and without difference between UC and CD patients (p=0.8824) (Figure 1A). Furthermore, we investigated the impact of biological therapy on plasma IgA levels in IBD patients, finding a significant decrease in plasma IgA levels after biological therapy (2182±254.7 ug/ml to 1824±135.5 ug/ml, p=0.0181). Similar trend was noted in UC patients under biological therapy with borderline statistical significant (2141± 307.7ug/ml to1809±173.3ug/ml, p=0.0561), but not found in CD patients (2265±518.3 ug/ml to 1855±247.5 ug/ml, p= 0.1333)(Figure 1B). Conclusions We found that baseline plasma IgA level was higher in IBD patients compared to healthy individuals. Besides, plasma IgA level decreased after biological therapy in IBD patients, especially in UC patients. These findings suggest that plasma IgA level may be a potential biomarker for IBD patients. Funding Agencies None

Approach To Pregnant Women with Mechanical Mitral Valve Prosthesis: A Case Report

Cardiovascular diseases are one of the leading causes of maternal mortality. The management of pregnant women with mechanical valve prosthesis is difficult. Fetal-maternal mortality and morbidity are high. Selection of the most appropriate anticoagulant that will minimize fetal, maternal mortality and avoid embryopathy risk should be tailored according to the needs of each individual patient. &#x0D; In this paper, in the light of the literature, we aimed to discuss our patient, who delivered at 39th gestational week after a pregnancy before which she had not been provided with prepregnancy counseling and during which she did not attend follow-up visits.&#x0D; These patients prepregnancy counseling, follow-up visits, anticoagulant management during pregnancy, and prophylaxis and management of complications at the postpartum period are very important and require close follow-up.

Impact of Weather Parameters on Seasonal Incidence of Oriental Armyworm, Mythimna separata (Lepidoptera; Noctuidae) Infesting Maize Ecosystem in North Kashmir

The investigation on the seasonal incidence of oriental armyworm, Mythimna separata was conducted at the Faculty of Agriculture, Wadura SKUAST-K during kharif 2021. Shalimar composite-6 maize variety was cultivated under the standard practices for Kashmir valley, recommended by SKUAST-K. The pest activity during the crop growth period was monitored by using light traps and visual observations. Findings revealed that adult M. separata on maize emerged in the 18th standard meteorological week (SMW) with its peak in the 24th week and remained active until the 37th week. Similarly, armyworm caterpillars appeared in the 19th to 37th SMW and reached their peak in the 29th week in the maize ecosystem during 2021. Moreover, the percentage of infestation during the Kharif season was found to be minimum of 10 per cent in the 19th SMW, reaching its peak of 63 per cent in the 29th SMW. The infestation gradually decreased and persisted for eight weeks, with 10 per cent infestation in the 37th SMW. The relationship between adult population and weather parameters showed a positive correlation with maximum temperature (r = 0.14) and a negative correlation with minimum temperature (r = -0.22), morning relative humidity (r = -0.52*) and evening relative humidity (r = -0.47*). However, M. separata adult populations showed a significant negative association with rainfall (r = -0.51*). Correlations drawn between important weather parameters and larvae of M. separata showed significant positive correlation with maximum temperature (r = 0.60**) and minimum temperature (r =0.56**), while morning RH (r = -0.36) and evening RH (r = -0.29) showed negative association and rainfall (r =-0.16) also exhibited negative association with the larval infestation of M. separata during Kharif 2021. The study on percentage infestation also demonstrated a significant positive correlation with maximum temperature (r = 0.47*) and minimum temperature (r = 0.53*), while morning relative humidity (r = -0.22) and evening relative humidity (r = -0.29) showed negative associations. Rainfall (r = -0.20) displayed a negative correlation with the per cent infestation of M. separata.

Functional and union outcome of combined column tibial plateau fracture treated with hybrid external fixator.

To determine the combined column tibial plateau fracture treated with a hybrid external fixator in terms of knee functionality, union outcome and complications. The quasi-experimental study was conducted at the Department of Orthopaedic Surgery, Mayo Hospital, Lahore, Pakistan, from July 5, 2019, to December 31, 2021, and comprised patients of either gender aged 20-50 years who presented with 2-column or 3-column fractures of proximal tibia classified according to the 3-column classification system after being diagnosed using radiographs and three-dimensional computed tomography scan. Knee function, union and complications, like neural, vascular, infection, delayed union, nonunion, malunion and implant failure, were evaluated. The Knee Society Score was used to assess knee function, and modified Rasmussen score for the union, while complications were assessed clinically on the 2nd, 6th, 12th, 16th, 24th, 36th weeks and one year post-operatively. Data was analysed using SPSS 26. Of the 113 patients, 91(80.53%) were males and 22(19.47%) were females. The overall mean age was 35.56±9.00 years. From the 12th week to the 24th week 45(39.83%) patients had good and 59(52.21%) patients had excellent functional outcomes. Union outcome in the 16th and 24th week was good in 57(50.44%) patients and excellent in 47(41.59%) patients. No neurovascular injury was observed. Superficial pin tract infection was observed in 21(18.6%) cases that healed with wound debridement and antibiotics. No delayed union, malunion and implant failure was observed. Good to excellent functional and union outcomes with minimum complications were observed with the hybrid external fixator.

Multilayer factors associated with excess all-cause mortality during the omicron and non-omicron waves of the COVID-19 pandemic: time series analysis in 29 countries.

The COVID-19 pandemic has resulted in significant excess mortality globally. However, the differences in excess mortality between the Omicron and non-Omicron waves, as well as the contribution of local epidemiological characteristics, population immunity, and social factors to excess mortality, remain poorly understood. This study aims to solve the above problems. Weekly all-cause death data and covariates from 29 countries for the period 2015-2022 were collected and used. The Bayesian Structured Time Series Model predicted expected weekly deaths, stratified by gender and age groups for the period 2020-2022. The quantile-based g-computation approach accounted for the effects of factors on the excess all-cause mortality rate. Sensitivity analyses were conducted using alternative Omicron proportion thresholds. From the first week of 2021 to the 30th week of 2022, the estimated cumulative number of excess deaths due to COVID-19 globally was nearly 1.39million. The estimated weekly excess all-cause mortality rate in the 29 countries was approximately 2.17 per 100,000 (95% CI: 1.47 to 2.86). Weekly all-cause excess mortality rates were significantly higher in both male and female groups and all age groups during the non-Omicron wave, except for those younger than 15 years (P < 0.001). Sensitivity analysis confirmed the stability of the results. Positive associations with all-cause excess mortality were found for the constituent ratio of non-Omicron in all variants, new cases per million, positive rate, cardiovascular death rate, people fully vaccinated per hundred, extreme poverty, hospital patients per million humans, people vaccinated per hundred, and stringency index. Conversely, other factors demonstrated negative associations with all-cause excess mortality from the first week of 2021 to the 30th week of 2022. Our findings indicate that the COVID-19 Omicron wave was associated with lower excess mortality compared to the non-Omicron wave. This study's analysis of the factors influencing excess deaths suggests that effective strategies to mitigate all-cause mortality include improving economic conditions, promoting widespread vaccination, and enhancing overall population health. Implementing these measures could significantly reduce the burden of COVID-19, facilitate coexistence with the virus, and potentially contribute to its elimination.

Pathogenic agents causing acute respiratory tract infections in pediatric patients in Spring, 2023, in Beijing

Objective: To explore the pathogenic agents of acute respiratory infection (ARI) in children in Beijing. Methods: In the cross-sectional study, 3 groups of children from different departments were enrolled from Feb 6th, 2023 (6th week) to May 28th (21th week), 2023, including influenza-like case group from emergency department for nucleic acid testing of influenza virus (Flu) and human metapneumovirus (HMPV), the outpatient ARI group under nucleic acid testing for Flu, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza virus (PIV), and the inpatient ARI group under nucleic acid testing for Flu, RSV, HMPV, ADV, human bocavirus (HBoV), Rhinovirus (Rh), PIV, coronavirus (HCoV), Mycoplasma pneumoniae (Mp) and Chlamydia pneumonia (Cp). Results: There were 320 influenza-like cases enrolled, including 192 males and 128 females, aged 4.7 (3.6, 6.9) years, and 117 cases (36.6%) positive for Flu A, which contained similar proportion of pandemic H1N1 (H1N1) 47.0% (55/117) and H3N2 53.0% (62/117), and 13 cases for HMPV 4.1% (13/320). The rate of Flu reached its peak at the 10th week, with H1N1 as the predominant one from the 6th to 9th week (10.0%-50.0%) and then H3N2 from the 10th to 16th week (15.0%-90.0%). HMPV was detected from the 15th week 5.0% (1/20), and then reached to 30.0% (6/20) at the 20th week. In the outpatient ARI group, 7 573 were enrolled, including 4 131 males and 3 442 females, aged 4.0 (2.1, 5.3) years, and the highest positive rate for RSV 32.9% (2 491/7 573), followed by Flu A 12.1% (915/7 573). The dominant one was Flu A in weeks 6-14 (23.2%-74.7%), then RSV in the 15th week 24.8% (36/145). In the inpatient ARI group, 1 391 patients were enrolled, including 804 males and 587 females, aged 3.3 (0.4, 5.8) years, and the highest positive rate for Rh 18.7% (260/1 391), followed by RSV 12.4% (173/1 391), Flu A 10.2% (142/1 391, of which 116 cases (81.7%) were H1N1, and 26 cases (18.3%) were H3N2) and HMPV 3.1% (43/1 391). H1N1 was detected from the 7th week 10% (6/60), to peak in the 11th week 31.8% (21/66). H3N2 was detected from the 8th week 1.5% (1/68), and then kept in low level. The proportion of H1N1 among Flu was 81.7% (116/142) in the inpatient ARI group. RSV was detected from 12th week 1.3% (1/80), reaching 30.4% (35/115) at 19th week. The positive rate of HMPV reached 12.1% (14/116) at 21th week. Conclusions: In the spring of 2023, the first one in Beijing is the Flu epidemic, with H1N1 being the predominant one in the early stage and H3N2 in the later stage. Then, there is a postponed RSV epidemic and an increased HMPV detection. In addition, nucleic acid testing for outpatient children should be strengthened to provide early warning of epidemics.

Physical activity, gestational weight gain in obese patients with early gestational diabetes and the perinatal outcome – a randomised–controlled trial

BackgroundExcessive gestational weight gain, especially among women with gestational diabetes, is associated with several adverse perinatal outcomes. Our study aimed to analyse the impact of the use of pedometers to supervise physical activity on maternal health and the obstetric outcomes of pregnant women with obesity and early gestational diabetes.Methods124 pregnant patients were enrolled in the presented research. Inclusion criteria: singleton pregnancy, age > 18 years, gestational diabetes diagnosed in the first half of pregnancy (< 20th week of pregnancy), obesity according to the American Endocrine Society criteria. Each patient was advised to take at least 5000 steps daily. Patients were randomly assigned to pedometers (N = 62), and were recommended to monitor daily the number of steps. The group without pedometers (N = 62) was not observed. Visit (V1) was scheduled between the 28th and 32nd gestational week (GW), and visit (V2) occurred between the 37th and 39th GW. Anthropometric measurements and blood samples were collected from all patients at each appointment. Foetal and maternal outcomes were analysed at the end of the study.ResultsIn the group supervised by pedometers, there were significantly fewer newborns with macrosomia (p = 0,03). Only 45% of patients satisfied the recommended physical activity guidelines. Patients who walked more than 5000 steps per day had significantly higher body weight at baseline (p = 0,005), but weight gain was significantly lower than in the group that did not exceed 5000 steps per day (p < 0,001). The perinatal outcome in the group of patients performing more than 5000 steps did not demonstrate significant differences with when compared to less active group. ROC curve for weight gain above the guidelines indicated a statistically substantial cut–off point for this group at the level of 4210 steps/day (p = 0.00001).ConclusionsMonitoring the activity of pregnant patients with gestational diabetes and obesity by pedometers did not have a significantly impact on their metabolic control and weight gain. However, it contributed to less macrosomia. Furthermore, physical activity over 5,000 steps per day positively affects weight loss, as well as contributes to improved obstetric and neonatal outcomes.