Biological Changes Research Articles

Transcriptome-aligned metabolic profiling by SERSome reflects biological changes following mesenchymal stem cells expansion

BackgroundMesenchymal stem cells (MSCs) are widely applied in the treatment of various clinical diseases and in the field of medical aesthetics. However, MSCs exhibit greater heterogeneity limited stability, and more complex molecular and mechanistic characteristics compared to conventional drugs, making rapid and precise monitoring more challenging.MethodsSurface-enhanced Raman spectroscopy (SERS) is an ultrasensitive, tractable and low-cost fingerprinting technique capable of identifying a wide range of molecules related to biological processes. Here, we employed SERS for reproducible quantification of ultralow concentrations of molecules and utilized spectral sets, termed SERSomes, for robust and comprehensive intracellular multi-metabolite profiling.ResultsWe revealed that with increasing passage number, there is a gradual decline in cell expansion efficiency, accompanied by significant changes in intracellular amino acids, purines, and pyrimidines. By integrating these metabolic features detected by SERS with transcriptomic data, we established a correlation between SERS signals and biological changes, as well as differentially expressed genes.ConclusionIn this study, we explore the application of SERS technique to provide robust metabolic characteristics of MSCs across different passages and donors. These results demonstrate the effectiveness of SERSome in reflecting biological characteristics. Due to its sensitivity, adaptability, low cost, and feasibility for miniaturized instrumentation throughout pretreatment, measurement, and analysis, the label-free SERSome technique is suitable for monitoring MSC expansion and offers significant advantages for large-scale MSC manufacturing.

The Relationship of Limitations in Daily Living Activities and Other Health-Related Factors with Early Retirement.

The deterioration in health and functionality in older ages, in addition to biological changes, is affected by physical changes. Therefore, early retirement may become an inevitable choice. This study aimed to evaluate the relationship between limitations in daily living activities, mobility, and other health factors with early retirement in workers aged 50-67 in the 4th wave of the SHARE study in Europe. In this prospective cohort study, the working status was examined in 4 waves. The frequency of early retirement was 16.1%; it was higher in male and low-educated people. Those with poor self-perceived health and those with more chronic diseases retired earlier. The frequency of early retirement was 16.0% for those who had no difficulty in basic daily living activities, 22.4% for those who had difficulties (p 0.019), and those who had limitations retired earlier (RR 1.50). Early retirement was higher in those with two or more chronic diseases compared to those without (RR 1.26) and was higher in those who consumed alcohol 5days a week than those who didn't (RR 1.34). A 1-unit increase in BMI increased the risk by 1.02 times. It has been clearly revealed how important basic activities are for early retirement. This new finding is a gain for the literature and will provide new insights intervention studies. Those who had difficulty in instrumental activities and mobility retired early more often, but this wasn't statistically significant. Our findings will contribute to increasing workplace protective approaches, and maintaining a healthy working force for years.

Effect of the COVID-19 Pandemic on the Management of Breast Cancer Patients

Background: The COVID-19 pandemic has significantly affected breast cancer patients by causing delays in diagnosis and treatment processes. This study aims to investigate the effects of the pandemic on the treatment process and short-term outcomes of breast cancer patients. Methods: This retrospective, cross-sectional, single-center study included 414 patients who underwent surgery for breast cancer at the Inonu University General Surgery Clinic between March 2018 and June 2021. The patients were divided into two groups: pre-pandemic (Pre-COVID-19; n = 240) and pandemic (COVID-19 Era; n = 174) periods. The groups were compared in terms of demographic, clinical, and histopathological variables. Results: During the pandemic period, the use of neoadjuvant therapy (from 21.3% to 34.5%) and preoperative PET-CT imaging (from 80.4% to 90.8%) rates increased, while breast-conserving surgery (from 27.9% to 19.0%) and the presence of comorbid diseases (from 45.0% to 29.9%) decreased significantly. While there was no significant difference between the groups in terms of the time from diagnosis to surgery (25 vs. 28.5 days, p = 0.121), the time to report the pathology result after surgery decreased during the pandemic period (28 vs. 23 days, p < 0.001). There was no significant difference between the groups in terms of immunohistochemical (ER, PR, Ki-67, E-cadherin, and c-erbB2), histopathological (lymphovascular invasion, perineural invasion, comedo necrosis, modified Bloom–Richardson grade, and TNM classification), and clinical (recurrence, metastasis, and axillary lymph node metastasis) features of the tumor. The mortality rate in the Pre-COVID-19 group (7.1%) was significantly higher than in the COVID-19 Era group (2.3%) (p = 0.049). Finally, in terms of the survival analysis, a statistically significant difference was found between the Pre-COVID-19 and COVID-19 Era groups in terms of the mean follow-up duration of the patients (p = 0.044). Conclusions: The study results show that the use of neoadjuvant therapy and radical surgery preference increased in breast cancer treatment during the pandemic period, but there was no significant change in tumor biology and histopathological features. Breast-conserving surgery rates, comorbidity rates, and pathology reporting times were significantly shortened. Long-term follow-up periods of 3 and 5 years are needed to see the impact of the pandemic on breast cancer patients.

Altered eotaxin-1 and interleukin-34 levels in obsessive-compulsive disorder: a case-control observational study in Bangladesh.

Obsessive-compulsive disorder (OCD) is a prevalent mental health condition that impacts daily life. It is thought to be associated with genetic, biological, and structural brain changes, serotonergic abnormalities, altered neuromodulation, and environmental factors. Limited observational studies have examined cytokines in Bangladeshi patients with OCD. This study aimed to assess the levels of eotaxin-1 and interleukin (IL)-34 in individuals with this disorder. This case-control observational study included 58 patients with OCD and 30 healthy controls (HCs) matched for age, sex, and body mass index. The severity of OCD was assessed using the Yale-Brown obsessive-compulsive scale (Y-BOCS). Psychiatrists evaluated participants according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Serum levels of eotaxin-1 and IL-34 were measured using enzyme-linked immunosorbent assay kits. Patients with OCD exhibited significantly higher serum eotaxin-1 levels (121.13±7.84 pg/mL) than HCs (85.52±9.42 pg/mL). Conversely, IL-34 levels were considerably lower in patients than in HCs (119.02±14.53 pg/mL vs. 179.96±27.88 pg/mL). The Cohen d values for eotaxin-1 and IL-34 were 0.55 and -0.48, respectively. Among patients with OCD, a significant positive correlation was found between serum eotaxin-1 level and Y-BOCS score, along with a negative correlation between serum eotaxin-1 and IL-34 levels. The findings suggest that altered eotaxin-1 and IL-34 levels may be associated with OCD. These chemokines and cytokines could serve as primary tools for assessing the risk of OCD, warranting further clinical investigation. This could potentially support more extensive research and the development of diagnostic and therapeutic strategies targeting these pathways.

Ontogenetic change in body shape for white sharks, Carcharodon carcharias, in Australian waters.

The analysis of how biological shape changes across ontogeny can provide us with valuable information on how species adapt behaviorally, physiologically, and ecologically. The white shark Carcharodon carcharias is one of the largest and most widely distributed apex predators globally, yet an understanding of ontogenetic changes in body shape and relative scaling of length and weight measures is limited, especially in relation to foraging ecology. Through analysis of a suite of shape-related metrics, we identified ontogenetic patterns of scaling throughout development. Isometric growth was exhibited for most metrics, failing to show a significant deviation from an isometric slope of 1.0 for length-length relationships, and 3.0 for weight-length relationships. The most notable difference from this trend was the negative allometric growth observed for the upper caudal-fin lobe length, trunk length, and the mouth length. The surface area of the fins also presented a strong, positive relationship with precaudal length (PCL) and the girth at the pectoral fin. Negative allometric growth was exhibited for three of the fins (pectoral, upper caudal fin, and lower caudal fin) against PCL, exhibiting a significant deviation from the expected isometric growth of 2.0 for area-length relationships. There were no significant differences in morphometric relationships between geographic regions within Australia that samples were collected from. No differences between the sexes were identified; however, this may be an artifact of the lack of mature animal samples. Conversely, life stage was found to have a significant effect on the girth-length and weight-length relationships. The development of regression equations for morphometric measures allows the assessment of white shark body condition and may serve as an assessment tool to understand the potential impacts of human-induced environmental change on white sharks.

AcidAGE: a biological age determination neural network based on urine organic acids.

Organic acids reflect the course of all important metabolic processes and the effects of diet, nutrient deficiency, lifestyle, and microbiota composition. In present work, we focused on identifying age-related changes in organic acids in urine, and creating a neural network model based on them to determine biological age. The investigation involves data on concentrations of 60 organic acids in urine of 863 samples. Due to data analysis we found these acids could be used to determine human biological age. Two models were created for calculating biological age: a comprehensive AcidAGE model and a concise AcidAGE model based on 10 indicators. Both models demonstrate high accuracy. The presented models are useful for dynamically assessing the impact of medical interventions, lifestyle and diet amendments, and taking nutraceuticals on overall health and the risk of disease occurrence or progression. Their advantage lies in their ability to quickly update estimates as the corresponding biological processes change.

Prevalence of depressive symptoms among first-year undergraduate students of government medical and engineering colleges in Thiruvananthapuram city

Background: Depression is a major health issue globally and is on par with lifestyle diseases such as diabetes and hypertension when it comes to morbidity. The first year in professional college is a critical transition period encompassing drastic biological, social, emotional, and academic changes which could be potential stressors for precipitating depressive symptoms. Aims and Objectives: The current study aims to find the prevalence of depressive symptoms among 1st-year undergraduate students of Government medical and engineering colleges in Thiruvananthapuram city. Materials and Methods: The cross-sectional study included 88 medical students and 212 engineering students. Patient Health Questionnaire-9 was used to assess depressive symptoms, brief resilience scale to assess resilience, and CRAFFT 2.0 to screen for substance use. SPSS was used for the analysis of data; Chi-square test was used for the comparison of proportion and t-test for comparing means. Results: 28% of total study subjects reported depressive symptoms. One in three medical students reported depressive symptoms while one in four engineering students reported depressive symptoms. Low resilience had negative association and history of substance use had positive association with the presence of depressive disorders. Conclusion: A significant number of students in professional colleges have depressive symptoms, either diagnosed or undiagnosed. Steps can be taken in the direction of reducing academic distress, promoting extra-curricular activities, setting up student support programs in institutions, legal policies to limit substance misuse among students, and creating awareness about positive parenting styles which give adequate importance to self-care and being mindful.

Soil amendments alter tree growth and wood decay after forest thinning

AbstractForest soil amendments are increasingly used in western US forests to dispose of unmerchantable woody residues, reduce wildfire risk, and improve soil properties. Our objective was to determine the effect of fertilizer and organic amendments on tree growth and organic matter decomposition after thinning. Treatments were a control, three single soil amendments (wood chips, fertilizer, and biochar), and one combined soil amendment (biochar + fertilizer), each applied after thinning a ponderosa pine (Pinus ponderosa Dougl. ex. Laws) stand. After 10 years, amendment treatments had no effect on tree diameter increment (p = 0.600), but the biochar + fertilizer and wood chip treatments significantly increased height growth (p = 0.006). To estimate belowground biological changes, we used wood stakes made from aspen (Populus tremuloides Michx.) and loblolly pine (Pinus taeda L.) as an index of microbial activity. Stakes were placed: (1) on top of the litter/amendments, (2) at the interface between the litter/amendments and mineral soil, and (3) vertically inserted into the mineral soil, and stake mass loss was measured over 5 years. Stake mass loss of each species was least on the soil surface and increased with increasing depth. Aspen stakes generally had greater mass loss at all three soil locations in the fertilizer and biochar treatments. In contrast, pine stake mass loss was lower than aspen and less affected by fertilizer. Using thinned tree biomass to create amendments can improve forest productivity by enhancing soil conditions and mitigating wildfire. However, the impact of amendments on tree growth may take decades to be detectable.

Prognostic value of residual disease (RD) biology and gene expression changes during the neoadjuvant treatment in patients with HER2+ early breast cancer (EBC)

Prognostic value of residual disease (RD) biology and gene expression changes during the neoadjuvant treatment in patients with HER2+ early breast cancer (EBC)

Bacteria Engineered to Produce Serotonin Modulate Host Intestinal Physiology.

Bacteria in the gastrointestinal tract play a crucial role in intestinal motility, homeostasis, and dysfunction. Unraveling the mechanisms by which microbes impact the host poses many challenges due to the extensive array of metabolites produced or metabolized by bacteria in the gut. Here, we describe the engineering of a gut commensal bacterium, Escherichia coli Nissle 1917, to biosynthesize the human metabolite serotonin for examining the effects of microbially produced biogenic amines on host physiology. Upon oral administration to mice, our engineered bacteria reach the large intestine, where they produce serotonin. Mice treated with serotonin-producing bacteria exhibited biological changes in the gut at transcriptional and physiological levels. This work establishes a novel framework employing engineered bacteria to modulate luminal serotonin levels and suggests potential clinical applications of modified microbial therapeutics to address gut disorders in humans.

Digital Quantitative Detection for Heterogeneous Protein and mRNA Expression Patterns in Circulating Tumor Cells.

Hepatocellular carcinoma (HCC) circulating tumor cells (CTCs) exhibit significant phenotypic heterogeneity and diverse gene expression profiles due to epithelial-mesenchymal transition (EMT). However, current detection methods lack the capacity for simultaneous quantification of multidimensional biomarkers, impeding a comprehensive understanding of tumor biology and dynamic changes. Here, the CTC Digital Simultaneous Cross-dimensional Output and Unified Tracking (d-SCOUT) technology is introduced, which enables simultaneous quantification and detailed interpretation of HCC transcriptional and phenotypic biomarkers. Based on self-developed multi-real-time digital PCR (MRT-dPCR) and algorithms, d-SCOUT allows for the unified quantification of Asialoglycoprotein Receptor (ASGPR), Glypican-3 (GPC-3), and Epithelial Cell Adhesion Molecule (EpCAM) proteins, as well as Programmed Death Ligand 1 (PD-L1), GPC-3, and EpCAM mRNA in HCC CTCs, with good sensitivity (LOD of 3.2 CTCs per mL of blood) and reproducibility (mean %CV = 1.80-6.05%). In a study of 99 clinical samples, molecular signatures derived from HCC CTCs demonstrated strong diagnostic potential (AUC = 0.950, sensitivity = 90.6%, specificity = 87.5%). Importantly, by integrating machine learning, d-SCOUT allows clustering of CTC characteristics at the mRNA and protein levels, mapping normalized heterogeneous 2D molecular profiles to assess HCC metastatic risk. Dynamic digital tracking of eight HCC patients undergoing different treatments visually illustrated the therapeutic effects, validating this technology's capability to quantify the treatment efficacy. CTC d-SCOUT enhances understanding of tumor biology and HCC management.

Rumination, loneliness, and non-suicidal self-injury among adolescents with major depressive disorder: The moderating role of resilience

Adolescents often experience negative emotions, such as depression and anxiety, due to rapid biological, cognitive, and social changes during this developmental stage. In recent years, the non-suicidal self-injury (NSSI) among adolescents with Major Depressive Disorder (MDD) has garnered increasing attention, with rumination identified as a significant risk factor for its occurrence. This study established a moderated mediation model to examine the impact of rumination on NSSI among adolescents with MDD and its underlying mechanisms. The final research sample consisted of 1,601 adolescents with MDD (18.2% males, mean age = 14.85 years, SD = 1.65) from 14 psychiatric/general hospitals across nine provinces in China. Participants completed self-report questionnaires assessing NSSI, rumination, loneliness, and resilience. Results indicated that rumination contribute to NSSI via loneliness during adolescence, whereas resilience may buffer the adverse effects of rumination on NSSI, implying the potential effectiveness of reducing loneliness and promoting resilience in the intervention and prevention of NSSI. These findings further illuminate the mechanisms underlying the development of NSSI, aiding in its prediction and prevention among adolescents, thereby assisting them in better coping with emotional and behavioral developmental challenges during adolescence.

Deliberate Absence: Mapping the Presence of Indian Transgender and Gender Diverse (TGD) Youth in Social and Medical Rights-Based Work Initiatives for the Community

Background: Adolescence, the transitional phase between childhood and adulthood, involves significant biological, social, cognitive and emotional changes. In India, adolescents (10–18 years) form 21% of the population, increasing to 33% when including those aged 10–24 years, making India home to the world’s largest adolescent population. The concept of adolescence, unlike the biological process of puberty, is culturally determined and influenced by globalisation and changing societal values. Objectives: This article aims to (a) elucidate the barriers hindering transgender and gender diverse (TGD) youth in India from accessing gender affirmation, including familial rejection, constraining legal provisions and inadequate public health infrastructure; (b) underscore the impact of socio-cultural and political attitudes on health disparities faced by TGD youth, emphasising the need for comprehensive and individualised healthcare and socio-cultural support; (c) advocate for a socio-medical approach to address the unique challenges of Indian TGD youth, focusing on collaborative efforts among healthcare professionals, social institutions and policymakers; (d) propose strategies for improving access to early gender-affirmative care, including training healthcare providers, promoting comprehensive medical support and advocating for the rights of TGD youth. Methods: A blind review of literature was conducted using PUBMED/MEDLINE, Google Scholar, Web of Science, PsycINFO and SCOPUS with keywords such as ‘transgender youth’, ‘nonbinary and gender diverse youth’, ‘gender-affirming medical care in India’ and ‘youth mental health’. The search eventually included peer-reviewed publications, books, reviews, editorials, opinion pieces, feature stories and individual case reports. Articles were screened and thematically analysed to synthesise findings. Results: The review highlights significant barriers to gender-affirming care for TGD youth in India, including familial rejection, restrictive legal frameworks and inadequate public health infrastructure. Socio-cultural and political attitudes contribute to health disparities, necessitating comprehensive healthcare and socio-cultural support. Conclusions: Addressing the challenges faced by TGD youth in India requires a socio-medical approach, emphasising collaborative efforts among healthcare providers, social institutions and policymakers. Strategies for improvement include training healthcare providers, promoting comprehensive medical support and advocating for the rights of TGD youth to ensure early and effective gender-affirmative care.

Symposium Review: The Impact of Fatty Acids as Bioactive Nutrients on the Development of Offspring

Fatty acids (FA) are normally considered a source of energy; however, some FA are essential nutrients with different biological functions such as ligands to membrane and nuclear receptors, and upon binding they modify cell function and transcript expression. The bioactive effects of the FA depend on the FA type and family (i.e., n-6 vs n-3). The FA effects on developmental programming have been studied in cattle and sheep with some similarities in the outcomes between species. Feeding n-3 FA during late gestation improves offspring production performance (i.e., milk yield in dairy cows and growth in beef cattle and sheep) compared with the offspring of dams supplemented with mono- and unsaturated FA or with offspring of dams with no FA supplementation. Also, there is a sexual dimorphism in the outcomes of n-3 FA supplementation, where the increase in growth due to n-3 FA seems to be more evident in males; but it might decrease growth in females. There are multiple assumptions as to how this physiological process occurs. Based on published literature, the developmental effect does not appear to be due to changes in hypothalamic regulations of dry matter intake and energy expenditure or liver and adipose tissue functions. The changes in offspring growth can be attributed to changes in gastrointestinal tract physiology, changes in immune response, or both, probably due to epigenetic changes in those tissues. Feeding n-3 FA in late gestation to the pregnant dam increases expression of amino acid transporters (mRNA and protein) in the offspring's duodenum, associated with changes in DNA methylation. Regarding immune function, the increase in offspring performance has been associated with decreased haptoglobin after weaning in calves or increases in lipid mediators, such as resolvin-D1 at birth. Omega-3 supplementation during late gestation affects offspring growth; changes in the offspring's gut and immune system biology can explain the sexual dysmorphism observed in changed body weight; however, we are unaware which of these basic mechanisms is responsible for the observed changes in biology.

The Role of Gender in Turkish Women’s Pregnancy Experiences

Background: Apart from the biological changes women experience throughout pregnancy, their exposure to a gender discrimination stemming from cultural values adopted by the society in which they live can make it difficult for them to adapt to pregnancy and thus lead to negative pregnancy experiences. Aim: This research was conducted using a cross-sectional and relation-seeking approach to evaluate the effects of social gender inequality on pregnancy experiences. Methods: Data for this cross-sectional and relation-seeking study were gathered between 25 November 2019 and 25 January 2020 using face-to face interviews the researcher conducted with childbearing women who visited the outpatient clinic and non-stress test units of a hospital for the pregnancy follow-up. Results:: When using the Pregnancy Experiences Scale to assess childbearing women, higher scores indicated more positive emotions than negative emotions. Independent variables that affect the scores on the Pregnancy Experiences Scale include a willingness to be pregnant, the baby's sex, the woman’s income status, gestational week and the Perception of Gender Scale (p<0.005). A positive but weakly significant relationship was found among the total score on the Perception of Gender Scale, the total score on the Pregnancy Experiences Scale and the average scores of positive emotions intensity and frequency in all sub-dimensions (p<0.005). Conclusion: Based on the data, we conclude that women’s pregnancy experiences are generally positive, and that social gender inequality is a significant determinant affecting pregnancy experiences.

Temporal Study of Environmental DNA and Acoustic Data Reveals Coexistence of Sympatric Bat Species in a North American Ecosystem

ABSTRACTBats are a species‐rich mammalian order that provide a host of ecosystem services, but presently face threats from habitat loss, disease, climate change, and insect declines. Bat species often co‐occur with other ecologically similar bats, making them a suitable group in which to study niche overlap and partitioning. This study aimed to compare different non‐invasive sources of data on wildlife populations, while examining dietary, temporal, and spatial partitioning patterns among sympatric bat species. We used two different methods to assess niche partitioning among insectivorous bats at a site in the San Francisco Bay Area, California: (1) eDNA sequencing of bat feces that were collected weekly from a bat roost, and (2) nightly acoustic recordings of ultrasonic bat calls from recorders at multiple sites. Both the eDNA and acoustic data were collected over the course of an entire roosting season in 2020. We hypothesized that the insectivorous bats at this site would rely on one or more niche partitioning mechanisms to promote interspecific coexistence and limit competition. We found evidence of fine‐scale spatial partitioning of the broad community of bat species in our study area based on acoustic data, as well as temporal differences in activity of different species. The two species using the roosting site, Tadarida brasiliensis and Eptesicus fuscus, displayed some differences in the identities and relative abundances of prey species consumed, but both ultimately exhibited a strong reliance on dipterans and aquatic‐dependent insects. We demonstrate differences between the acoustic data and eDNA data, which has implications for how such datasets may be interpreted in future research. The study finds evidence of some types of niche partitioning in this community and characterizes baseline interactions between species, providing a foundation for future efforts to non‐invasively monitor for unexpected biological change in local ecosystems.

Translational Research on Azacitidine Post-Remission Therapy of Acute Myeloid Leukemia in Elderly Patients (QOL-ONE Trans-2).

The achievement of complete remission (CR) is crucial for acute myeloid leukemia (AML) patients undertaking curative therapy, but relapse often occurs within months, highlighting the need for strategies to prolong disease-free survival (DFS). Our phase III study compared the efficacy and safety of azacitidine (AZA) to best supportive care (BSC) in elderly AML patients who achieved CR following intensive induction and consolidation therapy. This ancillary study (QOL-ONE Trans-2) evaluated biological changes in bone marrow using Next-Generation Sequencing (NGS). We analyzed baseline, randomization, and 6-month post-remission samples from 24 patients (median age of 71 and 12 males). High-throughput NGS targeted 350 myeloid malignancy-related genes, considering variants with a variant allele frequency ≥ 4%. At diagnosis, all patients had 5 to 17 (median = 10) mutations, with DNMT3A (42%), NPM1 (33%), and TET2 (33%) being most frequent. FANCA mutations in four patients were linked to a higher relapse risk (HR = 4.96, p = 0.02) for DFS at both 2 and 5 years. Further HLA-specific NGS analyses are ongoing to confirm these results and their therapeutic implications.

The Application of Calculus in Physics

One of the foundational areas of mathematics is calculus. Functions, limits, differential and integral calculus, and their applications make up most of the subject. Differentiation and integration are the limits of certain processes and forms, functions are the essential subjects of calculus investigation, and limits are the fundamental notions of calculus. This article explores the applications of calculus to gravity, rotational inertia, and force in physics. This exploration of calculus highlights the enduring importance of this mathematical tool in theoretical and applied physics, and its key role in driving future scientific breakthroughs. Calculus is a mathematical tool for studying the rate of change, area under a curve, and limits. By precisely expressing the rate of change information of a function at a given location, such as slope, area, and curvature, it can aid in the understanding and solution of problems pertaining to changes in physics, engineering, biology, and other subjects. The growth of mathematics is substantially aided by the introduction of calculus. employing calculus to find solutions to a wide range of issues that usually required only elementary mathematics. It makes it possible to describe functions, velocities, accelerations, and curve slopes using a common set of symbols.

Family support and depressive symptoms among the elderly in Gunungkidul Health Center Sumberejo-Yogyakarta, Indonesia

Background: The elderly represent an age group that undergoes various physical, biological, psychological, and social changes that impact their health. The elderly population in Indonesia continues to grow, reaching 11.49% in 2016 and is projected to reach 14.51% by 2020. Increased life expectancy does not always correlate with good health, making the elderly more vulnerable to various issues, including depression. The prevalence of elderly depression in Indonesia is 11.6%, with the highest rates occurring in the older age groups. Purpose: To examine the relationship between the level of family support received by the elderly and depressive symptoms they experience. Method: A quantitative study using a correlational analytic design with a cross-sectional research strategy. The sampling technique was random sampling, with 36 elderly individuals aged 60-74 years as the sample. Data was collected using a questionnaire to determine the relationship between family support and the depressive symptoms in the elderly. The data was analyzed using univariate and bivariate analyses with the Spearman’s rank correlation test. Results: The univariate analysis provided information on the respondents' characteristics, family support, and depressive symptoms. The majority of respondents received good family support (66.7%), while most respondents did not experience depressive symptoms (75%). The Spearman’s rank correlation test found a significant value of 0.001<0.05, indicating that family support is related to the incidence of depressive symptoms in the elderly. Conclusion: Providing family support can reduce depressive symptoms in the elderly, as indicated by the statistical test results showing a significance value of 0.001 <0.05. This means there is a relationship between family support and the incidence of depressive symptoms among the elderly.

The Effect of Mindfulness and Spiritual Combination Breathing Exercises towards Anxiety, Depression and Blood Pressure of Ischemic Stroke Patients

Background: Ischemic stroke causes serious ongoing problems in the lives of sufferers, including biological, psychological and spiritual changes so that comprehensive and multidisciplinary nursing care is necessary. Purpose: The purpose of this research is to analyze the effect of Mindfulness and Spiritual Combination Breathing Exercises towards anxiety, depression and blood pressure of ischemic stroke patients. Methods: This research is a quantitative research that uses a quasy experimental research design with a pretest - posttest control group design approach. The population of all ischemic stroke patients at RSAU dr. M.Munir Lanud Abdulrachman Saleh Malang as many as 108 people. The sample size is 50 respondents. The sampling technique is purposive sampling. The intervention group was given a combination of Mindfulness and SpiritualityBreathing Exerciseswithin 10-15 minutes 2 times a day for 5 days and the control group was given intervention according to hospital standards. Analysis used the Manova test with a significant p value <0.05. Results: The results of the study using the Manova test showed that there was a significant effect between anxiety, depression and blood pressure after giving the Combination of Spiritual Mindfulness and Breathing Exercise sshowed that p value = 0.000, with the highest partial Eta Squared value of 0.643 anxiety followed by 0.579 depression and 0.263 blood pressure. Conclusion: A combination of Spiritual Mindfulness and Breathing Exercises effectively reduce the level of anxiety, depression and blood pressure of ischemic stroke patients.