Health Problems Research Articles

Progress of induced pluripotent stem cell (iPSC)-derived renal organoids in clinical application

Background: Kidney disease has become a growing public health problem worldwide, and there is an urgent need to develop reliable models for investigating novel and effective treatment strategies. In recent years, kidney organoids, as novel models different from traditional two-dimensional cells and model animals, have attracted more and more attention. Current advances have allowed the generation of kidney organoids from the directed differentiation of induced pluripotent stem cells (iPSCs), which possess similar characteristics to embryonic stem cells (ESCs), but bypass ethical constraints and have a wide range of sources. Summary: Herein, the methods of generating renal organoids from iPSCs, the applications of iPSC-derived renal organoids in disease modeling, drug effectiveness detection, and regenerative medicine as well as the challenges were reviewed. Key messages: iPSC-derived renal organoids can be used to model kidney diseases, and are great models for studying kidney injury and toxicity. Many efforts are needed to finally apply organoids into clinical application.

Maternal mortality in Panama from 1998 to 2022.

To examine maternal mortality in Panama, analyzing its direct obstetric deaths, indirect obstetric deaths, and contributory conditions. This cohort study used publicly available data from the National Institute of Statistics and Census to present a 25-year retrospective analysis of maternal deaths in the Republic of Panama from 1998 to 2022. Public data were sourced from the National Institute of Statistics and Census website of Panama. Relevant codes from the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD) were used. The maternal mortality ratio (MMR) was defined as the number of maternal deaths per 100 000 live births. Trendline reliability with R 2 was performed to analyze the data. A total of 1 026 maternal deaths occurred in Panama from 1998 through 2022, of which 61.2% were attributed to direct obstetric causes; 23.9%, indirect obstetric causes; 13.6%, contributory conditions; and 1.4% were unknown or undetermined. The average MMR was 60.1. The trendline reliability resulted in R 2 = 0.1 (y = -0.5147x + 1094.7), which is not statistically significant but meets the 2030 Sustainable Development Goals. The specific primary causes of direct obstetric deaths were: 12.9% due to postpartum hemorrhage (ICD O72); 9.2%, eclampsia (ICD O15); 6.7%, puerperal sepsis (ICD O85); and 6.3%, pre-eclampsia (ICD O14). For indirect obstetric deaths, the primary causes were: 14.9% due to other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth, and the puerperium (ICD O99); and 7.3%, maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth, and the puerperium (ICD O98). The findings of this study confirmed that there were substantially more direct obstetric causes (61.2%) than indirect obstetric causes (23.9%), contributory causes (13.6%), or unknown/undetermined causes (1.4%) of maternal mortality, despite being highly preventable. Although Panama is right on track to fulfill the target of 70 MMR by 2030, these results highlight the lack of health care access due to the absence of obstetrician-gynecologists per 100 000 population in indigenous comarcas, where 30.8% of the maternal mortalities occur. Furthermore, the health system in Panama is not immune to pandemics and crises. From 1998 to 2022, there were 5 years when the MMR in Panama exceeded 70: 2001, 2002, 2006, 2011, and 2020. These findings also underscore the dichotomy between statistics and health policy. While the trendline reliability was insignificant (R 2 = 0.1), the MMR satisfies requirements for the 2030 Sustainable Development Goals. Future studies should consider factors related to indirect obstetrics and contributory causes of deaths, health care access, COVID-19, cesarean section and natural birth, age, economic income, prenatal and postpartum care, as well as the quality of private and public health facilities in the Americas.

Enhancing type 2 diabetes mellitus prediction by integrating metabolomics and tree-based boosting approaches

BackgroundType 2 diabetes mellitus (T2DM) is a global health problem characterized by insulin resistance and hyperglycemia. Early detection and accurate prediction of T2DM is crucial for effective management and prevention. This study explores the integration of machine learning (ML) and explainable artificial intelligence (XAI) approaches based on metabolomics panel data to identify biomarkers and develop predictive models for T2DM.MethodsMetabolomics data from T2DM (n = 31) and healthy controls (n = 34) were analyzed for biomarker discovery (mostly amino acids, fatty acids, and purines) and T2DM prediction. Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) regression to enhance the model’s accuracy and interpretability. Advanced three tree-based ML algorithms (KTBoost: Kernel-Tree Boosting; XGBoost: eXtreme Gradient Boosting; NGBoost: Natural Gradient Boosting) were employed to predict T2DM using these biomarkers. The SHapley Additive exPlanations (SHAP) method was used to explain the effects of metabolomics biomarkers on the prediction of the model.ResultsThe study identified multiple metabolites associated with T2DM, where LASSO feature selection highlighted important biomarkers. KTBoost [Accuracy: 0.938; CI: (0.880-0.997), Sensitivity: 0.971; CI: (0.847-0.999), Area under the Curve (AUC): 0.965; CI: (0.937-0.994)] demonstrated its effectiveness in using complex metabolomics data for T2DM prediction and achieved better performance than other models. According to KTBoost’s SHAP, high levels of phenylactate (pla) and taurine metabolites, as well as low concentrations of cysteine, laspartate, and lcysteate, are strongly associated with the presence of T2DM.ConclusionThe integration of metabolomics profiling and XAI offers a promising approach to predicting T2DM. The use of tree-based algorithms, in particular KTBoost, provides a robust framework for analyzing complex datasets and improves the prediction accuracy of T2DM onset. Future research should focus on validating these biomarkers and models in larger, more diverse populations to solidify their clinical utility.

Diabetes On Track: Redesigning Diabetes Management in Rural Primary Care

OBJECTIVE Diabetes remains an intractable public health problem, particularly in rural communities. The Diabetes On Track initiative returns control of designing and implementing strategies to improve diabetes care delivery systems to the local clinics and community partners. This article reports on protocol development and the first 18 months of the Diabetes On Track project within the health care setting. RESEARCH DESIGN AND METHODS Using a rapid-cycling quality improvement approach, the research team partnered with two rural clinics. Clinics completed a strengths and needs assessment before being offered a menu of possible strategies to implement. Clinics worked with the research team to implement, refine, and adapt these initial interventions and develop further strategies based on local data that were continually collected and shared. Six core indicators were established as primary outcome measures. Process measures were established based on the strategies chosen. RESULTS Both clinics decided to create a registered nurse health coach position to provide diabetes education to individuals with or at risk for developing diabetes. Both clinics also chose to implement a physician dashboard highlighting diabetes-related indicators so clinicians could track panel improvement over time. Other interventions included using a prediabetes outreach list and taking advantage of professional development opportunities, including a diabetes-focused Project ECHO series. CONCLUSION Improving diabetes care in rural communities is a challenge, and novel solutions are needed, with a focus on sustainability. The Diabetes On Track initiative is showing promising results, allowing primary care clinics to use community knowledge and data to redesign effective diabetes care delivery systems.

Disparities in casemix, acute interventions, discharge destinations and mortality of patients with traumatic brain injury between Europe and India.

Traumatic brain injury (TBI) is a major global health problem that disproportionally affects low- and middle-income countries. The needs for patients with TBI therefore may differ between levels of national development. We aimed to describe differences in epidemiology and acute care provision of TBI between India and Europe. We used data from two prospective observational registry studies - the Collaborative Indian NeuroTrauma Effectiveness Research in TBI (CINTER-TBI) and the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI), which included TBI patients with an indication for brain CT-scan presenting to 65 centres across Europe and Israel and two trauma centres in India. We performed descriptive analyses of demographic, injury, and treatment characteristics and used random-effects logistic regression with covariate adjustment to examine the likelihood of acute neurosurgical interventions and in-hospital mortality. We included 22 849 patients from CENTER-TBI and 3904 from CINTER-TBI. The median age in Europe was 55 years (IQR = 32-76) compared to 27 years (IQR = 18-40) in India. The most common cause of TBI in Europe were falls (n = 12150 (53%), while traffic incidents predominated in India (n = 2130 (55%)). The proportion of patients with severe TBI was higher in India (n = 867 (22%)) than in Europe (n = 1661 (7%). Professional pre-hospital care involving ambulance service was utilised by three-fourths (n = 17203 (75%)) of European and less than a one-tenth (n = 224 (6%)) of Indian patients in our sample. Patients with severe TBI were more likely to undergo surgical contusion/haematoma evacuation in India compared to Europe (OR = 2.0; 95% CI = 1.7-2.5) and Indian patients had higher odds of undergoing intracranial pressure monitor placement (OR = 2.3; 95% CI = 2.0-2.7). A primary decompressive craniectomy was likewise more often performed in the Indian cohort (OR = 5.1; 95% CI = 3.5-7.5). Discharge destinations in Europe included rehabilitation centres (n = 1261 (6%)) or nursing homes (n = 1208 (5%)), which was rarely the case in India (n = 13 (0%) and n = 9 (0%), respectively). Substantial disparities between India and Europe exist along the neurotrauma care chain, with both systems being likely to face unique features and challenges in the future.

Postnatal depressive symptoms in mothers of infants at high risk of cerebral palsy: the role of delayed infant communicative development

Purpose Recent diagnostic advantages enable detection of cerebral palsy (CP) in infants before five months of age. Parents of children with CP often face mental health problems, but specific knowledge for infancy is needed. In this study, depressive symptoms in mothers of 16-week-old infants and associations with infant development were investigated. Materials and methods This cross-sectional study involves 56 families, 22 high-risk and 34 infants without risk of CP. High-risk-CP was identified following international clinical guidelines. We assessed infant cognitive and language development using the Bayley-III and motor development using the Alberta Infant Motor Scale. Maternal depressive symptoms were self-reported using the Edinburgh Postnatal Depression Scale. Results Mothers of CP high-risk infants were 15.6 times more likely to experience risk of postnatal depression compared to mothers of infants without risk. Additionally, linear regression analyses showed that having an infant at high-risk of CP (β = .359, p = .006) and delayed language development (β = −0.510, p < .001) were associated with increased maternal depressive symptoms. Conclusions We recommend systematic screening of postnatal depressive symptoms following detection of high-risk-CP in infants. Early interventions could include a mother-infant interactional component to support caregivers in interpreting and responding to infant communicative cues.

Injury epidemiology and emergency department length of stay in trauma hospital in Addis Ababa, Ethiopia.

Injuries are a major cause of health problems in low- and middle-income countries than in high-income nations. This study aimed to describe injuries and identify factors associated with the emergency department (ED) length of stay (LoS). This study was conducted at the Addis Ababa Burn, Emergency, and Trauma (AaBET) hospital in Addis Ababa, Ethiopia. All injured patients who visited the ED between April 1, 2021, and March 30, 2022, were included in the study. Data were collected through a retrospective medical record review. Descriptive statistics were used to present the data and a multivariable binary logistic regression model was used to assess factors associated with LoS in the ED. A total of 6991 (86.8%) injured patients were studied out of 8055 patients who visited the ED. The majority of the patients were male, 5184 (74.2%), and aged between 18-44 years, 4368 (62.4%). The most common mechanism of injury was road traffic accidents, 2693 (38.5%), followed by falls, 1523 (21.8%). The most commonly reported injured body parts were the head (2179, 31.2%). Of the total injured patients, 101 (1.8%) died. The LoS in the ED was greater than 24 hours for 24.4% (95% CI: 23.3-25.5) of the injured patients, with a mean duration of 2.51 (SD = 5.18) days. Factors significantly associated with a prolonged LoS (>24 hours) in the ED included being residing in outside Addis Ababa in Oromia [AOR: 1.61, 95% CI (1.38-1.88)], Amhara [AOR: 1.56, 95% CI (1.14-2.14)] and other [AOR: 3.93, 95% CI (2.73-5.64)], male [AOR: 1.30, 95% CI (1.09-1.54)], aged 60 years or older [AOR: 1.38, 95% CI (1.03-1.85)]; sustaining injuries from road traffic accident [AOR: 2.43, 95% CI (1.19-4.94)], being triaged to orange [AOR: 3.03, 95% CI (2.40-3.83)] and red zones [AOR:3.37, 95% CI (2.65-4.28)]; having fracture injuries [AOR: 1.95, (1.34-2.83)]; and experiencing contusions and crushing injuries [AOR: 2.63 (1.57-4.42)]. Injuries are the major share of cases among ED patients at AaBET hospital. Patients were staying in the ED for longer than the recommended 24 hours by the Ethiopian health system. Intervention measures focusing on injury prevention are necessary to reduce the patient burden on the hospital and strengthen the hospital's capacity to reduce prolonged LoS.

Prevalence of mental illness and associated factors among the elderly in Ogun East Senatorial District, Nigeria

Abstract Background: Mental health problems are common in the elderly; they often go unnoticed, ignored, untreated, or considered part of normal aging. About a quarter of the Nigerian population have mental health problems, out of which 3.26% are elderly. Aim: This study aimed to determine the prevalence, types, and factors associated with mental illnesses among the elderly. Materials and Methods: This was a community-based cross-sectional survey of the elderly. Four hundred and two elderly people were selected by a multistage sampling technique and were interviewed using semi-structured questionnaires. Data analysis was done using the IBM SPSS Statistics version 22.0. Descriptive statistics were summarized using proportion and presented in frequency tables. Bivariate analyses were done using the Chi-square test and logistic regression analyses. The level of significance was set at a 95% confidence interval with P &lt; 0.05. Results: The prevalence of mental illness among the elderly respondents was 35.8%. Of all the mental illnesses, generalized anxiety disorder ranked the highest (15.4%), followed by current alcohol dependence (14.9%). The factors found to be associated with mental illness in the elderly included monogamous family type (odds ratio [OR] = 0.211, P = 0.034) and monthly income &lt;50,000 Naira (OR = 85.108, P = 0.003). Conclusion: This study revealed that the prevalence of mental illness was high among the community-dwelling elderly respondents of Ogun East Senatorial District. The determinants of mental illness among the elderly were monthly income of &lt;50,000 naira, while monogamous family type was found to be protective of mental illness in the elderly.

Poor sleep hygiene practice and associated factors among adults with epilepsy attending follow up care at Mettu Karl comprehensive specialized hospitals in Illu Ababora Zone and general hospital in Buno Bedele zone, Southwest Ethiopia’

BackgroundGlobally, sleep disorders are an important global public health problem. Poor sleep hygiene is at the core of chronic insomnia and other sleep disorders. Sleep hygiene practices are effective, practical, and affordable, and have no side effects other than other therapies benefiting patients with epilepsy. However, there is no research regarding sleep hygiene practice and its awareness among people with epilepsy in Ethiopia. This study aimed to assess sleep hygiene practice and its factors in patients with epilepsy.MethodsAn institutional-based cross-sectional study was conducted. The study included 424 participants selected through systematic random sampling. An interviewer-administered Sleep Hygiene Index (SHI) questionnaire was used to collect data.The collected data was analyzed using SPSS Version 25.0. Bi-variable and multi-variable analyses were conducted to identify factors related to poor sleep hygiene.ResultsThe frequency of poor sleep hygiene practice among people with epilepsy was 59.5%. Non-adherence to AED (AOR = 1.86, 95% CI: 1.13, 3.23), depression (AOR = 2.10, 95% CI: 1.42, 4.21), poor sleep quality (AOR = 5.7, 95% CI: 3.12, 10.01), anxiety (AOR = 2.71, 95% CI: 1.67, 4.82), and current alcohol drinkers (AOR = 1.74, 95% CI: 1.27, 3.13) were associated with poor sleep hygiene practice.Conclusion and recommendationThe perception of sleep hygiene practice among patients with epilepsy was poor. Non-adherence to AED, depression, poor sleep quality, anxiety, and current use of alcohol were associated with poor sleep hygiene practices. Therefore, regular screening, sleep issue management, and expanded mental health support are crucial. Training programs and awareness strategies to improve sleep hygiene are highly recommended. Professionals should incorporate sleep hygiene in epilepsy care.

Cicer arietinum phytosome ameliorates hepatosteatosis via downregulation of fatty acid synthase and stearoyl-CoA desaturase 1 in rats

Abstract Background Hepatosteatosis is considered a universal problematic health due to bad lifestyle. Thereby, the current study evaluates the influence of the Cicer arietinum polyunsaturated fatty acids (CAP) and newly synthesized C. arietinum polyunsaturated fatty acids phytosome (CAPP) against non-alcoholic fatty liver disease (NAFLD) persuaded through a high-fat diet (HFD) in addition to tamoxifen (TAM) in male albino rats. Forty-eight rats were separated into eight groups (6 rats/group). Rats of the control group were administered distilled water for 45 consecutive days, while phosphatidyl choline (PC), CAP, and CAPP groups administered distilled water (15 days), afterward administered PC, CAP, and CAPP, respectively (500 mg/kg b.wt), orally for 30 days. All the previous groups fed normal diet for the 45 days, while NAFLD rats feed HFD for 45 days and receive TAM (200 mg/kg b.wt, i.p) daily for 15 days, followed by administration of vehicle, PC, CAP, and CAPP orally for another 30 days. Results Hepatosteatosis was appraised biochemically by significant increase in the concentrations of serum AST, ALT, γGT, LDH, ALP, total bilirubin, total lipid, triglycerides, fatty acid synthase (FAS), stearoyl-CoA desaturase 1 (SCD-1), and LDL-cholesterol, as well as hepatic total lipids and triglycerides. In addition, a significant decline in serum total protein, albumin, and HDL-cholesterol concentrations was observed in comparison with the control group. NAFLD induces oxidative stress by noteworthy increase in hepatic MDA, H2O2, and meaningful reduction in hepatic GSH, SOD, GST, GRD, and CAT levels as compared with the corresponding control group. Liver histological changes were noted in the NAFLD group as compared to the control. Interestingly, CAP and CAPP treatments modulate the abnormal effects of NAFLD in all the previous parameters. For the histological changes caused by NAFLD, the liver tissue appeared nearly normal after the treatment with CAP and CAPP. Conclusion CAP and CAPP administration may have a potential role in alleviating hepatosteatosis. This may relate to its downregulation against FAS, SCD-1, and oxidative stress.

The lived experiences and unmet needs of prostate and colorectal male cancer survivors in rural Virginia: A qualitative study.

The goal of this study was to gain an in-depth understandingabout the lived experiences and unmet needs of rural male cancer survivors. Focus groups were conducted with male survivors of prostate (N=14) and colorectal cancers (N=10), from rural Virginia. Demographic and clinical information were collected via surveys. A focus group guide contained questions about needs, lifestyles, and social networks of rural male cancer survivors. Focus group data were analyzed using Braun and Clarke's thematic analysis guidelines. Four primary themes emerged from the data: (1) contending with health problems, (2) quality and availability of health care services, (3) coping strategies to navigate survivorship, and (4) advocating for cancer prevention. Survivors had to contend with physical and emotional problems, which were a result of their cancer treatments. Due to their rural location, survivors had difficulty accessing health care services and had a limited understanding of the cancer-related resources that existed in their counties. Family support, religiosity and acceptance served as important coping strategies. Many felt strongly about promoting cancer-related education and awareness. The lived experiences and unmet needs of rural male cancer survivors comprised several challenges, which included health problems and lack of health care access. Coping mechanisms comprised reliance on familial bonds and religion. Findings from this study reveal the need for tailored interventions to target the health care, psychosocial, and informational needs of rural male cancer survivors.

Study identifies eight traumatic and ACEs to psychiatric risk across development

There are eight TRACEs (traumatic and adverse childhood experiences) which can lead to mental health and cognitive problems during adolescents, according to researchers. Using the Adolescent Brain Cognitive Development (ABCD) data from the National Institutes of Health, the researchers drew on reports from youth and their caregivers to look at longitudinal change and how it is moderated by the TRACEs.

Strengthening Mental Health Though Resilience in Nursing Students: A Protocol for a Comprehensive Scoping Review

Background: Nursing students face unique challenges during their university education, making them vulnerable to mental health problems. Psychological resilience has been identified as a protective factor against these issues. However, previous reviews have identified gaps in the literature on resilience and mental health among nursing students. Objectives: This scoping review aims to identify and map studies on psychological resilience and mental health in undergraduate nursing students, synthesize current evidence on their relationship, identify interventions for enhancing resilience, and highlight gaps in the existing literature. Eligibility criteria: Studies published between January 2019 and April 2024 in English, Portuguese, and Spanish addressing resilience and mental health in undergraduate nursing students will be included. Primary studies, secondary studies, clinical guidelines, and grey literature will be considered. Sources of evidence: Searches will be conducted in multiple databases including EMBASE, ERIC, PubMed, Science Direct, Web of Science, DOAJ, ELSEVIER, EMERALD, and WILEY ONLINE LIBRARY. Grey literature sources will also be searched. Charting methods: Data will be extracted using a standardized form and synthesized narratively. Thematic analysis will be conducted using MAXQDA software ((Verbi GmbH, 24 version, 2023). Quantitative summaries, visual mapping, subgroup analyses, and trend analyses will be performed where appropriate. Results: As this is a protocol, results are not yet available. The review will present a comprehensive map of the current literature on psychological resilience and mental health in nursing students, including identified interventions and research gaps. Conclusions: This scoping review will provide valuable insights to guide curriculum development, support services, and policy-making in nursing education. The findings may support actions to strengthen resilience and prevent mental health problems among future nursing professionals.

Impact of Green Tea Consumption and Its Extracts on Fat Reduction and Weight Loss

Introduction: Obesity and overweight are major health problems and challenges in the world today. It is the task of modern pharmacology, medicine and dietetics to search for new therapeutic methods to reduce body weight and body fat. Green tea has been a focus of research on its effects on weight reduction for many years. This article will analyse the available studies on the effectiveness of green tea on body weight and body fat reduction in obese and overweight people. Aim of the study: The aim of this review is to analyse the available literature in order to answer the question of whether green tea and green tea extracts (GTE) have an effect on weight loss, body fat reduction and associated metabolic processes.Materials and method: For a comprehensive review on the effects of green tea on weight and body fat reduction, we reviewed studies and literature available in databases such as PubMed and Google Scholar by searching through keywords such as ‘green tea’, ‘obesity’, ‘fat’, ‘weight loss’, ‘matcha’.Conclusion: green tea and its isolated substances such as epigallocatechin-3-O-gallate (EGCG) appear to have a positive effect on weight and body fat reduction in obese and overweight individuals. It is likely that consumption of green tea extract increases fat oxidation during exercise. In addition, supplementation had a positive effect in a group of diabetics, polycystic ovary syndrome and metabolically stressed patients. The best effects from supplementation were obtained by those who additionally had physical activity. It is suggested that research on green tea, especially on matcha, should continue, as very little reliable research has been produced on this topic

Self-reported Health Problems of Professional Dancers from Five German Opera Houses or State Theatres: A Prospective Study with Weekly Follow-ups during One Season

BackgroundMost studies on injuries of professional dancers used a medical-attention and/or time-loss definition and did not analyse all health problems. Further, almost all studies included just one company. The aim was to analyse all self-reported health problems of professional ballet and contemporary dancers during one season and compare sexes and five companies in Germany.MethodsDancers of five professional companies completed weekly health questionnaires during the season (September 2022 to June 2023). Numerical rating scales were used for severity of all health problems, musculoskeletal pain, impairment of the ability to dance at full potential, physical and mental workload in the previous seven days. If the severity of all health problems were rated greater than “0”, the dancers were asked to report the type and consequences of their most severe health problem.ResultsDuring 43 weeks, 98 dancers (39.8% male) completed 3123 weekly reports (response rate 74.1%). The season prevalence of any health problem was 100% and of time-loss health problems 74.5%. The average weekly prevalence of any health problem was 62.7%, of musculoskeletal pain 83.4% and of impaired ability to dance at full potential, due to health problem 48.6%. While the season prevalence and type of health problems was similar between sexes, the average weekly prevalence of severe health problems was higher in female than in male dancers (Chi2 = 23.2; p < .001), and female dancers saw a qualified health professional more often than male dancers (Chi2 = 19.5; p < .001). Companies differed in almost all investigated variables, with more health problems in companies where more dancers rated their workload higher than “ideal”.ConclusionHealth problems are frequent in professional dancers and affect their ability to dance. Future studies should analyse the impact of physical and mental workload on health problems.

Exploring the Potential of Spray-Dried Blackberry Powder Enriched with Zinc and Folic Acid as a Nutritional Alternative for Children and Pregnant Women

Currently, strategies to achieve the Sustainable Development Goals (SDGs) are being sought worldwide. Accordingly, this study seeks to contribute to achieving SDGs 2 (Zero Hunger) and 3 (Good Health and Well-being) by addressing nutritional deficiencies in pregnant women and children. These vulnerable populations worldwide have malnutrition problems associated with a lack of zinc and folic acid, causing them health problems. This research aimed to develop a blackberry powder fortified with zinc and folic acid obtained by spray drying as a nutritional alternative for children and pregnant women. The blackberry was characterized according to the AOAC, an optimization of the spray drying process with a central composite experimental design. The powder’s bulk and tapped density, solubility, and anthocyanin content were determined. The variation in zinc and folic acid content over a storage period was measured. The moisture content of the fresh blackberries was 89%. The solubility and anthocyanin content of blackberry powder were 86% and 0.263 mg cyanidin-3-glucose/g, respectively. The optimal spray drying conditions were: 23.6% solid content and an air inlet temperature of 167.92 °C. The bulk density of the powder did not change with storage time (p > 0.05); the zinc and folic acid content in blackberry powder was 144 and 90 (µg/100 g), respectively. A blackberry powder fortified with zinc and folic acid was obtained by spray drying, guaranteeing 30% of the daily nutritional requirement for pregnant women and children, in a 50-gram portion of powder.

Triple Negative Breast Cancer: Experience of the Obstetrics and Gynecology Department 2 Over A Period of 3 Years about 105 Cases at the Hassan II University Hospital in Fes

Introduction: Breast cancer is the second leading cause of death worldwide and the leading cancer in women. It is both the most common and the leading cause of death in women from cancer, thus posing a real public health problem. It presents tumor heterogeneity on the histological and molecular levels, explaining the diversity of presentations, responses to treatments, and prognosis. Triple-negative breast cancer is defined by the absence of expression of hormone receptors: estrogen receptors (ER), progesterone receptors (PR) and by the absence of overexpression or amplification of genes encoding HER2 receptors (Human epidermal growth factor receptor 2) and representing only a minority of breast cancers (10-20%). The therapeutic choices for this type of breast cancer are limited because patients do not benefit from hormonal therapy or targeted therapies, which poses a real problem in therapeutic management. Our objective is to describe the epidemiological, clinical, anatomo-pathological characteristics, as well as the evolutionary profile after adequate management of triple-negative breast cancer through the analysis of a series of cases of triple-negative breast cancer collected at the gynecology-obstetrics department 2 at the Hassan II University Hospital in Fez. Method: This is a retrospective study of a series of triple negative breast cancer cases collected in the gynecology-obstetrics department II at the Hassan II University Hospital in Fez during the period between January 2020 and December 2023. Inclusion criteria: Histologically confirmed triple negative infiltrating breast cancer treated in the gynecology-obstetrics department 2 of the Hassan II University Hospital in Fez. IHC = ER = 0% RP = 0% HER2 negative Exclusion criteria: male sex and presence of distant metastases. Results: On the epidemio-clinical level: a peak in frequency between 31 and 42 years old, and 45.7% of patients still in genital activity. On the anatomo-pathological level: ...

The Impact of Parental Depressive, Anxiety, and Stress Symptoms on Adolescents’ Mental Health and Quality of Life: The Moderating Role of Parental Rejection

Background/Objectives: Parental internalizing issues, particularly maternal mental health, can significantly influence adolescents’ mental health by altering parenting behaviors and roles. This study explores the role of parental rejection in moderating the relationship between parental depressive, anxiety, and stress symptoms and adolescents’ mental health and quality of life. Methods: One hundred thirty eight mothers (mean age: 47.96, SD = 5.06 years) and 68 fathers (mean age: 51.07, SD = 5.53 years) of adolescents aged 12–18 completed measures on mental health, parental rejection, and adolescent well-being. Results: Maternal rejection was found to moderate the relationship between maternal anxiety symptoms and adolescents’ quality of life, as well as between maternal anxiety symptoms and adolescents’ mental health problems. Paternal rejection moderated the relationship between paternal stress symptoms and adolescents’ mental health. However, parental rejection did not moderate the relationship between parental depression and adolescents’ quality of life or mental health. Conclusions: These findings highlight the distinct roles of maternal and paternal rejection in adolescent development and suggest that parental mental health, particularly anxiety and stress, has a significant impact on adolescent well-being. Future studies should consider the influence of both parents and focus on longitudinal effects. These results emphasize the need for interventions addressing parental rejection to improve adolescent outcomes.

Evaluation par régression logistique binaire de déterminants de la mortalité néonatale dans la province du Kongo Central

Neonatal mortality disturbs the whole of humanity. Its frequency remains very high throughout the world, but more so in developing countries. The DRC is ranked among the countries with the highest number of neonatal deaths in the world with the ratio of 47 per 1000 live births, (Kalonji DC et al 2018). Indeed, the province of Kongo Central has not remained indifferent to this health problem. With a view to improving newborn health during the neonatal period, the present study is conducted and envisages identifying the determinants of neonatal mortality in Kongo Central Province. For this study, the general population consisted of all newborns in the Province of Kongo Central from 2021 to 2022. A random sample of 117 cases met the inclusion criteria, of which we matched 1 case to 2 controls. After data analysis, we found the following results: the overall neonatal mortality rate was 333 per thousand live births. The logistic regression model identified the following determinants of neonatal mortality: age (OR= 1.16562 IC95 [1.035635 -1.3163]. p=0.0105), age less than 2 years (OR= 2.01966 IC95 [1.021601-4.058]. p=0.0449) and acute fetal distress (OR=2.62027IC95 [1.179464-5.878]. p=0.0181). In order to improve neonatal health, pregnant women should be made aware of the importance of prenatal consultations for early detection and appropriate management of high-risk pregnancies. They should be present at the onset of labor and give birth in the presence of qualified personnel.

Leisure-time physical activity, cardiorespiratory fitness, and cognitive decline in middle-aged and older adults - The ELSA-Brasil study

ObjectivesDementia is a fast-growing public health problem. This study examined the association of physical activity and estimated cardiorespiratory fitness (eCRF) with the risk of cognitive impairment. Study designMulticentric, prospective cohort study. MethodsWe analyzed 10,121 participants of the ELSA-Brasil study. We assessed leisure-time physical activity using the long version of the IPAQ questionnaire and defined moderate-to-vigorous physical activity (MVPA) per week. We applied a non-exercise prediction equation to estimate eCRF and classified participants as unfit (lowest tertile) and fit. Leisure-time MVPA and eCRF were measured at baseline and follow-up. Incident cognitive impairment was based on memory, language, and executive function assessed at baseline and follow-up. ResultsDuring a median of 8.1 (7.8–8.5) years of follow-up, we identified 396 (3.9 %) incident cases of cognitive impairment. There was an inverse, non-linear association between the incidence of cognitive impairment and both leisure time MVPA and eCRF. Low eCRF (IRR: 1.29; 95%CI: 1.02, 1.64) and low MVPA (IRR: 1.40; 1.09, 1.82) were independently associated with an increased incidence. Increasing 1 MET in eCRF from baseline to follow-up visit was associated with a lower incidence of cognitive impairment (IRR: 0.80; 95%CI: 0.71, 0.91), while a decrease of 13.7 min per day in leisure time MVPA is associated with an increased incidence (IRR: 1.16; 95%CI: 1.01, 1.33) of cognitive impairment. These associations remained statistically significant in adults under 65 but not in older adults. ConclusionLow eCRF and leisure time MVPA are strong and independent predictors of incident cognitive impairment especially in middle-aged adults.