High Level Research Articles

Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study.

Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.

Prognostic Value of Systemic Arterial Lactate Levels in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract Background Acute myocardial infarction is the most severe manifestation of coronary artery disease, which causes more than 2.4 million deaths in the USA, more than 4 million deaths in Europe and northern Asia, and more than a third of deaths in developed nations annually. Objective To assess the prognostic value of systemic arterial lactate levels in patients with ST segment elevation myocardial infarction undergoing primary PCI and correlate with the results of primary PCI and 30 days MACE follow up. Patients and Methods This study included 300 patients who presented with documented STEMI and underwent reperfusion by successful primary PCI in Ain Shams University hospitals. Results There was statistically significant positive correlation found between serum lactate and (WBCs) count, (HbA1C) level and cardiac enzymes (CKtotal - CKmb – troponin) and negative correlation found between serum lactate and ejection fraction in echocardiography. Also, we found that other parameters were associated with MACE follow up in 30 days such as Killip class at admission, ST segment elevation resolution, heart block in ECG, lower ejection fraction, dyslipidemia, post-procedure TIMI flow, peri-procedural time intervals and occurrence of complications. Conclusion The value of an early lactate measurement in patients with STEMI is to be a part of the risk stratification of these patients and intensified medical care should be considered to patients with strongly elevated lactate levels. Also, increasing arterial lactate levels were associated with occurrence of MACE in 30 days, worse hemodynamics, lower ejection fraction in echocardiography, higher HbA1C level, large infarct area (cardiac biomarkers peak level), poor post-procedure TIMI flow and thrombus grade.

Proximal Gastrectomy is Associated with Lower Incidence of Anemia and Vitamin B12 Deficiency Compared to Total Gastrectomy in Patients with Upper Gastric Cancer.

Proximal gastrectomy is an alternative to total gastrectomy (TG) for early gastric cancer (EGC) treatment in the upper stomach. However, its benefits in terms of perioperative and long-term outcomes remain controversial. The aim of this study was to compare the perioperative, body compositional, nutritional, and survival outcomes of patients undergoing proximal gastrectomy with double-tract reconstruction (PG-DTR) and TG for pathological stage I gastric cancer in upper stomach. The study included 506 patients who underwent gastrectomy for pathological stage I gastric cancer in the upper stomach between 2015 and 2019. Clinicopathological, perioperative, body compositional, nutritional, and survival outcomes were compared between the PG-DTR and TG groups. The PG-DTR and TG groups included 197 (38.9%) and 309 (61.1%) patients, respectively. The PG-DTR group had a lower rate of early complications (p=0.041), lower diagnosis rate of anemia and vitamin B12 deficiency (all p<0.001), and lower replacement rate of iron and vitamin B12 compared to TG group (all p<0.001). The PG-DTR group showed reduced incidence of sarcopenia at 6-months postoperatively, preserved higher amount of visceral fat after surgery (p=0.032 and p=0.040, respectively), and showed a higher hemoglobin level (p=0.007). Oncologic outcomes were comparable between the groups. The PG-DTR for EGC located in the upper stomach offered advantages of fewer complications, lower incidence of anemia and vitamin B12 deficiency, less decrease in visceral fat volume, and similar survival compared to TG. Consequently, PG-DTR may be considered a superior alternative treatment option to TG.

Epigenetic differences in the tumor suppressor genes MLH1 and p16INK4a between Nepalese and Swedish patients with colorectal cancer

Abstract Objectives Colorectal cancer (CRC) is one of the most prevalent cancer types worldwide, exhibiting significant variance in incidence rates across different ethnicities and geographical regions. Notably, there is a rising incidence of CRC among younger adults, particularly evident in advanced stages, with a more pronounced trend observed in developing nations. Epigenetic alterations potentially play a role in the early onset of CRC and could elucidate interpopulation disparities. This study aimed to examine DNA methylation levels in the tumor suppressor genes MLH1 and p16INK4a, comparing Nepalese and Swedish patients with CRC. Methods Patients who underwent CRC surgery at Tribhuvan University Teaching Hospital, Nepal (n=39), and Sahlgrenska University Hospital, Sweden (n=39) were included. Demographic and clinicopathological data were analyzed, and pyrosequencing was employed to determine methylation levels in the MLH1 promoter region and the first exon of p16INK4a in tumor tissues and adjacent mucosa located 10 cm from the tumor site. Subsequently, methylation status was compared between Nepalese and Swedish patients and correlated with clinicopathological parameters. Results Nepalese and Swedish patients displayed equal levels of MLH1 and p16INK4a methylation in tumors, but Nepalese patients exhibited a significantly higher level of MLH1 methylation in mucosa compared to Swedish patients (p=0.0008). Moreover, a greater proportion of Nepalese patients showed MLH1 methylation in mucosa compared to Swedish patients (31 vs. 2.6 %). Aberrant methylation of p16INK4a was also observed in the mucosa of Nepalese patients, characterized by high methylation at specific sites rather than uniform methylation across CpG sites. There were no significant differences in methylation levels based on tumor location among Nepalese patients, whereas Swedish patients exhibited higher methylation in right- compared to left-sided colon tumors. Swedish patients showed an increase in p16INK4a methylation in tumors with advancing age. Conclusions Nepalese and Swedish patients displayed equal levels of MLH1 and p16INK4a methylation in tumors. In contrast, Nepalese patients had a higher level of MLH1 methylation as well as aberrant methylation of p16INK4a in mucosa compared to Swedish patients. These epigenetic differences may be linked to environmental and lifestyle factors. Ongoing research will further explore whether hypermethylation in the mucosa of Nepalese patients is associated with tumorigenesis and its potential utility in screening high-risk patients or predicting recurrence.

O-107 The contribution of women's modes of conception, self-mastery, perceived stress, and cognitive appraisal to personal growth in two phases during pregnancy

Abstract Study question How do women’s modes of conception, self-mastery, perceived stress, and cognitive appraisal contribute to personal growth during two phases of pregnancy? Summary answer Women who conceive through IVF experience the highest level of personal growth; Higher challenge appraisal is associated with higher personal growth in both study phases. What is known already Pregnancy can be experienced as a complex and stressful period, especially for women who conceive through fertility treatments. However, stress also constitutes an opportunity to experience personal growth, as shown by a few studies that examined women once during pregnancy. One study focused on cognitive appraisal and found that as women appraise their pregnancy as more challenging, they experience a higher level of growth during the third trimester of pregnancy. Additionally, scarce evidence indicates that personal growth increases from the third trimester to the postpartum period. Study design, size, duration The current study consists of three groups that differ in their modes of conception: spontaneous; first-line fertility treatments, such as intrauterine insemination (IUI); and in-vitro fertilization (IVF). A prospective design was employed in two phases during pregnancy: the first or second trimester (Phase 1; n = 400) and the third trimester (Phase 2; n = 268). Participants/materials, setting, methods Israeli pregnant women (age M = 32, SD = 4.5) were recruited by gynecologists and fertility specialists via several large women's health centers in Israel. Women completed five self-report questionnaires: Posttraumatic growth, self-mastery, perceived stress, cognitive appraisal, and questions relating to background and pregnancy-related details. Main results and the role of chance The findings indicate that women who conceived spontaneously have a higher sense of self-mastery than women who conceived through IVF. Whereas no differences were found between the study groups in perceived stress, the IVF group experienced higher personal growth than the spontaneous group during early pregnancy, but not during advanced pregnancy. The hierarchical regressions conducted to examine the contribution of the study variables to personal growth revealed that they accounted for 30.6% of its variance in the early phase of pregnancy and 23.6% in the advanced phase. In the early phase, lower self-mastery, a lower appraisal of the pregnancy as a threat, and a higher appraisal of the pregnancy as a challenge were associated with higher personal growth. In the advanced phase of pregnancy, only being first-time expecting mothers and higher challenge appraisal predicted personal growth. Finally, personal growth was greater in advanced pregnancy than in the earlier stage. Limitations, reasons for caution The findings rely on self-report measures, which may be biased. Also, the study was conducted in Israel, in which women who want to have children are eligible to receive fertility treatments sponsored by the health insurance fund up to the age of 44, thus should be considered in this context. Wider implications of the findings Women may experience positive implications following challenging conceiving circumstances. This can be translated to interventions aimed at strengthening women's internal resources and positive perceptions, as well as to raising awareness among professionals in fertility units that, alongside difficulties entailed in the process, it can also constitute an opportunity for growth. Trial registration number not applicable

Measurement of Vitamin D Level among Covid-19 Patients and its Correlation with Severity of the Disease

Abstract Background Coronavirus disease 2019 (covid-19) is defined as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified among an outbreak of respiratory illness cases in Wuhan City, China. Vitamin D is known to play a key role in the maintenance of bone health and calcium–phosphorus metabolism, yet many other functions of this vitamin have been recently postulated, such as modulation of the immune response in both infectious and autoimmune diseases. Different studies showed that severity of covid-19 infection is directly related to vitamin D level. Methods This is an observational cross-sectional study, which includes 80 COVID-19 patients, and admitted in the ward and ICU of EL Medany Hospital, EL Demerdash and EL Obour specialized hospital. All patients had positive PCR for COVID-19. Chest CT without contrast was done for all patients and categorized according to CORAD staging. Serum vitamin D level was measured, besides laboratory inflammatory markers (CRP, ferritin, d-dimer), kidney and liver function tests, and complete blood picture. Results Our study included 80 patients; 33 males and 47 females with mean age of (51±10.5 years). Measured Vitamin D level range was (10±9 ng/mL). It was found that male patients had higher level of serum vitamin D (12.6±8.6 ng/mL) than female patients (11.5±9.5 ng/mL) but with no statistically significant difference. The commonest presentations were sore throat (97.5%), and fever (93.75%). COVID-19 patients presenting with cough and fever had highly significantly lower levels of vitamin D than patients not presenting by these symptoms (P-value 0.006, 0.032) respectively. In the current study, patients with CORAD 5 in chest CT had the lowest vitamin D level (9.6±7.8 ng/mL), compared to patients with CORAD 3 (13.6±9.7 ng/mL), and CORAD 4 (11.8 ±8.8 ng/mL). According to the correlation analysis, a decrease in vitamin D levels was associated with more severe COVID-19 cases, with significantly higher blood levels of inflammatory markers CRP and ferritin (P-value 0.02, 0.01). No correlation was found between vitamin D levels and hemoglobin level, white cell count, platelet count, or D-Dimer. Conclusion Our findings suggest that the COVID-19-positive individuals with lower vitamin D levels, had significantly higher blood levels of inflammatory markers (Ferritin and CRP), and increased frequencies of ground-glass opacity appearance in chest CT scans. Accordingly, vitamin D deficiency may be a marker of poor prognosis in COVID-19 patients.

Management of Proximal Femoral Metastasis “Systematic Review/Meta-Analysis”

Abstract Background Adequate treatment of patients with proximal femur metastases demands higher level of attention due to the increasing life expectancy, and the need of maintaining good functional integrity and quality of life. In the presence of impending or actual pathologic fracture, treatment requires a reconstruction which provides pain control, stable and secure fixation and allows for immediate weight-bearing. Objective to evaluate management of proximal femoral metastasis as regards: functional outcome, oncological outcome and complications. Material and Methods This systematic review was conducted on human subjects in different literatures collected from different medical websites before 2022 in which we compared osteosynthesis including IMN (group 1) and reconstruction whether endoprosthesis replacement, total hip arthroplasty or hip hemiarthroplasty (group 2) in treatment of proximal femoral metastasis. Results Osteosynthesis results in a high recurrence, failure rate and non-union, while Dislocation rates and infections were common in reconstruction. the survival rate was prolonged in reconstruction than in osteosynthesis by IMN.

Gstp1 negatively regulates blood pressure in hypertensive rat via promoting APLNR ubiquitination degradation mediated by Nedd4.

Hypertension is a leading risk factor for disease burden worldwide. Vascular contraction and remodeling contribute to the development of hypertension. Glutathione S-transferase P1 (Gstp1) plays several critical roles in both normal and neoplastic cells. In this study, we investigated the effect of Gstp1 on hypertension and on vascular smooth muscle cell (VSMC) contraction and phenotypic switching. We identified the higher level of Gstp1 in arteries and VSMCs from hypertensive rats compared with normotensive rats for the first time. We then developed Adeno-associated virus 9 (AAV9) mediated Gstp1 downregulation and overexpression in rats and measured rat blood pressure by using the tail-cuff and the carotid catheter method. We found that the blood pressure of spontaneously hypertensive rats (SHR) and 2-kidney-1-clip (2K1C) renovascular hypertensive rats rose significantly with Gstp1 downregulation and reduced apparently after Gstp1 overexpression. Gstp1 did not influence blood pressure of normotensive Wistar-Kyoto (WKY) rats and Sprague-Dawley (SD) rats. Further in vitro study indicated that Gstp1 knockdown in SHR-VSMCs promoted cell proliferation, migration, dedifferentiation and contraction. Results from bioinformatic analysis showed that the Apelin/APLNR system was involved in the effect of Gstp1 on SHR-VSMCs. The rise in blood pressure of SHR induced by Gstp1 knockdown could be reversed by APLNR antagonist F13A. We further found that Gstp1 enhanced the association between APLNR and Nedd4 E3 ubiquitin ligases to induce APLNR ubiquitination degradation. Thus, in the present study, we discovered a novel anti-hypertensive role of Gstp1 in hypertensive rats and provided the experimental basis for designing an effective anti-hypertensive therapeutic strategy.

Education for sustainable development: comparative analysis and prospects at universities in Kazakhstan, Tajikistan, Kyrgyzstan and Uzbekistan

The study, conducted in higher education institutions in Kazakhstan, Tajikistan, Kyrgyzstan and Uzbekistan, highlights ongoing changes in approaches to education for sustainable development (ESD) in Central Asian countries. This region, exposed to various challenges such as climate change and environmental problems, has recognized the importance and role of education in achieving sustainable development. The study aims to identify the current level of awareness of students and teachers about the Sustainable Development Goals, as well as to understand how universities in the region are integrating ESD principles into their educational programs.The results show that students generally have limited knowledge about the global sustainable development goals, while teachers have a higher level of awareness. Most students receive information about the sustainable development goals (SDGs) through social media and the Internet, while it is less reflected in the curriculum. However, there is a trend towards changing this situation, in particular in Tajikistan, where curricula are becoming more focused on environmental education.Finally, recommendations for universities include integrating ESD principles into teacher development, developing teaching methods and materials, and strengthening collaboration at the regional and international levels to promote sustainable development goals.

Prevention and correction of micronutrient deficiencies. What do we know about it?

BACKGROUND: Micronutrient deficiencies, including deficiencies of vitamins and microelements, are a major public health concern worldwide. They are highly prevalent, particularly in developing countries, and have significant health consequences, including anemia, impaired immune function, cognitive impairment, and growth retardation. Micronutrient deficiencies can also contribute to the development of chronic diseases, such as cardiovascular disease and diabetes. Micronutrient deficiencies can also contribute to the development of chronic diseases. AIM: To study the knowledge, interest and motivation of different population groups regarding vitamin and micronutrient intake. MATERIALS AND METHODS: The original questionnaire with 45 questions was completed by 344 respondents: 141 (41%) without medical education, 91 (25.4%) with higher medical education, 112 (32.6%) by students of medical unvesities. RESULTS: Only 100 (29.4%) respondents considered their nutrition balanced. 180 (52.3%) people did not consume vegetables and fruits on a daily basis, 82 (23.3%) respondents almost never consumed fish and seafood. Almost all respondents [335 (97.4%)] took some vitamin and mineral complex at least in one of the periods of their life, 284 (82.6%) — did it without a doctor’s prescription. Female respondents demonstrated a higher level of knowledge about the problem under study: 115 (41.9%) women and only 17 (24.2%) men had checked vitamin D levels (p = 0.006), while 187 (68.2%) women and only 33 (47.1%) men had taken vitamin D (p = 0.006). Those receiving/having higher medical education were more likely to take vitamin D (4.4 times), vitamin B6 (3.8 times), selenium (3 times), and zinc (2.8 times) than non-medical respondents. CONCLUSIONS: The nature of nutrition indicates potential risks of micronutrient imbalance in the respondents. Knowledge about the problem of micronutrient imbalances among the study participants is not systematized. Men and people without medical education have less knowledge on this topic and are less likely to take various micronutrients.

Burnout, Engagement, and Resilience During the COVID-19 Lockdown: Keys to a Model for Teachers' Self-Efficacy.

Social isolation measures by the COVID-19 pandemic have impacted teaching work. In an "Emergency Remote Teaching" (ERT) context, it is relevant to investigate the factors that affect teachers' self-efficacy. A total of 289 teachers from schools in southern Spain have participated in this study. They have been asked about their levels of burnout, engagement, and resilience. Comparisons were made by groups in accordance with sex, type of center they belonged to, school social context, and educational level in which the teacher taught. Using a Structural Equations Model, the multivariate relationships between the variables related to burnout, engagement, and resilience were described. During the ERT, teachers' self-efficacy was influenced by the 3 factors: burnout-exhaustion and cynicism-engagement, and resilience. During the ERT, the teachers in semi-private and private centers showed greater self-efficacy. In turn, the teachers in childhood and primary education showed a significantly higher level of work engagement than the teachers in compulsory and post-compulsory secondary education. The results in relation to ERT are discussed in the context of the exceptionality and universal globality of the pandemic phenomenon and the complex self-perception of the social value of the teaching function.

Analysis of Demographic Variables Affecting Digital Citizenship in Turkey

Abstract The new technologies generated by the digital age are changing how individuals and societies communicate, learn, work, and manage. Although digital citizenship is defined as the behavioral norms regarding the use of technology in the most general sense, it also includes ethical and appropriate behaviors and being informed about this issue while using technology. However, there is a generational gap in digital information and literacy. In this context, the research analyzes digital citizenship according to gender, age, number of children, job position, and education level. In this analysis, which was structured as exploratory research to examine the digital citizenship status of participants, the descriptive model was preferred over quantitative research models. According to the analysis results, it can be said that the participants’ digital citizenship behavior is in the range of “I am undecided” (at a moderate level). Citizenship behavior with the lowest score was “political activism on the internet.” The groups with a significantly higher level of digital citizenship are women, those between the ages of 22 and 42 working as managers, and those at the graduate level.

Properties of flyash-dolomite powder-mangalore tile waste powder based alkali-activated binder cured in ambient condition

AbstractThis research addresses the slower reaction rate of flyash based alkali activated binders by investigating the use of dolomite powder (DP) and Mangalore Tile waste powder (MTWP) to enhance the reaction rate and improve binder properties. The study evaluates the feasibility of combining these materials with flyash to develop effective alkali activated binders. Material characterization was performed to access their suitability as precursors in alkali activation. The proportions of these precursors were varied while maintaining a constant rate of alkali activators such as sodium hydroxide and sodium silicate. Tests for initial and final setting times, flowabilty, pH, electrical conductivity and compressive strength of the binders were conducted. Microanalysis supported the findings by providing detailed insights. Results indicate that the alkali activated FA-DP-MTWP binder exhibited faster setting and hardening with decreased flow ability. The pH of all FDT binder mixes provides necessary alkaline environment for forming stable reaction products like CSH, CASH, NASH and MSH, as identified by SEM, EDS, and XRD studies. This higher level of these activation products also lead to increased electrical conductivity. Optimal precursor utilization was achieved with 5% MTWP and 10% DP in the total binder, beyond which DP and MTWP acted only as fillers. Mechanical, mineralogical, and morphological analyses confirmed the binder's satisfactory performance and cementitious properties, demonstrating its potential value for construction applications. The study concludes that incorporating these materials can effectively enhance the properties of flyash based alkali activated binders. Graphical abstract

Spiritual Intelligence and Spiritual Care Among Nursing Students in a Selected University

Background: To ensure that nursing education adequately prepares nurses for comprehensive patient care, educators must develop a heightened awareness of the religious and spiritual elements involved in patient care. Moreover, educators must possess the ability to equip student nurses with the necessary knowledge and skills to provide spiritually-based care ethically. Methods: A descriptive-correlation study was conducted among 359 Nursing students in a non-sectarian, private university in the Philippines. Convenience sampling was employed using two adopted tools, the Spiritual Intelligence Self-Report Inventory (SISRI) and the Student Survey of Spiritual Care (SSSC) to collect the data. A Spearman rank order was utilized for the test of the relationship. The data analysis was done using SPSS version 28.0. Results: The study revealed a higher level of spiritual intelligence in terms of critical existential thinking (M = 19.39, SD = 4.65) and lowest with conscious state expansion subscale (M = 13.65, SD = 3.55). Overall, the students exhibited a moderate level of spiritual intelligence (M = 66.16, SD = 3.82). Moreover, Nursing students perceived a very positive experience (M = 4.60, SD = 1.26) in providing spiritual care. There is a moderate relationship between spiritual intelligence and the ability to give spiritual care (rs = 0.515, p = 0.000), which was statistically significant. Conclusions: Spirituality holds great significance within the field of nursing, as it carries profound implications for the provision of care to patients. Moreover, it represents an indispensable component of holistic nursing care.

CD34+ Hematopoietic Stem Cell Count as a Novel Predictor of Vascular Event in Sickle Cell Disease Patients

Abstract Background Sickle cell disease (SCD) is one of the most common genetic disorders, it not only has hematological pathophysiological consequences, but also has systemic pathological manifestations such as vascular events (VEs). Prior studies have described that VEs are associated with poor outcomes in the short term and decreased quality of life in patients over the long term. There is no standardized method for predicting vascular injury in Sickle cell disease patients. Aim of the Work Our aim is to evaluate circulating CD34 as a novel predictive marker of occurrence of vascular event in Children with Sickle Cell Disease in their steady state and relate levels to severity of VEs in the following 6 months. Patient and Methods This study was an exploratory study, conducted at Pediatrics Hematology- Oncology Unit at Ain Shams University Children’s Hospital, where 50 children with sickle cell disease were enrolled at their steady state (defined as 2 months free from any Vascular Event prior to the study), aged 6 months - 16 years. Flow cytometry was done for quantification of circulating CD34+ at inclusion and compared to age and sex matched control and patients were followed up for 6 months for vascular events. Results There is statistically significant higher level of CD34+ among SCD patients compared to age and sex matched control with p value &amp;lt; 0.001.Circulating CD34+ showed significantly higher level in patients who developed systemic vascular events after 6 months of follow up with p value 0.022. There was no statistically significant correlation between circulating CD34+ and severity of peripheral vascular events (or any need for hospitalization) on follow up. Conclusion CD34+ cell count at steady state may be a promising biomarker of further vascular event in children with SCD.

P-516 Minimizing mosaicism: impact of trophectoderm (TE) biopsy specimen size on mosaic blastocysts in preimplantation genetic testing for aneuploidy (PGT-A)

Abstract Study question Is the size of TE biopsy specimens related to the chromosomal status of the blastocysts in PGT-A? Summary answer Smaller biopsy specimens are associated with higher proportion and altered composition of mosaic blastocysts in PGT-A. What is known already Concordance between TE biopsy and inner cell mass or whole embryos is influenced by mosaicism type, degree, biopsy location, number of cells biopsied, and cell loading. Particularly, mosaic embryos and those with structural rearrangements have a higher level of inconsistency. Recent studies have demonstrated the potential reclassification of chaotic embryos as euploid, leading to successful live births. This study aimed to investigate the potential influence of TE biopsy specimen size on the chromosomal status of blastocysts undergoing PGT-A. Study design, size, duration This retrospective study, conducted from October, 2023, to January, 2024, included 246 blastocysts from patients undergoing TE biopsy and PGT-A at the blastocyst stage on days 5, 6, or 7. Next-generation sequencing (NGS) was used to obtain PGT-A results, categorizing blastocysts into euploid, aneuploid, and mosaic based on their genetic composition. Participants/materials, setting, methods The biopsy specimen area was measured using the Image J program. Mosaic blastocysts were categorized into either a chaotic mosaic group or another group, which included blastocysts with fewer than three chromosomal aneuploidies and segmental mosaicism. Further analysis was conducted by classifying blastocysts into high-level mosaic (&amp;gt;30% aneuploidy) and low-level mosaic (≤30% aneuploidy) groups. Group differences were analyzed using t-tests and chi-square, with a significance threshold set at p&amp;lt;0.05. Main results and the role of chance In the analysis of expanded mosaic blastocysts, the chaotic mosaic group had smaller biopsy specimens than those in the comparison group (p&amp;lt;0.05). The high-level mosaic group also had significantly smaller biopsy specimens than the low-level mosaic group (p&amp;lt;0.05). When categorizing the biopsied sample size into two groups—below 1350 µM2 (n = 98) and above 1500 µM2 (n = 97)—the rates of mosaic embryos were 37% (36/98) and 30% (29/97), respectively, showing a numerical difference without statistical significance. These findings suggest a correlation between the size of biopsy specimens and the chromosomal status of mosaic blastocysts, particularly indicating that a smaller sample size is associated with an elevated chance of mosaic embryos showing chaotic or high-level mosaic characteristics. Limitations, reasons for caution The biopsy specimens were photographed, and their areas were measured using the Image J program, lacking a comprehensive representation of the three-dimensional sample morphology. This constraint could potentially affect the accuracy and in-depth understanding of the spatial characteristics of the biopsy specimens. Wider implications of the findings The study emphasizes the crucial role of optimizing biopsy specimen size in PGT-A. The identified correlation with the chromosomal status in mosaic embryos, especially the association with chaotic or high-level mosaic embryo outcomes in smaller samples, highlights the need for careful size considerations. Trial registration number not applicable

BIOCHEMICAL IMBALANCE IN ISCHEMIC HEART DAMAGE COMBINED WITH STEATOHEPATOSIS

The development of steatohepatosis in most cases is the primary process and consequence of the metabolic syndrome. This disease has a long asymptomatic course. The connection of steatohepatosis with the development and progression of coronary heart disease occurs when steatohepatosis is associated with metabolic syndrome and obesity. Patients with steatohepatosis usually have signs of metabolic syndrome: arterial hypertension, abdominal obesity, impaired glucose tolerance, atherogenic dyslipidemia, which are considered risk factors for cardiovascular diseases. Biochemical parameters were determined in coronary artery disease complicated by steatohepatosis. 101 people were examined. When examining the serum level of brain natriuretic peptide in patients with ischemic heart disease in combination with steatohepatosis, a higher level was found than in uncomplicated coronary heart disease, which indicates a deeper violation of the functional state of the myocardium in ischemic heart disease in combination with steatohepatosis. When examining the cytolytic syndrome markers LDH, AST and ALT, a probable increase in their activity is observed. The detected activation of LDH is associated with damage, tissue necrosis, which is observed in the case of damage to the myocardium and hepatocytes in the examined groups, which indicates an inflammatory type of pathogenesis. Apparently, activation of transaminases is associated with cytolytic syndrome in myocardial damage and increased energy expenditure of hepatocytes in fatty hepatosis. Signs of impaired glucose tolerance were found in the examined subjects: the fasting glucose level and the postprandial glucose level probably exceeded normal values, the HbA1c level was 1.5 times higher than the control in myocardial ischemia, and 1.7 times higher in coronary heart disease and steatohepatosis (p&lt; 0.05). Disruption of hormonal regulation of carbohydrate metabolism was detected in both examined groups. An elevated level of total cholesterol and dyslipoproteinemia were also found in both groups of examined patients, however, the most pronounced changes are observed in the case of complications of steatohepatosis. The obtained results indicate complex disorders of lipid metabolism in myocardial ischemia and ischemic heart damage in combination with steatohepatosis, which confirms the development of metabolic syndrome.

Evaluation of the sperm parameters, oxidative stress, and histopathological effects of vitamin B12 in preventing Helicobacter pylori-induced testicular toxicity: An experimental study

Background: Helicobacter pylori (H. pylori) causes sterility by affecting the reproductive system. vitamin B12 improves sperm quantity and function. Objective: Vitamin B12 protection against H. pylori adverse effects was investigated. Materials and Methods: 40 C57 male mice (6 wk) were randomly assigned to 4 equal groups (n = 10) including, group 1 (control without any intervention), group 2 (H), 3 (HP), and 4 (HB) received 1×109 colony forming unit (CFU) of H. pylori, 1×109 CFU of H. pylori+phosphate buffered saline, 1×109 CFU of H. pylori+50 μg/kg vitamin B12 intraperitoneally, respectively. In the induction groups, the H. pylori was orogasterically injected 3 times with 1 cc phosphate buffered saline throughout the day. Then testicular metrics, sperm motility, viability, quantity, and shape, plasma levels of malondialdehyde (MDA), superoxide dismutase, glutathione peroxidase, and total antioxidant capacity were measured. Also, testicular-tissue changes were examined using Johnson scores, tubular differentiation index, and spermatogenesis index. Vitamin B12, homocysteine, and testosterone serum levels were examined. Results: The results showed a significantly lower Johnson score, tubular differentiation index, and spermatogenesis index, and serum level of testosterone and homocysteine as well as a higher MDA level in the H and HP groups than the HB group (p &lt; 0.05). In contrast, the highest superoxide dismutase and glutathione peroxidase enzymes activity and total antioxidant capacity as well as the lowest serum level of MDA were found in the HB group compared to other groups (p &lt; 0.05). Conclusion: Vitamin B12 increased antioxidant enzyme activity, enhanced sperm parameters, and decreased injury to testicular tissue. It can be used as a potent antioxidant in reducing testicular damage induced by H. pylori. Key words: Helicobacter pylori, Reproductive medicine, Oxidative stress.

OsNAC121 regulates root development, tillering, panicle morphology, and grain filling in rice plant.

Transcription factors in coordination with phytohormones form an intricate regulatory network modulating vital cellular mechanisms like development, growth and senescence in plants. In this study, we have functionally characterized the transcription factor OsNAC121 by developing gene silencing and overexpressing transgenic rice plants, followed by detailed analyses of the plant architecture. Transgenic lines exhibited remodelling in crown root development, lateral root structure and density, tiller height and number, panicle and grain morphologies, underpinning the imbalanced auxin: cytokinin ratio due to perturbed auxin transportation. Application of cytokinin, auxin and abscisic acid increased OsNAC121 gene expression nearly 17-, 6- and 91-folds, respectively. qRT-PCR results showed differential expressions of auxin and cytokinin pathway genes, implying their altered levels. A 47-fold higher expression level of OsNAC121 during milky stage in untransformed rice, compared to 14-day old shoot tissue, suggests its crucial role in grain filling; as evidenced by a large number of undeveloped grains produced by the gene silenced lines. Crippled gravitropic response by the transgenic plants indicates their impaired auxin transport. Bioinformatics revealed that OsNAC121 interacts with co-repressor (TOPLESS) proteins and forms a part of the inhibitor complex OsIAA10, an essential core component of auxin signalling pathway. Therefore, OsNAC121 emerges as an important regulator of various aspects of plant architecture through modulation of crosstalk between auxin and cytokinin, altering their concentration gradient in the meristematic zones, and consequently modifying different plant organogenesis processes.

Trajectories of quality of life among disaster victims: A national longitudinal study.

This study categorized quality-of-life trajectories among disaster victims in South Korea and identified the characteristics and predictors of each trajectory. Disaster victims experience tremendous physical and mental distress, which has a long-term impact on their quality of life. We conducted a cross-sectional study using data obtained from the fourth Long-term Survey on the Change of Life of Disaster Victims conducted from 2017 to 2019. The study included 257 participants who experienced a typhoon, earthquake, or fire and completed the three-year follow-up. Latent transition analysis was used to identify the potential class of quality-of-life trajectories among disaster victims. Independent t tests, χ2 tests, and logistic regression were used to identify the predictors of quality-of-life trajectories. Two latent quality-of-life classes were identified: persistent low-level and persistent high-level. Factors associated with the persistent high-level trajectory included higher education level, no injury/disease from the disaster, better subjective health status, higher social support, and lower social maladjustment. Quality of life early after a disaster is maintained throughout subsequent years; early and active support following disasters is essential to promote its rapid improvement. Targeted educational programs in disaster-prone areas are recommended to bolster resilience among individuals with lower education. Moreover, governmental and institutional efforts are needed to support victims who lack resources for disaster recovery. There is a need to establish community-based social support systems and enhance nurses' disaster response capabilities to support vulnerable groups, with such interventions tailored to reflect disaster-affected victims' unique characteristics and needs, along with ongoing research and evaluation for continuous improvements to nursing practice and disaster response.