Ninth Month Research Articles

Exploring the Intersection of Bodybuilding and Ramadan: Strategies for Maintaining Muscle Mass and Performance During Fasting

Ramadan, the ninth month of the Islamic lunar calendar, involves fasting from dawn until sunset as a spiritual practice. For individuals engaged in bodybuilding and fitness pursuits, Ramadan presents unique challenges and opportunities. This article reviews the scientific literature on the effects of Ramadan fasting on muscle physiology and performance, as well as strategies for optimizing bodybuilding goals during this period. It examines nutritional and training considerations to help individuals maintain muscle mass, strength and performance while observing Ramadan.

Evaluation of the relationship between restless legs syndrome, mental status and sleep disorders among moroccan women during their third trimester of pregnancy

Background: Restless legs syndrome (RLS) is a motor disorder encountered during pregnancy and leading to psychological and sleep impairments. The latter seems to be non-restorative and its occurrence alters the quality of life of pregnant woman. The objective of this study was to evaluate the prevalence of RLS and its relationship with both anxio-depressive symptoms and sleep disorders among a population of Moroccan pregnant women during their third trimester of pregnancy. Methods: A cross-sectional study was conducted in a population of pregnant women in their third trimester (n=178) admitted to two health facilities in the city of Marrakech: Youssef Ibn Tachafine and Oasis. The face-to-face questionnaire was used to collect data including, demographic and clinical characteristics, the four diagnostic criteria of RLS, the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS). Patients were divided into two groups RLS+ (women with restless legs syndrome) and RLS- (women without restless legs syndrome). Results: The prevalence of RLS was 59.5%, this syndrome was more common in the ninth month (74.15%) compared with the seventh and eighth months. Sleep impairment including sleep efficiency was significantly higher in RLS+ more than RLS- (P-value 0.05). Anxiety but not depression is significantly increased in RLS+ compared to RLS- (48.11% versus 38.8%, P = 0.000). No significant differences between RLS+ and RLS- in terms of socio-demographic and other clinical characteristics. Conclusion: RLS is encountered during the prenatal period, with a higher prevalence in the last trimester. During this stage of pregnancy, women suffering from RLS were vulnerable to anxiety and sleep disorders. Prevention and early diagnosis of RLS syndrome could be a proactive healthcare management leading to ensure better health outcomes and better conditions of pregnancy which precedes childbirth.

Midterm Clinical Outcomes of Repetitive Transnasal Sphenopalatine Ganglion Blockade in Chronic Migraine

Aim: Chronic migraine affects quality of life negatively, causing high rates of disabilities. There is a requirement for specific prophylactic treatment options in chronic migraine patients. We aimed to evaluate effects of repetitive transnasal sphenopalatine ganglion blockade (SPG) on headache days, severity and duration of attacks, drug abuse, conversion to episodic migraine, and responses to chronic migraine treatment.
 Materials and Methods: Diagnosed with chronic migraine for at least six months, patients referred to the algology clinic and unresponsive to prophylactic treatments or not tolerating prophylactic treatments were evaluated in the study with a retrospective design. Patients undergoing four-session bilateral transnasal SPG blockade per week were included. SPG was performed with 0.5 cc 0.5% bupivacaine-impregnated swab sticks for 30 minutes.
 Results: In first, third, sixth, and ninth month follow-ups of 40 patients included, a statistically significant improvement was found in number of headache days and parameters of attack severity and frequency, compared to baseline values (p

The effectiveness of albendazole against hookworm infections and the impact of bi-annual treatment on anaemia and body mass index of school children in the Kpandai district of northern Ghana.

The impact of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) (initiated in 2000 in Ghana and ran for 12 years) in mitigating soil-transmitted helminth (STH) infections in LF-endemic areas is unknown. During a 1-year hiatus which ensued between 2011 and 2012, a longitudinal study was conducted to determine GPELF effect on hookworm infections in selected communities involved in the programme since its inception, while measuring the effectiveness of biannual ALB treatments on schoolchildren living in such communities. A total of 399 school children aged 3 to 18 years were randomly selected from four communities in the Kpandai district of northern Ghana. Each presented a single stool sample at baseline, 21 days post-treatment, at the 3rd and 6th months, 21 days post-second intervention (i.e. following sample collection and treatment with ALB in the 6th month), and in the ninth month of the study period. Haemoglobin (hb) levels were also measured at all time points using finger prick blood samples and a URIT digital test kit. Each participant submitting a sample, was treated with a single-dose ALB (400mg) at baseline and in the sixth month. Stool samples were processed by preparing duplicate Kato-Katz slides per sample, and examined by microscopy. The Body Mass Index-for-age z-scores (BAZ) of participants were assessed following the determination of BMIs at each time point by measuring their height and weight with a stadiometer and weighing scale. Overall hookworm prevalences were 25.68% (95% CI = 20.51-31.75) at baseline, 11.18% (95% CI = 7.87-15.41) 21 days post-treatment, 11.78% (95% CI = 8.38-16.11) and 6.95% (95% CI = 4.41-10.43) in the 3rd and 6th months, 0.91% (95% CI = 0.19-2.65) 21 days post-second intervention, and 8.46% (95% CI = 5.62-12.23) in the ninth month. Observed overall faecal egg count reduction rates (ERRs) were 94.21% (95% CI = 81.50%- 100.00%) 21 days after baseline treatment, 97.70% (95% CI = 85.08-100.00) and 96.95% (95% CI = 84.18%- 100.00%) in the 3rd and 6th months, 99.98% (95% CI = 86.42%- 100.00%) 21 days post-second intervention, and 17.18% (95% CI = 14.07%- 20.67%) in the 9th month. Respective cure rates (CRs) were 62.35% (95% CI = 46.71-81.56%), 85.88% (95% CI = 67.32-100.00%), 87.06% (95% CI = 68.36%- 100.00%), 98.82% (95% CI = 78.83%- 100.00%), and 36.36% (95% CI = 9.91%- 93.11%). Additionally, increases in the percent frequency of 'normal hb' (p < 0.01) were observed across the study time points, whilst 'normal BAZ' cases remained high (from 94.87% to 98.87%) throughout the study period. These findings primarily indicate satisfactory effectiveness of ALB which may be maintainable in mass drug administration programmes by the modification of treatment strategies from annual to bi-annual regimes. This could minimize the likelihood of emerging poorly-responding hookworm phenotypes in Ghana. Additionally, a positive impact of bi-annual treatment on participant anaemia status is herein indicated with particular regard to the school children in our cohort.

The Rate of Insulin use and Suboptimal Glycemic Control among Egyptian Patients with T2DM: Cohort Analysis of Eighth Wave of the International Diabetes Management Practices Study (IDMPS).

The International Diabetes Management Practices Study (IDMPS) is an international annual survey aiming to study and characterize the current standards of care for managing DM in developing countries. In Egypt, DM represents a substantial burden on the healthcare system, with an estimated 10.9 million patients, ranking it 10th amongst countries with the highest prevalence of DM. Previous studies showed that to maintain safety and achieve treatment goals among diabetic patients, optimal insulin therapy should be selected individually based on the patient's needs. We reported the proportion of Egyptian T2DM patients on insulin therapy who participated in the eighth wave of the IDMPS. The 2018 IDMPS wave consisted of cross-sectional and longitudinal phases and aimed to evaluate the proportion of T2DM who were on insulin therapy in 13 countries from four regions. In Egypt, 17 physicians agreed to participate in the present study and were required to include at least one patient. A total of 180 T2DM patients were included in the cross-section phase. At the end of the ninth month of follow-up, data from 170 T2DM patients were available. A total of 39 T2DM patients (21.7%) were on insulin therapy, with a mean duration of 32.4 ± 36.6 months. More than half of the patients (n = 22; 56.4%) were on basal insulin, mainly long-acting (n = 20; 90.9%). The mean basal insulin daily dose was 0.3 ± 0.1 IU/Kg. Notably, 28.2% of the patients received insulin via vials, and 46.2% stated that they were adjusting the insulin dose by themselves. On the other hand, 60.2% of the study population was on oral antidiabetic drugs at the cross-sectional phase. Nearly 17.4% and 27% of the patients in the cross-sectional phase achieved the glycemic target per recommendations of international guidelines and the treating physicians, respectively. At the end of the longitudinal phase, the percentage of T2DM patients who achieved glycemic targets increased to 38.4% and 77.4% as per recommendations of international guidelines and the treating physicians, respectively. Overall, 38.3% of T2DM patients received diabetes education, and 28.9% were involved in an educational program provided by the physician or their clinical staff. Besides, 85.5% of T2DM patients followed their diabetes medication dosage and frequency strictly as prescribed. The proportion of insulin use in patients with T2DM aligned with the previous studies from different countries; however, it is still inadequate to achieve the targeted glycemic control. Nearly one-third of Egyptian patients received diabetes education, highlighting the need for adopting a national educational program. Nonetheless, the level of adherence among T2DM from Egypt appears to be high.

UNEVENTFUL PREGNANCY IN DIDELPHYS UTERUS DELIVERED THROUGH CAESAREAN SECTION: A CASE REPORT

Didelphys uterus, also known as "double uterus," is a rare congenital anomaly characterised by the presence of two separate uteri, each with its cervix. This happens as a result of the Müllerian duct embryonic fusion failing. The chance of having a pregnancy in one of the uteri without having any complications during pregnancy is relatively low. We are reporting a case of a 24-year-old primigravida woman with a didelphys uterus. The patient presented with the complaint of leaking per vaginum at term gestation in hospital IPD. She had undergone ultrasonography many times during her pregnancy, but no ultrasound finding suspects any congenital anomaly of the uterus. During the ninth month of gestation, when the patient came with leaking per vaginal, two vagina were discovered with a thick longitudinal vaginal septum, so she underwent an elective caesarean section due to the potential risks associated with vaginal delivery and under the suspicion of two separate uteri. During caesarean section, uterus didelphys was confirmed as two uteri with separate fallopian tubes and ovary; one was gravid, and another was non-gravid. The management of this condition requires careful planning and coordination among the multidisciplinary team to ensure a successful and safe outcome. The present case report reveals her history, diagnostic workup, caesarean delivery, and management outcome.

The impact of anti-tumor necrosis factor alpha drugs on lipid profile of patients with rheumatoid arthritis or seronegative spondyloarthropathy

Background: Inflammatory arthritis is associated with abnormal levels of lipoprotein. The cause is considered to be inflammation. Recently, the use of biologic drugs in the treatment of inflammatory arthritis, especially rheumatoid arthritis (RA) and seronegative spondyloarthropathy, has increased. There are different results of the effect of these drugs on fat profile. Evaluate the impact of anti-tumor necrosis factor (TNF) alpha drugs on lipid profile of patients with RA or seronegative spondyloarthritis. Methods: In this cross-sectional descriptive study, 50 patients with rheumatoid arthritis or seronegative spondyloarthritis, who were candidates for TNF alpha treatment, were included in the study. After obtaining written consent, a checklist was completed for all patients including demographic information such as age, sex, height, weight, place of residence, level of education, type of disease, and lipid profile test results including total cholesterol, triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were recorded. Then the patients were treated and evaluated for fat profile after 3, 6, 9 months after receiving the relevant treatment regimen. The test results were recorded in checklists. After completing the study, the data were entered into the statistical package for the social sciences (SPSS) 24 software and analyzed. Results: The mean age of patients was 46.38±14.33 years. 54% of patients were female. 54% of patients had rheumatoid arthritis. 62% of patients were treated with Sinora. The results of this study showed that serum triglyceride levels increased during the study period and this increase was statistically significant but the trend of changes in serum cholesterol, HDL and LDL levels was not statistically significant. However, serum LDL levels measured in the ninth month increased significantly compared to the initial measurement. Conclusions: Results showed that there was a significant relationship between lipid profile changes and anti-TNF alpha consumption. Although decreased inflammation appears but other mechanisms may be involved in dyslipidemia.

Dry season temperature and rainy season precipitation significantly affect the spatio-temporal pattern of rubber plantation phenology in Yunnan province.

The ongoing global warming trajectory poses extensive challenges to plant ecosystems, with rubber plantations particularly vulnerable due to their influence on not only the longevity of the growth cycle and rubber yield, but also the complex interplay of carbon, water, and energy exchanges between the forest canopy and atmosphere. However, the response mechanism of phenology in rubber plantations to climate change remains unclear. This study concentrates on sub-optimal environment rubber plantations in Yunnan province, Southwest China. Utilizing the Google Earth Engine (GEE) cloud platform, multi-source remote sensing images were synthesized at 8-day intervals with a spatial resolution of 30-meters. The Normalized Difference Vegetation Index (NDVI) time series was reconstructed using the Savitzky-Golay (S-G) filter, coupled with the application of the seasonal amplitude method to extract three crucial phenological indicators, namely the start of the growing season (SOS), the end of the growing season (EOS), and the length of the growing season (LOS). Linear regression method, Pearson correlation coefficient, multiple stepwise regression analysis were used to extract of the phenology trend and find the relationship between SOS, EOS and climate factors. The findings demonstrated that 1) the phenology of rubber plantations has undergone dynamic changes over the past two decades. Specifically, the SOS advanced by 9.4 days per decade (R2 = 0.42, p< 0.01), whereas the EOS was delayed by 3.8 days per decade (R2 = 0.35, p< 0.01). Additionally, the LOS was extended by 13.2 days per decade (R2 = 0.55, p< 0.01); 2) rubber phenology demonstrated a notable sensitivity to temperature fluctuations during the dry season and precipitation patterns during the rainy season. The SOS advanced 2.0 days (r =-0.19, p< 0.01) and the EOS advanced 2.8 days (r =-0.35, p< 0.01) for every 1°C increase in the cool-dry season. Whereas a 100 mm increase in rainy season precipitation caused the SOS to be delayed by 2.0 days (r = 0.24, p< 0.01), a 100 mm increase in hot-dry season precipitation caused the EOS to be advanced by 7.0 days (r =-0.28, p< 0.01); 3) rubber phenology displayed a legacy effect of preseason climate variations. Changes in temperature during the fourth preseason month and precipitation during the fourth and eleventh preseason months are predominantly responsible for the variation in SOS. Meanwhile, temperature changes during the second, fourth, and ninth preseason months are primarily responsible for the variation in EOS. The study aims to enhance our understanding of how rubber plantations respond to climate change in sub-optimal environments and provide valuable insights for sustainable rubber production management in the face of changing environmental conditions.

Smoking Cessation Success and Affecting Factors in Geriatric Patients.

There are difficulties in the treatment of smoking cessation in elderly patients. However, elderly smokers who gave up smoking had lower rates of death from heart attack, stroke, and cancer, as well as improved cognitive function. This study aimed to investigate the affecting factors and the success of smoking cessation rate in patients aged 60 and over in Turkey. Six smoking cessation outpatient clinics from four provinces were included in the study. The records of 1,065 patients who applied to a smoking cessation outpatient clinic between 2016 and 2019 and who were 60 yr of age or older were scanned. Overall, 917 cases that could be reached after treatment were included in the study. Smoking cessation rates at the first month, 3rd month, 6th month, 9th month and 12th month were given. Of the 917 cases, 65.1% were male and 34.9% were female. Smoking cessation rates were 45.6% on the first month, 39% on the third month, 35.1% on the sixth month, 31.2% on the ninth month, and 30.3% at the twelfth month. Smoking cessation success was higher in men than in women. Since the success of smoking cessation in the elderly was similar to that of adults. Since smoking is an independent risk factor for death in the elderly, there should be greater willingness to provide elderly patients with smoking cessation treatment to reduce physical function loss and promote healthier aging.

Kinetics of Lymphocytosis during First-Line Treatment with BTK Covalent Inhibitors in Chronic Lymphocytic Leukemia Patients: An Italian Multicenter Experience of Real Life

CONCLUSIONS In chronic lymphocytic leukemia (CLL) patients (pts) the first phase of treatment with covalent Bruton's tyrosine kinase inhibitors (cBTKi), Ibrutinib or Acalabrutinib, is characterized by an increased absolute lymphocyte count (ALC), regardless of previous lines of treatment. Ibrutinib, as first-line therapy, induces lymphocytosis in about 57% of pts, and it is more prominent in IGHV mutated CLL patients. This phenomenon, due to the spread of neoplastic lymphocytes from the nodal compartment into peripheral blood, is transient in most patients, resolving within 8 months, but can rarely persist over 12 months, without any impact on survival: the criterion of Partial Response with Lymphocytosis (PR-L) was introduced for this phenomenon. Despite lymphocytosis in Ibrutinib has been widely investigated, little is known about the effective presence, kinetics and duration of lymphocytosis in patients treated with Acalabrutinib. The main purpose of this multicentric study was to define, in a real-life setting, the kinetics of drug-induced lymphocytosis in CLL patients treated with Acalabrutinib or Ibrutinib, in order to discover any possible differences in terms of entity and duration of this phenomenon. In our multicentric retrospective study we enrolled 204 pts (127 male and 77 female), treated in first line with cBTKi (136 Ibrutinib and 68 Acalabrutinib), from 16 different Italian centers, between April 2016 and November 2022, with last follow up in April 2023. For each patient we collected data about the burden of disease at baseline (in terms of staging, lymph nodes involvement, presence of splenomegaly), and about the biological features of the disease (cytogenetic aberrations and molecular mutations, IGHV status). Then we evaluated the ALC at the baseline and at well-defined time-points (after two weeks, 1, 2, 3, 6, 9, 12 months) over an observation period of 1 year. Patients' characteristics are reported in Figure 1. The main differences between the two groups were observed in FISH and molecular biology, with a prevalence of del17p and mutated TP53 among Ibrutinib-treated patients. We observed a median ALC increase after the beginning of therapy in both groups. Median lymphocytosis was higher than baseline during the first month of treatment in both cohorts. A progressive decline in median ALC occurred from the second month of treatment in both groups: at this time-point, median lymphocyte count was 62% of baseline in Acalabrutinib cohort versus 84% in Ibrutinib cohort (p=0.025). From the sixth month to the end of the study we found a statistical difference in the ALC with higher counts in the Ibrutinib group. In fact, at this time point, median ALC was 6960/microL in Acalabrutinib compared to 11010/microL in Ibrutinib group (13% vs 30% of baseline), at the ninth month it was 4550/microL vs 8230/microL (10% vs 20% of baseline) and after twelve months it was 2740/microL vs 5520/microL (8% vs 13% compared to baseline) in the Acalabrutinib versus Ibrutinib group, respectively. Besides, we evaluated the percentage of lymphocytosis resolution in both arms at different timepoints and we observed a quicker restoration of an ALC &amp;lt; 5000/mmc in the Acalabrutinib arm. The results are illustrated in Figure 1. Acalabrutinib seems to determine, like Ibrutinib, an increase of ALC immediately after the starting of treatment. Therefore, lymphocytosis appears as a cBTKi-class effect. Despite this, the kinetics of lymphocytosis are not overlapping in the two groups: since the sixth month of therapy ALC reaches almost-normal values in the Acalabrutinib group, with significant statistical differences compared to Ibrutinib. These data suggest that lymphocytosis seems to be less long-lasting in patients treated with Acalabrutinib than in those ones treated with Ibrutinib and the response criterion of PR-L may have a less scope for applicability during treatment with Acalabrutinib.

Real-Life Experience With Bictegravir/Emtricitabine/Tenofovir Alafenamide in Turkey.

Single-tablet regimens (STRs) can increase treatment success and even improve the quality of life of human immunodeficiency virus (HIV) patients. In this study, we aim to analyze the real-life efficacy and tolerability data of people living with HIV (PLWH) initiated on or switched to bictegravir/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF)as first-line treatment. This retrospective analysis was performed in HIV-1-positive patients who were initiated BIC/FTC/TAF in the HIV clinic between June 2020 and June 2022. Patients who received BIC/FTC/TAF for at least 12 months were included in this study. Virological suppression, laboratory parameters, side effects, and immunological response were analyzed at one, three, six, nine, and 12 months. A total of 116 patients, 66 (56.9%) treatment-experienced and 50 (43.1%) naive, were evaluated within the scope of the study. In the naive patient group, baseline HIV-RNA, CD4+ and CD8+ T cell counts, CD4/CD8 ratio, and estimated glomerular filtration rate (eGFR) values weresignificantly different in different follow-up months. The number of patients with HIV-1 RNA levels below 50 copies/mL was 55.9% in the first month, 73.7% in the third month, 90.2% in the sixth month, and 100% in the ninth and 12th months. In our real-life observational study, BIC/FTC/TAF treatment achieved rapid viral suppression, maintained viral suppression in virally suppressed patients, and was effective for immunological recovery in both treatment-experienced and naive HIV patients. No serious side effects were observed. Our study has proved the potential of BIC/FTC/TAF as an important option in the treatment of HIV patients.

IgG level of the third booster dose for mRNA of SARS-CoV-2 vaccines among Iraqi healthcare workers.

Mass vaccination is an effective method for controlling the outbreak of coronavirus disease 2019 (COVID-19) and limiting the consequent mortality due to severe COVID-19. After the second dose, immunity can decline in certain cases over time; therefore, a third booster dose should be administered. Therefore, the present study aimed to assess the immunogenicity of the third dose of the messenger ribonucleic acid BioNTech COVID-19 vaccine and determine the effect of the third booster dose of messenger ribonucleic acid COVID-19 vaccines, specifically (Oxford/AstraZeneca COVID-19 vaccine/AZD1222), BioNTech COVID-19 vaccine, and Sinopharm among healthcare workers. This longitudinal panel design was conducted with 256 healthcare workers in Duhok Province, Iraq, from June to October 2022. Most participants had a normal body mass index (44% and 41% in the first and second phase, respectively). In the first phase, significant associations were observed between COVID-19 vaccines and positivity (P value ≤ .001), and between age groups and positivity (P value = .001). The mean severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike receptor-binding domain immunoglobulin G antibody level in the ninth month was the highest among those who had received the Pfizer vaccine (6.7930), followed by AstraZeneca (2.8492), and Sinopharm (0.3060). In the 12th month, all 82 participants received Pfizer as a booster dose, and the highest mean SARS-CoV-2 anti-spike receptor-binding domain immunoglobulin G antibody in the 12th month belonged to those whose second dose was Pfizer (46.8835), followed by AstraZeneca (36.4635), and Sinopharm (21.7815). The Pfizer vaccine is highly effective in restoring SARS-CoV-2-specific immune responses and is well-tolerated. However, further investigation is required to determine the duration of disease protection of the third dose of the COVID-19 vaccine.

The effect of liquid bio-organic fertiizer on the productivity of ironwood (Eusideroxylon zwageri) leaf biomass

Ironwood (Eusideroxylon zwageri) is an endemic species in East Kalimantan known as ulin by the local community. Ironwood is a protected and slow-growing species. It is essential to look for an alternative use in less period. Ironwood young leaves have been used traditionally as a decoction with diuretic and hair-blackening properties. Such usage provides an opportunity to utilize ironwood without cutting down trees. As a reason for leaves sustainability, it is necessary to stimulate the formation of leaves, one of which is to use liquid bio-organic fertilizer. This study aimed to determine the effect of liquid bio-organic fertilizer on increasing the growth and yield of young ironwood leaves in nurseries. Fifty ironwood seedlings were given 5 ml of liquid bio-organic fertilizer every month, and the other 50 seedlings were not given any fertilizer. The number of young leaves was recorded in the third and ninth months, while the young leaves were harvested in the sixth and twelfth months. This research showed that liquid bio-organic fertilizer increased height increments by up to 107.58%, diameter increment by up to 20.36%, the number of iron wood shoots up to 184.62%, and it also increased the weight of young leaves that can be harvested by up to 588.89%. There were any differences effects of liquid bio-organic fertilizer applied with and without bio-organic fertilizer on the growth and yield of young ironwood leaves. Ironwood shoots’ growth and yield by application of liquid bio-organic fertilizer are better than nonliquid bio-organic fertilizer.

Dystocia due to external hydrocephalus in a primiparous buffalo heifer

A primiparous non-descript buffalo heifer in ninth month of gestation was presented for showing the signs of abortion, i.e., vaginal discharges and rupture of water bag (choreo-allantois). Obstetrical examination revealed an open cervix. The foetus was in anterior longitudinal presentation, dorso-sacral position and was locked in pelvic cavity. A round sructure was observed in the pelvic cavity. Based on history and clinical observations, it was diagnosed as late gestational threatened abortion. It was decided to deliver the calf by manual traction, if not possible, by cesarean section. Manual traction on the foetus using snares was applied and a dead foetus with hydrocephalus was delivered per vagina.

Immune Response Kinetics Following a Third Heterologous BNT162b2 Booster Dose After Primary 2-Dose ChAdOx1 Vaccination in Relation to Omicron Breakthrough Infection: A Prospective Nationwide Cohort Study in South Korea.

Immune responses to each vaccine must be investigated to establish effective vaccination strategies for the ongoing coronavirus disease (COVID-19) pandemic. We investigated the long-term kinetics of immune responses after heterologous booster vaccination in relation to Omicron breakthrough infection (BI). Our study included 373 healthcare workers who received primary ChAdOx1 vaccine doses and a third BNT162b2 vaccine dose. BIs that occurred after the third vaccine were investigated. Blood specimens were collected before and 3 months after the booster dose from participants without BI and 1, 4, and 6 months after BI from participants who experienced BI. Spike-specific binding and neutralizing antibody levels against the wild-type virus, Omicron BA.1, and Omicron BA.5, as well as cellular responses, were analyzed. A total of 346 participants (82 in the no BI group; 192 in the BI group during the BA.1/BA.2 period; 72 in the BI group during the BA.5 period) were included in the analysis. Participants without BI exhibited the highest binding and neutralizing antibody concentrations and greatest cellular response 1 month after the third vaccination, which reached a nadir by the ninth month. Antibody and cellular responses in participants who experienced BI substantially increased postinfection. Neutralizing antibody titers in individuals who experienced BI during the BA.1/BA.2 period showed more robust increase against wild-type virus than against BA.1 and BA.5. Our findings provide evidence of antigenic imprinting in participants who received a heterologous booster vaccination, thereby serving as a foundation for further studies on the impact of BIs on immune responses.

A COMPARATIVE EVALUATION OF URDU AND ENGLISH ANIMATED NURSERY RHYMES USING NEUMANN’S AND HERODOTOU EVALUATION RUBRIC

YouTube has fast become a pastime and source of info-cum-entertainment in Pakistan, winning it the ninth rank amongst countries with the most YouTube users. Parents allow children as young as ninth months old and onwards to watch YouTube for cartoons and rhymes, with oversight on children's screen-watch. The current study aims to assess whether Neumann's and Herodotus’ YouTube video evaluation rubric can be applied to YouTube nursery rhymes in other languages to evaluate the edutainment elements. The original 17-pointer rubric was extended to 21-pointers to compare age-appropriateness, content quality, design features, and learning objectives of famous Urdu and English animated nursery rhymes. The results show that Urdu rhymes videos are better in terms of age appropriateness, content quality, design features and learning objectives. Hence, they effectively contribute to children's socio-cultural and linguistic development

Comparison of quantitative and calculated postpartum blood loss after vaginal delivery

Because there is no consensus on the method of assessing postpartum blood loss, the comparability and relevance of the postpartum hemorrhage-related literature are questionable. Quantitative blood loss assessment using a volumetric technique with a graduated collector bag has been proposed to overcome limitations of intervention-based outcomes but remains partly subjective and potentially biased by amniotic fluid or missed out-of-bag losses. Calculated blood loss based on laboratory parameters has been studied and used as an objective method expected to reflect total blood loss. However, few studies have compared quantitative with calculated blood loss. This study aimed to compare the distribution of postpartum blood loss after vaginal delivery assessed by 2 methods-quantitative and calculated blood loss-and the incidence of abnormal blood loss with each method. Data were obtained from the merged database of 3 multicenter, randomized controlled trials, all testing different interventions to prevent postpartum blood loss in individuals with a singleton live fetus at ≥35 weeks of gestation, born vaginally. All 3 trials measured blood loss volume by using a graduated collector bag. Hematocrit was measured in the eighth or ninth month of gestation and on day 2 postpartum. The 2 primary outcomes were: quantitative blood loss, defined by the total volume of blood loss measured in a graduated collector bag, and calculated blood loss, mathematically defined from the peripartum hematocrit change (estimated blood volume × [(antepartum hematocrit-postpartum hematocrit)/antepartum hematocrit], where estimated blood volume [mL]=booking weight [kg] × 85). We modeled the association between positive quantitative blood loss and positive calculated blood loss with polynomial regression and calculated the Spearman correlation coefficient. Among the 8341 individuals included in this analysis, the median quantitative blood loss (100 mL; interquartile range, 50-275) was significantly lower than the median calculated blood loss (260 mL; interquartile range, 0-630) (P<.05). The incidence of abnormal blood loss was lower with quantitative blood loss than calculated blood loss for all 3 thresholds: for ≥500 mL, it was 9.6% (799/8341) and 32.3% (2691/8341), respectively; for ≥1000 mL, 2.1% (176/8341) and 11.5% (959/8341); and for ≥2000 mL, 0.1% (10/8341) and 1.4% (117/8341) (P<.05). Quantitative blood loss and calculated blood loss were significantly but moderately correlated (Spearman coefficient=0.44; P<.05). The association between them was not linear, and their difference tended to increase with blood loss. Negative calculated blood loss values occurred in 23% (1958/8341) of individuals; among them, >99% (1939/1958) had quantitative blood loss ≤500 mL. Quantitative and calculated blood loss were significantly but moderately correlated after vaginal delivery. However, clinicians should be aware that quantitative blood loss is lower than calculated blood loss, with a difference that tended to rise as blood loss increased.

The Discourse of Daily Life during the War: the 2022 Ukrainian Projection

Aim. To define and describe the positions of Ukrainians in their attitude to the war on Russia and reflection of this attitude in the discourse of daily life in wartime.&#x0D; Concept/Methods. 25 transcripts of semi-structured interviews subjected to thematic analysis. Relying on the categories identified through thematic analysis, the criteria differentiating the attitude of Ukrainians to the war, viz. personalization/depersonalization, media practice of content consumption, assessment of the so called “we-they-relationship”, reflection on the changes in daily life, the process of adaptation to changes, ideas of exemplary behavior were established.&#x0D; Results and conclusion. The analysis of the results enabled to outline the problematic field of assessment of the attitude of Ukrainians to the full-scale war on Russia and reflection of this attitude in the discourse of daily life in wartime. Relying on the criteria differentiating this attitude, three typical positions in the attitude of Ukrainians to the war were outlined – that of external observer, optimistic fatalist, and rational optimist.&#x0D; Practical application. Clarification of the specific characteristics of the attitude of Ukrainians to the war and perception of the enemy under such circumstances enables to envisage the public opinion response to certain decisions related to the full-scale Russian invasion of Ukraine, to plan communication campaigns promoting volunteer movement with due account of different positions taken by Ukrainians as well as to determine the degree of psycho-traumatizing of individuals in the crisis situation of war via discourse.&#x0D; Originality/Cognitive value. The study was conducted in October-November 2022, on the ninth month of the full-scale Russian invasion of Ukraine, and it reflects the thoughts of Ukrainian civilians concerning the war, its reasons, collective responsibility of Russians, and, finally, changes occurring in the life of the country and every individual, the process of adaptation to this complex situation. The use of quality methods (semi-structured interview) for the study ensured focusing on subjective peculiarities of the perception of war and daily life during in wartime.&#x0D; Conclusions: The typology of ideas, types of attitude of Ukrainians to the reality of war requires verification and further specification within a quantitative study aimed at clarification of quantitative figures representing the prevalence of the established positions.

Impact of selected risk factors on motor performance in the third month of life and motor development in the ninth month.

Proper motor development can be influenced by a range of risk factors. The resulting motor performance can be assessed through quantitative and qualitative analysis of posture and movement patterns. This study was designed as the cohort follow-up of the motor assessment and aimed to demonstrate, in a mathematical way, the impact of particular risk factors on elements of motor performance in the 3rd month and the final motor performance in the 9th month of life. Four hundred nineteen children were assessed (236 male and 183 female), including 129 born preterm. Each child aged 3 month underwent a physiotherapeutic assessment of the quantitative and qualitative development, in the prone and supine positions. The neurologist examined each child aged 9 month, referring to the Denver Development Screening Test II and assessing reflexes, muscle tone and symmetry. The following risk factors were analyzed after the neurological consultation: condition at birth (5th min Apgar score), week of gestation at birth, intraventricular hemorrhage, respiratory distress syndrome, and the incidence of intrauterine hypotrophy and hyperbilirubinemia determined based on medical records. A combination of several risk factors affected motor development stronger than any one of them solely, with Apgar score, hyperbilirubinemia, and intraventricular hemorrhage exhibiting the most significant impact. Premature birth on its own did not cause a substantial delay in motor development. Nonetheless, its co-occurrence with other risk factors, namely intraventricular hemorrhage, respiratory distress syndrome, and hyperbilirubinemia, notably worsened motor development prognosis. Moreover, improper position of the vertebral column, scapulae, shoulders, and pelvis in the third month of life may predict disturbances in further motor development.

Effects of Ramadan fasting on fetal health: A systematic review.

Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of the Islamic calendar. Although pregnant women are exempt from fasting, many make the decision to practise it. Concerns that fasting during pregnancy harms the fetus remain, as there are no firm recommendations regarding its safety. To provide a systematic review on the effects of RF on fetal health. We conducted a literature search for peer-reviewed articles through Ovid MEDLINE, PubMed, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) until 31 December 2021. All case-control and observational cohort studies that reported on fetal outcomes of pregnant women who underwent RF for at least one day during pregnancy are included. Two researchers independently reviewed the eligibility of all studies. A third researcher resolved any conflict between researchers. Findings are extracted from eligible papers and presented as narratives. Fourteen articles are included based on eligibility criteria, with a total sample size of 2889. Studies demonstrate negative associations between RF and neonatal weight, amniotic fluid index, preterm birth and growth parameters mainly during the second and third trimesters. However, the evidence is not strongly supported. There is limited data to elucidate the relationship between RF and fetal health, hence the need for more studies to provide a better understanding.