Ninth Month Research Articles

Differences in eating behaviours and mothers attitudes between baby-led weaning vs. traditional spoon-feeding approaches in Türkiye.

This study was aimed to examine the differences in eating behaviours and mothers attitudes between baby-led vs. traditional spoon-feeding approaches and its effect on eating behaviours in preschool children. The study was conducted with 150 mothers of children aged 2-6, who applied to the Pediatrics Polyclinic of Başkent University Ankara Hospital, between December 2022 and February 2023. Sociodemographics, biochemical parameters were recorded to form. Maternal attitudes and eating behaviours of children were evaluated with Mother's Attitudes Towards the Feeding Process Scale (MATFP) and Early Childhood Adaptive Eating Behaviour Scale (ECAEB), respectively. The mean age of the children was 43.80±11.04 months and 51.3% of them were girls. A weak negative correlation was found between the ECAEB total scores and the child age (r=-0.196, p<0.05). A moderate positive correlation was found between the total scores of the MATFP and ECAEB (r=0.699, p<0.001). There wasn't significant difference between the MATFP total scores who chose baby-led weaning or traditional feeding (p>0.05). According to the ECAEB; aggression and reaction to main meal order subgroup scores of children who consumed pureed vegetables until the ninth month were higher than those who didn't consume them (p<0.05). Mothers who prefer the TSF offer their babies more blenderized and pureed foods, while those who prefer the BLW serve fork-mashed, steamed and sliced foods (p<0,05). As the mothers' subscale scores for negative affect during meals, attitudes about insufficient/unbalanced feeding, negative feeding strategies, forced feeding, reaction to viewpoint of others increase, so did their subscale scores for child reluctance, eating refusal associated with sensory causes, aggression, reaction to main meal order increase. Consequently, it's believed that maternal attitudes and actions should be taken into account while evaluating the eating habits of toddlers.

Trajectories and predictors of gerontological service career adaptability among health science undergraduates: A longitudinal study

BackgroundIn response to the aging population, it is essential to examine gerontological service career adaptability among health science undergraduates. ObjectivesThis study aimed to clarify the trajectories and predictors of health science undergraduates' gerontological service career adaptability. DesignThis study adopted a longitudinal design. SettingsThis study was conducted at four universities in China. Participants and methodsHealth science undergraduates were recruited via convenience sampling. Data were collected in the third (Stage 1), sixth (Stage 2), and ninth (Stage 3) months of the participants' graduation year. A total of 471 undergraduates completed a three-stage self-report questionnaire that assessed gerontological service career adaptability, career motivation, proactive personality, and practice environment at Stage 1 and gerontological service career adaptability at Stages 2 and 3. The response rate was 76.84 %. Data analyses entailed multiple linear regression, a latent growth mixture model, and multiple logistic regression. ResultsThree subgroups representing different gerontological service career adaptability trajectories were identified: rapidly growing (6.16 %), stably growing (87.47 %), and decreasing (6.37 %). Changes were observed primarily from the third to sixth months of the participants' graduation year. Health science undergraduates with high career motivation and a strongly proactive personality were likely to be in the decreasing group, whereas those with a supportive practice environment were predisposed to belong to the decreasing and stably growing groups. ConclusionsThe health science undergraduates' gerontological service career adaptability trajectories are heterogeneous, with the critical period spanning the third to sixth months of their graduation year. Gerontological service career adaptability grows stably among most undergraduates who have a supportive practice environment. Additionally, gerontological service career adaptability changes easily among undergraduates with high career motivation and a strongly proactive personality. Educators should implement tailored interventions to enhance gerontological service career adaptability based on health science undergraduates' traits.

Effect of birth type and sex on growth performance, wither height, humerus-radius bone dimensions, humerus-ulna growth plate width and selected hormone profile in growing Gurcu goat kids.

In this study, the effects of sex and birth type on growth performance, withers height (WH), radiographic measurements and selected hormone profiles in Gurcu goat kids were investigated. Twenty kids (single female=5, single male=5, twin female=5, twin male=5) were included in the study. Body weight (BW), WH, radiographic measurements (humerus length [HL], radius length [RL], proximal humerus epiphyseal plate width [HEP] and distal ulna epiphyseal plate width [UEP]) and biochemical analysis (for serum calcitonin, free triiodothyronine [FT3], free thyroxine [FT4], growth hormone [GH] and insulin-like growth factor-I [IGF-I]) were performed at 1, 3, 5, 7, 9 and 12 months of age. BW was significantly higher in males starting from the seventh month compared to females (p<0.05). HL was higher in males at seventh (p=0.009) and ninth (p=0.033) months, whereas RL was lower in twins at the third month (p=0.021). UEP was wider in males at seventh (p=0.008) and ninth (p=0.036) months. Closure of HEP was observed in 65% of kids by the 12th month. Calcitonin was lower in twins at third (p=0.045) and fifth (p=0.006) months, with changes observed due to group and time effects (p<0.05), whereas other hormones only changed with time (p<0.05). Positive correlations were observed between BW, WH, HL, RL and IGF-I. There was a negative correlation between BW, WH, HL, RL, IGF-I and HEP, UEP, calcitonin, FT3, FT4, GH. Sex and birth type in Gurcu goat kids may have an impact on growth performance, radiographic measurements and certain hormonal profiles.

Clinical application of whole-genome sequencing in the management of extensively drug-resistant tuberculosis: a case report

BackgroundWhole-genome sequencing (WGS)-based prediction of drug resistance in Mycobacterium tuberculosis has the potential to guide clinical decisions in the design of optimal treatment regimens.MethodsWe utilized WGS to investigate drug resistance mutations in a 32-year-old Tanzanian male admitted to Kibong’oto Infectious Diseases Hospital with a history of interrupted multidrug-resistant tuberculosis treatment for more than three years. Before admission, he received various all-oral bedaquiline-based multidrug-resistant tuberculosis treatment regimens with unfavourable outcomes.ResultsDrug susceptibility testing of serial M. tuberculosis isolates using Mycobacterium Growth Incubator Tubes culture and WGS revealed resistance to first-line anti-TB drugs, bedaquiline, and fluoroquinolones but susceptibility to linezolid, clofazimine, and delamanid. WGS of serial cultured isolates revealed that the Beijing (Lineage 2.2.2) strain was resistant to bedaquiline, with mutations in the mmpR5 gene (Rv0678. This study also revealed the emergence of two distinct subpopulations of bedaquiline-resistant tuberculosis strains with Asp47f and Glu49fs frameshift mutations in the mmpR5 gene, which might be the underlying cause of prolonged resistance. An individualized regimen comprising bedaquiline, delamanid, pyrazinamide, ethionamide, and para-aminosalicylic acid was designed. The patient was discharged home at month 8 and is currently in the ninth month of treatment. He reported no cough, chest pain, fever, or chest tightness but still experienced numbness in his lower limbs.ConclusionWe propose the incorporation of WGS in the diagnostic framework for the optimal management of patients with drug-resistant and extensively drug-resistant tuberculosis.

Non-invasive Assessment of Microstructural Changes After CyberKnife Radiosurgery for Trigeminal Neuralgia Using Diffusion Tensor Imaging

Background and Aims: Given the absence of a universally accepted non-invasive and objective clinical tool to predict a patient’s response to stereotactic radiosurgery for Trigeminal Neuralgia (TN), this research endeavoured to appraise the potential of Diffusion Tensor Imaging as a predictive tool in managing TN. Objective: This study aimed to assess microstructural changes in the trigeminal nerve following CyberKnife radiosurgery (CKRS) for TN using diffusion tensor imaging (DTI) and to correlate these changes with clinical outcomes. Methods: Twenty-eight TN patients treated with CKRS underwent pre and 4-month post-treatment Three-Tesla magnetic resonance imaging scans with DTI metrics, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were collected. Clinical outcomes were assessed using the Barrow Neurological Institute Pain Intensity Score (BNI-PIS) at fourth, sixth and ninth months post-CKRS. Results: Twenty-four patients reported good pain relief (responders), while four patients did not experience adequate relief (non-responders). Responders exhibited significantly lower FA (mean drop of 13.8%, P &lt; .001) and lower RA (mean drop of 16.1%, P &lt; .001) compared to non-responders. RD, AD and MD remained constant across the study cohort. Conclusion: DTI metrics, particularly FA and RA, at 4 months post-CKRS, emerged as predictors of long-term treatment effectiveness for TN. These findings suggest the potential utility of DTI in evaluating microstructural changes in the trigeminal nerve post-CKRS and predicting clinical outcomes.

Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study

ObjectiveThe aim of the present pilot study was to assess the effectiveness of the platelet-rich fibrin (PRF) apical barrier for the placement of MTA for the treatment of teeth with periapical lesions and open apices.MethodsA total of thirty teeth on twenty-eight patients with open apices and periapical periodontitis were enrolled and divided into two groups in the present pilot study. In the PRF group (fourteen teeth in thirteen patients), nonsurgical endodontic treatment was performed using PRF as an apical matrix, after which the apical plug of the MTA was created. For the non-PRF group (fourteen teeth in fourteen patients), nonsurgical endodontic therapy was performed using only the MTA for an apical plug with no further periapical intervention. Clinical findings and periapical digital radiographs were used for evaluating the healing progress after periodic follow-ups of 1, 3, 6, and 9 months. The horizontal dimension of the periapical lesion was gauged, and the changes in the dimensions were recorded each time. The Friedman test, Dunn-Bonferroni post hoc correction, and Mann-Whitney U test were used for statistical analysis, with P < 0.05 serving as the threshold for determining statistical significance.ResultsAll patients in both groups in the present pilot study had no clinical symptoms after 1 month, with a significant reduction in the periapical lesion after periodic appointments. The lesion width of the PRF group was significantly smaller than that of the non-PRF group in the sixth and ninth month after treatment.ConclusionsPRF is a promising apical barrier matrix when combined with MTA for the treatment of teeth with open apices and periapical periodontitis. Small number of study subjects and the short time of follow-up period limit the generalizability of these results.Trial registrationTCTR, TCTR20221109006. Registered 09 November 2022 - Retrospectively registered, https://www.thaiclinicaltrials.org/show/TCTR20221109006.

Faricimab in Previously Treated Eyes With Neovascular Age-Related Macular Degeneration: An Assessment of Durability and Treatment Outcomes.

This study evaluated the efficacy and durability of faricimab in patients with neovascular age-related macular degeneration (nAMD) who were previously treated with anti-vascular endothelial growth factor (anti-VEGF) agents. This retrospective case series was conducted at a single tertiary center in the United States. It focused on nAMD patients who transitioned to faricimab after initial anti-VEGF therapy, with a follow-up period of at least 9 months. "Complete dryness" was defined as the absence of intra- and/or subretinal fluid on optical coherence tomography. Durability was gauged by the extension of treatment intervals relative to the injection frequency of the previous agent. Sixty-two eyes from 62 patients were included. Treatment interval ranged from 5 to 10 weeks; 10 (16%) patients were able to be extended by 2 or more weeks compared to their previous regimen. Median (interquartile range [IQR]) central field thickness was 310 μm (254, 376) on initiating faricimab and declined by the ninth month (P values at 3, 6, and 9 months were 0.01, 0.02, and 0.07, respectively). Median (IQR) visual acuity at initiation of faricimab was 0.4 (0.20, 0.50) and did not change by the ninth month. Complete anatomical dryness was present in 10 (16%) eyes before switching; 90% remained dry at 9 months. Of 52 (84%) incompletely dry eyes before switching, 15% achieved complete dryness by 9 months on faricimab. Faricimab modestly improved the treatment intervals for a small proportion of previously treated patients on anti-VEGF therapy. [Ophthalmic Surg Lasers Imaging Retina 2024;55:504-509.].

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.

RAMADHAN FASTING (صوم): A TRUE REJUVENATION OF BODY AND MIND.

Ramadan, the ninth month of the Islamic calendar, is the holy month of fasting observed by Muslims around the world. It is not just a religious and spiritual journey but also a potential period of physical and mental rejuvenation. Islam, with over two billion followers, is the second-largest religion globally and projected to outnumber Christians by 2050.1 Abstaining from food and drink from dawn to dusk for a month can bring about significant changes in the body and mind, promoting overall well-being. Ramadan fasting is a deeply spiritual practice that promotes self-discipline, empathy, and spiritual reflection. It is also a significant cultural and religious tradition that promotes social connection, contributing to mental rejuvenation. It has been associated with improved biochemical parameters and reduced risk of metabolic disorders, such as diabetes and obesity, contributing to physical rejuvenation.2

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

Restless legs syndrome (RLS) is a motor disorder encountered during pregnancy and leads to psychological and sleep impairments. The latter seems to be non-restorative and its occurrence alters the quality of life of pregnant women. 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. 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 RLS) and RLS- (women without RLS). 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+ 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). There were no significant differences between RLS+ and RLS- in terms of socio-demographic and other clinical characteristics. 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 could be a proactive healthcare management leading to 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.&#x0D; 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.&#x0D; 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

Comparison of ranibizumab, aflibercept, and dexamethasone implant monotherapy in treatment-naive eyes with diabetic macular edema: A 12-month real-life experience.

To compare the functional and anatomical outcomes of ranibizumab, aflibercept, and dexamethasone implant monotherapy in treatment-naive eyes with diabetic macular edema (DME) in real-life conditions. In this retrospective cohort study, data were obtained from the hospital database of treatment-naive patients diagnosed with DME with at least 12 months of follow-up. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline, third month, sixth month, ninth month, and 12th month were recorded. In addition, a subgroup analysis was performed based on having good (below 0.4 log of minimum angle of resolution [logMAR]) or poor (0.4 logMAR and above) vision. A total of 219 eyes of 142 patients were included in the study. The change in the mean BCVA from baseline to 12th month was from 0.62 logMAR to 0.42 logMAR (P < 0.001) in the ranibizumab group, from 0.56 logMAR to 0.39 logMAR (P < 0.001) in the aflibercept group, and from 0.46 logMAR to 0.5 logMAR (P = 0.653) in the dexamethasone group. There was no significant difference between the treatment groups at any time point (P > 0.05). The mean amount of CRT change was statistically significant at 12 months in all groups (ranibizumab: -175.4 µm, aflibercept: -153.3 µm, dexamethasone: -71.4 µm) (P < 0.05). In eyes with initially good vision, the final BCVA at 12 months was significantly better in the ranibizumab group compared to the dexamethasone group (P = 0.008). The aflibercept group had better visual acuity than the dexamethasone group, but there was no statistically significant difference (P = 0.059). There was no significant difference in final BCVA in eyes with initially poor vision. No serious ocular/systemic complications were noted. At the 12th month, a significant decrease in CRT was achieved in all treatment groups, whereas only ranibizumab and aflibercept groups had a significant BCVA increase. In eyes with initially good vision, the final BCVA at 12 months was better in the ranibizumab group compared to the dexamethasone group, whereas it was similar in all groups having initially poor vision.

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.

Morpho-biochemical parameters of blood and antioxidant protection of the body of repair pigs using natural metabolites

The authors conducted experiments to study the effect of natural metabolites fed to repair pigs in the last three months before insemination on their growth, changes in their live weight, the chemical composition of milk and the content of immunoglobulins in it, as well as morphological and biochemical blood compositions, protein, carbohydrate and lipid metabolism in pregnant and suckling sows. Four groups of repair pigs were formed for research white breed (control and three experimental) at the age of 6 months, 20 heads each, which were kept in separate machines. The control group received the basic diet, without additives. The pigs of the experimental groups were fed natural metabolites from the sixth to the ninth month inclusive. The animals of the I experimental group were fed organic selenium (Selenium) as part of the compound feed – 0.3 kg / t of feed, II experimental group – succinic acid at the rate of 20 mg / kg of live weight (frequency of 10 days), III experimental group - Carolin preparation (beta-carotene oil solution) – 15 ml / head per day. At the ages of 6.5 and 9 months, 5 pigs from each group had blood taken from the ear vein in the morning before feeding for research. The object of research was repair pigs of large white breed and Krasnodar meat type. Feeding of animals both in this experiment and subsequent ones was carried out taking into account detailed feeding standards. The composition and nutritional value of the diets were calculated using the «Kormoptimaexpert» program.

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.