Prevalence, Severity, and Treatment of Obstructive Sleep Apnea in Children with Down Syndrome in Qatar.

INTRODUCTION: Patients with Down syndrome (DS) are at risk for sleep disorder breathing (SDB) due to their abnormal craniofacial anatomy, hypotonia, and propensity for obesity. The prevalence and severity of SDB in this population vary between different cohorts due to the multifactorial nature of these patients and the different diagnostic criteria used. We aim to report the prevalence and severity of SDB in the DS population in Qatar. METHODS: This study is a retrospective review of all patients with genetically confirmed DS who completed a diagnostic polysomnography (PSG) study at Sidra Medicine in Doha, Qatar, which is the only pediatric sleep center in the country, between September 2019 and July 2022. Clinical and PSG data were collected from the patients' electronic medical records. Central and obstructive events were scored according to the American Academy of Sleep Medicine (AASM) criteria. Obstructive sleep apnea (OSA) diagnosis was made based on apnea-hypopnea index (AHI) and defined as AHI >1.5 events/hour. OSA was considered mild if AHI was ≥ 1.5 but < 5, moderate if AHI was ≥ 5 but < 10, and severe if AHI was ≥ 10 events/hour. Diagnosis with central apnea was considered if the central apnea index was > 5 events/hour. Hypoventilation was considered present if end-tidal/transcutaneous carbon dioxide gas was more than 50 mmHg for more than 25% of total sleep time. Multiple regression analysis was performed to evaluate predictors of high AHI and rapid eye movement (REM)-AHI. RESULTS: A total of 80 patients (49 males and 31 females) were included. Median (range) age was 7.3 years (0.9, 21). The mean (range) BMI z-score was 1.7 (-1.3, 4.3). Sixty-five patients were diagnosed with OSA, with a prevalence rate of 81%. OSA was mild in 25 (38.5%) patients, moderate in 15 (23.1%) patients, and severe in 25 (38.5%) patients. Only one patient was diagnosed with central apnea and five patients (6.9%) with alveolar hypoventilation. Multiple regression analysis showed BMI (P = 0.007) and snoring/apnea symptoms (P=0.023) to be predictive of high AHI. No correlation was found between the same variables and REM-AHI. Treatments used for OSA included anti-inflammatory medications in 37 (46%) patients, tonsillectomy/adenoidectomy in 13 (16.5%) patients, and positive airway pressure support in 10 (15%) patients. CONCLUSION: Our patient population with DS had a high prevalence of OSA comparable to other reported cohorts. High BMI and symptoms of snoring are predictive of OSA.

Lifestraw Family water filters in low- and middle-income countries: a systematic review and meta-analysis to define longer-term public health impact against childhood diarrhoea and inform scale-up.

Background: Diarrhoeal disease disproportionately affects children <5 years in low- and middle-income countries (LMICs). The pathogens responsible for diarrhoea are commonly transmitted through faecally-contaminated drinking water. Lifestraw Family point-of-use water filters have been the subject of intervention studies for over a decade and were the first filters evaluated by the World Health Organization in its water treatment evaluation scheme to provide comprehensive protection against many diarrhoea-causing pathogens. This systematic review aimed to: 1) report on aspects related to physical environment and implementation and 2) conduct an updated meta-analysis on Lifestraw Family filter effectiveness against childhood diarrhoea based on studies with ≥12 months of follow-up. Methods: We conducted a literature search in November 2022 using MEDLINE, Embase, Cochrane, and CINAHL databases. Inclusion criteria were: 1) RCTs, cluster-RCTs, quasi-experimental, or matched cohort studies on 2) Lifestraw Family 1.0 or 2.0 filters 3) conducted in LMICs 4) that evaluated filter effectiveness against diarrhoea in children <5 and 5) analysed ≥12 months of follow-up data on clinical effectiveness against diarrhoea and were 6) published from 2010 with 7) full-text availability in English. A modified Newcastle-Ottawa Scale was used to assess risk of bias. Relative risk (RR) and 95% confidence intervals (CIs) were extracted and analysed using a random-effects meta-analysis. Results: We included 6 studies in LMICs involving 4740 children <5. Of the four clinically-effective interventions, common characteristics were access to improved water sources (75%), the 2.0 version of the filter or the 1.0 version with additional water storage (100%), use of behaviour change theory, community engagement, and health messaging (75%), local filter repair-and-replace mechanisms (75%), and specially-trained local interventionists (100%). The meta-analysis showed a 30% reduction in diarrhoea risk in the intervention group (RR = 0.69; 95% CI = 0.52-0.91, P = 0.01). Conclusions: Lifestraw Family water filters can be effective interventions to reduce diarrhoea in vulnerable paediatric populations for at least one year, though certain aspects related to physical environment and implementation may increase their public health impact. The findings of this study suggest considerations for scale-up that can be applied in settings in need of longer-term interim solutions until universal access to safe drinking water is achieved.

Views of emergency care providers in providing healthcare for asylum seekers and refugees.

BACKGROUND: The number of asylum seekers awaiting decisions on their claims in the UK has more than tripled since 2014. How we meet international obligations to provide appropriate healthcare to asylum seekers and refugees (ASRs) is therefore an increasingly important issue. The views of frontline healthcare workers are vital to ensure the development of sustainable and effective health policy when it comes to caring for this group. METHOD: A single-centre qualitative study in the form of semistructured interviews was conducted at the Queen Elizabeth University Hospital ED in Glasgow, Scotland, between January and March 2023. Volunteering ED care providers (EDCPs)-doctors and nurses-working in the ED were interviewed and the data analysed and presented through a thematic analytical framework. RESULTS: 12 semistructured interviews were conducted-6 doctors and 6 nurses. Analysis revealed four themes: (1) 'staff attitudes' highlighted in particular the positive views of the participants in providing care for ASRs; (2) 'presentation patterns' revealed significant variations in opinion, with one-third of participants, for example, believing there was no difference in presentations compared with the general population; (3) 'challenges to optimal care' outlines multiple subthemes which impact care including the unique challenge of the ED triage system; and (4) 'transition in care' discusses participant concerns regarding arranging safe and appropriate follow-up for ASR patients. Ethical dilemmas in providing care, as highlighted in previous studies, did not feature heavily in discussions in this study. CONCLUSION: This study provides an insight into the views of EDCPs in providing care to ASRs in the ED. Study findings can potentially contribute to the development of ED-specific guidelines as well as inform wider health policy and provide a focus and direction for further research.

Management Challenges of Sleep-Disordered Breathing in a Child With Chronic Kidney Disease: A Case Report of a Child on Peritoneal Dialysis.

Chronic kidney disease in children is a challenging condition that requires careful management. When combined with sleep-disordered breathing, it can pose even greater difficulties. This case report highlights the management challenges of a child with chronic kidney disease and sleep-disordered breathing. Through careful analysis and effective intervention, we were able to address the challenges and improve the child's quality of life. Understanding the complex interaction between these two conditions is crucial for healthcare professionals to provide effective care for children with chronic kidney disease and sleep-disordered breathing.

The role of online hemodiafiltration with endogenous reinfusion in the treatment of systemic lupus erythematosus activity resistant to conventional therapy.

Introduction: Lupus is a diverse autoimmune disease with autoantibody formation. Lupus nephritis carries a grave prognosis. Complement involvement, namely, C1q deficiency, is linked to activity and renal involvement and could help in their assessment. LN therapies include plasma exchange, immune adsorption, and probably hemodiafiltration with online endogenous reinfusion (HFR), together with traditional immunosuppressive therapies. Aim: The aim of this study was to evaluate the role of HFR in improving signs and symptoms of systemic lupus erythematosus (SLE) activity and laboratory parameters in cases not responding to traditional immunosuppressive therapy. Settings and design: A controlled clinical study was conducted on 60 patients with lupus from Group A that was subdivided into two groups: cases 1 (47 patients), those who received traditional medical treatment, and cases 2 (13 patients), those who underwent HFR in addition to medical treatment. Group B consisted of two subgroups: control 1, composed of 20 healthy age- and sex-matched volunteers, and control 2, consisting of 10 cases with different glomerular diseases other than lupus. Methods and materials: Serum C1q was determined before and after the HFR as well as induction by medical treatment. Disease activity was assessed using SLEDAI-2K with a responder index of 50; quality of life was assessed using SLEQOL v2, and HFR was performed for the non-responder group. Results: C1q was lower in cases. It can efficiently differentiate between SLE patients and healthy controls with a sensitivity of 81.67% and a specificity of 90%. It can also efficiently differentiate between SLE patients and the control 2 group (non-lupus patients with renal glomerular disease) with a sensitivity of 83.33% and a specificity of 100%. C1q was more consumed in proliferative lupus, and correlated with anti-ds DNA, C3, and C4. Conclusions: C1q efficiently discriminates lupus patients and correlates with proliferative forms. HFR might ameliorate lupus activity and restore C1q.

Ethnic and sexual orientation inequalities in mental health-obesity comorbidity, self-harm, and attempted suicide among British adolescents.

PURPOSE: Mental illness and obesity (MH-OB) may co-occur in adolescence and have a strong risk to track into adulthood. Using an intersectional framework, we explored associations between ethnic-sexual identities and MH-OB comorbidity in adolescents. We examined the risk of self-harm (SH) and attempted suicide (AS) by comorbidity status and ethnic-sexual identities. METHODS: Participants included 9,789 adolescents (aged 17 years) from the UK-wide Millennium Cohort Study with data on self-identified ethnicity and sexuality. Participants were categorised as White-heterosexual, White-sexual minority (SM), Ethnic Minority (EM) heterosexual or EM-SM adolescents. We used multivariable logistic regression to examine associations between 1.dual ethnic-sexual identities and MH-OB comorbidity, 2.risk for self-harm (or attempted suicide) in relation to comorbidity and ethnic-sexual identities (including interactions between the comorbidity and ethnic-sexual identities variables to assess whether risk for self-harm differed by ethnic-sexual identities and comorbidity status). RESULTS: Comorbidity was higher among White-SM (OR = 3.73, 95%CI 2.42-5.75) and EM-SM (OR = 1.96, 1.03-3.73) adolescents. SM identities (OR = 3.02, 2.41-3.78 for White-SM) and having comorbidity (OR = 2.83, 2.03-3.95) were independently associated with SH or AS. Risk of SH among White-heterosexual individuals was greater among comorbid individuals (40%) relative to non-comorbid individuals (19%). Risk of SH was higher in SM individuals (58% vs. 41% in White-SM and 50% vs. 29% in EM-SM individuals with and without comorbidity, respectively). Risk of AS was 5% and 19% in comorbid and non-comorbid White-heterosexual individuals, respectively; the corresponding figures for White-SM individuals were 14% and 17%. CONCLUSION: Irrespective of ethnicity, SM adolescents have a significantly greater risk of SH and AS. Comorbidity further amplifies this risk.

Effect of local anesthesia on postoperative pain and hemostasis after dental rehabilitation under general anesthesia in pediatric patients: a randomized control trial.

Background: This study aimed to investigate the effect of local anesthesia (LA) on postoperative pain and hemostasis after dental rehabilitation under general anesthesia (DRGA) in pediatric patients. Methods: A total of 43 patients, aged 3-7 years and rated ASA I or II, who had a definitely negative rating on Frankel's behavior rating scale, were included in this two-arm, parallel-design, single-blinded, randomized, controlled study. The patients were allocated equally into two main groups receiving both restorative treatments and tooth extractions. Two pain scales and one bleeding scale were used. In Group A, the treatment was done with LA, and in Group B, the treatment was done without LA. Results: The statistical analysis revealed no significant differences in the pain scores between the groups. It also revealed significant differences in the bleeding scores between the groups but no significant differences in the duration of bleeding. Conclusion: Within the limitations of this study, the use of LA in pediatric dental patients undergoing DRGA had no effects on postoperative pain reduction or bleeding duration after teeth extraction. We also observed that the use of LA had an impact on the reduction in the bleeding scores in pediatric dental patients undergoing DRGA.

Is refugee experience in childhood a risk for poorer health in adulthood?-A Swedish national survey study.

Studies on experiences of migration in childhood and subsequent health in adulthood report conflicting results. While there is limited research on the long-term health outcomes of refugee children as they transition into adulthood, it is often observed that refugee children experience adverse health conditions upon their arrival in the host country. We examined whether adults with a childhood refugee experience were more likely to have poorer mental health, general health, and risk-behaviours compared to non-refugee migrants and Swedish-born peers We included a nationally representative sample of 18-64-year-olds who answered the Swedish National Public Health survey in 2018 or 2020. Using official register data, we categorized individuals as: 1) refugees in childhood (

Adverse childhood experiences and mental ill-health - obesity comorbidity among British adolescents - A national cohort study.

Background: Mental ill-health and obesity are increasingly prevalent in childhood with both conditions likely to co-occur. Less is known about associations between adverse childhood experiences (ACEs) and mental ill-health and obesity (MH-OB) comorbidity in adolescence. The aim of this study was to examine associations between ACEs and MH-OB comorbidity in adolescents from a national cohort study. Methods: Participants; 10,734 adolescents (males = 50.3%) from the Millennium Cohort Study with 6 ACEs (for e.g., parental MH, drug/alcohol misuse, physical punishment) collected prospectively between ages 3-11 years. MH-OB comorbidity (binary indicator) was based on objectively measured BMI (for overweight/obesity) and self-reported depression/anxiety at ages 14 and 17. Associations between: 1.total ACE scores (0, 1, 2 or ≥3) and additionally each individual ACE, and MH-OB, were analysed used logistic regression, separately at 14 and 17 years. Results: At age 14, ACE scores were associated with higher odds for MH-OB comorbidity, with a gradient of increasing odds ratios (OR) with increasing ACEs. Individuals with 1 (OR:1.22[95%CI: 1.1-1.6]), 2 (OR:1.7[1.3-2.3]), or ≥3ACEs (OR:2[1.5-2.6]) had increased odds for MH-OB comorbidity compared to those with 0 ACEs. At age 17, associations between ACE scores and MH-OB were attenuated and observed in individuals with ≥3ACEs (OR:1.54, 1.1-2.3). Parental MH (OR:1.5, 1.2-1.9), intimate-partner violence (OR:1.2, 1.1-1.6), physical punishment (OR:1.3, 1.1-1.6), bullying (OR:2, 1.6-2.5) were associated with MH-OB comorbidity age 14. However, only parental MH (OR:1.5, 1.1-2.1) and bullying (OR:1.6, 1.2-2.1) were associated with MH-OB comorbidity at age 17. Conclusion: ACEs are associated with increased risk of MH-OB comorbidity in between ages 14 and 17. These findings provide timely opportunity for interventions to reduce risk and are pertinent given that MH and obesity contribute significantly to global burden of disease and track across the lifecourse.

Synthesis of innovative and sustainable gelatin@graphene oxide-crosslinked-zirconium silicate@gelatin nanobiosorbent for effective biosorption of basic fuchsin dye.

Most dye stuffs and coloring materials are mainly categorized as hazardous pollutants in water effluents due to their nature as non-biodegradable, highly toxic and extremely carcinogenic. For this reason, rapid and efficient eradication of waste dyes from wastewaters before discharging into water streams must be accomplished by an acceptable approach as adsorption technique. Therefore, the present study is aimed and devoted to synthesize a novel nanobiosorbent from three different constituents, gelatin (Gel) as a sustainable natural product, graphene oxide (GO) as an example of highly stable carbonaceous material and zirconium silicate (ZrSiO4) as an example of combined metal oxides for the formation of Gel@GO-F-ZrSiO4@Gel by using formaldehyde (F) as a cross-linkage reagent. Several characterization techniques as FT-IR were employed to identify the incorporated surface reactive Functionalities in Gel@GO-F-ZrSiO4@Gel as -OH, =NH, -NH2, -COOH and C=O, etc. The morphology for particle shape and size of Gel@GO-F-ZrSiO4@Gel were confirmed from the SEM and TEM analyses providing 15.75- 32.79 nm. The surface area was determined by the BET and found to correspond to 219.46 m2 g-1. Biosorptive removal of basic fuchsin (BF) pollutant as an example of a widely applicable dye in various activities was monitored and optimized under the influence of pH (2-10), reaction time (1-30 min), initial BF pollutant concentration (5-100 mg L-1), nanobiosorbent dosage (5-60 mg), temperature (30-60 °C) and interfering ions. The maximum biosorptive removal values of BF dye were established as 96.0 and 95.2% using 5 and 10 mg L-1, respectively at the recommended pH 7 condition. The Thermodynamic parameters demonstrated that the BF dye adsorption onto Gel@GO-F-ZrSiO4@Gel was taken place via spontaneous and endothermic reaction. Chemisorption is the predominant adsorption mechanism by forming multilayers upon nonhomogeneous surface in accordance with Freundlich model hypothesis. The applicability of the optimized Gel@GO-F-ZrSiO4@Gel in biosorptive removal of BF pollutant from real water sample was successfully accomplished by the batch technique. Thus, this study clearly shows that Gel@GO-F-ZrSiO4@Gel exhibited significant influences on remediation of industrial effluents containing BF pollutant with superior efficiency.

Adverse childhood experiences and the development of multimorbidity across adulthood-a national 70-year cohort study.

AIM: To examine impact of adverse childhood experiences (ACE) on rates and development of multimorbidity across three decades in adulthood. METHODS: Sample: Participants from the 1946 National Survey of Health and Development, who attended the age 36 assessment in 1982 and follow-up assessments (ages 43, 53, 63, 69; N = 3,264, 51% males). Prospectively collected data on nine ACEs was grouped into (i) psychosocial, (ii) parental health and (iii) childhood health. For each group, we calculated cumulative ACE scores, categorised into 0, 1 and ≥2 ACEs. Multimorbidity was estimated as the total score of 18 health disorders.Serial cross-sectional linear regression was used to estimate associations between grouped ACEs and multimorbidity during follow-up. Longitudinal analysis of ACE-associated changes in multimorbidity trajectories across follow-up was estimated using linear mixed-effects modelling for ACE groups (adjusted for sex and childhood socioeconomic circumstances). FINDINGS: Accumulation of psychosocial and childhood health ACEs were associated with progressively higher multimorbidity scores throughout follow-up. For example, those with ≥2 psychosocial ACEs experienced 0.20(95% CI 0.07, 0.34) more disorders at age 36 than those with none, rising to 0.61(0.18, 1.04) disorders at age 69.All three grouped ACEs were associated with greater rates of accumulation and higher multimorbidity trajectories across adulthood. For example, individuals with ≥2 psychosocial ACEs developed 0.13(-0.09, 0.34) more disorders between ages 36 and 43, 0.29(0.06, 0.52) disorders between ages 53 and 63, and 0.30(0.09, 0.52) disorders between ages 63 and 69 compared with no psychosocial ACEs. INTERPRETATIONS: ACEs are associated with widening inequalities in multimorbidity development in adulthood and early old age. Public health policies should aim to reduce these disparities through individual and population-level interventions.

Ethnic and Sexual Identity-Related Inequalities in Adolescent Health and Well-Being in a National Population-Based Study.

Purpose: This study employed an intersectional framework to examine impact of inequalities related to sexual minority (SM) and ethnic minority (EM) identities in risk for health, well-being, and health-related behaviors in a nationally representative sample. Methods: Participants included 9789 (51% female) adolescents aged 17 years from the U.K.-wide Millennium Cohort Study, with data on self-identified sexual and ethnic identities. Adolescents were grouped into White heterosexual, White-SM, EM-heterosexual, and EM-SM categories. Questionnaires assessed mental health (e.g., self-reported psychological distress, doctor-diagnosed depression, attempted suicide), general health (self-rated health, chronic illness, body mass index), and health-related behaviors (e.g., smoking, substance use). Associations were analyzed using multivariable logistic regression. Results: SM individuals (White: 18% and EM: 3%) had increased odds for mental health difficulties and attempted suicide, with higher odds for White-SM individuals than for EM-SM individuals. Compared with White heterosexual individuals, White-SM and EM-SM individuals had higher risk for psychological distress (adjusted odds ratios [OR] 3.47/2.24 for White-SM/EM-SM, respectively) and emotional symptoms (OR 3.17/1.65). They had higher odds for attempted suicide (OR 2.78/2.02), self-harm (OR 3.06/1.52), and poor sleep quality (OR 1.88/1.67). In contrast, the White heterosexual and White-SM groups had similarly high proportions reporting risky behaviors except for drug use (OR 1.45) and risky sex (OR 1.40), which were more common in White-SM individuals. EM-heterosexual and EM-SM individuals had decreased odds for health-related behaviors. Conclusion: SM (White and EM) individuals had substantially worse mental health compared with heterosexual peers. Adverse health-related behaviors were more common in White-SM individuals. Investigation into the mechanisms leading to these differences is needed.

Health and health-related behaviours in refugees and migrants who self-identify as sexual or gender minority - A National population-based study in Sweden.

Background: To examine health and health-related behaviors in migrant and refugee individuals who identify as sexual or gender minority, and in comparison to their heterosexual peers. Methods: The study included 168,952 individuals (aged 16-84 years, males: 45·9%, sexual or gender minorities: 3·1%) who answered the Swedish National Public Health Survey in 2018 and 2020. Participants were grouped into Swedish-and Western-born (White) heterosexual, White sexual- or gender minority, migrant heterosexual, migrant sexual- or gender minority, refugee heterosexual, and refugee sexual- or gender minority. Outcomes included mental health (for example suicidal ideation, wellbeing), general health, risky behaviors (risk alcohol use, risk gambling, and substance use), and experiences of violence. Associations between 1) sexual- or gender -ethnic identities and 2) gender-ethnic identities and all outcomes were analyzed using logistic and linear regression adjusting for sex, age, and educational level. Findings: Being a sexual- or gender minority, regardless of ethnic minority status, was associated with worse general health and mental ill-health compared to heterosexual peers including suicidal ideation in refugee sexual- or gender minority individuals (OR 2·42, 95 % CI 1·44-4·08). Ethnic minorities (heterosexual and sexual- or gender minority migrants and refugees) had lower odds of drug and risk alcohol use compared to White heterosexual peers but higher odds of risk gambling (1·88, 1·49-2·37 for refugee heterosexuals). Transgender refugees had high odds for risk gambling (8·62, 1·94-38·40) and exposure to physical violence (7·46, 2·97-18·70). Interpretation: In this national population-based study, sexual and gender minority individuals have worse mental and general health regardless of ethnic minority status. We did not find evidence for worse health in sexual- or gender minority refugees in comparison to migrant, and White sexual- or gender minorities and their heterosexual peers. Transgender individuals (White and ethnic minority) experienced significantly higher levels of physical violence. Public health policy should emphasize preventive measures to reduce exposure to violence and discrimination in sexual- and gender minority individuals, increase access and use of mental healthcare services and sensitise healthcare professionals about higher rates of health and related issues faced by sexual- and gender minority individuals including those with multiple minority identities. Funding: We received no external funding for this study and hence the funder had no role in the study design, data collection, data analysis, data interpretation, writing of the manuscript and the decision to submit.

The relationship between the political skills and negotiation behaviors of front-line nursing managers.

BACKGROUND: Frontline nursing managers must possess sufficient political skills to successfully navigate organizational structures and relationships and produce positive results in complex healthcare systems. AIM: This study explores the relationship between the political skills and negotiation behaviors of frontline nursing managers. METHOD: The researchers adopted a quantitative correlational methodology to conduct the study in two selected hospitals with 100 frontline nursing managers determined through convenience sampling. Political Skill Inventory and Negotiation Self-Assessment Inventory were used to assess the political skills of nurse managers and measure the behaviors that they rely on most readily during negotiations, respectively. RESULTS: The study sample had an average level of political skill and relied moderately on compromise during negotiations. There was a strong positive correlation between political skills, accommodation, and collaboration behaviors. Moreover, there was a strong negative correlation between political skills, avoidance, and competition. Further, there was a negative correlation between political skills and compromise behavior of negotiation. CONCLUSION: Although nursing managers used different negotiation behaviors at different degrees in different situations, they mostly relied on compromise during negotiation. Therefore, hospital administrators should work on improving frontline nursing managers' political skills to improve their negotiation behaviors.

Spatiotemporal expression pattern of miR-205, miR-26a-5p, miR-17-5p, let-7b-5p, and their target genes during different stages of corpus luteum in Egyptian buffaloes.

BACKGROUND: No doubt that the corpus luteum (CL) plays a vital role in the regulation of female cyclicity in mammals. The scenarios among microRNAs (miRNAs) and their target genes and steroid hormones {estradiol (E2) and progesterone (P4)} are required for better understanding the molecular regulation of CL during its formation, maturation, and regression. We aimed to (I) study the changes in the relative abundance of miR-205, miR-26a-5p, miR-17-5p, and let-7b-5p and their target genes: LHCGR, CASP3, PCNA, AMH, and PLA2G3, during different stages of corpus luteum in Egyptian buffaloes, and (II) and to address different scenarios between steroid concentrations in the serum and the expression pattern of selected miRNAs and their targets. METHODS: The paired ovaries and blood samples were collected from apparently healthy 50 buffalo cows at a private abattoir. The ovaries bearing CL were macroscopically divided according to their morphological structure and color into hemorrhagic (CLH), developing (CLD), mature (CLM), regressed (CLR), and albicans (CLA). Small pieces from different stages of CL (CLH, CLD, CLM, CLR, and CLA) were cut and immediately kept at - 80 °C for total RNA isolation and qRT-PCR. The serum was separated for steroid level estimation. RESULTS: The LHCGR was expressed during different stages of CL, and the peak of expression was at the mid-luteal stage. The CASP3 revealed a stage-specific response at different stages of CL. The PCNA has an essential role in cellular proliferation in buffaloes CL. Both expression patterns of PLA2G3 and AMH were found over the various developmental and regression stages. It was noticed that miR-205 is conserved to target LHCGR and CASP3 transcripts. Moreover, CASP3 and AMH were targeted via miR-26a-5p. Additionally, the CASP3 and PLA2G3 were targeted via let-7b-5p. The P4 level reached its peak during CLM. There were positive and negative strong correlations between miRNAs (miR-26a-5p and miR-205), target genes (LHCGR and CASP3) during different stages of CL, and steroid hormones in the serum. CONCLUSIONS: Taken together, the orchestrated pattern among miRNAs, target genes, and steroid hormones is essential for maintaining the proper development and function of CL in buffalo cows.

Sperm quality and testicular histopathology of Wistar albino male rats treated with hydroethanolic extract of Cordia dichotoma fruits.

CONTEXT: Cordia dichotoma Forst. (Boraginaceae) has potent pharmacological impact. Meanwhile, its effect on fertility is unclear. OBJECTIVE: This study investigates the effect of Cordia fresh fruits hydroethanolic extract on fertility. MATERIALS AND METHODS: 120 Wistar albino male rats were divided into four groups (n = 30). The first group was negative control, and the second, third, and fourth groups received 125, 250, and 500 mg extract/kg bodyweight for 56 days. After 56 days, Cordia force-feeding stopped, and all groups were kept under laboratory conditions for another month to study the recovering effect. RESULTS: After day 56, extract at 500 mg/kg significantly reduced sperm total count, motility%, and alive%, to 47.60 ± 2.27 × 106 sperm/mL, 43.33% ± 1.49, and 63.67% ± 1.19, respectively, abnormalities% increased considerably (26.67% ± 0.54), compared to the negative control. Also, significant depletion on follicle-stimulating hormone (2.66 ± 0.21 mIU/L), luteinizing hormone (1.07 ± 0.06 mIU/L), and testosterone (2.69 ± 0.13 nmol/L) level was recorded, compared to the negative control. Cordia negative effect showed on histopathological studies of testes, prostate, and seminal vesicles. Fortunately, these adverse effects of Cordia recovered remarkably after stopping administration for one month. CONCLUSIONS: Cordia antifertility effect may be due to its hypocholesterolemic effect, where cholesterol, the steroid cycle precursor, was significantly reduced. This study can be incorporated in clinical research after being repeated on another small experimental animal, their offspring, and one large experimental animal, then going to a clinical study that we plan to do in the future.

'Long journey to shelter': a study protocol: a prospective longitudinal analysis of mental health and its determinants, exposure to violence and subjective experiences of the migration process among adolescent and young adult migrants in Sweden.

INTRODUCTION: According to the UN Refugee Agency (UNHCR), around 40% of the 79.5 million forcibly displaced persons in the end of the year 2019 were children. Exposure to violence and mental health problems such as posttraumatic stress disorder are frequently reported among migrant children, but there is a knowledge gap in our understanding of the complex longitudinal interplay between individual, social and societal risk and resilience factors that impact mental health and well-being, quality of life and ability to function and adapt. There is also an urgent societal need to facilitate interdisciplinary and intersectoral collaborative efforts to develop effective methods to prevent, detect and respond to the needs of the migrants. This project will study adolescent and young adult migrants in Sweden using multiple methods such as quantitative analysis of data from a prospective cohort study and qualitative analysis of data gathered from teller-focused interviews. The aim is to understand how different factors impact mental health and integration into the Swedish society. Furthermore, individual experiences related to the migration process and exposure to violence will be studied in detail. METHODS AND ANALYSIS: Study participants will include 490 migrants aged 12-25 years recruited through social services, healthcare, social media and the civil society. A subsample of adolescents (n=160) will be re-interviewed after 1 year. Data are collected using structured and semi-structured interviews along with saliva and hair sampling. Measures include sociodemographic data, longitudinal data on mental health and its determinants, including genotypes and stress-hormone levels, access to healthcare and the process of migration, including settlement in Sweden. ETHICS AND DISSEMINATION: The Regional Ethics Board of Linköping (2018/292-31 and 2018/504-32) and the National Ethics Board (2019-05473,2020-00949 and 2021-03001) have approved the study. Results will be made available to participants, their caregivers, professionals working with migrants, researchers and the funders.

Socioeconomic inequalities in prevalence and development of multimorbidity across adulthood: A longitudinal analysis of the MRC 1946 National Survey of Health and Development in the UK.

BACKGROUND: We aimed to estimate multimorbidity trajectories and quantify socioeconomic inequalities based on childhood and adulthood socioeconomic position (SEP) in the risks and rates of multimorbidity accumulation across adulthood. METHODS AND FINDINGS: Participants from the UK 1946 National Survey of Health and Development (NSHD) birth cohort study who attended the age 36 years assessment in 1982 and any one of the follow-up assessments at ages 43, 53, 63, and 69 years (N = 3,723, 51% males). Information on 18 health conditions was based on a combination of self-report, biomarkers, health records, and prescribed medications. We estimated multimorbidity trajectories and delineated socioeconomic inequalities (based on childhood and adulthood social class and highest education) in multimorbidity at each age and in longitudinal trajectories. Multimorbidity increased with age (0.7 conditions at 36 years to 3.7 at 69 years). Multimorbidity accumulation was nonlinear, accelerating with age at the rate of 0.08 conditions/year (95% CI 0.07 to 0.09, p < 0.001) at 36 to 43 years to 0.19 conditions/year (95% CI 0.18 to 0.20, p < 0.001) at 63 to 69 years. At all ages, the most socioeconomically disadvantaged had 1.2 to 1.4 times greater number of conditions on average compared to the most advantaged. The most disadvantaged by each socioeconomic indicator experienced an additional 0.39 conditions (childhood social class), 0.83 (adult social class), and 1.08 conditions (adult education) at age 69 years, independent of all other socioeconomic indicators. Adverse adulthood SEP was associated with more rapid accumulation of multimorbidity, resulting in 0.49 excess conditions in partly/unskilled compared to professional/intermediate individuals between 63 and 69 years. Disadvantaged childhood social class, independently of adulthood SEP, was associated with accelerated multimorbidity trajectories from age 53 years onwards. Study limitations include that the NSHD cohort is composed of individuals of white European heritage only, and findings may not be generalizable to the non-white British population of the same generation and did not account for other important dimensions of SEP such as income and wealth. CONCLUSIONS: In this study, we found that socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP.

Socioeconomic inequalities in co-morbidity of overweight, obesity and mental ill-health from adolescence to mid-adulthood in two national birth cohort studies.

AIM: To examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from childhood to mid-adulthood, and differences by sex and cohort. METHODS: Data were from 1958 National Child Development Study (NCDS58) and 1970 British Cohort Study (BCS70) [total N=30,868, 51% males] assessed at ages 10, 16, 23/26, 34 and 42 years. Socioeconomic indicators included childhood and adulthood social class and educational level. Risk for i. having healthy BMI and mental ill-health, ii. overweight and good mental health, and iii. overweight and mental ill-health was analysed using multinomial logistic regression. FINDINGS: Socioeconomic disadvantage was consistently associated with greater risk for overweight-mental ill-health comorbidity at all ages (RRR 1.43, 2.04, 2.38, 1.64 and 1.71 at ages 10, 16, 23, 34 and 42 respectively for unskilled/skilled vs. professional/managerial class). The observed inequalities in co-morbidity were greater than those observed for either condition alone (overweight; RRR 1.39 and 1.25, mental ill-health; 1.36 and 1.22 at ages 16 and 42 respectively, for unskilled/skilled vs. professional/managerial class). In adulthood, both childhood and adulthood socioeconomic disadvantage were independently associated with comorbid overweight-mental ill-health, with a clear inverse gradient between educational level and risk for comorbidity. For instance, for the no education group (compared to university education) the RRR is 6.11 (95% CI 4.31-8.65) at age 34 and 4.42 (3.28-5.96) at age 42. There were no differences observed in the extent of inequalities by sex and differences between cohorts were limited. INTERPRETATION: While socioeconomic disadvantage in childhood and adulthood are consistently and independently associated with greater risk for mental ill-health and being overweight separately, these associations are even larger for their comorbidity across the lifecourse. These findings are significant given the increasing global prevalence of obesity and mental ill-health, and their implications for lifelong health and mortality. FUNDING: This research was supported by grants from the Wellcome Trust (ISSF3/ H17RCO/NG1) and Medical Research Council (MRC) [MC_UU_00019/3].

Impact of travel by walk and road on testicular hormones, oxidants, traces minerals, and acute phase response biomarkers of dromedary camels.

This study aimed to compare the effect of truck transport and walk travel on testicular hormones, oxidants, antioxidants and acute-phase responses of camels' walked from Sudan to the Egyptian quarantine and were transported from the quarantine to the slaughterhouses by trucks. Blood samples were collected from walked camels (N ≤ 30) just arrived at the quarantine (Walk), unloaded (N ≤ 12) from the truck (Truck), and control camels (N ≤ 20). Animals were statistically categorized into Walk travel, Truck transport, and Control, then Total travel (Walk + truck transport) was compared to control. Haptoglobin, fibrinogen, superoxide dismutase (SOD), glutathione peroxidase (GPx), nitric oxide (NO), ascorbic acid, glucose, cholesterol, testosterone, estradiol, iron, copper, ALT, AST, alkaline phosphatase (ALP), total proteins, albumin, and creatinine were measured. Results showed that the travel by walk and truck increased haptoglobin (P ≤ 0.0001), fibrinogen (P < 0.05), ALT (P < 0.05), and creatinine (P ≤ 0.0001) but decreased NO (P ≤ 0.0001), albumin (P < 0.05), Ascorbic acid (P < 0.05), testosterone (P ≤ 0.0001), ALP (P < 0.0001), and glucose (P ≤ 0.0001). The declined NO (P ≤ 0.0001), Ascorbic acid (P ≤ 0.0001), iron (P ≤ 0.005), copper (P ≤ 0.023), cholesterol (P > 0.05), total proteins (P ≤ 0.0001), albumin (P ≤ 0.018), globulins (P ≤ 0.001), with increased haptoglobin (P ≤ 0.0001), AST (P ≤ 0.0001), ALP (P ≤ 0.0001), and testosterone (P ≤ 0.0001) was evident in camels transported by truck compared to walk transport. In conclusion, transport enhanced the acute phase proteins, retarded kidney function, antioxidant status, and energy but truck produced a significant acute-phase response and adversely affected the oxidant-antioxidant balance, destructed proteins kidney, and liver functions than the long travel by walk.