This study aimed to investigate the cytotoxic activity of decidual lymphocytes and the mRNA/protein expression of cytotoxic proteins in various cell types in the context of preeclampsia (PE) compared to those of healthy pregnancies. We analyzed fresh decidua basalis tissue and tissue embedded in paraffin (FFPE) from PE pregnancies (n = 15) and compared them with those of healthy pregnancies (n = 15) of the corresponding gestational age. Using double immunofluorescence staining, we observed differences in the intensity and distribution of staining for granzyme K (GZMK) and FasL in extravillous trophoblasts. RT-qPCR analysis of FFPE placental tissue showed that GZMK mRNA expression was statistically higher (p < 0.0001) in PE compared to that of healthy controls. On the contrary, there was a low expression (p < 0.001) of FasL mRNA in PE compared to controls, while there was no statistically significant difference for IFN-γ mRNA between PE and controls. Although the level of cytotoxic activity changed depending on the ratio of effector and target cells, there was no significant difference observed between PE and controls in this in vitro study. In conclusion, in PE, extravillous trophoblasts exhibited increased expression of GZMK and decreased expression of FasL. These changes may contribute to impaired trophoblast invasion. However, these alterations did not appear to affect the cytotoxic properties of decidual lymphocytes. Additionally, the possibility of cell sorter separation of decidual lymphocytes would greatly contribute to a better understanding of single cells’ genetic profiles.

Introduction: There are concerns with rising rates of antimicrobial resistance (AMR) across countries with appreciable impact on morbidity, mortality and costs. Amongst low- and middle-income countries, a key driver of AMR is the excessive use of antibiotics in ambulatory care, with a critical area being the appreciable selling of antibiotics without a prescription often driven by patient demand and limited knowledge. There is currently conflicting evidence in South Africa regarding this practice. Consequently, there is a need to explore these critical issues amongst patients, especially in more rural areas of South Africa. A pilot study was undertaken to address this. Methods: A two-step descriptive approach was undertaken. This involved two questionnaires amongst patients exiting chain and independent community pharmacies followed by cognitive interviews. Results: Overall, 21 patients were approached for an interview, including 11 for Part 1 of the questionnaire with 3 declining, and 10 for Part 2, with 2 declining. Subsequently 8 patients completed each part of the questionnaire.. On average, it took 2 min 13 s to complete both parts. 3 of the 5 patients being dispensed an antibiotic were dispensed one without a prescription, with all 3 patients exiting from independent pharmacies. Key reasons for self-purchasing included money and convenience. There was mixed knowledge regarding antibiotics and AMR amongst the 8 patients interviewed with Part 2. Overall, there was a satisfactory understanding of the Part 1 questions, although some modifications were suggested. Some participants had difficulty with fully understanding the questions in Part 2, with a number of suggestions made to improve this for the main study. Conclusion: There were concerns with the extent of purchasing antibiotics without a prescription in this pilot study as well as the knowledge of patients regarding antibiotics and AMR. Both areas need addressing and will be explored further in the main study.

There is increasing evidence of neurological involvement in patients with coronavirus disease. Reports of neurological manifestations include altered mental status, Guillain-Barré syndrome (GBS) and its forms, encephalopathy, psychosis, neurocognitive (dementia) syndrome, ischemic strokes, intracerebral hemorrhage, and acute transverse myelitis. We present three patients with rare neurological manifestations of the COVID-19 disease, with a special focus on rehabilitation in a health resort setting. Outcomes were evaluated based on neurological examination and the modified Barthel index. We highlight the importance of an interdisciplinary approach to reduce disability and improve functionality and quality of life.

Teaching is a process for which its plan should contain reflection onto previous experience. With that in mind, teaching situations should be continuously researched and improved in accordance with the research results. Led by this thought and the fact that students are uncritically using visualization to solve mathematical problems, we defined the aim of this research–determine the attitude of students about the visualization of mathematical content (VMC). The subject of this research are the attitudes of students towards VMC. By analyzing our research subject, we have discovered the research problem–students use visual aid to solve problems uncritically. Based on this problem, we have set the aim of our research. Our aim was to determine the students’ attitudes (and their opinions) about VMC. Based on the aim of our research, we have set four research tasks. Based on these research tasks, we have established the main (leading) research question–What is the attitude of high school students towards the application of VMC? We divided the main research question into five questions: Do high school students consider that they understand the term ‘VMC’? Who considers they use more methods of solving mathematical problems using visual aid–high school male students or female students? Students of which grades consider that they use solving problems using visual aid more? What is the attitude of high school students about the relationship between the substantiality of the picture (the amount of data it encompasses) and the difficulty of solving the problem? What is the attitude of students about the use of software to solve mathematical problems? The research has been conducted with 1,240 high school students from Sarajevo, Bosnia & Herzegovina. For the purposes of this article, we employed a survey, questionnaire-based research. The research was created as part of a larger study conducted in the context of preparing a doctoral dissertation related to VMC. It is one fundamental research. An essential aspect of this research involves students’ attitudes toward VMC. After obtaining all necessary approvals from relevant institutions and parents, students proceeded to testing and surveying in their school classrooms, under the supervision of designated individuals who facilitated the conduct of the research. The distribution of the data was not normal, so we used the Pearson Chi-square, likelihood ratio Chi-square, and linear-by-linear association test to examine the association between student attitudes and categorical variables (gender and grade). In addition, we used frequencies and percentages. It has been concluded that the students are mostly positive towards applying visualization in their process of solving mathematical problems and these should be used in the direction of improving the students’ success, their confidence and their level of contentment in their mathematics class, as well as in other life situations that encompass mathematical content. In future research, it could be examined why students expressed such attitudes about the presented situations. Additionally, it would be significant to explore why students do not consider themselves successful in applying VMC, despite claiming to understand the term. The analysis could extend to the content presented in textbooks or instructional materials students use–how visualized the content is or whether students are required to visualize it themselves. It would also be worthwhile to investigate the extent to which teachers encourage students to visualize specific tasks or do so on their behalf. Given the fluctuation in results (we observe affirmative answers–partially or completely) observed across grades–initial decrease, subsequent increase, followed by another decrease–it might be explored whether this is related to the curriculum taught in each grade (such as content, volume, number of class hours, etc.). Regarding images leading to incorrect conclusions, it would be interesting to investigate the types of images students have in mind, how frequently they encounter such situations, where they use these images, who creates them, and similar aspects. These are just some questions for future research.

The John Cunningham virus (JCV) is a polyomavirus that usually infects people at a young age and does not cause any symptoms in immunocompetent individuals. However, in immunocompromised individuals, such as kidney transplant recipients, JCV can cause severe and potentially fatal disease. Unfortunately, JCV has not been researched as extensively as the BK virus and is not mentioned in relevant kidney transplant guidelines. This lack of attention to JCV can lead to less consideration in kidney transplant patients’ care. Surveillance using locally available diagnostic methods is of the utmost importance. The presence of JCV can be diagnosed with urine decoy cells, viruria, or viremia verified by the PCR method. A low threshold for considering JCV as a possible cause of any neurological or renal dysfunction in kidney transplant recipients must be maintained. In such cases, kidney and brain biopsy are indicated. Maintaining the appropriate immunosuppression while avoiding over-immunosuppression to prevent JCV disease is crucial, and the approach should be individual, according to overall immunological risk. We hypothesize that the presence of the JCV can indicate overt immunosuppression and identify kidney transplant recipients more prone to opportunistic infections and diseases, including some malignancies. To explore that, future observational studies are needed.

This paper presents a multi-criteria decision-making model based on the application of two methods, DIBR II and MABAC. The DIBR II method was used to define weight coefficients. The MABAC method was used to rank alternatives, and it was applied in a rough environment. Four experts were engaged in defining the criteria and alternatives as well as in the relation of criteria. The model was applied for ranking the methods and techniques of Lean organization systems management in the maintenance of technical systems of special purposes. At the end of the application was conducted a sensitivity analysis which proved the stability of the obtained results.

One of the main causes of the dismal prognosis in patients who survive the initial bleeding after aneurysmal subarachnoidal hemorrhage is the delayed cerebral ischaemia caused by vasospasm. Studies suggest that cerebral magnesium and pH may potentially play a role in the pathophysiology of this adverse event. Using phosphorous magnetic resonance spectrocopy (31P-MRS), we calculated the cerebral magnesium (Mg) and pH levels in 13 patients who suffered from aSAH. The values between the group that developed clinically significant vasospasm (n = 7) and the group that did not (n = 6) were compared. The results of this study show significantly lower cerebral Mg levels (p = 0.019) and higher pH levels (p < 0.001) in the cumulative group (all brain voxels together) in patients who developed clinically significant vasospasm. Further clinical studies on a larger group of carefully selected patients are needed in order to predict clinically significant vasospasm.