University of Georgia

Background Alzheimer’s disease (AD) is a neurodegenerative disease that causes progressive cognitive decline over age 65. Individuals suffering from this disease suffer memory loss, and histological examination of the brains. Okadaic acid (OA), is a potent and selective inhibitor of protein phosphatases 1 and 2A. Intracerebroventricular (ICV) administration of OA can produce an Alzheimer‐like hyperphosphorylation of tau protein. Therefore, it was suggested that intracerebral injection of OA can affect the activity of neurotransmitters and their receptors in brain areas. Central cholinergic and glutamatergic activity together are known to be crucial for the acquisition and consolidation performance of a variety of learned behaviors. The present study was designed to investigate the effects of okadaic acid (OA) intracerebroventricular (ICV) injection on memory function and expression level of α7 subunit of nicotinic acetylcholine receptor (nAChR) and NR2B subunit of NMDA glutamate receptors in the hippocampus, as well as effect of the antidementic drug memantine on OA induced changes at systemic and molecular level in rats. Method OA was dissolved in artificial cerebrospinal fluid (aCSF) and injected ICV 200 ng/10 μl. Vehicle control received 10 μl of aCSF ICV. Control and OA injected rats were divided into 2 subgroups: treated i.p. with saline or memantine (5 mg/kg daily for 13 days starting from the day of OA injection). Rats were trained in the dual‐solution plus‐maze task that can be solved by using place or response strategies. The Western immunoblotting was used to determine relative amount of hippocampal receptors protein levels. Result Obtained data revealed that OA ICV injected rats were severely impaired at acquiring the place version of the maze accompanied by significant decline in hippocampal α7 subunit of nACh receptors protein levels. Memantine treatment can prevent OA induced impairment of hippocampal‐dependent spatial memory and accompanied by modulation of the expression level of α7 subunit of nACh and NR2B subunit of NMDA receptors in the hippocampus. Conclusion Thus, our results support the presumption that α7 nACh receptors may play an important role in the cognitive enhancer effects of memantine and emphasize the role of cholinergic‐glutamatergic interactions in memory.

The contemporary far right is entangled in multidimensional ways including various forms of reciprocal influences, the diffusion of subject matters and issue‐framings, the relevance of external examples for local political discussions and an extra‐national platform for influencing transnational developments. Departing from the ‘globalisation front’ in the study of the phenomenon, this article aims to deconstruct the nature of this transnationality by focusing on the forms of indirect diffusion and both negative as well as affirmative forms of referential inspirations. In doing so, the article proceeds from providing an overview of various perceptions of transnationalism in the study of the contemporary far right to offering an empirical analysis of the Georgian case to demonstrate nuances of the transnationality within far right discourses. The analysis is based on the social media data as well as the two sets of qualitative interviews with the leaders and representatives of national‐populist formations that are utilised for reconstructing discursive topics and strategies. Ultimately, the article demonstrates the importance of negative source inspiration and drawing of fictitious scenarios on top of lesson‐drawing and mimicking of political discourses as illustrative designs of increasing transnationalism.

Introduction Coronary artery disease (CAD) is a leading cause of global mortality and a prevalent health issue in Iran. Assessing the empowerment of CAD patients during treatment and care is essential. However, no scale is available to measure empowerment in CAD patients in Iran. Therefore, this study aimed to evaluate the validity and reliability of the Persian version of the "Coronary Artery Disease Empowerment Scale" (CADES). Method This methodological and cross-sectional study was conducted on patients with CAD from June 2022 to April 2023 in Kermanshah City, Iran. The scale was translated using the forward–backward translation method. Construct validity was examined using Exploratory Factor Analysis (EFA) with 190 samples and Confirmatory Factor Analysis (CFA) with 344 samples, both selected through convenience sampling. Internal consistency was assessed using Cronbach's alpha coefficient, and reliability was evaluated using the test–retest method. SPSS version 27 and LISREL version 8 software were utilized for data analysis. Results The EFA and CFA results confirmed the instrument with three factors and 25 items. The model's main indicators in factor analysis were all above 0.9, indicating a good fit for the model. The Pearson correlation coefficient between the items and subscales with the main scale showed a direct and significant relationship. Additionally, Cronbach's alpha coefficient (0.813) and test–retest reliability (0.763) confirmed the reliability of the Persian version of the CADES. Discussion The study's results suggest that the Persian version of CADES is both practical and acceptable for evaluating the empowerment of CAD patients. This tool can be relied upon as a valid and reliable method for assessing these patients' empowerment.

Background Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%. Objectives The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI). Design Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period. Methods Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI). Results D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, P = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; P = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; P = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78). Conclusion Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition. TRIAL REGISTRATION NCT05218863 (registered 19.01.2022).

In Georgia, a prospective financing system for hospital services using diagnosis-related groups (DRGs) was introduced in 2022 to increase the efficiency and transparency of the healthcare system. The purpose of this study is to evaluate the impact of DRG-based hospital reimbursement on the efficiency of medical care for patients with myocardial infarction. Hospitalization data from three large hospitals in Georgia before and after the introduction of DRGs, covering the period from 2021 to 2024, were analyzed. The study found that the implementation of DRGs in cardiology hospitals reduced length of stay, readmission, and mortality rates. Although the prices for nosologies have increased, patients' direct out-of-pocket payments have decreased, thereby improving financial access to medical services. The introduction of the DRG payment system had a positive effect on patient financial accessibility.

Objective To evaluate the effect of Grifola frondosa polysaccharides (GFP) in a rat model of Alzheimer’s disease (AD). Methods Seventy-five rats were divided into five groups: the normal control group and the AD group treated with or without GFP (100, 200, and 400 mg/kg). Behavioral responses in the open field test and elevated plus maze test were assessed. Additionally, the levels of malondialdehyde and ferric-reducing ability of plasma, and the mRNA expressions of TNF -α, IL-6 , and IL-1β in the hippocampus were measured. Results Treatment with GFP significantly improved AD-induced behavioral changes in the open field test and elevated plus maze test ( P < 0.05). In addition, the level of malondialdehyde and the mRNA expressions of TNF -α, IL -6, and IL-1β were decreased by GFP treatment in a dose-dependent manner in AD rats ( P < 0.05), while the level of ferric-reducing ability of plasma was significantly increased ( P < 0.05). Conclusions Oral administration of GFP can reduce inflammation and oxidative stress, as well as improve behavioral responses associated with AD, suggesting its potential use in AD treatment. However, additional studies are needed to elucidate its underlying mechanisms and efficacy.

Acute Lymphoblastic Leukemia (ALL) is a heterogeneous blood cancer characterized by the uncontrolled growth of immature lymphoid cells due to dysregulated signaling pathways. It is the most common pediatric cancer, with high cure rates in children, but significantly lower survival rates in adults. Current theranostic strategies, including chemotherapy, immunotherapy, and nanomedicine, aim to improve detection and treatment precision but are limited by side effects, drug resistance, high costs, and stability issues. Notably, extracellular vesicles (EVs) offer a promising alternative, addressing these limitations through their natural biocompatibility and targeted delivery capabilities. EVs play a dual role in ALL: they contribute to leukemia progression by promoting tumor growth, immune suppression, and drug resistance via the transfer of oncogenic molecules, while also serving as valuable non-invasive biomarkers due to their specific miRNA and protein content. Their ability to deliver therapeutic agents directly to leukemic cells, combined with their stability and low immunogenicity, makes EVs a compelling tool for improving ALL treatments. Indeed, by targeting the molecular pathways influenced by EVs or leveraging them for drug delivery, innovative therapeutic strategies can be developed to enhance treatment outcomes and reduce side effects. Thus, EVs represent a promising frontier for advancing theranostic strategies in ALL, offering new opportunities to improve diagnosis and treatment while overcoming the limitations of traditional therapies. This review will explore the dual roles of EVs in ALL, addressing their contributions to disease progression and their potential as therapeutic agents and biomarkers for early diagnosis and targeted therapies.

Introduction The competency of a nurse in integrating knowledge, skills, attitudes, and values in various healthcare areas depends on their ability to apply these elements. It is a basic indicator of performance in nursing, and its assessment is a necessity among nursing students. Objective The present study was conducted to determine the psychometric properties of the Persian version of the nursing competence tool for Iranian nursing students in 2023. Methods This is a methodological study in which the Nursing Student Competence Scale (NSCS) was translated into Persian using the forward–backward translation method. A total of 321 nursing students were selected for construct validity by the exploratory factor analysis (EFA) (the first 190 nursing students) and confirmatory factor analysis (CFA) by convenience sampling method. Cronbach's alpha coefficient was used to evaluate the internal consistency, and the test–retest method was used to check the instrument's reliability. Results The results of EFA and CFA confirmed the instrument with six factors and 28 items. The results showed that the fit indices of the model in CFA included (CFI = .91, NNFI = .90, goodness of fit index = .83, root mean square error of approximation = .075, standardized root mean square residual = .047). Pearson's correlation coefficient between items and subscales showed a direct and significant relationship with the main scale. Also, Cronbach's alpha coefficient (0.9) and test–retest (0.88) confirmed the reliability of the Persian version of (NSCS). Conclusion Generally, the Persian version of the NSCS with 28 items and six factors is a valid and reliable scale. This instrument has good internal consistency, validity, and reliability, which can be used to evaluate nursing students’ competence in bachelor training.

Importance The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking. Objective To create an expert consensus statement for LDOM prescribing for patients with hair loss. Evidence Review The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale. Findings Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus. Conclusions and Relevance This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. As additional evidence-based data emerge, these recommendations should be updated.

Background and objectives: Multiple sclerosis (MS) significantly impacts health-related quality of life (HRQOL). The Multiple Sclerosis Quality of Life-54 (MSQOL-54) is a widely used tool for assessing HRQOL in individuals with MS. Adapting this tool to the local language and culture is essential for ensuring cultural relevance, enabling comprehensive care, and allowing international comparability. This study aims to validate the Georgian version of the MSQOL-54 (MSQOL-54 GEO) and assess HRQOL in MS patients in Georgia. Methodology: A cross-sectional study was conducted, involving 384 individuals with MS. The MSQOL-54 questionnaire was translated using a forward-backward translation technique. Statistical analysis, performed using SPSS 22.0, included internal consistency reliability measured by Cronbach's alpha coefficient (α) with 95% confidence intervals (95% CI), while external validity was determined through the correlation of individual components and composite scores with the Expanded Disability Status Scale (EDSS). Results: The MSQOL-54-GEO demonstrated strong validity and reliability, with most components showing Cronbach's alpha values above 0.70, except for the "Social Function" component. The "Health Perceptions" component recorded the lowest average score (47.3 ± 20.0). Significant correlations were found between MS duration and "Physical Health," as well as "Cognitive Function." Conclusions and implications: The findings indicate that the MSQOL-54-GEO is a reliable, convenient, and accepted tool for assessing HRQOL among MS patients in Georgia. This validation contributes valuable insights into the internal consistency of the MSQOL-54-GEO, facilitating its essential use in clinical practice and research, for evaluating treatment outcomes and guiding holistic care approaches, encompassing physical, emotional, and social well-being.

Human life history is characterized by an extended period of immaturity during which there is a disjunction between cerebral and somatic growth rates¹. This mode of ontogeny is thought to be essential for the acquisition of advanced cognitive capabilities in a socially complex environment while the brain is still growing². Key information about when and how this pattern evolved can be gleaned from the teeth of fossil hominins because dental development informs about the pace of life history3–5. Here we show that the first evolutionary steps towards an extended growth phase occurred in the genus Homo at least 1.77 million years ago, before any substantial increase in brain size. We used synchrotron phase-contrast tomography⁶ to track the microstructural development of the dentition of a subadult early Homo individual from Dmanisi, Georgia. The individual died at the age of 11.4 ± 0.6 years, shortly before reaching dental maturity. Tooth growth rates were high, similar to rates in living great apes. However, the Dmanisi individual showed a human-like delayed formation of the posterior relative to the anterior dentition, and a late growth spurt of the dentition as a whole. The unique combination of great-ape-like and human-like features of dental ontogeny suggests that early Homo had evolved an extended growth phase before a general slow-down in life history, possibly related to biocultural reproduction⁷ rather than brain growth.

As land use intensifies globally, it increasingly exerts pressure on protected areas. Despite open, nonforested landscapes comprising up to 40% of protected areas globally, assessments have predominately focused on forests, overlooking the major pressures on rangelands from livestock overgrazing and land conversion. Across the southern Caucasus, a biodiversity hotspot extending over 5 countries, we conducted a broadscale assessment of the extent to which protected areas mitigate land‐use pressure on rangelands in them. Using satellite‐based indicators of rangeland vegetation greenness from 1988 to 2019, we assessed the effectiveness of 52 protected areas. This period encompassed the collapse of the Soviet Union, economic crises, armed conflicts, and a major expansion of the protected area network. We applied matching statistics combined with fixed‐effects panel regressions to quantify the effectiveness of protected areas in curbing degradation as indicated by green vegetation loss. Protected areas were, overall, largely ineffective. Green vegetation loss was higher inside than outside protected areas in most countries, except for Georgia and Turkey. Multiple‐use protected areas (IUCN categories IV–VI) were even more ineffective in reducing vegetation loss than strictly protected areas (I & II), highlighting the need for better aligning conservation and development targets in these areas. Mapping >10,000 livestock corrals from satellite images showed that protected areas with a relatively high density of livestock corrals had markedly high green vegetation loss. Ineffectiveness appeared driven by livestock overgrazing. Our key finding was that protected areas did not curb rangeland degradation in the Caucasus. This situation is likely emblematic of many regions worldwide, which highlights the need to incorporate degradation and nonforest ecosystems into effectiveness assessments.

The conservation of the number of nodes in the wavefunctions of one-electron diatomic quasimolecules is treated. The elaborated approach is focused on the behavior of separation constants and their relationship to the number of nodes as the distance between nuclei varies. By examining the separation constants for quasimolecules with different nuclear charges, we demonstrate the robustness of the number of nodes across different states and separations without explicitly defining the wavefunctions themselves.

The vast, untapped potential of the world’s oceans is revealing groundbreaking advancements in human health and vaccination. Microalgae such as Nannochloropsis spp. and Dunaliella salina are emerging as resources for recombinant vaccine development with specific and heterologous genetic tools used to boost production of functional recombinant antigens in Dunaliella salina and Nannochloropsis spp. to induce immunoprotection. In humans, several antigens produced in microalgae have shown potential in combating diseases caused by the human papillomavirus, human immunodeficiency virus, hepatitis B virus, influenza virus, Zika virus, Zaire Ebola virus, Plasmodium falciparum, and Staphylococcus aureus. For animals, microalgae-derived vaccine prototypes have been developed to fight against the foot-and-mouth disease virus, classical swine fever virus, vibriosis, white spot syndrome virus, and Histophilus somni. Marine organisms offer unique advantages, including the ability to express complex antigens and sustainable production. Additionally, the oceans provide an array of bioactive compounds that serve as therapeutics, potent adjuvants, delivery systems, and immunomodulatory agents. These innovations from the sea not only enhance vaccine efficacy but also contribute to broader immunological and general health. This review explores the transformative role of marine-derived substances in modern medicine, emphasizing their importance in the ongoing battle against infectious diseases.

This article examines the impact of Sasanian hegemony in Georgia (Kartli/Iberia) on the monuments of early Christian Georgia’s material culture. It explores how Sasanian political power and influence were conveyed through visual imagery, depicting Kartli as an adaptive yet creatively distinct realm that incorporated many elements of Sasanian art and culture into early Christian iconography. The article focuses on some iconographic motifs representing the Sasanian concept of royalty and their adaptation to Georgian culture, analyzed through both Iranian and Georgian visual sources, as well as Georgian textual data.

The probation (trial) period employment contract and the internship are characterized by certain specificity in Georgian law. The issue of protecting the labor rights of probationary employees and interns, especially the termination of the contract, is even more specific. Moreover, the issue of political or other views, as one of the types of freedom of expression and the form of discrimination is interesting in the internship and trial period labor relationship. Based on the specificity of the Georgian case law, due to the simple termination of the probation period (trial period) employment contract, it is possible that the employer may abuse his right and thus violate the rights of the employee and/or intern. The following article mainly focuses on the research of these issues. The article also analyses the recent approaches of the Georgian courts’ practice and several cases of the International Court of Justice, which are the most well-known and often cited cases in foreign legal literature.