Trends in Avoidable Mortality in Kazakhstan From 2015 to 2021.

BACKGROUND: The health system performance assessment is a challenging process for decision-makers. In case of Kazakhstan's healthcare system, the calculation of avoidable mortality, which has been underutilized to date, could serve as an additional tool to prioritize areas for improvement. Therefore, the aim of the study is to analyse avoidable mortality in Kazakhstan. METHODS: The data was retrieved from the Bureau of National Statistics, Kazakhstan. It covers population data by age, mortality rates from disease groups based on the Joint OECD (Organisation for Economic Co-operation and Development)/Eurostat classification of preventable and treatable causes of mortality. The data spans from 2015 to 2021, categorized by gender and 5-year age groups (0, 1-4, 5-9, ..., 70-74). Standardization was performed using the 2015 OECD standard population. We used joinpoint regression analysis to calculate the average annual percentage change (AAPC). RESULTS: From 2015 to 2019, the annual percentage change (APC) in avoidable mortality per 100 000 population was -3.8 (-5.7 to -1.8), and from 2019 to 2021 it increased by 17.6 (11.3 to 24.3). Males exhibited higher avoidable mortality rates compared to females. The preventable mortality rate was consistently higher than the treatable mortality. Both preventable and treatable mortality decreased from 2015 to 2019, with preventable mortality reaching 272.17 before rising to 379.23 per 100 000 population in 2021. Between 2015 and 2021, treatable mortality rates increased from 179.3 (176.93-181.67) to 205.45 (203.08-207.81) per 100 000 population. CONCLUSION: In Kazakhstan, the leading causes of avoidable mortality were circulatory diseases, respiratory diseases, and cancer. To achieve the goals of universal health coverage (UHC) and improve the overall population health, there is an urgent need to amend the healthcare system and reduce avoidable mortality. While it is important to acknowledge the influence of COVID-19 on these trends, our study's focus on avoidable mortality provides valuable insights that complement the understanding of pandemic-related effects.

Geobotanical characteristics of plant communities with participation of rare species Alnus glutinosa (L.) Gaertn.

The article gives a geobotanical description and a floristic analysis of communities with the participation of the rare and relict species Alnus glutinosa in condition of Aktobe region. The aim of the study is to provide a geobotanical assessment of the current status of a rare, relict species of the Alnus glutinosa population, which was included in the Red Data Book of Kazakhstan. At present, the flora of the Aktobe region is not sufficiently studied. Conservation of the biodiversity of the Aktobe region flora is one of the most topical issues. In Aktobe region, due to the lack of grazing, felling of trees, using as fuel and the emergence of uncontrolled tourism and at the same time due to the lack of natural renewal of the area, these consequences lead to a quantitative reduction in the species. In this regard, it is necessary to study the species and organize protection and conservation measures. The results of the study showed that the plant Alnus glutinosa is rarely found in the flora of Kazakhstan and also the distribution areas are reduced. Of the three investigated points, plants from 24 families were identified. Plant communities of Alnus glutinosa are being studied for the first time in the Aktobe region. For the first time in the conditions of the Aktobe region, the habitat of black alder was discovered. The floral composition of plant communities of Alnus glutinosa grown in various ecological environments was revealed, the ratio of life forms and phytocenotic features were studied for the first time. In addition, alder felt mite and ground bug, damaging black alder, were identified from 3 studied populations. It has been established that the main reason for the spread of this pest is a very strong moistening of the ground on which sticky Alder grows. Results sequencing showed that the DNA sample under study belongs to the fungus Alternaria alternata.

Effect of fertilizers and growth stimulants on the yield and feed qualities of the green mass of the yellow melilot in the Akmola region.

This study is aimed at evaluating the effect of various types of fertilizers and growth stimulants on the productivity and quality of yellow melilot. Their increase is necessary to ensure a balanced mineral composition of livestock diet. Research methods include the analysis of field germination of seeds, the study of plant growth at various stages, and the analysis of the agrochemical composition of the soil and feed mass. The field experiments were conducted in the steppe zone of the Akmola region, Kazakhstan with fluctuating air temperature and low rainfall. The results show that the use of fertilizers and growth stimulants significantly increased the field germination of seeds, the content of protein, carotene, and feed units, as well as the yield of the green mass of the yellow melilot. Particularly high rates were achieved with the use of the Fulvimax N and Start Up fertilizers and the Gumato Fosfat N and K growth stimulants. The results indicate the potential of fertilizers and growth stimulants to improve agricultural production and emphasize the importance of choosing the optimal fertilizers to achieve maximum results. The study contributes to the expansion of knowledge about methods of increasing the yield and quality of feed crops, which is an important issue in agriculture.

Monitoring studies of the occurrence of fire blight pathogen in Kazakhstan and identification of antagonistic microorganisms suppressing its development.

The paper presents data on phytosanitary monitoring of garden cenoses for fire blight in the Turkestan, Zhambyl, and Almaty regions of Kazakhstan. The purpose of this study is to assess the phytosanitary situation in various regions of Kazakhstan, determine the extent of fire blight spread, and isolate and identify the fire blight pathogen. During the study, methods such as hypersensitivity, pathogenicity, and fluorescent simplification-based specific hybridization polymerase chain reaction (FLASH-PCR) were used. It was found that in all the surveyed areas, disease foci were identified. For the first time, the fire blight pathogen was detected on fruit crops such as plum, peach, cherry plum, and quince, as well as on wild apricots. 274 plant samples were collected from which microorganisms were isolated. Isolates related to the fire blight pathogen Erwinia amylovora were identified by methods of hypersensitivity, pathogenicity, and FLASH-PCR diagnostics. Of the 156 isolates of microorganisms isolated from apple tree plant samples, 21 inhibited the in vitro growth of E. amylovora to varying degrees. Isolates 16.2 and 19.2 with maximum antagonistic activity were selected, where the pathogen growth inhibition zones were 52.2 ± 2.58 mm and 45.6 ± 0.55 mm, respectively. Based on the obtained sequence of nucleotides of the 16SpRNA gene site, it was found that the selected isolates with high antagonistic activity belonged to the Pseudomonas genus. In the future, based on these isolates, a new biological product for fire blight control can be created and adapted to the natural and climatic conditions of Kazakhstan.

Effect of DGAT1 gene polymorphisms in coarse-haired fat-tailed lambs of different genotypes.

The aim of this study was to investigate the DGAT1 gene polymorphism and its effects on lamb weight in kazakh and tajik sheep breeds. A total of 97 blood samples were collected from purebred (еdilbay х еdilbay) and crossbred lambs (еdilbay x gissar) breеd by the Baiserke Agro Scientific and Production Center in the Talgar District of the Almaty Region of Kazakhstan. Animals were genotyped for DGAT1-AluI polymorphism using the polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method. The result of PCR-RFLP showed that purebred (еdilbay х еdilbay) sheep had three genotypes (CC, CT and TT) and crossbred sheep had two genotypes (CC and CT). The predominant genotype was CC with a frequency of 0.70 and 0.58 in purebred sheep and crossbred sheep breeds, respectively. The DGAT1 gene showed no significant association with live weight of lambs at different times in both breeds studied. However, the study showed that the CC genotype produced higher live weight at day 60 in purebred sheep (CC: 33,668 kg and CT: 32,444) and at day 120 (CC: 41,487 and CT: 40,929) in crossbred lambs. The present study was the first to investigate the polymorphism and relationships between genotypes and lamb live weights for DGAT1 gene in sheep breeds, purebred and crossbred. We conclude that further comprehensive investigations should be done for the exact evidence of the effects of DGAT1/Alui polymorphism on lamb live weights.

WHO Country Office in Kazakhstan: annual activity report, 2022

In 2022, the WHO Country Office in Kazakhstan actively planned and implemented its actions to ensure achievement of the goals outlined in the Biennial Collaborative Agreement between Kazakhstan and WHO for 2022–2023, the European Programme of Work, 2020–2025 – “United Action for Better Health in Europe” and WHO’s Thirteenth general programme of work 2019–2023. The WHO Country Office in Kazakhstan also supportedemerging national priorities through regular discussions with representatives of the Government of Kazakhstan, the Ministry of Healthcare of Kazakhstan, UN agencies, and resource partners. This report provides detailed information on the programme activities implemented by the WHO Country Office in Kazakhstan from January to December 2022.

"The habit of keeping silent": An exploratory-descriptive qualitative study of the knowledge and attitudes of Kazakhstani gynecologists toward dyspareunia.

BACKGROUND: Dyspareunia (pain during sex) is a common condition that causes physical and emotional stress for many women. This condition can be caused by various factors, including physical, hormonal, inflammatory, viral, neoplastic, psychological, and traumatic events. Anatomical causes include pelvic floor muscular weakness, uterine retroversion, hymenal remnants, and pelvic organ prolapse. The etiology of this condition is complex, causing it to be often overlooked. OBJECTIVES: The main aim of this study was to conduct a qualitative exploratory study and provide a comprehensive description of the knowledge and attitudes held by gynecologists in Kazakhstan on the medical validity, diagnosis, and treatment of dyspareunia. DESIGN: This is an exploratory-descriptive qualitative study. METHODS: Semi-structured online interviews were conducted with 10 physicians. They were identified as obstetrics and gynecology specialists, gynecologic oncologists, and outpatient gynecologists. The average number of years spent practicing their specialty is 15.7, with the shortest being 4 years and the longest being 35 years. All the participants are female. Braun and Clarke's six-stage, step-by-step methodology was used for the thematic analysis. RESULTS: Findings suggest that gynecologists in Kazakhstan have knowledge of the most common causes of dyspareunia, although they still often attribute women's distress to psychological rather than physical factors. It was found that due to stigma and mutual embarrassment open dialogue about sexual health was lacking between patients and physicians. In addition, gynecologists describe difficulties discussing symptoms and performing intimate examinations due to time constraints and a lack of privacy at state facilities. CONCLUSION: To knowledgeably diagnose and treat patients with dyspareunia, gynecologists recommend further training to acquire the requisite evidence-based knowledge and competencies.

An Exploratory-Descriptive Qualitative Study of Kazakhstani Gynecologists' Knowledge and Attitudes Toward DyspareuniaBackground: Dyspareunia (pain during sex) is a common condition that causes physical and emotional distress in many women. Biological and psychological factors contribute to the onset of this condition, making diagnosis and management difficult for physicians. This painful condition can have a significant impact on women's physical, emotional, and psychological well-being, as well as their close relationships. Why was the study conducted? A thorough understanding of dyspareunia's causes, risk factors, and treatment techniques is required for effective management of the condition, but little research has been conducted in Kazakhstan on gynecologists' understanding of and attitudes toward dyspareunia. What did the researchers do? A qualitative study used online semi-structured interviews with gynecologists in Kazakhstan. What did the researchers find? The findings show that participating gynecologists are aware of the most common causes of dyspareunia, although they frequently attribute the condition to psychological rather than physical causes. It was found that due to stigma and mutual embarrassment, patients and participants did not engage in open discourse about sexual health. Furthermore, gynecologists have difficulty initiating discussions about women's sexual health and performing intimate examinations due to consultation time restrictions and a lack of privacy at state facilities. What do the researchers conclude? Additional training is recommended to gain the necessary evidence-based knowledge and competencies to accurately diagnose and treat patients with dyspareunia, and to address the lack of treatment protocols for dyspareunia in Kazakhstan, clinical guidelines published worldwide, including those issued by the American College of Obstetricians and Gynaecologists, may be considered for use in Kazakhstan.

Knowledge, attitude and practice related to anthrax among livestock farmers in West Kazakhstan.

BACKGROUND: Anthrax is the most prioritized zoonotic disease in Kazakhstan due to its threatening potential to the public health and agricultural sector. Sporadic anthrax outbreaks are being reported annually among human and livestock populations throughout the country, with the highest frequency occurring in West Kazakhstan. METHODS: A cross-sectional study was conducted using a survey-based face-to-face interview. From January to May 2022, 489 randomly selected participants were surveyed in 6 districts of the Baiterek province in West Kazakhstan oblast to evaluate the knowledge, attitude and practice (KAP) regarding anthrax among community members. This is the first KAP study conducted relating to outbreaks of anthrax in Kazakhstan. RESULTS: In this study, most participants (74%) surveyed were males, and 40% of respondents had a secondary level education. Overall, 91% of the community respondents were engaged in agriculture and livestock rearing. Among these community members, cattle rearing was the most common (67%) occupation compared to other livestock species. Additionally, over a 50% of the population studied had no knowledge about the zoonotic nature of the disease, and about 82% and 87% of respondents were unaware of any animal and human anthrax symptoms, respectively. About 70% of the respondents were interested in vaccinating their livestock against anthrax. Individuals aged 45-54 displayed notably higher animal vaccination rates (45%; 95% CI: 38.4-52.0; p < 0.025) compared to those aged 25-34 and 65-74. Respondents residing in the Beles district (20%; 95% CI: 17.1-24.7; p < 0.005) exhibited a significantly higher level of awareness concerning the fatality of anthrax in contrast to participants from Bolashak. Roughly 61% of respondents held the belief that anthrax is a lethal disease. An overwhelming majority of the survey participants (99%) affirmed their non-participation in the slaughter of infected animals. CONCLUSION: The findings of this study indicate that KAP among community members relating to anthrax is low and requires swift implementation of education programmes in building awareness of anthrax under the One Health approach, especially in anthrax prone regions.

Predictive accuracy of genetic variants for eye color in a Kazakh population using the IrisPlex system.

OBJECTIVE: This study assesses the accuracy of the IrisPlex system, a genetic eye color prediction tool for forensic analysis, in the Kazakh population. The study compares previously published genotypes of 515 Kazakh individuals from varied geographical and ethnohistorical contexts with phenotypic data on their eye color, introduced for the first time in this research. RESULTS: The IrisPlex panel's effectiveness in predicting eye color in the Kazakh population was validated. It exhibited slightly lower accuracy than in Western European populations but was higher than in Siberian populations. The sensitivity was notably high for brown-eyed individuals (0.99), but further research is needed for blue and intermediate eye colors. This study establishes IrisPlex as a useful predictive tool in the Kazakh population and provides a basis for future investigations into the genetic basis of phenotypic variations in this diverse population.

MODELING METHODS FOR TEACHING MEDICAL UNIVERSITY STUDENTS ABOUT THE REPRODUCTIVE SYSTEM.

One of the priority directions of the development of the Republic of Kazakhstan at the present stage is the formation of competitive specialists in various fields of the educational process, including in medical education. The article presents the introduction of modern information and educational programs and innovative technologies into the educational process at Karaganda State Medical University at the Department of Physiology, which are aimed at developing higher competencies among medical students. The aim was to show the application of the modeling method in the process of studying topics in the module "Reproductive system" and the effectiveness of using relevant teaching methods in the course of normal physiology for medical university students. Students have created a mock-up on the reproductive system, using the example of which the physiological mechanisms and principles of regulation of the female reproductive system are studied in practical classes. This type of independent active work of students activates mental activity, directs it to the subsequent solution of tasks, the formation of professional critical thinking.

Gut microbiome-immune interactions and their role in rheumatoid arthritis development.

Objective: The primary objective is to study the impact of gut microbiota and their interactions with diverse immunological markers on the development of rheumatoid arthritis. Methods: This study was performed in Astana, Kazakhstan, and included 77 Kazakh female patients older than 18 years, who met the American College of Rheumatology 2010 classification criteria for rheumatoid arthritis (RA), and 113 healthy controls. The DNA was extracted from fecal samples obtained from all study participants for subsequent sequencing at the 16S rRNA gene V1-V3 locus, facilitating the analysis of the gut microbiome. The Multiplex immunoassay was employed to measure the concentrations of inflammatory cytokines, chemokines, and immunoglobulins in both fecal and plasma samples. Results: Our taxonomic analysis revealed significant differences in the composition of the gut microbiota between the healthy control cohort and the cohort with rheumatoid arthritis RA. Alpha diversity was significantly lower in the RA group. Lachnospiraceae were the most abundant taxon and found to be crucial, showing correlations with immunological markers such as IL5. Additionally, Lachnospiraceae and Oscillospiraceae exhibited the most predictable power and distinguished the composition of both study groups. Conclusion: Our study identifies key differences in the gut microbiome of RA patients, revealing distinct microbial patterns and specific taxa abundance. We highlight potential biomarkers in immunological and bacterial pathways, offering insights into RA development and indicating possibilities for personalized treatment.

Enhancing lamb growth and meat quality: analysis of kazakh fat-tailed and crossbred in central Kazakhstan's sharply continental climate.

The article presents the results of scientific research on the production of lamb in the conditions of the Akmola region. The experiment was conducted on purebred Kazakh short-tailed rough-haired and cross-bred sheep obtained from industrial crossing of Kazakh short-tailed rough-haired queens with sheep- producers of the hampshire breed. Further, the article presents the results of feeding and fattening, as well as the morphological composition of the carcass of sheep of the Kazakh coarse-haired sheep breed of different ages. The object of the study for feeding and fattening were three groups of experimental sheep of the above-mentioned breed, where compound feed was included in the diet of the I experimental group in the form of top dressing, in the II experimental group, grain waste was also used for top dressing, and the control group was kept in the feed without top dressing. Based on the study of the feeding of experimental sheep, it was found that the absolute increase during the feeding period in experimental sheep who received fertilization in the form of compound feed is higher than in their peers, respectively, by 0.2 and 1.49 kg. In terms of morphological and varietal composition, in particular, the number of cuts of grade 1, there was also an advantage of experimental sheep that received fertilization in the form of compound feed compared to their peers, respectively, by 2.3-8.3%. In general, the results of a study on the growth, development and slaughter qualities of experimental sheep, i.e. purebred Kazakh short-tailed rough-haired and crossbred, obtained from crossing with sheep producers of the precocious breed "hampshire" showed that from the moment of birth to 2 and 4 months. For example, crossbred sheep were slightly superior to purebred peers in terms of the studied indicators. In particular, the results of feeding sheep of the Kazakh coarse-haired broad-tailed breed from 4 to 6 months, depending on the top dressing.

A citizen science approach to develop a digital intervention to reduce HIV stigma and promote HIV self-testing among adolescents and young adults: a mixed methods analysis from Kazakhstan.

INTRODUCTION: Kazakhstan has one of the fastest-growing HIV epidemics in the world, with increasing rates among adolescents and young adults (AYA). Innovative strategies are needed to increase HIV testing uptake and decrease HIV stigma among AYA. Citizen science, defined as the active engagement of the general public in scientific research tasks, promotes and facilitates community engagement throughout the research process. This citizen science study used crowdsourcing to engage AYA in Kazakhstan to develop a digital intervention to reduce HIV stigma and promote HIV self-testing. Our objectives in this paper are to describe the approach used, its feasibility and acceptability, and AYA motivations for and lessons learned collaborating on the study. METHODS: From October 2021 to July 2022, in collaboration with a Community Collaborative Research Board and a Youth Advisory Board, we developed an open call requesting multimedia submissions to reduce HIV testing stigma. Eligible submissions were separated by age group (13-19 or 20-29 years) and judged by a panel composed of AYA (n = 23), healthcare professionals (n = 12), and representatives from the local government and non-governmental organizations (n = 17). Each entry was reviewed by at least four judges and ranked on a 5-point scale. The top 20 open call contestants were asked to submit self-recordings sharing their motivation for and experience participating in the contest and lessons learned. Descriptive statistics were calculated for quantitative data. Qualitative data were coded using open coding. RESULTS: We received 96 submissions from 77 youth across Kazakhstan. Roughly, three-quarters (n = 75/96) of entries met judging eligibility criteria. Of the eligible entries, over half (n = 39/75) scored 3.5 or higher on a 5-point scale (70.0%). The most frequent types of entries were video (n = 36/96, 37.5%), image (n = 28/96, 29.2%) and text (n = 24/96, 25.0%). AYA's primary motivations for collaborating on the study included a desire to improve society and help youth. The main challenges included creating content to address complex information using simple language, finding reliable information online and technological limitations. CONCLUSIONS: Crowdsourcing was feasible and highly acceptable among AYA in Kazakhstan. Citizen science approaches hold great promise for addressing the increasingly complex health and social challenges facing communities today.

Being yourself is a defect: analysis of documented rights violations related to sexual orientation, gender identity and HIV in 2022 using the REAct system in six eastern European, Caucasus and Central Asian countries.

INTRODUCTION: Removing legal barriers to HIV services is crucial for the global 2030 goal of ending the HIV and AIDS epidemic, particularly in eastern Europe, the Caucasus and central Asia. Despite state commitments to uphold human rights, gay, bisexual and other men who have sex with men (gbMSM), along with transgender people (TP) still face stigma and discrimination. This article presents an analysis of rights violations based on sexual orientation and gender identity (SOGI) and HIV reported in 2022 across six countries, highlighting features and their links to legislation and law enforcement practices. METHODS: We examined documented cases of rights violations among gbMSM and TP in Armenia, Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan and Ukraine in 2022 using the REAct system, a tool for documenting and responding to rights violations against key populations. Initially, we employed directed content analysis based on Yogyakarta Principles to analyse narratives of violations. A codebook was developed through contextual, manifest and latent coding, with themes, categories and codes converted into quantitative variables for statistical analysis. Descriptive statistics were used to identify the characteristics of violations. RESULTS: A total of 456 cases of rights violations related to SOGI and HIV were documented, ranging from 22 cases in Tajikistan to 217 in Ukraine. Most violations concerned gbMSM (76.5%), with one-fifth involving TP, predominantly transgender women. Complex violations with multiple perpetrators or infringements were documented in Armenia and central Asia. Privacy rights were commonly violated, often through outing. Cases of violations of the right to the highest attainable standard of health (13.6%) and protection from medical abuses (2.6%) were also documented. Other rights violations were sporadic, with each country exhibiting distinct patterns of violated rights and types of violations. In Ukraine, the full-scale war in 2022 influenced the nature of documented cases, reflecting the challenges faced by gbMSM and TP. CONCLUSIONS: Monitoring rights violations proved effective for assessing the situation of gbMSM and TP, particularly in the insufficiently studied and diverse eastern Europe, Caucasus and central Asia regions. As rights violations are linked to both legislation and law enforcement practices, comprehensive interventions to minimize structural and interpersonal stigma are essential.

Mental health and cognition in relation to adherence to antiretroviral therapy among people living with HIV in Kazakhstan: a cross-sectional study.

INTRODUCTION: There is a research gap in how mental health and cognition are associated with antiretroviral treatment (ART) adherence among people living with HIV (PLWH) in Kazakhstan. METHODS: We randomly selected and enrolled 230 PLWH from the Almaty City AIDS Center registry (June-November 2019) into a cross-sectional study. We examined associations between self-reported ART adherence for the last 1 and 2 weeks; the Adherence Self-Efficacy Scale (ASES) and symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder tool [GAD-7]), post-traumatic stress disorder (PTSD Checklist [PTSD]); cognitive function (PROMIS v2.0 Adult Cognitive Function 8a short form) and forgetfulness (Forgetfulness Assessment Inventory). We used cut points of ≥5 for at least mild and ≥10 for at least moderate symptom severity for PHQ-9 and GAD-7 and of ≥44 for PTSD. Logistic and linear regression analyses were used. RESULTS: Participants' median age was 40.0 (IQR: 34-47) with 40.9% (n = 94) of females in the sample. Those who missed at least one pill for the last 2 weeks had higher odds of reporting at least mild depression (aOR = 3.34, 95% CI: 1.22-9.11, p < 0.05); mild anxiety (aOR = 3.27, 95% CI: 1.20-8.92, p < 0.05); and PTSD (aOR = 4.04, 95% CI: 1.15-14.21, p < 0.05) symptoms. Participants who missed at least one pill for the last week had higher odds of at least mild depression (aOR = 7.74, 95% CI: 1.31-45.7, p < 0.05), moderate anxiety (aOR = 21.33, 95% CI: 3.24-140.33, p < 0.005) and PTSD (aOR = 13.81, 95% CI: 2.36-80.84, p < 0.005) symptoms. Participants with better cognitive function had lower odds of non-adherence over the last week (aOR = 0.88, 95% CI: 0.81-0.96, p < 0.005) and higher ASES scores (ß = 0.26, 95% CI: 0.13-0.40, p < 0.005). Poor memory was associated with higher odds of non-adherence over the last week (aOR = 4.64, 95% CI: 1.76-12.24, p < 0.005) and lower ASES score (ß = -0.31, 95% CI: -0.45 to 0.16, p < 0.005). Those who had at least mild depression (ß = -0.21, 95% CI: -0.35 to -0.07, p < 0.005); moderate anxiety (ß = -0.21, 95% CI: -0.34 to -0.07, p < 0.005) and PTSD (ß = -0.19, 95% CI: -0.33 to -0.05, p < 0.005) symptoms had lower ASES scores. CONCLUSIONS: Depression, anxiety and PTSD symptoms, poorer cognition, and forgetfulness were associated with poorer ART adherence and worse adherence self-efficacy. It is crucial to assess and treat mental illness and provide support for PLWH with worsened cognition to enhance ART adherence.

Study of the stress in adults diagnosed with meningioma: Insights from a tertiary neurosurgical hospital.

BACKGROUND: Meningiomas are the most common type of primary brain tumor, originating from the meninges - the protective membranes that surround the brain and spinal cord. Several well-studied risk factors for meningiomas include gender, age, radiation exposure, genetic factors, and hormonal factors. Moreover, the influence of a person's psycho-emotional stateon their overall health and mental well-being, specifically stress, iscurrently a significant and relevant topic of discussion. AIMS: This case-control study aimed to study the association between perceived stress, chronic stress, and meningioma in adult patients. METHODS AND RESULTS: The study included cases, which comprised adult patients with histologically confirmed meningioma, and controls, consisting of adult patients with no history of brain cancer. Data collection involved the use of three types of questionnaires. The first questionnaire focused on patients' personal information, geographic factors, and lifestyle habits. Two additional questionnaires "The Perceived Stress Scale" and "The Chronic Stress Scale" were employed to assess perceived stress and chronic stress. The questioning was conducted by a neurologist. Microsoft Excel and Stata 14 were used for the data analysis. Overall, 148 questionnaires were completed and included in the analyses. The average age of participants was 45.60 ± 13.90 years. Females outnumbered males in both groups. Patients with meningioma diagnosis had a higher level of perceived high stress compared to those without meningioma (p = .045). Respondents without a diagnosis of meningioma have reported having more chronic stress in general and ambient problems (p = .004), financial issues (p = .006), work (p < .001), non-employment (p = .008), love and marriage (p < .001), isolation (p < .001), and residence (p < .001). Patients with meningioma, however, had less chronic stress compared to meningioma-free patients. CONCLUSION: This study revealed no discernible connection between stress and meningioma within our study sample. Further research with matched case-control methodology with a larger sample size is warranted to thoroughly evaluate the potential role of stress in patients with meningioma.

Haplotypes of ATP-Binding Cassette CaABCC6 in Chickpea from Kazakhstan Are Associated with Salinity Tolerance and Leaf Necrosis via Oxidative Stress.

Salinity tolerance was studied in chickpea accessions from a germplasm collection and in cultivars from Kazakhstan. After NaCl treatment, significant differences were found between genotypes, which could be arranged into three groups. Those that performed poorest were found in group 1, comprising five ICC accessions with the lowest chlorophyll content, the highest leaf necrosis (LN), Na+ accumulation, malondialdehyde (MDA) content, and a low glutathione ratio GSH/GSSG. Two cultivars, Privo-1 and Tassay, representing group 2, were moderate in these traits, while the best performance was for group 3, containing two other cultivars, Krasnokutsky-123 and Looch, which were found to have mostly green plants and an exact opposite pattern of traits. Marker-trait association (MTA) between 6K DArT markers and four traits (LN, Na+, MDA, and GSH/GSSG) revealed the presence of four possible candidate genes in the chickpea genome that may be associated with the three groups. One gene, ATP-binding cassette, CaABCC6, was selected, and three haplotypes, A, D1, and D2, were identified in plants from the three groups. Two of the most salt-tolerant cultivars from group 3 were found to have haplotype D2 with a novel identified SNP. RT-qPCR analysis confirmed that this gene was strongly expressed after NaCl treatment in the parental- and breeding-line plants of haplotype D2. Mass spectrometry of seed proteins showed a higher accumulation of glutathione reductase and S-transferase, but not peroxidase, in the D2 haplotype. In conclusion, the CaABCC6 gene was hypothesized to be associated with a better response to oxidative stress via glutathione metabolism, while other candidate genes are likely involved in the control of chlorophyll content and Na+ accumulation.

[The readiness of Kazakhstan to implementation of medicinal insurance: the sociological substantiation and education activities of public organizations].

Until recently, in Kazakhstan, both health care services and medication support of population were financed from National budget and compulsory social health insurance foundation. But actual system meet needs of Kazakhstanis in medications not in full measure. The purpose of the study is to identify readiness of citizens to implementation of new medicinal insurance program with state co-financing. The study was carried out in 2022 in 17 regions of Kazakhstan. The readiness of Kazakhstanis to participate in medicinal insurance program with state co-financing was studied through sociological survey of 5 819 Kazakhstanis. The sociological survey revealed that respondents express average degree of readiness to implementation of new medicinal insurance program with state co-financing and to purchasing of insurance policy. The correlation between social demographic characteristics (objective indicators) and readiness indicator (subjective indicator) was revealed. The younger males with higher education, residing in urban areas, with average and high income and officially married are more inclined to purchase insurance policy. At that, according to results of sociological survey, one third of respondents have no relevant information about health insurance in general and medicinal insurance in particular. They found it difficult to express their personal position about this issues. It is supposed that Kazakhstanis in the result of educational measures will take part in medicinal insurance program with state co-financing. The education projects can be implemented through public organizations operating locally and communicating with population at the micro level. It is determined that it is especially important to apply educational measures to rural residents, middle-aged and elderly people, females and persons with low average income per family member.

[On the issue of logistic support of export of medicinal preparations of national production].

The current geopolitical situation raised pointed question of developing new supply chains and looking for rolling stock to develop newly formed cargo flows, including medicinal preparations transportation. Considering necessity in timely and safe supply of medicines, it is necessary to develop set of measures permitting to implement export of this production of national industry to ensure ultimate independence from unfriendly states. The article considers main indicators of import and export operations of medicinal preparations and measures taken by the state to support industry in current conditions, requirements for international transportation of this category of goods. The measures increasing exports within the framework of the Pharmaceutical Industry Development Strategy until 2030, such as expansion of fleet of autonomous refrigerated containers, use of consolidation warehouses in Turkey and Kazakhstan to ensure decreasing of cost of multi-modal transportation of medicinal preparations, as well as validation of rolling stock in accordance with GDP requirements.

Genetic polymorphism of 27 Y-STR loci in Kazakh populations from Central Kazakhstan.

BACKGROUND: The haplotypes from Northern, Southern, Eastern, and Western Kazakhstan, analysed for 27 Y-STR loci, have been contributed to the Y-Chromosome STR Haplotype Reference Database, while the genetic profile of Central Kazakhstan remains inadequately explored. AIM: To investigate the genetic diversity of 27 Y-STR loci in the Kazakh populations from Central Kazakhstan. SUBJECTS AND METHODS: A total of 112 unrelated Central Kazakh males were genotyped via the Yfiler Plus kit. Data analysis yielded haplotype and allele frequencies, and forensic parameters. Genetic distances were graphically represented by a multidimensional scaling plot, with genetic linkages further elucidated through Nei's distance dendrograms and Median-joining networks. RESULTS: A total of 102 haplotypes were detected, of which 96 were unique. The haplotype diversity and discrimination capacity were 0.997 and 0.91, respectively. Central Kazakhstan displays a unique cluster in analyses, underscoring its distinct Y-chromosome diversity compared to other Kazakh regions. The analysis of the Naiman tribe, predominantly residing in Central, Southern and Eastern Kazakhstan, revealed three genetic clusters of distinct haplogroups associated with their clans. CONCLUSIONS: The identified haplotypes will enhance the existing reference database for Y-chromosomal studies in Kazakhstan, offering a robust tool for future research in population genetics, forensic science and genetic genealogy.