Background: We recently showed that a combined solution containing alpha-ketoglutarate (aKG) and 5-hydroxymethyl-furfural (5-HMF) has a solid antitumoral effect on the Jurkat cell line due to the fact of its antioxidative, caspase-3 and apoptosis activities, but no negative effect on human fibroblasts was obtained. The question arises how the single compounds, aKG and 5-HMF, affect peroxynitrite (ONOO⁻) and nitration of tyrosine residues, Jurkat cell proliferation and caspase-activated apoptosis. Methods: The ONOO⁻ luminol-induced chemiluminescence reaction was used to measure the ONOO⁻ scavenging function of aKG or 5-HMF, and their protection against nitration of tyrosine residues on bovine serum albumin was estimated with the ELISA technique. The Jurkat cell line was cultivated in the absence or presence of aKG or 5-HMF solutions between 0 and 3.5 µM aKG or 0 and 4 µM 5-HMF. Jurkat cells were tested for cell proliferation, mitochondrial activity and caspase-activated apoptosis. Results: aKG showed a concentration-dependent reduction in ONOO⁻, resulting in a 90% elimination of ONOO⁻ using 200 mM aKG. In addition, 20 and 200 mM 5-HMF were able to reduce ONOO⁻ only by 20%, while lower concentrations of 5-HMF remained stable in the presence of ONOO⁻. Nitration of tyrosine residues was inhibited 4 fold more effectively with 5-HMF compared to aKG measuring the IC50%. Both substances, aKG and 5-HMF, were shown to cause a reduction in Jurkat cell growth that was dependent on the dose and incubation time. The aKG effectively reduced Jurkat cell growth down to 50% after 48 and 72 h of incubation using the highest concentration of 3.5 µM, and 1, 1.6, 2, 3 and 4 µM 5-HMF inhibited any cell growth within (i) 24 h; 1.6, 2, 3 and 4 µM 5-HMF within 48 h (ii); 2, 3 and 4 µM 5-HMF within 72 h (iii). Furthermore, 4 µM was able to eliminate the starting cell number of 20,000 cells after 48 and 72 h down to 11,233 cells. The mitochondrial activity measurements supported the data on aKG or 5-HMF regarding cell growth in Jurkat cells, in both a dose- and incubation-time-dependent manner: the highest concentration of 3.5 µM aKG reduced the mitochondrial activity over 24 h (67.7%), 48 h (57.9%) and 72 h (46.8%) of incubation with Jurkat cells compared to the control incubation without aKG (100%). 5-HMF was more effective compared to aKG; the mitochondrial activity in the presence of 4 µM 5-HMF decreased after 24 h down to 68.4%, after 48 h to 42.9% and after 72 h to 32.0%. Moreover, 1.7 and 3.4 µM aKG had no effect on caspase-3-activated apoptosis (0.58% and 0.56%) in the Jurkat cell line. However, 2 and 4 µM 5-HMF increased the caspase-3-activated apoptosis up to 22.1% and 42.5% compared to the control (2.9%). A combined solution of 1.7 µM aKG + 0.7 µM 5-HMF showed a higher caspase-3-activated apoptosis (15.7%) compared to 1.7 µM aKG or 2 µM 5-HMF alone. In addition, 3.5 µM µg/mL aKG + 1.7 µM 5-HMF induced caspase-activated apoptosis up to 55.6% compared to 4.5% or 35.6% caspase-3 activity using 3.5 µM aKG or 4 µM 5-HMF. Conclusion: Both substances showed high antioxidative potential in eliminating either peroxynitrite or nitration of tyrosine residues, which results in a better inhibition of cell growth and mitochondrial activity of 5-HMF compared to aKG. However, caspase-3-activated apoptosis measurements revealed that the combination of both substances synergistically is the most effective compared to single compounds.

Background: Vitamin D₃ complexed to deglycosylated vitamin D binding protein (VitD-dgVDBP) is a water-soluble vitamin D dimeric compound (VitD-dgVDBP). It is not clear how VitD-dgVDBP affects circulating monocytes, macrophages, other immune cell systems, including phagocytosis and apoptosis, and the generation of reactive oxygen species (ROS) compared to dgVDBP. Methods: Flow cytometry was used to measure superoxide anion radical (O₂^*−) levels and macrophage activity in the presence of VitD-dgVDBP or dgVDBP. VitD-dgVDBP was incubated with normal human lymphocytes (nPBMCs), and several clusters of determination (CDs) were estimated. dgVDBP and VitD-dgVDBP apoptosis was estimated on malignant prostatic cells. Results: The macrophage activity was 2.8-fold higher using VitD-dgVDBP (19.8·10⁶ counts) compared to dgVDBP (7.0·10⁶ counts), but O₂^*− production was 1.8-fold lower in favor of VitD-dgVDBP (355·10³ counts) compared to dgVDBP (630·10⁶ counts). The calculated ratio of the radical/macrophage activity was 5-fold lower compared to that of dgVDBP. Only VitD-dgVDBP activated caspase-3 (8%), caspase-9 (13%), and cytochrome-C (11%) on prostatic cancer cells. PE-Cy7-labeled VitD-dgVDBP was found to bind to cytotoxic suppressor cells, monocytes/macrophages, dendritic and natural killer cells (CD8+), and helper cells (CD4+). After 12 h of co-incubation of nPBMCs with VitD-dgVDBP, significant activation and expression were measured for CD16++/CD16 (0.6 ± 0.1% vs. 0.4 ± 0.1%, p < 0.05), CD45k⁺ (96.0 ± 6.0% vs. 84.7 ± 9.5%, p < 0.05), CD85k⁺ (24.3 ± 13.2% vs. 3.8 ± 3.2%, p < 0.05), and CD85k⁺/CD123⁺ (46.8 ± 8.1% vs. 3.5 ± 3.7%, p < 0.001) compared to the control experiment. No significant difference was found using CD3+, CD4+, CD8+, CD4/CD8, CD4/CD8, CD16+, CD16++, CD14+, or CD123+. A significant decline in CD14+/CD16+ was obtained in the presence of VitD-dgVDBP (0.7 ± 0.2% vs. 3.1 ± 1.7%; p < 0.01). Conclusion: The newly developed water-soluble VitD₃ form VitD-dgVDBP affected cytotoxic suppressor cells by activating the low radical-dependent CD16 pathway and seemed to induce apoptosis in malignant prostatic cells.

Background/Objectives: Comparative analysis of work ability factors between German nurses without a migration background and Kosovar nurses working in Germany as nurses with a migration background. Methods: This is an observational cross-sectional study. We surveyed 814 nurses from hospitals in Kosovo and Germany using self-administered questionnaires. We used the Nurses Working Capability (WiN) Screening Manual to analyze work ability factors. Data analysis involved descriptive statistics, ANCOVA, and Bonferroni multiple comparison tests. Results: Of the 40 target factors, 17 showed significant differences. There were notable distinctions between German and Kosovar nurses in Germany. Concerning health and personal resources, Kosovar nurses in Germany reported poorer physical (M = 3.71) and social health (M = 3.83) but better mental health (M = 3.53) and fewer cognitive stress symptoms (M = 3.60) than German nurses (M = 3.97, M = 4.05, M = 3.40, and M = 4.00, respectively). As to the work-related factors, Kosovar nurses in Germany faced higher emotional demands (M = 3.33), felt greater time pressure (M = 3.43), and had a more negative view of the organizational structure (M = 2.09) but rated supervisor feedback more positively (M = 3.24) and faced fewer patient-related stressors (M = 2.16) relative to German nurses (M = 2.64, M = 2.64, M = 2.82, M = 2.76, and M = 3.09, respectively). Conclusions: Kosovar immigrant nurses in Germany face distinct challenges related to physical and social health, higher emotional demands, and time constraints; they also have a more negative view of organizational structure than native German nurses. The possible causes of these differences may be attributed to migration-related stress, cultural and environmental adaptations, varying job expectations, or organizational experiences.

Aims: This study aims to assess the state of mental health of nursing students in Kosovo and their willingness to provide professional health services for individuals at risk during the COVID-19 pandemic. Methods: In this cross-sectional survey, undergraduate nursing students from three higher education institutions in Kosovo participate from May 25, 2020, to June 5, 2020. Data was collected through a structured, anonymous, self-directed questionnaire via the online platform-google forms. Questions about nursing knowledge, skills and competencies, and willingness to work, if necessary, in healthcare facilities in Kosovo before graduation during the COVID-19 pandemic, were organised according to the Likert scale. Results: Four hundred and seventy-two nursing students (82% female; and mean age 20.3±1.8 years) participated in the study. 18.2% of students required further evaluation for depression, 48.3% for anxiety, and 30.7% for stress. 77.8% of students agreed that they had acquired sufficient knowledge, 80.6% that they had sufficient skills, and 75.9% that they had sufficient competencies, during their studies, to work as nurses. Female students had higher stress (8.55±4.06) and anxiety scores (6.65±4.08) compared to their male counterparts (7.46±4.35; and 5.02±4.07; respectively) (p0.05). Conclusion: Most nursing students in Kosovo appear ready and willing to join qualified nurses in healthcare institutions in delivering health services during the COVID-19 pandemic. Highlights: Most nursing students are willing to provide health services during the pandemic. The female students had higher stress and anxiety scores than their counterparts. This study discovered that students needed psychological support during the pandemic. Serving during the pandemic will put into practice problem-solving skills.

Aim: The aim of this study is to assess the opinion of secondary medical school students in Kosovo about nursing. Methods: This descriptive-analytical study was conducted with 1282 secondary medical school students from four regions of Kosovo through random sampling. Data were collected from March to May 2018 by a questionnaire designed for this study from the researchers. It consisted of two sections, the sociodemographic part and the second part about opinion and perceptions about the nursing profession. Continuous variables are summarized as mean and standard deviation (SD), categorical variables are summarized as frequency (n) and percentages (%). Chi square (x2) test is used to analyze the difference between categorical variables Results: The family had a proactive impact on the choice of the study program for their child. More than half of the students had a favourable opinion of nursing prior to enrolling in secondary medical school. After enrolling in the study program, more than two-thirds of students (72.2%) have a favourable opinion of nursing. More than half of the students (52.6%) believe that the community perceives nursing positively. Conclusion: Most of the secondary school students have a positive opinion about nursing and think that community have a positive opinion as well. The secondary medical school plays an important role in the improvement of student’s opinion about nursing. Keywords: opinions, nurses, students, secondary schools, Kosovo