Search Results (1,092)

Background/Objectives: Hepatitis E virus (HEV) infection is an increasingly recognized cause of acute hepatitis in Europe, but short-term in-hospital laboratory dynamics remain insufficiently described in hospitalized cohorts. We aimed to characterize admission biochemical abnormalities and paired admission-to-discharge laboratory changes in hospitalized patients with acute hepatitis E from Craiova, Romania, with exploratory sex- and age-stratified analyses. Methods: We conducted a single-center retrospective observational study including 40 consecutive hospitalized patients with acute hepatitis E during 2024–2025. Admission and discharge laboratory values were compared at the within-patient level, and exploratory subgroup analyses by sex and age class were performed. Given the limited sample size, multivariable analyses were restricted to parsimonious age-adjusted models for selected endpoints. Results: The cohort comprised 22 females (55%) and 18 males (45%), with a mean age of 53.05 ± 21.44 years; two in-hospital deaths occurred. At admission, marked transaminase elevation and frequent hyperbilirubinemia were observed, with 70% of patients having total bilirubin ≥ 2 mg/dL and 40% ≥ 10 mg/dL. During hospitalization, ALT and AST declined markedly, whereas total and direct bilirubin improved more modestly, indicating slower resolution of jaundice/cholestatic abnormalities. Platelets increased, while prothrombin index changes were heterogeneous. Male patients had higher bilirubin values at admission and discharge and more frequent clinically relevant hyperbilirubinemia thresholds; however, these findings should be interpreted cautiously given the small sample size, the retrospective design, and the absence of standardized clinical confounders and mechanistic data. Exploratory age-stratified analyses did not identify robust differences after multiplicity control. Conclusions: In hospitalized hepatitis E, hepatocellular injury markers improved rapidly during hospitalization, whereas cholestatic abnormalities resolved more slowly and often remained clinically relevant at discharge. The observed sex-related cholestatic pattern should be considered exploratory and requires confirmation in larger studies with standardized clinical covariates and longer follow-up. These findings support closer monitoring of bilirubin trajectories at discharge, particularly in male patients, and highlight the need for integrating laboratory dynamics into short-term clinical assessment of hospitalized HEV cases. Full article

Shellfish are one of the important aquatic products in coastal areas. Due to their feeding mechanism, viruses can accumulate in their tissues during the feeding process. Most of the current research on HEV in shellfish is limited to the sampling of the surface layer to detect its prevalence, and traditional quantitative risk assessment methods face challenges in assessing the potential risks associated with consumption. Using the R language, we combined 2011–2024 literature detection data with experimental results to simulate infection risk for Chinese urban and rural residents under cooked and raw-consumption scenarios. Single-exposure infection probabilities were similar, but annual risks were comparable across groups. For urban residents, the 95% CrI of annual risk was 3.83 × 10⁻⁵ (2.5 × 10⁻⁶–3.56 × 10⁻⁴) (raw) and 1.2 × 10⁻⁸ (3.8 × 10⁻¹⁰–4.3 × 10⁻⁷) (cooked); for rural residents, the confidence interval was 2.69 × 10⁻⁵ (1.8 × 10⁻⁶–2.50 × 10⁻⁴) (raw) and 8.4 × 10⁻⁹ (2.5 × 10⁻¹⁰–3.0 × 10⁻⁷) (cooked). By assessing the prevalence of HEV in shellfish and the probability of infection after consumption, the safety awareness of the Chinese population regarding shellfish consumption can be strengthened. Also, suggestions can be derived from HEV prevalence data in various countries, to improve the breeding environment and reduce relevant prevalence and risks. Full article

Hepatitis E virus (HEV) is recognized as one of the leading causes of acute viral hepatitis (AVH) in developing countries, where it is primarily transmitted through the consumption of contaminated food and water. Although often self-limiting, HEV infection poses a significant public health concern, particularly among pregnant women, due to its potential complications. The present study aimed to determine the seroprevalence of HEV infection in asymptomatic antenatal women attending a tertiary care center in South Punjab, Pakistan. A total of 100 asymptomatic pregnant women were screened for anti-HEV antibodies (IgM and IgG) using an ELISA kit (DIA PRO, Italy). The overall seropositivity rate was found to be 12%, indicating prior exposure to HEV infection in this cohort. Specifically, IgG antibodies were detected in 6% of women and IgM antibodies in 5%, while two women showed evidence of both IgG and IgM positivity, suggestive of recent or ongoing infection. Notably, the majority of participants reported reliance on untreated water sources irrespective of educational background, highlighting environmental risk factors. Although HEV is generally self-limiting, these findings underscore the importance of routine serological screening in antenatal populations to prevent adverse pregnancy outcomes. In addition, increased community awareness regarding transmission routes and preventive measures is essential. Given the scarcity of regional data, this study emphasizes the need for larger-scale epidemiological investigations to better understand the burden of HEV in South Punjab, Pakistan. Full article

Background: Acute hepatitis E (AHE) poses escalating risks to older adults (≥65 years), compounded by immunosenescence and comorbidities. Using Global Burden of Disease (GBD) 2021 data, this study analyzes global AHE burden, trends, and projections in aging populations. Methods: Age-standardized rates (ASIR, ASMR, ASDR) for AHE in adults ≥ 65 years were extracted from GBD 2021 across 204 countries (1990–2021). Frontier analysis assessed gaps between observed burdens and sociodemographic index (SDI)-based theoretical minima. Age-period-cohort (APC) modeling evaluated age/period/cohort effects. Bayesian (BAPC), NORDPRED, and ARIMA models projected trends to 2050. Results: Global ASIR increased by 1.5% annually (1990–2021), with ASMR and DALYs declining significantly. Middle SDI regions showed the steepest ASIR rise (net drift: 0.064%/year), while high SDI areas had volatile trends. Age effects peaked in ≥95-year-olds. Frontier analysis revealed persistent ASIR-SDI gaps, particularly in low-middle SDI regions. Projections indicate a ASIR rise by 2050 (113.04/100,000), contrasting with declining ASMR (0.056/100,000) and ASDR (1.31/100,000) and the NORDPRED, ARIMA, and EAPC models exhibit analogous global predictive trends. Conclusions: Diverging trends of rising incidence and falling mortality highlight unmet prevention needs. High-burden regions require SDI-stratified strategies, prioritizing vaccination programs (e.g., HEV 239), zoonotic transmission control, and enhanced surveillance. The Sustainable Development Goals (SDGs) envision hepatitis elimination by 2030 (Target 3.3). However, our analysis projects ongoing AHE burden in aging populations through 2050, indicating the need for post-2030 policy adaptations. Full article

Bone metastasis is a devastating complication of advanced osteotropic malignancies, notably breast, prostate, lung carcinomas, and malignant melanoma, and remains a primary driver of mortality. Historical paradigms have conceptualized skeletal dissemination almost exclusively as a hematogenous process wherein circulating tumor cells colonize receptive bone marrow niches. However, this model fails to reconcile why lymph node metastasis consistently serves as a potent predictor of bone involvement even though therapeutic lymphadenectomy rarely prevents distant spread. This discordance suggests that lymph nodes function not merely as passive reservoirs but as active ‘evolutionary gateways’ that sculpt bone-tropic metastatic clones. In this review, we introduce the Lymphatic–Bone Axis, a framework integrating lymphatic biology into models of bone metastasis. We synthesize emerging evidence elucidating how the lymph node microenvironment primes tumor cells through CCR7-CXCR4 switching, induction of osteomimicry programs, and metabolic reprogramming that favors survival within the bone marrow. We also discuss preclinical data demonstrating direct intranodal intravasation via high endothelial venules (HEVs), providing a rapid route into the systemic circulation that bypasses the thoracic duct. Beyond consolidating current knowledge, we outline a research agenda for dissecting this axis, including longitudinal single-cell transcriptomic mapping and functional assessments of lymph node-derived tumor cells. Finally, we consider translational implications, highlighting why bone-targeted agents alone may prove insufficient once cells are conditioned within lymphatic niches. By mechanistically linking lymphatic priming to skeletal colonization, this review informs the rational design of multimodal therapeutic approaches that jointly target lymphatic transit and the bone microenvironment. Full article

Compared with rule-based and optimization energy management strategies, online optimal energy management control strategies for a dual-mode power-split hybrid electric vehicles (PSHEVs) are able to achieve better fuel economy and real-time performance. Global online optimization of a finite time domain energy management strategy based on the hybrid model predictive control (HMPC) algorithm is proposed in this study. To reduce the computing time, a linearized predictive model is built; because dual-mode PSHEVs can be considered hybrid systems that include continuous and discrete states, the hybrid states can be expressed uniformly. Therefore, a mixed logical dynamic (MLD) predictive model is built based on hybrid system theory, and an HMPC energy management strategy is proposed based on the MLD predictive model. To solve the optimal control problem online to obtain the optimal control sequence, the optimal control problem is converted into a mixed-integer linear programming (MILP) problem. The HMPC-based energy management strategy is compared with dynamic programming (DP)-based and rule-based energy management strategies over two different driving cycles. Simulation results indicate that the HMPC-based EMS achieves 80.60% and 83.79% of the fuel economy performance obtained by the DP-based EMS. In comparison, the rule-based EMS only achieves 66.46% and 70.51% of the DP-based control performance. Therefore, the HMPC-based energy management strategy is favorable for real-time control while effectively improving fuel economy. Full article

This study introduces and compares online rule-based and optimization-based energy management strategies for a mild hybrid electric vehicle, with their performance evaluated against an offline Dynamic Programming benchmark. A structured rule-based strategy is proposed to enforce engine operation along its optimal efficiency line, while the remaining power demand is balanced by the electric motor. To achieve charge-sustaining battery operation, a soft state of charge regulation mechanism is incorporated. An Equivalent Consumption Minimization Strategy (ECMS) is also developed using a precise formulation of battery equivalent fuel consumption computed from instantaneous engine and electric path efficiencies, instead of constant efficiencies used in the literature. DP, which provides a globally optimal solution over the entire driving cycle, is employed as a benchmark for assessing the rule-based and ECMS strategies. The control strategies are compared under charge-sustaining conditions, considering engine and motor operation characteristics, overall fuel consumption, and battery usage intensity. Furthermore, the influence of load shifting between the internal combustion engine and the electric motor on overall vehicle performance is analyzed. Fuel consumption decreases by 13.5% relative to the engine-only baseline with the proposed ECMS with precise equivalent fuel consumption, and DP yields an additional 1.6% benefit. Compared with the developed rule-based controller, ECMS nearly halves the battery usage intensity, and DP provides 3.1% further reduction relative to ECMS. Full article

Cedar virus (CedV), related to the highly pathogenic bat-borne henipaviruses, Hendra virus (HeV) and Nipah virus (NiV), is non-pathogenic in small animal models, likely due to the inability to produce interferon-antagonist proteins. We evaluated the pathogenesis of recombinant CedV (rCedV) in the African green monkey (AGM) model and determined if prior infection conferred cross-protective immunity against a lethal challenge with NiV Bangladesh (NiV-B) or HeV. AGMs infected with rCedV remained asymptomatic, with no clinical signs of disease or detectable viremia. The rCedV infected animals developed homologous neutralizing antibody responses that failed to cross-neutralize NiV-B or HeV. At 42 days post-rCedV infection, AGMs were challenged with a lethal dose of NiV-B or HeV, and prior infection with rCedV failed to protect against NiV-B challenge, with all animals succumbing to NiV-B. Similarly, rCedV infection did not confer consistent protection against HeV, with 2/4 animals succumbing to lethal HeV. These findings confirm that CedV is non-pathogenic in the AGM model of NiV and HeV infection, justifying its classification as a BSL-2 agent. The findings also demonstrate that rCedV does not elicit a cross-protective immune response to prevent lethal disease from either NiV-B or HeV highlighting significant immunological differences between CedV and the pathogenic henipaviruses. Full article

Background/Objectives: Viral hepatitis A–E represents a significant public health problem. Data on the prevalence of viral hepatitis markers among alcoholics are inconsistent. Methods: The study included 151 patients treated for alcohol abuse in one Croatian center. The control group consisted of 110 individuals from the general population tested for a routine check-up. The prevalence of viral hepatitis markers was assessed using serology and molecular methods. Results: The prevalence rates of hepatitis markers among patients were as follows: anti-HAV, 15.2%; anti-HBs, 11.9%; anti-HBc/anti-HBs, 2.6%; anti-HCV, 4.0%; and anti-HEV, 14.6%. HCV RNA was detected in one patient (0.6%). Compared with the control group, patients showed significantly higher HCV seroprevalence (4.0 vs. 0%), while the prevalence of other hepatitis markers did not differ significantly between the groups. The anti-HAV prevalence was associated with age (from 0% in patients aged <40 years to 42.9% in patients aged 60+ years), employment status (highest among retired individuals at 46.2%), and age of occasional alcohol consumption (highest seroprevalence of 26.3% in those who reported consumption between 22 and 25 years). The association between anti-HEV and educational level was of borderline significance. Logistic regression showed that older and retired patients and those who consumed alcohol occasionally between 22 and 25 years showed higher odds for HAV seropositivity (OR = 11.454–49.400, OR = 6.857, and OR = 4.464, respectively). Patients with university degrees were at lower risk for HEV seroprevalence (OR = 0.083). Conclusions: Alcoholic patients showed a higher HCV seroprevalence than the general population, while the prevalence of other viral hepatitis markers did not differ between the groups. Further studies on a larger cohort of patients are needed to confirm these findings. Full article

Plug-in hybrid electric vehicles (PHEVs) operate using both electricity and liquid fuel, offering emissions reduction while eliminating driving-range concerns. Determining the optimal electric range or battery capacity is crucial for the total cost of ownership, decarbonization potential, and battery material demand. However, the effect of battery degradation has not been incorporated into market-oriented range-optimization studies. This paper extends the existing MOR-PHEV range optimization model by integrating both cycle-based and calendar-based battery degradations. The results show meaningful optimization benefits, reducing consumer ownership cost by approximately $3000–5000. The optimal solution—defined by the minimized lifetime cost and the optimal battery capacity—is robust across the key external parameters. Intertwined with certain factors, battery degradation can have a significant impact on the optimal battery capacity. Particularly, at faster cycle-based degradation, high driving intensity and high CS efficiency can lead to optimization tipping points, where the degradation effect is so significant that the consumer is better off by choosing a small-battery PHEV (or HEV if the choice space expands beyond PHEV) in order to fully degrade the battery faster, totally avoid the charging behavior cost earlier, and maximally benefit from the high CS efficiency earlier. This points to the importance of reducing the cycle-based degradation coefficient and improving the vehicle energy efficiency and charging convenience. One basis point (0.01%) reduction in the cycle-based degradation coefficient is estimated to reduce the optimal battery capacity by 4.9–5.2 kWh and increase consumer value by $275–497, depending on the battery unit cost. These are useful insights into decision-making regarding battery technology R&D, battery chemistry roadmaps, critical material supply risks, and EV product strategies. While the findings in the study scope depend on assumptions of consumer behavior, battery degradation, vehicle efficiency and charging infrastructure, the expanded MOR-PHEV provides a systematic framework for considering different assumptions in support of user-defined decision context and discussing future research. Full article

Hepatitis E virus (HEV) is a global public health concern, causing over 20 million infections annually. It is primarily transmitted via the fecal–oral route, with wild boars and domestic swine as major reservoirs involved in zoonotic transmission. Bahía de Samborombón is an important natural reserve in Argentina characterized by a high population of wild boars, located in a livestock-intensive region near major urban centers. As part of a wild boar control program, 11 sampling campaigns were carried out between 2022 and 2023. Fecal, blood, and liver samples were systematically collected from 80 captured animals for the detection and characterization of HEV through antibody and RNA testing. Serological analysis revealed a positivity rate of 42.4%, whereas RT-qPCR detected HEV RNA in 9.1% of fecal samples and 12.5% of liver samples. From the positive samples, seven viral sequences were recovered using RT-nested PCR, including six from ORF1 and one from ORF2. Phylogenetic analysis clustered these sequences within zoonotic HEV genotype 3, showing a close relationship with human sequences from Buenos Aires and neighboring provinces. This study confirms the presence of HEV in wild boars from Argentina, highlighting the circulation of genotype 3, clade abchijklmno and the associated zoonotic risk. Full article

The hepatitis E virus (HEV) is an emerging multi-host pathogen, with suids being the main reservoir. Humans are primarily infected through the consumption of contaminated water or food. In Argentina, HEV circulation has been confirmed in humans, domestic pigs, wild boar (Sus scrofa), and surface water. In El Palmar National Park, invasive wild boar and axis deer (Axis axis) are controlled, and their meat is released for public consumption, with trimmings and offal frequently fed to dogs. Between 2017 and 2019, we conducted a multi-species serological survey in this protected area to assess HEV exposure in invasive mammals and in dog and human consumers of game meat. We also evaluated associations between seropositivity and environmental variables, as well as behavioral risk factors among game-meat consumers. Total anti-HEV antibodies were detected in 29/75 (38.67%) wild boar, 1/134 (0.75%) deer, 1/18 (5.6%) dogs, and 6/59 (10.17%) humans. A spatial cluster of seropositive wild boar was identified in a low-lying, flood-prone area near the confluence of the El Palmar stream and the Uruguay river, suggesting increased risk of environmental transmission. This is the first report of HEV exposure in wild boar from this park and in axis deer and dogs in Argentina. Participation in culling and game meat handling and consumption may contribute to HEV exposure pathways among humans. These findings improve understanding of HEV epidemiology at the wildlife–domestic animal–human interface and highlight the influence of environmental factors and human behavior on zoonotic virus circulation. Full article

Hepatitis E virus (HEV) is an important cause of acute and chronic hepatitis worldwide, transmitted primarily through waterborne exposure and zoonotic foodborne pathways. In recent years, shellfish have attracted growing attention as a potential vehicle for HEV transmission. This interest is driven by epidemiological observations linking shellfish consumption to human HEV infection and by repeated detection of HEV RNA in bivalve mollusks across multiple geographic regions. This review critically evaluates the current evidence by integrating epidemiological data, environmental and food surveillance studies, and mechanistic insights into viral accumulation in shellfish. Signals from outbreak investigations, observational studies, seroepidemiological surveys, and case reports suggest that shellfish may contribute to HEV exposure. However, these findings are largely associative, methodologically heterogeneous, and limited by the absence of explicit documentation of raw or undercooked shellfish consumption in many cases. To date, no study has recovered infectious HEV from shellfish, nor has any established molecular epidemiological linkage between shellfish-derived HEV and human infections. Mechanistic knowledge from norovirus and hepatitis A virus demonstrates that bivalves can bioaccumulate enteric viruses through filter feeding, yet HEV-specific processes governing viral binding, persistence, and infectivity within shellfish remain poorly defined. Surveillance data reveal marked geographic variation in HEV RNA detection among shellfish species and production areas. Overall, existing evidence supports shellfish as a biologically plausible but unconfirmed source of HEV exposure. Addressing key knowledge gaps—particularly through direct infectivity assessments and high-resolution molecular linkage studies—will be essential to determine the public health significance of shellfish within the broader ecology of HEV transmission. Full article

Hepatitis E virus (HEV) is a significant public health concern and a leading cause of acute viral hepatitis worldwide. In recent years, HEV has been increasingly recognized as a wildlife-associated zoonotic pathogen, with numerous free-ranging species contributing to its maintenance and transmission. While domestic pigs remain the primary reservoir for human infection globally, growing evidence indicates that wild animals, particularly wild boars, cervids, lagomorphs, rodents, and carnivores, play a critical role in the ecology of HEV. Wild boars are the principal wildlife reservoir, with HEV seroprevalence in Europe ranging from less than 5% to more than 50%, including some of the highest levels reported in the Balkans. In addition to the frequent detection of HEV RNA in wild boar liver and muscle, viral RNA has also been identified in several other game species, most consistently in red deer, roe deer, and, in some regions, hares and wild rabbits, highlighting food safety risks associated with the consumption of raw or undercooked game meat. In regions such as the Balkans, where hunting activities and handling of wild game are widespread, these practices may further increase occupational and dietary exposure to HEV. Rodents may further complicate the epidemiological landscape through environmental contamination of water, soil, and farm surroundings, thereby facilitating indirect transmission pathways. As wildlife populations expand and human–animal interfaces intensify, understanding HEV dynamics in free-ranging species is essential for assessing zoonotic risks and implementing a strengthened One Health approach. This narrative review synthesizes and critically examines current evidence on HEV prevalence, molecular characteristics, and transmission pathways in wildlife, with particular emphasis on Europe and focused consideration of the Balkans as an epidemiologically heterogeneous and underrepresented subregion; examines associated public health implications; and highlights the importance of integrating wildlife into food safety and One Health surveillance frameworks. Existing knowledge gaps and limitations in wildlife surveillance are also discussed. Full article

Amid the growing global environmental challenges, precise and efficient vehicle emission management plays a critical role in achieving energy-saving and emission reduction goals. At the same time, the rapid development of connected vehicles and autonomous driving technologies has generated a large amount of high-dimensional vehicle operation data. This not only provides a rich data foundation for refined emission accounting but also raises higher demands for the construction of accounting models. Therefore, this study aims to develop an accurate and efficient emission accounting model to contribute to the precise nitrogen oxide (NO_x) emission accounting for hybrid electric vehicles (HEVs). A systematic approach is proposed that combines incremental dimensionality reduction with advanced regression algorithms to achieve refined and efficient emission accounting based on multiple variables. Specifically, the dimensionality of the real driving emission (RDE) data is first reduced using the feature selection and t-distributed stochastic neighbor embedding (t-SNE) feature extraction method to capture key parameter information and reduce subsequent computational complexity. Next, an incremental dimensionality reduction method based on dictionary learning is employed to efficiently embed new data into a low-dimensional space through straightforward matrix operations. Given the computational cost of the dictionary learning training process, this study introduces the FISTA (Fast Iterative Shrinkage-Thresholding Algorithm) for accelerated iterative optimization and enhances the computational efficiency through parameter optimization, while maintaining the accuracy of dictionary learning. Subsequently, an NO_x emission factor correction factor prediction model is trained using the low-dimensional data obtained from t-SNE embeddings, enabling direct computation of the corresponding correction factor when presented with new incremental low-dimensional embeddings. Finally, validation on independent HEV datasets shows that parameter K improves to 1 ± 0.05 and R² increases up to 0.990, laying a foundation for constructing an emission accounting model with broad applicability based on multiple variables. Full article