Search Results (495)

Background: Pulmonary tuberculosis (TB) is a significant trigger of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), so its timely and accurate diagnosis is essential. Also, the risk factors for TB occurrence in this population remain unclear. This study aimed to evaluate the performance of metagenomic next-generation sequencing (mNGS) for TB diagnosis in AECOPD patients, as well as to identify the associated risk factors. Methods: A retrospective observational cohort of 659 AECOPD patients with suspected pulmonary infection was enrolled. The microbial cell-free nucleic acids in bronchoalveolar lavage fluid samples were extracted and subjected to mNGS detection. The clinical data for each patient were collected from the hospital information system. The statistical analyses were performed with SPSS version 25.0. Results: A total of 170 cases, included for final analyses, were categorized into TB (n = 41), bacterial infection (n = 73), and non-infective control (n = 56) groups. Among these groups, the TB group had the highest intensive care unit (ICU) admission rate (46.34%) and longest median hospital stay (19.50 days) (p < 0.01). For TB diagnosis, mNGS demonstrated a greater sensitivity (86.00%), a lower specificity (93.30%), and a higher area under the curve (AUC, 0.877) than TB-DNA detection (70.21%, 100%, 0.848, respectively) and Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay (63.83%, 100.00%, 0.870, respectively). Notably, mNGS identified the bacterial or viral co-infections in 18.00% of TB cases. Furthermore, the stringently mapped read number determined by mNGS showed a positive correlation with ICU admission rate (r = 0.76) and in-hospital mortality (r = 0.77). The lower body mass index (BMI) and reduced natural killer (NK) cell count were identified as the independent risk factors in the TB group (both p < 0.05). Conclusions: For the diagnosis of pulmonary TB in AECOPD patients, mNGS demonstrated comparable performance to TB-DNA detection and Xpert MTB/RIF assay, and also mNGS identified co-infections. In addition, a lower BMI and reduced NK cell count were identified as the independent risk factors for TB occurrence in this cohort. Full article

The study analyzes a major deep-seated landslide affecting National Road 16 at KP 178+000 in the Rif region of northern Morocco, a corridor repeatedly impacted by geotechnical instability. Using historical information, detailed geological mapping, multiple field campaigns, and extensive subsurface investigations (core drilling, inclinometers), the authors characterize the site as a complex setting of metamorphosed, fractured, and altered peridotites overlain by Quaternary sediments dipping negatively toward the Mediterranean. The landslide is interpreted as deep-seated planar translational landslide and has been exacerbated by human activity, specifically the placement of excavated material on the downslope side during road upgrade works in late 2019. Inclinometer data show active movement extending to at least 20 m depth, confirming the deep-seated nature of the instability. Three remediation strategies were implemented: shifting the road alignment with terracing, combining road realignment with soil nailing and slope reprofiling, and installing large bored piles tied back with anchors, following recommendations from an external expert. The authors emphasize that robust geological investigations and properly regulated construction practices are essential to reduce landslide risk for infrastructure built in mountainous coastal regions. Full article

Background: Given the challenges in early detection and diagnosis, understanding the molecular underpinnings of endometrioid ovarian cancer (EOC) is crucial for improving patient outcomes. This multi-level study provides a new perspective on EOC, focusing on the expression of ARID1a (BAF250a) and RIF1. Methods: This study evaluates patient cohorts with EOC through semi-quantitative immunohistochemical staining of BAF250a (protein encoded by ARID1a) and RIF1 proteins alongside mutations that influence the gene expression of ARID1a and RIF1. Besides survival analyses, platinum- and taxane-based treatment responsiveness with regard to ARID1a and RIF1 expression has been analyzed using an online available database. Results: Histological and immunohistochemical analysis of clinical samples revealed a significant reciprocal alteration in protein expression, characterized by a marked reduction in the tumor suppressor BAF250a (p < 0.0001) and a concomitant elevation of RIF1 (p < 0.0001) in EOC compared to controls. Tumors harboring mutations in BRCA1 exhibited significantly (p = 2.82 × 10⁻⁴) lower ARID1a expression levels compared with corresponding wild-type tumors, whereas LAMB3-mutant tumors showed a significant (p = 5.16 × 10⁻³) upregulation of RIF1 mRNA expression. Conclusions: In conclusion, our study offers a new perspective, emphasizing that EOC is a distinct clinical and molecular entity. We demonstrated the expression patterns of ARID1a/BAF250a and RIF1 in EOC, establishing their potential relevance in the context of tumor biology and malignant transformation. Full article

Objectives: To evaluate the presence and dominance of Lactobacillus in the endometrial microbiome and their age-related associations in a large group of Bulgarian patients with recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL) who attend our clinic. Methods: This retrospective study included 199 patients (mean age: 35.69 ± 5.16) with RIF (n = 103) and RPL (n = 96) who visited our fertility clinic between October 2019 and November 2022. Endometrial samples were analyzed using real-time PCR for target DNA sequences. Results: Overall, 62.8% (n = 125) exhibited an absence of Lactobacilli in their endometrial samples, with 63.1% (n = 65) of the RIF group and 62.5% (n = 60) of the RPL group showing a lack of Lactobacilli, with no statistically significant difference between the groups (p = 0.926). A Lactobacillus-dominant microbiome was found in 23.6% of the entire cohort (n = 47), 25.2% of the RIF group (n = 26) and 21.9% of the RPL group (n = 21). A reduced abundance of Lactobacilli was identified in 13.5% of the cohort (n = 27), though to differing degrees. There was no significant relationship between the abundance of Lactobacilli and belonging to the RIF or RPL group. A statistically significant difference was found in the mean age of two groups in cases with a Lactobacillus-dominant microbiome (mean age of 36.4 ± 4.8 years in the RIF group and 32.5 ± 3.5 years in the RPL group) (p = 0.004). Conclusions: Our findings demonstrate a high prevalence of non-Lactobacillus-dominant microbiomes in a large group of Bulgarian patients with RIF and RPL and significant age-related Lactobacillus changes in the microbiome of patients with RPL. These results point to the potential role of the uterine microbiome and support the need for further prospective studies, especially in cases of advanced maternal age. Full article

Tuberculosis remains one of the leading infectious causes of morbidity and mortality worldwide, disproportionately affecting women of reproductive age, particularly in low- and middle-income countries. Tuberculosis during pregnancy represents a major clinical challenge, as physiological and immunological changes associated with pregnancy may obscure symptoms, delay diagnosis, and contribute to adverse maternal and perinatal outcomes. This narrative review provides an updated and clinically oriented overview of tuberculosis during pregnancy, with particular emphasis on diagnostic challenges, imaging strategies, microbiological testing, maternal–fetal complications, and therapeutic management. Key topics include symptom-based screening, tuberculin skin test and interferon gamma release assays, as well as molecular diagnostic methods such as GeneXpert Mycobacterium tuberculosis/Rifampicin (MTB/RIF) and Xpert MTB/RIF Ultra, chest radiography, computed tomography, and emerging biomarkers. We also discuss the impact of tuberculosis on pregnancy outcomes, including prematurity, low birth weight, maternal morbidity, and neonatal complications, as well as the particular challenges posed by human immunodeficiency virus HIV coinfection and multidrug-resistant tuberculosis. Current treatment strategies, preventive approaches, postpartum care, neonatal management, and Bacille Calmette–Guérin vaccination are reviewed in light of contemporary evidence and international recommendations. Finally, we highlight practical diagnostic algorithms, current evidence gaps, and priorities for future research aimed at improving maternal and neonatal outcomes in both high- and low-resource settings. Full article

Infrared–visible image fusion (IVIF) seeks to combine the thermal saliency of infrared images with the rich textures of visible images in a single representation. This study proposes RIF-Fuse, a framework designed to enhance fusion stability and detail fidelity through a band-controllable structure–detail decoupling mechanism. We utilize a wavelet-based pipeline to explicitly separate low-frequency structural components from high-frequency textures. A Haar residual enhancement path is integrated into the high-frequency branch to provide low-loss compensation for weak textures, while a band-aware differential fusion strategy is designed to suppress structural conflicts and accentuate edges at the subband level. A two-stage training scheme is further applied to ensure optimization stability. Extensive experiments on the TNO and RoadScene datasets demonstrate that RIF-Fuse produces sharper details and more natural structures compared to state-of-the-art methods. The results indicate that RIF-Fuse achieves a superior balance across multiple objective metrics, offering a robust solution for high-fidelity multimodal image synthesis. Full article

Intestinal tuberculosis (ITB) is a complex form of extrapulmonary tuberculosis characterized by nonspecific gastrointestinal symptoms and substantial overlap with conditions such as Crohn’s disease and gastrointestinal malignancies. These similarities frequently lead to diagnostic uncertainty, delayed diagnosis, and inappropriate management. This systematic review summarizes current evidence on the clinical presentation, diagnostic approaches, and therapeutic strategies for ITB, with particular emphasis on emerging diagnostic technologies and their role in reducing surgical interventions. A systematic literature search was conducted using PubMed, Scopus, and Google Scholar following PRISMA guidelines to identify relevant studies published from 2000 to 2025. The review focused on clinical manifestations, imaging findings, endoscopic features, histopathological characteristics, molecular diagnostics, pharmacological therapy, and minimally invasive therapeutic interventions. Accurate diagnosis requires an integrated approach combining clinical assessment with imaging, endoscopic evaluation, and histopathological confirmation. Molecular techniques such as GeneXpert MTB/RIF and GeneXpert MTB/RIF Ultra and multiplex polymerase chain reaction assays improve diagnostic accuracy and shorten detection time. Emerging technologies including artificial intelligence-assisted radiologic interpretation and CRISPR-based stool sequencing platforms show promise for earlier detection. Standard anti-tubercular therapy remains the cornerstone of treatment, while minimally invasive endoscopic and surgical procedures are effective for managing complications such as strictures, obstruction, and perforation. Early and precise diagnosis of intestinal tuberculosis is essential to prevent complications and optimize patient outcomes. Integrating conventional diagnostic approaches with emerging molecular and artificial intelligence-based technologies may enhance diagnostic precision and support individualized treatment strategies. Further ITB-specific clinical studies are needed to validate novel diagnostic tools and refine therapeutic approaches for improved patient care. Full article

Developing an ultrasensitive electrochemiluminescence (ECL) detection platform remains challenging due to the limited enrichment efficiency of ECL emitters and co-reactants at the electrode interface, as well as the insufficient catalytic enhancement of co-reactant conversion. Moreover, simultaneous in situ analyte enrichment and efficient anti-interference capability are often difficult to achieve in a single sensing interface. Herein, a new ECL platform was developed based on nanocatalyst-supported nanochannel-confined surfactant micelle (SM) system, which integrates an enhanced luminol-dissolved oxygen (DO) ECL response for the ultrasensitive detection of antibiotic rifampicin (RIF). A nanocomposite comprising nitrogen-doped graphene quantum dots and a molybdenum disulfide nanosheet (NGQDs@MoS₂) was modified on an indium tin oxide (ITO) electrode. This nanocomposite layer catalyzed the oxygen reduction reaction (ORR), boosting the co-reactant efficiency of DO. Vertically ordered mesoporous silica film filled with surfactant micelles (SM@VMSF) was subsequently grown in situ on the NGQDs@MoS₂ surface. The hydrophobic micelles enable the simultaneous enrichment of luminol, DO, and RIF. Integrating the triple-enrichment effect of surfactant micelles with the high electrocatalytic effect of NGQDs@MoS₂ nanocomposite results in significant ECL enhancement of the luminol–DO. SM@VMSF also provides an excellent molecular sieving effect, endowing the sensor with high anti-interference capability and stability. RIF quenches the ECL signal by consuming superoxide anion radicals, enabling sensitive detection. Detection of RIF was established with a high sensitivity (2927 a.u. per nM) wide linear range (10 pM to 10 μM) and a low limit of detection (LOD, 2.5 pM). The fabricated sensor exhibits good selectivity and high fabrication reproducibility (relative standard deviation, RSD, of 1.9%). Additionally, the determination of RIF in eye drops and seawater samples was realized. This work offers new insights for the design of high-performance ECL sensing interfaces and sensitive detection of RIF. Full article

Background: Chronic endometritis (CE) is a subtle, often asymptomatic endometrial inflammation marked by CD138⁺ plasma cell infiltration and linked to recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), and unexplained infertility. Emerging evidence implicates endometrial microbiome dysbiosis in CE. Objective: To systematically review and conduct meta-analysis on the association between CE and endometrial microbiome alterations and their reproductive implications. Methods: We searched MEDLINE, Embase, Web of Science, Scopus, Cochrane CENTRAL, and Google Scholar for studies diagnosing CE via CD138 immunostaining, assessing microbiota with molecular techniques. Data extraction, quality assessment, and meta-analysis were performed. Results: Twenty-two studies including 4022 women were analyzed. CE was associated with reduced prevalence of Lactobacillus-dominated microbiota and increased detection of non-Lactobacillus species, particularly Streptococcus spp., Enterococcus spp., Escherichia coli, Staphylococcus spp., Ureaplasma spp., and Gardnerella vaginalis. In the meta-analysis (2947 women), Enterococcus spp. and Ureaplasma spp. were significantly more prevalent in women with CE, whereas Streptococcus spp., E. coli, Staphylococcus spp. and G. vaginalis showed non-significant trends. Only E. coli and Streptococcus spp. showed significant heterogeneity between-studies. Conclusions: CE is linked to microbial dysbiosis with reduced Lactobacillus dominance and enrichment of potentially pathogenic taxa, notably Enterococcus and Ureaplasma spp. These findings suggest that the endometrial microbiome contributes to chronic inflammation and adverse reproductive outcomes, yet heterogeneity and limited evidence call for standardized diagnostics and robust trials before clinical implementation. Full article

Background: Drug-resistant tuberculosis remains a major challenge in resource-limited settings, particularly in rural regions of the Eastern Cape Province, where limited laboratory infrastructure, constrained access to advanced molecular diagnostics, shortages of specialized healthcare personnel, and prolonged diagnostic turnaround times can delay appropriate treatment initiation. This study examined whether routinely detectable genomic resistance markers could be integrated with parsimonious machine learning approaches to support early risk stratification for isoniazid (INH) and/or rifampicin (RIF) resistance and multidrug-resistant tuberculosis (MDR-TB). Methods: We conducted a retrospective analysis of clinical, demographic, and genomic data from 207 Mycobacterium tuberculosis isolates representing 207 unique patients. Resistance was classified as INH and/or RIF resistance or MDR-TB (concurrent resistance to both drugs). Predictors included age, sex, and canonical resistance-associated mutations (katG S315T, inhA −15C>T, and rpoB codon substitutions). Logistic regression was used to estimate adjusted odds ratios (aORs), while Random Forest models were applied to assess non-linear feature importance. Internal validation was performed using 10-fold cross-validation. A systems network analysis mapped the integration of model-derived risk bands into Clinical Governance structures and Community-Engaged Education pathways, including interventions delivered by Community Health Workers (CHWs). Results: INH and/or RIF resistance was identified in 58.9% of isolates, with 21.7% classified as MDR-TB. The most frequently detected mutations were katG S315T (29.0%) and rpoB S450L (26.6%). Logistic regression identified rpoB S450L (aOR 4.20; 95% CI: 2.10–8.45) and katG S315T (aOR 2.85; 95% CI: 1.40–5.80) as the strongest independent predictors, while age and sex were not statistically significant. Models demonstrated strong internal discrimination (AUCs of 0.96 for INH and/or RIF resistance and 0.99 for MDR-TB). Risk stratification categorized 18% of patients as high risk. Scenario-based modelling suggested that prioritizing high-risk patients for reflex Line Probe Assay testing could reduce the median time to appropriate treatment from 14 to 3 days and may reduce progression from isoniazid-resistant TB to MDR-TB under specified operational assumptions. Conclusions: Mutation-informed predictive modelling demonstrates strong internally validated discrimination and provides a structured framework for risk-stratified intervention. Integrating probability-based risk thresholds within Clinical Governance systems and community-level support structures, including CHW-led adherence and education strategies, may support earlier treatment optimization in high-burden rural settings. External validation and prospective implementation studies are required before broader programmatic adoption. Full article

NANOG overexpression has been reported to reverse aging-associated decline in mesenchymal stem/stromal cell (MSC) function, but the molecular machinery engaged by NANOG in MSCs remains incompletely defined. Here, we applied APEX proximity labeling coupled with quantitative mass spectrometry to define the NANOG proximity interactome (proxeome) in human MSCs. Of 1040 quantified proteins, 828 were significantly enriched in the APEX-NANOG (H₂O₂ labeling) samples, consistent with a broad NANOG-centered neighborhood rather than a single stoichiometric complex. Enriched proteins encompass RNA-processing pathways (including splicing/RNP factors and selected m6A-related proteins), transcriptional coactivation and elongation control (Mediator and 7SK/P-TEFb regulators), chromatin repression/poising modules (Polycomb and HDAC/NuRD/CoREST/SIN3), ATP-dependent chromatin remodeling (BAF/SWI-SNF), three-dimensional genome organization and replication-coupled chromatin maintenance (CTCF/cohesin, CHAF1A, RIF1, UHRF1), and regulators of MSC identity and signal integration (Hippo/mechanotransduction and TGFβ-linked transcriptional circuits). Together, these data provide a spatial proteomic map of NANOG-associated nuclear neighborhoods in MSCs and a foundation for mechanistic hypotheses for how NANOG may stabilize stem-like programs. Full article

Radiotherapy is essential for treating head and neck cancer but frequently leads to radiation-induced fibrosis (RIF) in salivary glands (SGs). RIF develops through a cascade of radiation-triggered events, including DNA damage, excessive oxidative stress, and epithelial cell death. Persistent injury can cause cells to become senescent and release inflammatory signals, fueling chronic inflammation. These processes activate pathways, particularly TGF-β/SMAD, resulting in fibroblast activation, myofibroblast differentiation, and extracellular matrix accumulation. Potential treatments include drugs, mesenchymal stem/stromal cell (MSC) therapy, and gene-transfer approaches. In which, MSC therapy is particularly promising as MSCs can migrate to injured tissue and support epithelial regeneration. Yet progress is limited by the difficulty of expanding human acinar cells (ACs) in vitro. To address this gap, tunable alginate–gelatin–hyaluronic acid (AGHA) bioink hydrogels have emerged as a suitable system as gelatin provides adhesion sites for AC attachment and 3D organoid formation, alginate offers tunable mechanical support through ionic crosslinking, and hyaluronic acid contributes essential cues for cell adhesion, migration, and morphogenesis. The aim of this review is to synthesize current understanding of the mechanisms driving RIF, evaluate available therapeutic strategies, and highlight the role of AGHA in generating engineered SG constructs to test MSC therapies for RIF. Full article

Objective: To investigate the relationship between the number of previous implantation failures (IFs) and embryo ploidy status, as well as subsequent clinical outcomes, in women with recurrent implantation failure (RIF) undergoing preimplantation genetic testing for aneuploidy (PGT-A). Methods: This retrospective cohort study included 422 women with RIF who underwent their first PGT-A cycle between 2017 and 2022. Participants were stratified by maternal age (<38 years, n = 292; ≥38 years, n = 130) and by the number of previous IFs, categorized as 3, 4, or ≥5. The primary outcomes were embryo ploidy rates (euploidy, aneuploidy, and mosaicism). Secondary outcomes included reproductive outcomes after single euploid blastocyst transfer (biochemical pregnancy, clinical pregnancy, ongoing pregnancy, live birth, and pregnancy loss) and neonatal birth weight. Results: Women aged ≥38 years had a significantly lower euploidy rate than those <38 years (24.8% vs. 47.3%, p < 0.001). Ploidy distribution did not differ significantly across IF categories. Among women aged <38 years with ≥5 IFs, a greater number of previous embryo transfer attempts was independently associated with higher odds of live birth after euploid embryo transfer (adjusted OR = 1.258, 95% CI: 1.051–1.505; p = 0.012). Neonatal weight did not differ significantly across IF categories. Conclusions: The number of previous IFs was not independently associated with embryo ploidy or clinical outcomes after euploid transfer, whereas advanced maternal age was strongly associated with a lower likelihood of obtaining euploid embryos. In younger women with ≥5 IFs, a greater number of previous embryo transfer attempts was associated with live birth after euploid transfer; however, this exploratory subgroup finding should be interpreted cautiously and requires prospective validation. Because this study did not directly evaluate therapeutic strategies, any potential role for individualized endometrial evaluation or optimization should be considered as hypothesis-generating rather than supported by the present data. Full article

Speech-based depression detection is promising for objective mental health assessment. However, conventional methods relying on short-frame acoustic features often fail to capture long-term temporal and behavioral characteristics of speech essential for modeling depression-specific speaking patterns. Herein, four novel acoustic feature sets extracted from long-term speech are proposed: utterance interval feature set (UIFS), pause interval feature set (PIFS), response interval feature set (RIFS), and speech density (SD). These features explicitly characterize temporal structures and session-level speech behaviors beyond short-frame analysis. These features are combined with conventional acoustic features, including standard features extracted using openSMILE and voice level features, and evaluated using support vector machines under subject-independent conditions for the binary classification of depressed and nondepressed speakers. Incorporating the proposed features improves classification performance compared with baseline features (accuracy: 0.54 for openSMILE and 0.52 for openSMILE + voice level features). The configuration integrating all four proposed feature sets achieves an accuracy of 0.58, a precision of 0.56, a recall of 0.58, and a specificity of 0.58, indicating consistent performance gains under subject-independent and strictly controlled evaluation conditions. Thus, depression-related speech patterns can be captured by explicitly modeling temporal and behavioral speech characteristics across entire dialog sessions. This study contributes to advancing acoustic feature design for speech-based depression detection and developing clinically supportive screening and monitoring technologies. Full article

This study evaluates the incidence of food and non-food social programs in function of income inequality in households in Peru during 2022–2024 in a context of persistent distributive gaps, despite social interventions aimed at promoting equity. Data from the National Household Survey (ENAHO) were used, with 93,148 observations corresponding to beneficiary and non-beneficiary households, and Recentered Influence Function (RIF) regressions were estimated to decompose the marginal effect of both types of programs on the Gini and Atkinson indices (ε = 0.5; 1.0 and 1.5). Food programs reduced inequality by 2.14% according to the RIF of the Gini and by −1.23%, −2.84% and −4.82% according to the RIF of the Atkinson. Non-food programs generated a greater reduction in the RIF of the Gini (−4.06%) and decreases of −2.52%, −3.51% and −3.06% in the Atkinson. Both types of programs positively influenced the decrease in inequality, highlighting the importance of incorporating structural determinants and household characteristics in redistributive policies. Social programs have positive redistributive effects, although insufficient in the face of structural and territorial inequalities. Strengthening their targeting and territorial articulation is recommended, especially in Andean and Amazon regions. Full article