Search Results (557)

Pimelea is one of the highly toxic plants in Australia, particularly affecting cattle. It contains simplexin, a potent toxin that can cause Pimelea poisoning (St. George Disease) in livestock. A survey was conducted to assess the current impact of Pimelea on livestock production, pasture systems, and financial losses among agricultural producers. In addition, information was also sought about the environmental conditions that facilitate its growth and the effectiveness of existing management strategies. The survey responses were obtained from producers affected by Pimelea across nine different Local Government Areas, through three States, viz., Queensland, New South Wales, and South Australia. Pimelea was reported to significantly affect animal production, with 97% of producers surveyed acknowledging its detrimental effects. Among livestock, cattle were the most severely affected (94%), when compared to sheep (13%), goats (3%), and horses (3%). The presence of Pimelea was mostly observed in spring (65%) and winter (48%), although 29% of respondents indicated that it could be present all year-round under favorable rainfall conditions. Germination was associated with light to moderate rainfall (52%), while only 24% linked it to heavy rainfall. Pimelea simplex F. Muell. was the most frequently encountered species (71%), followed by Pimelea trichostachya Lindl. (26%). Infestations were reported to occur annually by 47% of producers, with 41% noting occurrences every 2 to 5 years. Financially, producers estimated average annual losses of AUD 67,000, with 50% reporting an average of 26 cattle deaths per year, reaching up to 105 deaths in severe years. Some producers were spending up to AUD 2100 per annum to manage Pimelea. While chemical and physical controls were commonly employed, integrating competitive pastures and alternative livestock, such as sheep and goats, was considered as a potential management strategy. This study reiterates the need for further research on sustainable pasture management practices to reduce Pimelea-related risks to livestock and agricultural production systems. Full article

Background/Objectives: Maternal overweight and obesity are critical factors increasing the risk of various pregnancy complications. Maternal obesity can lead to fetal macrosomia and a heightened risk of intrauterine death, with long-term implications for the child’s health. This study aimed to analyze the incidence of obesity and its impact on pregnancy outcomes in women who delivered by cesarean section at the University Hospital “St. George”, Plovdiv. Methods: A single-center retrospective cohort study was conducted. The documentary method was used for gathering data. Records were randomly selected. The statistical methods used included mean values, confidence intervals (of mean), frequency, and the Kolmogorov–Smirnov test for normality of distribution. Data comparisons were performed using the Mann–Whitney test. Mean values of numerical variables were compared using the independent samples t-test. Results: In total, 46.36% of women in this study were affected by obesity to varying degrees, and the proportion of women who were overweight at the end of their pregnancy was 37.85%. In the studied cohort, 15.99% of women were affected by hypertensive complications. This significant prevalence of obesity highlights concerns regarding body weight among women of reproductive age. This study emphasized a strong correlation between maternal obesity, particularly severe obesity, and the occurrence of preeclampsia. Conclusions: In this study among women who delivered by cesarean section, a significant proportion of them were affected by overweight and obesity. Data for our country are insufficient, and a more in-depth study of this problem is needed. Future research should explore the long-term impacts of maternal obesity on the health of the mother and the newborn. Full article

Background: The Malnutrition Screening Tool (MST) is commonly used to identify malnutrition risk; however it has demonstrated poor sensitivity to detect malnutrition in inpatients with chronic kidney disease (CKD) and kidney replacement therapy (KRT) populations. Gastrointestinal symptoms, such as poor appetite, may better detect malnutrition. The accuracy of MST or other nutrition-related parameters to detect malnutrition in ambulatory patients with CKD stages 4–5 without KRT has not been evaluated. Methods: A single site retrospective audit of outpatient records from May 2020 to March 2025 was conducted. Patients with eGFR < 25 mL/min/1.73 m² without KRT who had both MST and a 7-point Subjective Global Assessment (SGA) within 7 days were included. Sensitivity, specificity, and ROC-AUC analyses compared nutritional parameters against SGA-defined malnutrition. Nutritional parameters tested included MST, hand grip strength, upper gastrointestinal symptom burden, poor appetite and a combination of some of these parameters. Results: Among 231 patients (68.8% male, median age 69 years, median eGFR 15), 29.9% were at risk of malnutrition (MST ≥ 2) and 33.8% malnourished (SGA ≤ 5). All potential screening tools had AUC ranging from 0.604 to 0.710, implying a poor-to-moderate discriminator ability to detect malnutrition. Combining HGS ≤ 29.5 kg or MST ≥2 demonstrated high sensitivity (95.5%) and negative predictive value (93.3%), but low specificity (33.3%) for detecting malnutrition, indicating this approach is effective for ruling out malnutrition but may over-identify at-risk individuals. Conclusions: MST and other tested tools showed limited overall accuracy to identify malnutrition. Using combined nutritional markers of HGS or MST score was the most sensitive tool for detecting malnutrition in this advanced CKD without KRT population. Full article

Medical education is the paradigm of 21st century education and the current changes involve the adoption of integrative and comprehensive patient-centered teaching and learning approaches. Thus, curricular developers from George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu Mures (G.E. Palade UMPhST of Targu Mures) have recently designed and implemented an innovative medical curriculum, as well as two valuable assessment tools for both theoretical knowledge and practical skills. Thus, during the first three preclinical years, the students will benefit from an organ- and system-centered block teaching approach, while the clinical years will focus on enabling students to achieve the most important practical skills in clinical practice, based on a patient bedside teaching system. In terms of theoretical knowledge assessment, the UNiX center at G.E. Palade UMPhST of Targu Mures, a recently designed center endowed with the latest next-generation technology, enables individualized, secured multiple-choice question-based assessments of the student’s learning outcomes. Moreover, an intelligent assessment tool for practical skills was also recently implemented in our branch in Hamburg, the Objective Structured Clinical Examination (O.S.C.E). This system uses direct observations for testing the student’s practical skills regarding anamnesis, clinical exams, procedures/maneuvers, the interpretation of laboratory tests and paraclinical investigations, differential diagnosis, management plans, communication, and medical counselling. The integrative, comprehensive, patient-centered curriculum and the intelligent assessment system, implemented in G.E Palade UMPhST of Targu Mures, help define innovation in education and enable the students to benefit from a high-quality medical education. Full article

Background: Immunological strategies for antibody-guided vaccine design intend to enhance viral neutralization and protection and increase efficacy. Here, we discuss advances in antibody-guided vaccine design and current antibody-guided strategies, including epitope-based, nanoparticle-based, and scaffold-based vaccine approaches. We review the challenges and limitations of vaccines against different pathogens, such as influenza A virus, HIV-1 virus, single-celled malaria parasite, respiratory syncytial virus, and SARS-CoV-2. We summarize the available literature guidance, including emerging techniques in immunological vaccine design, to help understand and improve antibody-based immunity. The search strategy we applied is a comprehensive literature review of major databases, with specific search terms related to antibody-mediated vaccine design, viral neutralization, and immune protection. We discuss the how future directions for next-generation vaccine platforms and personalized vaccines based on immunogenetics will help improve vaccine design for increased specificity and potency of antibodies that neutralize pathogens, offering more precise and effective immune responses and, therefore, protection. Full article

Very-high-energy electrons, coupled with ultra-high dose rates, are being explored for their potential use in radiotherapy to treat deep-seated tumours. The dose per pulse needed to achieve ultra-high dose rates far exceeds the limit of current medical linear accelerator capabilities. A high dose per pulse has been observed as the limiting factor for many existing dosimeters, resulting in saturation at doses far below what is required. The MOSkin, an existing clinical quality assurance dosimeter, has previously been demonstrated as dose rate independent but has not been subjected to a high dose per pulse. Within this study, the MOSkins dose-per-pulse response was tested for linearity, with a dose per pulse as high as 23 Gy within 200 ns at the ANSTO Australian Synchrotron’s Pulsed Energetic Electrons for Research facility. While using EBT-XD film as a reference dosimeter, a dose rate dependence of the EBT-XD was discovered. Once confirmed and a correction factor established, EBT-XD was used as an independent reference measurement. This work presents confirmation of the MOSkin suitability for ultra-high dose-rate environments with an electron energy of 100 MeV, and a theoretical discussion of its dose-rate and dose-per-pulse independence; the MOSkin is the only detector suitable for both clinical quality assurance, and ultra-high dose-rate measurements in its standard, unmodified form. Full article

Investigations of endogenous plant circular RNAs (circRNAs) in several plant species have revealed changes in their circular RNA profiles in response to biotic and abiotic stresses. Recently, circRNAs have emerged as critical regulators of gene expression. The destructive impacts on agriculture due to plant viral infections necessitate better discernment of the involvement of plant circRNAs during viral infection. However, few such studies have been conducted hitherto. Sobemoviruses cause great economic impacts on important crops such as rice, turnip, alfalfa, and wheat. Our current study investigates the dynamics of plant circRNA profiles in the host Arabidopsis thaliana (A. thaliana) during infections with the sobemoviruses Turnip rosette virus (TRoV) and Rice yellow mottle virus (RYMV), as well as the small circular satellite RNA of the Lucerne transient streak virus (scLTSV), focusing on circRNA dysregulation in the host plants and its potential implications in triggering plant cellular defense responses. Towards this, two rounds of deep sequencing were conducted on the RNA samples obtained from infected and uninfected plants followed by the analysis of circular RNA profiles using RNA-seq and extensive bioinformatic analyses. We identified 760 circRNAs, predominantly encoded in exonic regions and enriched in the chloroplast chromosome, suggesting them as key sites for circRNA generation during viral stress. Gene ontology (GO) analysis indicated that these circRNAs are mostly associated with plant development and protein binding, potentially influencing the expression of their host genes. Furthermore, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed photosynthesis as the most affected pathway. Interestingly, the non-coding exogenous scLTSV specifically induced several circRNAs, some of which contain open reading frames (ORFs) capable of encoding proteins. Our biochemical assays demonstrated that transgenic expression of scLTSV in A. thaliana enhanced resistance to TRoV, suggesting a novel strategy for improving plant viral resistance. Our results highlight the complexity of circRNA dynamics in plant–virus interactions and offer novel insights into potential circRNA-based strategies for enhancing plant disease resistance by modulating the differential expression of circRNAs. Full article

Endometriosis is a chronic gynecological pathology marked by the aberrant proliferation of tissue analogous to the endometrial lining outside the uterine cavity. This disorder frequently engenders persistent pelvic discomfort, infertility, and an extensive array of additional manifestations, including menorrhagia, dyspareunia, and gastrointestinal anomalies. Affecting an estimated 10% of women within the reproductive age demographic globally, endometriosis continues to present as a multifaceted and formidable challenge. The precise etiology remains elusive, leading to extended diagnostic intervals and personalized, often inadequate, therapeutic approaches. The intrinsic heterogeneity of endometriosis, evident in its varied phenotypes and clinical manifestations, further complicates both precise diagnosis and efficacious treatment. Conventional management hinges on hormonal interventions, which may not be appropriate for women desiring conception or for those experiencing substantial adverse effects. While surgical procedures are accessible, they do not provide a conclusive resolution, and the probability of recurrence remains high. Progress in diagnostic methodologies, such as non-invasive biomarker analyses, combined with an expanding understanding of the molecular and immunological frameworks that underpin the condition, presents promising prospects for the development of more targeted and individualized non-hormonal treatment modalities in the near future. Full article

Objectives: The goal of this study was to investigate lipid goal achievement rates in very high-risk patients over six months using high-intensity rosuvastatin or rosuvastatin/ezetimibe combination lipid-lowering therapy. Methods: This prospective, observational study was conducted on the patients of 150 general and 60 specialist practices. Our analysis included 3017 patients (47% women) who completed six months of therapy. Of these, 55.5% had pre-existing cardiovascular disease, 35.6% had cerebrovascular disease, and 20.4% had peripheral vascular disease. Results: At six months, in patients receiving rosuvastatin monotherapy (20.5%), the 1.8 LDL-C achievement rate was 37%; in those taking the fix rosuvastatin/ezetimibe combination (63.7%), it was 52%, and the 1.4 level attainment proved to be 11% and 22%, respectively. The rates of LDL-C reduction of at least 50% were 32% and 42%, respectively. Overall, non-HDL-C goal achievement rates were higher than when LDL-C was calculated using the Martin–Hopkins or Sampson methods but similar to those calculated with the Friedewald formula. When patients were stratified by triglyceride quartiles, non-HDL-C goal achievement rates were significantly higher (p < 0.001) in cases with triglyceride levels below 1.2 mmol/L. Conversely, Friedewald-calculated LDL-C (F-LDL-C) goal achievement rates were significantly higher (p < 0.001) in patients with triglyceride levels above 1.7 mmol/L. Conclusions: Our findings suggest that the consistent use of fixed high-intensity statin and ezetimibe combinations can improve lipid goal achievement. However, comparing the achievement of LDL-C goals (calculated by three methods) and non-HDL-C goals also confirmed that the common practice of automatically adding 0.8 mmol/L to the calculated LDL-C value to determine non-HDL-C leads to inaccuracies, particularly in the lower triglyceride ranges. Full article

Background: Teaching methodology has recently undergone significant evolution from traditional apprenticeship models as we adapt to ever-increasing rates of technological advancement. Big data, artificial intelligence, and machine learning are on the precipice of revolutionising all aspects of surgical practice, with far-reaching implications. Robotic platforms will increase in autonomy as machine learning rapidly becomes more sophisticated, and therefore training requirements will no longer slow innovation. Materials and Methods: A search of published studies discussing surgeon training and computer-enhanced simulation robotics and emerging technologies using MEDLINE, PubMed, EMBASE, Scopus, CRANE, CINAHL, and Web of Science was performed in January 2024. Online resources associated with proprietary technologies related to the subject matter were also utilised. Results: Following a review of 3209 articles, 91 of which were published, relevant articles on aspects of robotics-based computer-enhanced simulation, technologies, and education were included. Publications ranged from RCTs, cohort studies, meta-analysis, and systematic reviews. The content of eight medical technology-based websites was analysed and included in this review to ensure the most up-to-date information was analysed. Discussion: Surgeons should aim to be at the forefront of this revolution for the ultimate benefit of patients. Surgical exposure will no longer be due to incidental experiences. Rather, surgeons and trainees will have access to a complete database of simulated minimally invasive procedures, and procedural simulation certification will likely become a requisite from graduation to live operating to maintain rigorous patient safety standards. This review provides a comprehensive outline of the current and future status of surgical training in the robotic and digital era. Full article

The spore-forming probiotic Bacillus coagulans JBI-YZ6.3 interacts with the gut epithelium via its secreted metabolites as well as its cell walls, engaging pattern-recognition receptors on the epithelium. We evaluated its effects on human T84 gut epithelial cells using in vitro co-cultures, comparing metabolically active germinated spores to the isolated metabolite fraction and cell wall fraction under unstressed versus inflamed conditions. Germinated spores affected epithelial communication via chemokines interleukin-8, interferon gamma-induced protein-10, and macrophage inflammatory protein-1 alpha and beta after 2 and 24 h of co-culture. Non-linear dose responses confirmed that bacterial density affected the epigenetic state of the epithelial cells. In contrast, the cell wall fraction increased cytokine and chemokine levels under both normal and inflamed conditions, demonstrating that the intact bacterium had anti-inflammatory properties, regulating pro-inflammatory signals from its cell walls. During recovery from mechanical wounding, germinated spores accelerated healing, both in the absence and presence of LPS-induced inflammation; both the metabolite and cell wall fractions contributed to this effect. The release of zonulin, a regulator of tight junction integrity, was reduced by germinated spores after 2 h. These findings suggest that B. coagulans JBI-YZ6.3 modulates epithelial chemokine signaling, supports barrier integrity, and enhances epithelial resilience, highlighting its potential as an efficacious multi-faceted probiotic for gut health. Full article

Background/Objectives: Early care and education programs promote children’s social–emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. Methods: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers–Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children’s social–emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. Results: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. Conclusions: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention. Full article

Purpose: Socio-demographic inequities in mental health were magnified by COVID-19, with women experiencing greater household burden with less support in Canada and globally. While some health patterns during COVID-19 have been observed globally, there is a research gap in rural mental health during COVID-19 in Canada. We hypothesize there is a disparity in mental health decline during COVID-19 between men and women. Methods: In rural Ontario, mental health was measured through a survey of approximately 18,000 individuals living in seven counties. In 2021, survey respondents were asked to rate their mental health prior to and during COVID-19. Women reported poorer mental health during COVID-19 in comparison to men when tested via chi-squared tests, odds ratios, and percentage change. Responses to survey questions regarding social, financial, and mental health support were then evaluated. Findings: We found significant disparities in mental health ratings before and during COVID-19 between men and women. Women reported poorer mental health, increased substance use, and increased worry about social, financial, and community stressors. Respondents who self-identified as a woman were associated with poorer mental health outcomes. Conclusions: Interventions should be specific to geographic communities as well as individual needs (e.g., additional financial and childcare support). Rural communities need to be considered as independent geographies rather than as one geography (i.e., urban vs. rural). Full article

Objectives: This study compared the frequencies of circulating CD4+ T helper (Th) cell subsets in rheumatoid arthritis (RA) patients and healthy controls (HCs) and investigated their relationship with RA disease activity. Methods: Peripheral blood samples and demographic/clinical data were collected from 75 RA patients and 28 HCs from the A3BC Biobank. Flow cytometry was utilized to identify cell subsets. Data were analyzed using FlowJo and GraphPad Prism. Results: RA patients displayed altered Th cell subset frequencies compared with HCs, including a higher overall proportion of Th cells (p = 0.02) but lower proportions of memory Th (p = 0.03), Th1 (p < 0.0001), and Th17.1 (p = 0.004) cells. In DMARD-naïve RA patients (n = 16), lower proportions of Th1 (p = 0.0005), Th9 (p = 0.04), and Th17.1 (p = 0.003) cells, alongside a higher Th17 cell proportion (p = 0.017), were observed compared with those in HCs. Further analysis of matched treatment-naïve, new-onset RA patients and HCs confirmed these findings. Within the RA cohort, lower proportions of Th1 (p = 0.002) and Th17.1 (p = 0.025) cells and a higher proportion of Th2 cells (p = 0.015) were correlated with increased disease activity. Inverse correlations were also found between the proportions of Th1 (p = 0.002), Th9 (p = 0.024), and Th17.1 (p = 0.00017) cells and CRP levels in RA patients. Conclusions: This study demonstrates an imbalance in circulating Th cell subset frequencies in RA patients compared with those in HCs, with notably lower Th1 and Th17.1 cell proportions in RA patients. Decreased frequencies of these cell subsets were linked to increased disease activity, indicating that restoring the balance of Th cell subsets could be a potential therapeutic strategy for RA. Full article

Background: Uveitis encompasses a broad group of diseases with infectious and non-infectious etiologies, potentially leading to permanent and irreversible visual impairment. This study aimed to determine whether the etiology and anatomical location of uveitis influence the course and laterality of the disease. Methods: This retrospective observational study included patients with uveitis treated at the University Eye Clinic of “St. George” University Hospital in Plovdiv, Bulgaria, between January 2011 and December 2023. All participants underwent a comprehensive eye examination and minimal laboratory screening, with additional tests and specialist consultations performed when necessary. Uveitis cases were categorized into anterior, intermediate, posterior, and panuveitis according to anatomical location; unilateral or bilateral according to laterality; and acute, chronic, or recurrent based on disease course. Results: The study included 606 patients aged between 3 and 87 years. The etiology and anatomical location of uveitis were significantly associated with the course and laterality of the disease (p < 0.001). Anterior and posterior uveitis were mostly unilateral, with a defined cause and characterized by acute or recurring progression. Intermediate uveitis was mostly idiopathic and chronic, while panuveitis had a more uniform distribution regarding disease progression. Among cases with a determined etiology, HLA-B27-associated uveitis was the most common (32.5%), characterized by sequential involvement of both eyes and a recurrent course. Viral and toxoplasmic uveitis were more frequently unilateral. Conclusions: Our findings indicate that the etiology and anatomical location of uveitis can serve as prognostic factors for contralateral eye involvement and the progression of the inflammatory process. We found that anterior and posterior uveitis were predominantly unilateral and typically presented with an acute or recurrent course, whereas intermediate uveitis and panuveitis were more commonly chronic. In men, uveitis more often had an acute onset, while in women, it tended to follow a chronic course. Full article