Search Results (4,180)

Black tea is widely consumed worldwide, and its characteristic taste and color result from fermentation, where polyphenols are enzymatically oxidized to generate major pigments, including theaflavins (TFs), thearubigins (TRs), and theabrownins (TBs). This study investigated the effects of increased oxygen treatment during fermentation on the flavor attributes and chemical properties of Congou black tea. Fresh tea leaves (variety “Fuyun 6”) were subjected to four oxygen treatments: 0 h (CK), 1 h (TY-1h), 2 h (TY-2h), and 3 h (TY-3h), with oxygen supplied at 8.0 L/min. Sensory evaluation revealed that oxygen-treated samples exhibited tighter and deeper-colored leaves, a redder liquor, fuller taste, and a sweeter fragrance compared with CK. Chromatic analysis showed significant increases in redness (a*) and luminance (L*), alongside reduced yellowness (b*), indicating enhanced liquor color. Chemical analyses demonstrated elevated levels of TFs, TRs, and TBs in oxygen treatments, with TRs showing the most pronounced increase. Non-targeted metabolomics identified 2318 non-volatile and 761 volatile metabolites, highlighting upregulated flavonoids, phenolic acids, and lipids, and downregulated catechins and tannins, which collectively contributed to improved taste and aroma. Optimal results were achieved with 2–3 h of oxygen treatment, balancing pigment formation and sensory quality. These findings can provide a scientific basis for optimizing oxygen conditions in black tea fermentation to improve product quality. Full article

Tuberculosis (TB) is an ancient and re-emerging granulomatous infectious disease that continues to challenge public health. Early diagnosis and prompt effective treatment are crucial for preventing disease progression and reducing both morbidity and mortality. These steps play a vital role in infection control and in lowering death rates at both individual and population levels. Although diagnostic methods have improved sufficiently in recent decades, TB can still present with ambiguous laboratory and imaging features. This ambiguity can lead to diagnostic pitfalls and potentially disastrous outcomes due to delayed diagnosis. In this article, we present a case of TB that was difficult to diagnose. The disease had invaded the mediastinum, right atrium, right coronary artery, and inferior vena cava (IVC), resulting in Budd–Chiari syndrome. This rare presentation created clinical, laboratory, and radiological confusion, resulting in a diagnostic dilemma that ultimately led to open cardiac surgery. The patient initially presented with progressive shortness of breath on exertion and fatigue, which suggested possible heart disease. This suspicion was reinforced by computed tomography (CT) imaging, which showed infiltrative mass lesions predominantly in the right side of the heart, invading the right coronary artery and IVC, with imaging features mimicking angiosarcoma. Although laboratory findings revealed an exudative effusion with lymphocyte predominance and elevated adenosine deaminase (ADA), the Gram stain was negative for bacteria, and an acid-fast bacilli (AFB) smear was also negative. These findings contributed to diagnostic uncertainty and delayed the confirmation of TB. Open surgery with excisional biopsy and histopathological analysis ultimately confirmed TB. We conclude that TB should not be ruled out solely based on negative Mycobacterium bacteria in pericardial effusion or AFB smear. TB can mimic aggressive tumors such as angiosarcoma or lymphoma with invasion of the surrounding tissues and blood vessels. Awareness of the clinical presentation, imaging findings, and potential diagnostic pitfalls of TB is essential, especially in endemic regions. Full article

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

Background: Disease-modifying drugs (DMDs) for multiple sclerosis (MS) slightly increase the risk of tuberculosis (TB) disease. The QuantiFERON-TB-Plus (QFT-Plus) test is approved for TB infection (TBI) screening. Currently, there are no data available regarding the characterization of QFT-Plus response in patients with MS. Objectives: This study aimed to compare the magnitude of QFT-Plus responses between patients with MS and TBI (MS-TBI) and TBI subjects without MS (NON-MS-TBI). Additionally, discordant responses to TB1/TB2 stimulation were documented. Results were evaluated considering demographic and clinical data, particularly the impact of DMDs and the type of TB exposure. Methods: Patients with MS (N = 810) were screened for TBI (2018–2023). Thirty (3.7%) had an MS-TBI diagnosis, and 20 were recruited for the study. As a control group, we enrolled 106 NON-MS-TBI. Results: MS-TBI showed significantly lower IFN-γ production in response to TB1 (p = 0.01) and TB2 stimulation (p = 0.02) compared to NON-MS-TBI. The 30% of TB2 results of MS-TBI fell into the QFT-Plus grey zone (0.2–0.7 IU/mL). Only 7% of NON-MS-TBI showed this profile (p = 0.002). Conclusions: MS-TBI had a lower QFT-Plus response and more borderline results compared to NON-MS-TBI. Future studies should clarify the significance of the borderline results in this vulnerable population to improve QFT-Plus accuracy regarding sensitivity, specificity, and TB prediction. Full article

Recent advancements in deep learning have significantly enhanced brain tumor segmentation from MRI data, providing valuable support for clinical diagnosis and treatment planning. However, challenges persist in effectively integrating prior medical knowledge, capturing global multimodal features, and accurately delineating tumor boundaries. To address these challenges, the Hybrid Network for Multimodal Brain Tumor Segmentation (HN-MBTS) is proposed, which incorporates prior medical knowledge to refine feature extraction and boundary precision. Key innovations include the Two-Branch, Two-Model Attention (TB-TMA) module for efficient multimodal feature fusion, the Linear Attention Mamba (LAM) module for robust multi-scale feature modeling, and the Residual Attention (RA) module for enhanced boundary refinement. Experimental results demonstrate that this method significantly outperforms existing approaches. On the BraT2020 and BraT2023 datasets, the method achieved average Dice scores of 87.66% and 88.07%, respectively. These results confirm the superior segmentation accuracy and efficiency of the approach, highlighting its potential to provide valuable assistance in clinical settings. Full article

Ant venoms are rich sources of bioactive molecules, including peptide toxins with potent and selective activity on ion channels, which makes them valuable for pharmacological research and therapeutic development. Voltage-dependent potassium (Kv) channels, critical for regulating cellular excitability or cell cycle progression control, are targeted by a diverse array of venom-derived peptides. This study focuses on MYRTX_A4-Tb11a, a peptide from Tetramorium bicarinatum venom, which was previously shown to have a strong paralytic effect on dipteran species without cytotoxicity on insect cells. In the present study, we show that Tb11a exhibited no or low cytotoxicity toward mammalian cells either, even at high concentrations, while electrophysiological studies revealed a blockade of hKv1.3 activity. Additionally, Ta11a, an analog of Tb11a from the ant Tetramorium africanum, demonstrated similar Kv1.3 inhibitory properties. Structural analysis supports that the peptide acts on Kv1.3 channels through the functional dyad Y21-K25 and that the disulfide bridge is essential for biological activity, as reduction seems to disrupt the peptide conformation and impair the dyad. These findings highlight the importance of three-dimensional structure in channel modulation and establish Tb11a and Ta11a as promising Kv1.3 inhibitors. Future research should investigate their selectivity across additional ion channels and employ structure-function studies to further enhance their pharmacological potential. Full article

Introduction: Despite the key role of healthcare workers (HCWs) in tuberculosis (TB) prevention and control, there is a lack of regional data on their knowledge, attitudes, and practices (KAPs) regarding the disease in Atlantic Canada. Objectives: To assess the KAPs of HCWs and identify targets for educational interventions to enhance TB care and control. Methods: A cross-sectional study was conducted among HCWs in Atlantic Canada aged $\ge$19 years from October 2023 to February 2024. Participants were recruited via multiple channels such as social media, collegiate email lists, and snowball sampling. Survey data were collected using an online platform and analyzed using IBM SPSS Statistics v29. KAPs were assessed using Likert-type scales and internal consistency was evaluated using Cronbach’s alpha. Results: A total of 157 HCWs participated in this study (age range: 19 to 69 years); most were women (n = 145, 92%), born in Canada (n = 134, 85.4%), with nearly three-quarters (n = 115, 73.2%) who had never lived outside of Canada. Study participants demonstrated moderately high knowledge (M = 29.32, SD = 3.25) and positive attitudes (M = 3.87, SD = 0.37) towards TB and strong practices (M = 4.24, SD = 0.69) in TB care; however, gaps were identified in HCW abilities to recognize less common TB symptoms (e.g., rash and nausea), as well as inconsistent practices in ventilation and pre-treatment initiation. Internal consistency analysis indicated suboptimal reliability across all three KAP domains, with Cronbach’s alpha values falling below 0.7, thwarting further planned analyses. Conclusions: This study found overall moderate-to-strong TB-related KAPs among HCWs in Atlantic Canada; however, critical gaps in knowledge and practice were noted. This new information can now guide future educational initiatives and targeted training to enhance TB preparedness and ensure equitable care for patients in the region. Full article

Background: Stigma associated with tuberculosis (TB) continues to undermine patient well-being, treatment adherence, and public health goals and objectives. This study aims to systematically review the literature to identify and synthesize TB stigma reduction interventions published between 2015 and 2025. Methods: Following the PRISMA guidelines, we conducted a comprehensive literature search across PubMed, Scopus, Science Direct, ProQuest, and Google Scholar. Eligible studies included those with qualitative, quantitative, and mixed-methods designs that focused on interventions related to TB-related stigma. We categorized the studies into three groups: (1) intervention development studies, (2) TB treatment programs with stigma reduction outcomes, (3) stigma-specific interventions. Data extraction and quality appraisal were conducted independently by two reviewers using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 15 studies met the inclusion criteria. Five studies focused on co-developing stigma interventions, which incorporated multi-level and multicomponent strategies targeting internalized, enacted, anticipated, and intersectional stigma. Two studies assessed TB treatment-related interventions (e.g., home-based care, digital adherence tools) with incidental stigma reduction effects. The remaining seven studies implemented stigma-targeted interventions, including educational programs, video-based therapy, peer-led support, and anti-self-stigma toolkits. Interventions addressed stigma across individual, interpersonal, institutional, community, and policy levels. Conclusions: This review highlights the evolution and diversification of TB stigma interventions over the past decade. While earlier interventions emphasized education and support, recent strategies increasingly integrate peer leadership, digital platforms, and socio-ecological frameworks. The findings underscore the need for comprehensive, contextually grounded interventions that reflect the lived experiences of people affected by TB. Full article

Background/Objectives: Romania remains a tuberculosis (TB) hotspot in the European Union, yet host-derived factors of poor outcomes are poorly characterised. We quantified circulating pro-inflammatory cytokines and examined their interplay with behavioural risk factors, the nutritional status, and the clinical course in adults hospitalised with pulmonary TB. We analysed 80 adults with microbiologically confirmed pulmonary TB and 40 respiratory symptom controls; four TB patients (5%) died during hospitalisation, all within 10 days of admission. Methods: A retrospective analytical case–control study was conducted at the Constanța regional TB referral centre (October 2020—October 2023). Patients with smear- or culture-confirmed TB were frequency-matched by sex, 10-year age band, and BMI class to culture-negative respiratory controls at a 2:1 ratio. The patients’ serum interferon-γ (IFN-γ), interleukin-1α (IL-1α), interleukin-1β (IL-1β), and tumour-necrosis-factor-α (TNF-α) were quantified within 24 h of admission; the neutrophil/lymphocyte ratio (NLR) was extracted from full blood counts. Independent predictors of in-hospital mortality were identified by multivariable logistic regression; factors associated with the length of stay (LOS) were modelled with quasi-Poisson regression. Results: The median TNF-α (24.1 pg mL⁻¹ vs. 16.2 pg mL⁻¹; p = 0.009) and IL-1β (5.34 pg mL⁻¹ vs. 3.67 pg mL⁻¹; p = 0.008) were significantly higher in the TB cases than in controls. TNF-α was strongly correlated with IL-1β (ρ = 0.80; p < 0.001), while NLR showed weak concordance with multiplex cytokine patterns. Among the patients with TB, four early deaths (5%) exhibited a tripling of TNF-α (71.4 pg mL⁻¹) and a doubling of NLR (7.8) compared with the survivors. Each 10 pg mL⁻¹ rise in TNF-α independently increased the odds of in-hospital death by 1.8-fold (95% CI 1.1–3.0; p = 0.02). The LOS (median 29 days) was unrelated to the smoking, alcohol, or comorbidity load, but varied across BMI strata: underweight, 27 days; normal weight, 30 days; overweight, 23 days (Kruskal–Wallis p = 0.03). In a multivariable analysis, under-nutrition (BMI < 18.5 kg m⁻²) prolonged the LOS by 19% (IRR 1.19; 95% CI 1.05–1.34; p = 0.004) independently of the disease severity. Conclusions: A hyper-TNF-α/IL-1β systemic signature correlates with early mortality in Romanian pulmonary TB, while under-nutrition is the dominant modifiable determinant of prolonged hospitalisation. Admission algorithms that pair rapid TNF-α testing with systematic nutritional assessment could enable targeted host-directed therapy trials and optimise bed utilisation in high-burden settings. Full article

The exponential increase in electronic waste (e-waste) from end-of-life electrical and electronic equipment presents a growing environmental challenge. E-waste contains high concentrations of rare earth elements (REEs), which are classified as critical raw materials (CRMs). Their removal and recovery from contaminated systems not only mitigate pollution but also support resource sustainability within a circular economy framework. The present study proposed the use of hazelnut shells as a biosorbent to reduce water contamination and recover REEs. The sorption capabilities of this lignocellulosic material were assessed and optimized using the response surface methodology (RSM) combined with a Box–Behnken Design (three factors, three levels). Factors such as pH (4 to 8), salinity (0 to 30), and biosorbent dose (0.25 to 0.75 g/L) were evaluated in a complex mixture containing 9 REEs (Y, La, Ce, Pr, Nd, Eu, Gd, Tb and Dy; equimolar concentration of 1 µmol/L). Salinity was found to be the factor with greater significance for REEs sorption efficiency, followed by water pH and biosorbent dose. At a pH of 7, salinity of 0, biosorbent dose of 0.75 g/L, and a contact time of 48 h, optimal conditions were observed, achieving removals of 100% for Gd and Eu and between 81 and 99% for other REEs. Optimized conditions were also predicted to maximize the REEs concentration in the biosorbent, which allowed us to obtain values (total REEs content of 2.69 mg/g) higher than those in some ores. These results underscore the high potential of this agricultural waste with no relevant commercial value to improve water quality while providing an alternative source of elements of interest for reuse (circular economy). Full article

Extrapulmonary tuberculosis (EPTB) remains diagnostically challenging due to its paucibacillary nature and variable presentation. Xpert and culture are limited in EPTB diagnosis due to sampling challenges, low sensitivity, and long turnaround times. This study evaluated the performance of the MPT64 antigen detection test for diagnosing EPTB, particularly tuberculous lymphadenitis (TBLN) and tuberculous pleuritis (TBP), in a high-TB, low-HIV setting. Conducted at Gulab-Devi Hospital, Lahore, Pakistan, this study evaluated the MPT64 test’s performance against conventional diagnostic methods, including culture, histopathology, and the Xpert MTB/RIF assay. Lymph node biopsies were collected, and cell blocks were made from aspirated pleural fluid from patients clinically presumed to have EPTB. Of 338 patients, 318 (94%) were diagnosed with EPTB. For TBLN, MPT64 demonstrated higher sensitivity (84%) than Xpert (48%); for TBP, the sensitivity was 51% versus 7%, respectively. Among histopathology-confirmed TBLN cases, MPT64 outperformed both culture and Xpert (85% vs. 58% and 47%). Due to the low number of non-TB cases, specificity could not be reliably assessed. The MPT64 test shows promise as a rapid, sensitive diagnostic tool for EPTB, particularly TBLN, in routine settings. While sensitivity is notably superior to Xpert, further studies are needed to evaluate its specificity and broader diagnostic utility. Full article

Background: This study aims to evaluate the efficacy of a combined transcranial magnetic stimulation (TMS) protocol incorporating intermittent theta burst stimulation (iTBS) and low-frequency TMS in adults diagnosed with first-episode and recurrent depressive disorders. Methods: A prospective, double-blind, parallel-group trial was conducted involving 42 participants (21 with first-episode depressive disorder and 21 with recurrent depressive disorder) recruited from Chengdu, China. All subjects received 10 sessions of TMS over two weeks. The primary outcome measure was suicidal ideation, assessed using the Beck scale for suicide ideation. Secondary outcomes included sleep quality, depressive symptoms, anhedonia, and cognitive function. Event-related potentials (ERPs) were also recorded. Data were analyzed using SPSS V.21.0, with statistical significance defined as p < 0.05. Results: Both patient groups exhibited significant reductions in suicidal ideation following the composite TMS intervention. Secondary outcomes showed significant improvements in sleep quality, overall depressive symptoms, anhedonia, and cognitive function. Notably, a significant association was found between improvements in sleep quality and depressive symptoms in the first-episode group, suggesting differential underlying mechanisms compared to recurrent depression. Limitations: The relatively short intervention and follow-up period limits the ability to assess the long-term sustainability of the observed benefits. Future studies with extended follow-up periods are warranted to evaluate the persistence of TMS effects and the potential need for maintenance sessions. Conclusions: The combined protocol of iTBS and low-frequency TMS effectively reduces suicidal ideation and improves various clinical outcomes in both first-episode and recurrent depressive disorders, indicating the effectiveness of the physical intervention, especially for the first-episode patients. These findings underscore the importance of personalized treatment strategies based on the clinical history of depressive episodes. Further research with longer follow-up periods is warranted to assess the long-term sustainability of TMS effects. Full article

Latent tuberculosis infection (LTBI) remains an important public health issue, as individuals can harbor Mycobacterium tuberculosis without symptoms and later develop active disease. This study aimed to assess the prevalence and risk factors associated with LTBI positivity among tuberculosis (TB) contacts in congregate settings in Gyeongsan City, the Republic of Korea (ROK), from 2014 to 2023. A total of 213 index cases and 3666 contacts were analyzed using data from the Korea Tuberculosis Infection Control System (KTB-NET). Overall, 20.7% of contacts tested positive for LTBI, with the highest rates observed among contacts aged ≥65 years (50.4%) and in healthcare facilities (34.8%). Binary logistic regression analyses revealed that age ≥65 years (OR: 2.93; 95% CI: 1.95–4.39; p < 0.001), social welfare facilities (OR: 2.75; 95% CI: 2.10–3.58; p < 0.001), workplaces (OR: 2.42; 95% CI: 1.88–3.10; p < 0.001), and healthcare facilities (OR: 3.42; 95% CI: 2.63–4.43; p < 0.001) were significantly associated with increased LTBI risk. These findings highlight the importance of targeted interventions and prevention strategies focused on older adults and high-risk groups to prevent future TB outbreaks by reducing the burden of LTBI. Full article

Bacillus species have shown the potential to recover rare earth elements (REEs), but strains with adsorption selectivity for terbium(III) remain understudied. In this study, six Bacillus strains with the capability for efficient adsorption of Tb(III) were screened from an ionic rare earth mine and were identified based on 16S rRNA gene sequencing. Adsorption experiments showed that Bacillus sp. DW011 exhibited exceptional Tb(III) adsorption efficiency, with an adsorption rate of 90.45% and adsorption selectivity for heavy rare earth elements. Notably, strain DW011 was also found to be tolerant against Tb(III) with the 24 h 50% lethal concentration (LC₅₀) of 2.62 mM. The biosorption mechanisms of DW011 were investigated using adsorption kinetics, SEM-EDS, and FTIR. The results indicated that the adsorption of strain DW011 conforms to the second-order kinetic model, and the teichoic acid–peptidoglycan network (phosphate-dominated) serves as the primary site for heavy REE adsorption, while carboxyl/amino groups in the biomembrane matrix provide secondary sites for LREEs. This study provides new information that Bacillus strains isolated from ionic rare earth mine deposits have potential as green adsorbents and have high selectivity for the adsorption of heavy REEs, providing a sustainable strategy for REE recovery from wastewaters. Full article

Calcium microcapsules were developed by spray-drying using mannoproteins (MPs) extracted from brewer’s spent yeast, xanthan gum (XG), and maltodextrin as encapsulating materials. The formulas included 11 g of calcium, 24 g of MP, and 0, 2, 4, or 8 g of XG 100 g⁻¹ solids, obtaining C1, C2, C3, and C4 microcapsules, respectively. Maltodextrin was added to complete 100 g of solids. Calcium intestinal (IB), colonic (CB), and total bioaccessibility (TB) were estimated after a simulated gastrointestinal digestion followed by in vitro colonic fermentation. The macromolecules of microcapsules interacted by ionic and hydrophobic forces. Microcapsules C1 and C2 showed a spherical shape. However, the addition of XG to the formulation contributed to the formation of concavities in the microcapsules. All microcapsules had higher IB than the control (CaCl₂), probably due to the calcium-chelating peptides dialyzed from MP. Moreover, C1 and C2 showed the highest IB values (≈23%). However, C3 and C4 showed the highest CB values (≈11%), attributing this effect to the short-chain fatty acids produced during colonic fermentation. Finally, C1 and C2 showed the highest TB (31.8 ± 0.1 and 32.0 ± 0.4%, respectively). The use of MP allowed for obtaining a supplement with high calcium bioaccessibility. Full article