Search Results (22,481)

Mandibular prognathism (Class III malocclusion) is a craniofacial anomaly characterized by an anteriorly positioned mandible, a concave facial profile and impaired mastication, and appears unusually frequently in Dolang sheep (Ovis aries). We combined clinical phenotyping and three-dimensional (3D) genome profiling to investigate this trait in a Dolang sheep flock. We examined 959 animals using standardized criteria, estimated a local prevalence of 10.3%, and assembled a 200 affected/200 unaffected case–control cohort for genomic analyses. As an exploratory pilot study of 3D genome architecture, we generated in situ Hi-C datasets from mandibular bone of two affected and two control sheep. At 40 kb resolution, global topologically associating domain (TAD) organization and boundary strength were broadly conserved between groups, but sliding-window analyses identified a small number of 1 Mb hotspots where affected animals showed increased TAD-boundary density and strengthened insulation. These UNDER-enriched windows lay near genes with plausible roles in craniofacial development, including ROBO2, COL27A1, VRK2 and a cytokine cluster (IL22/IL26/IFNG with MDM1). Together, our data indicate that mandibular prognathism in Dolang sheep is associated with localized remodeling of chromatin insulation at a restricted set of gene-proximal loci and highlight candidate regions and mechanisms for integration with whole-genome sequencing, association and transcriptomic data. Full article

Chronic kidney disease (CKD) is a frequent and clinically significant comorbidity in patients with rheumatoid arthritis (RA), with a reported prevalence ranging from 20% to 50% depending on the cohort and definition applied. The high burden of CKD in RA reflects the complex interplay between traditional risk factors (aging, hypertension, diabetes, and dyslipidemia) and RA-specific factors such as persistent systemic inflammation, immune complex deposition, and long-term exposure to nephrotoxic agents, including older DMARDs (gold, D-penicillamine) and calcineurin inhibitors. Histopathologically, RA-associated kidney involvement encompasses a broad spectrum of conditions, including mesangial proliferative glomerulonephritis, membranous nephropathy, AA amyloidosis, and drug-induced interstitial nephritis. Recent advances in RA therapy, particularly the widespread use of biologic DMARDs, have markedly reduced the incidence of AA amyloidosis and may exert indirect renoprotective effects through stringent inflammation control. However, targeted synthetic DMARDs such as Janus kinase (JAK) inhibitors require careful dose adjustment in CKD and heightened infection vigilance. CKD in RA is a strong predictor of cardiovascular events, serious infections, and all-cause mortality. Importantly, recent data indicate that even low-grade albuminuria below the traditional microalbuminuria threshold is associated with excess mortality in RA. Early detection through routine monitoring of eGFR and urinary albumin-to-creatinine ratio (uACR), combined with individualized pharmacologic adjustment and close collaboration with nephrologists, is essential for optimizing long-term outcomes. This review provides an updated synthesis of the epidemiology, pathophysiological mechanisms, therapeutic strategies, and prognostic implications of CKD in RA, with a particular focus on both Japanese and international evidence. Full article

Background/Objectives: Late-life depression is prevalent yet frequently underdiagnosed, underscoring the need for accessible and safe non-pharmacological approaches. Pet-assisted interventions, including live animal-assisted therapy and robotic pets, have gained attention, but their comparative effectiveness remains unclear. This study aimed to evaluate and rank different pet-assisted approaches for reducing depressive symptoms in older adults using network meta-analysis. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library up to August 2025 for randomized controlled trials involving adults aged 60 years or older with depression. The protocol was prospectively registered on INPLASY (INPLASY2025100023). Depression severity, assessed using validated scales, was synthesized using a frequentist random-effects network meta-analysis framework. Results: Twenty trials involving 1073 participants were included. Live animal-assisted therapy produced the greatest reduction in depressive symptoms versus passive control (SMD −2.04; 95% CI −3.03 to −1.04). Combining it with gait training (structured walking-based activity conducted with the animal) was associated with a reduction in depressive symptoms (SMD −4.82; 95% CI −6.69 to −2.95). Robotic pets showed a directionally beneficial but non-significant effect (SMD −1.21; 95% CI −2.79 to 0.38). Conclusions: Pet-assisted interventions are effective in reducing depressive symptoms among older adults. Live animal-assisted therapy, particularly when delivered in structured or combined formats, shows the greater benefit. Robotic pets may serve as a practical alternative when live animals cannot be implemented. Full article

Background: Osteoarthritis (OA) is a prevalent degenerative joint disease and a major cause of disability in the aging population. Total knee arthroplasty (TKA) is a common intervention for advanced OA, yet postoperative outcomes may vary, particularly among individuals with obesity. Elevated body mass index (BMI) is a recognized risk factor for the development and progression of OA and may influence perioperative and postoperative complication rates. Objective: This literature review evaluates whether a specific BMI threshold should guide eligibility for primary TKA, with particular emphasis on the impact of BMI on surgical risk, implant outcomes, and functional recovery. Methods: A systematic search was conducted across PubMed (MEDLINE), Cochrane Library, EMBASE, and Google Scholar to identify peer-reviewed studies from the past two decades examining the relationship between BMI and clinical outcomes following primary TKA. Findings: Higher BMI—especially ≥40 kg/m²—is consistently associated with increased perioperative and postoperative complications, including wound issues, infection, thromboembolic events, longer hospital stay, and higher revision risk. Despite these elevated risks, evidence demonstrates that obese and morbidly obese patients experience substantial improvements in pain, mobility, and function that are comparable in magnitude to those seen in non-obese individuals. The literature does not support a universally applicable BMI cutoff for determining surgical eligibility. Conclusions: BMI is an important modifier of surgical risk but should not be used as an absolute criterion for excluding patients from TKA. Instead, a personalized approach is recommended—one that considers BMI within the context of comorbidities, functional limitation, patient motivation, and opportunities for preoperative optimization. With appropriate patient selection and risk-mitigation strategies, TKA remains a clinically valuable and justified intervention across all BMI categories. Full article

Background/Objectives: This study aims to evaluate COVID-19 parental vaccine hesitancy (CPVH) and refusal among parents of children between 5 and 11 years and to identify potential factors influencing them. A secondary aim was to assess knowledge, concerns, and beliefs associated with COVID-19 and immunization. Methods: This cross-sectional study was conducted among parents of children between 5 and 11 years using an anonymous, self-administered questionnaire. Sociodemographic characteristics, knowledge, concerns, and beliefs regarding COVID-19 and immunization in children; CPVH according to Parent Attitudes about Childhood Vaccines short scale; COVID-19 vaccination status and intention; and sources of information about COVID-19 vaccination were investigated. Results: Among 506 participating parents, only 12.7% correctly answered all six knowledge items. High CPVH was found in 60.1% of respondents and was more prevalent among younger parents and those with lower knowledge levels. Compared to having received no information on COVID-19 vaccination, high CPVH was positively associated with having received information from informal sources and trusting them and negatively associated with information from formal ones. More than half (58.3%) had vaccinated their child, and 38.5% had no intention to vaccinate their child against COVID-19. High CPVH, lower knowledge levels, and a need for further information were significant predictors of vaccine refusal. Conversely, refusal was negatively associated with parental COVID-19 vaccination status, and with having received information from formal and from both formal and informal sources compared to not having received information. Conclusions: The findings highlight the need for establishing and investing in platforms to promote vaccine awareness and dispelling misinformation among parents. Full article

Background and Objectives: Osteoporosis is a prevalent skeletal disorder characterized by decreased bone mass and compromised bone microarchitecture, leading to an elevated risk of fractures and significant morbidity, particularly among aging populations. Early diagnosis and personalized management are critical to reducing fracture incidence and associated healthcare burdens. Recent advances in artificial intelligence (AI) and machine learning (ML) have led to potential improvements in enhancing osteoporosis care by enabling accurate diagnostic imaging analysis, robust fracture risk prediction, and personalized therapeutic strategies. Materials and Methods: We performed a narrative review to summarize and critically evaluate the current literature on AI and ML applications in osteoporosis diagnosis and management. We searched relevant literature from inception to January 2025 to provide a comprehensive perspective, focusing on key themes, methodological approaches, and clinical implications. Results: Deep learning models, especially convolutional neural networks, facilitate rapid and accurate bone mineral density assessment from routine radiographs, expanding screening capabilities beyond conventional dual-energy X-ray absorptiometry (DXA). Machine learning algorithms harness clinical and demographic data to generate fracture risk models that often outperform traditional tools, enabling timely identification of high-risk individuals. Furthermore, AI-driven analyses of historical treatment responses coupled with real-time monitoring through wearable technologies and mobile applications allow for personalized therapeutic optimization and enhance patient engagement. Despite these promising advances, challenges remain regarding ethical considerations, data privacy, legal liability, incomplete model validation, lack of standardization, and the need for critical appraisal of real-world clinical efficacy for widespread clinical adoption. Conclusions: This narrative review indicates that AI and ML hold significant promise to revolutionize osteoporosis management by enabling early detection, precise risk stratification, and tailored interventions. However, the current evidence is heterogeneous, often lacking robust external validation and quantitative synthesis. Critical gaps include insufficient evaluation of model robustness across diverse populations, discussion of negative or conflicting results, and a comprehensive assessment of the limitations inherent in current AI evidence. Strategic efforts to validate, regulate, and critically integrate these technologies into routine clinical workflows are essential to realize their full potential and address the growing burden of osteoporosis worldwide. Full article

Background: Childhood obesity is a persistent global health challenge, often rooted in early-life dietary patterns shaped within the home environment. Objective: To investigate the association between parents’ culinary skills, children’s eating behavior, and the degree of child involvement in family culinary practices. Methods: A cross-sectional, analytical study. In the public and private schools in southern Brazil. A total of 205 families with children aged 3 to 13 years participated. Parents or caregivers answered a structured questionnaire on culinary skills and sociodemographic variables. Children’s eating behavior was assessed through the validated Brazilian version of the Children’s Eating Behaviour Questionnaire (CEBQ). Student’s T test was used to compare means, and Pearson’s chi-square or Fisher’s exact test to compare proportions. Multivariate linear regression was applied to control for potential confounders. Analyses were conducted using SPSS version 27.0 and R software. Results: Most parents (90.7%) reported cooking regularly, and 65.9% involved children in cooking activities. The predominant culinary profile (40%) was classified as “convenience cooking,” marked by frequent use of processed ingredients. Healthier parental cooking practices were positively associated with adaptive eating behaviors in children, reflected by lower food fussiness, satiety responsiveness, food responsiveness and food refusal scores and higher enjoyment of food scores domains of the CEBQ. Conclusions: Despite the high prevalence of routine cooking, convenience-oriented practices remain dominant, reflecting broader sociocultural patterns. Engagement in healthier cooking practices was positively associated with more favorable eating behaviors in children. These findings underscore the importance of promoting culinary education and parental involvement in cooking as strategies to support healthy childhood eating behaviors. Full article

Background: Smoking has a detrimental effect on the periodontal condition. Smoking intensity has recently been considered as a criterion for grading periodontitis cases. However, the influence of smoking intensity on the subgingival microbial community has not been evaluated in depth. This cross-sectional analytical study aims to assess the differences in the subgingival microbiome in adult patients with chronic periodontitis and different smoking habits (heavy smokers versus moderate smokers versus non-smokers). Methods: Sixty patients diagnosed with chronic periodontitis were grouped according to their daily smoking intensity as follows: group I (smoke ≥ 10 cigarettes/day), group II (smoke < 10 cigarettes/day), and non-smokers (group III). For each patient, samples from subgingival plaque were harvested from the deepest three periodontal pockets, and their 16S rRNA was sequenced using the S5 Ion Torrent platform. Sequences were clustered in taxonomic units, and the microbial diversity was expressed using the Shannon index or Simpson index, while the abundance of the microbial species was expressed using the Chao index. Results: Bacterial diversity was lowest in the heavy smoker group (group I) and highest in non-smokers (group III). Veillonella, Streptococcus, Prevotella, Fusobacterium, and Dialister were found to have different prevalences in the three study groups. Campylobacter decreased and Fusobacterium increased as a function of the number of cigarettes smoked per day. The moderate smoker group showed a higher abundance of Spirochaetes. At the species level, the heavy smoker group (group I) showed a higher abundance of Fusobacterium compared to the other two groups. Conclusions: Greater smoking intensity has been associated with higher Fusobacterium abundance, together with decreased diversity of the subgingival microbiome, establishing a more stable putative subgingival bacterial environment. Full article

Steatotic liver disease (SLD) represents a major global health burden, with environmental toxicants emerging as critical contributors alongside metabolic dysfunction. Bisphenol F (BPF), an increasingly prevalent replacement for bisphenol A, is widely detected in human biological samples and environment, yet its hepatotoxic mechanisms remain incompletely characterized. This review synthesizes current evidence on BPF-induced SLD, with a particular focus on resolving the “pregnane X receptor (PXR) paradox”, the mismatch between BPF’s weak direct activation of PXR and the PXR-like metabolic effects observed in vivo. Comprehensive analysis of mechanistic pathways reveals that BPF-induced SLD develops predominantly through PXR-independent mechanisms involving oxidative stress, endoplasmic reticulum dysfunction, Drp1-mediated mitochondrial fission, NLRP3/NF-κB-driven inflammation, dysregulated post-translational modifications, and epigenetic remodelling. These converging pathways collectively disrupt hepatic lipid metabolism, promote triglyceride accumulation, and establish a self-perpetuating cycle of metabolic dysfunction. Notably, weak indirect PXR modulation via oxidative stress represents a secondary, non-causal mechanism unsupported by functional validation. This framework distinguishes toxicant-induced steatosis from metabolic dysfunction-associated steatotic liver disease while highlighting critical evidence gaps—particularly the absence of causal PXR validation studies and human epidemiological data. Therapeutic opportunities exist at validated convergence points including mitochondrial dynamics (Drp1), inflammatory signalling (NLRP3/NF-κB), and energy metabolism (AMPK-mTOR), though combination strategies targeting multiple pathways will likely be required for durable disease reversal. These findings necessitate the expansion of regulatory screening paradigms to incorporate cellular stress pathway biomarkers alongside traditional nuclear receptor endpoints, ensuring comprehensive hepatotoxic risk assessment of emerging BPA substitutes. Full article

Cattle tick fever (CTF), caused by Anaplasma marginale, Babesia bovis and Babesia bigemina, remains a sanitary and economic challenge for cattle farming in Brazil. Thus, this study evaluated the prevalence, regional distribution, co-infection patterns, and risk factors associated with CTF causative agents in cattle the semi-arid region of Paraíba, the semi-arid region of Ceará, and the Tropical Humid region of Paraíba, Northeast Brazil. Blood samples were collected from 336 cattle, from 60 farms, and analyzed by means of conventional PCR and nested-PCR, while epidemiological data were obtained through questionnaires applied to producers. The overall infection prevalence by at least one pathogen was 82.7% (278/336), with higher rates in the tropical humid region of Paraíba at 94.8% (109/115), followed by the semi-arid region of Ceará, with 88.1% (89/101) and the semi-arid region of Paraíba with 66.6% (80/120). Co-infections were frequent, especially the association between A. marginale and B. bigemina, detected in 23.2% (78/336) of the animals, while triple infections occurred in 15.8% (53/336) and were most frequent in the semi-arid region of Ceará at 21.8% (22/101). The semi-arid region of Paraíba had the fewest entirely positive properties (7/20) and the highest number of entirely negative properties (2/20). The tropical humid region of Paraíba had the highest number of entirely positive properties (17/21), with no properties entirely free of CTF agents. Multivariate analysis identified the presence of horn fly (OR = 7.23; CI 3.05–18.86; 95% CI), needle reuse (OR = 5.8; CI: 2.62–13.90; 95% CI), animal purchase and introduction without quarantine (OR = 5.4; CI: 2.17–14.93; 95% CI), and pasture sharing (OR = 3.21; CI: 1.08–11.25; 95% CI) as risk factors, while beef herds showed lower susceptibility (OR = 0.28; CI: 0.15–0.52; 95% CI). These findings demonstrate that infections by CTF causative agents are endemic but exhibit region-specific epidemiological patterns, reflecting the combined effects of climate and management practices, and localized transmission foci that may be intensified by commercial cattle movement. Full article

This scoping review aimed to summarize the current literature on the etiological and pathophysiological mechanisms associated with the development of retrograde cricopharyngeus dysfunction (R-CPD) through a PRISMA literature search. According to the current literature, a family history of R-CPD was reported in 28.0% of patients across studies, with childhood onset in 55.5% of cases. Gastroesophageal reflux disease and laryngopharyngeal reflux disease prevalence in R-CPD patients ranged from 16.3 to 51.9%, with improvement of heartburn symptoms after treatment. High-resolution manometry revealed dysmotility disorders in 43.5–80.0% of patients, with absent peristalsis in 11–25%. Carbonated drink provocative testing provided diagnostic usefulness in patients with unclear diagnoses by demonstrating failure of cricopharyngeal sphincter relaxation for retrograde gas. Notably, 75.5–79.9% of patients maintained symptom relief beyond the expected pharmacologic duration of botulinum toxin (approximately 6 months), suggesting potential neuroplastic adaptation or learned compensatory mechanisms in overcoming retrograde cricopharyngeal sphincter dysfunction. The pathophysiology of R-CPD remains incompletely understood, with a lack of epidemiological and pediatric studies. The genetic and environmental factors may play a key role, but future studies are needed to clarify their roles in the development of R-CPD. Full article

Background: The prevalence of pulmonary hypertension (PH) in patients who are positive for myositis-specific antibody (MSA) and myositis-associated antibody (MAA) remains unclear. Methods: We conducted a retrospective study of patients with an age of 18 years or older diagnosed with myositis interstitial lung disease (ILD) at our university’s ILD clinic between 2019 and 2022. Echocardiographic PH was defined by tricuspid regurgitation velocity (TRV) ≥ 2.9 m/s on transthoracic echocardiography (TTE) consistent with intermediate probability of PH using 2022 European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines. We grouped patients based on low probability of PH vs. intermediate to high probability of PH. We examined 6 min walk test (6MWT) data, pulmonary function tests (PFTs), all-cause mortality, and rate of lung transplantation. We also evaluated patients who were on immunosuppression vs. those not on immunosuppression. Results: The intermediate to high probability of PH group had a higher prevalence of dermato-specific antibodies (14.2% vs. 34.5%, p = 0.048). Specifically, MDA-5 was found to be more prevalent in patients with intermediate to high probability of PH (7.1% vs. 24.1%, p = 0.040). There was no difference in 6MWT parameters between groups (363.2 ± 115.6 m vs. 294.9 ± 147.5 m, p = 0.108). FVC and DLCO were lower in patients with intermediate to high probability of PH (71.3 ± 22.4 L vs. 58.8 ± 16.7 L, p = 0.037; 56.3 ± 21.8 mL/min/mmHg vs. 36.9 ± 15.5 mL/min/mmHg, p = 0.003). The all-cause mortality and rate of lung transplantation was higher in the intermediate to high probability of PH group (5.4% vs. 20.7%, p = 0.041, 0% vs. 6.9%, p = 0.049). There was no difference in all-cause mortality between patients who were on immunosuppression vs. those who were not on immunosuppression in patients with intermediate to high probability of PH (33.3% vs. 7.1%; p = 0.169). Conclusions: Patients with MSA/MAA may have an increased risk of PH with reduced lung function, higher mortality, and greater rate of lung transplantation. Our study further elucidates the growing body of evidence that dermato-specific antibodies, such as MDA-5 are associated with an increased risk of PH. Further research is needed to investigate the role of PH and immunosuppression in these patients. Full article

Background: Childhood overweight and obesity represent growing public health challenges globally, driven by complex interactions between demographic, behavioral, and familial factors. This study assessed the prevalence and determinants of overweight and obesity among school-aged children and adolescents attending urban schools in the Aseer Region of Saudi Arabia (Abha and Khamis Mushait). Methods: A cross-sectional study was conducted among 413 urban school students aged 6–18 years. Anthropometric measurements were obtained using standardized procedures, and lifestyle behaviors were assessed through a structured questionnaire. Data were analyzed using descriptive statistics, Chi-square tests, and multivariate binary logistic regression. Variables with p < 0.05 in univariate analysis, alongside conceptually relevant predictors, were included in the final model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results: The combined prevalence of overweight and obesity was high, particularly among older age groups and secondary-school students. Significant associations were found between BMI category and age, school level, parental education, and family history of obesity. Lifestyle behaviors including fast-food consumption, low fruit and vegetable intake, prolonged screen time, and short sleep duration showed strong relationships with overweight/obesity. In the adjusted model, key predictors included frequent fast-food intake (AOR = 2.74), low fruit/vegetable intake (AOR = 2.20), physical inactivity (AOR = 1.70), high screen time (AOR = 2.40), short sleep duration (AOR = 1.55), and positive family history of obesity (AOR = 3.10). Conclusions: Childhood overweight and obesity in the Aseer Region are influenced by both modifiable lifestyle behaviors and familial predisposition. Targeted interventions promoting healthy dietary habits, adequate physical activity, reduced screen time, and sufficient sleep are essential. Preventive strategies should prioritize adolescents and children with a family history of obesity to effectively reduce obesity risk. Full article

Background: Vulvodynia is a chronic vulvar pain syndrome with multifactorial etiology and unclear pathophysiology. Despite its high prevalence, it remains underdiagnosed and under-researched, with significant repercussions for women’s physical, psychological, and social well-being. Objective: To synthesize the available scientific evidence on quality of life (QoL) in women diagnosed with vulvodynia, identifying the main affected domains and the assessment tools used in the literature. Methods: A rapid review was conducted following PRISMA 2020 and Cochrane Rapid Reviews guidelines. Searches were performed in PubMed, Web of Science, Scopus, CINAHL, Biblioteca Virtual en Salud, and CUIDEN without date or geographic restrictions. Studies including adult women diagnosed with vulvodynia and reporting QoL outcomes were eligible. Data was extracted and synthesized narratively, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Twenty studies published between 2006 and 2025 met the inclusion criteria (13 quantitative and 7 qualitative). Vulvodynia was consistently associated with reduced QoL across physical, psychological, and social dimensions. The most frequently reported issues were chronic vulvar pain, sexual dysfunction, anxiety, depression, and social withdrawal. Tools such as SF-12, SF-36, WHOQOL-BREF, DLQI, Skindex-29, and SQLQ-F were commonly used, although heterogeneity among instruments limited comparability. Multidisciplinary interventions combining physiotherapy and psychological therapy showed improvements in emotional and physical well-being, though sexual dysfunction often persisted. Conclusions: Vulvodynia substantially impairs women’s quality of life, reflecting complex biopsychosocial interactions. The findings highlight the need for standardized QoL measures and gender-sensitive, multidisciplinary approaches to diagnosis, management, and research. Full article

This study integrates data on the prevalence, infection dynamics and risks associated with African swine fever virus (ASFV) outbreaks in Croatian wild boar during 2023–2024. Although the overall ASFV DNA prevalence in Croatia was 0.24%, the highest prevalence (2.29% in 2023 and 4.69% in 2024) was recorded in Vukovar-Srijem County. Genetic typing identified ASFV genotype II, subgroup 19, consistent with strains isolated from domestic pigs in Croatia and circulating in neighboring countries. Anti-ASFV specific antibodies were detected in 10.34% of wild boar tested in counties with previously reported DNA findings. In Vukovar-Srijem County, 4.60% of wild boar were positive for both, ASFV DNA and antibodies, suggesting ongoing virus infection, whereas the proportion of boar positive only for antibodies was 5.75%, indicating survival of acute infection. Statistical analysis revealed an increase in ASFV DNA detection from 2023 to 2024 (p = 0.043), with a higher prevalence in carcasses than in hunted animals (p = 0.001), highlighting the need for passive monitoring. While gender showed no statistical significance, a higher infection rate was observed in older animals (p = 0.001). The identified course of infection involved spillover events between domestic pigs and wild boar, with a significant anthropogenic influence. Full article