Search Results (74)

The brown marmorated stink bug, Halyomorpha halys (Stål), is an invasive pest that increasingly threatens apple production in Europe by causing fruit damage, yield losses, and quality deterioration under commercial orchard conditions. This study investigated seasonal population dynamics, spatial patterns of fruit damage, yield effects, and post-harvest fruit responses of two apple cultivars (‘Cripps Pink’ and ‘Fuji’) in a commercial orchard over two consecutive seasons (2024–2025). Adult and nymphal activity was monitored using pheromone traps, while fruit damage was assessed at harvest across orchard positions and canopy layers. Potential yield losses were estimated based on damage incidence, and selected physicochemical properties of healthy and affected fruits were analysed. Clear cultivar-dependent differences were observed. ‘Fuji’ exhibited typical external feeding damage, with low but consistent damage levels and limited yield losses in both seasons. In contrast, ‘Cripps Pink’ showed substantially higher damage rates and potential yield losses, particularly in 2025; however, classical external feeding damage was not observed. Instead, fruits exposed to H. halys pressure expressed atypical responses, primarily as increased individual fruit mass and size, and atypical skin color patterns, including pronounced striping and uneven pigmentation. Damage in ‘Cripps Pink’ was strongly structured within the orchard, with higher incidence in the upper and middle canopy layers and in areas adjacent to the forest edge, whereas damage in ‘Fuji’ remained low and spatially uniform. Overall, the results demonstrate that the impact of H. halys depends not only on pest pressure but also on cultivar traits and within-orchard spatial heterogeneity. These findings support the development of cultivar-specific and spatially targeted integrated pest management (IPM) strategies that better reflect the uneven distribution and expression of stink bug injury in commercial apple orchards. Full article

Callous–unemotional (CU) traits are characterised by reduced empathy, guilt, and emotional responsiveness, and are strongly linked to atypical socioemotional processing. Eye-tracking research provides a valuable window into these processes by capturing early developing patterns of attention to emotionally salient social cues, particularly facial expressions. This narrative review examines how alterations in gaze behaviour contribute to the emergence of CU traits across neurodevelopmental disorders (NDs), with a focus on autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD). Across studies, elevated CU traits are associated with reduced fixations on the eye region, most consistently in response to fearful faces. ASD is associated with robust eye avoidance, ADHD with inhibitory and attentional control difficulties during face processing, and CD with atypical gaze allocation to negative emotional expressions such as fear and anger. These patterns appear amplified when CU traits co-occur with NDs. Competing explanatory accounts, including aberrant amygdala functioning, oculomotor disinhibition, and hostile attribution biases, each capture aspects of these patterns but fail to provide a unified explanation. Integrating developmental, neurobiological, and environmental perspectives, we propose that CU traits reflect a transdiagnostic developmental construct shaped by early attentional–emotional mechanisms, rather than a disorder-specific identity. Full article

Objective: To synthesize current evidence on the relationships between adolescent idiopathic scoliosis (AIS), stress-related mechanisms, neuroanatomical asymmetry, and mental disorders, and to propose an integrative conceptual framework describing their interaction. Materials and Methods: A comprehensive literature review was conducted using the PubMed, Web of Science, and Scopus databases. Search terms targeted the etiology and pathogenesis of adolescent idiopathic scoliosis, hemispheric lateralization, stress responses, body schema disturbances, and associated mental disorders. The review was reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. A structured qualitative synthesis of 225 relevant publications was performed. Results: The analyzed studies revealed several complementary conceptual approaches to AIS pathogenesis. Emerging evidence suggests that atypical hemispheric lateralization, potentially associated with right-hemisphere (RH) dysfunction, may contribute to susceptibility to AIS. Such patterns of lateralization have been linked to specific stress-related coping strategies, including harm avoidance, as well as to disturbances of body schema and an increased prevalence of certain mental disorders. Gender-related differences in stress responses and in the development and progression of AIS were consistently reported across studies. Collectively, these findings support the hypothesis that neuropsychological and stress-related mechanisms, including phenomena described as the “distorting mirror effect”, may contribute to the persistence and progression of spinal deformity in vulnerable individuals. Conclusions: AIS appears to be a multifactorial condition in which atypical neuroanatomical asymmetry, stress-related processes, and altered body representation interact. This integrative perspective generates hypotheses suggesting that prevention and treatment strategies for AIS could benefit from incorporating approaches aimed at modulating stress responses and enhancing brain neuroplasticity. Further interdisciplinary studies integrating clinical, neuroimaging, and neurobiological methods are warranted to clarify underlying mechanisms. Full article

Background/Objectives: Cutaneous metastases from primary bone sarcomas are exceedingly rare and poorly characterized, often posing diagnostic challenges due to their atypical presentation. This systematic review aimed to describe the clinical patterns, temporal relationships, and prognostic implications of cutaneous metastases across major bone sarcoma histologies. Methods: A comprehensive literature search was conducted to identify all reported cases of cutaneous metastases from osteosarcoma, chondrosarcoma, Ewing sarcoma, and chordoma. Data on patient demographics, primary tumor site, cutaneous lesion characteristics, latency periods, synchronous metastases, morphology, and clinical outcome were extracted and analyzed descriptively. Results: 102 cases were identified, with chordoma representing the most frequent histology. Cutaneous metastases showed histology-specific patterns: osteosarcoma and Ewing sarcoma typically presented with multiple lesions in the context of widespread systemic disease and poor prognosis, whereas chordoma more often exhibited solitary or skin-dominant metastases with longer latency and occasional favorable outcomes, including complete responses after local treatment. Conclusions: Cutaneous metastases in bone sarcomas display heterogeneous behavior, with chordoma demonstrating a more indolent and potentially manageable pattern compared to other histologies. Increased clinical awareness is essential to avoid diagnostic delays and optimize management. Full article

Background: Posterior canal benign paroxysmal positional vertigo (PSC-BPPV) is the most frequently encountered vestibular disorder in otoneurological clinical practice. However, diagnosis may be challenging in the presence of less common variants, which are characterised by atypical nystagmus patterns and may complicate clinical assessment. Methods: This study analysed a cohort of 295 patients diagnosed with PSC-BPPV and treated between January and August 2025 at the Audiology and Phoniatrics Unit of San Pio Hospital, Benevento. Of these, 25 patients presented with less common PSC-BPPV variants, namely the apogeotropic variant, the Scocco variant, and the Yetiser variant. Clinical features, therapeutic manoeuvres performed, time to symptom resolution, and associated comorbidities were evaluated. All patients were treated exclusively using the Epley manoeuvre. This observational study describes our experience in the diagnosis and management of these rare PSC-BPPV variants, with the aim of expanding the currently available evidence. Results: The Scocco variant was the only less common form of PSC-BPPV that required a statistically significantly greater number of liberatory manoeuvres when compared with classic PSC-BPPV (p < 0.05). No statistically significant differences were observed for the remaining variants with regard to treatment response or time to symptom resolution. Conclusions: Less common variants of PSC-BPPV represent both diagnostic and therapeutic challenges due to their atypical nystagmus patterns. Our findings indicate that the Scocco variant may be more resistant to standard liberatory treatment. In addition, this study reports auxiliary diagnostic and clinical tools which, in our experience, facilitated patient management. Full article

Ferritin heavy chain (FTH1) is a key subunit of ferritin and serves as a core regulator of iron metabolism, playing an important role in alleviating cellular damage caused by oxidative stress or regulating programmed cell death. This study identified 7 FTH1 homologs (AgFTH1-1 to AgFTH1-7) across the entire genome of Anadara granosa and investigated their expression responses during Vibrio infection. The 7 AgFTH1 genes are arranged in tandem across 6 chromosomes, with AgFTH1-5 and AgFTH1-6 undergoing gene amplification via a local duplication event. Among these homologous genes, 5 genes contain a single conserved ferritin domain (PF00210) and retain key ferroxidase center residues (Glu23, His65). Following Vibrio infection, these 5 genes exhibit downregulated expression, which may increase intracellular free iron and be consistent with ferroptosis-like cell death contributing to pathogen clearance, as suggested by previous studies. AgFTH1-5 contains a signal peptide and exhibits increased expression, suggesting it may regulate extracellular local iron storage. AgFTH1-4 (synaptonemal N-terminal SNARE) and AgFTH1-7 (GTPase domain) lack signal peptides, exhibit atypical structures, and show no significant expression changes under bacterial stress, indicating they may be associated with vesicle trafficking rather than classical iron storage. This study systematically analyzed the genomic features and expression patterns of the FTH1 gene family in A. granosa, laying a foundation for further revealing its role in shellfish immune defense. Full article

Background: Children with autism spectrum disorder (ASD) frequently experience eating-related behavioral difficulties; however, the relationships among these difficulties, core ASD deficits, and executive function remain poorly understood. The present study examined how core ASD characteristics—restrictive and repetitive behaviors (RRBs) and social impairments—relate to eating behaviors, including food approach and avoidance tendencies. In addition, the study explored whether executive function serves as a mediating mechanism underlying these associations. Methods: A total of 184 children aged 3–12 years participated in this cross-sectional study. All variables were measured using parent-reported questionnaires, and data were analyzed through path modeling. The Social Responsiveness Scale–Second Edition (SRS-2) and the Repetitive Behavior Scale–Revised (RBS-R) were employed to assess social impairments and RRBs, respectively. Eating behaviors—comprising food approach and food avoidance dimensions—were evaluated with the Children’s Eating Behavior Questionnaire (CEBQ), while executive function was measured using the Child Executive Functioning Inventory (CHEXI). Results: The analysis revealed significant associations between RRBs and both food approach and food avoidance behaviors in children with ASD. Crucially, follow-up regression analyses specifying RRBs subtypes showed that Stereotyped Behavior independently predicted both food approach (β = 0.305, p < 0.001) and avoidance (β = 0.217, p = 0.002), while Compulsive Behavior specifically predicted food avoidance (β = 0.173, p = 0.021). Furthermore, executive function appeared to serve as a potential mediator in these relationships, suggesting that impairments in executive control may partially explain how repetitive behaviors influence eating patterns. Although social impairments showed weaker direct associations with eating behaviors, they indirectly affected both food approach and avoidance behaviors through deficits in executive function, highlighting the complex interplay among behavioral, cognitive, and social domains in ASD. Conclusions: These findings indicate that RRBs—one of the core characteristics of ASD—can predict children’s eating behaviors and are concurrently linked to two seemingly opposite eating patterns. Both social impairments and RRBs appear to influence eating behaviors through executive dysfunction. This study provides new insights into the mechanisms underlying atypical eating behaviors in children with ASD and identifies executive function as a promising target for interventions aimed at improving eating-related outcomes in this population. Full article

Background: SPATA5L1-related neurodevelopmental disorder is a recently described condition characterized by psychomotor delay, sensorineural hearing loss, and variable motor dysfunction. Because only a few cases have been reported, the full phenotypic spectrum remains poorly defined. Expanding clinical characterization is crucial for improving early diagnosis and targeted management. Case Presentation: We report a 24-month-old female with compound heterozygous SPATA5L1 variants c.1918C>T (p.Arg640Ter) and c.2066G>T (p.Gly689Val). She presented with global psychomotor delay, bilateral sensorineural hearing loss, strabismus, and craniofacial dysmorphism. Brain MRI showed cortical and white matter atrophy, delayed myelination, and a thin corpus callosum. Vojta neurodevelopmental assessment demonstrated an 11-month motor delay, abnormal responses in all seven Vojta postural reactions, and persistent primitive reflexes. Early EEG recordings were without significant changes, whereas abnormalities emerged later in the clinical course. Genetic testing confirmed the variants in trans. Management and Outcomes: Early rehabilitation including reflex locomotion therapy was initiated. The persistence of primitive reflexes, central hypotonia, and pathological postural reactions provided a coherent neuromotor profile and indicated a high vulnerability to atypical motor development, and do not rule out the possibility of later evolution toward a spastic–dystonic motor pattern. These findings, combined with neuroimaging abnormalities, refined the patient’s neuromotor phenotype and guided individualized therapeutic planning. Conclusions: This case expands the clinical and neurodevelopmental spectrum associated with SPATA5L1 variants and highlights the diagnostic value of integrating genomic sequencing with structured motor assessments. Early, multidimensional evaluation may improve recognition of rare neurodevelopmental disorders and support more precise prognostication and rehabilitation strategies. Full article

Background/Objectives: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related mortality worldwide. Immune checkpoint inhibitors (ICIs) have transformed treatment paradigms, but assessing response remains challenging due to atypical patterns such as pseudoprogression, hyperprogression and dissociated response. Conventional evaluation criteria, such as RECIST 1.1, may not fully capture these patterns, leading to potential misclassification and premature therapy discontinuation. This review explores the role of 18F-FDG PET/CT in assessing immunotherapy response and highlights novel imaging criteria to enhance clinical decision-making. Methods: A systematic literature review was conducted across PubMed, Web of Science, Scopus, and Cochrane Library, selecting relevant studies published between 2013 and 2024. The review focuses on the strengths and limitations of PET-based imaging in monitoring NSCLC immunotherapy outcomes. Specific attention was given to evolving evaluation frameworks, including iRECIST, PERCIST, imPERCIST, and iPERCIST, as well as metabolic biomarkers such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Results: Compared with anatomical-based assessment, metabolic imaging using 18F-FDG PET/CT may offer deeper insights into tumor behavior during immunotherapy. PET-derived parameters seem to improve the detection of immune-related response patterns, providing a more refined approach to differentiate true progression from pseudoprogression. Emerging evidence indicates that metabolic biomarkers such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) could serve as useful predictors of therapeutic efficacy and support treatment adaptation. Nevertheless, current findings are mainly based on small, heterogeneous, and predominantly retrospective studies, with variable PET timing and threshold definitions that limit the generalizability of these results. Conclusions: 18F-FDG PET/CT represents a promising complementary tool for assessing immunotherapy response in NSCLC. Its integration with advanced imaging criteria and metabolic tumor biomarkers may enhance response evaluation and assist clinical decision-making. Nonetheless, the current evidence remains preliminary, and further standardization and large prospective validation studies are required before its routine implementation in clinical practice. Full article

Background: Autism Spectrum Disorder (ASD) is characterized by atypical brain oscillatory dynamics and altered connectivity, impairing sensory integration, socio-communicative responsiveness, and behavioral regulation. Methods: Radio Electric Asymmetric Conveyer (REAC) technology delivers non-invasive neurobiological modulation through standardized, operator-independent protocols. The Brain Wave Optimization Neurodevelopment–Autism (BWO ND-A) protocol was designed to address oscillatory patterns frequently altered in ASD, aiming to promote network coherence and multidomain functional improvement. This retrospective pre–post single-arm study evaluated 39 children with ASD (31 males, 8 females; mean age 7.85 ± 2.90 years). All received one Neuro Postural Optimization (NPO) session to prime central nervous system adaptive capacity, followed by BWO ND-A (18 sessions, ~8 min each), administered 3–4 times daily over ~two weeks. The primary outcome was the Autism Treatment Evaluation Checklist (ATEC) total score; secondary outcomes were its four subscales. Results: Mean total ATEC decreased from 67.76 ± 16.11 to 56.25 ± 23.66 (mean change −11.51 ± 14.48; p < 0.0001; Cohen’s dz = 0.78). Clinically meaningful improvement (≥8-point reduction) occurred in 59% of participants. In 10.3% of cases, caregiver ratings indicated an apparent worsening (≥8-point increase). However, no objective deterioration or adverse effects were observed. This pattern was most likely related to a transient phase of functional re-adaptation, during which emerging changes may initially be perceived by caregivers as worsening before stabilizing into improvement. Conclusions: While these findings suggest promising short-term real-world efficacy and safety, the absence of a control group, lack of objective neurophysiological measures, and no long-term follow-up limit causal inference. Future controlled studies with neurophysiological monitoring are needed to confirm the targeted neuromodulatory action and durability of effects. Full article

Objectives: Typical BPPV forms are widespread and easily diagnosed disorders. However, some forms of labyrinthine lithiasis can differ from the typical BPPV paradigm, showing their own signs and symptoms and resulting in variable therapeutic responses. The aim of this retrospective study is to describe the incidence of the so-called atypical forms compared to the more common BPPV, describing their clinical behavior. Methods: This retrospective study analyzed clinical and instrumental data of 139 patients evaluated over a 12-month period at a referral center. Patients were divided into two groups. The first group (Group A) included patients with so-called “typical” and unilateral labyrintholithiasis, while the second group (Group B) included patients with so-called “atypical” forms. Results: Based on clinical characteristics, 82 patients were assigned to group A while 57 (51.01%) to group B. In group A, resolution of the clinical picture required fewer sessions and a smaller number of therapeutic maneuvers than in group B (p < 0.001). Furthermore, in group A, resolution of symptoms was observed immediately after one of the therapeutic maneuvers performed in 74.07% of cases, while in group B, resolution of the clinical picture was observed during one of the follow-up visits in 39.66% of cases (p < 0.001). Conclusions: Although considered rare, “atypical” forms have an increased prevalence in tertiary centers. The location of the canaliths within the labyrinth can be hypothesized based on the pattern of nystagmus, which serves as a guide for treatment. Full article

This paper reviews the apparent impact of how changes in nitrate, sulphate activities, and moisture affect the surface pH of rock art paintings at Cueva del Ratón, in the Sierra de San Francisco in Baja California Sur, Mexico. The data was collected after atypical weather events caused rain and mist in this normally arid area. The rock art paintings had been previously examined over several years and observed the unexpected formation of silica skins over some surfaces; such coatings are not often experienced in arid environments. The local geology of the cave and the availability of moisture can dramatically alter the microbiological activity on faecal material and development of surface acidity from such reactions which interacts with both the host rock and the pigments. Through a series of surface pH measurements and localised measurements on chloride, sulphate and nitrate it appears that both nitrate and sulphate concentrations have a significant impact on the surface pH, which is controlled by a diffusion-based movement of moisture from the closed to the open end of the shelter. The exfoliation of the rock surface and formation of the silica skins involves chemical reactions as contrasted with diffusion-controlled reactions which distribute the metabolites of the yeasts, moulds and bacteria, which are dominated by the availability of water through drip lines. The results are particularly relevant due to changing weather patterns in the last decade, caused by climate change, with an increase in hurricanes directly affecting the Baja California peninsula. The use of disposable test strips for semi-quantitative assessment of how these major anions impact on the decay mechanisms was a novel response to budget constraints and the remoteness of the location. Full article

Since the emergence of SARS-CoV-2, the interplay of human behavior, environmental factors, viral evolution, and public health interventions has resulted in unexpected changes in the timing, intensity, and geography of respiratory virus outbreaks. For example, respiratory syncytial viruses (RSV) exhibited a surge during atypical summer months in several countries. Influenza, on the other hand, nearly vanished in the early years of the pandemic, but returned with unusual strength and altered seasonal patterns. Concurrently, new variants of concern in coronaviruses have demonstrated increased airborne transmissibility, greater resilience to environmental conditions, and the ability to evade both natural and vaccine-induced immunity. In this review article, we have synthesized the current understanding of the aerobiology of respiratory infectious viruses, with a particular emphasis on the paradoxical trends observed in recent years. We examined various aspects, including viral morphology and environmental survivability, shifts in seasonality, the drivers of mutation and resistance, and the impact of environmental and climatic factors. Key issues we explored include viral morphology adaptation in response to airborne selective pressures and climate variability influence on the ecology of airborne viruses. Lastly, we investigated future risks and proposed an interdisciplinary framework for monitoring and mitigating airborne viral threats in an ever-changing world. Full article

Nephrogenic diabetes insipidus (NDI) is a rare hereditary disorder characterized by renal resistance to arginine vasopressin (AVP), resulting in the kidneys’ inability to concentrate urine. Approximately 90% of NDI cases follow an X-linked inheritance pattern and are associated with pathogenic variants in the AVPR2 gene, which encodes the vasopressin receptor type 2. The remaining 10% are attributed to mutations in the AQP2 gene, which encodes aquaporin-2, and may follow either autosomal dominant or recessive inheritance patterns. We present the case of a male infant, younger than nine months of age, who was clinically diagnosed with NDI at six months. The patient presented recurrent episodes of polydipsia, polyuria, dehydration, hypernatremia, and persistently low urine osmolality. Despite adjustments in pharmacologic treatment and strict monitoring of urinary output, the clinical response remained suboptimal. Given the lack of improvement and the radiological finding of an absent posterior pituitary (neurohypophysis), the possibility of coexistent central diabetes insipidus (CDI) was raised, prompting a therapeutic trial with desmopressin. Nevertheless, in the absence of clinical improvement, desmopressin was discontinued. The patient’s management was continued with hydrochlorothiazide, ibuprofen, and a high-calorie diet restricted in sodium and protein, resulting in progressive clinical stabilization. Whole-exome sequencing identified a novel homozygous missense variant in the AQP2 gene (c.398T > A; p.Val133Glu), classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria: PM2 (absent from population databases), PP2 (missense variant in a gene with a low rate of benign missense variation), and PP3 (multiple lines of computational evidence supporting a deleterious effect)]. NDI is typically diagnosed during early infancy due to the early onset of symptoms and the potential for severe complications if left untreated. In this case, although initial clinical suspicion included concomitant CDI, the timely initiation of supportive management and the subsequent incorporation of molecular diagnostics facilitated a definitive diagnosis. The identification of a previously unreported homozygous variant in AQP2 contributed to diagnostic confirmation and therapeutic decision-making. The diagnosis and comprehensive management of NDI within the context of polyuria-polydipsia syndrome necessitates a multidisciplinary approach, integrating clinical evaluation with advanced molecular diagnostics. The novel AQP2 c.398T > A (p.Val133Glu) variant described herein was associated with early and severe clinical manifestations, underscoring the importance of genetic testing in atypical or treatment-refractory presentations of diabetes insipidus. Full article

Primary hepatic gastrointestinal stromal tumours (PHGISTs) are rare and frequently misdiagnosed due to their atypical presentation and uncertain origin. The purpose of this article is to present the case of a 79-year-old female patient with a gigantic PHGIST characterized by a predominantly cystic nature—an extremely rare presentation, as most cases of PHGIST are solid. Despite extensive imaging and exploratory laparotomy, the primary origin remained uncertain, leading to questioning about whether it was a true primary hepatic GIST or an atypical metastatic lesion. The initial therapeutic approach involved a surgical procedure aimed to confirm the diagnosis and achieve reductive tumourectomy. Following the surgery, the patient was administered imatinib with a favourable clinical response for four and a half years—an atypical pattern of resistance, as most patients typically develop therapeutic resistance within two to three years. A second surgical intervention was performed to address a cystic lesion localized in the left hepatic lobe, followed by an atypical segment III hepatectomy to achieve macroscopic resection. Subsequently, the patient received sunitinib for two and a half years, which resulted in temporary disease stabilization. However, the sunitinib treatment was associated with hypertension and leukopenia. The patient’s overall survival was 8 years, suggesting that individualized therapeutic strategies and close monitoring might be the key in such cases. Furthermore, this case confirms the role of surgical intervention even in advanced disease stages, with multiple major resections contributing significantly to prolonged survival. The interplay between surgical and oncologic therapies remains essential to guiding clinical decisions. Given the unusual cystic presentation, this case highlights the necessity to expand the pathological and molecular profiling of PHGISTs. Furthermore, the atypical timeline of resistance development and treatment-related toxicity emphasizes the importance of further research into the genetic and pharmacological determinants of PHGISTs. These findings advocate for the refinement of diagnostic, therapeutic, and surveillance protocols tailored to rare GIST subtypes. Full article