Search Results (384)

Background/Objectives: Intravascular large B-cell lymphoma (IVLBCL) is a rare and diagnostically challenging disease, often presenting as fever of unknown origin (FUO). This study aimed to develop and validate diagnostic predictive models and scoring systems to distinguish IVLBCL from other causes of FUO in hospitalized patients. Methods: A retrospective analysis was conducted in patients with IVLBCL or other causes of FUO who were treated between February 2015 and October 2023. Two multivariable logistic regression models and corresponding integer-based scoring systems were developed in a training cohort comprising 42 patients with IVLBCL and 45 FUO controls. Internal validation was performed using leave-one-out cross-validation and bootstrap resampling, followed by temporal validation in an independent cohort of 18 patients with IVLBCL and 21 FUO controls. Model 1 was additionally evaluated for sensitivity in an external case-only cohort comprising 40 patients with IVLBCL from eight hospitals. Results: Model 1 incorporated peripheral edema, hypoxemia, neurological symptoms, hemophagocytic lymphohistiocytosis, and interstitial lung abnormalities on computed tomography and achieved an area under the receiver operating characteristic curve (AUC) of 0.916 in the training cohort. Model 2 combined the interleukin-10/interleukin-6 (IL-10/IL-6) ratio with peripheral edema, hypoxemia, and neurological symptoms and demonstrated significantly improved discrimination (AUC = 0.982, p = 0.021 vs. Model 1). In the temporal validation cohort, the AUCs of Models 1 and 2 were 0.975 and 0.997, respectively. The corresponding integer-based scoring systems achieved AUCs of 0.903 and 0.952 in the training cohort and 0.926 and 0.992 in the temporal validation cohort. In the external case-only cohort, both Model 1 and its integer-based score identified 32 of 40 patients, yielding a sensitivity of 80.0%. Random skin biopsy provided the histological diagnosis in 58% of cases, with a positivity rate of 79.5%. Conclusions: Two diagnostic models and their simplified scoring systems were developed and internally and temporally validated to aid the diagnosis of IVLBCL in hospitalized patients with FUO. These models may assist in the diagnostic workup of hospitalized FUO patients, especially when IL-10/IL-6 testing is unavailable. Their performance in outpatient or community settings remains uncertain, and prospective multicenter validation with appropriate FUO controls is warranted. Full article

Alzheimer’s disease (AD), the leading cause of dementia, lacks an inexpensive and non-invasive method for early detection. Here, we investigate whether electrodermal activity (EDA), a measure of changes in electrical conductance at the skin’s surface, can offer a convenient avenue for AD screening by capturing the autonomic dysfunction associated with the disease’s pathology. As few studies have comprehensively examined EDA’s utility as a standalone biomarker for AD, we conducted a pilot study with 10 cognitively healthy controls and 20 patients with AD, evaluating EDA recordings collected during an orthostatic test and a Montreal Cognitive Assessment (MoCA). The AD group included both carriers from Colombian kindreds affected by autosomal-dominant AD and patients with sporadic late-onset AD. We compared EDA features between groups using statistical analysis and tested whether machine learning models could separate the two groups using these features. During the MoCA, phasic EDA measures, specifically the number of skin conductance responses (NSSCR) and mean time-variant sympathetic tone (TVSymp), were significantly lower in the AD group than in controls (NSSCR: $p=0.0083$, Cohen’s $d=-1.07$; mean TVSymp: $p=0.0166$, $d=-0.96$), suggesting a blunted sympathetic response to cognitive stress in AD. No significant between-group differences were observed during the orthostatic test (all $p\ge 0.60$). A random forest classifier trained on MoCA-derived EDA features achieved a balanced accuracy of 78% (95% CI 60 to 93%; 75% sensitivity, 80% specificity, AUROC 0.75), with phasic features contributing most to performance. Performance did not differ significantly from that of the support vector machine or logistic regression models. These results provide preliminary, hypothesis-generating evidence for the utility of EDA in screening for AD. The small sample size, unequal group allocation, sex imbalance, and substantial mean age disparity between groups (≈23.5 years) limit the strength of these conclusions and necessitate replication in larger, age- and sex-matched cohorts that include prodromal stages. Full article

Rising temperatures and the occurrence of heat waves due to climate change can increase the risk of various skin disorders. Moreover, elevated temperatures worsen oxidative damage and inflammation caused by other climate change stressors, such as UV exposure. Consequently, there is growing interest in innovative solutions to protect skin health from the effects of pollution and climate change stressors. Among natural cosmeceuticals, carotenoids are recognized for their antioxidant and anti-inflammatory properties. This study evaluated the thermoprotective effects of Hematococcus lacustris (the microalga formerly called Hematococcus pluvialis) extract (HLE), which is considered the richest natural source of carotenoid astaxanthin, against acute hyperthermia, which mimics the conditions of heat waves. In addition, we separately assessed the effects of HLE against UVA and hydrogen peroxide stress, complementing the antioxidant profile of the extract under study. The evaluation was conducted using in vitro tests on human HaCaT keratinocytes and the nematode Caenorhabditis elegans, which is a model organism sensitive to environmental stressors. The treatment of HaCaT keratinocytes with HLE counteracted the intracellular formation of reactive oxygen species and cytotoxicity induced by hyperthermia, UVA, and hydrogen peroxide exposure. Under the same experimental conditions, HLE also restored the impaired expression of stress-sensitive genes, such as matrix metalloproteinase-1, in HaCaT keratinocytes and promoted wound closure mimicking the process of re-epithelization. Lastly, experiments in C. elegans confirm that HLE reduces heat stress-induced oxidative damage and preserves motility, supporting a systemic protective effect consistent with dietary uptake of the extract. These findings suggest that HLE, rich in carotenoid astaxanthin, can protect keratinocytes against oxidative damage and cytotoxicity induced by thermal stress, indicating its potential role in mitigating thermal aging. Full article

Lumpy skin disease (LSD) is a transboundary viral disease of cattle, including Asian water buffalo and yaks, and certain wild ruminants (e.g., African buffalo, giraffe, wildebeest, eland, and Arabian oryx). It is caused by lumpy skin disease virus (LSDV), a member of the genus Capripoxvirus (family Poxviridae) together with goatpox virus (GTPV) and sheeppox virus (SPPV). High nucleotide identity and serological cross-reactivity among these viruses hinder differential diagnosis. The aim of this study was to develop a Duplex TaqMan-MGB qPCR Assay for Differential Detection of Chinese Epidemic Lumpy Skin Disease Virus Strains and Goatpox Virus. We developed a duplex TaqMan-MGB real-time PCR (qPCR) assay targeting the LSDV GPCR and GTPV RPO30 loci. Virus-specific primers and MGB probes were designed, and the reaction was optimized for single-tube, two-target detection. The assay showed no cross-amplification, limits of detection of 1 × 10¹ copies/μL (LSDV) and 1 × 10¹ copies/μL (GTPV), and coefficients of variation < 1%. The assay was applied to 175 yak-derived field specimens from Qinghai–Tibet Plateau, of which 16 and 36 were positive for LSDV and GTPV, respectively. LSDV- and GTPV-positive samples showed specific amplification in the FAM and VIC channels, respectively. The duplex format enables concurrent detection and unambiguous differentiation of LSDV and GTPV and is compatible with high-throughput screening. This sensitive, specific, and reproducible assay supports surveillance and control of LSD in endemic and at-risk regions. Full article

The detection of outer-wall defects in thick ferromagnetic structures by conventional pulsed eddy current testing is limited by the shallow penetration depth caused by the high magnetic permeability of ferromagnetic materials. In this study, a magnetic saturation pulsed eddy current testing method is proposed to improve the detectability of such defects. The analytical dependence of the eddy current skin depth on magnetic permeability was first clarified, and finite element simulations were carried out to visualize the effect of magnetic saturation on the magnetic field and eddy current distributions. Pulsed eddy current responses under different relative permeabilities were then numerically analyzed, followed by experimental validation using Q345B steel plates with different thicknesses and cubic Q345B specimens containing flat-bottom hole defects of different depths. The influence of the direction of the saturation magnetic field on testing performance was also investigated. The results demonstrate that magnetic saturation effectively increases eddy current penetration depth and significantly improves the sensitivity of pulsed eddy current testing to wall-thinning defects in thick ferromagnetic structures. Signal separation for different defect depths was markedly enhanced under saturated conditions. In addition, the optimal testing performance was achieved when the saturation magnetic field was parallel to the probe axis. These results, obtained on uncoated specimens under laboratory conditions, provide a validated physical basis and a preferred field-probe configuration for applying magnetic saturation pulsed eddy current testing to thick-walled ferromagnetic components. Full article

This paper presents an experimental study on the amount of formaldehyde released during a fire in apartments, focusing on the flooring most commonly used in Bulgaria. Formaldehyde is a potentially hazardous chemical known to be carcinogenic in large amounts. It often causes respiratory problems and skin irritation. People prone to allergies are especially sensitive to formaldehyde. These health risks depend on the duration and level of exposure. The experiment tested seven types of laminate samples and six types of natural parquet samples at three different combustion temperatures in a room. Each sample was placed in a muffle furnace, heated to the specified temperatures of 150, 250, and 400 °C, respectively. Full article

Neonatal sepsis remains a leading cause of morbidity and mortality in the first month of life, yet its presentation is nonspecific, and its microbiological confirmation is uniquely difficult. Low-circulating bacterial loads, small obtainable blood volumes, frequent intrapartum antibiotic exposure, and the ambiguity of skin-commensal isolates erode the sensitivity and specificity of blood culture, the long-standing reference standard, so that most evaluated infants are treated empirically despite sterile cultures. This review synthesizes current evidence on the integrated microbiological evaluation of the newborn: the host- and specimen-related diagnostic challenge; the etiologic spectrum and its antimicrobial-resistance burden; conventional culture; rapid and molecular methods, including mass spectrometry and syndromic and broad-range PCR; metagenomic and cell-free-DNA sequencing; host-response biomarkers; and antimicrobial-susceptibility determination. The evidence indicates that newer methods accelerate or supplement culture but do not yet replace it, each addressing one limitation while introducing caveats of its own. Notably, much of the evidence for direct-from-blood molecular testing, microbial cell-free DNA, and metagenomic sequencing is extrapolated from adults, whereas neonatal data are stronger for several biomarkers. The greatest benefit arises from integrating complementary modalities within diagnostic- and antimicrobial-stewardship frameworks. Neonatal-specific validation, standardized thresholds, and outcome-driven trials remain the principal priorities. Full article

Cutaneous leishmaniasis (CL) is a vector-borne disease caused by Leishmania spp. Molecular methods such as conventional PCR (cPCR) and real-time PCR (qPCR) show high accuracy but remain restricted to reference centers. Loop-mediated isothermal amplification (LAMP) enables rapid DNA amplification under isothermal conditions. LAMP targeting 18S rDNA using WarmStart^® Colorimetric LAMP 2× Master Mix and Bst 2.0 DNA Polymerase with SYBR^® Green I (BstSg) was evaluated in swab samples (extracted by kit—SW-kit and direct boil—SW-DB) and specimens collected through biopsy from ulcerated lesions of patients attending a reference center in Rio de Janeiro, Brazil. The reference standard was defined as at least one positive parasitological or molecular (cPCR) test plus clinical confirmation. Analytical sensitivity reached 10 fg with WS and 10 pg with BstSg. The diagnostic accuracy of LAMP ranged from 51.8% to 78.6%, with sensitivity from 52.5% to 81% and specificity from 39.6% to 89.4%. LAMP, particularly when applied to swab samples with DNA extracted using the SW-kit protocol and amplified with BstSg, showed promising diagnostic accuracy and operational feasibility as a less invasive approach for CL diagnosis, eliminating the need for skin biopsy and reducing patient discomfort during sample collection. Full article

Pantothenic acid (PA; vitamin B5) is an essential component of many key metabolic processes. Vitamin B5 deficiency causes dysfunction in various systems and organs. Humans do not produce vitamin B5, so it must be constantly replenished through diet or supplementation. Pantothenic acid is synthesized by plants, fungi, and bacteria, so a well-balanced diet is a good source of pantothenic acid. Pantothenates have beneficial effects on the skin (regenerative, healing, and anti-inflammatory effects). They are readily absorbed through the skin, making them a common active ingredient in cosmetics and medications with soothing, healing, regenerative, moisturizing, and protective properties for damaged, sensitive, or atopic skin, including topical products labeled hypoallergenic or specifically intended for people with sensitive skin. Although PA is considered non-allergenic and safe, paradoxically, frequent exposure, especially to damaged skin, appears to lead to hypersensitivity to this substance. The pathogenetic mechanisms of pantothenate hypersensitivity have not been clearly defined. The main sensitization pathway is likely a delayed cellular mechanism (type IV, contact). However, other types of hypersensitivity, including immediate (type I) and mixed mechanisms, cannot be ruled out. PA allergy is considered rare and therefore difficult to diagnose. This is due to the unexpected sensitizing factor and the lack of standard diagnostic tests. Due to the likely contact nature of the allergy, patch testing (PT) with a cosmetic (drug) provided by the patient (“as is”) and PA (5% in petrolatum; 5% PET) appears to be the best approach. It is also suggested that PA (5% PET>) be included in the standard series of allergens (haptens) used in routine PT diagnostics. It appears that PA allergy is more common than currently believed, particularly in people with atopic skin and polysensitized individuals, who are the primary users of products containing pantothenate. It is possible that in these individuals, pantothenic acid may be more harmful than beneficial. Full article

Introduction: Fish skin is the first line of defense against the aquatic environment, acting as a physical, chemical, and immunological barrier. In addition to preventing pathogen entry, the skin and its mucus contribute to osmoregulation, innate immunity, and redox balance. Skin lesions—caused by mechanical damage, parasites, environmental stress, or handling—disrupt this barrier, increasing susceptibility to infections, inflammation, and production losses. Thus, efficient skin regeneration is essential for fish welfare and performance. Nutrition plays a key role in this process by providing substrates for epithelial repair, immune function, and antioxidant defense. Among dietary factors, zinc (Zn) is particularly important due to its involvement in cell proliferation, enzymatic activity, and maintenance of skin integrity. Objective: Our objective is to assess the effectiveness of image-based analysis in quantifying the skin healing process in Atlantic salmon fed diets supplemented with zinc. Methodology: The trial comprised three dietary treatments: a control diet with 42 mg Zn per kg (D1), and two diets supplemented up to 120 mg/kg of zinc, derived from inorganic (D2) or organic (D3) forms. Pit-tagged fish with an initial body weight (78 ± 0.1 g) were fed the diets for 75 days. After 15 days of experimental feeding, a standardized wound lesion (2.5 mm diameter × 0.5 mm depth) was inflicted in deeply anesthetized fish, with a disposable biopsy punch, in the dorsal area. After wound infliction, the fish resumed their normal feeding regime for the rest of the trial days. The progression of skin wound healing was assessed using standardized digital image analysis. High-resolution photographs of individual wounds were collected 8, 16, 24 and 32 days post-wounding. All images were acquired under standardized conditions with the inclusion of ArUco identifiers to enable a subsequent computer-assisted comparison. Morphometric parameters (wound width, diameter, perimeter and area) were used to assess wound contraction and closure over time. In parallel, a semi-quantitative visual scoring system was applied to each wound image to capture qualitative aspects of healing that are not fully described by morphometric data alone. Results: Full data analysis is currently underway, but the first results show beneficial effects of dietary zinc supplementation on the skin regenerative process. Conclusions: The combined use of objective digital measurements and standardized visual scoring enabled a comprehensive evaluation of wound healing progress, bridging quantitative tissue remodeling with biologically relevant phenotypic outcomes. This image-based framework provides a sensitive and reproducible approach for assessing dietary interventions targeting skin regeneration and barrier restoration in Atlantic salmon. Full article

Effective hand washing takes time and hand sanitizers that contain alcohol have a number of drawbacks, and frequent use of alcohol may cause skin damage. The objective of this study is to formulate nanostructured lipid carrier systems containing chlorhexidine digluconate to be applied topically for hand hygiene, especially for people sensitive to alcohol. A cytotoxicity experiment was conducted to ascertain the safe dosage for each of the three nano-cream formulas (F1, F2 and F3). Following each treatment, the viral titer was assessed using tissue culture infectious dose₅₀ and standard plaque assays. The selected formulation was characterized rheologically. Furthermore, fifteen volunteers of various ages and genders participated in the vivo antimicrobial test of the selected formulation as a hand sanitizer. All of the formulas were found to be safe. Using the disc diffusion method, the three formulations exhibited in vitro antimicrobial effects against different microbes. F1 showed biphasic release, reasonable skin deposition and spherical droplets under a microscope. F1 exhibited a non-Newtonian shear thinning flow behavior. After 30 min, the reduction values for rotavirus and Phix-174 were 21 and 4%, respectively. Additionally, the impact of F1 was assessed on the infectivity of simian rotavirus sa-11 (ds RNA) and Phix-174 (ss DNA) bacteriophage. According to the findings of the in vivo study, the percentage of total bacterial counts that were removed varied from 91 to 100%. Moreover, the range of the removal percentage of total fungi was 95.38 to 100%. In summary, F1 can be used as an economic, safe, and effective hand antiseptic. It can also completely replace alcohol in the market. Full article

Background/Objective: Postpartum hemorrhage is a leading cause of maternal morbidity and mortality, particularly among high-risk women undergoing cesarean section. This systematic review and meta-analysis evaluated the efficacy and safety of prophylactic tranexamic acid in high-risk cesarean sections. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted. Risk of bias was assessed using RoB 2.0 and certainty of evidence was evaluated with GRADE. Random-effects meta-analyses, subgroup analyses and sensitivity analyses were performed. PROSPERO: CRD420251087054. Results: Nine randomized controlled trials involving 1776 participants were included. Tranexamic acid reduced total blood loss (MD −300.78; 95% CI −459.78 to −157.77), with greater efficacy when administered 15–20 min before incision (SMD −0.61; 95% CI −0.82 to −0.39). It also reduced intraoperative blood loss (MD −256.71 mL; 95% CI −375.04 to −138.39), blood loss >1000 mL (RR 0.24; 95% CI 0.14 to 0.41), additional uterotonics (RR 0.37; 95% CI 0.24 to 0.58), blood transfusions (RR 0.30; 95% CI 0.22 to 0.40), and complementary surgical interventions (RR 0.35; 95% CI 0.16 to 0.78). Conclusions: Prophylactic tranexamic acid may reduce blood loss in high-risk cesarean deliveries, particularly when administered 15–20 min before skin incision. It may decrease total and intraoperative blood loss and blood loss exceeding 1000 mL. It also likely reduces the postoperative decline in hemoglobin, the need for additional uterotonics, blood transfusions, and complementary surgical interventions; however, its effect on hematocrit remains uncertain. Full article

Background/Objective: Leishmaniasis is a neglected tropical disease caused by species of the genus Leishmania, with a broad clinical spectrum that can overlap with other infectious and non-infectious conditions. Accurate species identification is critical for appropriate treatment and prognosis; however, parasitological methods are limited by suboptimal sensitivity, specificity, and inability to reliably differentiate species. This study aimed to develop and validate a real-time PCR assay based on melting-curve analysis (Leish-qPCR) for the detection of Leishmania spp. and the differentiation of Leishmania (Leishmania) amazonensis and Leishmania (Viannia) braziliensis. Methods and Results: Genus-specific primers were designed based on the kDNA (kinetoplast DNA) minicircle consensus sequences of Leishmania species, while species-specific primers targeted the internal transcribed spacer 2 (ITS2) consensus regions of the ribosomal RNA locus of L. (L.) amazonensis and L. (V.) braziliensis. Analytical performance was evaluated in silico and in vitro using a panel of protozoa, fungi, and bacteria, exhibiting 100% specificity with no cross-amplification. The limit of detection was one copy per reaction for all targets using positive controls. Clinical validation was performed using skin biopsy specimens from patients with granulomatous lesions. The optimized Leish-qPCR assay, performed in separate reaction tubes within the same run, demonstrated reliable analytical specificity and sensitivity, with distinct and reproducible melting temperature (Tm) peaks across plasmid controls, parasite DNA, and clinical samples. Comparative analysis with histopathological examination demonstrated moderate agreement between the methods, supporting the applicability of the assay for sensitive detection and species-level discrimination of Leishmania spp. in clinical samples. Conclusions: The Leish-qPCR assay presented high sensitivity, specificity, and diagnostic accuracy, representing a promising tool for routine diagnosis of leishmaniasis and for the differentiation of L. (L.) amazonensis and L. (V.) braziliensis in clinical samples. Full article

To address the recognition challenges caused by blurred state boundaries and the limitations of single monitoring modalities during aircraft skin laser paint stripping, this study proposes a multimodal data fusion method for state recognition based on laser-induced breakdown spectroscopy (LIBS) and surface imaging. By constructing a synchronous monitoring platform, a dataset covering five key physical states, namely topcoat (Tc), topcoat–primer transition (Tc-Pr), primer (Pr), primer–substrate transition (Pr-As), and substrate damage (As), was established. The proposed gated weighted multimodal fusion network (PGMF-Net) employs SE-ResNet1D to capture variations in elemental composition features from the spectra and integrates ResNet18 to extract changes in surface morphology from the images. The experimental results show that the proposed model outperforms the single-modal methods as well as the compared early-fusion and late-fusion methods, achieving a recognition accuracy of 94.12% on the test set and an average accuracy of 94.87% in stratified cross-validation. The bootstrap-based confidence interval analysis further verifies the stability of this method under the current dataset conditions. Further analysis indicates that the single-spectrum model has difficulty effectively distinguishing coating transition states because different transition states contain identical or highly similar characteristic peak information. The single-vision model, however, shows insufficient sensitivity to subtle substrate damage, whereas multimodal fusion enables complementary representation of material composition information and surface morphological information. Experimental validation under different power conditions further confirms that the model outputs are generally consistent with the macroscopic morphological evolution observed on the sample surface. This method compensates for the limitations of traditional single-source monitoring and provides a methodological foundation for online monitoring and state feedback during the laser paint stripping process. Full article

Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide, with children representing a particularly vulnerable population in whom diagnosis is often challenging. Pediatric TB is typically paucibacillary and presents with non-specific clinical manifestations, limiting the sensitivity of microbiological confirmation and increasing reliance on immunological tests. The Tuberculin Skin Test (TST) and Interferon-Gamma Release Assays (IGRAs) are the most widely used tools for detecting Mycobacterium tuberculosis infection, yet both have important limitations, especially in young children and in Bacillus Calmette–Guérin (BCG)-vaccinated populations. TST lacks specificity due to cross-reactivity with BCG and environmental mycobacteria, while IGRAs, although more specific, require laboratory infrastructure and may have reduced sensitivity in early childhood. The Tuberculosis Skin Test (TBST), based on M. tuberculosis-specific antigens such as ESAT-6 and CFP-10, has emerged as a promising alternative that combines the operational simplicity of TST with the antigenic specificity of IGRA. This paper reviews the immunological principles, diagnostic performance, and practical considerations of TBST in pediatric populations, with direct comparison to TST and IGRA. Evidence from recent studies suggests that TBST may offer improved specificity over TST, with broadly comparable diagnostic accuracy to IGRA in some settings, although findings are not fully consistent across studies. Particular attention is given to its performance in BCG-vaccinated children and, based on emerging evidence, in those under five years of age. The potential role of TBST in clinical algorithms and public health strategies is discussed, along with current evidence gaps and future research priorities. Full article