Search Results (7,301)

Background: High infectious disease burden and uncontrolled antibiotic usage across human, animal, and environmental contaminants make antimicrobial resistance (AMR) a growing public health problem in Africa. Mobile genetic elements (MGEs) such plasmids, transposons, integrons, conjugative elements, and phages help spread AMR via horizontal gene transfer (HGT) across human, animal, food, and environmental sources. Despite growing evidence for antibiotic resistance genes (ARGs), Africa lacks a one-health-focused synthesis of mobile genetic element-mediated AMR. Objective: This systematic review and meta-analysis aimed to consolidate information on MGEs and ARGs in AMR dissemination throughout Africa’s one health interface. Methods: The literature was searched using PubMed, Scopus, and ScienceDirect. Observational. molecular epidemiology, whole genome sequencing (WGS), and metagenomic investigations of MGE-associated AMR in Africa were eligible. The study selection, data extraction, and quality assessment were performed by two independent reviewer and quality was graded using ROBVIS 2 utilizing Rayyan software. Narrative synthesis, random-effect meta-analysis, subgroup analysis, and meta-regression were utilized. Results: A total of 109 studies were included, with 91 studies contributing to the meta-analysis. MGEs reported were plasmids (71.7%) and integrons (54.8%). ARGs carried by MGEs were blaCTMX-M-15 (78.6%), Sul2 (69.6%), blaTEM (59.1%), and tetA (49.9%). Horizontal gene transfer was seen in 259 instances; however, transmission was unclear. In 442 observations, transmission pathways across human, animal, and environmental interfaces showed AMR prevalence of 75.1% in human, 98.0% in human–animal, and 61.3% in one health interface. Whole-genome sequencing was the most frequently used method for detecting MGEsThe pooled pathogen and AMR prevalence rates were 73.3% (95% CI: 60.5–83.7%) and 94% (95% CI: 85–98%), with significant heterogeneity (I² = 97.8% and 97.4%, respectively). The prevalence of Escherichia coli was 93% and Salmonella enterica 85% in subgroup analysis. Fluoroquinolones, aminoglycosides, and beta-lactams were prevalent in humans (89.7%) and human–animal interactions (98.0%) according to AMR Class. Conclusions: Horizontal gene transfer has propagated MGE-mediated antimicrobial resistance across human, animal, and environmental interfaces in Africa. To combat AMR in Africa, coordinated, genomics-informed One Health surveillance and antibiotic stewardship are needed. Due to variability and publication bias, these data should be considered cautiously. Pooled data may only show descriptive patterns, and not necessarily precise continent-wide prevalence estimates. Full article

Tick-borne diseases pose a significant threat to global cattle production, with species displacement between ticks compounding this issue. This narrative review synthesises the literature to examine the drivers behind the expansion of the invasive Rhipicephalus microplus and its displacement of the native Rhipicephalus decoloratus in Southern Africa. We analysed the biological, ecological, environmental, and anthropogenic factors by reviewing existing scientific studies and reports. Our findings indicate that R. microplus possesses a competitive advantage due to its shorter life cycle, higher reproductive output, and greater acaricide resistance. Furthermore, anthropogenic activities such as communal grazing practices, unregulated livestock movement, and land-use changes facilitate the spread of this parasite. Climate change and vegetation shifts also create more favourable habitats for this invasive species. The conclusion is that the displacement of R. decoloratus by R. microplus intensifies the burden of tick-borne diseases, leading to substantial economic losses. Effective mitigation requires an integrated tick management approach that combines chemical, biological, and ecological strategies, supported by improved surveillance and farmer education. Full article

Since tumor spread through air spaces (STAS) was first described over a decade ago, numerous studies have demonstrated that it is a high-risk prognostic feature in non-small cell lung cancer (NSCLC). However, due to preoperative and intraoperative limitations in pathologic diagnosis, STAS is generally diagnosed following curative intent resection. While STAS should influence NSCLC treatment strategy—particularly upfront surgical decision-making—postoperative diagnosis of STAS has heretofore limited this possibility. While limited to retrospective studies, the current evidence suggests that patients with tumor STAS should undergo a more extensive anatomical resection—preferably a lobectomy, if they are candidates. These results are particularly important in the setting of the results of the JCOG0802 and CALGB 140503 randomized controlled trials which have begun a paradigm-shift toward sublobar resections for early-stage NSCLC, which may not hold similar benefit for early-stage STAS+ disease. The aims of this review are to: (1) detail the current evidence concerning choice of resection extent for STAS+ disease, (2) summarize the current evidence about optimum surgical margins for STAS+ disease, (3) detail the potential role for adjuvant chemotherapy in early-stage STAS+ disease, (4) assess the current limitations in preoperative STAS risk prediction and intraoperative STAS detection, and (5) highlight promising AI-based advancements which will allow surgeons to risk-stratify STAS probability or confirm STAS status intraoperatively. The main limitation of this review is the reliance on retrospective studies as there is a current lack of prospective or randomized data within STAS+ NSCLC, particularly regarding optimal resection strategy for STAS+ disease. Full article

Extracellular vesicles (EVs) are nanoscale membrane-bound particles that mediate intercellular communication by transferring proteins, nucleic acids, lipids, and metabolites. Increasing evidence implicates EVs in Alzheimer’s disease (AD) pathogenesis through the propagation of amyloid-β, tau, and neuroinflammatory signals across neural and glial networks. In parallel, EVs isolated from biofluids have emerged as promising sources of disease-associated biomarkers and potential therapeutic carriers. This review aims to synthesize current evidence on EV-mediated mechanisms in AD, evaluate the diagnostic value of EV-associated biomarkers, and discuss emerging EV-based and bioengineered therapeutic strategies. We summarize how EVs derived from neurons, astrocytes, microglia, and peripheral cells contribute to amyloid-β and tau spread, neuroinflammation, synaptic dysfunction, and metabolic stress in AD. Disease-associated alterations in EV cargo from blood, cerebrospinal fluid, and urine are critically assessed for biomarker applications. We further highlight advances in EV bioengineering, including cargo loading, surface modification, targeting strategies, and modulation of EV biogenesis. Finally, key translational challenges—such as EV heterogeneity, biodistribution, immune clearance, and standardization—are discussed to define future directions for leveraging EVs as diagnostic and therapeutic platforms in AD. Full article

Objective: To characterize the frequency, timing, patterns of first distant metastasis, and post-metastatic survival in uterine sarcoma using population-based registry data. Methods: This study included all patients diagnosed with uterine sarcoma between 2000 and October 2025 in the regional cancer registry of Saxony-Anhalt, Germany. Patients with carcinosarcoma were excluded. Metastatic disease was classified as primary (present at diagnosis or ≤3 months) or metachronous (>3 months). Metastatic patterns were analyzed based on the first metastatic presentation only. Overall survival (OS), recurrence-free survival (RFS), and post-metastatic OS were estimated using Kaplan–Meier methods. RFS was defined as the interval from confirmed tumor-free status after primary therapy to first recurrence or death, and was restricted to patients who achieved tumor-free status (n = 114). Multivariable Cox regression analyses for OS and RFS were performed with administrative censoring at 5 years. Results: A total of 155 patients with uterine sarcoma were included. During follow-up, 54 patients (34.8%) were diagnosed with metastatic disease, of whom 30 (55.6%) presented with primary metastatic disease. Lung was the most frequent site of first metastasis, followed by bone, peritoneum, and liver; 43.4% of metastatic patients had multiple synchronous metastatic sites at first presentation. Median time to first metastasis was short, with several metastatic sites showing median values of zero months, reflecting the high proportion of primary metastatic disease. Median post-metastatic OS was 12 months. Advanced FIGO (Fédération Internationale de Gynécologie et d’Obstétrique) stage and failure to achieve tumor-free status after primary therapy were independently associated with worse OS, whereas histologic subtype was not. Conclusions: In this population-based cohort, metastatic disease occurred in more than one-third of patients with uterine sarcoma and was frequently present at diagnosis. Lung metastases predominated as the first site of distant spread, and post-metastatic survival was poor. These findings underscore the importance of comprehensive staging at diagnosis and highlight the aggressive metastatic behavior of uterine sarcoma in real-world practice. Full article

Senecavirus A (SVA) has rapidly emerged as a globally distributed swine pathogen, with clinical signs mimicking vesicular diseases such as Foot-and-Mouth Disease, posing challenges for timely detection and control. Here, we analyzed 329 complete SVA genomes spanning multiple continents to provide a comprehensive view of its evolutionary dynamics, recombination patterns, haplotype diversity, and global dissemination. Phylogenetic analyses revealed two major lineages: Lineage 1, consisting mainly of early strains from the United States before 2007, and Lineage 2, which emerged post-2007 and subsequently spread across the Americas and East Asia. Recombination was confined to Lineage 2 and concentrated in nonstructural regions, particularly 2C, highlighting intra-lineage genetic exchange as a driver of recent diversification. Haplotype analysis of the 3AB gene identified 170 distinct haplotypes, revealing a star-like network structure consistent with rapid population expansion from a central ancestral variant, while secondary branches reflect ongoing regional diversification. Despite this high genetic variation, genome-wide dN/dS ratios remained below one, and purifying selection was strongest in the N-terminal domains of structural and nonstructural proteins, indicating functional constraints that maintain viral fitness. Time-scaled phylogenetic reconstruction and Bayesian Skyline analysis revealed rapid lineage diversification and a marked increase in effective population size in the early 2010s. Phylogeographic inference further identified repeated introductions from the Americas into East Asia, likely facilitated by swine trade and other anthropogenic factors. Collectively, SVA evolution is driven by frequent mutation and intra-lineage recombination yet constrained by pervasive purifying selection, generating extensive genetic diversity while maintaining functional integrity, with implications for genomic surveillance and targeted control. Full article

Wheat streak mosaic (WSM), historically attributed to wheat streak mosaic virus (WSMV) and transmitted by the wheat curl mite (WCM; Aceria tosichella), remains a major cause of yield loss in the Texas High Plains. In recent years, Triticum mosaic virus (TriMV), also transmitted by WCM, has emerged as an increasingly important component of the WSM disease complex. Under field conditions, TriMV is most frequently detected in mixed infections with WSMV. Management of WSM relies primarily on resistant cultivars carrying genes such as Wsm1 or Wsm2. Although synergistic interactions between WSMV and TriMV have been documented under controlled conditions, their dynamics during natural field infections—particularly during the latent phase between initial infection and symptom development—remain poorly understood. Moreover, the extent to which host genotype influences virus–virus interactions and vector acquisition dynamics in the field has not been fully resolved. Replicated field trials conducted over two growing seasons were used to quantify temporal accumulation patterns and relative ratios of WSMV and TriMV in susceptible (TAM 304) and resistant cultivars differing in resistance source (BT [Wsm1] and Joe [Wsm2]) under natural disease spread. WSMV remained the predominant virus in mixed infections across cultivars, sampling times, and disease stages. However, as plants aged and entered senescence, WSMV titers declined more rapidly than TriMV titers, resulting in a progressive reduction in the WSMV-to-TriMV ratio. From early infection through disease development, the Wsm1 cultivar (BT) consistently supported significantly lower TriMV accumulation than the Wsm2 cultivar (Joe), providing a mechanistic explanation for the comparatively stronger disease suppression associated with WSM. Mites feeding on BT also acquired lower TriMV titers. Although viral concentrations in wheat tissue were strongly correlated with those detected in feeding mites, substantial differences in plant-level WSMV-to-TriMV ratios among cultivars were not mirrored within the vector. These findings indicate that while host resistance regulates absolute virus accumulation, vector-associated factors may influence the relative proportions of viruses detected following acquisition, with important implications for WSM epidemiology and resistance deployment in field systems. Full article

Miniprobe endoscopic ultrasonography (mEUS) combines high-resolution imaging of the gastrointestinal (GI) wall and bile ducts with ease of applicability during routine endoscopy. This narrative review aims to provide an overview of known and emerging fields of application for mEUS in gastrointestinal endoscopy. After its initial development in pancreatobiliary scenarios in the early 1990s, mEUS has been recently reconsidered a third-space endoscopic technique that is progressively developing and spreading for the treatment of early gastrointestinal neoplastic lesions. The high spatial resolution of mEUS provides an accurate assessment of the degree of submucosal invasion in early esophageal, gastric, and colorectal neoplasia, while the small caliber of catheters allows for mEUS employment in settings where standard echoendoscopes are impractical (e.g., severe stenoses or proximal colonic lesions). Beyond cancer staging, mEUS offers point-of-care characterization of subepithelial lesions by defining the layer of origin and echo-pattern, eventually defining endoscopic resectability, but definitive diagnosis remains histological. In pancreatobiliary diseases, miniprobe intraductal ultrasonography (IDUS) shows its strongest application for indeterminate biliary strictures when endoscopic retrograde cholangiopancreatography (ERCP)-based sampling strategies and brushing cytology show inconclusive diagnoses, and in choledocholithiasis, particularly for the detection of small stones/sludge and confirmation of duct clearance. IDUS is also valuable for the staging of ampullary tumors, for longitudinal extension mapping in hilar cholangiocarcinoma and for selected portal biliopathy scenarios. Overall, mEUS and IDUS are high-resolution adjuncts that can meaningfully refine local decision-making in the treatment of superficial epithelial/subepithelial tumors or lesions involving the bile ducts. Limitations include shallow penetration, lack of tissue acquisition capability, a relative increase in post-ERCP pancreatitis risk for intraductal use, and substantial cost with limited availability in lower-volume centers. Full article

Background: Influenza A(H3N2) viruses remain a major public health concern due to their rapid antigenic evolution and association with severe disease, particularly among high-risk populations. During the 2025–2026 influenza season, a marked epidemiological shift was observed in Europe, with the emergence and predominance of the A(H3N2) subclade K (J.2.4.1). Objectives: This narrative review aims to provide an integrated overview of the epidemiology, evolutionary dynamics, and public health implications of subclade K, with a particular focus on its impact on vaccine effectiveness, in comparison with the 2024–2025 influenza season. Methods: A non-systematic literature review was conducted using major scientific databases and official public health sources, including WHO and ECDC reports. Recent surveillance data, genomic analyses, and epidemiological updates were included. Given the rapidly evolving evidence base, selected preprint studies were also considered and interpreted with caution. Results: The 2025–2026 influenza season in Europe was characterized by a relative genetic convergence, with subclade K accounting for the majority of A(H3N2) sequences. This variant demonstrated a clear selective advantage and was associated with an earlier and more intense epidemic peak. Molecular analyses indicate the accumulation of multiple mutations in the hemagglutinin protein, particularly within key antigenic sites, contributing to immune escape. These evolutionary changes have important implications for vaccine effectiveness, with current estimates suggesting moderate protection against infection but preserved effectiveness against severe outcomes. Antigenic mismatch, manufacturing constraints, and host-related factors further contribute to reduced vaccine performance. Conclusions: The emergence and rapid spread of subclade K highlight the dynamic nature of influenza virus evolution and its impact on public health. Continuous genomic surveillance and timely vaccine updates remain essential. Despite suboptimal effectiveness against infection, influenza vaccination continues to provide significant protection against severe disease and should remain a cornerstone of prevention strategies. Full article

Background: Conjunctival melanoma is a rare but potentially aggressive ocular surface malignancy characterized by frequent local recurrence and risk of metastatic spread. In carefully selected cases, depending on tumor extent, clinical course, and patient condition, management may require balancing oncologic control with preservation of the globe, visual function, and quality of life. Case Presentation: We report the case of a 78-year-old woman with amelanotic conjunctival melanoma of the left eye. Initial treatment consisted of wide local excision using a no-touch technique, conjunctival autograft reconstruction, and adjuvant topical Mitomycin C (MMC). During a 10-year follow-up period, the patient developed multiple local recurrences requiring repeated surgical excisions and additional MMC therapy. Despite the chronic relapsing course, useful visual function and globe preservation were maintained. In December 2024, a subcutaneous lesion of the upper eyelid was detected and histopathologically confirmed as locoregional metastasis from the primary conjunctival melanoma. Given the patient’s advanced age, preserved visual function, absence of documented distant metastatic disease, and overall clinical context, management continued with a conservative, eye-preserving approach. Conclusions: This case illustrates that prolonged eye preservation may be achievable in carefully selected patients with recurrent conjunctival melanoma through repeated conservative management. However, this strategy does not eliminate the risk of delayed progression and requires individualized decision-making together with long-term surveillance. Full article

Ovarian cancer is the most lethal gynaecological cancer, largely because it is often diagnosed late and shows strong tumour heterogeneity, therapy resistance, and rapid metastatic spread. A key driver of this aggressive behaviour is the tumour’s ability to reshape its surrounding microenvironment to support invasion, angiogenesis, and escape from treatment. Cathepsin L (CTSL), a lysosomal cysteine protease, has emerged as an important mediator of these processes and is gaining attention as both a prognostic marker and a potential therapeutic target. This review examines the diverse roles of CTSL in ovarian cancer progression, focusing on how its expression, localisation, and extracellular release are altered within the hypoxic and acidic conditions typical of the tumour microenvironment. It also outlines emerging therapeutic strategies aimed at targeting CTSL, including selective inhibitors, multi-cathepsin approaches, CTSL-activated prodrugs and antibody-drug conjugate linkers, and nanomedicine systems designed for tumour-specific delivery. Overall, the evidence highlights CTSL as a central regulator of invasion, angiogenesis, and relapse in ovarian cancer, underscoring its potential as a target for new therapies in aggressive disease. Full article

This study explored the application of carbon stable isotopes for tracing the geographical origin of Monochamus alternatus, an insect vector responsible for spreading pine wilt disease. The primary vector of pine wilt disease, an aggressive disease caused by the pine wood nematode and affecting pine forests, is Monochamus alternatus. Samples of Monochamus alternatus were collected from 12 provinces across China, and their carbon isotope ratios (δ¹³C) were measured. By analyzing the correlation between these ratios and various environmental factors, including latitude, longitude, altitude, and bioclimatic conditions, it was found that precipitation seasonality and solar radiation were the most important factors influencing the carbon isotope ratio of Monochamus alternatus. The spatial distribution of Monochamus alternatus carbon isotopes in China was predicted using the co-Kriging interpolation method, incorporating these two environmental variables. The findings revealed a gradient in the carbon isotope ratio of Monochamus alternatus, which could help differentiate the species across various geographical regions in China. Full article

Soybean rust is a widespread and rapidly spreading fungal disease that poses a serious threat to both the yield and quality of soybeans. Traditional vegetation indices struggle to effectively assess disease severity across different infection stages, particularly during early or mild stages, due to weak spectral responses. In this study, we propose a soybean rust resistance identification model, RustNet-3D (Soybean Rust Disease Diagnosis Network-3D), which integrates a 3D deformable convolution module and a spectral dilated convolution module to achieve accurate classification of different disease severity levels. We further introduce a spectral feature band extraction module, iBSAM (improved Band Selection and Attention Module), which employs a modified depthwise separable convolution architecture. iBSAM incorporates bandwise independent convolution to enable individualized modeling of each spectral band. It also applies a hard thresholding strategy to remove redundant information, and integrates a channel attention mechanism to reinforce the model’s sensitivity to discriminative wavelengths. By modeling the temporal hyperspectral data of soybean rust, five highly sensitive spectral bands—581 nm, 605 nm, 596 nm, 609 nm, and 628 nm—are identified and subsequently used to construct the Soybean Rust Spectral Index (SRSI). Experimental results demonstrate that the RustNet-3D model achieves an overall accuracy (OA) of 92.74%, and the correlation coefficient between SRSI and disease severity reaches 0.89, validating the effectiveness of the selected spectral features. This study provides a rapid and accurate solution for soybean rust severity evaluation, offering a high-efficiency and automated approach for resistance identification and intelligent breeding. Full article

Background/Objectives: Malaria remains a major global health burden, particularly in sub-Saharan Africa, where the recent invasion and urban expansion of Anopheles stephensi are increasing transmission risk in densely populated areas. Conventional vector control strategies, including widespread insecticide application, are progressively losing efficacy due to the rapid spread of resistance. These limitations have accelerated the development of genetic control approaches aimed at either suppressing vector populations or replacing them with genetically modified mosquitoes incapable of transmitting pathogens, with the shared objective of reducing disease transmission. For population suppression strategies, an essential component is a conditional regulatory system that enables precise control of toxic or otherwise deleterious effector proteins. The most widely used platform, the tetracycline-dependent (Tet) system, modulates gene expression in response to tetracycline. However, this system can exhibit leaky expression and variable regulation, which may compromise its reliability and limit its application in certain contexts. The dihydrofolate reductase (DHFR) destabilization domain (DD) system, developed in Drosophila, offers an alternative strategy for post-translational control of protein stability. In this system, proteins fused to a destabilization domain are rapidly degraded unless stabilized by the small molecule trimethoprim (TMP), enabling tight and reversible control. In Drosophila and prior reports, this system has been associated with relatively low fitness costs, although such effects have not been systematically evaluated in mosquitoes. Before adapting this system for mosquito genetic control, it is therefore essential to assess the impact of TMP exposure on key life-history traits. Methods: Here, we assessed the effects of varying TMP concentrations on mosquito development, survival, and reproductive output. Results: Our results demonstrate that low concentrations of TMP exposure had no detectable effects on immature development, adult survival, or reproductive output under the conditions tested, supporting the implementation of the DHFR-DD system in mosquitoes. Importantly, these effects were dose-dependent, with moderate to high TMP concentrations producing measurable impacts on mosquito fitness. Conclusions: These findings provide a foundational step toward the development of more precise and reliable conditional expression systems for genetic vector control, advancing innovative strategies to mitigate malaria transmission in high-risk regions. Full article

Background: Pancreatic neuroendocrine neoplasms (PanNENs) represent a heterogeneous tumor entity with a steadily rising incidence, mainly due to advances in imaging and growing diagnostic awareness. In pancreatic ductal adenocarcinoma (PDAC), the mesopancreas (MP) has been identified as a frequent site of microscopic tumor spread and a key determinant of circumferential resection margin (CRM) status, leading to the concept of standardized mesopancreatic excision (MPE). While its oncological relevance in PDAC is increasingly recognized, the role of the mesopancreas in PanNENs remains unclear. This study aimed to systematically evaluate mesopancreatic infiltration in PanNENs and to identify associated clinicopathological predictors. Methods: Consecutive patients undergoing oncological pancreatoduodenectomy, spleen-preserving distal pancreatectomy, or distal splenopancreatectomy for PanNENs and PanNECs were included. The mesopancreas was histopathologically examined for tumor infiltration within CRM assessment. Results: MP infiltration was detected in 60% of patients. It was associated with higher Ki-67 index, larger tumor size, lymph node involvement, venous invasion, and positive CRM status. A Ki-67 index ≥ 5% and tumor size ≥ 21.5 mm were identified as predictors of MP infiltration. Higher T stage predicted reduced overall survival (OS), whereas MP infiltration, lymphatic (L1) and venous (V1) invasion, and Ki-67 ≥ 5% were associated with impaired disease-free survival (DFS). Conclusion: Mesopancreatic infiltration is frequently present in PanNENs and correlates with aggressive tumor characteristics. Given its association with CRM positivity and reduced DFS, consideration of the mesopancreas in staging and surgical strategies appears oncologically justified. Larger studies are required to validate these findings. Full article