Search Results (236)

Addressing the challenges of extreme sample scarcity, complex underwater optical environments, and significant variations in lesion scales in real-world aquaculture, this paper proposes a small-sample grass carp disease recognition method, namely Swin Transformer with Supervised Contrastive Learning (ST-SCL), integrating dual-stream data augmentation and supervised contrastive learning. First, a frequency-spatial dual-stream augmentation strategy is constructed. In the frequency domain, the Amplitude-Mix technique is introduced to simulate diverse lighting and turbidity styles by mixing background amplitude spectra, thereby enhancing environmental generalization. In the spatial domain, a pathology-mask-guided instance-level Copy-Paste strategy is employed to directionally expand scarce lesion samples and address data imbalance. Second, the Swin Transformer is adopted as the backbone network, leveraging its hierarchical shifted window attention mechanism to effectively capture multi-scale features, balancing the detection of tiny parasites and extensive superficial ulcerations. Finally, supervised contrastive learning is incorporated to maximize intra-class compactness and minimize inter-class separability within the feature space, effectively reducing overfitting inherent to small-sample learning. Experimental results demonstrate that the proposed method achieves a macro-average F1-score of 95.86% across six disease categories. Compared with mainstream models such as ResNet and ConvNeXt, the ST-SCL exhibits notable performance improvements and enhanced robustness in small-sample scenarios, offering a promising technical path for precise fish disease diagnosis in complex aquatic environments. Full article

The pharmaceutical industry is a major source of pollution in wastewater effluents, characterized by chemical residues that are complex and difficult to degrade. Naproxen, a commonly detected drug in sewage effluents, exceeds safe concentrations for aquifers and is highly persistent, posing significant risks to aquatic life and ecosystems. This drug is known to cause long-term side effects in humans, such as gastrointestinal ulcers and nephrosis, associated with frequent and prolonged use. Additionally, the recent pandemic has led to a marked increase in drug consumption over a short period, exacerbating environmental contamination. Titanium dioxide has been extensively used as a photocatalyst in recent decades, proving effective in reducing these emerging pollutants. In this study, TiO₂ doped with cerium was synthesized using the sol–gel method, with cerium concentrations varied at 1, 3, 5, and 10% by weight. The resulting nanocatalysts were characterized through nitrogen physisorption, scanning electron microscopy (SEM), X-ray diffraction (XRD), and UV-Vis diffuse reflectance spectroscopy. Photocatalytic activity was assessed using a UV-Vis spectrophotometer to monitor the degradation of the drugs. XRD analysis confirmed the crystallinity and anatase phase of TiO₂. UV-Vis diffuse reflectance spectra indicated a decrease in bandgap energy of up to 3.00 eV compared to pure TiO₂. The materials demonstrated significant degradation of naproxen (NPX) and acetaminophen (ACTP), both prepared at 30 ppm, over a 6 h reaction period. Full article

The genus Serjania (family Sapindaceae) comprises more than 240 species, primarily distributed in Brazil and Mexico, and it exhibits considerable ethnobotanical and therapeutic potential. Ethnobotanical evidence documents the widespread use of decoctions prepared from the leaves, stems, and roots of Serjania species for the treatment of gastrointestinal disorders, renal pain, inflammatory conditions, and infections. Among the most extensively studied species are S. marginata, S. erecta, S. lethalis, S. caracasana, S. goniocarpa, S. schiedeana, S. yucatenensis, S. triquetra, and S. racemose. Phytochemical research has identified a diverse array of bioactive secondary metabolites, including saponins, flavonoids, phenolic acids, tannins, and terpenoids. Significant experimental evidence supports the broad spectrum of biological activities of these Serjania species, including antimicrobial, anti-inflammatory, antioxidant, gastroprotective, antihypertensive, analgesic, antivenom, cytotoxic, antimutagenic, anti-ulcer, photoprotective, antiparasitic, and vasorelaxant effects, as demonstrated in both in vitro and in vivo models. Although preliminary toxicity assessments of extracts from some Serjania species in murine models, Oreochromis niloticus (Nile tilapia), and Artemia salina suggest a favorable safety profile, significant research gaps remain. Additionally, several Serjania species have shown potential as natural pesticides and bioherbicides, highlighting their relevance in agricultural applications. Future studies should prioritize the isolation and structural characterization of individual bioactive compounds, as well as the elucidation of their molecular mechanisms of action, moving beyond crude extract-based screening approaches. Overall, this review summarizes current knowledge on traditional uses, phytochemical composition, biological activities, and biotechnological applications of Serjania species. Full article

Rapidly progressive infectious keratitis may involve the anterior uveal tract and lead to anterior segment inflammation, resulting in severe structural damage of the cornea and potentially causing corneal perforation or endophthalmitis if not promptly treated. We report the case of a 63-year-old male admitted to the Emergency Ophthalmology Department of the University Clinical Center in Katowice, Poland, with a rapidly progressive corneal ulcer of the left eye that had not responded to two weeks of outpatient topical antibiotic therapy. The condition developed after ocular trauma sustained while chopping wood. At presentation, visual acuity was limited to light perception with preserved projection. Multimodal imaging, including slit-lamp examination, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy, revealed extensive corneal ulceration with severe stromal destruction, progressive corneal melting, and marked anterior segment inflammation, with an imminent risk of perforation. Microbiological cultures identified Pseudomonas aeruginosa. Despite intensive empiric topical antimicrobial therapy targeting both bacterial infection and a possible fungal component related to trauma with organic material, rapid clinical deterioration necessitated emergency therapeutic penetrating keratoplasty (PK). The procedure resulted in rapid resolution of inflammation and improvement in visual acuity, with best-corrected visual acuity (BCVA) reaching 0.3 logMAR during follow-up. At the three-month follow-up, the corneal graft remained clear with stable visual acuity and no recurrence of infection. The patient remains under regular long-term follow-up, with ongoing monitoring of graft clarity, intraocular pressure (IOP), and visual function. This case differs from routine presentations of infectious keratitis by demonstrating exceptionally rapid stromal melting despite promptly initiated empiric topical therapy. Multimodal imaging, particularly AS-OCT provided clinically meaningful information by revealing structural instability and an imminent risk of perforation not fully appreciable on slit-lamp examination, thereby supporting timely urgent keratoplasty. These findings highlight the practical diagnostic value of imaging-based assessment in advanced infectious keratitis and underscore its role in guiding surgical decision-making in eyes at high risk of corneal perforation. Full article

Pythiosis is a neglected infectious disease caused by the aquatic oomycete Pythium insidiosum and remains underrecognized in cattle, particularly in tropical regions. Here, we report the first molecularly confirmed outbreak of bovine pythiosis in the Amazon biome, affecting more than 400 animals raised under extensive production systems and areas with prolonged exposure to standing water. Clinically affected cattle presented ulcerative and exudative cutaneous lesions, predominantly involving the distal limbs. Given the diagnostic challenges associated with pythiosis, etiological confirmation was achieved through quantitative PCR (qPCR) targeting the internal transcribed spacer (ITS) region of P. insidiosum, providing rapid and specific molecular detection during the outbreak investigation. Therapeutic interventions were implemented as part of routine field management, including intramuscular triamcinolone combined with topical copper sulfate; this regimen was associated with clinical improvement in a substantial proportion of affected animals, though treatment efficacy was not formally evaluated. The outbreak occurred in flood-prone pastures during the rainy season, highlighting the role of aquatic environments in pathogen transmission. These findings expand the current understanding of bovine pythiosis in tropical ecosystems and underscore the importance of molecular diagnostics, outbreak surveillance, and a One Health approach for the identification and management of water-associated pathogens in livestock. Full article

Background: The neutrophil-to-lymphocyte ratio (NLR) is a simple biomarker that reflects the balance between innate immune response and adaptive immunity. Currently, the genetic basis and clinical implications of NLR in relation to inflammatory gastrointestinal diseases have not been extensively explored. Methods: We carried out a genome-wide association study (GWAS) on European individuals from the UK Biobank to detect genetic variants related to NLR, followed by post-GWAS analyses including colocalization analysis, transcriptome-wide association studies (TWAS), and LD score regression. Logistic regression, Cox regression, and gene–environment interaction analysis were used to evaluate the impact of NLR polygenic risk scores (PRS) on inflammatory gastrointestinal disease risks. Results: GWAS of 395,442 Europeans identified 306 genomic regions (731 lead SNPs) associated with NLR, mapping to 1542 genes enriched for immune pathways. Colocalization revealed shared genetic signals with TWAS prioritization of 59, 19, 14, 22 and 28 genes in the whole blood, spleen, terminal ileum, transverse colon and sigmoid colon, respectively. LD-score regression showed significant positive genetic correlations with CD (rg = 0.132), coeliac disease (rg = 0.124), peptic ulcer (rg = 0.138) and duodenal ulcer (rg = 0.220). One-SD increase in NLR PRS predicted higher risk of IBD (OR = 1.05, 95% CI 1.03–1.08), Crohn’s disease (OR = 1.06, 1.02–1.10), ulcerative colitis (OR = 1.05, 1.02–1.08) and coeliac disease (OR = 1.07, 1.03–1.11). Restricted cubic splines demonstrated non-linear relationships of NLR PRS for IBD, CD and UC. Gene environment analyses showed smoking and diabetes amplified the risks, while cardioprotective diet, oily fish intake and polyunsaturated fatty acid level attenuated NLR PRS-associated risk in IBD (mainly CD). Conclusions: Our study delineates the polygenic basis of NLR and establishes its genetic correlation with inflammatory gastrointestinal diseases, offering a genetically informed indicator for disease risk stratification with potential utility in population-level prevention strategies. Full article

Protein-losing enteropathy (PLE) is an uncommon and often underrecognized manifestation of lymphoproliferative disorders and may be difficult to diagnose when conventional gastrointestinal investigations are unrevealing. We present an 82-year-old woman with recurrent hospital admissions initially spanning six months for diarrhea, weight loss, peripheral edema, and persistent hypoalbuminemia. Initial upper gastrointestinal endoscopy was normal, and colonoscopy was deferred due to intercurrent infection. Despite extensive laboratory and radiologic evaluation, including routine biochemical testing and imaging, the etiology of PLE remained unclear. Peripheral blood flow cytometry subsequently identified a small kappa-restricted monoclonal B-cell population compatible with marginal zone lymphoma, later confirmed on bone marrow biopsy, raising suspicion for gastrointestinal involvement. Video capsule enteroscopy demonstrated diffuse erosive and ulcerative disease throughout the small intestine, providing an anatomical explanation for the patient’s protein loss. Following lymphoma-directed therapy, repeat capsule enteroscopy showed complete normalization of the small bowel mucosa. This case highlights the diagnostic value of combining peripheral blood flow cytometry and capsule endoscopy in unexplained protein-losing enteropathy, a rare and diagnostically challenging presentation of indolent lymphoma, and illustrates the role of capsule imaging in both disease localization and treatment monitoring. As a single-case report, these findings are not generalizable, and further studies are required to evaluate the broader applicability of this diagnostic approach. Full article

Background/Objectives: Extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT), is a rare and extremely aggressive subtype of non-Hodgkin lymphoma that most frequently involves the nasal cavity and upper aerodigestive tract. Primary isolated oral manifestation is exceptionally uncommon and may mimic odontogenic or infectious diseases, delaying diagnosis. We report a case of ENKTCL-NT presenting initially as a destructive oral lesion without sinonasal involvement at diagnosis. Methods: A 32-year-old man with progressive palatal ulceration underwent clinical and imaging assessment (panoramic radiography and staging ^18F-FDG PET–CT) and repeated biopsies. Diagnosis was established using histopathology (H&E), immunohistochemistry (T-cell markers and cytotoxic profile), EBV detection by EBER in situ hybridization, and T-cell receptor gamma (TCRG) gene rearrangement analysis. Results: The lesion presented as a hemorrhagic, ulcerative palatal destruction covered by pseudomembranous exudate and was complicated by fungal infection, periostitis, and severe dental inflammatory foci, contributing to diagnostic delay. Histopathological examination revealed extensive necrosis with a dense atypical lymphoid infiltrate; angiocentric and angiodestructive growth was identified in one biopsy specimen. Tumor cells expressed T-cell markers (CD2, CD3, CD5, CD7; heterogeneous) and cytotoxic markers (TIA-1) and showed CD30 and CD56 positivity, with EBV positivity confirmed by EBER in situ hybridization. Molecular analysis demonstrated monoclonal TCRG rearrangement, and Ki-67 indicated high proliferative activity. Initial PET–CT demonstrated an intensely FDG-avid, locally invasive lesion without distant organ involvement. The patient was treated with L-asparaginase-based SMILE chemotherapy followed by radiotherapy (50 Gy), achieving marked initial clinical improvement and partial metabolic response; however, systemic relapse subsequently occurred with refractory disease despite salvage therapy and immunotherapy. Conclusions: This case highlights the substantial diagnostic challenge posed by isolated oral extranodal NK/T-cell lymphoma, nasal type, which may closely mimic benign inflammatory or infectious conditions and lead to significant diagnostic delay. Persistent, progressive, or therapy-resistant oral ulcerations should prompt early consideration of hematologic malignancy. Timely biopsy with comprehensive immunophenotyping, EBV testing, and close multidisciplinary collaboration are essential for accurate diagnosis and may contribute to earlier diagnosis and improved patient outcomes in these rare and atypical presentations. Full article

Background: Ulcerative colitis (UC) and sarcoidosis are chronic inflammatory diseases that share immunological pathways but rarely coexist. The increasing use of biologic agents in inflammatory bowel disease (IBD) has raised concerns regarding paradoxical inflammatory manifestations, including sarcoidosis-like reactions. Case presentation: We report the case of a 63-year-old man with long-standing UC treated with vedolizumab who developed systemic sarcoidosis characterized by bilateral hilar lymphadenopathy, mediastinal and abdominal lymph node enlargement, pulmonary involvement, and erythema nodosum. Extensive diagnostic work-up, including imaging and histopathology, confirmed non-necrotizing granulomatous disease consistent with sarcoidosis, while alternative infectious, malignant, and drug-induced causes were excluded. Vedolizumab was temporarily discontinued, leading to UC relapse, and subsequently reintroduced with rapid clinical remission of UC. Discussion: Sarcoidosis remained clinically and radiologically stable despite vedolizumab re-initiation, suggesting a coincidental association rather than a direct causal relationship. This case highlights the diagnostic challenges and therapeutic dilemmas in patients with immune-mediated diseases receiving biologic therapy. Conclusion: The coexistence of UC and sarcoidosis during vedolizumab therapy is rare. Although causality cannot be established, our findings suggest that vedolizumab may be safely continued in selected patients under close multidisciplinary monitoring. Full article

Diabetic foot ulcer (DFU) infections frequently involve biofilm formation and exhibit limited responsiveness to conventional antibiotic therapy. In particular, Pseudomonas aeruginosa often participates in mono- and polymicrobial biofilms that display high tolerance to antimicrobial agents. This study evaluated the efficacy of methylene blue-mediated antimicrobial photodynamic therapy (aPDT), alone and in combination with antibiotics, against P. aeruginosa biofilms formed either as single-species or in mixed communities with Enterococcus faecalis, under conditions mimicking DFU infections. Macrocolony biofilms were challenged with amikacin alone (for single-species biofilms) or amikacin plus ampicillin (for mixed biofilms), aPDT, or sequential combinations of these treatments, and bacterial viability was quantified by colony-forming unit enumeration. Antibiotic treatment alone produced only modest reductions in P. aeruginosa viability, even at high concentrations, while aPDT using methylene blue was effective only at high photosensitizer concentrations. In contrast, sequential treatment with antibiotics followed by aPDT and a second antibiotic challenge resulted in a marked reduction in P. aeruginosa viability in both mono- and polymicrobial biofilms. Scanning electron microscopy revealed extensive structural damage in P. aeruginosa cells following combined treatments, whereas E. faecalis remained unaffected. Overall, our findings demonstrate that combining aPDT with antibiotics significantly enhances antibiofilm activity against P. aeruginosa, highlighting this approach as a promising alternative for the management of biofilm-associated DFU infections. Full article

Gastric ulcer (GU) is a common upper gastrointestinal disorder characterized by oxidative stress and inflammatory responses, which significantly impact the patient’s quality of life and pose a serious challenge to public health. Excessive and chronic alcohol consumption are considered primary contributing factors to gastric ulcer. Pharmacodynamic and pharmacological experiments showed that aspirin eugenol ester (AEE) had good anti-inflammatory and anti-oxidant effects. Therefore, it was speculated that AEE could alleviate ethanol-induced gastric mucosal injury through anti-inflammatory and antioxidant pathways. This study aimed to systematically evaluate the effect of AEE on ethanol-induced gastric mucosal injury using in vivo and in vitro experiments. In a gastric injury model induced by ethanol, H&E staining, AB-PAS staining, RT-PCR, immunohistochemistry, and a series of other molecular biological assays and omics techniques were employed to investigate AEE potential mechanisms. The results revealed extensive necrosis in the gastric mucosa of the ethanol group with a marked reduction in mucus secretion on the mucosal surface and a significantly decreased expression of ZO-1, claudin-1, and occludin, while AEE exhibited a significant protective effect when compared to ethanol group. AEE inhibited NF-κB pathway activation and reduced the expression of inflammatory cytokines. AEE significantly enhanced superoxide Dismutase (SOD) levels and reduced the ethanol-induced increases in reactive oxygen species (ROS), malondialdehyde (MDA), and lipid peroxidation (LPO) levels by reversing the ethanol-induced decline in Nrf-2 expression. AEE also mitigated cellular damage by inhibiting ferroptosis in the cells. AEE significantly improved the metabolic profiles of gastric tissue and serum. AEE exerts gastric protective effects by synergistically modulating multiple pathways and biological processes. AEE can enhance antioxidant capacity and inhibit ferroptosis by activating the Nrf-2/GPX4 pathway, alleviate inflammatory responses by suppressing the NF-κB pathway, and simultaneously maintain gastric mucosal barrier integrity through regulation of metabolic reprogramming and enhancement of tight junction function. Full article

Background/Objectives: Oral health-related quality of life (OHRQoL) is a complex topic, encompassing the medical, functional and psychosocial aspects of well-being, especially in the context of systemic conditions that can trigger oral cavity impairment. While this subject has been extensively investigated in adults, evidence remains limited in pediatric populations, particularly in children with leukemia who are at high risk for oral complications related to the disease itself and its treatment. Moreover, children and parent perceptions of oral health are essential for guiding preventive and personalized therapeutic strategies, yet they are poorly explored in this clinical context. The objective of this study was to assess OHRQoL in children with leukemia and gingival inflammation, and compare it with that of children without this systemic condition. Methods: This observational, cross-sectional, case–control study was conducted on 99 subjects, divided into two groups: the study group n = 49 leukemia subjects and the control group n = 50 subjects without oncologic pathology. Clinical examination of all subjects was performed and oral health status was evaluated using Oral Health Index-Simplified (OHI-S) and Gingival Index (GI). Parents filled out a personalized exploratory questionnaire, adapted after established scales, designed to capture the child’s perceived impact of certain leukemia-related gingivo-periodontal alterations, including pain, ulcerations, gingival bleeding and xerostomia. Data were analyzed using descriptive statistics, Pearson’s Chi-square test and comparative graphical analyses (IBM SPSS Statistics 26). Results: Children with leukemia reported higher frequencies of xerostomia, ulcerations and gingival bleeding compared to children in the control group, with xerostomia showing a suggestive association to gingival inflammation. Oral hygiene status of children in the leukemia group was generally better among children receiving parental assistance during brushing or those practicing dental flossing. Comparative graphical analyses showed differences in symptom reporting and oral hygiene support between groups. Conclusions: The results suggest that xerostomia seemed to align with gingival inflammation in children with leukemia, while parental assistance and dental flossing seemed to be associated with better oral hygiene status. Our findings also support the need for developing standardized, disease-oriented scales of evaluating OHRQoL, as well as individualized oral care and continuous monitoring in order to improve oral health-related quality of life in this vulnerable pediatric population. Full article

Precise medical segmentation of oral ulcers is mandatory and crucial for early diagnosis, but it remains a very challenging task due to rich backgrounds, overexposed or underexposed lesions, and the complex surrounding areas. Therefore, in order to address this challenge, this paper introduces HF-EdgeFormer, a novel hybrid model for oral ulcer segmentation on the AutoOral dataset. This U-shaped transformer-like architecture is, based on publicly available models, the second documented solution for oral ulcer segmentation and it explicitly integrates high-order frequency interactions by using multi-dimensional edge cues. At the encoding stage, a HFConv (High-order Focus Convolution) module divides the feature channels into local streams and global streams, performing learnable filtering via FFT and depth-wise convolutions. After that, it fuses them through stacks of focal transformers and attention gates. In addition to the HFConv block, there are two edge-aware units: the EdgeAware Localization module (that uses eight-direction Sobel filters) and a new Precision EdgeEnhance module (channel-wise Sobel fusion), both used in order to reinforce the boundaries. Skip connections imply Multi-dilated Attention Gates, accompanied by a Spacial-Channel Attention Bridge to accentuate lesion-consistent activations. Moreover, the novel architecture employs an innovative lightweight vision transformer-based bottleneck. It consists of four SegFormerBlock modules localized at the network’s deepest point, so we can achieve global relational modeling exactly where the largest receptive field is present. The model is trained on the AutoOral dataset (introduced by the same team that developed the HF-Unet arhitecture), but due to the limited available images, it needed to be extended by using extensive geometric and photometric augmentations (like RandomAffine, flips, and rotations). This novel architecture achieves a test Dice score of almost 82% and a little over 85% sensitivity while maintaining high precision and specificity, highly valuable in medical segmentation. These results surpass prior HF-UNet baselines while maintaining the model light, with minimal inference memory gains. Full article

Background/Objectives: Tumor necrosis factor alpha (TNF-alpha) plays a key role in systemic inflammation in multiple disorders, including inflammatory bowel diseases (IBDs). Our purpose was to investigate the contribution of two promoter single-nucleotide polymorphisms (rs361525/–238G/A and rs1800629/–308G/A) to disease susceptibility, clinical features, and response to biologic therapy in a cohort of Romanian patients with IBDs. Methods: A total of 198 patients with IBDs, 106 with Crohn’s disease (CD) and 92 with ulcerative colitis (UC), as well as 160 healthy controls, all Caucasians of Romanian origin, were genotyped using TaqMan Allelic Discrimination Assays. Phenotypical and anti-TNF treatment characteristics of the patients with IBDs were recorded. Statistical analyses were performed using OpenEpi and PLINK v1.07 software. Results: We found a significantly higher frequency of the minor allele A of rs361525 in patients with CD than in the controls (6.6% vs. 2.2%, p = 0.01, OR = 3.16). Half of the patients with extraintestinal manifestations (EIMs) had at least one copy of the rs1800629 A allele compared with approximately 10% of patients without EIM (p = 1 × 10⁻⁴, OR 9.58 for UC and p = 9 × 10⁻⁴, OR 6.60 for CD). In the whole IBD group of patients, the carriers of the minor allele (AA+GA) for both SNPs studied (rs1800629 and rs361525) were significantly more likely to have EIM associated with IBDs (p = 3 × 10⁻⁷, OR 7.87; p = 0.03, OR 3.02, respectively). In patients with UC, the analysis according to disease extension revealed that the frequency of the minor allele of rs1800629 was significantly higher in the subgroup with the E2 phenotype compared to the E1 and E3 phenotypes (16.6% versus 5.6%, p = 0.02, OR 3.32). Conclusions: These findings highlight the role of genetic TNF-alpha variants in disease susceptibility, phenotype, and systemic involvement, supporting their potential relevance in understanding IBD heterogeneity. Full article