Search Results (20,558)

Background: Foodborne outbreaks remain a major public health concern, particularly for immunocompromised individuals who experience a disproportionate burden of severe enteric disease. Although environmental prevention represents the cornerstone of food safety, outbreak investigations may also provide valuable evidence for identifying populations that could benefit most from future vaccination strategies. This study investigated a point-source foodborne outbreak in Southern Italy to describe clinical outcomes among exposed individuals, including an immunocompromised oncology patient, and to explore the potential relevance of host vulnerability for future enteric vaccine research. Methods: A retrospective cohort study combined with an environmental outbreak investigation was conducted following a restaurant-associated gastroenteritis cluster. Clinical data, epidemiological information, and laboratory findings were collected for all exposed individuals. Stool samples were analyzed using multiplex real-time polymerase chain reaction (RT-PCR), while microbiological and molecular analyses were performed on kitchen water samples collected during the official sanitary inspection. Results: Four of six exposed individuals developed acute gastroenteritis (overall attack rate: 66.7%; food-specific attack rate: 100%) within 24–48 h after consuming the same meal. Three previously healthy adults experienced prolonged symptoms lasting 15–21 days and subsequently developed post-infectious irritable bowel syndrome (PI-IBS) during follow-up. In contrast, a 43-year-old woman receiving cisplatin chemotherapy for cervical cancer developed severe dehydration requiring emergency hospitalization. Multiplex RT-PCR identified polymicrobial infection with Campylobacter spp., norovirus, and three diarrheagenic Escherichia coli pathotypes (EAEC, EPEC, and ETEC). Environmental investigation demonstrated contamination of the restaurant’s kitchen water supply with total coliforms (>80 CFU/100 mL), intestinal Enterococci (30 CFU/100 mL) and norovirus genogroups I and II, confirming the common source of exposure. Conclusions: This outbreak demonstrates how identical environmental exposure may result in markedly different clinical outcomes according to host immune status. While rigorous food safety measures remain essential, these findings may help develop hypotheses regarding populations that could be considered in future studies of enteric vaccination strategies. Outbreak investigations may therefore contribute not only to source identification and outbreak control but also to informing future vaccination strategies for vulnerable populations. Full article

The widespread use of antibiotic growth promoters (AGPs) in livestock production has contributed to the emergence of antimicrobial resistance (AMR) in pathogens. Furthermore, improper dosing and insufficient withdrawal periods lead to the presence of antibiotic residues in meat, posing significant risks to human health. Consequently, regulatory bans on AGP use in poultry and livestock have increased the susceptibility of poultry to previously controlled infectious diseases, highlighting the need for effective and safe alternatives. Postbiotics, defined as preparations of inanimate microorganisms and/or their components that confer a health benefit on the host, have emerged as one of the promising AGP alternatives. Some postbiotic preparations exert immunomodulatory, antioxidant, antimicrobial, and anti-inflammatory effects, modulate gut microbiota, and reduce enteric pathogen loads, leading to improved growth performance, health status, and resilience against heat stress, thereby supporting their role in sustainable poultry production. This review summarizes the current understanding of the effects of postbiotics on poultry health and zootechnical performance and their mechanisms of action, explicitly distinguishing empirical findings demonstrated in poultry from those extrapolated from mammalian or in vitro models. Finally, it outlines knowledge gaps in the biochemical processing and standardization of postbiotics, along with future research priorities for their use as an AGP alternative. Full article

Background: Potentially inappropriate medication (PIM) use among older people is a serious public health problem associated with increased adverse drug events. PIM refers to medications where the adverse risks outweigh the potential benefits. Identifying the risk factors for PIM is essential for optimizing prescription practices and improving patient safety. Objectives: To establish a risk prediction model for potentially inappropriate medications (PIMs) in older patients with depression, providing guidance to optimize medication plans, reduce adverse drug reactions, and improve treatment outcomes and quality of life. Methods: Prescriptions for depression patients among all hospitals in the Chengdu area were taken as an example. A significant factor influencing PIM risk was identified through univariate and multivariate logistic regression analyses, and a nomogram was constructed. The discrimination and calibration of the model were evaluated via receiver operating characteristic (ROC) curves. Results: According to the analysis of the nomogram drawn from the prescriptions of patients with depression, it can be found that the department name, reimbursement, hospital grade, age, number of diseases, sleep disorders, hypertension, cerebrovascular disease and so on each have p < 0.05 for PIM. Data from the Chengdu area (n = 4629) were divided into a training set (n = 3548) and an internal validation set (n = 1081), with Zhengzhou data (n = 1620) used as the external validation set. ROC curve analysis revealed that the area under the curve (AUC) for the training set was 0.721, that for the internal validation set was 0.668, and that for the external validation set was 0.663. Conclusions: The prediction model based on these factors has predictive value for PIM use in older patients with depression, It shows some discriminatory ability, but its external performance is moderate and its calibration is insufficient. Nevertheless, it can be used for preliminary judgment of patients’ medication and as an auxiliary screening tool. Further optimization and prospective validation are still needed. Full article

Background: Physical inactivity is common among people living with chronic non-communicable disease, and nurses are frequently the professionals with the most sustained patient contact. How nursing support for physical activity is experienced by patients, and how nurses understand their own role in providing it, remain poorly described. Objective: To explore how patients with chronic diseases and nursing professionals describe nursing support for physical activity and exercise adherence, and where their accounts converge or diverge. Methods: A qualitative descriptive study using individual semi-structured interviews and reflexive thematic analysis. Seventeen participants (nine patients with chronic diseases and eight nursing professionals) were purposively recruited from five healthcare institutions in the Riyadh region of Saudi Arabia. Interviews lasted 30 to 60 min (mean 45 min) and were conducted between December 2025 and February 2026. No quantitative measures of exercise frequency, intensity, duration, or session regularity were collected, so the study reports perceptions and experiences rather than measured adherence, and no causal relationships were examined. Rigor was addressed through researcher reflexivity, member checking, peer debriefing, and an audit trail; reporting follows COREQ. Results: Five themes were constructed: (1) Nursing-Facilitated Empowerment Through Education and Guidance; (2) Personalized Support and Accountability Mechanisms; (3) Barriers and Facilitators to Exercise Adherence; (4) Perceived Health Benefits and Motivation Enhancement; and (5) Gaps in Current Nursing Practice and Opportunities for Enhancement. Participants identified individualized explanation, graduated goal-setting, correction of fear-based misconceptions, scheduled exercise-specific review, and family involvement as the components of support they valued most, and lapsed follow-up, generic advice, limited interdisciplinary coordination, and scarce patient resources as the principal shortfalls. Conclusions: Patients and nurses in this setting described sustained, individualized nursing support as central to how patients engage with exercise, while both groups identified structural constraints that limit it. These accounts indicate targets that intervention studies with objective activity measurement could test; they do not establish that nursing support changes exercise behavior. Full article

Host genetic variation is a key determinant of malaria susceptibility, particularly in endemic regions where intense transmission has driven strong selective pressures on red blood cell-related genes. However, Senegalese and other African populations remain underrepresented in genomic studies, limiting population-specific inference. We analyzed malaria-related host genetic variants in 140 febrile patients from southern and south-eastern Senegal, focusing on key loci (ACKR1, Dantu blood group, HBB and G6PD) and on composite Multilocus Genotype Profiles (MGPs). We described the co-occurrence of the variants within individuals, allowing exploratory assessment of combined genetic architectures. We identified both well-established malaria-protective variants, including the Duffy-negative Fy(a–b–) phenotype (observed in all individuals), G6PD key variants (e.g., G202A with an allelic frequency of ~3%, A376G at ~40%, T968C at ~1%), and HBB variants (HbS at ~7% and HbC at ~1%), as well as some rare and less characterized polymorphisms. To the best of our knowledge, this study provides the first description in the Senegalese population of the Dantu variant (rs186873296) and the rare ACKR1 rs577808287 variant, each observed in 2 distinct individuals. Five major composite MGPs across the four loci were predominantly observed and together represented more than 75% of individuals. Excluding Duffy status, most of these profiles included at least one variant previously reported in the literature as malaria-protective, a pattern consistent with the hypothesis of malaria-driven balancing selection, despite the presence of potentially deleterious alleles. This study highlights substantial genetic heterogeneity in malaria-relevant host genes in Senegal and demonstrates the value of integrating composite genetic architectures into malaria research. These findings provide population-specific data that are critical for improving malaria risk assessment, clinical interpretation, and public health strategies in endemic regions. Moreover, the relatively high frequencies of some variants may reflect balancing selection, possibly partially driven by the adaptive benefits they confer in populations exposed to malaria. Full article

Obesity has become a major global public health concern, with prevalence rates rising dramatically over the past several decades and affecting more than one billion people worldwide. The increasing burden of obesity has been largely driven by sedentary lifestyles and the consumption of energy-dense, nutrient-poor diets, although its etiology is multifactorial, involving complex interactions among genetic, metabolic, endocrine, and environmental factors. Beyond excess adiposity, obesity is closely associated with numerous chronic diseases, including cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), hypertension, cancer, and chronic inflammatory disorders. Emerging evidence indicates that oxidative stress plays a pivotal role in the pathogenesis of obesity and its related metabolic complications. Reactive oxygen species (ROS) and reactive nitrogen species (RNS), which are generated during normal cellular metabolism, serve important physiological functions in cell signaling and redox regulation. However, excessive production of these reactive species or impairment of endogenous antioxidant defense systems disrupts redox homeostasis, leading to oxidative damage to lipids, proteins, and nucleic acids. Such alterations contribute to cellular dysfunction, chronic inflammation, and disease progression. In this context, dietary antioxidants have attracted considerable attention due to their ability to neutralize free radicals, inhibit lipid peroxidation, and restore redox balance. Natural antioxidants derived from fruits, vegetables, and other plant-based foods may act individually or synergistically to enhance cellular defense mechanisms against oxidative stress. Furthermore, growing evidence suggests that antioxidant-rich dietary patterns may offer protective effects against obesity-associated metabolic disturbances and chronic diseases. However, clinical benefits of isolated antioxidant supplementation remain inconsistent and appear to depend on dose, bioavailability, baseline redox status, disease stage, and the preservation of physiological redox signaling. Understanding the molecular mechanisms underlying antioxidant-mediated regulation of redox homeostasis may facilitate the development of nutritional strategies for obesity prevention and management, while contributing to the reduction in oxidative stress and obesity-related disease burden and the promotion of long-term health. Full article

Bacterial self-healing cement-based materials (BSHCMs) couple microbial mineralization with cement-based material design to autonomously seal cracks and potentially restore durability. However, their performance depends on a complex interaction among bacterial viability and physiological state, mineralization pathway, carrier and nutrient systems, calcium availability, matrix chemistry, crack characteristics, moisture, and exposure history. This review, supported by bibliometric mapping of 805 Scopus-indexed records, examines these interdependencies through the specific lens of artificial intelligence (AI) readiness. The mapping revealed six interconnected research themes spanning bacterial mineralization, sustainable cement-based systems, matrix chemistry and transport, encapsulation, durability, and machine learning (ML). AI evidence was classified as directly demonstrated in bacterial self-healing systems, transferable from adjacent concrete and structural health monitoring applications, or prospective. Although existing ML studies report high internal predictive performance, their engineering generalizability remains limited by heterogeneous and frequently literature-derived datasets, random train–test partitioning, potential feature leakage, synthetic data dependence, insufficient uncertainty reporting, and scarce independent laboratory or field validation. The analysis further shows that sustainability and economic benefits cannot be assumed from the biological nature of the technology but must be demonstrated through service life extension relative to the additional burdens of cultivation, nutrients, carriers, and processing. Advancing BSHCMs toward trustworthy AI-supported engineering, therefore, requires harmonized and machine-readable datasets, matched attribution controls, delayed cracking and realistic exposure experiments, explicit uncertainty and negative result reporting, study-grouped and external validation, and pilot- to field-scale testing. AI should consequently be regarded not as a substitute for biological healing, but as a decision support layer whose value depends fundamentally on the quality, traceability, and transferability of the underlying experimental evidence. Full article

This study evaluated the effects of dietary SYNSEA Premium postbiotics on growth, immunity, disease resistance, intestinal microbiota, and host metabolism in Asian seabass (Lates calcarifer). Fish were fed a control diet or diets supplemented with heat-killed Lactiplantibacillus plantarum LP28, L. plantarum LP1008, and Bacillus subtilis at 10⁸ (LSP) or 10⁹ (HSP) cells kg⁻¹ diet for 56 days. Postbiotic supplementation did not significantly affect growth performance, feed efficiency, production, condition factor, or dorsal muscle composition, but significantly improved survival. Fish receiving postbiotics also exhibited higher survival following Vibrio alginolyticus and iridovirus challenges. These protective effects were accompanied by enhanced superoxide dismutase, phagocytic, and lysozyme activities and modulation of immune-related genes, including tgf-β1, tnf, ifn-γ1, c3, and mx. Exploratory microbiome and metabolome analyses, which were restricted to the control and LSP groups, identified differences in the relative abundance of specific intestinal microbial taxa and associations between microbial composition and host metabolic profiles. The LSP group showed lower relative abundances of potential pathogens such as Salmonella enterica, Lactococcus garvieae, and Staphylococcus warneri, although the overall microbial community structure did not differ significantly between groups. Metabolomic analysis of the LSP group further showed changes in D-glucose, pentose phosphate pathway intermediates, reduced glutathione, CoA, and 2-methylacetoacetyl-CoA relative to the control. Collectively, SYNSEA Premium improved survival, immune responses, and resistance to bacterial and viral infections without significantly affecting growth performance, while exploratory omics analysis of the LSP treatment identified associated microbial and metabolic changes. Full article

Background/Objectives: Trunk injection of oxytetracycline (OTC) can suppress Candidatus Liberibacter asiaticus (CLas) and improve the productivity of citrus trees affected by huanglongbing (HLB), a devastating bacterial disease, but conventional acidic formulations may cause phytotoxicity and exacerbate trunk injury. This study evaluated a proprietary adjuvant intended to stabilize OTC at higher pH and assessed streptomycin (STM) as an alternative or complement to OTC. Methods: Two commercial field trials with HLB-affected ‘Valencia’ sweet orange trees compared a 2 × 4 factorial combination of two formulations, adjuvant/high-pH and no-adjuvant/low-pH, and four antibiotic treatments: none, OTC, STM, and OTC + STM. Tree growth, canopy health, phytotoxicity, CLas load, external wound responses, fruit drop, yield, and fruit quality were evaluated. Results: Tree growth and canopy health were not affected by treatment. The adjuvant/high-pH formulation caused severe canopy phytotoxicity in trial 1 and increased wound width, wound length, and bark cracking in both trials, compared to the control. OTC and OTC + STM generally reduced fruit drop, increased yield, and improved fruit quality attributes though effects on CLas were moderate and not consistent. STM alone provided no consistent therapeutic or horticultural benefit, and OTC + STM were not consistently superior to OTC alone. Conclusions: OTC was the primary effective component to mitigate HLB in affected citrus trees. The adjuvant/high-pH formulations did not affect OTC efficacy but caused tree injury, even in the absence of OTC. Novel trunk-injection formulations must balance chemical stability and delivery with plant tissue compatibility and safety to meet commercial viability. Full article

Background: Cinnamomum chago (C. chago) B.S.Sun et H.L.Zhao, a rare tree species endemic to Yunnan Province of China, produces fruit kernels that are rich in fatty oils (CCKF); however, the potential health benefits of CCKF have not been previously reported. Method: We characterized the chemical composition of CCKF and evaluated its therapeutic potential in a rat model of loperamide-induced functional constipation (FC). Results: CCKF contained an abundance of dodecanoic acid, accounting for 70.18%. CCKF alleviated constipation by increasing fecal pellet output and moisture content, enhancing small intestinal propulsion rate, and ameliorating colonic pathological damage. Additionally, CCKF modulated gastrointestinal hormone levels and enhanced the expression of ZO-1 and Occludin. Furthermore, CCKF increased gut microbial diversity, altered the Bacillota/Bacteroidota ratio, enriched potentially beneficial bacteria (including Kineothrix, Roseburia, Lacrimispora, and Lawsonibacter), and reduced Segatella abundance. CCKF may affect Arginine and proline metabolism, Biosynthesis of amino acids, D-Amino acid metabolism, etc. Conclusion: The present results provide a scientific basis for the potential application of CCKF as a functional food to alleviate functional constipation. Full article

This study assessed the geographic, demographic, and temporal factors underlying the evolution of the HIV/AIDS epidemic across the health macroregions of Minas Gerais, Brazil, comparing the periods before (2009–2014) and after (2015–2022) the implementation of universal HIV notification and immediate antiretroviral therapy (ART). An ecological study was conducted using statewide surveillance and clinical monitoring databases. Epidemiological indicators, including HIV detection, AIDS incidence, AIDS-related mortality, ART coverage, and sustained viral suppression (SVS), were analyzed according to sex and health macroregion using generalized linear models with negative binomial regression and spatial analysis. HIV detection increased markedly following the expansion of mandatory notification, while ART coverage and SVS also increased significantly. In contrast, AIDS incidence and AIDS-related mortality declined during the later period. Substantial heterogeneity was observed across macroregions, with important differences in epidemiological indicators and HIV care cascade performance. These findings demonstrate that the benefits of expanded HIV detection and universal ART have not been distributed uniformly across the state. Regional disparities in access to diagnosis, treatment, and long-term care remain important barriers to HIV control, highlighting the need for targeted, region-specific public health strategies to reduce territorial inequalities and strengthen the HIV care cascade. Full article

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, with aging as one of its main risk factors. Cellular senescence and oxidative stress form a bidirectional vicious cycle that drives vascular aging, endothelial dysfunction, and atherosclerotic progression. This state-of-the-art review synthesizes current evidence on the interplay between oxidative stress and senescence in cardiovascular aging and critically assesses whether antioxidant strategies can benefit vascular health. A targeted literature search was conducted in PubMed/MEDLINE, Web of Science, and Scopus (2016–2026). While endogenous antioxidant defenses decline with age, exogenous antioxidants, including resveratrol, vitamins C and E, omega-3 fatty acids, carotenoids, and coenzyme Q10,demonstrate promising preclinical effects, yet large-scale clinical trials have yielded inconsistent results. The VITAL and STRENGTH trials failed to demonstrate significant cardiovascular benefit with omega-3 supplementation, and elevated serum β-carotene was found paradoxically associated with increased cardiovascular mortality. Emerging mitochondria-targeted antioxidants (MitoQ, MitoTEMPO) show preclinical promise but require further clinical validation. Current evidence does not support antioxidant supplementation for cardiovascular prevention. Lifestyle interventions, particularly antioxidant-rich dietary patterns such as the Mediterranean diet, remain the safest strategy. Future research should develop personalized approaches guided by oxidative stress biomarkers and long-term trials. Full article

Osteoporosis affects over 200 million people worldwide, with postmenopausal women at the highest risk. The treatment benefits of currently available drugs are constrained by safety concerns, and they lack bidirectional regulation of bone metabolism, driving growing interest in safe dietary interventions. Milk is rich in functional components, including minerals (calcium, phosphorus), casein phosphopeptide (CPP), lactoferrin (LF), osteopontin (OPN), and milk fat globule membrane (MFGM), that promote mineral absorption, regulate bone cell activity, and support intestinal health. This review examines their dual mechanisms in bone health regulation. Directly, LF activates Wnt/MAPK pathways to enhance osteogenesis and inhibit osteoclast activity, OPN modulates mineralization, and CPP synergizes with calcium and phosphorus to support bone formation. Indirectly, these components modulate gut microbiota via the gut–bone axis, raising short-chain fatty acids, lowering intestinal pH to boost calcium absorption, repairing the intestinal barrier, and reducing systemic inflammation. Remaining challenges lie in extraction, purification, and product development. Looking forward, the field must move from cell and animal-level evidence to human clinical validation and establish robust steady-state delivery of these bioactives. Successful translation along these lines is essential to turn milk-derived components into effective, evidence-based functional foods for bone health. Full article

Air pollution poses a major environmental and public health challenge in Metropolitan Lima, Peru, where complex topography, coastal meteorological conditions, and intense urbanization generate highly dynamic patterns of pollutant concentrations. Accurate multi-horizon forecasting is therefore essential for supporting environmental monitoring and early-warning systems. This study proposes a hybrid deep learning framework, called VMD-Attention-BiLSTM, for forecasting hourly PM_2.5, PM₁₀, and NO₂ concentrations using a decade of hourly air quality observations (2015–2024) collected by the National Meteorology and Hydrology Service of Peru (SENAMHI). The proposed methodology integrates a strictly causal preprocessing pipeline—including forward-only imputation, spatial-corroborated percentile-95 outlier detection, and pollutant-calibrated Variational Mode Decomposition (VMD)—with a Bidirectional Long Short-Term Memory (BiLSTM) network enhanced by a Bahdanau-style attention mechanism. All transformations are fitted exclusively on the training partitions of a five-fold TimeSeriesSplit cross-validation to prevent information leakage. A systematic benchmark of 1008 imputation experiments was conducted to justify the choice of causal linear interpolation over Kalman Filter alternatives. Model performance was evaluated at 24-, 48-, and 72-h forecasting horizons. The optimized framework achieved competitive predictive performance across the evaluated horizons, yielding best RMSE values of 9.04, 19.93, and 9.41 µg/m³ for PM_2.5, PM₁₀, and NO₂ at 24 h, degrading to 9.79, 24.56, and 11.02 µg/m³ at 72 h. All metrics are reported on the original concentration scale. VMD sensitivity analysis revealed that the optimal mode count is pollutant-dependent ($K=12$ for particulate matter; $K=4$ for NO₂). Furthermore, the ablation study showed that the complete VMD-Attention-BiLSTM configuration provided competitive and frequently improved performance relative to the baseline and partial configurations, with the magnitude of the improvement varying according to pollutant and forecasting horizon. The obtained results indicate that integrating signal decomposition with attention-based bidirectional learning can provide complementary benefits for forecasting under highly non-stationary urban conditions, particularly at shorter forecasting horizons. The proposed framework provides a reproducible and scalable solution for intelligent air-quality forecasting and serves as a valuable decision-support tool for environmental monitoring and public health protection in complex metropolitan environments. Full article

Background/Objectives: Poor oral health, which is often overlooked in nursing homes (NHs), is associated with aspiration pneumonia. This analysis assesses the cost effectiveness of an oral hygiene intervention, “Mouth Care Without a Battle©” (MCWB), which trains NH staff to provide daily mouth care. The first year of a pragmatic cluster randomized effectiveness trial conducted in 14 NHs demonstrated a significant reduction in pneumonia incidence in intervention NHs. Methods: Because the two-year primary outcome was not statistically significant, the first-year analysis is post hoc. The incremental cost-effectiveness ratio (ICER) of costs (staff training, time spent providing mouth care, and pneumonia-related hospitalizations) to effects (reductions in pneumonia cases) over one year was estimated using bootstrapping. Results: Analyses for 1605 residents with clustering by NH show that the likelihood that MCWB is cost-saving ranges from 6.5% to 61.1% depending on whether staff are paid benefits and various levels of estimated hospital costs. Similarly, the likelihood that MCWB results in reduced pneumonia cases but with higher costs ranges from 32.0% to 86.6%. Whether MCWB is cost-effective depends on society’s willingness to pay for reduced pneumonia cases and related unmeasured benefits. These estimates may represent a lower bound of potential cost savings because analyses did not include costs of treating pneumonia if not hospitalized, ambulance transport, or the emotional costs of illness. However, other excluded costs (e.g., dental restorations) and resources required to improve fidelity could reduce the likelihood of cost savings. Conclusions: MCWB and similar interventions that improve oral health care in NHs may yield cost savings or produce benefits from the reduction in pneumonia that justify net increases in costs incurred. It is also important to consider who bears the costs (e.g., the NH) versus who reaps the benefits (e.g., healthier residents and reduced Medicare payments). Full article