Search Results (1,370)

Invasive candidiasis (IC), characterized by the most common clinical manifestation of candidemia, is a fungal infection with a high mortality rate and a significant impact on global public health. It is estimated that each year there are between 227,000 and 250,000 hospitalizations related to IC, with more than 100,000 associated deaths. In Latin America and the Caribbean (LA&C), the absence of a standardized surveillance system has led to multicenter studies documenting incidences ranging from 0.74 to 6.0 cases per 1000 hospital admissions, equivalent to 50,000–60,000 hospitalizations annually, with mortality rates of up to 60% in certain high-risk groups. Armed conflicts and structural violence in LA&C cause forced displacement, the collapse of health systems, and poor living conditions—such as overcrowding, malnutrition, and lack of sanitation—which increase vulnerability to opportunistic infections, such as IC. Insufficient specialized laboratories, diagnostic technology, and trained personnel impede pathogen identification and delay timely initiation of antifungal therapy. Furthermore, the empirical use of broad-spectrum antibiotics and the limited availability of echinocandins and lipid formulations of amphotericin B have promoted the emergence of resistant non-albicans strains, such as Candida tropicalis, Candida parapsilosis, and, in recent outbreaks, Candidozyma auris. Full article

Ongoing changes in the distribution and abundance of several tick species of medical relevance in Canada have prompted the development of the eTick platform—an image-based crowd-sourcing public surveillance tool for Canada enabling rapid tick species identification by trained personnel, and public health guidance based on tick species and province of residence of the submitter. Considering that more than 100,000 images from over 73,500 identified records representing 25 tick species have been submitted to eTick since the public launch in 2018, a partial automation of the image processing workflow could save substantial human resources, especially as submission numbers have been steadily increasing since 2021. In this study, we evaluate an end-to-end artificial intelligence (AI) pipeline to support tick identification from eTick user-submitted images, characterized by heterogeneous quality and uncontrolled acquisition conditions. Our framework integrates (i) tick localization using a fine-tuned YOLOv7 object detection model, (ii) resolution enhancement of cropped images via super-resolution Generative Adversarial Networks (RealESRGAN and SwinIR), and (iii) image classification using deep convolutional (ResNet-50) and transformer-based (ViT) architectures across three datasets (12, 6, and 3 classes) of decreasing granularities in terms of taxonomic resolution, tick life stage, and specimen viewing angle. ViT consistently outperformed ResNet-50, especially in complex classification settings. The configuration yielding the best performance—relying on object detection without incorporating super-resolution—achieved a macro-averaged F1-score exceeding 86% in the 3-class model (Dermacentor sp., other species, bad images), with minimal critical misclassifications (0.7% of “other species” misclassified as Dermacentor). Given that Dermacentor ticks represent more than 60% of tick volume submitted on the eTick platform, the integration of a low granularity model in the processing workflow could save significant time while maintaining very high standards of identification accuracy. Our findings highlight the potential of combining modern AI methods to facilitate efficient and accurate tick image processing in community science platforms, while emphasizing the need to adapt model complexity and class resolution to task-specific constraints. Full article

In December 2023, infections of western equine encephalitis virus (WEEV) within Argentina were reported to the World Health Organization (WHO). By April 2024, more than 250 human infections, 12 of which were fatal, and 2500 equine infections were identified in South America. Laboratory diagnosis and surveillance in affected countries were hindered by a lack of facilities equipped with BSL-3 laboratories, as confirmatory serodiagnosis for WEEV requires live virus in the plaque reduction neutralization test (PRNT). To expand serodiagnosis for WEEV in the Americas, we developed a virus chimera composed of vesicular stomatitis virus (VSV) engineered to display the E2-E1 glycoproteins of WEEV (VSV/WEEV) in place of the VSV glycoprotein (G). PRNT₉₀ and IC₉₀ values of parental WEEV and VSV/WEEV were analogous using sera collected from mice, horses, and chickens. VSV/WEEV rapidly formed plaques with clear borders and reduced the assay readout time by approximately 8 h compared to the parental virus. Overall, we demonstrate that chimeric VSV/WEEV is a suitable surrogate for WEEV in a diagnostic PRNT. Use of chimeric VSV/WEEV in place of authentic WEEV will dramatically expand testing capacity by enabling PRNTs to be performed at BSL-2 containment, while simultaneously decreasing the health risk to testing personnel. Full article

Combustion of aviation jet fuel emits a complex mixture of pollutants linked to adverse health outcomes among airport personnel and nearby communities. While epidemiological studies showed the detrimental effects of aviation-derived air pollutants on human health, the molecular mechanisms of the interactions of these pollutants with cellular biomolecules like proteins that drive the adverse health effects remain poorly understood. In this study, we performed molecular docking simulations of 272 pollutant–protein complexes using AutoDock Vina 1.2.7 to characterize the binding strength of the pollutants with the selected proteins. We selected 34 aviation-derived pollutants that constitute three chemical categories of pollutants: volatile organic compounds (VOCs), polyaromatic hydrocarbons (PAHs), and organophosphate esters (OPEs). Each pollutant was docked to eight proteins that play critical roles in endocrine, metabolic, transport, and neurophysiological functions, where functional disruption is implicated in disease. The effect of binding of multiple pollutants was analyzed. Our results indicate that aliphatic and monoaromatic VOCs display low (<6 kcal/mol) binding affinities while PAHs and organophosphate esters exhibit strong (>7 kcal/mol) binding affinities. Furthermore, the binding strength of PAHs exhibits a positive correlation with the increasing number of aromatic rings in the pollutants, ranging from nearly 7 kcal/mol for two aromatic rings to more than 15 kcal/mol for five aromatic rings. Analysis of intermolecular interactions showed that these interactions are predominantly stabilized by hydrophobic, pi-stacking, and hydrogen bonding interactions. Simultaneous docking of multiple pollutants revealed the increased binding strength of the resulting complexes, highlighting the detrimental effect of exposure to pollutant mixtures found in ambient air near airports. We provide a priority list of pollutants that regulatory authorities can use to further develop targeted mitigation strategies to protect the vulnerable personnel and communities near airports. Full article

Background/Objectives: This scoping review critically evaluated existing literature and summarized the impact of occupational, physiological, and psychological stressors on adrenal and neuroendocrine responses, body composition, and physical performance amongst women in tactical occupations. Methods: Boolean searches identified potentially qualifying reports involving: (1) adult women (≥19 y) currently employed or completing their training for a tactical profession; (2) ≥1 marker of “stress”; and (3) ≥1 adrenal, neuroendocrine, body composition, or fitness/performance outcome. Quantitative data (e.g., sample characteristics, outcomes of interest) were extracted and summarized. The completeness of reporting for each study was documented using existing checklists and quantified as: low (<50%), moderate (50–79%), or high (≥80%). Results: 40 studies (k) of moderate reporting quality (~64%) were included in the final sample (3693 women); 11 studies (28%) focused on women exclusively, and 16 studies identified sex differences in ≥1 outcome. Most studies involved military trainee populations (80%, k = 32). Occupation-related stress tended to negatively impact adrenal, neuroendocrine, body composition, and performance outcomes. Conclusions: This review highlights progress in assessing occupational performance in female tactical personnel exposed to diverse stressors; however, our understanding remains incomplete due to methodological and conceptual limitations in the literature. Holistic research strategies are needed to capture the complexity of performance readiness in women, integrating how stress affects key tactical performance aspects such as muscle physiology, reproductive health, and energy and nutrient balance in realistic operational contexts. Integrating such data is vital for informing policy, improving readiness, and enhancing the health and career longevity of female tactical personnel. Full article

Sport-related injuries are common presentations to primary care and hospital settings. Australian osteopaths practice mainly in private clinical settings in which the frequency of sport-related injury presentations, and how these injuries are managed, is unknown. The objective of the study was to describe the demographic, practice, and clinical management characteristics of Australian osteopaths who report often treating sport-related injuries. The study is a secondary analysis of data derived from the Australian osteopathy practice-based research network. Respondents indicated the frequency treating sports-related injuries in addition to other demographic, practice, and patient management characteristics. Backward logistic regression identified significant characteristics associated with often treating sport injuries. Over half (51%) of a nationally representative sample of Australian osteopaths reported treating sport-related injuries often. Those osteopaths who treat sports injuries often were likely to be male (p < 0.01) and utilise exercise prescription (OR2.34) and sports taping (OR5.99). Australian osteopaths who often treat sports-related injuries provide advice to patients and use exercise prescription more frequently than osteopaths who do not treat these injuries often. The data in the current work begin to explore how osteopaths manage sports-related injuries and highlights how they may be able to provide sports injury care for both recreational and elite sport populations. Full article

To enhance agricultural soil health and soil organic carbon (SOC) sequestration, it is important to accurately measure SOC. The aim of this study was to compare common methods for measuring SOC in soils in order to determine the most effective approach among different agricultural land types. The measurement methods of loss-on-ignition (LOI), automated dry combustion (Dumas), and real-time near-infrared spectroscopy (NIRS) were compared. A total of 95 soil core samples, ranging in clay and calcareous content, were collected across a range of agricultural land types from forty-eight fields across five farms in the Southwest of England. There were similar and positive correlations between all three methods for measuring SOC (ranging from r = 0.549 to 0.579; all p < 0.001). On average, permanent grass fields had higher SOC content (6.6%) than arable and temporary ley fields (4.6% and 4.5%, respectively), with the difference of 2% indicating a higher carbon storage potential in permanent grassland fields. Newly predicted conversion equations of linear regression were developed among the three measurement methods according to all the fields and land types. The correlation of the conversation equations among the three methods in permanent grass fields was strong and significant compared to those in both arable and temporary ley fields. The analysed results could help understand soil carbon management and maximise sequestration. Moreover, the approach of using real-time NIRS analysis with a rechargeable portable NIRS soil device can offer a convenient and cost-saving alternative for monitoring preliminary SOC changes timely on or offsite without personnel risks from the high-temperature furnace and chemical reagent adopted in the LOI and Dumas processes, respectively, at the laboratory. Therefore, the study suggests that faster, lower-cost, and safer methods like NIRS for analysing initial SOC measurements are now available to provide similar SOC results as traditional soil analysis methods of the LOI and Dumas. Further studies on assessing SOC levels in different farm locations, land, and soil types across seasons using NIRS will improve benchmarked SOC data for farm stakeholders in making evidence-informed agricultural practices. Full article

Military personnel deployed to Iraq and Afghanistan were exposed to emissions from open-air burn pits, where plastics, metals, and medical waste were incinerated. These exposures have been linked to deployment-related respiratory diseases (DRRD) and may also impact neurological health via the lung–brain axis. To investigate molecular mechanisms, adult male rats were exposed to filtered air, naphthalene (a representative volatile organic compound), or a combination of naphthalene and carbon black (surrogate for particulate matter; CBN) via whole-body inhalation (six hours/day, three consecutive days). Lung, brain, and plasma samples were collected 24 h after the final exposure. Pro-inflammatory biomarkers were assessed using multiplex electrochemiluminescence and western blot. Differentially expressed genes (DEGs) were identified by RNA sequencing, and elastic net modeling was used to define exposure-predictive gene signatures. CBN exposure altered inflammatory biomarkers across tissues, with activation of nuclear factor kappa B (NF-κB) signaling. In the lung, gene set enrichment revealed activated pathways related to proliferation and inflammation, while epithelial–mesenchymal transition (EMT) and oxidative phosphorylation were suppressed. In the brain, EMT, inflammation, and senescence pathways were activated, while ribosomal function and oxidative metabolism were downregulated. Elastic net modeling identified a lung gene signature predictive of CBN exposure, including Kcnq3, Tgfbr1, and Tm4sf19. These findings demonstrate that inhalation of a surrogate burn pit mixture induces inflammatory and metabolic gene expression changes in both lung and brain tissues, supporting the utility of this animal model for understanding systemic effects of airborne military toxicants and for identifying potential biomarkers relevant to DRRD and Veteran health. Full article

Background/Objectives: Oral health has specific importance and consequences from a military and Navy standpoint. The aim of this study was to determine and compare caries prevalence and dental care in Spanish Navy personnel. Methods: A retrospective observational study was carried out with a sample size of 1318 individuals (34.65 ± 8.82 years old) stationed at the Rota naval base in Spain, whose dental charts were examined. Caries prevalence was assessed using the Decayed, Missing, Filled Teeth (DMFT) index; dental care was evaluated using the care index (CI); and demographic and occupational factors were recorded. Results: The population of this study had a mean DMFT index of 5.99 ± 4.71 and a CI of 79%. Through the results of the DMFT index and CI, the statistical significance of the age and rank variables (p < 0.01) was confirmed, with personnel >45 years old and non-commissioned officers (NCOs) having the highest mean DMFT values and the youngest and officer groups having the greatest CI variable. Comparing the DMFT index across genders and ages and between age and rank also revealed significant differences. Conclusions: This study’s findings show a low prevalence of cavitated caries (14.5%), with intermediate DMFT values and higher CIs compared to those in previous published data. Full article

Background/Objectives: Pathology is often perceived as a technical medical specialty that lacks direct contact with the patient. However, oncological histopathological diagnosis requires a high degree of moral and emotional responsibility. The objective of this study was to investigate how empathy is manifested toward the “invisible” patient, the emotional impact on pathology staff, and potential repercussions in their personal lives. Method: We conducted a descriptive, cross-sectional study with a quantitative component, using an anonymous 22-item questionnaire among Romanian pathologists and medical personnel working in pathology services. The questionnaire was focused on three research directions: professional empathy in the absence of direct patient contact, the emotional impact of oncologic diagnosis on medical personnel in pathology departments, and the carryover of emotions from professional to personal life. A total of 165 respondents were included in the study (physicians, technicians, registrars). Results: Most of the respondents consider that the absence of the patient’s direct contact does not cancel the empathy, this being felt in a cognitive and more natural way. Over 60% of the respondents see oncologic histopathological diagnosis as an emphatic medical act. Over 80% of the respondents experience a sense of emotional responsibility and 70% consider that professional training does not include adequate emotional support. There is a high interest in empathy and psychological support. The professional activity of a pathologist may influence sleep, dreams, and the perception on their own health status. Diagnosing pediatric or young patients is perceived as particularly emotionally challenging. Collegial support is moderate and discussion about professional stress is rare. Conclusions: Empathy is present and relevant in pathology, despite the absence of direct patient interaction. Oncological diagnostics has a significant emotional impact on pathology department personnel, with the need to acknowledge the emotional dimension of the profession and to integrate psychological support mechanisms into pathology practice. Full article

Background/Objectives: This study examines the academic discourse surrounding Critical Incident Stress Debriefing (CISD) and Critical Incident Stress Management (CISM) for first responders using Latent Dirichlet Allocation (LDA) topic modeling. It aims to uncover latent topical structures in the literature and critically evaluate assumptions to identify gaps and limitations. Methods: A corpus of 214 research article abstracts related to CISD/M was gathered from the Web of Science Core Collection. After preprocessing, we used Orange Data Mining software’s LDA tool to analyze the corpus. We tested models ranging from 2 to 10 topics. To guide interpretation and labeling, we evaluated them using log perplexity, topic coherence, and LDAvis visualizations. A four-topic model offered the best balance of detail and interpretability. Results: Four topics emerged: (1) Critical Incident Stress Management in medical and emergency settings, (2) psychological and group-based interventions for PTSD and trauma, (3) peer support and experiences of emergency and military personnel, and (4) mental health interventions for first responders. Key gaps included limited focus on cumulative trauma, insufficient longitudinal research, and variability in procedural adherence affecting outcomes. Conclusions: The findings highlight the need for CISD/M protocols to move beyond event-specific interventions and address cumulative stressors. Recommendations include incorporating holistic, proactive mental health strategies and conducting longitudinal studies to evaluate long-term effectiveness. These insights can help refine CISD/M approaches and enhance their impact on first responders working in high-stress environments. Full article

Microbiological contamination of healthcare workers’ gowns represents a critical risk for the transmission of healthcare-associated infections (HAIs). Despite their use as protective equipment, gowns can act as reservoirs of antibiotic-resistant bacteria, favouring the spread of pathogens between healthcare workers and patients. The presence of these resistant bacteria on healthcare workers’ gowns highlights the urgent need to address this risk as part of infection control strategies. The aim of this work was to assess the microbiological risks associated with the contamination of healthcare staff gowns with Gram-negative bacteria, including the ESKAPE group, and their relationship with antimicrobial resistance. An observational, cross-sectional, prospective study was conducted in 321 hospital workers. The imprinting technique was used to quantify the bacterial load on the gowns, followed by bacterial identification by MALDI-TOF mass spectrometry. In addition, antimicrobial resistance profiles were analysed, and tests for carbapenemases and BLEE production were performed. The ERIC-PCR technique was also used for molecular analysis of Pantoea eucrina clones. Several Gram-negative bacteria were identified, including bacteria of the ESKAPE group. The rate of microbiological contamination of the gowns was 61.05% with no association with the sex of the healthcare personnel. It was observed that critical areas of the hospital, such as intensive care units and operating theatres, showed contamination by medically important bacteria. In addition, some strains of P. eucrina showed resistance to carbapenemics and cephalosporins. ERIC-PCR analysis of P. eucrina isolates showed genetic heterogeneity, indicating absence of clonal dissemination. Healthcare personnel gowns are a significant reservoir of pathogenic bacteria, especially in critical areas of Hospital Juárez de México. It is essential to implement infection control strategies that include improving the cleaning and laundering of gowns and ideally eliminating them from clothing to reduce the risk of transmission of nosocomial infections. Full article

Every year, diarrhoea is responsible for >1 million deaths in children with ages from 0 to 5 years, with rotavirus as the leading cause. The regions most affected lack routine rotavirus diagnosis due to high cost, lack of necessary equipment and shortage of trained-personnel for Enzyme-Link-Immunosorbent-Assay (ELISA) and molecular methods. We report the development and evaluation of a cheap, nanoparticle-based immunoassay for routine machine-free rotavirus diagnosis. In this work, optimal conditions for oxidation of cotton swabs and aldehyde production for kit development was confirmed by Fourier-Transform Infrared Spectroscopy (FTIR). Lactoferrin (LF) needed to bind the virus to the cotton swab was immobilised on activated cotton swabs, followed by the capture of commercial rotavirus antigen on LF-immobilised swabs. This was dipped in coloured nanobeads covalently coupled to rotavirus-group-specific monoclonal antibody for visual rotavirus detection. Subsequently, rotavirus detection by nanoassay, commercial ELISA and quantitative reverse transcription PCR were compared using same set of 186 stool samples and subjected to statistical analyses. Optimal oxidisation condition was observed using 48 mg/mL NaIO₄ in 0.1 M sodium acetate buffer at 35 °C for 9 h. Rotavirus detection was confirmed visually by blue colour retention on swabs after several washings. Sensitivity, specificity, positive-predictive-value and negative-predictive-value of ELISA in rotavirus detection were 60%, 84%, 53% and 88%, respectively, while our immunoassay showed performance at 88%, 94%, 82% and 96%. This immunoassay will provide effective rotavirus public health interventions in low-and-middle-income countries with high morbidity/mortality. Full article

Highly infectious and pathogenic viruses seriously threaten global public health, underscoring the need for rapid and accurate diagnostic methods to effectively manage and control outbreaks. In this study, we developed a comprehensive Surface-Enhanced Raman Scattering–Lateral Flow Immunoassay (SERS-LFIA) detection system that integrates SERS scanning imaging with artificial intelligence (AI)-based result discrimination. This system was based on an ultra-sensitive SERS-LFIA strip with SiO₂-Au NSs as the immunoprobe (with a theoretical limit of detection (LOD) of 1.8 pg/mL). On this basis, a negative–positive discrimination method combining SERS scanning imaging with a deep learning model (ResNet-18) was developed to analyze probe distribution patterns near the T line. The proposed machine learning method significantly reduced the interference of abnormal signals and achieved reliable detection at concentrations as low as 2.5 pg/mL, which was close to the theoretical Raman LOD. The accuracy of the proposed ResNet-18 image recognition model was 100% for the training set and 94.52% for the testing set, respectively. In summary, the proposed SERS-LFIA detection system that integrates detection, scanning, imaging, and AI automated result determination can achieve the simplification of detection process, elimination of the need for specialized personnel, reduction in test time, and improvement of diagnostic reliability, which exhibits great clinical potential and offers a robust technical foundation for detecting other highly pathogenic viruses, providing a versatile and highly sensitive detection method adaptable for future pandemic prevention. Full article

Background/Objectives: Mobile healthcare units (MHUs) comprise flexible, ambulatory healthcare teams that deliver community care services, particularly in underserved or remote areas. In Greece, MHUs were pivotal in epidemiological surveillance during the COVID-19 pandemic and are now evolving into a sustainable and integrated service for much-needed community-based healthcare. To support this expanded role, targeted, competency-based training is essential; however, this can pose challenges, especially in coordinating synchronous learning across geographically dispersed teams and in ensuring engagement using an online format. Methods: A nationwide, online training program was developed to improve the knowledge of the personnel members of the Hellenic National Public Health Organization’s MHUs. This program was structured focusing on four core themes: (i) prevention–health promotion; (ii) provision of care; (iii) social welfare and solidarity initiatives; and (iv) digital health skill enhancement. The program was implemented by the University of Crete’s Center for Training and Lifelong Learning from 16 January to 24 February 2025. A multidisciplinary team of 64 experts delivered 250 h of live and on-demand educational content, including health screenings, vaccination protocols, biomarker monitoring, chronic disease management, treatment adherence, organ donation awareness, counseling on social violence, and eHealth applications. Knowledge acquisition was assessed through a pre- and post-training multiple-choice test related to the core themes. Trainees’ and trainers’ qualitative feedback was evaluated using a 0–10 numerical rating scale (Likert-type). Results: A total of 873 MHU members participated in the study, including both healthcare professionals and administrative staff. The attendance rate was consistently above 90% on a daily basis. The average assessment score increased from 52.8% (pre-training) to 69.8% (post-training), indicating 17% knowledge acquisition. The paired t-test analysis demonstrated that this improvement was statistically significant (t = −8.52, p < 0.001), confirming the program’s effectiveness in enhancing knowledge. As part of the evaluation of qualitative feedback, the program was positively evaluated, with 75–80% of trainees rating key components such as content, structure, and trainer effectiveness as “Very Good” or “Excellent.” In addition, using a 0–10 scale, trainers rated the program relative to organization (9.4/10), content (8.8), and trainee engagement (8.9), confirming the program’s strength and scalability in primary care education. Conclusions: This initiative highlights the effectiveness of a structured, online training program in enhancing MHU knowledge, ensuring standardized, high-quality education that supports current primary healthcare needs. Future studies evaluating whether the increase in knowledge acquisition may also result in an improvement in the personnel’s competencies, and clinical practice will further contribute to assessing whether additional training programs may be helpful. Full article