Search Results (282)

Salmonella is a major foodborne pathogen that poses an increasing threat due to the emergence of mcr-1-mediated colistin resistance. However, data on mcr-1-positive Salmonella in pork products are limited. In this study, 457 samples collected in 2023 from pig slaughterhouses in Guangdong province were investigated to determine the prevalence and genomic characteristics of mcr-1-positive Salmonella isolates. We found that 92 Salmonella isolates (20.1%, 92/457) were recovered, representing six serotypes, including Salmonella Typhimurium (n = 29) and Salmonella Rissen (n = 29). High resistance to tetracycline (90.2%, 83/92) and multidrug resistance (58.7%, 54/92) were observed. Critically, two colistin-resistant Salmonella Kentucky ST198 isolates (2.2%) harboring mcr-1 on transferable IncI2 plasmids were identified. Genomic analysis revealed a novel multidrug resistance region (MRR, ~57 kb) inserted into the bcfH locus (containing floR, qnrS1, bla_CTX-M-55, and aph (3’)-Ia) and a variant Salmonella Genomic Island 1 (SGI1-KI, containing tet (A), sul1, qacEΔ1 and aadA7) in these isolates. The MRR and SGI1-KI may enhance bacterial survival under antibiotic selection pressure. Phylogenetic analysis showed close relatedness to human clinical strains, suggesting food chain transmission. The findings highlight a high antimicrobial resistance burden, the emergence of transferable last-resort colistin resistance (mcr-1), and acquisition of complex resistance determinants (MRR, SGI1-KI), underscoring an urgent need for enhanced “One Health” surveillance. Full article

Objective: To investigate public attitudes in New Zealand towards the euthanasia of dogs and cats and to explore the factors that influence these views. Materials and Methods: Data were collected through a nationwide online survey conducted in 2019 as part of the Furry Whānau Wellbeing research project. The survey included questions about pet euthanasia, and respondents were asked to indicate their level of agreement with various statements. Results: Of 2293 respondents to the 2019 New Zealand Pet Survey, the majority (n = 1756) opposed euthanasia for stray, unwanted, or financially burdensome pets (76.7%; 90.2% and 66.3% of these disagreed or strongly disagreed, respectively). In contrast, a slim majority (n = 1162) supported it for sick animals. Females were less likely to agree with euthanasia in most scenarios compared to males. Māori and New Zealand European respondents (n = 1790) showed higher levels of neutrality than other ethnicities regarding stray animals and lower levels of disagreement regarding financially constrained situations. Older respondents (65+) were more likely to support euthanasia for sick animals, while younger respondents (18–24) were less inclined. Higher education levels are correlated with increased neutrality towards euthanising stray animals and increased support for euthanising feral animals. Respondents with children were more likely to be neutral or to disagree with euthanasia in most scenarios. Those with rural upbringings were more accepting of euthanasia for stray and feral animals. A thematic analysis of 653 respondent comments revealed key themes: euthanasia was seen as complex and context-dependent, a humane last resort for suffering animals, but not for convenience. Respondents emphasised responsible pet ownership and a right to life, even for feral animals, advocating for alternatives such as trap–neuter–release. Conclusion: New Zealanders largely view euthanasia as an ethically acceptable option for terminally ill or suffering animals but reject it when driven by convenience or financial hardship. Attitudes vary across demographic groups, highlighting the need for culturally sensitive education and policy. The findings align with Sustainable Development Goal 3 (Good Health and Well-being) and support broader discussions on responsible pet ownership, ethical decision making, and animal welfare legislation. Full article

Urban air pollution remains a significant environmental and public health issue, especially in European coastal cities such as Klaipėda. However, there is still a lack of local-scale knowledge on how land use structure influences pollutant distribution, highlighting the need to address this gap. This study addresses this by examining the spatial distribution of nitrogen dioxide (NO₂) concentrations in Klaipėda’s seaport city and several inland and coastal resort towns in Lithuania. The research specifically asks how different land cover types and demographic factors affect NO₂ variability and population exposure risk. Data were collected using passive sampling methods and analyzed within a GIS environment. The results revealed clear air quality differences between industrial/port zones and greener resort areas, confirmed by statistically significant associations between land cover types and pollutant levels. Based on these findings, a Land Use Pollution Pressure index (LUPP) and its population-weighted variant (PLUPP) were developed to capture demographic sensitivity. These indices provide a practical decision-support tool for sustainable urban planning, enabling the assessment of pollution risks and the forecasting of air quality changes under different land use scenarios, while contributing to local climate adaptation and urban environmental governance. Full article

The illegal sale of mussels is a persistent problem for food safety and public health in the Campania region, where bivalve molluscs are often sold without traceability, evading regulatory controls. In this study, ten batches of mussels seized from unauthorized vendors were analyzed to evaluate their microbiological safety and trace their geographical origin. High loads of Escherichia coli, exceeding European regulatory limits (Regulation (EC) No 2073/2005), were detected in all samples. In addition, Salmonella Infantis strains resistant to trimethoprim-sulfamethoxazole and azithromycin were isolated, raising further concerns about antimicrobial resistance. Of the 93 Vibrio isolates, identified as V. alginolyticus and V. parahaemolyticus, 37.63% showed multidrug resistance. Approximately 68.57% of the isolates were resistant to tetracyclines and cephalosporins. The presence of resistance to last-resort antibiotics such as carbapenems (11.43%) is particularly alarming. Near-infrared spectroscopy, combined with chemometric models, was used to obtain traceability information, attributing a presumed origin to the seized mussel samples. Of the ten samples, seven were attributed to the Phlegraean area. These findings have provided valuable insights, reinforcing the need for continuous and rigorous surveillance and the integration of innovative tools to ensure seafood safety and support One Health approaches. Full article

Background/Objectives: Patients with an ileoanal pouch change their diet to manage their symptoms and will often resort to the internet for nutrition advice. Currently, no evidence-based dietary guidelines exist to inform online resources. Hence, this study aims to assess the quality of online nutrition information directed towards patients with an ileoanal pouch. Methods: A systematic Google search was conducted to identify consumer websites including information on nutrition for those with ileoanal pouches. Quality was assessed using the DISCERN instrument, and the readability of written content was assessed using the Flesch–Kincaid score. A summative content analysis was used to identify the frequency of particular topics. Websites were also assessed against standards from the National Institute for Health and Care Excellence (NICE) framework for shared decision-making support tools. Results: A total of 12 websites met the inclusion criteria. Mean total DISCERN scores across all websites are 33 out of 75, indicating that overall, the websites were of poor quality. The mean Flesch–Kincaid score was 57 out of 100, or “fairly difficult” in terms of readability. The main themes according to the content analysis were “general dietary advice for pouch”, “dietary strategies for symptom management”, “addressing risks associated with having a pouch”, and “optimisation of nutritional intake”. Overall, websites did not meet the standards for shared decision-making. Conclusions: Online nutrition information for patients with an ileoanal pouch is of poor quality and difficult to understand. There is a need for higher quality online resources for these patients, ideally co-produced with a multidisciplinary team and patient, to provide patients with good quality, understandable, and accessible nutrition information. Full article

Background/Objectives: Increasing levels of antimicrobial resistance (AMR) have recently been observed at the human–domestic animal–wildlife interface. Wild birds have been identified as carriers of antimicrobial-resistant bacteria and serve as excellent biomarkers for epidemiological studies. This study assessed the current AMR presence in Eastern Spain’s commensal Escherichia coli isolated from free-ranging Bonelli’s eagles (Aquila fasciata). Methods: Nestlings and their nests were intensively sampled between 2022 and 2024 to determine their AMR profile and characterize E. coli. AMR testing was conducted using the broth microdilution method, following the European Committee on Antimicrobial Susceptibility Testing guidelines. Additionally, the presence of eaeA (intimin gene) and stx-1 and stx-2 (shiga toxins) was analyzed by real-time PCR to classify E. coli strains into enteropathogenic (EPEC) and Shiga-toxigenic (STEC) pathotypes. Results: Of all E. coli isolates, 41.7% were resistant to at least one antimicrobial, and 30% were multidrug-resistant. Only two strains were classified as EPEC and none as STEC. The highest resistance rates were observed for amoxicillin and tetracycline (19.6% each). Alarmingly, resistance to colistin and meropenem, last-resort antibiotics in human medicine, was also detected. Conclusions: Although the mechanisms of resistance acquisition remain unclear, transmission is likely to occur through the food chain, with synanthropic prey acting as intermediary vectors. These results highlight the role of Bonelli’s eagles as essential sentinels of environmental AMR dissemination, even in remote ecosystems. Strengthening One Health-based surveillance is necessary to address AMR’s ecological and public health risks in wildlife. Full article

Introduction: Knee osteoarthritis (OA) is defined by articular cartilage loss, increased discomfort, and functional restrictions. Changes in lifestyle, painkillers, intra-articular injections, and, as a last resort, surgery are all part of clinical therapy. In this setting, intra-articular injections of hyaluronic acid (HA) represent a relevant and diffused therapeutic option. Materials and Methods: A prospective observational study was performed from October 2024 to May 2025 in 70 patients with knee OA. HA was administered in three intra-articular injections and was followed up at 3 and 6 months from the last injection. Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated as primary outcome measure; Visual Analogue Scale (VAS), time up and go test, six-minute walking test, general health assessment with 36-Item Short Form Health Survey (SF-36), Zung’s Self-Rating Anxiety Scale (Zung SAS), and Zung’s Self-Rating Depression Scale (Zung SDS) as secondary outcome measures. Results: We observed a statistically significant improvement in clinical scores at 3 months in both HA formulations compared to the control group. No relevant side effects were described during the study. Conclusion: Hyalubrix 30 mg/2 mL and DIART 1.8%/2 mL are two safe and effective therapeutic options to manage knee OA, offering benefits in pain control, functionality and emotional wellness. Full article

To date, there has been a noticeable lack of a systematic and structured approach to the development of forest therapy tourism. This study addresses this problem by introducing a forest tourism attractiveness model and an evidence-based framework for the conceptual development of Forest Climatic Spa Resorts. Based on an attributive theory approach, a comprehensive set of forest tourism attractiveness attributes is defined, a model of forest tourism attractiveness is developed, and theoretical and conceptual foundations to support the criteria for the development of Forest Climatic Spa Resorts are presented. This research contributes to the ongoing discourse on sustainable tourism practices and emphasises the role of forest environments in promoting health and well-being in therapeutic tourism activities. Ultimately, our findings offer valuable insights for policymakers, tourism developers, and practitioners in the field of forest therapy tourism, providing a foundation for future initiatives aimed at enhancing the appeal and sustainability of forest-based tourism experiences. Full article

Oral cancer, the most common form of head and neck cancer, is worldwide a serious public health problem. Most patients present a locally advanced disease, and face poor prognosis, even with multimodality treatment. They may also develop second primary tumors in the entirety of their upper aerodigestive tract. The most altered signaling pathways are the PI3K/AKT/mTOR, TP53, RB, and the WNT/β-catenin pathways. Genomic and molecular cytogenetic analyses have revealed frequent losses at 3p, 8p, 9p, and 18q, along with gains at 3q, 7p, 8q, and 11q, and several genes frequently affected have been identified, such as TP53, CCND1, CTTN, CDKN2A, EGFR, HRAS, PI3K, ADAM9, MGAM, SIRPB1, and FAT1, among others. Various epigenetic alterations were also found, such as the global hypomethylation and hypermethylation of CDKN2A, APC, MGMT, PTEN, CDH1, TFP12, SOX17, GATA4, ECAD, MGMT, and DAPK. Several microRNAs are upregulated in oral cancer, including miR-21, miR-24, miR-31, miR-184, miR-211, miR-221, and miR-222, while others are downregulated, such as miR-203, miR-100, miR-200, miR-133a, miR-133b, miR-138, and miR-375. The knowledge of this molecular pathogenesis has not yet been translated into clinical practice, apart from the use of cetuximab, an EGFR antibody. Oral tumors are also genetically heterogenous and affect several pathways, which means that, due to the continuous evolution of these genetic alterations, a single biopsy is not sufficient to fully evaluate the most adequate molecular targets when more drugs become available. Liquid biopsies, either resorting to circulating tumor cells, extracellular vesicles or cell-free nucleic acids, have the potential to bypass this problem, and have potential prognostic and staging value. We critically review the current knowledge on the molecular, genetic and epigenetic alterations in oral cancer, as well as the applications and challenges of liquid biopsies in its diagnosis, follow-up, and prognostic stratification. Full article

Youth violence—the deliberate use of physical force or harm by young people between the ages of 10 and 24 to intimidate or cause harm to others, both online and offline—is a critical public health issue in the United States. Yet, successfully predicting future violent offenders is a complex and challenging task, as the question of why some youths resort to extreme violence while others refrain from it—despite facing similar risk factors—remains widely debated. This article highlights both risk and protective factors of youth violence through a socio-ecological lens to offer a comprehensive understanding of the multifaceted factors driving youth violence in the United States. To understand the interconnectedness between individual factors and the broader environments in which individuals are embedded, we outline the risk and protective factors related to youth violence across five socio-ecological levels: (1) individual, (2) interpersonal, (3) neighborhood, (4) cultural, and (5) life course. Approaching youth violence from a holistic lens offers a greater opportunity to mitigate contributing factors and to address the deleterious impacts of this complex issue. Practice and research implications are discussed. Full article

Physical and mental health are fundamental human needs, yet modern medicine cannot always preserve them. At this point, alternative and complementary medical approaches sometimes offer significant contributions. In this context, religious healing stands out as a practice that plays a complementary role in many cultures and is frequently relied on, although it often faces criticism from the perspective of official religious doctrine. This study examines the phenomenon of “religious healing” from a sociological perspective. The provinces of Iğdır, Ağrı, and Erzurum, located in eastern Türkiye, were selected for the fieldwork. Interviews were conducted with 31 individuals who sought religious healing. The main purpose of this article is to understand the motivations of individuals who participate in such practices and how their healing experiences are transformed into religious experiences. The field data indicate that religious healing commonly involves practices such as recitation and blowing of the Qur’an, drinking blessed water, and the preparation of amulets. Feelings of helplessness and fear of social stigma are prominent in participants’ reasons for resorting to religious healers. The participants’ turn to healers can be seen as a defense mechanism, shifting blame to external forces like the evil eye, jinn, and magic, thereby reducing personal responsibility. Religion was instrumentalized to make the behavior of applying to a healer reasonable and acceptable. Full article

Background: Unlike other chronic diseases, cancer patients undergo different types of treatments that affect their well-being, and as a result, they tend to have different experiences from those of other chronic disease sufferers. The purpose of this study was to assess the effects of cancer diagnosis and coping strategies on patients in Vhembe District hospitals in Limpopo Province. Methodology: The study design used was a quantitative descriptive cross-sectional survey. The target population included patients in the Vhembe District of Limpopo who had started treatment within the last year. Probability-stratified sampling was used to sample 207 patients from seven selected hospitals in Vhembe District. A self-administered questionnaire was used to collect data, and the data were analyzed using a software package for descriptive statistics (SPSS version 23). Tables were used to display the results visually, and chi-square tests were used to compare the variables. Ethical principles were considered for the participants’ privacy, anonymity, and informed consent. Findings: The findings revealed that the majority of patients 185 (89.4%) experienced a sense of psychosocial distress such as emotional pain; 142 (68.6%) participants experienced hopelessness and despair, 127 (61.3%) resorted to substance use, 160 (77.3%) did not have a positive attitude towards seeking the medical and other support resources available, only a minority resorted to spirituality, and 121 (63.2%) indicated seeking further clarity about the disease. The study recommends supporting cancer patients and their families through the cancer journey. Contributions: Clinicians should provide psychosocial support interventions to enhance mental health and quality of life in cancer patients, and decentralize oncology services by including primary care professionals in delivering chronic illness disease management strategies. Full article

Background: Urinary tract infections (UTIs) caused by the multidrug resistance (MDR) phenotype termed extended-spectrum beta lactamase (ESBL)-producing E. coli is a significant and growing global health concern. In response to the rising prevalence, the novel Beta Lactam-Beta Lactamase inhibitor (BL/BLI) combinations have been introduced in recent years. While these agents have shown efficacy, their clinical utility is constrained by high cost, limited availability, and emerging resistance mechanisms. The rational of this study was to test the in vitro activity of a cost-effective alternative to currently available BL–BLI combinations against ESBL-producing E. coli isolated from urinary tract infections (UTIs). Objective: This study investigates the in vitro antimicrobial activity of cefaclor (CFC), both as monotherapy and in combination with the β-lactamase inhibitors clavulanic acid (CA) and sulbactam (SUL), against 52 ESBL-producing E. coli isolates derived from urine cultures of patients diagnosed with UTIs. Methods: The susceptibility ranges were measured by disk diffusion and minimal inhibitory concentration (MIC) methods. In addition, the Time kill assay and disk approximation method were performed to measure the synergistic and bactericidal activity of the approached combination. Results: The MIC50 and MIC90 for CFC were improved from more than 128 µg/mL to 8/4 µg/mL when CFC was combined with either CA or SUL. The triple combination format of CFC/CA/SUL showed MIC50 and MIC90 values at 8/4/4 µg/mL and 64/32/32 µg/mL, respectively. The recovered susceptibility percentages were 54%, 54%, and 58% for CFC/CA, CFC/SUL, and CFC/CA/SUL combinations, respectively. Disk approximation and time–kill assay results revealed synergy and bactericidal effects when CFC combined with CA or SUL for isolates that showed susceptibility restorations of CFC when coupled with CA or SUL by the disk diffusion and MIC method. Conclusions: This study proposes a cost-effective combination that could mitigate resistance development and offer a sparing option to last resort treatment choices including carbapenems. However, testing efficacy in a clinical setting is crucial. Full article

Although the transition to electric vehicles (EVs) is well underway and expected to continue in global car markets, most vehicles on the world’s roads will be powered by internal combustion engine vehicles (ICEVs) and fossil fuels for the foreseeable future, possibly well past 2050. Thus, good environmental performance and effective emission control of ICE vehicles will continue to be of paramount importance if the world is to achieve the stated air and climate pollution reduction goals. In this study, we review 228 publications and identify four main issues confronting these objectives: (1) cheating by vehicle manufacturers, (2) tampering by vehicle owners, (3) malfunctioning emission control systems, and (4) inadequate in-service emission programs. With progressively more stringent vehicle emission and fuel quality standards being implemented in all major markets, engine designs and emission control systems have become increasingly complex and sophisticated, creating opportunities for cheating and tampering. This is not a new phenomenon, with the first cases reported in the 1970s and continuing to happen today. Cheating appears not to be restricted to specific manufacturers or vehicle types. Suspicious real-world emissions behavior suggests that the use of defeat devices may be widespread. Defeat devices are primarily a concern with diesel vehicles, where emission control deactivation in real-world driving can lower manufacturing costs, improve fuel economy, reduce engine noise, improve vehicle performance, and extend refill intervals for diesel exhaust fluid, if present. Despite the financial penalties, undesired global attention, damage to brand reputation, a temporary drop in sales and stock value, and forced recalls, cheating may continue. Private vehicle owners resort to tampering to (1) improve performance and fuel efficiency; (2) avoid operating costs, including repairs; (3) increase the resale value of the vehicle (i.e., odometer tampering); or (4) simply to rebel against established norms. Tampering and cheating in the commercial freight sector also mean undercutting law-abiding operators, gaining unfair economic advantage, and posing excess harm to the environment and public health. At the individual vehicle level, the impacts of cheating, tampering, or malfunctioning emission control systems can be substantial. The removal or deactivation of emission control systems increases emissions—for instance, typically 70% (NO_x and EGR), a factor of 3 or more (NO_x and SCR), and a factor of 25–100 (PM and DPF). Our analysis shows significant uncertainty and (geographic) variability regarding the occurrence of cheating and tampering by vehicle owners. The available evidence suggests that fleet-wide impacts of cheating and tampering on emissions are undeniable, substantial, and cannot be ignored. The presence of a relatively small fraction of high-emitters, due to either cheating, tampering, or malfunctioning, causes excess pollution that must be tackled by environmental authorities around the world, in particular in emerging economies, where millions of used ICE vehicles from the US and EU end up. Modernized in-service emission programs designed to efficiently identify and fix large faults are needed to ensure that the benefits of modern vehicle technologies are not lost. Effective programs should address malfunctions, engine problems, incorrect repairs, a lack of servicing and maintenance, poorly retrofitted fuel and emission control systems, the use of improper or low-quality fuels and tampering. Periodic Test and Repair (PTR) is a common in-service program. We estimate that PTR generally reduces emissions by 11% (8–14%), 11% (7–15%), and 4% (−1–10%) for carbon monoxide (CO), hydrocarbons (HC), and oxides of nitrogen (NO_x), respectively. This is based on the grand mean effect and the associated 95% confidence interval. PTR effectiveness could be significantly higher, but we find that it critically depends on various design factors, including (1) comprehensive fleet coverage, (2) a suitable test procedure, (3) compliance and enforcement, (4) proper technician training, (5) quality control and quality assurance, (6) periodic program evaluation, and (7) minimization of waivers and exemptions. Now that both particulate matter (PM, i.e., DPF) and NO_x (i.e., SCR) emission controls are common in all modern new diesel vehicles, and commonly the focus of cheating and tampering, robust measurement approaches for assessing in-use emissions performance are urgently needed to modernize PTR programs. To increase (cost) effectiveness, a modern approach could include screening methods, such as remote sensing and plume chasing. We conclude this study with recommendations and suggestions for future improvements and research, listing a range of potential solutions for the issues identified in new and in-service vehicles. Full article

Background: Harmful alcohol use and nicotine dependence are major public health concerns. One group particularly at risk may be medical students, who might resort to substance use as a coping mechanism for stress. Various factors may influence these behaviors, either positively or negatively—among them, dietary knowledge and eating habits. Methods: In this study, we used the KOMPAN questionnaire to assess dietary habits and nutrition knowledge, the AUDIT questionnaire to evaluate problematic alcohol consumption, and the Fagerström Test to assess nicotine dependence. A total of 2801 medical students participated in this study, including 2374 alcohol users and 379 smokers. Results: Smoking students demonstrated significantly lower dietary quality (p < 0.0001) and nutrition knowledge (p = 0.0004). Among alcohol users, lower levels of problematic alcohol consumption were observed in individuals with better dietary quality (p = 0.0006) and higher nutrition knowledge (p < 0.0001). Conclusions: Future research should explore additional factors contributing to the clustering of unhealthy behaviors and the underlying causes of alcohol consumption and poor dietary habits among healthcare professionals. Full article