Search Results (250)

This study presents an approach based on machine learning (ML) techniques to analyze the relationship between emergency room (ER) admissions for cardiorespiratory diseases (CRDs) and environmental factors. The aim of this study is the development and verification of an interpretable machine learning framework applied to environmental and health data to assess the relationship between environmental factors and daily emergency room admissions for cardiorespiratory diseases. The model’s predictive accuracy was evaluated by comparing simulated values with observed historical data, thereby identifying the most influential environmental variables and critical exposure thresholds. This approach supports public health surveillance and healthcare resource management optimization. The health and environmental data, collected through meteorological sensors and air quality monitoring stations, cover eleven years (2013–2023), including meteorological conditions and atmospheric pollutants. Four ML models were compared, with XGBoost showing the best predictive performance (R² = 0.901; MAE = 0.047). A 10-fold cross-validation was applied to improve reliability. Global model interpretability was assessed using SHAP, which highlighted that high levels of carbon monoxide and relative humidity, low atmospheric pressure, and mild temperatures are associated with an increase in CRD cases. The local analysis was further refined using LIME, whose application—followed by experimental verification—allowed for the identification of the critical thresholds beyond which a significant increase in the risk of hospital admission (above the 95th percentile) was observed: CO > 0.84 mg/m³, P_atm ≤ 1006.81 hPa, Tavg ≤ 17.19 °C, and RH > 70.33%. The findings emphasize the potential of interpretable ML models as tools for both epidemiological analysis and prevention support, offering a valuable framework for integrating environmental surveillance with healthcare planning. Full article

 Porcine epidemic diarrhea virus (PEDV) continues to circulate globally, causing substantial economic losses to the swine industry. Historically, PEDV strains are classified into the classical G1, epidemic G2, and S-INDEL genotypes. Among these genotypes, the highly virulent and prevalent G2 genotype has been extensively studied. However, recent clinical outbreaks in China necessitate a reevaluation of the epidemiological and evolutionary dynamics of circulating strains. This study analyzed 37 newly sequenced S genes and public sequences to characterize the genetic variations of S-INDEL strains. Our analysis revealed that S-INDEL strains are endemic throughout China, with a phylogenetic analysis identifying two distinct clades: clade 1, comprising early endemic strains, and clade 2, representing a recently dominant, geographically restricted lineage in China. While inter-genotypic recombination has been documented, our findings also demonstrate that intra-genotypic and intra-clade recombination events contributed significantly to the emergence of clade 2, distinguishing its evolutionary pattern from clade 1. A comparative analysis identified 22 clade-specific amino acid changes, 11 of which occurred in the D0 domain. Notably, mutations at positively selected sites—113 and 114 within the D0 domain, a domain associated with pathogenicity—were specific to clade 2. A phylodynamic analysis indicated Germany as the epicenter of S-INDEL dispersal, with China acting as a sink population characterized by localized transmission networks and frequent recombination events. These results demonstrate that contemporary S-INDEL strains, specifically clade 2, exhibit unique recombination patterns and mutations potentially impacting virulence. Continuous surveillance is essential to assess the pathogenic potential of these evolving recombinant variants and the efficacy of vaccines against them.  Full article

As the body of knowledge on feline mammary tumors (FMTs) continues to grow, their histological classification and grading systems have undergone revisions and updates to better reflect the biological behavior of these tumors. In this review, the historical evolution of these frameworks is traced and later revisited in the context of their prognostic relevance. Numerous studies have investigated clinicopathological prognostic factors in feline mammary carcinomas (FMCs); however, the heterogeneity in assessment methods, inclusion criteria for survival analysis, and the clinical endpoints considered can often complicate direct comparisons across different studies and may contribute to seemingly conflicting results. Furthermore, the small cohort size of many studies limits the robustness and transferability of their findings. This paper provides an updated overview of the epidemiological, clinical, and pathological prognostic factors of these tumors, while also highlighting current challenges, methodological limitations, and areas for future improvement. Full article

This review focuses on CRISPR genome editing technology, particularly its application in the study of Macrobrachium rosenbergii (M. rosenbergii). It first elaborates on the basic principles and mechanisms of CRISPR–Cas9 technology, base editors, and prime editors. Then, it explores the application of this technology in M. rosenbergii breeding, including improving growth rate, enhancing disease resistance, and sex control. Additionally, it introduces the progress of genome editing technology in M. rosenbergii, epidemiology and pathogenesis, diagnostic techniques, analyzes the opportunities and challenges it faces, reviews the historical evolution, and looks ahead to future development directions. CRISPR technology has brought new opportunities to the research and industrial development of M. rosenbergii, but it also needs to address numerous technical and safety challenges. Full article

Wastewater-based epidemiology (WBE) has historically proven to be a powerful surveillance tool, particularly during the SARS-CoV-2 pandemic. Effective WBE depends on the sensitive detection of pathogens in wastewater. However, determining the process limit of detection (PLOD) of WBE through a comprehensive evaluation that accounts for pathogen concentration, nucleic acid extraction, and molecular analysis has rarely been documented. We prepared dilution series with known concentrations of S. Typhi, V. cholerae, rotavirus, and SARS-CoV-2 in surface water and wastewater. Pathogen concentration was performed using Nanotrap particles with the KingFisher™ Apex robotic platform, followed by nucleic acid extraction. Quantitative real-time PCR (qPCR) and digital PCR (dPCR) were used to detect the extracted nucleic acids of the pathogens. The PLODs and recovery efficiencies for each of the four pathogens in surface water and wastewater were determined. Overall, the observed PLODs for S. Typhi, V. cholerae, and rotavirus in surface water and wastewater were approximately 3 log₁₀ loads (2.1–2.8 × 10³/10 mL) using either qPCR or dPCR as the detection method. For SARS-CoV-2, the PLOD in surface water was 2.9 × 10⁴/10 mL with both RT-qPCR and dPCR, one log₁₀ higher than the PLODs of the other three pathogens. In wastewater, the PLOD for SARS-CoV-2 was 2.9 × 10⁴/10 mL using RT-qPCR and 2.9 × 10³/10 mL using dPCR. The mean recovery rates of S. Typhi, V. cholerae, rotavirus, and SARS-CoV-2 for dPCR in both surface water and wastewater were below 10.4%, except for S. Typhi and V. cholerae in wastewater, which showed significantly higher recoveries, from 26.5% at 4.6 × 10⁵/10 mL for S. Typhi to 58.8% at 4.8 × 10⁵/10 mL for V. cholerae. Our study demonstrated that combining qPCR or dPCR analysis with automated Nanotrap particle concentration and nucleic acid extraction using the KingFisher™ platform enables the sensitive detection of S. Typhi, V. cholerae, rotavirus, and SARS-CoV-2 in surface water and wastewater. Full article

Pediatric delirium (PD) is an acute neuropsychiatric syndrome marked by fluctuating disturbances in attention and cognition, frequently observed in pediatric intensive care units (PICUs) and associated with increased morbidity, mortality, and long-term cognitive impairment. Despite its clinical significance, PD remains underdiagnosed due to challenges inherent in assessing consciousness and cognition in children at varying developmental stages. Several bedside tools have been developed and validated in recent years, including the Cornell Assessment of Pediatric Delirium (CAPD), PreSchool Confusion Assessment Method for the Intensive Care Unit (psCAM-ICU); Pediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU), and Sophia Observation Withdrawal Symptoms—Pediatric Delirium Scale (SOS-PD), enhancing early recognition and management of PD in critically ill children. This narrative review explores the historical background, epidemiology, risk factors, pathophysiology, clinical subtypes, diagnostic tools, and current prevention and treatment strategies for PD from newborns to 21 years old. The screening tools available and the integration of non-pharmacological interventions, such as environmental modifications and family-centered care, as well as cautious and selective pharmacological management, are emphasized in this review. Early identification and targeted interventions are essential to mitigate the adverse outcomes associated with PD. Full article

Lyssaviruses are RNA viruses in the Family Rhabdoviridae, Genus Lyssavirus. They represent the causative agents of acute, progressive encephalitis, known historically as rabies. Regardless of specific etiology, their collective viral morphology, biochemistry, pathobiology, associated clinical signs, diagnosis, epizootiology, and management are essentially the same. Despite centuries of clinical recognition, these quintessential neurotropic agents remain significant pathogens today, with substantive consequences to agriculture, public health, and conservation biology. Notably, the singular morbidity caused by lyssaviruses is incurable and constitutes the highest case fatality of any viral disease. All warm-blooded vertebrates are believed to be susceptible. The dog is the only domestic animal that serves as a reservoir, vector, and victim. In contrast, felids are effective vectors, but not reservoirs. All other rabid domestic species, such as livestock, constitute spillover infections, as a bellwether to local lyssavirus activity. Frequently, professional confusion abounds among the veterinary community, because although the viral species Lyssavirus rabies is inarguably the best-known representative in the Genus, at least 20 other recognized or putative members of this monophyletic group are known. Frequently, this is simply overlooked. Moreover, often the ‘taxonomic etiology’ (i.e., ‘Lyssavirus x’) is mistakenly referenced in a biopolitcal context, instead of the obvious clinical illness (i.e., ‘rabies’). Global consternation persists, if localities believe they are ‘disease-free’, when documented lyssaviruses circulate or laboratory-based surveillance is inadequate to support such claims. Understandably, professional chagrin develops when individuals mistake the epidemiological terminology of control, prevention, elimination, etc. Management is not simple, given that the only licensed veterinary and human vaccines are against rabies virus, sensu lato. There are no adequate antiviral drugs for any lyssaviruses or cross-reactive biologics developed against more distantly related viral members. While representative taxa among the mammalian Orders Chiroptera, Carnivora, and Primates exemplify the major global reservoirs, which mammalian species are responsible for the perpetuation of other lyssaviruses remains a seemingly academic curiosity. This zoonosis is neglected. Clearly, with such underlying characteristics as a fundamental ‘disease of nature’, rabies, unlike smallpox and rinderpest, is not a candidate for eradication. With the worldwide zeal to drive human fatalities from canine rabies viruses to zero by the rapidly approaching year 2030, enhanced surveillance and greater introspection of the poorly appreciated burden posed by rabies virus and diverse other lyssaviruses may manifest as an epidemiological luxury to the overall global program of the future. Full article

While archipelagos have a demonstrated role in the stepping-stone process of the global dissemination of Aedes-borne viruses, they are often neglected in epidemiological and modelling studies. Over the past 20 years, some Atlantic archipelagos have witnessed a series of Aedes-borne viral outbreaks, prompting inquiries into the local historical suitability for transmission. In this study, the climate-based suitability for transmission of Aedes-borne viruses between 1980 and 2019 across Madeira, the Canaries, Cape Verde, and São Tomé e Príncipe archipelagos was estimated. For each island, we characterized the seasonality of climate-based suitability, mapped the spatial landscape of suitability, and quantified the historical effects of climate change. Results show that both island-level suitability and the historical impact of climate change decrease with distance from the equator, while significant seasonality patterns are observed only in subtropical climates. This study provides a unique historical perspective on the role of climate in shaping Aedes-borne virus transmission potential in Atlantic archipelagos. The findings herein described can inform local public health initiatives, including human-based prevention, targeted viral surveillance, and mosquito control programs. Full article

Background: Desmoid fibromatosis (DF) is a rare, locally aggressive soft tissue tumour with unpredictable clinical behaviour. Historically, treatment has involved surgery; however, contemporary guidelines, such as those from the Desmoid Tumour Working Group, advocate active surveillance. This article reviews current perspectives on DF, focusing on epidemiology, pathogenesis, treatment strategies, emerging research directions and cost effectiveness based on our experience at the West of Scotland Musculoskeletal Oncology Service, Glasgow Royal Infirmary (GRI). Methodology: We reviewed 101 patients diagnosed with desmoid fibromatosis between 2010 and 2024. A review of patient records was conducted to gather information on demographics, date of diagnosis, prior treatment, treatment initiation, intervention types, imaging intervals, follow-up duration, recurrence rate for surgery and other intervention, and discharge timelines. All data was systematically organized and analyzed to assess our outcomes. Results: Out of 101 patients with DF in the study, 66% were females. The most common site of primary tumour was lower extremity (39.6%) followed by near equal distribution in upper extremity and trunk. Out of the total cases, 72 (71.2%) were successfully managed with active surveillance involving serial imaging and clinical reviews in accordance with European guidelines. A total of 22 patients (21%) received treatment: 10 underwent surgery alone, 2 had surgery combined with radiotherapy, 8 received only radiotherapy, 1 was treated with hormonal therapy and 1 participated in a trial with Nirogacestat. Of the seven remaining patients, six had unplanned surgery outside followed by active surveillance at GRI. One patient was on alternative treatment modality, homeopathy. The average number of MRI scans per patient was 3.11, with many patients requiring significantly more imaging. MRI surveillance varies significantly in desmoid tumours due to their heterogeneous behaviour. Active or symptomatic tumours often require more frequent scans (every 3–6 months), while stable cases may need only imaging annually or just clinical monitoring. Recurrence was noted in eight patients, all of which were related to prior surgery. The total combined cost of imaging and appointments exceeds £6500 per patient in active surveillance. Conclusions: We conclude that most patients with desmoid fibromatosis in our cohort were effectively treated with active surveillance, consistent with current European guidelines. Surgical management of desmoid fibromatosis in our cohort is historic and has shown a significant recurrence risk. Our study proposes a revised follow-up protocol that significantly reduces costs without compromising on patient care. We suggest a two-year surveillance period for stable disease with patient-initiated return to reduce unnecessary clinic visits, imaging and healthcare costs. Full article

Municipal Solid Waste Incinerators (MSWIs) are facilities designed to burn municipal solid waste to reduce its volume and mass and generate energy. A significant concern related to MSWIs is the emission of toxic and carcinogenic pollutants, including polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs), heavy metals, and particulate matter. This review synthesizes global epidemiological and exposure assessment studies investigating cancer risks associated with residential proximity to MSWIs. Findings reveal a complex relationship: older incinerators with high emissions correlate with elevated risks of non-Hodgkin lymphoma (NHL), soft-tissue sarcoma (STS), and liver cancer in some studies, particularly in Europe. However, results remain inconsistent due to methodological limitations such as exposure misclassification, latency periods, and confounding factors like socioeconomic status. Modern facilities equipped with advanced pollution control technologies demonstrate reduced risks, often within regulatory thresholds. Key challenges include accurately quantifying historical exposures and disentangling MSWI-specific risks from other environmental or lifestyle factors. While advancements in dispersion modeling and biomonitoring have improved risk assessments, geographical and temporal variations in findings underscore the need for continued research. The review concludes that while historical evidence suggests potential cancer risks near older MSWIs, stricter emissions regulations and technological improvements have mitigated health impacts, although vigilance through long-term monitoring remains essential to safeguard public health. Full article

Squash, which originated in the early 19th century, was officially incorporated into the 2028 Los Angeles Olympic Games by the International Olympic Committee in 2023. This inclusion marks a significant milestone, highlighting its growing international recognition and potential for global development. However, squash has historically been underrepresented in academic research compared to other popular sports, with studies being scattered and relatively underdeveloped. To systematically evaluate the current state of squash research and foster academic development in the field, this study employs a combination of bibliometric and qualitative analyses, aiming to provide a comprehensive overview of squash research in terms of research progress, collaboration networks, key findings, and thematic evolution. Drawing on Web of Science, Scopus, and PubMed data, the analysis covers 206 publications from 36 countries spanning from 1973 to 2024. Network analysis based on co-authorship frequency and geographic clustering identifies the UK and Australia as leading contributors, with extensive collaboration among institutions and authors. Performance analysis (tactical and technical modeling), physiological profiling (energy demands), and medical studies (injury epidemiology) emerged as the three core research areas. The study reveals a shift in research focus from safety and physiological characteristics to performance enhancement, which is driven by technological innovation. Future research should prioritize underdeveloped areas such as youth development, psychology, and nutrition while integrating diverse participant groups (e.g., female athletes, recreational players) and advanced technologies. Full article

The Myanmar government aims to eliminate malaria by 2030, but comprehensive summaries of its malaria control efforts are scarce. To support this goal, a literature review and long-term document preservation are essential. This study collected academic papers, master’s and doctoral theses, and policy documents on malaria control in Myanmar and its surrounding regions, published between 1950 and 2016 through Official Development Assistance. The documents were sourced from online databases, medical universities, and research institutions in Yangon. They were categorized by region and WHO-defined malaria control activity areas and archived digitally at the Ministry of Health. A total of 1107 relevant papers were identified, with 818 collected. Epidemiology-related studies accounted for 40%, followed by drug resistance, surveillance, and treatment. Recent years have seen a rise in genetic and molecular epidemiology research. Full-text analysis revealed significant malaria research in border regions, particularly near the borders of Thailand and China. This study highlights the progress and historical trends in Myanmar’s efforts to control malaria. The archive created will be a valuable resource for future policy planning and implementation efforts aimed at achieving malaria elimination. Full article

Even at historically low levels of air pollution, epidemiological time series studies carried out in cities across the globe have documented its substantial detrimental health effects. A time series analysis of counts of respiratory hospital admissions in Gjakova and outdoor air pollutants was performed, applying a General Additive Model with a Poisson distribution, controlling for time trends and meteorological factors over a 4-year period (2020–2023) with different time lags (0–7 days). The effects were further analyzed per age group (children and adults). We found significant associations between gaseous pollutants, mainly NO₂, and respiratory disease-related hospital admissions in the city. The strongest association between NO₂ and total hospital admissions was observed after a lag of 6 days, with an increase of 0.14 cases per 10 μg/m³ increase in concentration. The effects were stronger in adults. An adverse effect was also seen with SO₂, but not particulate pollution. Our findings call for greater awareness regarding environmental protection and the implementation of effective measures to improve air quality, which may reduce the risk of adverse health effects. Full article

Here, research on seed-borne virus diseases of cool-season pulses caused by bean yellow mosaic virus (BYMV) in Australia’s grain cropping regions since the 1940s is reviewed. A historical approach is taken towards all past studies involving the main cool-season pulse crops grown, lupin, faba bean, field pea, lentil and chickpea, and the minor ones, narbon bean, vetches and Lathyrus species. The main emphasis adopted is on describing what these studies revealed concerning BYMV biology, epidemiology and management. The field and glasshouse experimentation that enabled the development of effective phytosanitary, cultural and host resistance control strategies, supported by many image illustrations from past investigations, is emphasized. This review commences by providing brief background information and describing past studies on BYMV symptom and sequence variants, and alternative BYMV hosts. Next, as the lupin/BYMV pathosystem has been investigated in much greater depth than any other cool season pulse/BYMV pathosystem combination in Australia, what past studies using it have found is covered considerable detail under a series of nine different sub-headings. Finally, what is known about the less thoroughly investigated cool-season pulse/BYMV pathosystems, especially those involving faba bean, field pea and lentil, is reviewed under seven different sub-headings. Recommendations are provided concerning future research priorities. Full article

The trematodes Fasciola hepatica and F. gigantica are transmitted by lymnaeid snails and cause fascioliasis in livestock and humans. Human infection is emerging in southern and southeastern Asia. In India, the number of case reports has increased since 1993. This multidisciplinary study analyzes the epidemiological scenario of human infection. The study reviews the total of 55 fascioliasis patients, their characteristics, and geographical distribution. Causes underlying this emergence are assessed by analyzing (i) the climate change suffered by India based on 40-year-data from meteorological stations, and (ii) the geographical fascioliasis hotspots according to archeological–historical records about thousands of years of pack animal movements. The review suggests frequent misdiagnosis of the wide lowland-distributed F. gigantica with F. hepatica and emphasizes the need to obtain anamnesic information about the locality of residence and the infection source. Prevalence appears to be higher in females and in the 30–40-year age group. The time elapsed between symptom onset and diagnosis varied from 10 days to 5 years (mean 9.2 months). Infection was diagnosed by egg finding (in 12 cases), adult finding (28), serology (3), and clinics and image techniques (12). Climate diagrams and the Wb-bs forecast index show higher temperatures favoring the warm condition-preferring main snail vector Radix luteola and a precipitation increase due to fewer rainy days but more days of extreme rainfall, leading to increasing surface water availability and favoring fascioliasis transmission. Climate trends indicate a risk of future increasing fascioliasis emergence, including a seasonal infection risk from June–July to October–November. Geographical zones of high human infection risk defined by archeological–historical analyses concern: (i) the Indo-Gangetic Plains and corridors used by the old Grand Trunk Road and Daksinapatha Road, (ii) northern mountainous areas by connections with the Silk Road and Tea-Horse Road, and (iii) the hinterlands of western and eastern seaport cities involved in the past Maritime Silk Road. Routes and nodes are illustrated, all transhumant–nomadic–pastoralist groups are detailed, and livestock prevalences per state are given. A baseline defining areas and seasons of high infection risk is established for the first time in India. This is henceforth expected to be helpful for physicians, prevention measures, control initiatives, and recommendations for health administration officers. Full article