Search Results (13,479)

Background/Objectives: Breastfeeding represents a critical developmental window during which maternal biology, environmental exposures, and nutrition converge to influence infant gastrointestinal health and long-term developmental trajectories. From a One Health perspective, breastfeeding can be conceptualized not as a static nutritional act, but as a dynamic and modifiable biological system in which maternal factors shape early-life microbiota assembly and immune programming. This narrative review explores how microbiota-oriented strategies during breastfeeding may foster a favorable trajectory of infant health, potentially extending to transgenerational outcomes. Methods: This narrative review is structured around a ten-point decalogue addressing interconnected domains relevant to the maternal–milk–infant microbiota axis, including maternal diet, microbial diversity, environmental exposures, psychological stress and probiotic use. Current mechanistic and clinical evidence was examined to evaluate how these domains may modulate microbiota composition and function during breastfeeding. Attention was given to probiotic supplementation, including strain specificity, timing of administration, and clinical context, as well as to the broader implications of a One Health framework. Results: Available evidence suggests that maternal nutritional patterns, environmental and psychosocial exposures, and targeted microbiota-modulation strategies may influence the composition and functional properties of human milk and the developing infant microbiota. Probiotic use during breastfeeding appears to have strain-specific and context-dependent effects, with potential benefits in selected clinical scenarios. However, findings remain heterogeneous, and uncertainties persist regarding optimal strains, timing, and long-term outcomes. Conclusions: Breastfeeding can be understood as a dynamic biological interface shaped by maternal and environmental factors. Integrating microbiota-oriented strategies within a One Health framework may support infant gastrointestinal health and possibly contribute to longer-term developmental trajectories. Nevertheless, careful interpretation of the current evidence is warranted to avoid reductionist, supplement-centered approaches and to prevent maternal overmedicalization or blame. Full article

Background: Schistosoma spp. are trematodes occurring in tropical endemic areas but can be imported to non-endemic regions as causes of travel-associated infections. In this study, two pan-trematode-specific real-time PCR assays were evaluated for their diagnostic sensitivity in detecting Schistosoma spp. DNA in diagnostic human samples. Methods: Two previously described pan-trematode-specific real-time PCR assays were comparatively assessed using diagnostic samples containing DNA of either the S. haematobium complex or the S. mansoni complex, as confirmed by Schistosoma species complex-specific real-time PCR. Results: Out of a total of 655 samples containing Schistosoma spp. DNA, positive signals in at least one of the two pan-trematode real-time PCR assays were recorded for 17 (2.6%) nucleic acid extractions. Although sensitivity was in the >90% range for stool samples, only a few individual blood plasma and serum samples, and none of the Schistosoma spp. DNA-containing tissue or urine samples, tested positive by pan-trematode PCR. The lower sensitivity of pan-trematode PCR compared with Schistosoma spp.-specific PCR was semi-quantitatively confirmed by higher cycle threshold (Ct) values in the former. When comparing samples with concordant versus discordant positive results for Schistosoma spp.-specific and pan-trematode PCR, Ct values of the Schistosoma spp.-specific PCR were lower in concordantly positive samples than in discordantly positive samples. Conclusions: While the assessed pan-trematode PCR assays showed insufficient sensitivity as screening tools for blood plasma, blood serum, tissue, and urine samples from individuals with suspected schistosomiasis, they were sufficiently sensitive when applied to stool samples, in which substantial amounts of target DNA, as indicated by low Ct values in the Schistosoma species complex-specific real-time PCR assays, can be expected. For screening for Schistosoma spp. DNA in sample materials other than stool, the use of highly sensitive target-specific PCR remains necessary. Full article

Background/Objectives: Several studies previously investigated the risk factors for post-operative recurrence of primary spontaneous pneumothorax (PSP), with conflicting results. Identification of patients at greater risk of recurrence may help optimize therapeutic strategies. The aim of this study is to identify potential predictors of post-operative recurrence of PSP and compare our results with the available literature. Methods: We retrospectively evaluated all patients who underwent surgery for PSP at our institution between January 2005 and December 2022. We analyzed data on patient characteristics, surgical details, method of pleurodesis and perioperative outcomes and used Cox regression analysis to identify predictors post-operative ipsilateral recurrence. Results: 226 patients were included in our study, of which 29 (12.8%) developed an ipsilateral recurrence of pneumothorax. A positive history of previous contralateral episodes (37.9% vs. 19.3%, p = 0.03) and the positioning of larger chest drains after the procedure (65.5% vs. 44.8%, p = 0.032) were more frequent in the recurrence group. At multivariable regression analysis, a history of previous contralateral pneumothorax was found to be the only independent predictive factor of pneumothorax recurrence (HR 2.16, 95% C.I. 1.001–4.662, p = 0.049). Conclusions: Previous contralateral pneumothorax is a risk factor for the development of post-operative recurrences. Full article

Background/Objectives: Antimicrobial resistance (AMR) in companion animals is an emerging public health threat due to zoonotic potential and limited therapeutic options. Dogs with otitis externa may harbor multidrug-resistant (MDR) bacteria, including Escherichia coli (E. coli), Proteus mirabilis (P. mirabilis), and Enterobacter cloacae complex (E. cloacae complex), some producing extended-spectrum beta-lactamase (ESBL) or AmpC β-lactamases. This study aimed to assess the prevalence, AMR patterns, MDR occurrence, β-lactamase production, and co-infection profiles of these pathogens in canine otitis externa. Methods: Ear canal samples were collected from 592 dogs presenting clinical signs of otitis externa, with one sample per dog included in the analysis. Samples were collected from veterinary clinics in Timiș County, Romania, from 2022 to 2025. Samples were cultured on blood agar and MacConkey agar, followed by biochemical testing and MALDI-TOF mass spectrometry for bacterial identification. Antimicrobial susceptibility testing against 15 agents across six classes was performed using the VITEK^® 2 system. MDR and β-lactamase production (ESBL, AmpC) were determined according to CLSI 2018 veterinary guidelines. Co-isolation with bacterial and fungal species were recorded. Results: E. coli, P. mirabilis, and E. cloacae complex were isolated in 9.12%, 6.25%, and 1.2% of cases, respectively. E. coli exhibited the highest resistance to aminoglycosides (tobramycin 72.2%, gentamicin 61.1%) and full susceptibility to carbapenems. P. mirabilis showed the highest resistance to ampicillin (54%) and trimethoprim + sulfamethoxazole (46%), with complete susceptibility to carbapenems and fluoroquinolones. E. cloacae complex displayed universal resistance to cephalosporins but remained susceptible to non-cephalosporin β-lactams (piperacillin–tazobactam), carbapenems and aminoglycosides. MDR prevalence was 35.2% for E. coli, 18.9% for P. mirabilis, and 14.3% for the E. cloacae complex. ESBL production was detected in 13% of E. coli and 8.1% of P. mirabilis isolates, while all E. cloacae complex isolates were AmpC-positive. Co-isolations were common, primarily involving Staphylococcus pseudintermedius (S. pseudintermedius) and Malassezia pachydermatis (M. pachydermatis). Conclusions: MDR and β-lactamase-producing bacteria were identified in dogs with otitis externa, emphasizing the importance of routine antimicrobial susceptibility testing, targeted therapy based on local resistance profiles, and continuous AMR surveillance to prevent treatment failure and mitigate zoonotic risk. Full article

Leptospirosis is a globally widespread zoonosis, with wildlife species playing a key role in the maintenance and environmental dissemination of Leptospira spp. Wild boar (Sus scrofa) are increasingly recognized as potential reservoir; however, molecular data on renal carriage of Leptospira spp. in Europe and particularly in Germany, remain scarce. In this study, 1281 wild boar kidney samples collected in the federal state of Saxony-Anhalt were analyzed by real-time PCR to investigate the presence of pathogenic and intermediate Leptospira DNA. Pathogenic Leptospira DNA was detected in 3.1% (95% CI = 2.3–4.2) of the samples, whereas intermediate Leptospira DNA was identified in 0.6% (95% CI = 0.3–1.2). Pathogenic Leptospira showed a widespread distribution across the study area, with a significantly higher prevalence in the district of Salzlandkreis (p = 0.04, OR = 3.4, CI = 0.8–10.3). Evaluation of host-related and environmental factors revealed a significant association between pathogenic Leptospira DNA detection and both sub-adult age class (χ² = 13.1, df = 2, p = 0.0014) and autumn season (χ² = 12.3, df = 3, p = 0.0066), whereas no significant association was observed for sex. Neither of these factors showed a significant relation with intermediate Leptospira spp. Sequence analyses of rrs and 16S rRNA genes predominantly identified as L. interrogans (62.5%), followed by L. borgpetersenii (20.0%) and L. kirschneri (5.0%). All intermediate Leptospira sequences were identified as L. fainei. Notably, this study provides the first molecular evidence of intermediate L. fainei DNA in wild boar kidneys in Germany. Overall, these findings suggest that wild boar may act as renal carriers of Leptospira spp. and support their potential relevance in the epidemiology of leptospirosis within wildlife populations in Saxony-Anhalt. Full article

Aqueous supercapacitors are a class of crucial high-power, long-life, safe and reliable energy storage devices, with their performance fundamentally dependent on electrode materials. Two-dimensional (2D) vanadium-based MXenes, possessing rich multivalent redox activity and tunable layered structures, have emerged as one of highly promising electrode candidates, exhibiting significantly superior specific capacitance and pseudocapacitive properties compared to conventional Ti₃C₂T_z. To overcome inherent limitations in conductivity and structural stability, this review summarizes strategies for regulating composition and microstructure through transition metal solid solution and medium-/high-entropy design. These approaches synergistically optimize electron conduction, expand ion migration pathways, and suppress electrode degradation, thereby comprehensively enhancing rate performance, cycle life, and energy density. This review systematically reveals the composition–structure–performance relationships, providing critical design insights and theoretical foundations for developing next-generation high-performance, long-life aqueous MXene-based supercapacitors. Full article

Phage-encoded Shiga toxin (Stx) released by Shiga toxin-producing E. coli (STEC) can kill multiple eukaryotic bacterial predators, including Acanthamoeba castellanii, Tetrahymena thermophila and Caenorhabditis elegans. However, the impact of Stx type, Stx amount, and the serogroup of the E. coli on the effectiveness of this exotoxin are poorly understood. These factors impact the severity of Stx-mediated disease in humans and therefore, by studying their role in modulating predator–prey interactions, we may gain insight into how these virulence factors evolved to contribute to human pathogenicity. Herein, we investigated the effects of these factors on predator killing by measuring the efficiency with which five different hemolytic uremic syndrome (HUS)-causing STEC strains consume and/or kill A. castellanii and C. elegans. These strains express various combinations of Stx types and amounts and O-antigens. We found that variations in Stx types and amounts significantly affect the ability of a given bacterial strain to kill predator A. castellanii and C. elegans, with higher Stx1 titers (HUSEC 31 vs. 19) and the presence of Stx2 alone (HUSEC 20) correlating with significantly greater predator killing. These attributes also affect STEC pathogenicity in humans, suggesting that ecological selective pressures for anti-predator defense inadvertently drive the evolution of strains with higher virulence potential in humans. Full article

Translating heterogeneous user requirements (URs) into robust engineering specifications for public-access products is a critical challenge, often impeded by information uncertainty and fragmented design processes. To address this, we propose an integrated decision-making framework underpinned by Rough Set Theory (RST) as a unified mathematical language for uncertainty management. The framework systematically guides customer-driven product development by integrating a series of RST-based methods: a Kano model analysis to screen URs, a novel rough-Shapley value model to determine their interdependent weights, a rough-QFD approach to translate them into weighted design requirements (DRs), and the rough-VIKOR method to select the optimal design alternative. A case study on public-access faucets validates the framework’s efficacy. The results demonstrate its capability to identify critical URs, derive robust DRs by systematically resolving technical attribute conflicts, and select a superior design solution that optimally balances hygiene, durability, and user experience. The application of the framework successfully identified Alternative ${\mathrm{A}}_1$ (Push-Activated Spout) as the optimal solution, demonstrating superior performance in proactive hygiene and core functionality. The results prove that maintaining data integrity through a unified RST pipeline effectively resolves early-stage design conflicts. This research contributes a rigorous, data-driven decision support system that enhances objectivity and information fidelity, providing a transparent and auditable methodology for designing human-centered public infrastructure. Full article

Foodborne diseases remain a major public health challenge. Among them, salmonellosis is one of the most frequently reported illnesses, associated with clusters and outbreaks and with considerable morbidity, potentially severe in vulnerable populations. Children are more susceptible due to biological, behavioral, and dietary factors. This study aimed to summarize and describe national surveillance data from the Mandatory Notification System, combined with serotyping data, on reported salmonellosis cases in Greece during the period 2005–2024, with a focus on children aged 0–14 years. During the study period, a total of 7340 salmonellosis cases were reported among children aged 0–14 years. Notification rates declined gradually until 2021, followed by an increase through 2024. The mean annual notification rate was 23.0 cases per 100,000 population, with the highest incidence observed among children aged 0–4 years. A clear seasonal pattern was observed, with a peak during summer months, alongside notable geographical variation. The most frequently identified serovars were Salmonella Enteritidis and Salmonella Typhimurium. These findings indicate that salmonellosis remains a public health concern in the pediatric population, highlighting the need for enhanced surveillance, improved food hygiene practices, and targeted prevention strategies to reduce disease burden. Full article

The aim of this study was to evaluate the potential of minimally processed beetroot pomace (BP), obtained from an industrial juice producer selected as a case study, converted into a stable beetroot pomace flour (BPF) at an industrial scale level, for flour fortification, functional confectionery development, and dietary supplementation. It was characterized by a high dietary fiber content (~27 g/100 g) and a very low carbohydrate-to-fiber ratio (1.9). High level of total phenolics and flavonoids (14.1 ± 0.1 mg GAE/g and 1.43 ± 0.1 mg QE/g), betacyanins and betaxanthins (898 ± 54 and 960 ± 65 µg/g), as well as pronounced antioxidant (FRAP 31.5 ± 1.1 and DPPH 25.8 ± 2.9 µmol TE/g), anti-hyperglycemic and anti-inflammatory activity (27.3 ± 1.3% and 41.0 ± 3.4%) remained upon in vitro digestion. Replacing 14–28% of cereal and pseudo-cereal flour with BPF reduced the carbohydrate-to-fiber ratio to the recommended 10:1, while incorporation of 20% BPF into cookies reduced this ratio by 2.5-fold and the glycemic index from ~56 to ~30. Furthermore, long-term supplementation of standard and high-fat/high-sucrose diet with BPF (0.5% w/w) reduced feed efficiency by 1.7 and 2.6-fold respectively, and improved glucose tolerance in C57BL/6J mice. Findings show the effectiveness of the by-product in bridging the fiber intake gap and body weight regulation. Full article

The widespread utilization of synthetic dyes within the textile industry, driven by their chemical recalcitrance and diverse chromatic spectra, constitutes a significant global environmental challenge. Improper discharge of these highly stable effluents into natural water bodies leads to severe ecological imbalances, affecting aquatic life and soil integrity while posing indirect risks to human health due to their mutagenic potential. Conventional physicochemical treatment methods are often hindered by prohibitive operational costs and the frequent generation of hazardous secondary pollutants. Consequently, there is an urgent demand for sustainable biotechnological alternatives to mitigate these industrial impacts. Bioremediation, specifically using white-rot fungi, represents a robust and eco-friendly strategy for the degradation of complex aromatic structures. Species such as Trametes versicolor, Pleurotus ostreatus, and Phanerochaete chrysosporium utilize a specialized extracellular enzymatic complex to mineralize toxic compounds effectively. Here we review the ligninolytic capacity of white-rot fungi and their specialized enzymatic systems for environmental sustainability. The primary points are: (i) the biochemical mechanisms of the ligninolytic system of laccases and peroxidases during dye degradation; (ii) the influence of operational parameters such as pH, temperature, and nutrient availability on fungal metabolic efficiency; (iii) the diverse environmental applications of these microorganisms in treating real textile effluents; (iv) the current biotechnological challenges, including maintaining enzymatic stability in non-sterile industrial environments; and (v) the future perspectives for scaling up fungal treatment systems from laboratory research to large-scale industrial implementation. Full article

Background/Objectives: Schools, as structured social environments, are important settings for shaping lifelong eating habits, and teachers play a mediating role in nutrition education. This study aimed to assess nutrition knowledge among public school teachers, examine their perceptions of the school food environment, and identify factors associated with knowledge scores. Methods: A stratified cross-sectional survey was conducted among 736 teachers from 12 public schools during the fall of 2025. A structured questionnaire based on the Knowledge–Attitudes–Practice model was used to evaluate nutrition knowledge, teaching practices, perceived school food environment, and teachers’ observations of student food-related behaviors. Group differences were examined using t-tests and ANOVA, and multivariable logistic regression was applied to identify factors associated with low nutrition knowledge. Results: The mean knowledge score was 6.26 ± 2.64 out of 12, with 23.6% of teachers classified as having low knowledge, 59.9% satisfactory, and 16.4% good. Primary school teachers scored significantly higher than subject teachers (7.27 vs. 5.64; p < 0.001). Regular conduct of nutrition classes was associated with lower odds of low knowledge (adjusted OR 0.10, 95% CI 0.05–0.23, p < 0.001). A sensitivity analysis using continuous knowledge scores confirmed this pattern, with the absence of nutrition teaching predicting a 1.40-point reduction in scores (95% CI −1.86 to −0.94, p < 0.001). Teachers rated school meal quality moderately high, and frequently observed student refusal of canteen food and purchase of sweets or fast food outside school. Conclusions: This study found that public school teachers in Karaganda, Kazakhstan showed satisfactory overall nutrition knowledge, with gaps in applied understanding and common dietary myths. Primary teachers and those actively teaching nutrition had higher knowledge scores, indicating an association between pedagogical engagement and content knowledge. To help optimize the school food environment, educational policies would benefit from the development of cross-curricular instructional materials fitted specifically for secondary school subject teachers. Full article

Background: Preoperative differentiation between uncomplicated and complicated paediatric appendicitis remains challenging. This study aimed to evaluate the diagnostic performance of routine admission biomarkers and blood cell count-derived inflammatory indices for severity stratification and to determine whether fibrinogen provides additional predictive value beyond commonly used markers. Methods: We conducted a retrospective single-centre study (2018–2025) using electronically recorded clinical data. Patients with suspected appendicitis were identified through appendicitis-related ICD-10 codes and diagnostically validated. The final analytical cohort required complete admission laboratory data, including C-reactive protein (CRP), fibrinogen, and complete blood count parameters. Derived inflammatory indices included the neutrophil-to-lymphocyte ratio (NLR) and the systemic immune-inflammation index (SII). Diagnostic discrimination and multivariable prediction models were evaluated to assess the ability of these markers to distinguish complicated from uncomplicated appendicitis. Results: Of 1518 screened records, 1132 patients met inclusion criteria (620 complicated; 512 uncomplicated). Complicated appendicitis was associated with higher inflammatory markers and longer hospital stay (all p < 0.001). CRP demonstrated the strongest univariable discrimination (area under the curve [AUC] 0.785), while fibrinogen showed lower performance (AUC 0.744). A combined model including CRP, NLR, and SII achieved good discrimination (AUC 0.812), with minimal improvement after adding fibrinogen (AUC 0.813). In multivariable analysis, log-transformed CRP and SII remained independently associated with complicated appendicitis (both p < 0.001). A rule-out probability threshold of 0.303 achieved 90% sensitivity (negative predictive value 0.803), whereas a CRP cut-off ≥92.24 mg/L showed high specificity (0.943) and positive predictive value (0.900). Conclusions: Routine admission biomarkers and inflammatory indices derived from complete blood counts can support severity stratification in paediatric appendicitis. CRP and SII provide meaningful predictive information, whereas fibrinogen contributes little additional discriminatory value beyond CRP-based models. These findings suggest that a small set of routinely available laboratory markers may assist early risk stratification, although external validation is required before clinical implementation. Full article

Clostridium tertium is an emerging opportunistic pathogen typically associated with immunocompromised hosts, yet it can also cause serious infections in non-neutropenic individuals. We present a case of postoperative peritonitis and bacteremia caused by C. tertium in a non-neutropenic 75-year-old woman following emergency obturator hernia repair. Diagnosis was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and successful treatment was achieved with piperacillin–tazobactam combined with levornidazole alongside surgical source control. A review of 128 cumulative cases (including ours) revealed two distinct patterns: bacteremia in severely neutropenic patients versus a broader spectrum of localized and bloodstream infections in non-neutropenic hosts, often linked to intestinal barrier disruption. Mortality was largely driven by underlying comorbidities and polymicrobial sepsis. These findings indicate that C. tertium infection should be considered in non-neutropenic patients with postoperative or gastrointestinal barrier-disruptive infections, especially when there is a poor response to initial empiric therapy. Consequently, in such clinical scenarios, empirical therapy should be guided by its unique resistance pattern, favoring carbapenems, vancomycin, or piperacillin–tazobactam, often combined with a nitroimidazole, alongside urgent source control. Full article

Background/Objectives: Autism spectrum disorder (ASD) is a clinically and genetically heterogeneous neurodevelopmental condition, and the diagnostic yield of whole-exome sequencing (WES) varies across settings. This single-center study aimed to determine the molecular diagnostic yield of WES in pediatric ASD and to explore genotype–phenotype overlap using a structured, phenotype-driven reanalysis strategy. Methods: We enrolled 60 children with syndromic and non-syndromic ASD, who underwent detailed clinical and dysmorphology assessment. WES for single-nucleotide and copy-number variant (CNV) detection was performed in an accredited laboratory, followed by clinician-driven reinterpretation, integrating expanded phenotypic data and ACMG/AMP-based variant classification. Genes were considered if they harbored rare, potentially pathogenic variants and were previously reported or curated in established ASD-associated gene resources. Results: The initial external laboratory report identified 5 of 60 patients (8.3%) with a pathogenic (P) or likely pathogenic (LP) variant (positive result), 30 of 60 (50.0%) with a variant of unknown significance (VUS) (inconclusive result), and 25 of 60 (41.7%) with a negative result. Clinician-based variant reinterpretation identified pathogenic or likely pathogenic variants in 9 of 60 patients (15.0%), representing an 80% relative increase in diagnostic yield, as well as 43 VUSs distributed across 34 patients, while 17 patients had no reportable variants (negative result). Overall, reanalysis revealed 11 additional variants of interest (pathogenic, likely pathogenic, or VUS) that had not been reported in the initial assessment. In total, 52 sequence and copy-number variants in 46 genes were detected, most of which were VUSs (83%). Conclusions: In this pediatric ASD cohort, WES with phenotype-driven reinterpretation and CNV assessment yielded a clinically positive result in 15% of patients and uncovered additional candidate variants, highlighting both the value and the current interpretative challenge of comprehensive genomic testing in ASD. Full article