Search Results (396)

Background & Objectives: Periodontal disease is a common but preventable condition characterised by chronic inflammation of the periodontium caused by microbial infection. School-based oral health education can promote healthy behaviours and enhance periodontal health. This study was to assess the effects of an interactive oral educational program on periodontal status, oral hygiene, and related behaviours among 9th-grade students in Nablus City. Method: A pre-test/post-test experimental design was conducted from 2023 to 2024 in governmental and private schools. A stratified random sampling procedure selected 536 students for the intervention group and 410 for the control group. Baseline and two-month follow-up data were collected via a self-administered questionnaire and clinical examinations using the Community Periodontal Index for Treatment Needs (CPITN) and the Simplified Oral Hygiene Index (S-OHI). Statistical analysis (chi-square test; paired and independent t-tests) was performed with significance set at p < 0.05. Results: At follow-up, the intervention group showed significant reductions in CPITN (from 10.99 ± 2.77 to 10.00 ± 2.64; p < 0.001) and S-OHI (from 12.90 ± 3.10 to 10.89 ± 2.78; p < 0.001). Significant improvements were also observed in oral hygiene practices, dietary habits, and smoking behaviour scores (all p < 0.001). No significant changes occurred in the control group. Conclusions: The interactive, school-based oral health education program effectively improved periodontal health, oral hygiene status, and related behaviours among adolescents. Full article

Background/Objectives: The COVID-19 pandemic has significantly disrupted healthcare systems worldwide, exposing longstanding weaknesses, particularly in the prevention and control of healthcare-associated infections (HAIs). Regional disparities in infection prevention and control (IPC) strategies offered valuable lessons for improving public health preparedness. This systematic review aims to identify and compare regional IPC approaches adopted during and after the pandemic, highlighting best practices to strengthen healthcare resilience. Methods: The review was conducted in line with PRISMA guidelines and registered in the PROSPERO database (CRD420251032525). Articles published between 1 January 2020 and 31 March 2025, were retrieved from PubMed, Scopus, and Web of Science. Only full-text studies in English were included. The risk of bias was assessed using the ROBINS-I tool. Results: Of the 63 articles initially identified, 8 met the inclusion criteria. The selected studies demonstrated substantial variability in the implementation of IPC. The availability of infrastructure, funding, coordination capacity, and training of medical staff had a significant impact on outcomes. In regions with well-defined protocols and a solid infrastructure, there was a significant decrease in HAIs, while in resource-poor areas, there was a significant increase. Effective measures included continuous monitoring, regular staff training, provision of adequate equipment, expansion of testing capacity, reorganisation of hospitals, and introduction of technological innovations in healthcare. Conclusions: COVID-19 emphasised the importance of adaptable IPC frameworks. Strengthening health systems requires context-specific standards, sustained investment in infrastructure, continuous training, and increased international cooperation to better prepare for future health emergencies. Full article

Antimicrobial resistance (AMR) is a growing threat to global health, accelerated by the widespread inappropriate use of antibiotics. Although educational initiatives have been launched worldwide, there is little evidence on how younger generations in high-income countries (HICs) understand and address AMR. Addressing the AMR crisis requires proactive education of younger generations, including children, adolescents, and young adults, who will shape future healthcare practices. This review analyzes existing research on AMR literacy among these age groups in HICs, as knowledge gaps and risky behaviors persist even in HICs, despite their strong education and health infrastructures. The purpose of this review is to examine the knowledge, attitudes, and behaviors related to antibiotic use and antibiotic resistance in younger generations while identifying effective educational interventions. Methods: We performed a comprehensive literature search in PubMed until June 2025, followed by AI-assisted screening (Claude 4.0 Sonnet) and a manual review. The search strategy combined terms from the areas of health literacy, antibiotics, antibiotic resistance/AMR, and young populations. Studies in HICs that examined the younger generation’s knowledge about antibiotics and AMR, analyzed their attitudes or behavior toward them, or evaluated relevant educational interventions were included. Data were synthesized thematically across all included studies. Results: Nineteen studies from 11 HICs were included, including thirteen cross-sectional surveys and six educational intervention studies. The results showed that misconceptions about how antibiotics work are still very common. Several of those asked (22–80%) incorrectly stated that resistance develops in the human body and not in bacteria. Many (26–77%) mistakenly agreed with the statement that antibiotics treat viral infections. Concerning behaviors included high rates of self-medication, non-adherence to treatment, and unsafe storage practices. Several authors propose an amendment of curricula. Educational interventions, particularly gamification and peer education approaches, showed improvements in knowledge and sustained learning outcomes. Conclusions: Knowledge of AMR among young people in HICs is still inadequate, despite educational advantages. Most existing studies focus on college students, while children and adolescents, crucial groups for early prevention, are underrepresented. Targeted, age-appropriate education employing interactive methods represents an evidence-based strategy to improve antibiotic use behavior and support global AMR control efforts. Full article

Schistosomiasis remains a significant public health concern, with Schistosoma japonicum infection endemic in certain regions of Asia. Praziquantel (PZQ), primarily known as an effective therapeutic agent, has recently shown potential as a prophylactic measure against delayed S. japonicum infections. This study investigated the preventive efficacy of PZQ pretreatment at varying cercarial infection intensities and determined the parasite developmental stages targeted by the pretreatment in a mouse model. Results demonstrated that PZQ pretreatment significantly reduced both worm burdens and liver egg counts at low (10 and 20 cercariae) and high (100 cercariae) infection intensities, with reductions in worm burdens ranging from approximately 48% to 60% and liver egg counts by 47% to 73% compared to control groups (p < 0.05). Further analysis revealed that the mortality of parasites in PZQ-pretreated mice predominantly occurred during the juvenile schistosomula stages, particularly in worms younger than 15 days post-infection. These findings provide critical evidence supporting the application of PZQ pretreatment as a practical prophylactic measure to prevent S. japonicum infections, particularly in populations and animals frequently exposed to contaminated water in endemic areas. Full article

Gastrointestinal (GI) interventional endoscopy has evolved into a cornerstone of modern gastroenterology, offering minimally invasive solutions for complex conditions. However, these procedures are not without risk, particularly with respect to post-procedural infections. While rare, such infections can have significant clinical consequences and are increasingly recognized as a public health concern. This narrative review provides a comprehensive overview of infections associated with GI endoscopy, focusing on transmission mechanisms, microbial agents involved, host susceptibility, preventive strategies, and diagnostic and therapeutic approaches. Infections following GI endoscopy remain infrequent but clinically significant, particularly in high-risk procedures such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Duodenoscopes represent a major vector for exogenous infection, often involving multidrug-resistant bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus spp. Host-related factors increase the risk of infection. Risk factors associated with post-endoscopic infections include advanced age, male sex, non-white ethnicity, immunosuppression, presence of cholangiocarcinoma, autoimmune diseases, liver cirrhosis of viral and/or alcoholic etiology, chronic kidney disease, high-risk cardiac conditions, or chemotherapy. New reprocessing methods, such as ethylene oxide gas sterilization, automated endoscope reprocessors, and selective use of single-use endoscopes and duodenoscopes, may contribute to lowering infection rates. Greater awareness of infection risks, improved infection control practices, and adherence to updated guidelines are crucial for enhancing patient safety in digestive endoscopy. Multidisciplinary strategies, including surveillance, device innovation, and personalized risk assessment, are needed to address this evolving challenge. Full article

Background: The global COVID-19 pandemic has significantly disrupted healthcare systems, inadvertently influencing the epidemiology of antimicrobial resistance (AMR). Among the most critical AMR threats are carbapenem-resistant organisms (CROs), which include carbapenem-resistant Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa. This review explores the pandemic’s impact on carbapenem resistance patterns worldwide. Objectives: This study aimed to assess the effects of the COVID-19 pandemic on carbapenem resistance trends, identify key drivers, and discuss implications for clinical practice and public health policy. Methods: A comprehensive review of peer-reviewed literature, national surveillance reports, and WHO/ECDC data from 2019 to 2025 was conducted, with emphasis on hospital-acquired infections, antimicrobial use, and infection control practices during the pandemic. Results: The pandemic has led to increased use of broad-spectrum antibiotics, including carbapenems, often in the absence of confirmed bacterial co-infections. Overwhelmed healthcare systems and disruptions in infection prevention and control (IPC) measures have facilitated the spread of carbapenem-resistant organisms, particularly in intensive care settings. Surveillance data from multiple countries show a measurable increase in CRO prevalence during the pandemic period, with regional variations depending on healthcare capacity and stewardship infrastructure. Conclusions: COVID-19 has accelerated the emergence and dissemination of carbapenem resistance, underscoring the need for resilient antimicrobial stewardship and IPC programs even during public health emergencies. Integrating pandemic preparedness with AMR mitigation strategies is critical for preventing further escalation of resistance. Full article

Background: Infection prevention and control (IPC) competencies are essential to safe patient care across practice settings. This cross-sectional survey study aimed to describe the ability of an escape room to reinforce IPC concepts and knowledge retention rates for third-year student pharmacists. Methods: An IPC-themed escape room using a mixture of online and physical puzzles was incorporated into a third-year student pharmacist course. Students in the course took knowledge assessment and perception surveys before the escape room (T1), after the escape room (T2), and for retention at the end of the semester (T3). Results: Statistically significant (p < 0.05) increases in knowledge occurred on four out of five of the knowledge assessment questions between the pre- and post-assessments (T1, T2) as well as between the pre- and retention assessments (T1, T3). Student confidence in their ability to provide patient care compliant with IPC practices also demonstrated statistically significant improvement between pre, post, and retention assessments (T1, T2, T3). Conclusions: An IPC escape room is an effective tool to reinforce IPC concepts and increases student pharmacist knowledge and confidence in patient safety practices. Future study iterations should evaluate the role of an IPC IPE event for utility across multiple health professions curricula. Full article

The present study investigates the gut microbiota dynamics of Micropterus salmoides during Nocardia seriolae infection and identifies potential probiotic candidates for disease control in aquaculture. We artificially infected M. salmoides with N. seriolae and analyzed the gut microbiota of dying fish, asymptomatic fish during the peak mortality period, and healthy fish. The results showed that N. seriolae infection significantly altered the gut microbiota diversity. Based on analysis of gut microorganisms, we isolated and identified an N. seriolae-resistant Bacillus from the gut of M. salmoides, which was named B. amyloliquefaciens MS05 (BaMS05). BaMS05 demonstrated significant antibacterial activity against N. seriolae and other common pathogens of M. salmoides both in vitro and in vivo. Additionally, BaMS05 could colonize the gut of M. salmoides for at least five days and exhibited a protective effect against N. seriolae infection, reducing cumulative mortality by 40% at the fifth day. This study provides insights into the role of gut microbiota in disease resistance and highlights BaMS05 as a potential probiotic for preventing and controlling N. seriolae infections in aquaculture. Further research will focus on optimizing the application of BaMS05 and verifying its biosafety for practical use in M. salmoides farming. Full article

Hospital infection prevention is critical to patient safety, yet data on the prevalence and contributing factors of healthcare-associated infections (HAIs) in Aljouf, Saudi Arabia, are scarce. This retrospective cross-sectional study aimed to investigate the prevalence, microbiological profile, and associated risk factors of HAIs among intensive care unit (ICU) patients in a referral hospital between January 2020 and December 2023. Medical records of 260 ICU patients were reviewed for demographic details, comorbidities, infection types, pathogens, and invasive device use. Forty patients (15.38%) developed HAIs with the highest prevalence in 2020 (50.0%). Infections were more common in males (56.5%) and those aged ≥56 years (54.6%). The predominant infections were catheter-associated urinary tract infections (47.5%), ventilator-associated pneumonia (35.0%), and central line-associated bloodstream infections (17.5%). Klebsiella pneumoniae (35.0%) and Acinetobacter baumannii (27.5%), pathogens commonly associated with multidrug resistance, were the most frequently isolated organisms. All HAI cases involved invasive device use with the use of three or more devices significantly increasing infection risk (p < 0.05). Additionally, 85% of infected patients had chronic conditions, primarily hypertension or diabetes. These findings emphasize the urgent need for strengthened infection control practices and targeted antimicrobial strategies to reduce HAIs and improve ICU patient outcomes in underreported regions. Full article

Background/Objectives: The COVID-19 pandemic significantly disrupted healthcare systems worldwide, leading to increased healthcare-associated infection rates, particularly in the intensive care unit (ICU) setting. Little is known about the evolution of this phenomenon in subsequent years. Methods: This retrospective analysis of prospectively collected data (January 2020–December 2024) examined central line-associated bloodstream infections (CLABSI) in the Wroclaw Medical University hospital’s ICU during and after the COVID-19 pandemic. Results: Ninety CLABSI cases were observed in 3149 ICU patients across 39,837 patient-days and 36,038 central-vascular-catheter-days (CVC-D). The mean CLABSI frequency was 2.97 per 100 admissions, with an incidence density of 2.49 per 1000 CVC-D. CLABSI occurred more frequently in males than in females (3.51% vs. 1.69%, p = 0.003) and in patients with concomitant SARS-CoV-2 infection than in individuals without such coinfection (6.06% vs. 1.88%, p = 0.00037). Microbiological analysis revealed Staphylococcus epidermidis as the most frequent etiological factor of CLABSI (33.3%). Alert pathogens constituted 34.26% of all CLABSI etiological factors, with higher prevalence during the pandemic than afterward (51.16% vs. 23.08%, p = 0.005437). Patients with CLABSI had significantly longer ICU stays (53.57 vs. 11.62 days, p = 0.001). After adjusting for immortal time bias using matched cohort analysis, CLABSI was not associated with increased mortality (p = 0.735). The overall compliance level of adherence to CLABSI prevention measures was 86.9%, with no statistically significant difference between the pandemic and post-pandemic periods, p = 0.417. The study did not systematically collect data on catheter types, insertion sites, or clinical circumstances (emergency vs. elective), which are known risk factors that may have influenced the observed CLABSI incidence rates. Conclusions: Despite increased patient volume post-pandemic, CLABSI metrics remained stable, possibly due to the successful adaptation of infection prevention protocols. However, interpretation of incidence data should consider unmeasured confounding factors. These findings address knowledge gaps regarding how the pandemic affected CLABSI epidemiology and antimicrobial resistance patterns, with implications for infection control practices during future healthcare crises. Full article

Legumes are among the most important crops globally, serving as a major food source for protein and oil. In tropical regions, the cultivation of legumes has expanded significantly due to the increasing demand for food, plant-based products, and sustainable agriculture practices. However, tropical environments pose unique challenges, including high temperatures, erratic rainfall, soil infertility, and a high incidence of pests and diseases. Indeed, legumes are vulnerable to infections caused by bacteria, fungi, oomycetes, viruses, and nematodes. This review highlights the importance of legumes in tropical farming and discusses major diseases affecting productivity and their impact on the economy, environment, and lives of smallholder legume farmers. We emphasize the use of legume genetic resources and breeding, and biotechnology innovations to foster resistance and address the challenges posed by pathogens in legumes. However, an integrated approach that includes other cultivation techniques (e.g., crop rotation, rational fertilization, deep plowing) remains important for the prevention and control of diseases in legume crops. Finally, we highlight the contributions of plant genetic resources to smallholder resilience and food security. Full article

The global elimination of hepatitis C virus (HCV) has been prioritized by the World Health Organization (WHO) as a key public health target, with a deadline set for 2030. This initiative aims to significantly reduce both new infection rates and HCV-associated mortality. A major breakthrough in achieving this goal has been the development of direct-acting antiviral agents (DAAs), which offer cure rates exceeding 95%, along with excellent safety and tolerability. Nevertheless, transmission via parenteral routes continues to be the dominant pathway, particularly among high-risk groups, such as individuals who inject drugs, incarcerated populations, those exposed to unsafe medical practices, and healthcare professionals. Identifying, monitoring, and delivering tailored interventions to these groups is crucial to interrupt ongoing transmission and to reduce the burden of chronic liver disease. On a global scale, several nations have demonstrated measurable progress toward HCV elimination, with some nearing the targets set by WHO. These achievements have largely resulted from context-adapted policies that enhanced diagnostic and therapeutic access while emphasizing outreach to vulnerable communities. This review synthesizes current advancements in HCV prevention and control and proposes strategic frameworks to expedite global elimination efforts. Full article

Background: Intravenous vancomycin remains a key agent in the treatment of complex orthopedic infections, particularly those involving methicillin-resistant Staphylococcus aureus (MRSA). However, its use is associated with significant risks, most notably nephrotoxicity. Despite guideline recommendations, standardized dosing and monitoring protocols are often absent in orthopedic settings, leading to inconsistent therapeutic drug exposure and preventable adverse events. This study evaluated the clinical impact of implementing a structured standard operating procedure (SOP) for intravenous vancomycin therapy in orthopedic inpatients. Methods: We conducted a single-center, pre-post cohort study at a university orthopedic department. The intervention consisted of a standard operating procedure (SOP) for intravenous vancomycin therapy, which mandated weight-based loading doses, renal function-adjusted maintenance dosing, trough level monitoring, and defined dose adjustments. Patients treated before SOP implementation (n = 58) formed the control group; those treated under the SOP (n = 56) were prospectively included. The primary outcome was the incidence of vancomycin-associated acute kidney injury (VA-AKI) defined by KDIGO Stage 1 criteria. Secondary outcomes included therapeutic trough level attainment and infusion-related or ototoxic adverse events. Results: All patients in the post-SOP group received a loading dose (100% vs. 31% pre-SOP, p < 0.001). The range of measured vancomycin trough levels narrowed substantially after SOP implementation (7.1–36.2 mg/L vs. 4.0–80.0 mg/L). The proportion of patients reaching therapeutic trough levels increased, although this was not statistically significant. Most notably, VA-AKI occurred in 17.2% of patients in the control group, but in none of the patients after SOP implementation (0%, p = 0.0013). No cases of ototoxicity were observed in either group. Infusion-related reactions decreased after the implementation of the SOP, though not significantly. Conclusions: The introduction of a structured vancomycin protocol significantly reduced adverse drug events and improved dosing control in orthopedic inpatients. Incorporating such protocols into routine practice represents a feasible and effective strategy to strengthen antibiotic stewardship and clinical quality in surgical disciplines. Full article

Banana Fusarium wilt (BFW, also known as Panama disease) is a highly infectious and destructive disease that threatens global banana production, requiring early recognition for timely prevention and control. Current monitoring methods primarily rely on continuous variable features—such as band reflectances (BRs) and vegetation indices (VIs)—collectively referred to as basic features (BFs)—which are prone to noise during the early stages of infection and struggle to capture subtle spectral variations, thus limiting the recognition accuracy. To address this limitation, this study proposes a discretized enhanced feature (EF) construction method, the automated kernel density segmentation-based feature construction algorithm (AutoKDFC). By analyzing the differences in the kernel density distributions between healthy and diseased samples, the AutoKDFC automatically determines the optimal segmentation threshold, converting continuous BFs into binary features with higher discriminative power for early-stage recognition. Using UAV-based multi-spectral imagery, BFW recognition models are developed and tested with the random forest (RF), support vector machine (SVM), and Gaussian naïve Bayes (GNB) algorithms. The results show that EFs exhibit significantly stronger correlations with BFW’s presence than original BFs. Feature importance analysis via RF further confirms that EFs contribute more to the model performance, with VI-derived features outperforming BR-based ones. The integration of EFs results in average performance gains of 0.88%, 2.61%, and 3.07% for RF, SVM, and GNB, respectively, with SVM achieving the best performance, averaging over 90%. Additionally, the generated BFW distribution map closely aligns with ground observations and captures spectral changes linked to disease progression, validating the method’s practical utility. Overall, the proposed AutoKDFC method demonstrates high effectiveness and generalizability for BFW recognition. Its core concept of “automatic feature enhancement” has strong potential for broader applications in crop disease monitoring and supports the development of intelligent early warning systems in plant health management. Full article

Equine piroplasmosis (EP) is a tick-borne disease caused by Theileria equi, Theileria haneyi and Babesia caballi. It affects equids, representing significant health and economic concerns for the equine industry. EP is endemic in Portugal, so developing and implementing preventive strategies is essential. Accessing veterinarians’ knowledge, attitudes and practices (KAP) through a survey is a suitable approach, and no such studies have been conducted in Portugal until now. A KAP survey was applied to 41 Portuguese equine vets, representing mainly the Alentejo region. The average knowledge score went from medium to high, correctly identifying the causative agents, transmission routes and clinical signs. Knowledge gaps mostly concerned the identification of T. haneyi as an agent, transplacental transmission, duration of infection and diagnostic methods. Reported practices were appropriate overall, including enhancing breeders’ awareness of the disease and its prevention. Diagnostic and treatment protocols were generally consistent with current recommendations; however, these protocols are not yet fully standardized. Our findings highlight key areas where increasing expertise is needed and could serve as a foundation for future evidence-based guidelines to improve EP control in Portugal. Full article