Search Results (6,176)

In recent years, with the significant decline in fine particulate matter (PM_2.5) concentrations, ozone (O₃) has emerged as a major composite air pollutant during the warm season in China, attracting increasing attention due to its associated health burden and economic costs. This study focuses on Tianjin, using ozone monitoring data from 2017 to 2023 combined with health statistics to assess the health impacts and economic losses attributable to ozone pollution. First, ozone exposure indicators and compliance criteria were constructed based on national air quality standards, and the interannual variation and spatial differences of O₃ levels were analyzed at both citywide and district scales. Second, multiple machine learning classification models, including logistic regression, decision tree, k-nearest neighbors, and gradient boosting, were developed using ozone and meteorological variables to predict the occurrence risks of five diseases: cardiovascular diseases, respiratory diseases, hand-foot-and-mouth disease (HFMD), influenza, and dengue fever. Finally, excess cases were estimated using health impact functions, and the associated economic losses were quantified by combining the value of a statistical life (VSL) with cost-of-illness and willingness-to-pay (WTP) approaches. The results showed that the annual evaluation value of ozone in Tianjin, defined as the 90th percentile of the daily maximum 8 h average O₃ concentration, exhibited a pattern of initially increasing, then decreasing, and subsequently rebounding. It peaked at 201 µg/m³ in 2018, declined to a minimum of 164 µg/m³ in 2021, and rebounded to 188 µg/m³ in 2023. Machine-learning results indicated that the logistic regression model showed relatively stable overall performance across predictions of different diseases, while the gradient boosting tree model also achieved high accuracy in predicting certain infectious diseases. Overall, ozone pollution exhibits significant heterogeneous effects across different disease types, and the associated health-related economic losses show stage-wise fluctuations in response to pollution levels. Based on these findings, it is recommended to implement refined control measures during periods of high ozone exceedance and in key regions, while strengthening protection for vulnerable populations such as the elderly, children, and patients with respiratory diseases, in order to achieve synergistic improvements in air quality management and public health outcomes. Full article

Recently, mycotoxin prediction has mainly relied on meteorological data and crop physiology. The contribution of soil characteristics as additional environmental variables remains largely unexplored. A systematic literature search was carried out to analyze the latest research (from 2020 to 2025) on the relationship between soil properties (temperature, water content, pH, and electrical conductivity), fungal communities (particularly Aspergillus and Fusarium), and different crops (mainly peanut, wheat, and maize). Measurement methodologies were analyzed, with a focus on the use of in-field soil sensors in correlation studies and predictive models. Disease incidence and mycotoxin occurrence were related to stressful soil conditions, such as different pH levels, wetness or drought, and temperatures above 25 °C. Other external variables (crop and field management) must also be considered. Laboratory equipment was primarily used in correlation studies, with limited in-field sensor implementation. Although recent predictive models included soil properties as effective inputs, they mostly relied on satellite data. However, real-time conditions and fluctuations, which can be captured by in-field soil sensors, are essential for training new functional models. To monitor soil properties, IoT technologies must be considered, but their implementation is still not sufficient to collect widespread data. Therefore, groundwork is needed to fill this gap with high-quality soil data for future in-field experimentation. Full article

Background/Objectives: Proteolysis Targeting Chimeras (PROTACs) are heterobifunctional small molecules that induce ubiquitin–proteasome–mediated degradation of target proteins and have matured from proof-of-concept chemistry to a clinically validated therapeutic modality, with the first Phase 3 readout reported in 2025. A systematic bibliometric analysis covering this pivotal-trial era, however, has been lacking. This study aimed to map the historical trajectory, current research front, and emerging frontiers of PROTAC research. Methods: We analyzed 2630 PROTAC-related publications indexed in the Web of Science Core Collection (WoSCC) from 2001 to 2025 using a combined toolkit of CiteSpace, HistCite, the Alluvial Generator, and R (ggplot2), covering co-occurrence networks, burst detection, keyword clustering, citation historiography, alluvial flow analysis, and reference co-citation timeline visualization. Results: China and the USA led global output, and the Chinese Academy of Sciences, China Pharmaceutical University, and Harvard University were the most productive institutions; the Journal of Medicinal Chemistry was the leading publishing venue, and Alessio Ciulli, Jian Jin, and Craig M. Crews anchored the author network. Keyword burst analysis showed that early research centred on E3 ubiquitin ligase recruitment and small-molecule PROTAC design, whereas the current hotspots, resolved through keyword clustering and co-citation timelines, included structural basis and ternary complex design, EGFR-directed degradation, oral bioavailability optimization, applications in multiple myeloma and Alzheimer’s disease, tumour-targeted delivery, and computational/AI-driven design. Conclusions: This study extends the bibliometric record of PROTACs across 2001–2025 and identifies oral bioavailability, E3 ligase repertoire expansion, and CNS-penetrant degrader design as the emerging frontiers likely to shape the next phase of the field. Full article

Purpose: To analyze choroidal thickness (CT) and choroidal volume (CV) using ultra-wide-field (UWF) spectral-domain optical coherence tomography (SD-OCT) in patients with central serous chorioretinopathy (CSC) and to assess their associations with disease duration and best-corrected visual acuity (BCVA). Methods: This prospective case–controlled study included 50 eyes of 41 CSC patients and 56 eyes of 32 healthy controls matched for age and sex. CT was measured at 24 points using the REVO 130 UWF SD-OCT device with a wide-field adapter, covering a 21 × 21 mm retinal area across central, mid-peripheral (4 mm), and peripheral (8 mm) zones. CV was estimated using a quadratic nonlinear model. ROC curve analysis and univariate logistic regression were applied to evaluate discriminative capacity and odds ratios (OR) for CT and CV. Results: CT was significantly higher in CSC eyes at all 24 measurement points (all p < 0.0001). Mean subfoveal CT was 472.6 µm vs. 344.8 µm in controls (+37%), with greater relative increases at mid-peripheral (+46%) and peripheral (+44%) zones. Mean CV was 61.47 (±11.37) mm³ vs. 42.29 (±10.02) (+45%; p < 0.0001). CV showed a higher OR for CSC occurrence than central CT (OR = 2.88; 95% CI: 1.53–5.42 vs. OR = 1.04; 95% CI: 1.02–1.07). Significant discriminative CT points (AUC > 0.60) clustered at the 2/8, 4/10, and 6/12 clock meridians. Both CT and CV correlated positively with disease duration (Spearman rho 0.35–0.41; p ≤ 0.0004) but not with BCVA. Conclusions: UWF SD-OCT confirms diffuse pachychoroid thickening in CSC extending to the periphery. CV is a sensitive biomarker in association with CSC status. Peripheral CT and CV correlate with disease duration, supporting the link between higher volumetric choroidal values and longer disease course. Integration of these parameters may improve CSC diagnosis and prognostic evaluation. Full article

Porcine circovirus type 5 (PCV5) is a recently reported porcine-associated CRESS DNA virus, but information regarding its occurrence, genomic characteristics, and evolutionary relationship remains limited. In this study, a total of 100 diagnostic samples collected from clinically diseased pigs from 27 commercial swine farms in 16 cities across seven provinces of China during 2025 were screened for PCV5 using quantitative PCR. PCV5 was detected in 22% (22/100) of the tested samples, with positive samples identified in Henan and Fujian provinces among the sampled regions. PCV5-positive samples were mainly fecal samples and were obtained from pigs showing diarrhea, respiratory signs, wasting, or systemic disease. Co-detection analysis showed that most PCV5-positive samples were also positive for other swine viral pathogens, particularly PCV3, PCV2, and PEDV, indicating that the clinical significance of PCV5 should be interpreted cautiously. Complete genome amplification and sequencing yielded two identical PCV5 genomes from Henan and Fujian provinces. A representative strain, designated PCV5-Henan2025-ZJQ01, was further characterized and deposited in GenBank under accession number PZ496079. The complete genome was 2903 nt in length and contained a positive-sense ORF encoding Cap and a negative-sense ORF encoding Rep, showing a distinct genomic organization compared with classical porcine circoviruses. Phylogenetic analysis based on Rep and Cap amino acid sequences showed that PCV5-Henan2025-ZJQ01 was closely related to previously reported PCV5-related sequences but distinct from classical PCV1–PCV4. These findings provide additional molecular and genomic evidence for PCV5 in Chinese swine diagnostic samples and support the need for continued surveillance and further studies on its epidemiological and pathogenic significance. Full article

Background: Secondary bacterial infections are increasingly recognized after coronavirus disease 2019 (COVID-19); however, bacterial abscess formation remains uncommon, and the simultaneous occurrence of brain and lung abscesses has not been previously reported. We report a rare case of Streptococcus intermedius infection presenting with multiple brain microabscesses and a lung abscess following COVID-19. Case Presentation: A 75-year-old man with no significant medical history except cholelithiasis experienced persistent fever following a diagnosis of COVID-19 and subsequently developed impaired consciousness 17 days later. Because bacterial meningitis was suspected, he was admitted to a neurology-specialized hospital on the same day. Brain MRI revealed more than 80 small enhancing lesions scattered throughout the brain parenchyma, consistent with multiple microabscesses. Chest CT demonstrated a mass-like lesion in the left lower lobe. Although cerebrospinal fluid cultures were negative, blood cultures obtained on admission yielded S. intermedius. Further investigation of the source of infection revealed moderate periodontitis, suggesting the oral cavity as the probable portal of entry. The patient was treated with intravenous antibiotics for eight weeks based on antimicrobial susceptibility testing, resulting in near-complete resolution of the lesions. Conclusions: Although a causal relationship between COVID-19 and abscess formation cannot be established, COVID-19-associated immune and mucosal barrier dysfunction may have contributed to the progression and dissemination of infection in this patient. Clinicians should be aware of the possibility of severe bacterial superinfection when fever or respiratory symptoms related to COVID-19 persist, even in patients without overt immunocompromise, particularly in those with pre-existing oral infections. Full article

Freshwater amphipods of the genus Gammarus are important trophic components of aquatic ecosystems and are increasingly considered a potential bioresource for aquaculture. However, their role in the maintenance and transmission of infectious agents remains poorly understood. This study evaluated the presence of major crustacean and fish pathogens in Gammarus lacustris populations from Kazakhstan and characterized associated viral communities using metagenomic sequencing. Six pooled samples collected from freshwater ecosystems across Kazakhstan were screened using PCR and RT-PCR assays targeting World Organisation for Animal Health (WOAH)-listed pathogens, including White Spot Syndrome Virus, Taura Syndrome Virus, Infectious Myonecrosis Virus, Aphanomyces astaci, and Aphanomyces invadans. In parallel, high-throughput sequencing (Illumina NovaSeq) was performed to assess virome composition and structure. No WOAH-listed pathogens were detected, suggesting a low detectable occurrence of major notifiable agents under the conditions of the present study. Metagenomic analysis revealed a virome dominated by RNA viruses, particularly picorna-like viruses (Picornaviridae), Dicistroviridae, and Marnaviridae. Phylogenetic and genome organization analyses identified potentially novel or highly divergent viral lineages within Picornavirales. Collectively, these findings suggest a favorable epizootiological profile of G. lacustris populations while highlighting freshwater amphipods as hosts of diverse and partially uncharacterized viral communities relevant to aquatic disease surveillance and aquaculture biosecurity. Full article

Introduction: The global ornamental fish trade is a rapidly expanding sector and a major pathway for the introduction of non-native species, particularly in freshwater ecosystems in developed countries. The introduction of non-native species can result in a range of ecological impacts, including predation, competition, hybridization, and disease transmission, often leading to ecosystem degradation and biotic homogenization. Therefore, it represents a clear ecological risk, especially serious in freshwater systems with a high endemism rate, such as the Iberian Peninsula. The occurrence of ornamental non-native species in the Iberian Peninsula has been common, yet little has been done to describe the overall ornamental fish trade as a first step to evaluate invasion risk. Objective: This study characterizes the import dynamics of ornamental freshwater fish in Portugal between 2020 and 2024 and evaluates its potential role as a pathway for species introductions. Methodology: Data were obtained from the Institute for Nature Conservation and Forests database, including information on species composition, quantities, sizes, prices, and countries of origin. A total of 431 records were analyzed, resulting in 27,689 validated entries of imported freshwater fish, which were taxonomically verified and filtered to retain only freshwater species. Results: A total of 666 species from 88 families were identified, with an average of 380 species imported annually, reflecting high taxonomic diversity. Import volumes increased from approximately 1.25 million individuals in 2020 to 1.75 million in 2024, while total import value nearly doubled from €300,000 to €600,000. Imports were predominantly from five Southeast Asian countries, particularly Indonesia and Vietnam, and largely supported by aquaculture production (88%). A stable core of highly traded species, including Carassius auratus, Poecilia reticulata, and Paracheirodon innesi, suggests a sustained and very high propagule pressure, while some species variability was observed on yearly basis, suggesting the importance of monitoring programs on actual imports. Conclusions: Overall, the ornamental fish trade represents a significant and growing pathway for biological invasions in Portugal. The combination of increasing trade volume, high species diversity, and persistent dominance of key taxa highlights the need for improved monitoring, regulatory frameworks, and public awareness to mitigate ecological risks. Full article

Background and Clinical Significance: Peristomal pyoderma gangrenosum (PPG) is a rare subtype of pyoderma gangrenosum, most commonly associated with inflammatory bowel disease or haematologic disorders. Its occurrence in patients with solid malignancies is uncommon. PPG in an oncologic setting poses diagnostic and therapeutic challenges because systemic immunosuppressive therapy, wound care, and ongoing chemotherapy must be carefully balanced; Case Presentation: We report the case of a Japanese man in his 50s with stage IVB rectal adenocarcinoma who developed rapidly progressive peristomal ulceration clinically consistent with PPG around a colostomy 12 weeks after initiation of panitumumab-containing systemic chemotherapy. The diagnosis was made on clinical grounds and was strongly supported by the clinical morphology, exclusion of major mimickers, and response to systemic corticosteroid therapy, although histopathological confirmation was not obtained. Because existing diagnostic criteria for pyoderma gangrenosum are not specifically designed for peristomal disease, they were used as supportive rather than definitive diagnostic tools. Skin biopsy was avoided due to the risk of pathergy at the peristomal site. Superficial cultures were not obtained because frequent cleansing and faecal contamination were likely to compromise diagnostic accuracy. To minimise mechanical pathergy, the stoma appliance was changed from a one-piece soft convex system to a two-piece flat system. Multidisciplinary management, including systemic corticosteroids, meticulous stoma care, and selective ultrasonic debridement, resulted in complete epithelialisation by Week 26. Chemotherapy was temporarily withheld during the active inflammatory phase and later resumed. Despite successful control of the peristomal ulceration, the patient died from progressive malignancy at Week 34; Conclusions: This case highlights the clinical challenge of balancing immunosuppressive therapy for clinically suspected PPG with ongoing oncologic treatment. Mechanical pathergy related to stoma appliance use was considered a more likely precipitating factor than chemotherapy alone, although panitumumab may have contributed to impaired cutaneous repair. Close collaboration among dermatologists, oncologists, surgeons, WOC nurses, and family caregivers is essential for multidisciplinary decision-making in complex oncologic settings. Full article

Inflammatory bowel disease (IBD) is associated with microbial dysbiosis, yet subtype-specific alterations in the tongue-coating microbiome remain insufficiently characterized. In this cross-sectional study, tongue-coating samples from 158 participants (94 healthy controls [HC], 19 ulcerative colitis [UC] patients, and 45 Crohn’s disease [CD] patients) were analyzed by 16S rRNA gene amplicon sequencing. We compared alpha and beta diversity, taxonomic composition, differential taxa, exploratory random-forest feature rankings, and SPIEC-EASI co-occurrence networks. Species richness did not differ significantly among groups, whereas Shannon and Simpson indices were lower in UC than in HC and CD. Bray–Curtis and Jaccard ordinations showed significant but partially overlapping community differences among the three groups. UC was characterized by enrichment of Proteobacteria, Neisseria, and Porphyromonass (p < 0.001), whereas CD showed higher relative abundances of Prevotella, Veillonella, Leptotrichia, and TM7x. Random forest and LEfSe analyses yielded concordant candidate discriminative taxa, but no independent validation cohort was available. Network analysis suggested group-specific co-occurrence patterns, with results interpreted as statistical associations rather than direct microbial interactions. These findings support the presence of subtype-associated tongue-coating dysbiosis in IBD and identify candidate taxa for future validation. Full article

Background: Ventricular septal defects (VSD) are the most common form of congenital heart disease (CHD). Current guidelines recommend surveillance transthoracic echocardiograms (TTE) following surgical closure of perimembranous VSDs (pVSD); however, duration of screening is not explicitly stated. The goal of this study is to determine the utility of follow-up TTEs after uncomplicated pVSD surgical closure. Methods: Single-site retrospective analysis was conducted on patients who underwent pVSD surgical closure. Patients were excluded if diagnosed with other CHD, had complications 1 year post-repair, or lacked data 1 year post-repair. Serial TTEs were reviewed. A Kaplan–Meier curve was used to illustrate the 5-year complication-free survival. Results: A total of 117 patients met inclusion criteria. A 97% 5-year complication-free survival was observed. Four patients had complications >1 year post-repair: one non-obstructive subaortic ridge, one pulmonary vein stenosis, one pinhole residual pVSD, and one ventricular ectopy with ventricular dysfunction. Of the 113 complication-free patients, 197 TTEs were performed with no change in clinical management. Conclusions: Beyond 1 year post-repair, the occurrence of new complications following uncomplicated pVSD surgical closure is rare. Unless clinical concerns arise, the utility of routine TTEs > 1 year post-repair in this uncomplicated post-surgical cohort should be reassessed. Larger multicenter studies are needed to determine the utility of routine TTEs. Full article

Background/Objectives: Ventilator-associated pneumonia (VAP) remains a major complication in patients requiring prolonged mechanical ventilation. The effect of tracheostomy on VAP risk remains controversial, particularly when differences in duration of mechanical ventilation are considered. This study evaluated the association between tracheostomy, VAP occurrence, and clinical outcomes in mechanically ventilated ICU patients. Methods: We conducted a retrospective matched exposed–unexposed cohort study in a tertiary-care ICU in Mexico City. Patients undergoing tracheostomy were compared with an age- and sex-matched subcohort of intubated patients receiving invasive mechanical ventilation for ≥48 h. VAP incidence was assessed using cumulative incidence, incidence density, and multivariable generalized linear models. Results: A total of 218 patients were included (55 tracheostomized and 163 intubated). VAP incidence density was similar between groups (31.5 vs. 30.3 per 1000 ventilator-days; RR 1.04, 95% CI 0.7–1.7), whereas cumulative incidence was higher among tracheostomized patients (61.8% vs. 22.7%; RR 2.7, 95% CI 1.9–3.9). Broad-spectrum antibiotics, mechanical ventilation ≥ 5 days, chronic pulmonary disease, and ICU stay remained associated with VAP occurrence in an exploratory multivariable model. Gram-negative microorganisms predominated, and antimicrobial resistance was more frequent among tracheostomized patients. Conclusions: Tracheostomy was associated with higher cumulative incidence of VAP, but a similar incidence density compared with endotracheal intubation. The crude association between tracheostomy and VAP disappeared after adjustment for confounding factors, suggesting that prolonged mechanical ventilation and ICU exposure are more important determinants of VAP risk than tracheostomy itself. Full article

Background/Objectives: Telomeres are critical biomarkers of biological aging, with shortened leukocyte telomere length strongly linked to all-cause mortality and age-related disease risk. Although exercise modulates telomere dynamics, the field’s evolution from descriptive measurements to mechanistic inquiries involving redox biology and epigenetics remains incompletely mapped. This study systematically characterized the global research landscape of telomere–exercise science over 25 years to establish a strategic evidence base for precision exercise prescription. Methods: A bibliometric analysis was conducted on 858 publications from the Web of Science Core Collection (2000–2025). CiteSpace and VOSviewer were used for keyword co-occurrence analysis, strategic thematic mapping, and citation burst detection to visualize global research trends and identify emerging frontiers. Results: Annual publication volume grew from 2 (2000) to 71 (2025), with a compound annual growth rate of 15.4%. China emerged as one of the leading global contributors. Thematic analysis revealed a paradigm shift from descriptive leukocyte telomere length studies toward mechanistic investigations of oxidative stress, mitochondrial homeostasis, and epigenetic clocks. Keyword network analysis confirmed oxidative stress and inflammation as central hubs, mediating telomere protection via redox regulation and non-canonical telomerase functions. Conclusions: Exercise preserves telomere integrity primarily through redox–mitochondrial homeostasis, hormesis-driven antioxidant upregulation, and non-canonical telomerase activation. For aging populations and individuals at metabolic risk, aerobic training and high-intensity interval training (HIIT) are recommended as first-line non-pharmacological interventions for healthspan extension. Leukocyte telomere length and telomerase activity should be integrated as biomarkers in preventive medicine practice. Future large-scale randomized controlled trials incorporating multi-omics approaches and sex-stratified analyses are warranted to establish individualized dose–response guidelines for precision exercise prescription. Full article

Background and Clinical Significance: Inflammatory myopericardial syndrome is an umbrella term recently introduced by the European Society of Cardiology, which encapsulates the overlap that exists in clinical practice between myocardial and pericardial disease. It has a heterogeneous aetiology and a broad spectrum of severity in terms of its clinical features. Toxoplasma gondii is a rare but recognised infectious cause of myopericarditis and is typically seen in immunocompromised individuals. Case Presentation: We present the case of a young, immunocompetent male, presenting with pleuritic chest pain following a recent flu-like illness. Investigations revealed an acute myocardial injury based on elevated troponin T levels, in the absence of ventricular dysfunction. Toxoplasma immunoserology was consistent with primary toxoplasma infection. The remainder of his viral panel was negative. There was prompt symptom improvement following commencement of treatment with colchicine and a non-steroidal anti-inflammatory agent. Cardiac magnetic resonance imaging post-discharge revealed findings consistent with prior myocarditis. Conclusions: This case is an example of the rare occurrence of toxoplasma myopericarditis in an immunocompetent individual. Cardiac MRI is an invaluable imaging modality used to evaluate myocardial function and tissue characteristics in patients presenting with inflammatory myopericardial syndrome. Full article

In tropical countries, broiler chickens are exposed to elevated ambient temperatures and humidity, which are sometimes exacerbated by high stocking densities and poor litter quality, thereby predisposing birds to severe stress, weakening immune function, and promoting BCO lameness progression. BCO lameness causes tremendous economic losses to the poultry industry and increases the risk of foodborne disease. BCO is frequently underdiagnosed in live populations, resulting in an iceberg phenomenon in which subclinical lesions are more prevalent than clinically apparent lameness. Therefore, a total of 500 Cobb500 broiler chickens from five commercial broiler flocks in Central Java, Indonesia, were randomly selected, weighed, slaughtered, and necropsied to evaluate the prevalence of BCO lameness lesions in the proximal femoral and tibial heads across distinct market ages ranging from 33 to 43 days. The ambient housing temperature in the region can reach 28–29 °C during the day. The results showed that more than 80% of the samples had normal femora at 33 days of age with an average body weight of 1.9 kg. A significant increase in the frequency and severity of femoral and tibial lesions was recorded at 35 to 36 days of age, when the average body weight reached approximately 2.5 kg. The high frequency of worsening BCO lesions observed during the 5th week suggests an age-related pattern in BCO occurrence during the late stages of grow-out. These findings suggest that improvements in nutrition, environment, and production management strategies before 36 days of age are necessary to mitigate the impact of BCO lameness in the poultry industry. Full article