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Blastocystis spp. is an enteric protist that is present worldwide. Despite being discovered a century ago, there is still much to be learned about its pathogenicity and transmission. Different subtypes (ST) of Blastocystis spp. have been identified in various hosts, including humans, birds, and insects, and there is potential for zoonotic transmission through contact between humans and animals. The prevalence of Blastocystis spp. in humans and macaques in Singapore was understudied, and the findings revealed a significant prevalence of the parasite, with rates of 90% and 100% observed in each respective Macaca fascicularis population 1 and 2, with main subtypes (ST1, ST2, ST3, and ST5). Using metagenomics, the different subtypes of Blastocystis spp. (comprising ST2, ST3, and ST17) were identified in a healthy Singaporean cohort. Additionally, seven incidental findings of Blastocystis spp. were discovered in human patients with other gut parasites, including two ST1, two ST2, two ST3, and one ST8. Several factors such as diet or reverse zoonotic transmission are suggested to play a role in Blastocystis sp. subtype distribution. Full article

Background: Temporomandibular disorders are a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint with multifactorial pattern and genetic background. The aim of this observational study was to investigate the correlation between craniomandibular disorders and the presence of occlusal alterations. A clinical evaluation of the occlusal and articular status of the patients was carried out, integrating the latter with the electromyographic recording the activity of the masseter and temporalis muscles. Methods: A clinical observational study on 20 adults assessed temporomandibular disorders using DC/TMD criteria, anamnesis, clinical exams, occlusal and electromyographic analyses. Occlusion was evaluated morphologically and functionally. Electromyography tested static/dynamic muscle activity. Data were statistically analyzed using t-tests and Pearson correlation (p < 0.05). Results: Electromyographic analysis revealed significant differences between subjects with and without visual correction, suggesting that visual input influences masticatory muscle activity. Correlations emerged between occlusal asymmetries and neuromuscular parameters. These findings highlight clinical implications for mandibular function, muscle symmetry, and the potential for therapeutic rebalancing through targeted interventions. Conclusions: The study demonstrates a significant correlation between visual–motor integration and masticatory muscle efficiency. It emphasizes lateralized neuromuscular activation’s influence on occlusal contact distribution. Moreover, it identifies mandibular torsion–endfeel inverse correlation as a potential diagnostic marker for craniomandibular dysfunctions via surface electromyography. Full article

Many speech coding strategies have been developed over the years, but comparing them has been convoluted due to the difficulty in disentangling brand-specific and patient-specific factors from strategy-specific factors that contribute to speech understanding. Here, we present a comparison with a ‘virtual’ patient, by comparing two strategies from two different manufacturers, Advanced Combination Encoder (ACE) versus HiResolution Fidelity 120 (F120), running on two different implant systems in a computational model with the same anatomy and neural properties. We fitted both strategies to an expected T-level and C- or M-level based on the spike rate for each electrode contact’s allocated frequency (center electrode frequency) of the respective array. This paper highlights neural and electrical differences due to brand-specific characteristics such as pulse rate/channel, recruitment of adjacent electrodes, and presence of subthreshold pulses or interphase gaps. These differences lead to considerably different recruitment patterns of nerve fibers, while achieving the same total spike rates, i.e., loudness percepts. Also, loudness growth curves differ significantly between brands. The model is able to demonstrate considerable electrical and neural differences in the way loudness growth is achieved in CIs from different manufacturers. Full article

Objectives: Burkholderia cepacia complex (Bcc), a Gram-negative organism, is a well-recognized cause of hospital outbreaks, often linked to a contaminated shared source, such as multidose medications. In this study, we report an outbreak of Bcc infections in a tertiary care hospital, associated with the intrinsic contamination of a prepared solution used in interventional radiology (IR) procedures. Additionally, we provide a detailed explanation of the interventions implemented to control and interrupt the outbreak. Methods: Records from the infection control committee from 1 January 2023 to 31 October 2024 were screened to identify cases with Bcc growth in cultured blood, urine, or respiratory samples. Clinical and laboratory data were collected in March 2025. Bacterial identification was performed using conventional methods and MALDI-TOF (Bruker Daltonics, Bremen, Germany). Controls were matched to cases by ward, date of initial growth, and duration of hospitalization. Demographic and clinical data of these patients were systematically collected and analyzed. Microbiological cultures were obtained from environmental objects of concern and certain medications. Results: A total of 82 Burkholderia species were identified. We enrolled 77 cases and 77 matched controls. The source of contamination was identified in ready-to-use intravenous medications (remifentanil and magnesium preparations) in the IR department. These preparations were compounded in advance by the team and were used repeatedly. Although the outbreak originated from contaminated IV medications used in IR, secondary transmission likely affected 28 non-IR patients via fomites, shared environments, and possible lapses in isolation precautions. The mortality rate among the cases was 16.9%. Infection with Bcc was associated with prolonged intensive care unit stays (p = 0.018) and an extended overall hospitalization duration (p < 0.001); however, it was not associated with increased mortality. The enforcement of contact precautions and comprehensive environmental decontamination successfully reduced the incidence of the Bcc outbreak. No pathogens were detected in cultures obtained after the disinfection. Conclusions: The hospital transmission of Bcc is likely driven by cross-contamination, invasive medical procedures, and the administration of contaminated medications. Implementing stringent infection control measures such as staff retraining, updated policies on medication use, enhanced environmental decontamination, and strict adherence to isolation precautions has proven effective in curbing the spread of virulent and transmissible Bcc. Full article

Background/Objectives: Traumatic brain injury is one of the leading causes of death and disability. When traumatic brain injury is repeated over time, it can lead to the development of Chronic Traumatic Encephalopathy, a chronic neurodegenerative disease commonly observed in individuals who engage in contact sports or military personnel involved in activities with a high risk of repeated head trauma. At autopsy, the examination of the brain reveals regional atrophy, corresponding to high concentrations of glutamate receptors. Microscopically, the primary findings are the deposition of neurofibrillary tangles and neuropil threads. The aim of this study is to highlight the clinical and histopathological characteristics of Chronic Traumatic Encephalopathy, providing diagnostic support to forensic pathologists. Additionally, it seeks to aid in the differential diagnosis of similar conditions. Methods: A review of literature was conducted following the PRISMA criteria. Of 274 articles, 7 were selected. Results: According to these papers, most patients were male and exhibited neurological symptoms and neuropsychiatric impairments, and a proportion of them committed suicide or had aggressive behavior. Conclusions: Chronic Traumatic Encephalopathy remains largely underdiagnosed during life. The definitive diagnosis of Chronic Traumatic Encephalopathy is established post-mortem through the identification of pathognomonic tauopathy lesions. Early and accurate antemortem recognition, particularly in at-risk individuals, is highly valuable for its differentiation from other neurodegenerative conditions, thereby enabling appropriate clinical management and potential interventions. Full article

Traditional wound and burn treatments often fall short in balancing antimicrobial efficacy, patient comfort, and ease of application. This study introduces a novel, transparent, thermoresponsive sol–gel formulation incorporating polyhexamethylene biguanide (PHMB) for advanced topical therapy. Utilizing Poloxamer 407 as a biocompatible carrier, the formulation remains a sprayable liquid at room temperature and instantly gels upon contact with body temperature, enabling painless, pressure-free application on sensitive, injured skin. Comprehensive in vitro and in vivo evaluations confirmed the formulation’s broad-spectrum antimicrobial efficacy (≥5 log₁₀ reduction in 30 s), high biocompatibility (viability > 70% in fibroblasts), non-irritancy (OECD 425-compliant), and physical stability across three months. Importantly, the formulation maintained fibroblast migration capacity—crucial for wound regeneration—while exhibiting rapid sol-to-gel transition at ~34 °C. These findings highlight the system’s potential as a next-generation wound dressing with enhanced user compliance, transparent monitoring capability, and rapid healing support, particularly in disaster or emergency scenarios. Full article

Background/Objectives: Pharmacists are highly accessible healthcare providers who have frequent, repeated contact with diverse patient populations. They are poised to offer expanded and comprehensive healthcare, including mental health services. One potential barrier to this is a lack of knowledge, confidence, or training in mental health, which may be overcome with a program like Mental Health First Aid (MHFA) training. The aim of this systematic review and meta-analysis is to fill this gap in knowledge by critically evaluating all studies of MHFA training for pharmacists or pharmacy students that report on knowledge, attitudes, or self-efficacy outcomes. Methods: A systematic review was performed to identify all relevant studies. Data was extracted and a random-effects meta-analysis was performed for knowledge and attitudes/self-efficacy outcomes, respectively. Subgroup analyses were performed based on survey question type, geographic location, and population studied. Results: Overall, MHFA training significantly increased pharmacists’ and pharmacy students’ knowledge (Hedges’ g = 0.228) and combined attitudinal/self-efficacy measures (Hedges’ g = 0.376). Subgroup analyses based on question type, study quality, design, population studied, and location showed similar, significant effects. Conclusions: MHFA training appears to have significant effects on pharmacist and pharmacy student knowledge, attitudes, and self-efficacy. Future work should establish the durability of these effects. Full article

Continuous monitoring of respiratory patterns is essential for disease diagnosis and daily health care. Contact medical devices enable reliable respiratory monitoring, but can cause discomfort and are limited in some settings. Radar offers a noncontact respiration measurement method for continuous, real-time, high-precision monitoring. However, it is difficult for a single radar to characterize the coordination of chest and abdominal movements during measured breathing. Moreover, motion interference during prolonged measurements can seriously affect accuracy. This study proposes a dual radar system with customized narrow-beam antennas and signals to measure the chest and abdomen separately, and an adaptive dynamic time warping (DTW) algorithm is used to effectively suppress motion interference. The system is capable of reconstructing respiratory waveforms of the chest and abdomen, and robustly extracting various respiratory parameters via motion interference. Experiments on 35 healthy subjects, 2 patients with chronic obstructive pulmonary disease (COPD), and 1 patient with heart failure showed a high correlation between radar and respiratory belt signals, with correlation coefficients of 0.92 for both the chest and abdomen, a root mean square error of 0.80 bpm for the respiratory rate, and a mean absolute error of 3.4° for the thoracoabdominal phase angle. This system provides a noncontact method for prolonged respiratory monitoring, measurement of chest and abdominal asynchrony and apnea detection, showing promise for applications in respiratory disorder detection and home monitoring. Full article

Background/Objectives: To evaluate the effectiveness and limitations of a newly developed unit-dose eye drop instillation aid in patients with glaucoma. Methods: Hospitalized adult glaucoma patients at the University of Yamanashi were enrolled if they had self-administered glaucoma eye drops for at least six months, had no upper limb impairments or cognitive decline, and had corrected visual acuity of ≥20/200 in at least one eye. This study used 0.1% hyaluronic acid mini-ophthalmic drops. Eye drop instillation was performed in the following order: without aid in the sitting position, with aid in the sitting position, without aid in the supine position, and with aid in the supine position. One practice trial with the device was conducted beforehand. Successful instillation was defined as delivery of a drop into the conjunctival sac without contact with the ocular surface, eyelashes, or face. Patients were also surveyed regarding the perceived usefulness of the device. Results: Sixty-three patients (37 males, 26 females; mean age 71.3 ± 11.2 years) participated. In the sitting position, the success rate improved significantly from 70.3% without the aid to 89.1% with the aid (p = 0.0005). Success rates decreased with age but improved more markedly in older patients. In the supine position, the rate was 76.6% without the aid and 100% with the aid (p < 0.0001). Conclusions: Unit-dose eye drop aids significantly increase the success rate of instillation, especially among elderly patients, and may contribute to better adherence and treatment outcomes in glaucoma care. Full article

Background: Among all ambulatory antibiotic prescriptions, about 20% are non-visit-based (ordered outside of an in-person clinical encounter), and about 30% are not associated with an infection-related diagnosis code. Objective/Methods: To identify the rationale for ambulatory antibiotic prescribing, we queried the electronic health record (EHR) of a single, large health system in the Midwest United States to identify all oral antibiotics prescribed from November 2018 to February 2019 and examined visit, procedure, lab, department, and diagnosis codes. For the remaining antibiotic prescriptions—mostly non-visit-based, no-infectious-diagnosis-documented—we randomly selected and manually reviewed the EHR to identify a prescribing rationale and, if none was present, surveyed prescribers for their rationale. Results: During the study period, there were 47,619 antibiotic prescriptions from 1177 clinicians to 41,935 patients, of which 2608 (6%) were eligible non-visit-based, no-infectious-diagnosis-documented. We randomly selected 2298. There was a documented rationale for 2116 (92%) prescriptions. The most common documented reasons—not mutually exclusive—were patient-reported symptoms (71%), persistence of symptoms after initial management (18%), travel (17%), and responding to lab or imaging results (11%). We contacted 160 clinicians who did not document any prescribing rationale in the EHR and received responses from 62 (39%). Clinicians’ stated reasons included upcoming or current patient travel (19%), the antibiotic was for the prescriber’s own family member (19%), or the clinician made a diagnosis but did not document it in the EHR (18%). Conclusions: Non-visit-based, no-infectious-diagnosis-documented antibiotic prescriptions were most often in response to patient-reported symptoms, though they also occur for a variety of other reasons, some problematic, like in the absence of documentation or for a family member. Full article

Chronic diseases are a leading cause of death worldwide and have a significant negative impact on public health, overall well-being, national economies, and the long-term sustainability of already burdened health systems. In addressing some of the current health challenges, the contribution of pharmacists and community pharmacies is of particular significance. Pharmacists play a vital role in the medication use process, enhancing the efficacy of pharmacological interventions and facilitating the delivery of health services. Community pharmacies occupy a key position within the healthcare system, acting as a primary point of contact with the public and frequently representing the most accessible healthcare facility for patients. In recent times, community pharmacies have undergone a process of adaptation, shifting from a narrow focus on the dispensing of medications towards a more comprehensive approach that is patient-centered and incorporates a range of healthcare services, while also prioritizing the quality of the services provided. This work aims to explore the role of pharmacists in the provision of pharmaceutical services in three countries with distinct healthcare systems, examining how these services operate, the requirements for their delivery, the associated remuneration structures, and the extent of out-of-pocket costs for patients—ultimately analyzing their impact on health outcomes. Full article

Background/Objectives: The aim of this study is to compare the parameters of the corneal endothelium in a group of patients with well-controlled type 2 diabetes (study group) to those of patients who do not have type 2 diabetes (control group). Methods: The study aims to compare the corneal endothelium parameters of 80 eyes (80 patients) with well-controlled type 2 diabetes to 80 eyes (80 patients) without type 2 diabetes. The endothelial cell density (ECD), percentage of hexagonal cells (%HEX), coefficient of variation in cell size (CV), and central corneal thickness (CCT) were recorded using a non-contact specular microscope (Nidek CEM-530, Nidek Co., Ltd., Gamagori, Japan). Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were also measured. Results: The groups were matched for age and sex. A significantly lower ECD value was observed in the group of patients with type 2 diabetes (2480.76 cells/mm² ± 303.48) compared to the control group (2629.64 cells/mm² ± 304.73) (p = 0.002). BCVA was also significantly lower in the study group (0.44 ± 0.18) compared to the control group (0.50 ± 0.19) (p = 0.049). No statistically significant differences were found between the groups in terms of IOP, CV, %HEX, and CCT. Conclusions: Patients with well-controlled type 2 diabetes exhibit a lower ECD compared to individuals without diabetes, even in the absence of advanced diabetic complications. These subtle changes may have clinical implications for preoperative evaluation and long-term management in diabetic patients. The other morphological parameters of the corneal endothelium remain comparable between the groups. Full article

Background/Objectives: Pathology is often perceived as a technical medical specialty that lacks direct contact with the patient. However, oncological histopathological diagnosis requires a high degree of moral and emotional responsibility. The objective of this study was to investigate how empathy is manifested toward the “invisible” patient, the emotional impact on pathology staff, and potential repercussions in their personal lives. Method: We conducted a descriptive, cross-sectional study with a quantitative component, using an anonymous 22-item questionnaire among Romanian pathologists and medical personnel working in pathology services. The questionnaire was focused on three research directions: professional empathy in the absence of direct patient contact, the emotional impact of oncologic diagnosis on medical personnel in pathology departments, and the carryover of emotions from professional to personal life. A total of 165 respondents were included in the study (physicians, technicians, registrars). Results: Most of the respondents consider that the absence of the patient’s direct contact does not cancel the empathy, this being felt in a cognitive and more natural way. Over 60% of the respondents see oncologic histopathological diagnosis as an emphatic medical act. Over 80% of the respondents experience a sense of emotional responsibility and 70% consider that professional training does not include adequate emotional support. There is a high interest in empathy and psychological support. The professional activity of a pathologist may influence sleep, dreams, and the perception on their own health status. Diagnosing pediatric or young patients is perceived as particularly emotionally challenging. Collegial support is moderate and discussion about professional stress is rare. Conclusions: Empathy is present and relevant in pathology, despite the absence of direct patient interaction. Oncological diagnostics has a significant emotional impact on pathology department personnel, with the need to acknowledge the emotional dimension of the profession and to integrate psychological support mechanisms into pathology practice. Full article

Intravenous infusion is an important clinical medical intervention, and its safety is critical to patient recovery. To mitigate the elevated risk of complications (e.g., air embolism) arising from delayed response to infusion endpoints, this paper designs a flexible double pole capacitive (FPB) sensor, which includes a main pole plate, an adaptive pole plate, and a back shielding electrode. The sensor establishes a mapping between residual liquid volume in the infusion bottle and its equivalent capacitance, enabling a non-contact adaptive monitoring system. The system enables precise quantification of residual liquid levels, suppressing baseline drift induced by environmental temperature/humidity fluctuations and container variations via an adaptive algorithm, without requiring manual calibration, and overcomes the limitations of traditional rigid sensors when adapting to curved containers. Experimental results showed that the system achieved an overall sensitivity of 753.5 $\mathrm{f}\mathrm{F}/\mathrm{m}\mathrm{m}$, main pole plate linearity of 1.99%, and adaptive pole plate linearity of 0.53% across different test subjects, linearity of 0.53% across different test subjects, with liquid level resolution accuracy reaching 1 mm. These results validate the system’s ultra-high resolution (1 mm) and robust adaptability. Full article

Cardiac tissue engineering is a promising strategy to restore cardiac function in heart failure patients. Understanding the cardiac tissue architecture including the cardiac stroma is essential for developing not only advanced cardiac tissue engineering but also novel therapeutic strategies. One of the crucial components of the cardiac stroma is the myocardial vasculature. To enhance the spatial visualization of the cardiac stromal cytoarchitecture with a particular focus on myocardial vasculature, we performed 3D reconstructions of the murine cardiac micro vessels using Serial Block-Face Scanning Electron Microscopy (SBF-SEM). These analyses revealed that pericyte cell bodies were primarily oriented lengthwise and extended several cellular protrusions towards the endothelium. At capillary branching points, some pericytes made contact with both capillaries emerging from branching. In addition to pericytes that are completely encapsulated by the common basal lamina together with capillary endothelial cells, we identified other vascular-associated cells located outside this sheath. Based on marker expression, these cells were distinguished from fibroblasts and suggested to be telocytes. The vascular-associated cells formed electron-dense contact zones with endothelial cells, suggesting functional coupling between these both cell types. In conclusion, this study provides detailed three-dimensional visualizations of the cardiac stroma with a particular focus on cardiac microvasculature, offering enhanced insight into the cardiac stromal cytoarchitecture. Full article