Search Results (7,147)

Background: The appropriateness of the World Health Organization (WHO) body mass index (BMI) cut-off (≥25 kg/m²) for gestational diabetes mellitus (GDM) screening in Asian populations remains controversial due to the “Asian phenotype,” characterized by higher body fat percentage and visceral adiposity at lower BMI values. This systematic review evaluated the screening and prognostic performance of pre-pregnancy BMI thresholds (≥23, ≥24, ≥25 kg/m²) for predicting GDM in Asian women. Methods: A systematic review and meta-analysis were conducted following the JBI Manual for Evidence Synthesis and PRISMA-DTA guidelines. A comprehensive search was performed in PubMed, Scopus, Embase, CINAHL, Cochrane Library, and Google Scholar from January 2015 to August 2024. Studies reporting screening and prognostic performance of pre-pregnancy BMI for GDM prediction in Asian populations were assessed using the QUADAS-2 tool. Data were synthesized using MetaBayesDTA for univariate random-effects meta-analysis of sensitivity and specificity. A supplementary DerSimonian-Laird random-effects meta-analysis of odds ratios (ORs) was conducted to assess the prognostic association between BMI thresholds and GDM risk. Results: A total of 13 studies were included in the review, comprising a total of 427,159 Asian pregnant women. Most included studies were conducted in East Asian populations, predominantly Chinese, and findings may not generalize to South or Southeast Asian subgroups. For the Asian-standard threshold (≥23 kg/m²; n = 3 studies), pooled sensitivity was 0.47 (95% CrI 0.45–0.49) and specificity was 0.71 (95% CrI 0.56–0.83). For the intermediate threshold (≥24 kg/m²; n = 7 studies), sensitivity was 0.31 (95% CrI 0.25–0.37) and specificity 0.84 (95% CrI 0.80–0.88). For the WHO standard (≥25 kg/m²; n = 3 studies), sensitivity was 0.31 (95% CrI 0.11–0.61) and specificity 0.80 (95% CrI 0.45–0.95). Heterogeneity was extremely high for BMI ≥ 25 kg/m² (I² = 92% for sensitivity), substantially limiting the interpretability of pooled estimates for this threshold. Conclusions: Based on low-certainty evidence from three studies with very high heterogeneity, the WHO BMI criterion (≥25 kg/m²) appears to have clinically insufficient sensitivity for GDM detection in East Asian populations. The Asian-standard threshold (≥23 kg/m²) shows improved prediction (moderate-certainty evidence) but still misses approximately 53% of true positives. Supplementary OR meta-analysis confirms that all three thresholds are significantly associated with GDM risk (pooled ORs 1.80–2.38), though effect sizes are modest. BMI alone is insufficient for GDM screening and should be integrated into multifactorial risk assessment strategies. These findings apply primarily to East Asian populations and may not generalize to South or Southeast Asian subgroups. Full article

Background: Exercise modulates the immune system and may enhance anti-cancer activity, offering potential synergy with cancer immunotherapy. Tumours with low immune cell infiltration (“cold” tumours) often respond poorly to immunotherapy and are associated with poor prognosis. Here, we demonstrate that exercise can reshape the immune landscape of tumours across the cold spectrum. Methods: C57BL/6 mice underwent orthotopic implantation of PANC02 (murine pancreatic adenocarcinoma) cells and BALB/c mice underwent intraperitoneal injections of AB-1 (murine mesothelioma) cells. Mice were then divided into groups; exercise with anti-Programmed Cell Death Protein 1 (PD-1), exercise with isotype, no exercise with anti-PD-1 and no exercise with isotype. Treadmill-running was performed for 20 min/day, 4 days/week at a speed of 12 metres/minute. Resistance training consisted of hanging upside down on a wire-mesh screen for 1 min 2 days/week. Flow cytometry was used to measure TME immune populations. Tumour and liver samples were harvested, paraffin wax-embedded/sectioned and analysed using SlideViewer 2.9.0™. A total of 22 healthy volunteers underwent a single bout of high-intensity interval cycling. Blood was collected pre- and post-exercise. Flow cytometry was used to measure leucocyte subpopulations. MSTO-211H (mesothelioma) and PANC-1 (pancreatic cancer) cells were cultured with pre- and post-exercise serum, with/without HSV1716, and viability determined using alamarBlue^®. PANC-1 apoptosis and migration were assessed using caspase-3/7 and scratch assays, respectively. Results: In an orthotopic pancreatic cancer mouse model, combining exercise with immunotherapy significantly increased tumour necrosis and reduced metastatic potential. In both pancreatic cancer and mesothelioma models, this combination remodelled the tumour microenvironment, enhancing cytotoxic CD8⁺ T cell infiltration, upregulating Programmed Cell Death Protein 1 (PD-1), and reducing Myeloid-Derived Suppressor Cells and regulatory T cells (Tregs). Complementary human studies revealed an acute systemic release of Natural Killer cells and a reduction in Tregs following high-intensity interval exercise in healthy volunteers. Moreover, exercise-conditioned serum from these participants exerted anti-cancer effects on pancreatic cancer and mesothelioma cell lines. Conclusions: Altogether, these findings highlight exercise as a promising adjunct to immunotherapy for poorly immunogenic cancers such as pancreatic cancer and mesothelioma. Full article

Background: Brucella canis is an emerging zoonotic pathogen responsible for canine reproductive disorders and public health concerns. This study assessed the seroprevalence of B. canis in dogs from Campania, Southern Italy (2022–2025). Methods: Serum samples (n = 400) were retrospectively screened using an indirect immunofluorescence assay (IFAT), performed according to the manufacturer’s instructions. Screening was conducted at a 1:40 cut-off, followed by serial dilutions to determine endpoint titres. Statistical analysis included chi-square tests for univariable screening, followed by nominal logistic regression models to evaluate the association between IFAT positivity and predictive factors (year, province, and sex of dogs). Additionally, a general linear model (GLM) was applied to the seropositive subset (n = 69) to analyse the magnitude of the antibody response, expressed as geometric mean titres (GMTs). Results: The overall seroprevalence was 17.3% (95% CI: 13.6–21.0%). Dog’s sex, year of sampling, and province were not significant independent predictors of infection (p > 0.05), but GLM analysis showed that sampling year (p = 0.0024) and province (p = 0.0490) significantly influenced antibody intensity. A significant temporal increase in antibody intensity was observed towards 2025 (p = 0.037), suggesting an intensification of infection pressure. Conclusions: Our results confirm that Brucella canis is an endemic pathogen in the shelter dog population of southern Italy. The high seroprevalence and significant increase in antibody magnitude (GMT) over the study period indicate rising infection pressure, highlighting the urgent need for mandatory screening and a coordinated One Health surveillance strategy to manage zoonotic risk effectively. Full article

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune dysregulation and systemic inflammation, with the cardiovascular (CV) system representing a major yet frequently under-recognized target. Cardiac involvement spans from subclinical myocardial inflammation to overt pericardial disease, myocarditis, valvular abnormalities, coronary microvascular dysfunction, and accelerated atherosclerosis. Given that CV disease remains a leading cause of morbidity and mortality in SLE, early detection of silent cardiac injury is crucial. Aim: This review aims to provide a comprehensive and clinically oriented overview of CV involvement in SLE, focusing on the role of multimodal cardiac imaging in the detection, characterization, and risk stratification of cardiac abnormalities, as well as its potential implications for clinical management and preventive strategies. Methods: This narrative review is based on a structured, non-systematic search of PubMed (2013–2026), combining the term “systemic lupus erythematosus” with imaging-related keywords including “transthoracic echocardiography,” “cardiac magnetic resonance,” and “cardiac computed tomography.” English-language studies in adult populations were screened and selected according to clinical relevance, methodological robustness, and contribution to understanding SLE-related cardiac involvement. Discussion: Multimodal cardiac imaging plays a central role in the evaluation of SLE-related cardiac disease. Transthoracic echocardiography (TTE) represents the first-line modality for the assessment of ventricular function, pericardial disease, and valvular abnormalities, while deformation imaging enables the detection of subtle myocardial dysfunction. Cardiac magnetic resonance (CMR) provides comprehensive tissue characterization, allowing differentiation between active inflammation and chronic fibrosis. Cardiac computed tomography (cCT) identifies subclinical coronary atherosclerosis and high-risk plaque features, whereas nuclear imaging techniques offer insight into inflammatory activity and microvascular dysfunction. Conclusions: An integrated, imaging-based approach enables early diagnosis, refined CV risk stratification, longitudinal monitoring, and personalized therapeutic strategies. Multimodal imaging thus represents a key pillar of precision medicine in lupus-associated CV disease. Full article

Background: The impact of screen time is having serious adverse effects on people’s lives. Unfortunately, early childhood is the most vulnerable stage in the lifespan, and most children are using television, computers, parents’ and mothers’ mobile phones, or tablets, for longer than recommended. For this reason, the interest of the education community in proposing programs for reducing screen time has grown, which could be of interest for families and professionals in early childhood development and care for children adhering to a healthy lifestyle. For this reason, the objective of this study is to compile programs including families that have tried to reduce preschool-aged children’s time in front of screens. Method: The search strategy is designed based on the PICOS framework. A review was conducted in three databases (PubMed, Web of Science, and ProQuest Central) on 11 October 2024, following the PRISMA guidelines. The systematic review is registered in PROSPERO. Results: A total of 287 articles were initially found, and 15 met all inclusion criteria. Conclusions: The results reveal that programs based on training parents in addition to performing games with children have positive effects for reducing screen time in children up to six years old, even in a specific population. Full article

Background/Objectives: Global estimates suggest that approximately 43% of individuals living with diabetes remain undiagnosed, underscoring the need for early identification of adults at high risk of type 2 diabetes mellitus (T2DM) to support timely preventive interventions. This scoping review aimed to map and summarize existing non-invasive screening tools for identifying adults at high risk of T2DM. Methods: PubMed (MEDLINE), Web of Science, ScienceDirect, and Scopus were searched in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). Studies published between 1995 and 2026 that described screening tools for adult populations were included. Results: A total of 58 studies describing screening tools were identified. The tools were developed and applied across diverse populations and ethnic groups. Most were questionnaire-based, easy to administer, and low cost. Commonly included variables comprised demographic characteristics, anthropometric measures, lifestyle factors, and clinical indicators associated with increased T2DM risk. Substantial heterogeneity was observed in tool structure and reported predictive components. Conclusions: This scoping review provides an overview of available screening tools for the early identification of adults at high risk of T2DM. The mapped evidence may inform future validation studies and support context-specific implementation in public health and clinical practice settings, including integration into digital platforms. Full article

To perform screening of the retina on a population scale, an automated procedure is required that incorporates accurate, reproducible, interpretable, and computationally costeffective models. Existing approaches using convolutional or transformer architectures typically do not adequately represent both fine-grained pathology and large-scale retinal context simultaneously, which could adversely affect their reliability if used for large-scale applications in clinical practice. In this paper, we propose a hierarchical transformer-based screening framework for retinal fundus images that incorporates patch-based tokenization, global transformer encoding, and hierarchical aggregation of contextual information. We also developed a lightweight prediction head that supports screening for both single and multiple diseases. The framework has been evaluated using standard screening metrics, robustness, and cross-dataset generalization analyses on two eye retinopathy image databases: EyePACS and RFMiD. With regard to screening for a binary outcome of diabetic retinopathy, our method provided an accuracy of 89.4% and an area under the receiver operating characteristic (AUROC) curve of 93.6% on EyePACS and attained an accuracy of 95.2% and a macro-averaged F1 score of 82.7% on RFMiD. Our hierarchical transformer achieved improved robustness to degraded images and increased generalizability across datasets compared with all current state-of-the-art models. The proposed hierarchical transformer demonstrates strong potential for large-scale retinal screening and provides a promising foundation for future clinically validated deployment. Full article

Background/Objectives: Children and young people (CYP) with a learning disability are at higher risk of living with overweight and obesity and may consume fewer fruits and vegetables compared to the general paediatric population. They are more likely to experience eating and drinking difficulties, restrictive eating, and mealtime behavioural challenges. The school environment is considered an ideal setting to improve CYP’s dietary intakes. The primary objective was to identify existing interventions to support healthier food choices for CYP attending specialist schools. Secondary objectives considered intervention development, fidelity and outcomes. Methods: A scoping review and narrative synthesis. Eligible studies were identified from bibliographic databases (e.g., Medline, Embase, PsychInfo) and grey literature (e.g., Clinicaltrials.gov, the Cochrane Library). A two-stage screening process was used. Intervention components were mapped according to the TIDieR-PHP and AACTT frameworks. Results: Seven studies, reported in ten records, were included. Interventions included modifications to the dining environment, sensory exploration, health promotion and social reinforcement. Interventions were implemented across the school day: lunchtime (n = 2), breaktime (n = 3) and other times (n = 2). Studies mainly focused on adolescents. There was some mixed evidence of increased consumption of fruits and vegetables, whole grains and water. Due to small sample sizes and heterogeneity, definitive conclusions are limited. A key finding is the lack of interventions to improve CYP’s food choices in specialist schools. Conclusions: This review highlights a crucial need for the development of multi-component interventions co-produced with stakeholders to promote healthy food choices and improve the dietary intakes of CYP attending specialist schools. Full article

Background: Mild traumatic brain injury (mTBI) is frequently associated with persistent cognitive and psychosocial symptoms, yet biological correlates of recovery remain poorly understood, particularly among Asian and Pacific Islander (API) populations. Pre-injury psychosocial adversity may further shape post-injury recovery trajectories. This pilot study examined associations between participation in a 2-week, home-based, dual-task cognitive–walking intervention (Daily Brain Exercise; DBE) and changes in cognitive, psychological, and salivary microRNA (miRNAs) measures among APIs with and without a self-reported history of mTBI. Methods: API participants completed remote cognitive testing (CNS Vital Signs), psychosocial assessments (Neuro-QoL), and saliva collection before and after DBE participation. Salivary RNA was purified, and miRNA expression was profiled using nCounter^® Human v3 miRNA Expression Panels (NanoString). Differential expression analyses were conducted using ROSALIND^® platform (OnRamp Bioinformatics, San Diego, CA, USA), a cloud-based bioinformatics analysis system, to calculate fold changes and p-values. Pre-injury psychosocial adversity was assessed via the Trauma History Screen and examined descriptively as a contextual modifier of functional outcomes. Results: Twenty-one APIs (mean age 22.9 years; 76.7% female) were enrolled, including 14 individuals with a self-reported history of mTBI (mean 4.64 years post-injury; 50% with multiple injuries). Following DBE participation, increases in cognitive flexibility and executive function scores were observed in both mTBI and control groups. Additional increases in psychomotor speed, processing speed, sleep disturbance, and depressive symptoms were observed descriptively within the mTBI group. Subgroup analyses suggested variability in pre–post patterns across combinations of mTBI history and pre-injury psychosocial adversity. Exploratory miRNA analyses identified seven miRNAs that were differentially expressed in the mTBI group following DBE (unadjusted p < 0.005), including hsa-miR-7-5p, previously reported in association with neurodevelopmental and neurological pathways. Conclusions: In this pilot, feasibility-focused study, participation in a brief, home-based, dual-task intervention was associated with descriptive changes in selected cognitive and psychosocial measures among APIs, particularly those with a history of mTBI and pre-injury adversity. The observed subgroup patterns warrant confirmation in adequately powered, controlled studies. Exploratory changes in salivary miRNAs co-occurred with functional improvements, thus generating a hypothesis for a future investigation. Full article

Drug-resistant tuberculosis (DR-TB) represents a major public health threat, particularly in the prisons of Latin America and the Caribbean, where rates are up to 40 times higher than those observed in the general population. These facilities act as community amplifiers due to overcrowding, poor ventilation, diagnostic delays, and treatment discontinuity. This study offers a critical reflection on the magnitude, determinants, and implications of DR-TB in regional penitentiary contexts. A reflective analytical review was conducted in PubMed, Scopus, Web of Science, SciELO, and LILACS, complemented by WHO and PAHO reports, prioritising studies from 2019 to 2024. The findings reveal MDR-TB and pre-extensively drug-resistant (pre-XDR) outbreaks in Peru, Paraguay, and the Dominican Republic, as well as community transmission linked to prisons in Brazil and Colombia. Persistent gaps remain in systematic screening, drug susceptibility testing coverage, and post-release follow-up. Scientific production continues to be uneven and predominantly biomedical, with limited consideration of social and human rights determinants. DR-TB in prisons reflects the structural deficiencies of health and justice systems; its control requires intersectoral policies, genomic surveillance, and strategies that ensure early diagnosis, treatment continuity, and dignified detention conditions. Full article

Objectives: Peduncle length (PL) is a critical agronomic trait in sorghum [Sorghum bicolor (L.) Moench], influencing mechanical harvesting efficiency. Exploration of the PL genetic mechanism and the PL major genes of sorghum can provide a reference for breeding of sorghum suitable for mechanization and PL genetic research of other graminaceous crops. Methods: Here, we conducted genetic analysis, transcriptome analysis, and candidate major gene screening of PL using long-peduncle (KY133B) and short-peduncle (KY123B) parents, as well as their constructed F2 segregated populations. Results: Genetic analysis revealed that PL trait may be controlled by two major genes with additive-dominant effects, showing a heritability of 69.638%. At the early stage of sorghum peduncle elongation, the young panicle of the parents was sampled and performed transcriptome analysis. DEGs 3603 genes were obtained. With the short peduncle parent (F) as the control, 2204 upregulated genes and 1399 downregulated genes were expressed in the long peduncle parent (M). We compared the 1161 genes obtained by BSA-seq from the laboratory in the early stage with the DEGs obtained by RNA-seq, and obtained 148 co-localized genes. Through the high DEGs screening criteria (|Log₂FC(M/F)| ≥ 5, p < 0.0001), we further identified 36 genes with highly significant expression differences between parents. Functional annotation identified four candidate major genes strongly associated with PL: LOC8056900 (MIZU-KUSSEI 1), LOC8065075 (ethylene-responsive transcription factor WIN1), LOC8083493 (GDSL esterase/lipase), and LOC8085367 (auxin-responsive protein IAA21). qPCR validated their expression trends, corroborating RNA-seq results. Conclusions: The comprehensive information presented here provides a reference for understanding the PL mechanism of sorghum and provides some important candidate major genes related to PL. This study laid the foundation for subsequent gene functional verification and mechanism analysis of sorghum peduncle length major genes. Full article

Infertility is a prevalent clinical issue which disrupts normal human life and exerts an impact on fertility rates within the population. The increase in environmental pollutants, including acetyl tributyl citrate (ATBC), has given rise to concerns regarding their potential toxicity in infertility-related disorders. Icariin exhibits therapeutic effects on infertility, yet its mechanism of action against plasticiser-induced reproductive disorders remains unclear. This study aims to elucidate the potential toxicological targets and molecular mechanisms of ATBC-induced infertility, as well as the therapeutic targets and mechanisms of icariin in treating ATBC-induced reproductive disorders, through network toxicology, molecular-docking techniques and molecular dynamics simulation. Utilising the component-target database SwissTargetPrediction, the Similarity Ensemble Approach, PharmMapper, the ChEMBL database, and disease databases including the Therapeutic Target Database, OMIM, GeneCards, and DrugBank, 63 targets for ATBC-induced infertility and 33 targets for icariin treatment were identified. Screening via the STRING platform and Cytoscape 3.10.1 software yielded four core targets for ATBC-induced infertility—HSP90AA1, PIK3CA, CASP3, HRAS—and four core targets for icariin treatment—IL6, TNF, STAT3, and INS. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed that ATBC-induced infertility correlates with pathways including pathways in cancer, prostate cancer, and PI3K-Akt signalling pathways. Conversely, the core targets of icariin therapy for related reproductive disorders are closely associated with tumour-associated signalling pathways and the AGE-RAGE signalling pathway. Molecular-docking and molecular dynamics simulation further confirmed the strong binding interactions between ATBC and infertility-related targets, as well as between icariin and core targets for treating reproductive disorders. This provides a theoretical foundation for understanding ATBC’s toxicological targets and the complex molecular mechanisms underpinning icariin’s treatment of infertility. It informs the development of strategies for icariin to prevent and treat infertility caused by exposure to ATBC-containing plastics or excessive ATBC contact. Full article

To comprehend the current state and future of newborn screening (NBS), it is essential to understand its history. Over the past six decades, this well-established and exemplary population-based screening program has been guided by screening principles dating back more than half a century. Advances in laboratory and point-of-care testing, diagnostic methods, and a surge of available treatments and even cures have made it challenging to balance screening criteria that have not kept pace with the current landscape. The availability to screen as well as the demand from parents and stakeholders to screen for more and increasingly complex conditions while limiting the retention of NBS specimens and genetic material has been both exciting and challenging. This paper shares the history of NBS in the United States, followed by the development and integration of genomic sequencing as a complement to current practice. It explores evidence supporting the concomitant use of biomarker- and DNA-sequencing-based approaches for NBS, how disorders are selected for inclusion, and available treatments, and offers recommendations regarding what to consider and how to proceed in this ever-changing NBS landscape. Full article

Background: Hepatitis B and C remain a major public health challenge in Greece, particularly amid demographic shifts, migration, and evolving socioeconomic conditions. Updated epidemiological data are essential to guide public health planning and prevention strategies. Methods: A repeated cross-sectional study was conducted among adults (n = 36,085) attending the General Hospital of Nikaia “Agios Panteleimon”, Piraeus, Greece, from 2018 to 2024. Participants consisted of inpatients and outpatients, including recognized high-risk groups. Serological markers assessed current hepatitis B infection (HBsAg) and past or recent hepatitis C exposure (anti-HCV). Associations were examined using univariate and multivariate logistic regression, reporting adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: Overall prevalence was 4.65% for HBsAg (n = 1677) and 6.6% for anti-HCV (n = 2378). Females had significantly lower odds compared to males for both markers (HBsAg aOR = 0.24, anti-HCV aOR = 0.77, both p < 0.001). Anti-HCV prevalence declined with age, with the ≥70 group showing the lowest odds (aOR = 0.24, p < 0.001). For HBsAg, older age groups also showed reduced odds, particularly ages 60–69 (aOR = 0.49, p < 0.001) and ≥70 (aOR = 0.75, p = 0.005). Compared to Attica region, most regions had significantly lower odds of both infections, including Thrace (HBsAg aOR = 0.08; anti-HCV aOR = 0.32, both p < 0.001), Crete (HBsAg aOR = 0.13; anti-HCV aOR = 0.35, both p < 0.001), and Macedonia (HBsAg aOR = 0.37; anti-HCV aOR = 0.64, both p < 0.001). Compared to 2018, the odds were markedly higher in 2023 and peaked in 2024 for both infections (anti-HCV aOR = 1.78; HBsAg aOR = 3.10, both p < 0.001 for 2024). High-risk social groups demonstrated substantially elevated odds of anti-HCV (aORs 3.9–5.51, all p < 0.001), but had lower odds of HBsAg (aORs 0.32–0.60, all p ≤ 0.001). Conclusions: Increasing prevalence trends, regional disparities, and pronounced differences among vulnerable groups highlight the urgent need for strengthened screening, vaccination, and targeted hepatitis B and C prevention strategies, particularly among healthcare-attending and high-risk populations in Greece. Full article

Hepatitis E virus (HEV) is recognized as one of the leading causes of acute viral hepatitis (AVH) in developing countries, where it is primarily transmitted through the consumption of contaminated food and water. Although often self-limiting, HEV infection poses a significant public health concern, particularly among pregnant women, due to its potential complications. The present study aimed to determine the seroprevalence of HEV infection in asymptomatic antenatal women attending a tertiary care center in South Punjab, Pakistan. A total of 100 asymptomatic pregnant women were screened for anti-HEV antibodies (IgM and IgG) using an ELISA kit (DIA PRO, Italy). The overall seropositivity rate was found to be 12%, indicating prior exposure to HEV infection in this cohort. Specifically, IgG antibodies were detected in 6% of women and IgM antibodies in 5%, while two women showed evidence of both IgG and IgM positivity, suggestive of recent or ongoing infection. Notably, the majority of participants reported reliance on untreated water sources irrespective of educational background, highlighting environmental risk factors. Although HEV is generally self-limiting, these findings underscore the importance of routine serological screening in antenatal populations to prevent adverse pregnancy outcomes. In addition, increased community awareness regarding transmission routes and preventive measures is essential. Given the scarcity of regional data, this study emphasizes the need for larger-scale epidemiological investigations to better understand the burden of HEV in South Punjab, Pakistan. Full article