Search Results (185)

Background: Cardiac involvement is common in Fabry disease (FD) and typically manifests with left ventricular hypertrophy (LVH). Patients with FD are frequently misdiagnosed, and this is mainly related to the lack of disease awareness among clinicians. The aim of this study was to determine whether providing a targeted educational intervention on FD may enhance FD diagnosis. Methods. This research was designed as a single-arm before-and-after intervention study and evaluated the impact of providing a specific training on FD to cardiologists from different Italian centers, without experience in rare diseases. In the 12-month period after the educational intervention, the rate of FD screening and diagnosis was assessed and compared with those conducted in the two years preceding the study initiation. Results: Fifteen cardiologists participated to this study, receiving a theoretical and practical training on FD. In the two previous two years, they conducted 12 FD screening (6/year), and they did not detect any cases of FD. After the training, they performed 45 FD screenings, with an eight-fold rise in the annual screening rate. The screened population (age: 61 ± 11 years, men: 82%) was mainly composed of patients with unexplained LVH (n = 43). There were four new FD diagnoses and, among of them, three had a late-onset GLA variant. After the cascade genetic screening, 11 affected relatives and 8 heterozygous carriers were also detected. Conclusions: A targeted educational intervention for cardiologists allowed the identification of four new families with FD. Enhancing FD awareness is helpful to reduce the diagnostic and therapeutic delay. Full article

Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of antenatal psychosocial risk using the validated Antenatal Risk Questionnaire–Revised (ANRQ-R) in a nationally underrepresented population. Methods: A cross-sectional survey was conducted among 216 third-trimester pregnant women in Bulgaria. Data on sociodemographic characteristics, health behaviours, and reproductive history were collected. Multivariate logistic regression identified predictors of elevated psychosocial risk. Results: A total of 65.7% of participants met the criteria for elevated psychosocial risk. Significant risk factors included passive smoking exposure during pregnancy (OR = 5.03, p < 0.001), physical activity prior to pregnancy (OR = 1.81, p = 0.004), and a family history of hereditary disease (OR = 42.67, p < 0.001). Protective factors were better self-rated current health (OR = 0.37, p = 0.004), the presence of chronic illness (OR = 0.42, p = 0.049), previous childbirth experience (OR = 0.11, p = 0.032), and residence in Northwestern Bulgaria (OR = 0.31, p = 0.028). Despite the high prevalence of psychosocial vulnerability, only 9.5% of affected women sought professional help. Conclusions: While our findings point to important unmet needs in antenatal mental health, further research is required before national screening policies can be implemented. Pilot programs, cultural validation of tools, and system-level readiness assessments should precede broad adoption. Full article

Background: The mental health of physicians has become a pressing global concern. High rates of depression, anxiety, and burnout are reported in the literature, with each condition linked to reduced job satisfaction, increased medical errors, and ultimately suicidal ideation (SI). Although research on physicians’ mental health is emerging in Saudi Arabia, data on suicidality remain scarce. Objective: This study aims to determine the prevalence of SI and its determinants among physicians in Saudi Arabia. Methods: A cross-sectional study was conducted with 423 physicians across all medical specialties of all ranks, who were recruited using a convenience sampling technique. The study tool comprised three main sections. The first section included questions regarding sociodemographic factors, lifestyle, and work-related factors. The second section included items on suicidality and the Patient Health Questionnaire-9 to screen for depressive symptoms. The third section included the Brief Resilient Coping Scale (BRCS) to measure the coping mechanisms of the participants. Results: SI was disclosed by 9.7% of the respondents, with 0.5% reporting previous suicide attempts. Suicidal ideation was independently associated with low income (OR = 3.94, 95% CI 1.32–11.76, p = 0.014) and higher depression scores (OR = 1.09 per point, 95% CI 1.02–1.16, p = 0.008). Moreover, knowing a colleague with suicidal behavior (i.e., knowing a colleague who had contemplated suicide or had attempted suicide/died by suicide) was significantly associated with SI among our participants (p < 0.001 and p < 0.006, respectively). Higher scores on the BRCS, specifically with respect to growing from adversity and actively replacing losses, were linked to lower odds of SI (p < 0.001 and p < 0.045, respectively). Conclusions: Physicians in Saudi Arabia experience an alarming level of SI that is associated with low income and depression. The results of this study underscore the importance of additional research to evaluate the effectiveness of intervention programs designed to enhance mental health support for physicians, encourage adaptive coping mechanisms, foster peer support networks, and combat stigma associated with mental illnesses. Full article

The COVID-19 pandemic is considered a potentially traumatic event, as it introduced new challenges and threats to people around the world, disrupting daily life due to the restrictions imposed. The psychological defenses of individuals mobilized to deal with stress reactions are influenced by a set of factors, including previous traumatic experiences, which can amplify the current trauma. Recognizing that people exposed to adverse childhood experiences (ACEs) have increased risks of an array of adverse mental and physical health outcomes throughout life, the present study aimed to investigate the relationship between ACEs—more specifically, child abuse and child neglect—and PTSD symptoms in a sample of European adults during the pandemic. A sample of 8459 participants (67.1% female and 32.9% male, with a mean of 43.95 years old) was evaluated. The survey questionnaire included questions on sociodemographic and clinical characteristics, the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and the Adverse Childhood Experiences (ACEs) questionnaire. According to our findings, younger women who have suffered from child abuse or child neglect are more likely to develop PTSD symptoms. The most significant factor influencing the PTSD risk was child neglect, contrary to many studies that indicate that child abuse is the most impactful adverse childhood experience. Full article

Improved medical treatments have extended survival and life expectancy in adults with congenital heart defects (ACHD), placing greater emphasis on psychosocial health. Up to one-third of ACHD experience anxiety or depression, and half develop a mental illness during their lifetime. While there is solid evidence on the prevalence of mental health, many do not receive psychological, psychotherapeutic, or psychiatric treatment (PST) and the psychological care situation remains understudied. In a nationwide, online cross-sectional survey conducted in Q1 2024, 1486 ACHD aged 18 to 85 (M_age = 36.84 years; 60.8% female) registered in the German National Register for Congenital Heart Defects (NRCHD) completed self-report questionnaires on sociodemographics, illness identity (Illness Identity Questionnaire), mental well-being, and utilisation of PST. CHD diagnoses were determined in conformity with the International Pediatric and Congenital Cardiac Code (IPCCC) and CHD was classified according to Warnes et al. (simple/moderate/complex). Analyses included chi-square tests, t-tests, and binary logistic regression. Overall, 32.8% of participants reported current and/or previous PST (women 37.5%, men 25.3%). PST utilisation was significantly higher in those with complex (40.2%) compared to moderate (29.6%) and simple CHD (25.3%) (ps < 0.01). Primary treatment reasons were mental illness (41.7%) and CHD-related concerns (37.2%). Nearly half of treatments were self-initiated (45.8%) and about one-third were physician-recommended (30.8%). Logistic regression revealed CHD severity as a significant predictor of PST use (ps < 0.05), with lower odds for simple (OR = 0.48) and moderate (OR = 0.66) compared to complex CHD when controlling for sex (p < 0.001, OR = 1.87), age (p = 0.022, OR = 1.011), education level (ps between 0.060 and 0.780), and net income (ps < 0.05). Those receiving PST showed significantly higher maladaptive illness-identity scores (engulfment, rejection) and lower acceptance. Approximately one in three ACHD requires mental health support, particularly those with complex CHD. The CHD itself acts as a key stressor and treatment motivator. Findings underscore the need for integrated care linking cardiological and psychosocial services. Routine screening for psychological distress and low-threshold access to PST—also for patients with simple and moderate CHD—are essential to identify and address mental health needs early. Full article

Low-quality power grid image data can greatly affect the effect of deep learning in the power industry. Therefore, adopting accurate image quality assessment techniques is essential for screening high-quality power grid images. Although current blind image quality assessment (BIQA) methods have made some progress, they usually use only one type of feature and ignore other factors that affect the quality of images, such as noise and brightness, which are highly relevant to low-quality power grid images with noise, underexposure, and overexposure. Therefore, we propose a multi-dimension distortion feature network (MDFN) based on CNN and Transformer, which considers high-frequency (edges and details) and low-frequency (semantic and structural) features of images, along with noise and brightness features, to achieve more accurate quality assessment. Specifically, the network employs a dual-branch feature extractor, where the CNN branch captures local distortion features and the Transformer branch integrates both local and global features. We argue that separating low-frequency and high-frequency components enables richer distortion features. Thus, we propose a frequency selection module (FSM) which extracts high-frequency and low-frequency features and updates these features to achieve global spatial information fusion. Additionally, previous methods only use the CLS token for predicting the quality score of the image. Considering the issues of severe noise and exposure in power grid images, we design an effective way to extract noise and brightness features and combine them with the CLS token for the prediction. The results of the experiments indicate that our method surpasses existing approaches across three public datasets and a power grid image dataset, which shows the superiority of our proposed method. Full article

Oxidative stress plays a crucial role in the development and progression of various diseases. Antioxidant peptides have attracted great attention in agricultural, food, and clinical fields due to their low toxicity, high efficacy, and easy absorption, but the development of antioxidant peptides and their in-depth molecular mechanisms are still lacking. The previous study established a platform for the high-throughput design and screening of multifunctional peptides and successfully identified a novel hybrid peptide, VLP-Aβ (VA), which exhibits both antioxidant and immunomodulatory properties. This study aimed to evaluate the antioxidant activity of VA and investigate the underlying molecular mechanisms. The antioxidant effects of VA were evaluated using both in vitro (H₂O₂-induced oxidative damage in HepG2 cells) and in vivo (CCl₄-induced liver damage in mice) models. VA exhibited significant antioxidant activity both in vitro and in vivo, significantly improving the cell viability and increasing the levels of antioxidant enzymes (SOD, CAT, GSH-Px) to alleviate oxidative stress. These findings indicated that the antioxidant effect of VA is dependent on NRF2, as evidenced by NRF2 knockdown experiments. Further investigation revealed that VA alleviates oxidative stress by modulating the KEAP1-NRF2-ARE signaling pathway. These findings provide insights into the properties of the antioxidant peptide VA, expand the understanding of its molecular mechanisms, and suggest new opportunities for developing VA as a novel functional agent in the agricultural, food, and clinical industries. Full article

The role of blind endometrial sampling, in the era of hysteroscopy-guided biopsy, can be only considered as a screening tool or a first-line approach if a hysteroscopy cannot be performed for whatever reason. Several devices are available, with Perma (a sharp-edged spatula sliding inside a flexible cannula) being one of them. Objectives: The aims of this study were to compare the concordance of blind to visual endometrial sampling, and the influence of operators’ experience on the results. Materials and Methods: Women undergoing hysteroscopy were invited to undergo a Perma biopsy as well. If accepted, a Perma sampling was performed before the hysteroscopy and only if there was no cervical dilatation (as an office setting). The operator was randomly chosen between expert (two staff members) and non-expert (two residents) operators. All cases were collected at the AOU Maggiore della Carità, Novara, Italy. Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD. The association between categorical variables was evaluated using Fisher’s exact test. Clinical outcomes were analyzed, and the results were first compared within the same patient and subsequent within the doctors’ group (inter- and intra-variation) in terms of Cohen’s Kappa. Results: 82 women performed both hysteroscopy and Perma. A sensitivity of 81.8% and specificity of 100% was found when Perma was compared to hysteroscopy (the gold standard). The comparison between valid vs. invalid samples in terms of sufficient evaluable tissue was not significant (p = 0.583). There are no statistical associations with body mass index, parity, or previous intrauterine surgery related to the outcomes of hysteroscopy and Perma. Cohen’s Kappa between non-experts was 0.43 (moderate), between experts was 0.30 (fair), with the highest concordance being between one non- and one expert (0.68 = substantial). Perma represents a pragmatic diagnostic tool, which could also be used in outpatient. Full article

Accurate and efficient acquisition of the acoustic reflection properties of sediments with different grain sizes is key for sediment substrate classification and the construction of seafloor acoustic scattering models. To accurately measure surface sediments on the seafloor, an in-depth investigation of the acoustic properties of sediments with different grain sizes at different measurement distances is an indispensable prerequisite. While previous studies have extensively explored the acoustic reflection properties of sediments in mid- and low-frequency bands (e.g., 6–85 kHz), research on high-frequency reflectivity (95–125 kHz) remains limited. Existing equipment often suffers from large beam angles (e.g., >10°), leading to challenges in standardising laboratory measurements. To this end, we developed a technique using a high-frequency submersible sub-bottom profiler (HF-SSBP) to measure the high-frequency reflection intensity of homogeneous sediments screened by grain size. To ensure stable measurements of the high-frequency reflection intensity, we conducted experiments using standard acrylic plates. This demonstrates the dependability of the HF-SSBP and determines the absolute measurement error of the HF-SSBP. Variations in radiofrequency reflection intensity across different sediment types with different grain sizes in a frequency range of 95–125 kHz were investigated. The reflectance amplitude was measured and the reflectance coefficients were calculated for six uniform sediments with different grain sizes ranging from 0.1–0.3 to 2.0–2.5 mm. The scattering intensity of the six sediments with a uniform grain size distribution at the same measurement distance varies to some extent. There is variation in the intensity of acoustic wave reflections for different grain sizes, but some of the differences are not statistically significant. The dispersion coefficients of the acoustic reflection intensities for all sediments, except for those with a grain size of 1.0–1.5 mm, are less than 5% at different measurement distances. These coefficients are almost independent of the detection distance. Full article

Very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD) is due to a defect in metabolism of long-chain fatty acids. Infants with VLCADD may experience cardiomyopathy, hypoglycemia, or even death; thus, early detection and intervention is crucial. The spectrum of disease and natural variation in newborn metabolism, however, lead to overlap in acylcarnitine values between affected and unaffected individuals, which contributes to the difficulty in identifying true positive cases while minimizing false positive cases. VLCADD was added to the state of Wisconsin’s newborn screening (NBS) panel in 2000. A previous retrospective review of VLCADD screen positive cases identified between 2000 and 2014 resulted in a change to the screening algorithm. Following implementation, a reduction in the percentage of false positive screens from 25.3% to 20.4% was observed between 2015 and 2021. The overall PPV also decreased, from 37.2% to 28%, due to an increase in the number of carriers identified (27.5% of cases in 2000–2014 and 51.8% of cases in 2015–2021). A data review also identified three long-chain acylcarnitine elevations (C14:1, C14:1/C16, and C14:1/C2) that had statistically significant differences in concentrations in true positive populations versus false positive populations. Utilization of the C14:1, C14:1/C16, and C14:1/C2 values in newborn screening may provide clearer distinction between true positive and carrier populations and additionally increase the PPV of this screen. Full article

The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite establishing a theoretical basis for ligament restoration through PBM, identifying effective LED wavelength combinations and ensuring safety in animal models remain unresolved challenges. In our previous study, we demonstrated that combined irradiation at 630 nm and 880 nm promotes cell proliferation and migration, which are critical processes during the early stage of tendon healing in human-derived tendon fibroblasts. Based on this, we hypothesized that 630/880 nm LED-based PBM might promote rapid healing during the initial phase of tendon healing, and we aimed to analyze the results after PBM treatment in a murine model. Migration kinetics were analyzed at two specific wavelengths: 630 and 880 nm. The Achilles tendon in the hind limbs of Balb/c mice was severed by Achilles tendon transection. Subsequently, the mice were randomized into LED non-irradiation and LED irradiation groups. Mice with intact tendons were employed as healthy controls. The total number of mice was 13 for the healthy and injured groups and 14 for the LED-irradiated injured group, and the data presented in this manuscript were obtained from one representative experiment (n = 4–5 per group). The wounds were LED-irradiated for 20 min daily for two days. Histological properties, tendon healing mediators, and inflammatory mediators were screened on day 14. The roundness of the nuclei and fiber structure, indicating the degree of infiltrated inflammatory cells and severity of fiber fragmentation, respectively, were lower in the LED irradiation group than in the LED non-irradiation group. Immunohistochemical analysis depicted an increase in tenocytes (SCX⁺ cells) and recovery of wounds with reduced fibrosis (lower collagen 3 and TGF-β1) in the LED irradiation group during healing; conversely, the LED non-irradiation group exhibited tissue fibrosis. Overall, the ratio of M2 macrophages to total macrophages in the LED irradiation group was higher than that in the injured group. LED-based PBM in the Achilles tendon rupture murine model facilitated a rapid restoration of histological and immunochemical outcomes. These findings suggest that LED-based PBM presents remarkable potential as an adjunct therapeutic approach for tendon healing and warrants further research to standardize various parameters to advance and establish it as a reliable treatment regimen. Full article

Alfalfa (Medicago sativa L.) is an outstanding species used for the remediation of heavy metal-contaminated soil, and our previous research has shown that PGPR can promote plant growth under high-concentration lead stress. This discovery has forced scientists to search for PGPR strains compatible with alfalfa to develop an innovative bioremediation strategy for the remediation of lead-contaminated soil. This study used lead-tolerant rhizosphere soil of red clover as experimental material; cultured, isolated, and screened 52 excellent lead-tolerant bacteria that promote rhizosphere growth; and then inoculated them into alfalfa. Marked differences existed in the secretion of auxin, protease, and ACC deaminase among these strains. The results indicated that Pseudomonas spp. (strain Y2), Pseudomonas spp. (strain Y22), and Bacillus spp. (strain Y23) exhibited a strong growth-promoting ability in alfalfa, and there was no antagonistic reaction among the three strains, enabling their coexistence. The pot experiment manifested that strains Y2, Y22, Y23, and YH (a mixture of Y2, Y22, and Y23) could increase the plant height, root length, fresh and dry weight above ground, and fresh and dry weight below ground of alfalfa. They could all significantly raise the chlorophyll content and antioxidant enzyme activity in alfalfa (p < 0.05) and the content of malondialdehyde (MDA) in alfalfa. Furthermore, the concurrent inoculation of three distinct types of plant growth-promoting rhizobacteria (PGPR) significantly diminished lead (Pb) concentrations in rhizosphere soil, enhanced the levels of available potassium (AK) and available phosphorus (AP), and augmented the capacity of plants to absorb Pb. The results imply that PGPR can be employed to facilitate plant growth and microbial-assisted remediation of lead and other heavy metal-contaminated soil and establish a basis for further research on the growth-promoting mechanism of PGPR in plants. Full article

Colorectal cancer (CRC) ranks third in terms of global cancer prevalence and is the second most common cause of cancer-related mortality. Although CRC rates are decreasing in the United States, inequalities still exist despite the effectiveness of invasive screening methods, such as colonoscopy, flexible sigmoidoscopy, and computed tomography (CT) colonography in detecting colorectal cancer. Many current interventions promoting CRC screening do not utilize a modern theory-based approach, which has led to the low utilization of these screening methods. This cross-sectional study aims to address the lack of theory-based treatments for promoting visual CRC screening examinations by applying the multi-theory model (MTM) of health behavior change to explicate the health-related factors for individuals to seek visual colorectal cancer screening examinations for CRC screening. A 57-item validated questionnaire assessing MTM constructs and CRC screening was administered online. The survey questionnaire was administered to a sample of 640 adults from the United States. The participants were between the ages of 45 and 75 years. Hierarchical multiple regression was used to assess the relationship between MTM constructs with the initiation and sustenance of CRC screening behaviors. Out of the total participants in this nationwide sample, 71.4% (n = 457) reported that they had undergone a visual CRC screening examination. MTM subscales, specifically participatory dialogue, changes in the physical environment along with age, recommendation for CRC screening from a healthcare provider, and previous experience with colonoscopy, were found to be significant factors in predicting the initiation of visual CRC screening behavior. These factors accounted for 22% of the variation in initiation among this group (R² = 0.222, F = 3.521, p < 0.001). The MTM can be a valuable framework for designing educational media, information media, social media platforms, and clinical interventions to promote visual colorectal cancer screening examinations. Full article

Trianthema portulacastrum L. (Aizoaceae), commonly known as desert horse purslane or black pigweed, is a C4 dicot succulent invasive annual plant that is widespread in agricultural fields in Southeast Asia, tropical America, Africa, and Australia. In Israel, Trianthema portulacastrum is an invasive weed of increasing importance in agricultural fields, including mainly corn, tomato, alfalfa watermelon, and groundnut crops. The significance of this weed in crops has been recently reported in neighboring countries of Jordan and Egypt. In previous studies, we have examined and described the spread, biology, and germination requirements of Trianthema portulacastrum in Israel. The present study aimed to investigate the efficiency of single pre- and post-emergence herbicides and the combination of pre-applied herbicides for the control of this invasive weed in pots in a nethouse. We conducted three sequential experiments in a nethouse: (1) screening of pre-emergence herbicides, (2) screening of post-emergence herbicides, and (3) assessment of residual activity of combined pre-emergence herbicides in three distinct Hula Valley soil types. Efficacy was evaluated through weekly assessments of seedling emergence and vigor, with the final shoot fresh weight determined upon the experiment’s completion. In all experiments, weekly counts and vigor estimation of T. portulacastrum seedlings were conducted, and shoot fresh weights were determined at the end of the experiments. The results of pre-emergence herbicide screening showed that Fomesafen, Terbutryne, Flurochloridon, Sulfosulfuron, Cyrosulfamid + Izoxaflutole, and Dimethenamid were the most effective herbicides, leading to complete eradication of T. portulacastrum plants. Results of the post-emergence screening revealed that Saflufenacil, Foramsulfuron, Tembotrione + Isoxdifen-ethyl, and Rimsulfurom Methyl completely controlled the weed. In the soil residual study, three herbicide combinations (Fomesafen + Terbutryn, Sulfosulfuron + Fomesafen, and Dimethenamid + Flurochloridon) provided effective control across all soil types. These findings provide a foundation for future field trials investigating integrated pre- and post-emergence herbicide programs for T. portulacastrum management in various crops. Full article

Acarbose, a pseudo-tetrasaccharide produced by Actinoplanes sp. SE50/110, is an α-glucosidase inhibitor and is used as a medication to treat type 2 diabetes. While the biosynthesis of acarbose has been elucidated, little is known about its regulation. Gene silencing using CRISPRi allows for the identification of potential regulators influencing acarbose formation. For this purpose, two types of CRISPRi vectors were established for application in Actinoplanes sp. SE50/110. The pCRISPomyces2i vector allows for reversible silencing, while the integrative pSETT4i vector provides a rapid screening approach for many targets due to its shorter conjugation time into Actinoplanes sp. These vectors were validated by silencing the known acarbose biosynthesis genes acbB and acbV, as well as their regulator, CadC. The reduction in product formation and the diminished relative transcript abundance of the respective genes served as evidence of successful silencing. The vectors were used to create a CRISPRi-based strain library, silencing 50 transcriptional regulators, to investigate their potential influence in acarbose biosynthesis. These transcriptional regulatory genes were selected from previous experiments involving protein–DNA interaction studies or due to their expression profiles. Eleven genes affecting the yield of acarbose were identified. The CRISPRi-mediated knockdown of seven of these genes significantly reduced acarbose biosynthesis, whereas the knockdown of four genes enhanced acarbose production. Full article