Search Results (9,306)

Background/Objectives: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are priority antimicrobial-resistant pathogens with significant implications for food safety and public health. Food-producing animals and their derived products represent a key interface for zoonotic transmission, yet prevalence data across Nigeria remain fragmented and unsynthesized. This systematic review and meta-analysis assessed the prevalence, species distribution, geographical patterns, and detection methods of ESBL-producing E. coli in food-producing animals and animal-derived food products across Nigeria. Methods: A comprehensive search of PubMed, Web of Science, Scopus, and African journals online was conducted for studies published between January 2000 and January 2026, following PRISMA 2020 guidelines. Twenty eligible studies collectively analyzed 5104 samples, and 984 ESBL-positive isolates were included in the meta-analysis. Results: The overall pooled prevalence of ESBL-producing E. coli was 17.0% (95% CI: 13.0–21.0%; I² = 89.4%). Subgroup analysis by animal species revealed the highest pooled prevalence among caprine (32.0%, 95% CI: 17.0–52.0%), bovine (24.0%, 95% CI: 17.0–33.0%), porcine (17.0%, 95% CI: 7.0–36.0%) and avian species (13.0%, 95% CI: 9.0–19.0%). Animal-derived food products showed a pooled prevalence of 19.0% (95% CI: 17.0–21.0%). Regional analysis showed the highest pooled prevalence in South-West (19.0%, 95% CI: 13.0–27.0%) and South-South (19.0%, 95% CI: 9.0–34.0%). Studies using combined culture and molecular methods reported higher pooled prevalence (19.0%, 95% CI: 14.0–25.0%) than culture alone (12.0%, 95% CI: 8.0–18.0%). However, the difference between subgroups was not statistically significant (test for subgroup differences: p = 0.0563). Conclusions: These findings confirm extensive ESBL-producing E. coli circulation in Nigerian food-producing animals and highlight critical gaps in antimicrobial stewardship, veterinary surveillance, and food safety infrastructure, underscoring the urgent need for coordinated One Health strategies to contain the spread of resistant strains through the food chain. Full article

Endothelial dysfunction (ED) arises in multiple pathologies, and its severity correlates with disease progression. Common ED biomarkers could provide prognostic value for associated complications. This study aims to identify shared ED biomarkers and assess their prognostic significance. Endothelial cells in culture (human microvascular endothelial cells, HMEC-1) were exposed to sera from patients in five disease groups (n = 20 patients/group)—liver cirrhosis with portal hypertension, idiopathic pulmonary arterial hypertension, placental disorders such as intrauterine growth restriction, coronary artery disease with acute myocardial infarction, and chronic kidney disease—or matched controls, in the absence/presence of anti-inflammatory (apixaban) and antioxidant (EUK134) compounds. We explored changes in: VCAM-1, ICAM-1, eNOS, VWF, extracellular matrix thrombogenicity, and reactive oxygen species (ROS). In serum samples, proteomics and metabolomics analyses (including lipids, amino acids, and polar metabolites) were performed through an extraction protocol to identify common ED biomarkers. Expression of VCAM-1, ICAM-1, VWF, platelet adhesion, and ROS increased in most groups versus controls (p < 0.05). Both drugs decreased all biomarker levels except eNOS (n = 6 for in vitro experiments). For serum ED biomarkers, 18 metabolites and 24 proteins showed AUC-ROC and hit rates >77.5%, and six metabolites were associated with event-free survival. These diseases share ED driven by systemic inflammatory, oxidative, and metabolic stress, are partially reversible in vitro, and are linked to biomarkers associated with clinical outcomes. Overall, ED emerges as a modifiable pathological axis with potential prognostic value. Full article

Background: Haitian immigrants in the United States face health literacy challenges related to recent migration, language discordance, and unfamiliar healthcare systems, yet no general health literacy instrument has been psychometrically validated in Haitian Creole. This study translated, culturally adapted, and evaluated the Haitian Creole HLS₁₉-Q12 (HLS₁₉-Q12-HC). Methods: Haitian Creole-speaking adults without cancer diagnoses in South Florida (n = 168) completed the HLS₁₉-Q12-HC and the Haitian Creole Brief Health Literacy Screen. Translation included forward–backward procedures, expert review, and cognitive interviews (n = 7). Psychometric evaluation used confirmatory factor analysis, reliability testing, and assessment of convergent and known-groups validity. Results: Cognitive interviews supported clarity and cultural appropriateness with minor refinements. Reliability was excellent (ω = 0.949; α = 0.944; AVE = 0.584). The unidimensional model showed good fit (CFI = 0.951; TLI = 0.944; RMSEA = 0.065; SRMR = 0.048), whereas multi-factor models showed limited discriminant validity. Convergent and known-groups validity were supported. Using provisional European-derived cutpoints, 70.2% of participants were classified as having inadequate or problematic health literacy. Conclusions: The HLS19-Q12-HC showed evidence of reliability and validity as a unidimensional measure of general health literacy and may support research, needs assessment, and culturally responsive interventions for Haitian Creole-speaking populations. Findings should be interpreted in light of the convenience sample from South Florida and the predominantly female composition of the cohort. Full article

The digital transformation of healthcare requires stronger digital competencies among pharmacists, yet evidence on the effectiveness of structured training remains scarce. This study examines the impact of a blended digital health training programme delivered to practicing pharmacists in Bihor County, Romania, as part of the Romanian pilot of the EU-funded European Health Professionals’ and the DigitAl team SkillS (H-PASS) project. A single-group pre–post educational design was applied to pharmacists from Bihor County, Romania, participating in a modular digital health training programme delivered between May and July 2025. A total of 84 pharmacists completed both pre-training and post-training self-reported competency assessments comprising 18 items across three modules: digital innovation and change management, communication and collaboration, and data management and digital literacy. Paired samples t-tests, Cohen’s d effect sizes, Cronbach’s alpha, moderator analyses, and ceiling effect analyses were conducted using Python-based statistical workflows. Statistically significant improvements were observed across all three modules (all p < 0.0001), with large effect sizes (d = 1.04–1.30). Post-training internal consistency increased substantially, with overall Cronbach’s alpha reaching 0.74. The greatest item-level gains were recorded in adaptive communication, cultural adaptation of care, and data protection ethics. No significant moderation effects were found for age, gender, or years of experience. Course satisfaction showed a moderate positive correlation with competency gains (r = 0.528), while perceived improvement was not significantly associated with observed score change. A ceiling effect indicated greater gains among participants with lower baseline competencies. The Romanian implementation of the H-PASS training programme was associated with improved self-reported digital health competencies among practicing pharmacists, high-lighting its potential as a scalable model for digital upskilling in healthcare. Full article

The tourism industry is a wide and holistic industry, the value of which cannot be overestimated: it plays a key role in promoting inter-cultural understanding and socio-cultural development. Sri Lanka is a renowned tourism destination that offers many diverse tourism products. However, the tourism industry has been continuously and severely disturbed by prolonged civil war. After the war, tourist arrivals in Sri Lanka, particularly to war zones and war memorial sites, rapidly grew. The main objective of this study is to explore dark tourism development in the Northern Province (NP), Sri Lanka. Employing a qualitative methodological approach, this study is underpinned by an interpretive research philosophy. Research data were collected through field-based interviews. For in-depth interviews, sixteen interviewees from different stakeholder groups were selected, using a purposive sampling technique. The research results reveal that twenty-seven dark tourism destinations in the northern territory face various challenges in being developed as sustainable dark tourism destinations. Furthermore, this study indicates that the Sri Lankan Army was aggressively involved in the revitalization of the tourism industry in the northern territory. This research recommends the following moves intended to promote dark tourism development in the NP. First and foremost, when developing dark tourism in the NP, the active participation of locals should be accommodated. Second, rituals must be taken into account as a key mechanism for impressing upon tourists the richness and historical value of dark sites. When developing dark tourism packages, death-related rituals ought to be considered. If so, travelers can experience amazing intangible heritage associated with death. Full article

Petroleum contamination of soils remains a significant environmental problem in boreal regions, where low temperatures constrain natural attenuation processes and complicate bioremediation. Nitrogen biostimulation is widely used to enhance petroleum hydrocarbon degradation; however, the combined effects of temperature regime, nitrogen form, contamination level, and nitrogen dosage remain insufficiently resolved for sandy podzolic soils of northern regions. This study investigated nitrogen-assisted biostimulation of petroleum-contaminated sandy podzolic soil collected in the Khanty–Mansi Autonomous Okrug (Western Siberia, Russia) using a factorial experimental design. Soil samples were artificially contaminated with crude oil at concentrations of 25, 50, and 100 g kg⁻¹ and incubated under warm and cold temperature regimes. Two nitrogen sources, urea and ammonium nitrate, were applied at several dosages. Changes in residual petroleum hydrocarbon content were monitored together with the abundance of culturable microorganisms under the applied cultivation conditions at the intermediate contamination level on day 60. Nitrogen supplementation enhanced petroleum hydrocarbon removal relative to the untreated control, but the magnitude of the effect depended substantially on temperature, nitrogen form, and contamination level. Under the tested conditions, ammonium nitrate was generally associated with stronger hydrocarbon removal than urea, particularly at the intermediate contamination level (50 g kg⁻¹). The results indicate that the response to nitrogen biostimulation in sandy boreal soils is controlled by interacting experimental factors rather than by nitrogen addition alone. These findings improve the positioning of nutrient-assisted remediation in cold-region soils and provide a basis for future mechanistic and field-scale studies. Full article

Human parainfluenza virus type 4 (hPIV4) remains poorly characterized compared with other hPIV serotypes and information on its genomic diversity is particularly limited for Russia and Eastern Europe. In this study, we report the first complete genome sequences of hPIV4 isolates from Russia and place them in the context of global hPIV4 genetic diversity. Eight hPIV4 viruses were isolated in cell culture from respiratory samples collected from hospitalized children in Saint Petersburg between 2017/2018 and 2023/2024. Complete viral genomes were recovered using a metagenomic whole-genome amplification approach based on SMART-9N technology. Phylogenetic analysis of 178 complete hPIV4 genomes showed clear separation into hPIV4a (n = 132) and hPIV4b (n = 46) subtypes. Based on genetic distance approach, hPIV4a formed two major clusters, with the dominant cluster B subdivided into four subclusters (B1–B4); and subcluster B4 further resolved into four genetic lineages. All Russian isolates belonged to the subcluster B4 and were distributed among multiple co-circulating lineages. In contrast, hPIV4b genomes segregated into three distinct clusters, reflecting structured genetic diversity within the subtype. Collectively, this study provides, to the best of our knowledge, the first p-distance-based framework for hPIV4 whole-genome classification and contributes new complete genome sequences for an underrepresented region. Full article

This study examines whether the association between parenting styles and adolescent adjustment reflects universal principles or culturally embedded processes, comparing adolescents from Germany (n = 395) and Spain (n = 331). Grounded in the bidimensional model of parental socialization (warmth × strictness), four styles were identified: authoritative, indulgent, authoritarian, and neglectful. Participants (Mage = 15.6 years) completed measures of parental socialization (ESPA29) and multidimensional self-concept (AF5); academic achievement was obtained from school records; and substance use was self-reported. A cross-sectional design was employed. Multivariate analyses of variance that revealed warmth was positively associated with all self-concept domains and negatively with substance use, whereas strictness showed weak or negative links. Significant Parenting Style × Country interactions emerged for academic self-concept, achievement, and substance use. In the Spanish sample, indulgent parenting exhibited a distinct pattern, particularly with respect to academic self-concept. Among German adolescents, both indulgent and authoritative styles yielded favorable outcomes, with authoritative parenting demonstrating protective effects against substance use. These findings suggest that the effectiveness of the authoritative style may not be uniform across contexts and underscore the importance of cultural factors in defining optimal parenting, supporting a contextualist model of adolescent socialization across European contexts. Full article

Background/Objectives: Hepatocellular carcinoma (HCC) remains a major malignancy with high incidence and mortality, in part due to its diverse etiology and intratumoral heterogeneity, which contributes to drug resistance and frequent recurrence. SALL1 (Spalt-Like Transcription Factor 1), a zinc-finger transcription factor, was reported to function as a tumor suppressor in several cancers, including breast cancer and glioma, and accumulating evidence support its involvement in tumor biology. In this study, the role of SALL1 in HCC was examined. Methods: Public RNA and protein databases derived from human HCC were interrogated. Western blotting quantification of clinical HCC for SALL1 levels was carried out. Cell culture and xenograft studies were performed using genetically modified HCC tumor cells. Results: As revealed by pubic RNA and protein database analysis and further western blotting quantification of clinical samples of HCC, SALL1 is decreased in human HCC. The effect of reduced SALL1 expression on the tumorigenic properties and transcriptional regulation in HCC was then examined. Knockdown of SALL1 in the HCC cell lines Huh7 and Hep3B, enhanced cell proliferation in vitro and accelerated tumor growth in a xenograft mouse model, suggesting that lower SALL1 expression increases cell proliferation and tumorigenesis in HCC. RNA-seq and ChIP analyses further identified three novel candidate target genes (SLC6A14, GABRG1, and AKR1B10), suggesting that SALL1 may exert a tumor-suppressive effect, at least in part, through negative regulation of these genes. Conclusions: These findings establish SALL1 as a possible tumor suppressor and provide new insights into the biological significance of SALL1 downregulation in HCC. SALL1 could be a candidate prognostic marker and a potential therapeutic target. Full article

Wastewater surveillance is an effective approach for monitoring populations of antibiotic-resistant bacteria and tracking the spread of antimicrobial resistance (AMR) across different settings. In this study, hospital and municipal wastewater were collected monthly for 12 months from multiple locations in the greater Pittsburgh area to quantify the presence of antibiotic-resistant bacteria and investigate their genomic diversity. After quantitative culturing on six different selective media types, a total of 150 isolates were speciated by 16S rRNA sequencing, which revealed diverse pathogenic and non-pathogenic taxa, including Klebsiella spp. (n = 28), Pseudomonas spp. (n = 20) and Aeromonas spp. (n = 37). A subset of isolates (n = 46) underwent whole genome sequencing, which identified several antibiotic resistance genes of clinical concern, such as bla_KPC (n = 17), bla_NDM (n = 6) and bla_IMP (n = 6), and revealed genetic similarities between wastewater isolates and clinical isolates collected from infected patients at a Pittsburgh-area medical center. In addition, analysis of plasmids carried by wastewater isolates revealed closely related plasmids present in isolates from different species and sampling locations. Overall, these findings suggest that both hospital and municipal wastewater act as interconnected reservoirs of antimicrobial resistance. Integrating wastewater surveillance with clinical and genomic data could enable the early detection of emerging resistance threats and support proactive infection-control strategies. Full article

African swine fever (ASF) is a highly contagious and often fatal viral disease of pigs that poses serious economic consequences to the swine industry due to its high mortality rate and rapid spread. Currently, the identification of infectious ASF virus (ASFV) is the confirmatory test when clinical samples are positive for ASFV by any other diagnostic methods. Detection of infectious ASFV requires the availability of primary swine macrophage cultures as a cell substrate. We demonstrate here that cryopreserved swine primary macrophages are a suitable cell substrate for the detection, isolation and propagation of ASFV, showing similar results as when fresh swine macrophages are utilized. The possibility of using cryopreserved macrophages for detecting infectious ASFV would improve the efficacy of diagnostics in ensuring the availability of macrophage cell cultures during an emergency response. Full article

Tuberculosis (TB) remains a major global cause of morbidity and mortality. Current tools for monitoring treatment response rely on sputum-based microscopy and culture, which are often insensitive, time-consuming, and impractical in extrapulmonary or pediatric TB and in individuals unable to produce sputum. Metabolomics has emerged as a promising approach for identifying host-derived biomarkers that reflect treatment-associated immunometabolic changes; however, the available evidence remains heterogeneous and has not been comprehensively synthesized. We conducted a comprehensive literature review of human studies evaluating metabolomic biomarkers in relation to TB treatment response or outcomes. PubMed, Scopus, and EMBASE were searched for human studies evaluating targeted or untargeted metabolomics (NMR, LC-MS, GC-MS, CE-MS) in relation to treatment response or outcomes. Two reviewers independently screened studies, extracted data, and assessed risk of bias using QUIPS and PROBAST. Findings were synthesized using a structured framework organized across treatment stages and outcomes. Of 218 records identified, 139 titles and abstracts were screened and 42 full texts assessed; 15 studies met the inclusion criteria. Recurrent treatment-associated signals involved amino acid metabolism, particularly the tryptophan–kynurenine pathway, as well as vitamin and cofactor metabolites (pyridoxate, nicotinamide, trigonelline). Plasma studies frequently reported lipid remodeling and bile acid perturbations, whereas urine studies highlighted polyamine metabolism (e.g., N¹,N¹²-diacetylspermine) and fatty acid β-oxidation markers. Common limitations included inadequate adjustment for confounders and, in prediction models, small sample sizes and limited external validation. Metabolomics reveals reproducible but heterogeneous immunometabolic changes during TB therapy. Key pathways include tryptophan–kynurenine metabolism, vitamin and cofactor metabolism, lipid remodeling, and urine polyamine pathways. Standardization and prospective multicenter validation are needed for clinical translation. Full article

Background/Objectives: Helicobacter pylori (HP) antibiotic eradication treatment in Germany is, at present, empirical according to the national guidelines. The aim of our prospective multicentre study was to implement routine susceptibility testing in daily clinical practice to facilitate resistance-oriented first-line antibiotic therapy and to collect local resistance data. Methods: From 1 January 2024 to 30 April 2025, in two German hospitals (in Bielefeld and Datteln), the patients who underwent gastroscopy and those who had biopsies for histopathology also underwent biopsies for the Helicobacter urease test (HUT). Positive HUT samples were sent for susceptibility testing: they were checked for phenotypic/cultural resistance to amoxicillin, clarithromycin, metronidazole, levofloxacin, rifampicin and tetracycline and genotypic/molecular resistance to clarithromycin and fluoroquinolones. Results: In total, in 1503 cases, both HUT and histology were performed, in which 256 (17.0%) histologies were HP-positive. We sent 311/1503 (20.7%) positive HUTs for susceptibility testing. In 120 (38.6%) of them, it was possible to culture HP, and for 118 cases, phenotypic resistance testing was performed. In 200/311 cases, PCR was also executed, with 111/200 cases being subjected to subsequent molecular resistance testing. Resistance patterns varied regionally, with metronidazole resistance observed in 3–33%, clarithromycin resistance in 16–20% and levofloxacin resistance in 13–16% cases. Conclusions: it is technically and logically feasible to perform HP antibiotic susceptibility testing via the same biopsy used for the HUT. The proposed procedures might be applied both in hospital and outpatient settings in endoscopic offices. Routine susceptibility testing is useful not only for the individual patient but also for monitoring the development of regional resistance patterns as a basis for better-targeted empiric therapy. Additionally, this approach might help to reduce the resistance dynamics at large in terms of antimicrobial stewardship. Full article

Background: Urinary tract infections (UTIs) are prevalent bacterial infections associated with significant morbidity and healthcare burden. Traditional diagnosis relies on urine culture, which is limited by long turnaround times and potential contamination. Automated urine flow cytometry, particularly the UF-5000 (Sysmex Corporation, Kobe, Japan), offers rapid and precise screening through bacterial and white blood cell (WBC) quantification. This systematic review and meta-analysis evaluates the diagnostic accuracy of the UF-5000 for UTI screening. Methods: We searched PubMed, Embase, Science Direct, and Web of Science for studies assessing the UF-5000’s performance, including sensitivity and specificity, with a minimum sample size of 40 and at least 10 UTI cases. Quality assessment was performed using QUADAS-2. Pooled estimates for sensitivity, specificity, and agreement (kappa) were calculated using random-effects models. Results: Eighteen studies, encompassing 25,337 samples, were included in the analysis. Pooled sensitivity and specificity for bacterial count (nine studies) were 0.927 (95% CI, 0.872–0.959) and 0.751 (95% CI, 0.558–0.878), respectively. For WBC count (four studies), sensitivity was 0.897 (95% CI, 0.755–0.961) and specificity was 0.600 (95% CI, 0.293–0.844). The UF-5000 also demonstrated moderate agreement (pooled kappa 0.52, 95% CI, 0.08–0.79) in distinguishing Gram-negative bacteria. Conclusions: Despite heterogeneity across studies, the UF-5000 demonstrates high diagnostic accuracy, particularly high sensitivity, supporting its role as a useful UTI screening tool to rule out infection in clinical settings. The device further provides clinical value through its ability to assist in the differentiation of Gram-negative bacteria. Full article

Contemporary educator preparation programs face sociopolitical constraints that limit critical discussions surrounding how systemic, structural, and institutional inequities influence teaching and learning, leaving future educators underprepared to meaningfully nurture diverse ways of knowing in K-12 schools. To address this challenge, in this study we explored how video-mediated transcultural dialogues between 60 pre-service educators from Taiwan and the U.S. influenced the development of essential critical cultural competencies. Using a nested theoretical perspective, we analyzed participants’ discussions related to internalized notions of teaching and learning across diverse ecologies. Analysis revealed that through these conversations, incremental development of interconnected global awareness, self-determination, reflexive relationality, and social justice orientations occurred. Modest individual perspective shifts transpired as participants cultivated emerging critical cultural competencies. Despite limitations including a small sample size and a term duration, this pedagogical innovation demonstrated a possible pathway for further exploration to develop future educators’ critical cultural competencies while bridging global relations even within restrictive sociopolitical contexts. Full article