Search Results (893)

Pomegranate heart rot (black heart) was observed in several pomegranate-growing areas of Algeria. From 2022 to 2025, surveys were conducted across 15 provinces (20 localities), and a total of 85 fruits (symptomatic and asymptomatic) were collected. Fruits were cut transversely to assess internal symptoms, ranging from early aril browning to dry black rot. Thirty Alternaria isolates were obtained and grouped into four morphotypes based on colony and conidial morphological traits. A subset of 18 isolates was analysed by multilocus phylogeny (ITS, EF-1α, GAPDH and OPA10-2); all analysed isolates clustered within the Alternaria alternata species complex, in the clade including the ex-type strain CBS 916.96. Fruit pathogenicity tests with Algerian isolate GA reproduced typical internal heart rot symptoms, and the pathogen was consistently re-isolated from symptomatic tissues. In fruit inoculations with isolate GA, cultivars differed in susceptibility, with mean disease severities of 94%, 62% and 9.5% in ‘Taferrante’, ‘Ikhessène’ and ‘Kares’, respectively, expressed as the percentage of the fruit section presenting rot symptoms. Detached leaf assays indicated isolate-dependent differences in aggressiveness, and ‘Kares’ showed the lowest susceptibility. Overall, the results confirm that A. alternata is the causal agent of pomegranate heart rot in Algeria and provide baseline information for disease diagnosis and management. Full article

Background and Objectives: Pregnancy and the postpartum period profoundly affect female sexual function, yet longitudinal data integrating obstetric and psychosocial domains are scarce. We aimed to chart sexual-function trajectories from early pregnancy to 12 months postpartum and identify predictors of persistent dysfunction. Materials and Methods: In this single-center prospective cohort, 187 pregnant women were eligible to complete the FSFI at three trimesters and at 6–8 weeks, 3 months, and 6–12 months postpartum, plus postpartum PHQ-9, WHOQOL-BREF, and body-image scales. Associations with FSFI-defined dysfunction (FSFI < 26.55) and continuous FSFI were examined, of which 90 women were included for having documented dysfunction. Results: Mean FSFI declined from 27.4 ± 3.9 (first trimester) to a nadir of 20.1 ± 4.2 at 6–8 weeks postpartum, with partial recovery to 25.5 ± 4.0 at 6–12 months (p < 0.001). Depressive symptoms were higher in women with dysfunction (PHQ-9 8.8 ± 3.3 vs. 6.7 ± 3.5; p < 0.001) and correlated inversely with FSFI (r = −0.39; p < 0.001). A multivariable model explained 19% of FSFI variance, with each 1 SD PHQ-9 increase predicting a 1.2-point FSFI decrease (p = 0.005). Body-image disturbance exerted a partially PHQ-9-mediated effect, and three FSFI trajectory clusters showed postpartum dysfunction rates from 28.6% to 89.7%. A combined psychosocial prediction model achieved an AUC of 0.9 with a sensitivity and specificity of 0.8. Conclusions: Postpartum sexual dysfunction was common and persisted in many women at one year; depressive symptoms, body image, and psychological quality of life were more influential than mode of birth, breastfeeding, or pelvic-floor symptoms. Full article

Childhood obesity is a complex pathology that triggers early vascular damage through endoplasmic reticulum (ER) stress and fibrinolytic imbalance; however, the role of the ATF6/PLAT regulatory axis in this process has not yet been fully elucidated. This study aims to investigate the molecular basis of vascular risk by determining the expression levels of these genes and the potential regulatory hsa-miR-340-5p in children with obesity. Gene expression analyses were performed using the RT-qPCR method on blood samples obtained from 55 children with obesity and 40 healthy controls, while in silico protein–protein interaction (PPI) networks were mapped using the STRING database. The findings revealed that ATF6 expression was significantly downregulated (p < 0.001) and PLAT expression was significantly upregulated (p = 0.005) in the obese group compared to controls. No significant difference was detected in hsa-miR-340-5p levels (p = 0.447). PPI analysis confirmed the strong functional clustering of ATF6 with metabolic stress pathways and PLAT with coagulation cascades. In conclusion, the suppression of ATF6 in obesity indicates the “exhaustion” of adaptive cellular defense mechanisms, while the upregulation of PLAT points to a compensatory response to the chronic prothrombotic environment. These molecular alterations demonstrate that vascular risk in childhood obesity begins at the transcriptomic level long before clinical symptoms emerge, highlighting the ATF6/PLAT axis as a potential biomarker for early risk assessment. Full article

Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of biological biomarkers assessed alongside validated burnout measures in emergency department (ED), emergency medical services (EMS), and related acute care settings. Specifically, we asked whether reproducible biological correlates of burnout can be identified in emergency and acute-care healthcare workers when biomarker endpoint class and sampling context are systematically considered. Materials and Methods: We conducted a systematic scoping review with evidence mapping (PRISMA-ScR). PubMed/MEDLINE and the MDPI platform were searched for English-language studies published from 2018 onward (through January 2026). Eligible quantitative studies enrolled ED/EMS or acute care HCWs, assessed burnout using validated instruments, and reported at least one biological biomarker. Evidence was charted by biomarker domain and endpoint class (basal measures, stress reactivity paradigms, and chronic indices such as hair-based markers). Results: Overall, 19 studies were included in mapping/synthesis. Biomarker selection clustered around the hypothalamic–pituitary–adrenal axis (cortisol; n = 10/19), with fewer studies focused on autonomic function (heart rate variability; n = 2/19) and immune–inflammatory markers (n = 2/19), and single-study coverage for oxidative stress (n = 1/19), cardiometabolic candidates (n = 1/19), cellular aging (n = 1/19), neuroglial/multi-system candidates (n = 1/19), and feasibility-oriented multi-marker designs (n = 1/19). Reported associations with burnout were heterogeneous in direction and magnitude, but were more interpretable when endpoint class, timing anchors, and shift/sleep-related covariates were explicitly reported. Rates of confounder adjustment were low across studies (e.g., only 3/19 reported multivariable adjustment, and none systematically measured sleep or circadian factors), substantially limiting interpretability. Conclusions: The 2018+ literature does not support a single reproducible biomarker for burnout in emergency and acute care workforces. Evidence instead suggests multi-system dysregulation that is highly sensitive to endpoint class, sampling timing, and contextual confounding. Future studies should prioritize timing-anchored repeated-measures protocols across shift and recovery windows, jointly model sleep/circadian factors and depressive symptoms, and evaluate multi-marker panels and intervention responsiveness. Full article

Ash dieback is an often-fatal disease caused by the fungus Hymenoscyphus fraxineus (T. Kowalski) Baral, Queloz & Hosoya. It emerged in Europe during the 1990s and poses a substantial threat to ash populations. In Hungary, symptoms were first detected on common ash (Fraxinus excelsior L.) in 2008. The disease also severely impacts another native species, the narrow-leaved ash (Fraxinus angustifolia Vahl). An effective strategy for counteracting ash decline is to identify and utilize sources of tolerance. We are monitoring the health status of the selected trees that demonstrate low susceptibility (plus trees) and conducting molecular genetic studies to enable their genetic characterization and individual identification using 16 nuclear microsatellite (nSSR) markers. The PCoA (Principal Coordinates Analysis) separated the eight assessed groups into two distinct clusters based on the taxonomic traits. Based on the Structure analysis results, K = 2 was the most probable cluster number. Hybridization was also indicated in the case of several individuals across various groups. We intend to incorporate the results in the establishment of seed orchards using the selected plus trees, considering the taxonomical, geographical, and genetic distinctiveness of the different groups. Full article

Background/Objectives: Pain is a common symptom for hospitalised older adults. Pain is not always adequately assessed, which can lead to inadequate pain management and adverse patient outcomes. Thus, new technology-driven pain assessment tools have been developed; however, little is known about patients’ and families’ experiences of nurses using them in acute care. This study aimed to explore the perspectives of older adult inpatients and their families’ regarding nurses’ use of the digital technology-driven pain assessment application PainChek^® Universal. Methods: A survey was undertaken as part of a stakeholder evaluation of a randomised control trial exploring the effectiveness of nurse-led volunteer support and technology-driven pain assessment in improving the outcomes of hospitalised older adults. The PainChek^® Universal application was implemented on two medical wards of an acute private hospital in Western Australia as part of a larger single-centre, prospective, non-blinded, cluster-randomised control trial. This stakeholder evaluation invited older adult inpatients and their family members to participate in a survey about nurses’ use of the PainChek^® Universal application for pain assessment. Results: A total of 96 inpatients and 27 family members completed the survey. Thirteen patients and nine family members provided additional feedback. Over 90% of patients and family members agreed that the use of the PainChek^® Universal application was a positive addition to pain assessments, rendered no concerns, and helped nurses complete pain assessments. A total of 84% of patients and 87% of family members felt PainChek^® Universal provided a more accurate pain assessment. Survey feedback related to PainChek^® Universal application use, integration of technology, and need for further education. Conclusions: The findings suggest that older adults and their families recognised the benefits of nurses using a digital application for pain assessments. Technology integration in healthcare must be accompanied by patient and family education. Full article

Background: Vaginal infections often present with overlapping symptoms and involve single or multiple pathogens. However, the relationship between clinical symptoms and molecularly defined vaginal pathogen profiles, especially in multi-pathogen infections, remains poorly characterized in a routine care setting. This study exams the connection between vaginal symptoms and pathogen profiles among women with vaginitis in Northern Vietnam. Methods: We conducted a multicenter cross-sectional study of women with vaginitis at Bac Ninh CDC and Hanoi Obstetrics and Gynecology Hospital between December 2023 and December 2024. Baseline demographics and clinical symptoms were assessed by physicians. Vaginal swabs were collected for pH measurement and pathogen detection using multiplex real-time PCR. The correlation was analyzed using logistic regression in GraphPad Prism v10.1.1. Results: Among 289 symptomatic women, abnormal vaginal discharge and itching were the most common symptoms. Gardnerella vaginalis was the most commonly detected pathogen, occurring alone or in combination with Candida albicans, Mycoplasma hominis, and other genital pathogens. Multi-pathogen infection was associated with abnormal vaginal discharge (OR = 5.44), itching (OR = 2.13), and elevated vaginal pH (OR = 4.70). Women at the tertiary hospital showed greater symptom burden (OR = 1.75) and higher prevalence of multi-pathogen infections (OR = 9.75) than those attending the provincial CDC. Conclusions: Multiplex real-time PCR combined with simple clinical indicators (symptom clustering and vaginal pH) provides practical diagnostic value for identifying multi-pathogen infections in symptomatic women. This integrated approach may support more accurate etiologic diagnosis and guide rational testing strategies, particularly in resource-limited settings. Full article

West Nile neuroinvasive disease (WNND) causes substantial morbidity in endemic regions, yet data on its burden in Serbia remain limited. We conducted a retrospective, population-based study of WNND cases reported in Vojvodina Province, Serbia, from 2012 to 2025. Incidence and mortality trends were analysed by year, residence, age, sex, and week of symptom onset. Multivariable logistic regression was used to identify predictors of fatal outcome. Of 1337 suspected cases, 557 (41.66%) met the WNND case definition (530 confirmed, 27 probable cases) and 98.9% were autochthonous. The mean annual incidence was 2.17/100,000 (95% CI 0.60–3.75), ranging from 0.48/100,000 (2015) to 10.31/100,000 (2018), with additional peaks in 2013 and 2022. Cases clustered predominantly in epidemiological weeks 31–34. The mean mortality was 0.28/100,000 (95% CI 0.02–0.53) and the mean case fatality rate was 12.93% (95% CI 10.14–15.71%). Incidence increased with age, peaking at 5.97/100,000 in those 70–79 years; highest mortality occurred in ≥80 years (1.78/100,000). All districts reported cases, with the highest incidence and mortality in South Banat. Higher Charlson Comorbidity Index, cardiovascular disease, diabetes and malignancy independently predicted fatal outcome. WNND remains a significant public health problem in Vojvodina, requiring improved surveillance, targeted prevention, and early treatment of high-risk patients. Full article

Background/Objectives: Functional difficulty and depression often coexist in older adults, yet local Singapore-based research often lacks detailed temporal resolution due to heterogeneity in ageing. This study employs non-parametric, data-driven longitudinal clustering to analyse functional trajectories and their association with depression, using high-frequency data to pinpoint key intervention periods. Methods: Data were drawn from 4273 community-dwelling older adults from Singapore Life Panel^® (2020–2024). Participants completed quarterly self-reported assessments of ADL, IADL and depressive symptoms (8-item CES-D). We employed k-means longitudinal clustering (kml) to identify functional trajectory groups and Cox regression to evaluate the hazard of increased depression (≥5-point increase in CES-D). Results: Three distinct trajectories emerged for both ADL and IADL (Stable, Medium increase in difficulty, High increase in difficulty). In fully adjusted Cox models, Medium and High clusters had higher hazard ratios for increased depression than Stable (ADL: HR 1.71 and 2.37; IADL: HR 1.60 and 2.20). Median time-to-event was not reached in the Stable group and occurred earlier in Medium/High clusters (ADL: 3.25 years and 1.75 years; IADL: 4.0 years and 2.1 years). The High cluster, comprising older and socioeconomically disadvantaged individuals, exhibited worse baseline health and psychosocial factor scores. Depression scores escalated in the Medium and High groups. Conclusions: Rapid functional difficulty acts as a precursor to worsening depressive symptoms. Routine monitoring of functional trajectories offers a strategic window for proactive mental health interventions in at-risk older adults. Full article

Cerebral Cavernous Malformations (CCMs) are low-flow vascular lesions located within the central nervous system, with a reported prevalence in the general population of 0.16–0.5%. Patients with CCMs may remain asymptomatic or present new onset symptoms such as seizures or focal neurological deficits often related to the occurrence of intracerebral hemorrhage. CCM may appear sporadic or as part of familial forms linked to mutations in the CCM-gene cluster, affecting endothelial cell integrity and triggering molecular cascades, including the MEKK3/KLF2/4 signaling pathway. Recent studies have highlighted the roles of inflammatory, angiogenic, and coagulation pathways alongside the emerging evidence of a gut–brain axis influencing microbiome-driven TLR4 signaling. This systematic review aims to describe molecular biomarkers associated with CCM pathophysiology, emphasizing their potential use as diagnostic and prognostic tools. Circulating plasma biomarkers such as CRP, vitamin D, and interleukins may reflect ongoing inflammatory and endothelial processes, while some imaging biomarkers like Quantitative Susceptibility Mapping (QSM) have shown a correlation with iron deposition and vascular leakage. Leveraging both circulating and imaging biomarkers may improve the therapeutic decision-making process. Further studies are encouraged to validate these findings and to facilitate the development of personalized, evidence-based strategies for the management of CCM. Full article

Sleep disorders and primary headache syndromes frequently coexist, and accumulating evidence suggests that this relationship is bidirectional and biologically mediated rather than coincidental. Patients with migraine, tension-type headache, and cluster headache commonly report poor sleep quality, insomnia symptoms, and irregular sleep patterns, while individuals with sleep disorders such as insomnia, obstructive sleep apnea, restless legs syndrome, and narcolepsy experience a higher prevalence, severity, and chronification of headache disorders. This narrative review synthesizes current clinical, epidemiologic, and translational evidence supporting shared neurobiological mechanisms linking sleep and headache disorders. We focus on five major overlapping pathways: dopaminergic dysfunction, iron deficiency, hypothalamic and circadian dysregulation, central sensitization, and neuroinflammation. Evidence from population-based studies, clinical cohorts, neuroimaging, genetic research, and experimental models demonstrates that these mechanisms converge within hypothalamic, brainstem, and trigeminovascular circuits that regulate arousal, pain processing, and homeostasis. Conditions such as insomnia, obstructive sleep apnea, restless legs syndrome, and circadian disruption not only exacerbate headache burden but may act as modifiable risk factors that promote headache onset and progression. Recognizing sleep disorders as integral components of headache pathophysiology has important clinical implications, emphasizing the need for systematic sleep assessment and targeted sleep interventions as part of comprehensive headache management strategies. Full article

Phytoplasmas are obligate intracellular parasitic bacteria that infect over 1000 plant species globally, causing devastating diseases characterized by yellowing, witches’ broom, phyllody, and significant yield losses in economically important crops. The unculturable nature of these pathogens has historically hindered their study; however, advances in molecular biology and genomics have substantially accelerated progress over the past two decades. This review provides a comprehensive overview of current knowledge on phytoplasma diseases and control technologies. In terms of taxonomy, phytoplasmas are currently classified into 37 16Sr groups with over 150 subgroups based on 16S rRNA gene analysis, and approximately 50 ‘Candidatus Phytoplasma’ species have been formally named. Genomic studies have revealed that phytoplasmas possess highly reduced genomes (530–1350 kb) lacking many essential metabolic pathways, reflecting their obligate parasitic lifestyle. Regarding pathogenesis, secreted effector proteins such as SAP (Secreted Aster Yellows Witches’ Broom Protein), TENGU (tengu-su inducer), and SWP (Secreted Wheat Blue Dwarf Protein) manipulate plant hormone signaling and developmental processes, leading to characteristic disease symptoms. Detection technologies have evolved from traditional microscopy to molecular methods, including nested PCR, real-time quantitative PCR, loop-mediated isothermal amplification (LAMP), and CRISPR/Cas-based systems (Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR-associated protein), with AI-based image recognition and remote sensing emerging as promising tools for large-scale field monitoring. Integrated management strategies encompassing agricultural practices, insect vector control, biological control agents, induced resistance, and breeding for resistance are discussed. Finally, future research directions, including functional genomics, microbiome-based approaches, and precision agriculture technologies, are highlighted. This review aims to provide researchers and practitioners with a systematic reference for understanding phytoplasma biology and developing effective disease management strategies. Full article

Background: The demand for digitally supported chronic pain management has grown. Yet, the employment of a well-structured and sustainable program for older adults is limited due to insufficient research studies involving both older adults and their informal caregivers. Objective: This cluster randomized controlled trial evaluated the effectiveness of a Dyadic Pain Management (DPM) program, with the primary outcome of pain intensity. Secondary outcomes included pain interference, pain self-efficacy, activities of daily living, pain knowledge, psychological symptoms (depression, anxiety, stress), and caregiver burden. Methods: A cluster randomized controlled trial was conducted with 150 dyads (community-dwelling older adults with chronic non-cancer pain and their informal caregivers) over 8 weeks. The intervention comprised 4 weeks of on-campus group sessions followed by 4 weeks of WhatsApp-based support, while the control group received lesson pamphlets. Outcomes were assessed at baseline (T0), week 8 (T1), and week 16 (T2). Results: Statistically significant improvements in pain outcomes were observed in the intervention group compared with the control group over follow-up. Between-group differences were significant for pain intensity (primary outcome) and pain interference, and pain self-efficacy also improved. Significant between-group differences were also observed for depression, anxiety, and stress after the intervention, and caregiver burden was lower in the intervention group at follow-up. Conclusions: These findings suggest that a dyadic, non-pharmacological pain management program with a WhatsApp-based component may support improvements in pain- and psychosocial-related outcomes among community-dwelling older adults with chronic pain and their informal caregivers. Full article

Background: The aim of this study was to identify patient clusters based on acute symptom profiles and individual characteristics most likely to develop pediatric post-acute sequelae of SARS-CoV-2 infection (PASC), as well as clusters among patients with PASC based on post-acute sequelae and associated characteristics. Methods: This multicenter cohort study in 12 Italian pediatric units enrolled patients aged 0–17 years within three months of a laboratory-confirmed SARS-CoV-2 infection. Participants who completed at least two surveys developed by the ISARIC over one year were analyzed. PASC was defined per WHO criteria. Multiple Correspondence Analysis and Hierarchical Clustering were performed. Results: Of 1137 children enrolled, 850 (76%) completed at least two surveys. The most prevalent age group was older children (6–11 years) (46%); adolescents (12–17) and young children (0–5) were numerically similar. Males were more represented (51.9%), except for the adolescent group (45.1%). PASC occurred in 32.8% of participants, with the distribution of sequelae types varying by age. Clustering in COVID-19 cases identified three clusters: young children mainly presented with respiratory symptoms and with a higher risk of hospitalization, while older children were spared in both acute and post-acute phases. Adolescents, particularly females, reported more pronounced acute symptoms and developed PASC more frequently. Clustering analysis of cases with PASC identified three clusters, confirming these age-related patterns. Young children still exhibited respiratory sequelae, and older children confirmed good recovery with minimal complications, while adolescents, especially females, remained the most affected subgroup, reporting persistent neuropsychological sequelae such as fatigue and insomnia. Conclusions: Findings support age-tailored follow-up, emphasizing respiratory monitoring for young children and targeted neuropsychological care for adolescents, particularly girls. Full article

Fibromyalgia is a complex chronic pain condition characterized by pervasive pain, persistent fatigue, and cognitive disturbances. Despite advances in understanding its neurobiological mechanisms, diagnosis largely relies on subjective symptom assessment and exclusion criteria, contributing to underdiagnosis and treatment delays. Recent research has increasingly focused on identifying objective biomarkers and leveraging digital phenotyping to improve diagnostic precision. Promising biomarkers include neuroimaging indicators of altered pain processing, neuroinflammatory signatures in cerebrospinal fluid and blood, and dysregulated neuroendocrine and autonomic patterns. In addition, metabolomics and transcriptomics have revealed molecular profiles associated with fibromyalgia pathophysiology. Concurrently, digital health tools (e.g., wearable sensors, ecological momentary assessment, and machine learning-based symptom clustering) offer opportunities for continuous, real-world data collection and individualized disease characterization. This body of work suggests that integrating biological and digital metrics could enable a transition from subjective to objective data-driven fibromyalgia classification, facilitating earlier diagnosis and improved therapeutic outcomes. Full article