Search Results (15,937)

Clinical data on antimicrobial profiles are useful for dairy udder health treatment programmes and represents a component of antimicrobial stewardship. The study aimed to determine the bacterial aetiology of clinical mastitis in dairy herds in Western Australia and to evaluate their antibiotic resistance profiles. This retrospective study utilised clinical antimicrobial profile data from two referral diagnostic centres within the region of Western Australia. A total of 545 mastitic samples were submitted for antimicrobial culture and testing over a period of 10 years (2008–2018). Of these, 406 showed bacterial growth and 139 no bacterial growth was observed. The most common isolates were Streptococcus uberis (25.3%), Staphylococcus aureus (17.2%), and Escherichia coli (9.4%). No growth was identified in 25.5% of the mastitis milk samples. The antimicrobial profiles revealed high susceptibilities towards cefuroxime (95.7%), clavulox (89.4%), and oxytetracycline (89%), whilst showing high resistance towards novobiovin (70%). From this study, it is concluded that there was a decline in the resistance trends towards the isolates of both S. uberis and S. aureus over the 10-year period and contagious mastitis had a higher occurrence. There is a need to consider surveillance programmes that determine the patterns of on-farm antimicrobial usage and further characterise the pathogens based on the presence of resistance antimicrobial genes. Data on antimicrobial surveillance represent an important component of antimicrobial stewardship. Full article

Diffusion-weighted imaging (DWI) has been increasingly utilized in the emergent evaluation of acute ischemic stroke (AIS) patients. DWI enhances sensitivity and specificity and enables the use of delayed reperfusion treatments in selected cases. However, DWI is not devoid of limitations. DWI-negative AIS is not uncommon in clinical practice and is reported in up to 1 of 4 AIS patients. We reviewed the relevant literature and searched the PubMed and Google Scholar databases for studies reporting on DWI-negative AIS prevalence during the 2021–2025 time period. Additionally, we included cases from our practice to highlight key points. DWI-negative AIS prevalence was 16% in one meta-analysis and ranged from 6.9% to 23.2% in identified studies that met our inclusion criteria. The biological, pathophysiological, technical, epidemiological and clinical factors that contribute to DWI-negative stroke are presented in detail. Overall, the application of diffusion imaging modalities for stroke is not bereft of blind spots despite enhanced sensitivity. Over-reliance on advanced neuroimaging and unfamiliarity with its limitations predispose DWI to errors in AIS assessment. Awareness of the predisposing factors, treatment effect, and prognosis guides appropriate decision-making, promoting good outcomes. Prospective appropriately designed trials should address the lingering questions identified, such as the association between time of imaging and DWI negativity. Full article

The two-spotted spider mite, Tetranychus urticae Koch, is a major agricultural pest whose control is increasingly constrained by resistance to synthetic acaricides. This study evaluated the long-term field efficacy of three commercial entomopathogenic fungal (EPF) biopesticides—Velifer^® (Beauveria bassiana), Metab^® (B. bassiana + Metarhizium anisopliae), and Botanigard^® (B. bassiana)—against larval and protonymph stages of T. urticae on two host plants, Italian cypress (Cupressus sempervirens) and sweet orange (Citrus sinensis). Two foliar applications were conducted during the 2023 growing season (25 May and 25 July), and mite populations were monitored for 140 days after the final application. A randomized complete block design was used, and efficacy was calculated using the Henderson–Tilton formula. All EPF treatments significantly reduced mite populations compared with the untreated control throughout the monitoring period. Velifer consistently achieved the highest suppression of larval populations, particularly on C. sinensis, with efficacy comparable to the chemical standard. Botanigard showed more gradual but sustained population reduction over time, whereas Metab exhibited lower but stable efficacy in all cases. Treatment performance was strongly influenced by host plant species and mite developmental stage, with larvae consistently more susceptible than protonymphs. On C. sinensis, Velifer achieved the highest larval suppression (84.6%), comparable to the chemical standard abamectin, while Botanigard and Velifer were most effective on C. sempervirens. Survival analysis confirmed isolate- and host-dependent differences in hazard effects over time. These results demonstrate that EPF-based products can provide sustained, long-term suppression of T. urticae under field conditions, supporting their integration into integrated pest management programs. Full article

Background/Objective: Ketorolac is an effective alternative and addition to opioids for postoperative pain control; however, there is concern of perioperative bleeding risk with its use. Within gynecology, this risk has not yet been explored in the context of hysterectomy. This study aimed to evaluate the risk of postoperative bleeding complications with ketorolac administration in the context of hysterectomy. Methods: This was a retrospective cohort study that included all patients who underwent hysterectomy for benign indications between 2015 and 2024 at a quaternary care academic hospital. Inclusion criteria were any type of hysterectomy during the study period, while exclusion criteria were malignancy and peripartum status. Complication data for up to thirty days post operation were collected. Multivariable regression analysis, including age, American Society of Anesthesiology category, use of celecoxib before surgery, anticoagulant treatment, uterus size, surgical approach, increased surgical complexity, and lysis of adhesions, was performed to identify the adjusted odds of postoperative bleeding complications. The primary outcome was a composite of any postoperative bleeding complications by use of postoperative ketorolac, including postoperative transfusion, readmission, or reoperation for bleeding. Results: In total, 4236 patients underwent hysterectomy for benign indications during our study period, of which 76% (n = 3236) received ketorolac postoperatively. The composite postoperative bleeding rate was lower in the ketorolac group (2.1% vs. 4.1%, p = 0.001). There was no association between ketorolac use and risk of postoperative bleeding in multivariable regression analysis (aOR 1.02, 95% CI 0.36–2.88). There was no difference in overall intraoperative or perioperative complications (p = 0.070 for both). Major perioperative complications were less likely in the ketorolac group (p = 0.046). Additionally, there were no differences in postoperative complications except for ileus, which was less likely in the ketorolac group (p = 0.034). Conclusions: Ketorolac administration was not associated with a higher risk of bleeding complications after hysterectomy, including when celecoxib was used preoperatively as part of an enhanced recovery protocol. It may safely be administered as an opioid-sparing pain medication in this setting. Full article

Objectives: The purpose of the current research is to examine and analyze the attitudes of healthcare service users towards the integration of remote medical services into ophthalmology in Bulgaria, including teleglaucoma. Methods: A cross-sectional survey study was conducted among 902 healthcare users during the period from May 2023 until December 2024. Descriptive statistics, parametric, and non-parametric tests for hypothesis testing were used. Results: The present study outlined predominantly positive attitudes towards the use of telemedicine services in ophthalmology, with 69.6% of respondents reporting a positive overall opinion in the final assessment. The greatest support was observed during remote consultations with a familiar doctor (77.4%) and during continuous follow-up of eye conditions (55.2%). Willingness to use such services was lower in emergencies or when contacting an unfamiliar specialist. A significant correlation was established between socio-demographic characteristics and attitudes—respondents with greater education levels (p = 0.006), men, and younger participants were more positive towards telemedicine (p < 0.05). The high level of awareness about glaucoma, particularly among those with university-level education, served as a positive prerequisite for the implementation of teleophthalmology services related to its monitoring. Mobile applications and digital solutions were evaluated as beneficial means of facilitating communication and increasing adherence to treatment. Regarding the use of artificial intelligence, certain skepticism and insufficient awareness levels were observed, which required additional efforts to increase trust and digital literacy among users. Conclusions: The implementation of telemedicine services into ophthalmology has potential but outlines the necessity of considering the individual attitudes of applying coherent quality and safety standards and of directed awareness campaigns, especially towards the groups of lower technological and healthcare literacy. Full article

To address the bottlenecks of low water and fertilizer utilization efficiency and limited yield potential inherent in Henan Province’s traditional winter wheat cultivation model of “furrow irrigation + conventional row seeding”, this study delved into the synergistic regulatory mechanisms of drip irrigation combined with wide-row precision seeding. It focused on their effects on the physiological ecology and yield-quality traits of winter wheat. A two-factor experiment, encompassing “sowing method × irrigation method” will be carried out during the 2024–2025 wheat growing season, featuring four treatments: furrow irrigation + conventional row seeding (QT), drip irrigation + conventional row seeding (DT), furrow irrigation + wide-row precision seeding (QK), and drip irrigation + wide-row precision seeding (DK). Results reveal that wide-row precision seeding optimized the canopy structure, raising the leaf area index (LAI) at the heading stage by 20.19% compared to QT, thereby enhancing ventilation and light penetration and reducing plant competition. Drip irrigation, with its precise water delivery, boosted the net photosynthetic rate of the flag leaf 35 days after flowering by 62.99% relative to QT, stabilizing root water uptake and significantly delaying leaf senescence. The combined effect of the two treatments (DK treatment) synergistically improved the canopy structure and photosynthetic performance of winter wheat, prolonging the functional period of green leaves by 29.41%. It established a highly efficient photosynthetic cycle, marked by “high stomatal conductance-low intercellular CO₂ concentration-high net photosynthetic rate”. The peak net photosynthetic rate (P_n) 13 days post-flowering rose by 23.9% compared to QT. Moreover, while reducing total water consumption by 21.4%, it substantially increased water use efficiency (WUE) and irrigation water use efficiency (IWUE) by 43.2% and 14.2%, respectively, compared to the QT control. Ultimately, the DK treatment achieved a synergistic enhancement in both yield and quality: grain yield increased by 14.7% compared to QT, wet gluten content reached 35.5%, and total protein yield per unit area rose by 13.1%. This study demonstrates that coupling drip irrigation with wide-row precision seeding is an effective strategy for achieving water-saving, high-yield, and high-quality winter wheat cultivation in the Huang-Huai-Hai region. This is achieved through the synergistic optimization of canopy structure, enhanced photosynthetic efficiency, and improved WUE. These findings provide a mechanistic basis and a scalable agronomic solution for sustainable intensification of winter wheat production under water-limited conditions in major cereal-producing regions. Full article

Research has demonstrated that incorporating nitrate into animal feed can effectively decrease methane production in ruminants, though its impact on carcass characteristics and meat attributes in Hu sheep requires further investigation. This experiment examined how a dietary inclusion of 3% calcium nitrate (CN) influenced slaughter parameters, meat properties, gut microbial populations, and host gene regulation in Hu sheep. The study involved sixty healthy male Hu sheep aged 120 days with comparable body weights (31.11 ± 3.39 kg), randomly allocated into two groups: a control group receiving standard feed (CON) and a CN-supplemented group. The trial lasted 60 days, including a 15-day adaptation period and a 45-day formal trial period. They were housed individually and fed twice daily (at 8:00 and 18:00). The findings revealed that CN supplementation notably reduced the water loss rate in the longissimus dorsi muscle (LD), elevated meat color brightness, and enhanced the proportion of polyunsaturated fatty acids (PUFA), particularly n-6 PUFA, along with the n-3/n-6 PUFA ratio. Conversely, it reduced the levels of saturated fatty acids such as myristic acid (C14:0) and oleic acid (C18:1n9t). Additionally, the treatment boosted ruminal Ammoniacal nitrogen content and total short-chain fatty acid production, thereby contributing to energy metabolism in the animals. Microbiological examination demonstrated that CN supplementation led to a decrease in Fibrobacterota and Methanobrevibacter populations within the ruminal environment, while promoting the growth of Proteobacteria in the duodenal region. The gene expression profiling of digestive tract tissues showed an increased activity in nitrogen processing genes (including CA4) and oxidative phosphorylation pathways (such as ATP6), indicating an improved metabolic efficiency and acid–base homeostasis in the host animals. These findings demonstrate that CN-enriched diets enhance the carcass characteristics of Hu sheep by modifying intramuscular lipid profiles through gastrointestinal microbial community restructuring and metabolic pathway adjustments. Such modifications affect energy utilization and acid–base equilibrium, ultimately impacting muscle characteristics and adipose tissue distribution, presenting viable approaches for eco-friendly livestock farming practices. Full article

In this study, we prepared edible films using chitosan/gelatin/phlorotannins (CGPs) embedded with probiotics and evaluated their preservation effects on strawberries. Edible films encapsulating Limosilactobacillus fermentum FUA033 (CGPFUA033) were prepared using the casting method. The intermolecular interactions, crystal structure, thermal stability, and morphology of the films, both prior to and following the incorporation of L. fermentum FUA033, were characterized using FT-IR, XRD, TG, and SEM analyses. The preservation efficacy of the edible films, with and without encapsulated L. fermentum FUA033, was assessed by monitoring the physical, chemical, and microbial properties, as well as the visual quality, of strawberries during a eight-day storage period. The results showed that encapsulation of L. fermentum FUA033 enhanced intermolecular interactions and thermal stability within the film matrix but did not significantly affect the crystalline structure of the edible film. At 0, 2, 4, 6, and 8 days, the CGPFUA033 treatment had preservation effects: the weight loss was 30.70 ± 1.53%, the total soluble solid content was 8.83 ± 0.28%, the decay index was 45.33 ± 1.53%, the malondialdehyde content was 7.44 ± 0.13 μmol/g, firmness was 21.49 ± 0.83 N, and the ascorbic acid content was 43.51 ± 0.79 mg/100 g. The shelf life of strawberries was extended by six days in the CGPFUA033 treatment group. Therefore, the chitosan/gelatin/phlorotannin edible film embedded with L. fermentum FUA033 has high preservation effects on strawberries, highlighting that L. fermentum FUA033 can be used as a probiotic for enhancing food preservation. Full article

Gastrointestinal nematodes (GIN) represent a major constraint to sheep production, and sustainable alternatives to routine anthelmintic use are increasingly required. This study compared two parasite control strategies in Zerasca sheep: routine albendazole treatment administered twice yearly (T) and a long-term non-chemical approach based on rotational grazing (relocation to a new pasture when grass height fell below 10 cm) combined with quarterly veterinary monitoring (NT). Twenty-four adult ewes (n = 12 per group) were monitored over an eight-month period. Mean faecal egg counts (EPG) differed significantly between groups (T: 210 ± 78; NT: 529 ± 89; p = 0.0007). In group T, EPG values decreased markedly 7 days after treatment but increased again by 150 days, resulting in no persistent differences between groups over time. Despite higher parasite burdens, NT sheep showed significantly higher body condition scores compared with treated animals (3.00 ± 0.61 vs. 2.51 ± 0.53; p = 0.0014). Haematological parameters were largely comparable between groups, although mild reductions in RBC, HGB, and HCT were observed in both. Treated sheep exhibited higher AST activity (p < 0.0001) and transient increases in ALT and BUN following treatment. Hair cortisol concentrations did not differ significantly between groups. Overall, these findings suggest that a non-chemical parasite management strategy, when combined with controlled grazing and veterinary monitoring, may maintain acceptable parasite levels while supporting body condition and stable welfare indicators, potentially reducing reliance on routine anthelmintic treatments. Full article

Artificial cyanobacterial crusts (ACCs) are a potentially effective biological strategy for combating desertification. However, while functional microorganisms influence ACCs formation efficiency, research on their role is limited, and their underlying promotion mechanisms remain unclear. Here, we investigated the effects of three functional synthetic microbial communities (SynComs), each dominated by microorganisms specialized in exopolysaccharide (EPS) production (3 strains), siderophore production (3 strains), or nitrogen fixation (4 strains), on ACCs formation following inoculation with Microcoleus vaginatus. This study was carried out in a controlled laboratory setting with a 12 h light/dark cycle and a light intensity of 2400–2700 lux. Following a 24-day cultivation period, EPS-producing or nitrogen-fixing SynComs significantly increased the chlorophyll-a content by 16.0–16.3%. Except for the nitrogen-fixing bacteria treatment, other SynComs enhanced the soil organic matter content of ACCs by 9.1% to 27.3%. The content of EPS was significantly improved by all three SynComs by 14.1~19.2%. Urease activity rose by 6.7% when siderophore-producing bacteria were added. The impacts of SynComs on ammonium nitrogen (NH₄⁺-N) showed different temporal dynamics: nitrogen-fixing SynComs significantly increased NH₄⁺-N early (≤10 days), while EPS-producing and siderophore-producing SynComs enhanced accumulation later (17–24 days). SynComs inoculation markedly accelerated cyanobacterial and general microbial colonization and growth. In comparison to day 0, the 16S rRNA gene copy number of ACCs increased by 24.1% and 43.0%, respectively, in the EPS-producing and nitrogen-fixing SynComs. Additionally, correlation analysis showed that SynComs transformed the weak correlations in the control into a strong positive correlation between NH₄⁺-N and both Chl-a and microbial biomass. Our findings demonstrate SynComs, particularly the EPS-producing or nitrogen-fixing SynComs, enhance ACCs formation through elucidated mechanisms, providing a theoretical basis for optimizing ACCs-based desertification control strategies. Full article

Background: Bladder cancer (BC) predominantly affects older patients, and their multidisciplinary treatment often includes surgical intervention. Frailty can influence treatment decisions and is associated with poorer outcomes. This study analyses trends in demographics, treatment patterns and frailty in a large, nationwide, real-world inpatient cohort in Germany. Methods: This retrospective observational study included a total of 49,139 consecutive patients, who received inpatient care for BC at all HELIOS hospitals in Germany between 2016 and 2022. Frailty was assessed using the Hospital Frailty Risk Score (HFRS) and categorised as low (<5), intermediate (5–15), or high (>15). Trends in HFRS, treatment modalities, and demographic variables were analysed using regression models and compared between the periods 2016–2019 and 2020–2022. Results: Of the 49,139 patients, 27,979 were treated between 2016–2019 and 21,160 between 2020–2022. Patients treated in the later period were slightly older but had a lower comorbidity index. The proportion of patients with low frailty increased (73.4% vs. 75.5%, p < 0.01), intermediate frailty decreased (23.5% vs. 21.5%, p < 0.01) and the proportion of highly frail patients remained stable at 3.0% (p = 0.95). Rates of transurethral resection declined over time, whereas rates of RC remained stable (p = 0.12). The use of systemic therapy increased (p = 0.003), particularly among low frailty elderly patients. Early intravesical chemotherapy following transurethral resection declined significantly in 2020–2022 (p < 0.001), particularly among elderly patients with high frailty. Mean length of hospital stay decreased by one day, while ICU admission rates and in-hospital mortality remained stable across time periods. Conclusions: This study shows frailty-specific changes in hospitalisation patterns and inpatient management of BC in Germany, underscoring the value of frailty assessment in population-based research. The proportion of patients classified as having low frailty increased over time. Significant changes in the use of intravesical chemotherapy and systemic therapy were associated with frailty. The decline in early intravesical chemotherapy may have implications for recurrence risk and downstream healthcare utilisation. Full article

Background/Objectives: In order to develop a comprehensive understanding of gastric-type endocervical adenocarcinoma (GEA), an increasingly prevalent HPV-independent cervical cancer, we summarized clinicopathological information and performed prognostic analysis. Methods: A total of 182 patients diagnosed with GEA at our center during the period 2014–2025 were included in this study. Nineteen GEA cases, 6 HPV-independent non-GEA cases, 59 HPV-associated usual endocervical adenocarcinoma cases, and 66 squamous cell carcinoma cases from online database were also included. Results: Vaginal bleeding (39.56%) and watery discharge (35.16%) were the most common symptoms. As many as 21.43% of patients had no specific complaints, and 80% of GEA showed no distinct mass through gynecological examination. A total of 64% of GEA were stage IIB–IV at diagnosis, with a 5-year survival of 41% versus 85% for stage I–IIA (p < 0.05). The rate of lymphovascular space invasion (LVSI), lymph node metastasis, and ovarian metastasis were 49.64%, 42.00%, and 29.29%, respectively. The 5-year survival and recurrence rates after primary therapy were 57% and 23%, respectively. For GEA treatment, surgery might be associated with improved overall survival for the population at stage III–IV. Survival analysis identified deep infiltration depth (≥2/3), a maximum diameter of the tumor (MDOT) of ≥3 cm, and ovary metastasis as potential indicators of worse OS and PFS for whole patients. Additionally, ovary metastasis indicated poor PFS and OS for stage I–II. Genomic information TP53 mutation, PTEN deletion and STK11 mutation might be the most prevalent genomic alterations. Conclusions: These findings indicated GEA as an aggressive cervical cancer, with high rate of lymph node metastasis, high recurrence rate and short 5-year survival. Ovary metastasis reflected advanced disease burden and surgery might be associated with improved survival in advanced stage. For genomic information, GEA showed genetic heterogeneity and a low level of genomic instability. Full article

Mechanical coffee drying is an energy-intensive stage of postharvest processing that directly affects product quality and production costs. This study evaluated the technical and economic feasibility of using expanded polystyrene (EPS) as a thermal insulation material to improve the performance of a mechanical coffee dryer and to demonstrate its potential for sustainable reuse. Experiments were conducted using a total of 210 kg of wet parchment coffee (Coffea arabica L. var. Cenicafé 1) per treatment, corresponding to three experimental replicates of 70 kg each, dried at 50 ± 2 °C, comparing an EPS-insulated dryer (0.02 m thickness) with a non-insulated control. A theoretical model based on steady-state heat transfer through series resistances estimated energy losses and system efficiency for different insulating materials. Theoretical results indicated that EPS, polyethylene foam, and cork reduced heat losses by 58.1%, 54.3%, and 50.9%, respectively. Experimentally, EPS reduced drying time by 7.82%, fuel consumption by 13.9%, and energy demand by 9.5%, while increasing overall efficiency by 6.7% and reducing wall heat losses by 37.7%. Improved temperature stability enhanced heat retention and moisture migration behavior. Economically, EPS reduced operating costs, yielding annual savings of USD 81.5, a 0.45-year payback period, and an annual return on investment (ROI) of 10.86, confirming its viability as a cost-effective and sustainable solution for improving energy efficiency in mechanical coffee drying. Full article

Ischemia–reperfusion injury (IRI) is a mechanism based on inflammatory mediators’ release and activation of effectors of damage. Studies showed a correlation between cytokine, severity of damage, and post-operative outcomes. Ex situ perfusion may work as a platform for the treatment of IRI mechanisms, such as the removal of cytokines using cytokine adsorption (CA). We assessed the safety and benefits of an integrated CA during ex situ dual-oxygenated hypothermic (D-HOPE) and normothermic perfusion (NMP). During the period of July 2021–December 2023, 84 octogenarian liver grafts, suitable for transplantation, were considered: 12 were randomized to D-HOPE or NMP with or without CA (D-HOPE + CA, D-HOPE, NMP + CA, NMP groups, n = 3 each) and compared to 72 performed using grafts preserved in static cold storage (SCS). IL-1, IL-6, IL-10, and TNF-a perfusate concentrations were evaluated together with perfusion parameters and post-operative outcomes. Perfusion procedures were unaffected by CA integration. In NMP, cytokine levels were 10–40 times higher than in healthy subjects and 20–50 times higher than D-HOPE. Cytokines were removed both in D-HOPE and NMP, but the concentration-dependent mechanisms of action of CA led to more remarkable removal in NMP. IL-10 and TNF-a concentrations were significantly lower in NMP + CA than in NMP. The application of CA was associated with significantly higher arterial flows both in D-HOPE and NMP, and reduced neutrophil infiltration in NMP. No differences in post-operative outcomes were found among groups. In conclusion, cytokine adsorption during ex situ machine perfusion of liver grafts from elderly donors is safe and feasible and is associated with modulation of inflammatory mediators and perfusion dynamics. These findings are hypothesis-generating, and larger studies are required to determine the clinical impact of this strategy. Full article

Atrial fibrillation (AF) is the most common sustained heart rhythm disorder. It is estimated that AF affects over 52 million people worldwide, with its prevalence expected to double in the next four decades. AF significantly increases the risk of stroke and heart failure, contributing to 340,000 excess deaths annually. Beyond these life-threatening complications, AF results in limitations in physical, emotional, and social well-being causing significant reductions in quality of life and resulting in 8.4 million disability-adjusted life-years per year, highlighting the wide-ranging impact of AF on public health. Moreover, AF is increasingly recognized for its association with cognitive decline and dementia. AF is a chronic and progressive disease characterized by rapid and erratic electrical activity in the atria, often in association with structural changes in the heart tissue. AF is often initiated by triggered activity, often from ectopic foci in the pulmonary veins. These triggered impulses may initiate AF via: (1) sustained rapid firing with secondary disorganization into fibrillatory waves, or (2) by triggering micro re-entrant circuits around the pulmonary venous-LA junction and within the atrial body. In each instance, AF perpetuation necessitates the presence of a vulnerable atrial substrate, which perpetuates and stabilizes re-entrant circuits through a combination of slowed and heterogeneous conduction, as well as functional conduction abnormalities (e.g., fibrosis disrupting tissue integrity, and abnormalities in the intercalated disks disrupting effective cell-to-cell coupling). The re-entry wavelength, determined by conduction velocity and refractory period, is shortened by slowed conduction, favoring AF maintenance. One major factor contributing to these changes is the disruption of the extracellular matrix (ECM), which is induced by atrial fibrosis. Fibrosis-driven disruption of the ECM, especially in the heart and blood vessels, is commonly caused by conditions such as aging, hypertension, diabetes, smoking, and chronic inflammatory or autoimmune diseases. These factors lead to excessive collagen and protein deposition by activated fibroblasts (i.e., myofibroblasts), resulting in increased tissue stiffness, maladaptive remodeling, and impaired organ function. Fibrosis typically occurs when cardiac fibroblasts are activated to myofibroblasts, resulting in the deposition of excessive collagen and other proteins. This change in ECM interferes with the normal electrical function of the heart by creating irregular, fibrotic regions. AF and atrial fibrosis have a reciprocal relationship: AF promotes fibrosis through fibroblast activation and extracellular matrix buildup, while atrial fibrosis can sustain and perpetuate AF, contributing to higher rates of AF recurrence after treatments such as catheter ablation or cardioversion. Full article