Search Results (53)

Cervical cancer remains a major public health challenge, particularly in low- and middle-income countries. The primary cause of cervical cancer is high-risk human papillomavirus (HPV), and screening using physician-collected samples is complicated by stigma, inconvenience, and access. There are non-invasive alternatives to the physician-collected samples, including self-sampling methods such as first-void urine and vaginal swabs. This systematic review and meta-analysis evaluated and compared the diagnostic accuracy of vaginal and urine self-sample methods for detecting high-risk HPV. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for studies published between January 2015 and October 2025. Bivariate random-effects models and HSROC models were used to estimate pooled sensitivity and specificity results compared with clinician-collected samples for CIN2+. Meta-regression assessed sources of heterogeneity. Twenty-two studies involving over 9000 participants were included. Vaginal self-sampling showed a pooled sensitivity of 91.3% and a specificity of 86.9%, while urine self-sampling showed 86.9% sensitivity and 79.5% specificity. Vaginal swabs demonstrated higher sensitivity in head-to-head comparisons. DNA-based PCR assays showed higher sensitivity than mRNA-based tests, and room-temperature storage decreased urine sample sensitivity. Both methods are effective for high-risk HPV detection. Vaginal self-sampling showed superior performance, while urine self-sampling remains a valuable non-invasive option for under-screened populations. Full article

The forensic reliability of biological fluids in sexual assault investigations depends on substrate type, environmental exposure, time since deposition, and analytical methodology. This systematic review evaluates the forensic reliability of major biological fluids, semen, blood, saliva, and vaginal secretions by comparing detectability and persistence on porous and non-porous substrates, assessing environmental and temporal effects on DNA integrity, and examining the performance of identification methods. A systematic search of PubMed, Scopus, and Web of Science (2001–2025) was conducted following PRISMA 2020 guidelines. Eligible studies investigated fluid persistence, degradation, or identification reliability under controlled or casework-relevant conditions. A weighted scoring framework categorised relative reliability. Twenty-seven studies met inclusion criteria. Semen and blood demonstrated higher reliability across substrates, particularly when collected within recommended timeframes. Porous substrates reduced surface detectability but occasionally preserved DNA from rapid degradation. Elevated temperature, humidity, and prolonged intervals consistently reduced DNA quality and detection success. Molecular approaches, including mRNA profiling, showed enhanced specificity in degraded or mixed samples, though methodological variability limited direct comparability across studies. The forensic reliability of biological fluids is context-dependent, shaped by complex interactions between substrate characteristics, environmental exposure, and analytical technique. Semen and blood remain robust DNA sources, while emerging technologies offer improved specificity in challenging scenarios. Standardised evaluation frameworks and timely evidence collection remain essential to enhance evidential value and minimise misinterpretation in sexual assault investigations. Full article

Background and Objectives: Early mother–newborn skin-to-skin contact (SSC) after birth is widely recommended to support neonatal physiological stabilization, including thermoregulation. Under routine clinical practice, however, SSC may be brief or interrupted, and its effectiveness in maintaining neonatal body temperature under such conditions is less well described. This study aimed to evaluate early neonatal temperature changes under routine post-birth care practices that included brief SSC followed by separation for incubation care. Materials and Methods: This retrospective cohort study included 620 term mother–infant dyads delivered at a single regional teaching hospital. Newborns were managed according to routine clinical practice and were allocated to either a brief early SSC group or a control group without SSC. SSC duration differed by mode of delivery (approximately 10 min after cesarean section and 20 min after vaginal birth). Infant body temperature was recorded at predefined time points from birth through early incubation care. Associations between temperature changes and clinical factors, including mode of delivery, gestational age, parity, and birth weight, were analyzed. Results: No significant difference was observed between the SSC and control groups in overall changes in infant body temperature from birth to the beginning of incubation care (p = 0.245). After one hour of incubation, mean body temperature was comparable between groups (p = 0.357). Within the SSC group, infant body temperature decreased significantly during the SSC period (change from birth: −0.68 °C ± 0.35 °C; p < 0.001). At the start of incubation care, a significantly lower proportion of infants in the SSC group (22%) had body temperatures below 36.5 °C compared to the control group (32%) (p = 0.018). Multivariable analysis identified mode of delivery, reflecting differences in post-birth care routines and SSC duration, as the only factor independently associated with temperature changes during SSC. Conclusions: Under routine clinical conditions, brief and interrupted SSC was associated with transient reductions in neonatal body temperature; however, brief SSC was associated with a lower proportion of hypothermia compared with immediate incubation care, suggesting that even short periods of SSC may support early neonatal thermoregulation. Full article

Many piglet-producing farms are facing poor reproductive performance, yet their characteristics remain poorly understood. This study aimed to identify factors contributing to reproductive disorders based on information easily identifiable through an oral survey. Therefore, forty Austrian piglet producing farms (35–2000 sows) were surveyed using a questionnaire mainly addressing management, treatment and prophylaxis. Five key performance indicators (KPIs) were defined to assess farm productivity: farrowing rate, return-to-estrus rate, abortion rate, total piglets born per litter, and piglets weaned per litter. Farrowing rates were significantly higher in larger farms (r = 0.368; p = 0.019), PRRS-negative farms (r = 0.415; p = 0.008), and farms that did not clean the vulva before artificial insemination (r = 0.357; p = 0.024). Return-to-estrus rates were significantly higher in smaller farms (r = −0.431; p = 0.006), farms with more vaginal discharge after farrowing (r = 0.397; p = 0.011), those not using hormonal farrowing induction (r = 0.339; p = 0.033), and farms with older teaser boars (r = 0.385; p = 0.039). Larger farms had more piglets born per litter (r = 0.342; p = 0.031) and weaned more piglets (r = 0.391; p = 0.013). Weaned piglet numbers were also higher in farms with all-in/all-out implementation in farrowing pens (r = 0.353; p = 0.026), with restricted access of other animal species to the barn (r = 0.366; p = 0.028) and hormonal farrowing induction (r = 0.348; p = 0.028). Common well-established strategies for improving fertility performance like evaluation of body temperature after farrowing, antimicrobial, and hormonal treatments showed limited relevance. Further research is needed to confirm these findings and to identify additional factors influencing reproductive performance of sows. Full article

Perineal tears are common during vaginal delivery and are associated with significant maternal morbidity. While chorioamnionitis and intrapartum fever are known to affect labor dynamics and perineal tissue integrity, their relationship with perineal trauma in spontaneous vaginal deliveries has not been established. This study aimed to evaluate the prevalence of perineal tears among women with intrapartum fever who delivered spontaneously. This retrospective cohort study included women who underwent spontaneous vaginal delivery during 2013–2021 in Israel. The study group comprised women diagnosed with intrapartum fever (≥38 °C), while afebrile women served as controls in a 1:2 ratio matched by age (<35 or ≥35 years) and gestational age (preterm/term). Perineal tears were classified according to the Royal College of Obstetricians and Gynaecologists (RCOG) criteria. Multivariable logistic regression was performed to adjust for statistically significant variables including obesity, induction of labor, epidural analgesia, amniotomy, delivery week, gestational diabetes, birth number, duration of the second stage of labor, and episiotomy. The cohort included 373 women with intrapartum fever and 746 controls. The overall rate of perineal tears was similar between febrile and afebrile women (42% vs. 40%; adjusted odds ratio [aOR] 0.99, 95% confidence interval [CI] 0.72–1.36). However, the rate of obstetric anal sphincter injury (OASIS) was lower among women with intrapartum fever (0.5% vs. 2.0%; aOR 0.10, 95% CI 0.02–0.52). Intrapartum fever was associated with higher rates of postpartum hemorrhage, manual exploration of the uterus, endometritis, anemia, and blood transfusion. Bacterial cultures were positive in 31% of febrile women, predominantly Escherichia coli and Group B Streptococcus, without association with perineal trauma. Alltogether, Intrapartum fever did not increase the risk of perineal tears in spontaneous vaginal deliveries and was paradoxically associated with a lower rate of OASIS. Further studies are warranted to explore the underlying physiological mechanisms linking temperature and perineal tissue resilience. Full article

Achieving satisfactory levels of weight gain for developing replacement beef heifers is challenging when utilizing toxic endophyte-infected tall fescue (Schedonorus arundinaceus) as the primary forage. This is due to the intensifying impact of ergot alkaloids produced by the fungal endophyte on heifer heat stress in the summer. The purpose of this trial was to determine if clipping hair coats would reduce heat stress impacts experienced by fall-born heifers stocked on toxic endophyte-infected tall fescue. Heifers were randomly assigned to a control cohort and a clipped cohort. The heifers in the clipped treatment group were sheared along the body of the heifer. Vaginal temperature loggers were used to record core temperatures every ten minutes during several sampling periods. Hair coats on clipped heifers resembled hair coats of the control heifers by the conclusion of the 16-week trial. Average daily gains of the clipped heifers exceeded the average daily gains of the control heifers only in the first four-week period. There were no differences in seasonal average daily gain or pregnancy rates. Clipped heifers had cooler core temperatures by 0.2–0.3 °C in the morning compared to the control heifers. Clipping hair coats of heifers only provided short-term relief for cattle stocked on toxic endophyte-infected tall fescue. Full article

Calving is a crucial event in dairy production, and predicting its exact date is challenging due to variable gestation lengths and environmental factors. Failure to recognize signs of impending calving can lead to dystocia, increased calf mortality, veterinary costs, and economic losses. This review discusses both invasive and non-invasive methods for monitoring calving signs. Invasive methods, such as temperature loggers, intra-vaginal GSM devices, and blood progesterone tests, provide direct physiological data but can cause stress to the animals. Non-invasive approaches, including the use of sensors on limbs, necks, or tails, as well as video monitoring systems, offer less intrusive alternatives, improving cow comfort. Advances in artificial intelligence (AI) and machine learning have enhanced the predictive accuracy of these methods, enabling better management of the calving process. Full article

Many antifungal agents, including isoconazole nitrate (ISN), suffer from low aqueous solubility and inconsistent dissolution kinetics, which limit their therapeutic potential. To address these challenges, this study aimed to enhance the solubility and stability of ISN through the development of inclusion complexes with hydroxypropyl-β-cyclodextrin (HP-β-CD). HP-β-CD inclusion complexes were prepared using a spray-drying technique and characterized through phase-solubility studies, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance (¹H-NMR), and differential scanning calorimetry (DSC). The inclusion complex significantly improved ISN solubility, increasing from 0.5088 mg/mL to 3.6550 mg/mL. These complexes were incorporated into a thermosensitive, mucoadhesive in situ gel system using Pluronic^® F127 and hydroxypropyl methylcellulose (HPMC) to optimize vaginal drug delivery. The formulations were evaluated for gelation temperature, viscosity, swelling behavior, and pH, confirming their suitability for vaginal application. Antimicrobial studies demonstrated that the ISN/HP-β-CD gels exhibited superior activity against Candida albicans, C. glabrata, and C. krusei compared to ISN alone. In vitro release studies further revealed sustained drug release following Peppas-Sahlin kinetics, supporting enhanced bioavailability and prolonged therapeutic action. This study demonstrates that the ISN/HP-β-CD-loaded in situ gel system offers a promising and effective approach for improving the solubility, stability, and antifungal efficacy of ISN for the treatment of vaginal infections. Full article

Vaginal candidiasis poses significant health concerns that affect approximately 75% of women globally and often leads to discomfort and a decrease in quality of life. Traditional treatments, despite their effectiveness, may cause discomfort and adverse effects, such as vaginal discharge, bleeding, and dryness, promoting the exploration of alternative formulations. In this study, we aimed to develop a novel therapeutic approach for the treatment of vaginal candidiasis utilizing oleic acid containing emulgels made from thermoresponsive poloxamer-based hydrogels. These emulgels were designed to provide a sustained release of clotrimazole, an antifungal agent. Incorporating oleic acid enhanced the drug’s solubility and contributed to vaginal health. The formulations were characterized by their rheological properties, in vitro release, mucoadhesion, and spreadability. We conducted rheological measurements on the hydrogels that served as the base for the emulgels, as well as on the emulgels themselves. The emulgels exhibited continuous rheological behavior with changing temperatures, making them suitable for storage at room temperature. With an increasing HPMC content, we achieved enhanced mucoadhesion, which is beneficial for formulations used in body cavities. Moreover, in vitro release studies revealed sustained drug release profiles, which can be adjusted by varying the ratios of poloxamers and HPMC. These findings suggest that the developed emulgels offer a promising therapeutic option for vaginal candidiasis, addressing both the symptoms and the treatment of discomfort. Full article

Background/Objectives: Cytolytic vaginosis or, classically, Doderlein’s cytolysis is characterized by significant growth of species of the Lactobacillus genus, which leads to high amounts of lactic acid in the vaginal environment. Lactobacillus crispatus has been proposed as a key pathogen in this clinical condition. The symptomatology of cytolytic vaginosis is commonly confused with that of vulvovaginal candidosis, leading to inadequate and ineffective azole therapies. Nevertheless, historically, the use of sodium bicarbonate intimate baths was an effective way to reduce the symptoms of cytolytic vaginosis. Methods: In this study, four HPMC gel prototypes were developed, containing sodium bicarbonate concentrations ranging from 4% to 7% (w/w). These gels were evaluated for their physicochemical properties, antimicrobial activity, interference with lactobacilli adhering to cells, and cellular and tissue biocompatibility. Results: The gels presented pH values of around 9.0, and osmolality between 706 mOsm/kg (F4) and 1065 mOsm/kg (F7). The viscosity upon heating to physiologic temperature and dilution with simulated vaginal fluid was highly affected by the concentration of sodium bicarbonate. Gels with higher sodium bicarbonate concentrations (F6 and F7) were not shown to be stable in these conditions. All formulations exhibited effective antimicrobial activity against seven L. crispatus strains, with MIC values ranging from 6.25% to 25% (v/v) in terms of dilution. Additionally, the 4% (w/w) gel significantly interfered with the adhesion of L. crispatus to epithelial cells in competition and exclusion assays, reducing adhesion by more than 90% in relation to the control. Cytotoxicity tests on the Hec-1A, HeLa, and VK2/E6E7 cell lines indicated that the F4 and F5 gels demonstrated lower cytotoxicity levels compared to those with higher concentrations. Furthermore, ex vivo assays using porcine vaginal tissue confirmed that the 4% gel was non-toxic at a 25% (v/v) dilution. Conclusions: Based on these results, the 4% (w/w) sodium bicarbonate gel (F4) emerges as a promising therapeutic option for cytolytic vaginosis, offering effective bacterial interference, favourable physicochemical properties, and biocompatibility suitable for vaginal application. Full article

Metritis affects 5–20% of cows after parturition, negatively impacting animal welfare and the profitability of dairy farms, increasing culling rates and costs, and decreasing productivity and reproduction rates. This study compared the results of a comprehensive biochemical panel consisting of 25 salivary and 31 serum analytes between healthy cows (n = 16) and cows with metritis (n = 12). Descriptive parameters such as depression, rectal temperature, body condition score (BCS), heart rate, respiratory rate, mucous color, ruminal motility, vaginal discharge, milk production, and complete hematology analyses were also assessed for comparative purposes. The biochemistry analytes comprised five analytes related to stress, five to inflammation, five to oxidative status, and nineteen to general metabolism. The two-way ANOVA analysis revealed that, in saliva, eight biomarkers (lipase, adenosine deaminase (ADA), haptoglobin (Hp), total proteins, g-glutamyl transferase (gGT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and creatine kinase (CK)) were significant higher in cows with metritis. In serum, eight biomarkers (ADA, Hp, serum amyloid A (SAA), fibrinogen, ferritin, AOPPs/albumin ratio, non-esterified fatty acids (NEFAs), and bilirubin) were significantly higher in cows with metritis, whereas six (total esterase (TEA), albumin, urea, lactate, phosphorus, and calcium) were lower. Of the total number of 23 biomarkers that were measured in both saliva and serum, significant positive correlations between the two biofluids were found for six of them (Hp, FRAP, CUPRAC, AOPPs, urea, and phosphorus). Urea showed an R = 0.7, and the correlations of the other analytes were weak (R < 0.4). In conclusion, cows with metritis exhibited differences in biomarkers of stress, inflammation, cellular immune system, and general metabolism in both salivary and serum biochemistry profiles. These changes were of different magnitudes in the two biofluids. In addition, with the exception of ADA and Hp, the analytes that showed changes in the saliva and serum profiles of cows affected by metritis were different. Overall, this report opens a new window for the use of saliva as potential source of biomarkers in cows with metritis. Full article

Pelvic floor muscle (PFM) strength is a critical factor for optimal pelvic floor function. Fluctuations in strength values based on different phases of the menstrual cycle (MC) could signify a need for a paradigm shift in evaluating, approaching, and planning training. This research aims to examine and contrast the pelvic floor muscle strength during different phases of the menstrual cycle. A prospective observational study employing digital assessment with the modified Oxford scale and vaginal dynamometry measurements was performed, in order to assess the baseline strength and the contraction strength of the PFMs in eumenorrheic females at three different phases of the MC: the early follicular phase (EFP), the late follicular phase (LFP), and the mid-luteal phase (MLP). During two complete cycles, tympanic temperature and body weight were measured and the urinary luteinizing hormone concentration was tested to determine the time of ovulation. In total, 216 dynamometric measurements of PFM strength were obtained from eighteen nulliparous women (25.72 ± 5.03 years). There were no differences between the baseline strength (p = 0.886) and the contraction strength (p = 0.756) with the dynamometric speculum. In the post hoc analysis, the baseline strength, contraction strength, and strength showed no significant differences between MC phases. As no differences in PFM strength in women were found, the PFMs do not seem to be weaker at any time during the menstrual cycle. It appears that the assessment, establishment, and monitoring of a PFM training program could be initiated at any point in the cycle. Full article

Rectal and vaginal temperatures are utilised in both in vivo and in vitro models to study the effects of heat stress on oocyte competence and embryo viability in cattle. However, uterine temperature increases by only 0.5 °C in heat-stressed cows, significantly lower than simulated increases in in vitro models. Temperature variations within oviducts and ovarian follicles during heat stress are poorly understood or unavailable, and evidence is lacking that oocytes and pre-implantation embryos experience mild (40 °C) or severe (41 °C) heat stress inside the ovarian follicle and the oviduct and uterus, respectively. Gathering detailed temperature data from the reproductive tract and follicles is crucial to accurately assess oocyte competence and embryo viability under realistic heat stress conditions. Potential harm from heat stress on oocytes and embryos may result from reduced nutrient availability (e.g., diminished blood flow to the reproductive tract) or other unidentified mechanisms affecting tissue function rather than direct thermal effects. Refining in vivo stress models in cattle is essential to accurately identify animals truly experiencing heat stress, rather than assuming heat stress exposure as done in most studies. This will improve model reliability and aid in the selection of heat-tolerant animals. Full article

Human papillomavirus (HPV) is a prevalent cause of mucosal and cutaneous infections and underlying conditions ranging from benign warts to anogenital and oropharyngeal cancers affecting both males and females, notably cervical cancer. Cervical cancer is the fourth leading cause of cancer deaths among women globally and is the most impactful in low- and middle-income countries (LMICs), where the costs of screening and licensed L1-based HPV vaccines pose significant barriers to comprehensive administration. Additionally, the licensed L1-based HPV vaccines fail to protect against all oncogenic HPV types. This study generated three independent lots of an L2-based target antigen (LBTA), which was engineered from conserved linear L2-protective epitopes (aa11–88) from five human alphapapillomavirus genotypes in E. coli under cGMP conditions and adjuvanted with aluminum phosphate. Vaccination of rabbits with LBTA generated high neutralizing antibody titers against all 17 HPV types tested, surpassing the nine types covered by Gardasil^®9. Passive transfer of naïve mice with LBTA antiserum revealed its capacity to confer protection against vaginal challenge with all 17 αHPV types tested. LBTA shows stability at room temperature over >1 month. Standard in vitro and in vivo toxicology studies suggest a promising safety profile. These findings suggest LBTA’s promise as a next-generation vaccine with comprehensive coverage aimed at reducing the economic and healthcare burden of cervical and other HPV+ cancers in LMICs, and it has received regulatory approval for a first-in-human clinical study (NCT05672966). Full article

Automated activity monitoring (AAM) systems are critical in the dairy industry for detecting estrus and optimizing the timing of artificial insemination (AI), thus enhancing pregnancy success rates in cows. This study developed a predictive model to improve pregnancy success by integrating AAM data with cow-specific and environmental factors. Utilizing data from 1,054 cows, this study compared the pregnancy outcomes between two AI timings—8 or 10 h post-AAM alarm. Variables such as age, parity, body condition, locomotion, and vaginal discharge scores, peripartum diseases, the breeding program, the bull used for AI, milk production at the time of AI, and environmental conditions (season, relative humidity, and temperature–humidity index) were considered alongside the AAM data on rumination, activity, and estrus intensity. Six predictive models were assessed to determine their efficacy in predicting pregnancy success: logistic regression, Bagged AdaBoost algorithm, linear discriminant, random forest, support vector machine, and Bagged Classification Tree. Integrating the on-farm data with AAM significantly enhanced the pregnancy prediction accuracy at AI compared to using AAM data alone. The random forest models showed a superior performance, with the highest Kappa statistic and lowest false positive rates. The linear discriminant and logistic regression models demonstrated the best accuracy, minimal false negatives, and the highest area under the curve. These findings suggest that combining on-farm and AAM data can significantly improve reproductive management in the dairy industry. Full article