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Background: Given the limited understanding of individuals' positive gains, this study aimed to identify these gains that could be leveraged by policymakers to enhance future health and societal resilience., Methods: We used a global qualitative approach to survey adults over 18 from 30 countries across six World Health Organization (WHO) regions, who detailed up to three personal positive gains from COVID-19 pandemic via an open-ended question. Inductive thematic analysis was employed to identify main themes, and quantitative methods were used for demographic and regional comparisons based on the percentage of responses for each theme., Results: From 35 911 valid responses provided by 13 853 participants, six main themes (one negative theme), 39 subthemes, and 673 codes were identified. Five positive gain themes emerged, ordered by response frequency: 1) improved health awareness and practices; 2) strengthened social bonds and trust; 3) multi-dimensional personal growth; 4) resilience and preparedness building; 5) accelerated digital transformation. The percentage of responses under these themes consistently appeared in the same order across various demographic groups and economic development levels. However, there were variations in the predominant theme across WHO regions and countries, with either Theme 1, Theme 2, or Theme 3 having the highest percentage of responses. Although our study primarily focused on positive gains, unexpectedly, 12% of responses (4304) revealed 'negative gains', leading to an unforeseen theme: 'Distrust and emerging vulnerabilities.' While this deviates from our main topic, we retained it as it provides valuable insights. Notably, these 'negative gains' had a higher percentage of responses in areas like Burundi (94.1%), Rwanda (31.8%), Canada (26.9%), and in the African Region (37.7%) and low-income (43.9%) countries, as well as among non-binary individuals, those with lower education, and those facing employment challenges., Conclusions: Globally, the identified diverse positive gains guide the domains in which health policies and practices can transform these transient benefits into enduring improvements for a healthier, more resilient society. However, variations in thematic responses across demographics, countries, and regions highlights need for tailored health strategies., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2025 by the Journal of Global Health. All rights reserved.)

Background: We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements., Methods: From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network., Results: Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05)., Conclusions: In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research., Keywords: global; across-country comparisons; lifestyle; health outcomes; network analysis., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2025 by the Journal of Global Health. All rights reserved.)

Memory loss is becoming an increasingly significant health problem, largely due to Alzheimer's disease (AD), which disrupts the brain in several ways, including causing inflammation and weakening the body's defenses. This study explores the potential of medicinal plants as a source of novel therapeutic agents for AD. First, we tested various plant extracts against acetylcholinesterase (AChE) in vitro , following molecular docking simulations with key AD-related protein targets such as MAO-B, P-gp, GSK-3β, and CD14. Rosemary extract was found to be the most inhibitory towards AChE. The compounds found in rosemary (oleanolic acid), sage (pinocembrin), and cinnamon (italicene) showed promise in potentially binding to MAO-B. These chemicals may interact with a key protein in the brain and alter the production and removal of amyloid-β. Luteolin (from rosemary), myricetin (from sage), chamigrene, and italicene (from cinnamon) exhibited potential for inhibiting tau aggregation. Additionally, ursolic acid found in rosemary, sage, and chamigrene from cinnamon could modulate CD14 activity. For the first time, our findings shed light on the intricate interplay between neuroinflammation, neuroprotective mechanisms, and the immune system's role in AD. Further research is needed to validate the in vivo efficacy and safety of these plant-derived compounds, as well as their interactions with key protein targets, which could lead to the development of novel AD therapeutics., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: In this study, we assessed the general population's fears towards various diseases and events, aiming to inform public health strategies that balance health-seeking behaviours., Methods: We surveyed adults from 30 countries across all World Health Organization (WHO) regions between July 2020 and August 2021. Participants rated their fear of 11 factors on an 11-point Likert scale. We stratified the data by age and gender and examined variations across countries and regions through multidimensional preference analysis., Results: Of the 16 512 adult participants, 62.7% (n = 10 351) were women. The most feared factor was the loss of family members, reported by 4232 participants (25.9%), followed by cancer (n = 2248, 13.7%) and stroke (n = 1416, 8.7%). The highest weighted fear scores were for loss of family members (mean (x̄) = 7.46, standard deviation (SD) = 3.04), cancer (x̄ = 7.00, SD = 3.09), and stroke (x̄ = 6.61, SD = 3.24). The least feared factors included animals/insects (x̄ = 3.72, SD = 2.96), loss of a mobile phone (x̄ = 4.27, SD = 2.98), and social isolation (x̄ = 4.83, SD = 3.13). Coronavirus disease 2019 (COVID-19) was the sixth most feared factor (x̄ = 6.23, SD = 2.92). Multidimensional preference analyses showed distinct fears of COVID-19 and job loss in Australia and Burundi. The other countries primarily feared loss of family members, cancer, stroke, and heart attacks; this ranking was consistent across WHO regions, economic levels, and COVID-19 severity levels., Conclusions: Fear of family loss can improve public health messaging, highlighting the need for bereavement support and the prevention of early death-causing diseases. Addressing cancer fears is crucial to encouraging the use of preventive services. Fear of non-communicable diseases remains high during health emergencies. Top fears require more resources and countries with similar concerns should collaborate internationally for effective fear management., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Background: Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements., Methods: We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test., Findings: Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05)., Conclusion: To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Background: The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences., Methods: An international cross-sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic., Results: Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction)., Conclusions: Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

Background: The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic., Methods: We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels., Results: 16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised., Conclusions: Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

Cancer is the deadliest threat that human beings are currently facing. Prostate cancer is the second largest cancer in males all over the world. During the last decade, scientists made breakthroughs in combatting this deadliest threat through naturally identified drugs. As in the majority of the cases, the natural products have been reported as non-toxic to the healthy cells of the body; therefore, scientists are taking special interest in identifying those and making tiresome efforts to isolate compounds from the naturally occurring living resources. Marine natural products are given a special preference over other natural products because of their diverse atmospheric and structural variations as well as signaling pathways for carcinogenesis. This study covers the anti-prostate cancer agents extracted from marine organisms including algae, fungi, bacteria, sponges, soft-bodied corals, fish, and other miscellaneous organisms. These natural products belong to different classes such as terpenes, terpenoids, carotenoids, alkaloids, polyketides, peptides, lactones, quinones, polysaccharides, and steroids. These compounds act against prostate cancer cells via in vitro and in vivo pathways, show special affinity towards the targeted area, and are specific because they bind to specific signaling paths. This review article covers data published from 2003 to 2023, which consists of anti-prostate cancer agents from marine sources., Competing Interests: Declarations. Ethical approval: Not applicable. No human or animal studies were performed. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To determine the causes of low vision among Sudanese patients with diabetic retinopathy (DR) by using ophthalmic B-scan ultrasonography., Materials and Methods: A total of 100 patients with DR at different grades, were recruited prospectively between September 2016 and January 2018. Nidek (Echoscan US-4000) ultrasound unit was used to determine the causes of low vision in diabetic patients according to their glycated haemoglobin (HbA1c) and early treatment of diabetic retinopathy scale (ETDRS) severity levels., Results: Vitreous hemorrhage (VH) 42(66.6%), asteroid hyalosis (AH) 12(14.3%), and partial retinal detachment (PRD) 9(19%) were the main cause of low vision in patients presenting with moderately regulated HbA1c and graded with either minimal or mild nonproliferative retinopathy (NPDR). While VH 15(40.5%), total retinal detachment (TRD) 12(32.4%), posterior vitreous detachment (PVD) 7(19%), and choroidal detachment (CD) 3(8.1%), were dominant in patients with poorly regulated HbA1c and graded either as moderate NPDR; severe NPDR; and proliferative retinopathy (PR)., Conclusions: Ophthalmic B-mode ultrasound is a rapid, noninvasive imaging technique that can be used with minimum discomfort in ophthalmological practice for the detection and evaluation of DR complications that predict the visual outcome.

Introduction: Many clinical studies suggest a direct association between hepatic fat content and visceral adiposity and the progression of fibrosis., Aim: This work aims to clarify the relation between the Visceral Adiposity Index (VAI) and severity of necroinflammatory activity and liver fibrosis in Egyptian patients with chronic Hepatitis C Virus (HCV) infection., Materials and Methods: A cross-sectional study, over a period of six months, was performed on 50 chronic HCV patients subjected to routine laboratory investigations, abdominal ultrasonography, measurement of Waist Circumference (WC), calculation of Body Mass Index (BMI) and VAI, ultrasound guided liver biopsy and assessment of hepatic fibrosis by METAVIR staging., Results: A total of 50 HCV positive patients, 29 (58%) males and 21 (42%) females were included in the study. Age ranged from 29-60 years (44.4±8.4). BMI was ranged from 20.3 to 41.4 kg/m 2 (31.7±5.5). VAI for males was 0.4±0.2 and for females was 0.5±0.3. There were significant positive correlations between VAI and BMI, Triglycerides (TG), fibrosis stages, grades of liver inflammation and FIB-4 Fibrosis-4 score. There were significant negative correlations between VAI and high density lipoprotein, platelets and haemoglobin., Conclusion: There is an association between visceral obesity represented by VAI and the severity of hepatic inflammatory response in chronic hepatitis C patients. Other studies are recommended to measure the clinical implication of visceral obesity on the response to the novel directly acting antivirals.

In this study, we isolated 15 endophytic fungi from five Sudanese medicinal plants. Each fungal endophytic strain was identified by sequencing of internal transcribed spacer (ITS) regions of rDNA. Ethyl acetate extracts were prepared from each endophyte cultivated in vitro and tested for their respective antibacterial activities and antiproliferative activities against human cancer cells. Antibacterial screening was carried out against two bacterial strains: Gram-negative Escherichia coli and Gram-positive methicillin-resistant Staphylococcus aureus, by the broth dilution method. Cell viability was evaluated by the MTT procedure after exposure of MCF7 breast cancer cells and HT29 or HCT116 human colon adenocarcinoma cells to each endophytic extract. Of interest, Byssochlamys spectabilis isolated from Euphorbia prostata showed cytotoxicity (IC50 = 1.51 ± 0.2 μg mL(-1)) against MCF7 cells, but had a low effect against HT29 or HCT116 cells (IC50 > 20 μg mL(-1)). Cladosporium cladosporioides 2, isolated from Vernonia amygdalina leaves, showed antiproliferative activities against MCF7 cells (IC50 = 10.5 ± 1.5 μg mL(-1)) only. On the other hand, B. spectabilis and Alternaria sp. extract had antibacterial activities against the S. aureus strain. The findings of this work revealed that endophytic fungi associated with medicinal plants from Sudan could be considered as an attractive source of new therapeutic compounds., (© FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Association between prostate cancer and obesity remains controversial. Allelic deletions of PTEN, a tumor suppressor gene, are common in prostate cancer in men. Monoallelic Pten deletion in mice causes low prostatic intraepithelial neoplasia (mPIN). This study tested the effect of a hypercaloric diet on prostate cancer in Pten (+/-) mice., Methods: 1-month old mice were fed a high-calorie diet deriving 45% calories from fat for 3 and 6 months before prostate was analyzed histologically and biochemically for mPIN progression. Because Pten (+/-) mice are protected against diet-induced insulin resistance, we tested the role of insulin on cell growth in RWPE-1 normal human prostatic epithelial cells with siRNA knockdown of PTEN., Results: In addition to activating PI3 kinase/Akt and Ras/MAPkinase pathways, high-calorie diet causes neoplastic progression, angiogenesis, inflammation and epithelial-mesenchymal transition. It also elevates the expression of fatty acid synthase (FAS), a lipogenic gene commonly elevated in progressive cancer. SiRNA-mediated downregulation of PTEN demonstrates increased cell growth and motility, and soft agar clonicity in addition to elevation in FAS in response to insulin in RWPE-1 normal human prostatic cells. Downregulating FAS in addition to PTEN, blunted the proliferative effect of insulin (and IL-6) in RWPE-1 cells., Conclusion: High-calorie diet promotes prostate cancer progression in the genetically susceptible Pten haploinsufficient mouse while preserving insulin sensitivity. This appears to be partly due to increased inflammatory response to high-caloric intake in addition to increased ability of insulin to promote lipogenesis.

The current study was designed to investigate the potential association of serum interleukin-10 and interleukin-12 with HCV infection in chronic liver disease and to evaluate their possible role as new biomarkers in HCC development. Material and Methods. Forty-one patients suffering from chronic liver disease (33 patients harbor HCV infection and 8 are HCV-negative patients) were enrolled in the present study and histopathologically diagnosed into 15 patients with HCC, 16 patients with LC, and 10 patients with liver histology compatible with precirrhotic hepatitis (PCH). Ten patients complaining of cholecystitis were included as nondisease control. Serum levels of IL-10 and IL-12 were measured by enzyme linked immunosorbent assay (ELISA). Results. HCV-infected patients showed elevated expression of IL-10 and IL-12 compared to nondisease controls (P < 0.0001) but there is no significant difference with respect to their expression in HCV-negative patients. Serum IL-10 and IL-12 were elevated significantly with disease progression (P < 0.0001) and a positive correlation coefficient was detected between IL-10, IL-12 (r = 0.785, P < 0.0001), and transaminase values suggesting their possible role in chronic inflammation progression leading to HCC. Conclusion. IL-10 and IL-12 might be involved in chronic inflammation progression leading to HCC and their evaluation could be used as new biomarkers to reflect the degree of inflammation in HCC development.

The marine endophytic fungus Coniothyrium cereale produces the structurally unusual polyketide-type alkaloids (-)-cereolactam (1) and (-)-cereoaldomine (3), incorporating a lactam and an imine functionality, respectively, as well as the related metabolite (-)-trypethelone (2). Compounds 1 and 3 showed selective inhibition of human leukocyte elastase with IC50 values of 9.28 and 3.01 μM, respectively. Compound 2 was found to be inhibitory toward Mycobacterium phlei, Staphylococcus aureus, and Escherichia coli and also cytotoxic against mouse fibroblast cells (IC50=7.5 μM).

Epoxyphomalins A (1) and B (2) are highly potent cytotoxic fungal metabolites. During the course of purifying larger quantities of 1 and 2 from Paraconiothyrium sp. fermentation extracts, three new epoxyphomalins (3-5) were isolated and characterized, showing modifications to the oxidation pattern of the cyclohexene moiety or of C-9 of the decalin system. IC(50) values for cytotoxicity against a panel of 36 human tumor cell lines were determined for all new compounds. Compound 4 was found to be cytotoxic particularly toward prostate PC3M (IC(50) = 0.72 μM) and bladder BXF 1218 L (IC(50) = 1.43 μM) cancer cell lines. In addition, inhibition of chymotrypsin-, caspase-, and trypsin-like activity of purified 20S proteasomes was determined for epoxyphomalins A (1) and B (2). The results indicate that compounds 1 and 2 exert their cytotoxic effect through potent inhibition of the 20S proteasome.

Chemical investigation of a strain of the marine-derived fungus Phoma sp. has led to the discovery of epoxyphomalin A (1) and B (2), two new prenylated polyketides with unusual structural features. Epoxyphomalin A (1) showed superior cytotoxicity at nanomolar concentrations toward 12 of a panel of 36 human tumor cell lines. In COMPARE analyses, the observed cytotoxic selectivity pattern of 1 did not correlate with those of reference anticancer agents with known mechanisms of action.

Background: Although direct-acting antivirals (DAAs) have revolutionized the management of chronic HCV, the debatable association with hepatocellular carcinoma (HCC) occurrence/recurrence has raised major concerns about their long-term use, especially in cirrhotic cases. The role of epithelial tight junction proteins (TJPs) in hepatocarcinogenesis has been highlighted; however, the association of their expression in peripheral blood mononuclear cells (PBMCs) with HCC has rarely been reported. This study aimed to explore the role of peripheral claudin (Cldn)1 in liver pathogenesis and its crosstalk with soluble immune mediators in HCC prognosis. Methods: The study population included six independent subgroups: healthy controls, cirrhotic/non-cirrhotic treatment-naïve HCV patients, DAA-SVR patients, and anticancer treatment-naïve de novo HCC patients. The laboratory tests included serum levels of alpha-fetoprotein (AFP), albumin, liver transaminases, total bilirubin, and CBC profiling. The serum levels of soluble cluster of differentiation (sCD)163, IL-10, and IL-12 were estimated by corresponding ELISA kits, whereas the levels of Cldn1 and transforming growth factor (TGF)-β in PBMCs were quantified using quantitative PCR (qPCR). Results: Serum sCD163, IL-10, and IL-12 levels were significantly higher in the HCC patient group than in the control and non-malignant patient groups (P < 0.0001). No significant difference was detected in the serum levels of the three markers between cirrhotic and non-cirrhotic patients, whereas their levels were significantly different between cirrhotic and non-cirrhotic patients (P < 0.0001). Similarly, the transcriptional levels of peripheral Cldn1 and TGF-β were significantly higher in patients with HCC and non-malignant cirrhosis than in patients without cirrhosis (P = 0.0185–<0.0001 and 0.0089–<0.0001, respectively). Logistic regression analysis revealed a significant association between all the abovementioned markers and HCC (P = 0.0303 to < 0.0001), which was further confirmed by the results of receiver operating characteristic (ROC) analysis, which revealed an area under the curve (AUC) value ranging from 0.883 to 0.996. The calculated cutoff values demonstrated remarkable prognostic capacity, with ranges of 88–99.41% and 82.14–97.92% and positive/negative predictive values ranging from 84.62 to 98.3% and 92–98%, respectively. Conclusion: The proposed HCC predictors are novel non-invasive HCC biomarkers that maintain their predictive power under different pathological conditions and circumvent the drawbacks of conventional prognostic markers in patients with mild cirrhosis and/or normal AFP, albumin, and/or platelet counts. [ABSTRACT FROM AUTHOR]

This article is concerned with a thermoelastic response in a non-local micro-stretch completely covered in the endless non-viscous fluid under temperature dependent, the medium is investigated employing the theory of Green-Naghdi (G-N III) and the model of three-phase-lag (3PHL).Basic equations are derived based on these models. The normal mode technique is employed to achieve an analysis solution to the problem. The study used a magnesium crystal element to compare non-local measurements of thermo-micro-stretch elasticity in water using the (G-N III) theory and the (3PHL) model. The non-local effect has been discovered to have a considerable impact on all physical quantities. Furthermore, comparisons are made between three different frequency values. [ABSTRACT FROM AUTHOR]

Background: Chronic liver disease (CLD) patients with abrupt deterioration of hepatic function with associated extrahepatic organ failures is defined as acute on chronic liver failure (ACLF). The triggering incidents most common being alcohol followed by drug-induced injury, viral hepatitis, bacterial infections, hypoxia-related injury and major surgical procedures. An acute triggering event inflicts damage upon hepatocytes, leading to the accumulation of inflammatory cytokines leading to cascade of events resulting in further injury to the liver when hepatocyte regeneration fails (liver decompensation), compromised immune function and render them to infections, multi-organ failure, and eventual mortality. Studies regarding in hospital course and mortality for ACLF patients are very few in this region. Hence, this study was conducted to evaluate the clinical profile of ACLF patients, assessment of the in-hospital course, mortality and outcome and to determine the factors affecting the outcome. Materials and Methods: This study was conducted in Regional Institute of Medical Sciences (RIMS), Imphal from May 2022 to July 2024. All patients with chronic liver disease fulfilling the Asian Pacific Association for the Study of Liver criteria for ACLF, admitted in the Department of Medicine, were enrolled. On the day of admission (within 24hours), severity of liver disease was assessed and routine blood investigations, ultrasound whole abdomen, ascitic fluid analysis, upper GI endoscopy were done. Child Pugh Score, Model for End Stage Liver Disease-Na, Sequential Organ Failure Assessment and EASL-CLIF (European Association for the study of Liver-Chronic liver failure) consortium criteria were used. Outcome or mortality were compared among survivors and non - survivors of ACLF.A p value <0.05 was considered significant. Results: A total of 70 ACLF patients were enrolled. The mean age of patients were 45.25±7.9 years with majority being males 63 (89.9%). Jaundice is detected in all patients (100%) and alcohol is the most common etiology of CLD found in 59 patients (84.1%). The most common acute insult precipitating ACLF was bacterial infection (34.3%){Spontaneous bacterial peritonitis followed by active alcoholism (32.9%)}. In our study, anemia and thrombocytopenia were present in 60(85.7%) and 52 (25.7%) patients respectively. Majority of patients belonged to Child Pugh class C (64%). There was significant association between a higher MELD score and mortality (p<0.05), 58 patient (82.6%) survived and 12 (17.4%) died with the mean duration of hospital stay of 11.7±4 days. The most common organ failure was cerebral failure (25.7%) (grade II hepatic encephalopathy). ACLF grade 0,1,2,3 were present in 15(21.7%), 29(42%), and 19 (27.5%) patients respectively. There was significant association between ACLF grade and outcome, 66.7% of the non-survivors were in ACLF grade 3 (p<0.05). Conclusions: Majority of the patients had multi-organ failure at the time of admission (42%) and was significantly associated with mortality (p<0.05). Higher grades of ACLF was associated with higher mortality. Parameters predicting poor outcome are low hemoglobin and platelet, high total leucocyte count, low serum albumin, elevated creatinine and high INR. Therefore, better characterization of the disease, vital signs and organ function will help in improving the patients' outcome and early implementation of organ-specific interventions. [ABSTRACT FROM AUTHOR]

Background: Despite early detection having been identified as a key factor in long-term survival of patients with breast cancer, women with locally advanced breast cancer continued to present at many medical centers., Methods: Women with locally advanced breast cancer (LABC) (N = 11) and matched controls (N = 11) with Stage I or II breast cancer completed semi-structured interviews and the Hospital Anxiety and Depression Scale, Life Orientation Test, Multidimensional Health Locus of Control Scale, Body Investment Scale, Monitor-Blunter Style Scale, and Religious Coping Scale. Five spouses of the LABC group and eight control partners were similarly assessed., Results: On psychological tests, no significant differences were found between patient groups; however, LABC spouses reported significantly greater active religious surrender (t = 2.37, P = 0.037) and depression (t = 3.54, P = 0.047) than control spouses. The women's semi-structured interviews identified that LABC was associated with inattention to routine breast cancer screening, denial, fatalism and reliance on alternative therapies. Spouses of the LABC group tended to be more passive in their wives' medical care, and also utilized fatalistic thinking and denial., Conclusions: It is important for health care providers to identify patients who will require extra encouragement to seek timely medical care and to follow through with treatment recommendations.

Background/aims: p53 gene mutation occurs in about 50-60% of colorectal carcinoma cases. This mostly occurs as a late event in the adenoma-carcinoma sequence. These late stages are associated with more aneuploidy compared to adenomas and early carcinomas. However there is a controversy regarding the relation between p53 overexpression and DNA index. This study was designed to investigate the relationship between p53 status and DNA ploidy pattern., Methodology: Nuclear DNA content of paraffin-embedded material from 83 colectomy specimens for colorectal carcinoma was measured by flow cytometry. Also, p53 was detected by immunohistochemistry in 73 out of the 83 tumor cases using a monoclonal antibody that detects both wild and mutant p53 proteins (Biogenex 1801)., Results: Aneuploidy was identified in 37 cases (46.25%). Tumors with rectal location were significantly more aneuploid in comparison to other sites (P = 0.009), p53 staining showed three patterns: diffuse staining (29 cases), focal (13 cases), and negative (31 cases). Diffuse p53 staining was associated with aneuploidy (P = 0.04). The majority of DNA indices fell within the range 1.1-2.2 (32 out of 37). Twenty-one of these had DNA index = 1.1-1.8 (aneuploidy short of tetraploidy) significantly associated with diffuse p53 staining compared with peritetraploid cases (DNA index 1.8-2.2) (P = 0.034)., Conclusions: p53 immunohistochemistry demonstrates two distinct patterns in colorectal carcinoma. Diffuse p53 staining, which is associated with aneuploidy short of tetraploidy (DNA index 1.1-1.8), a finding which is different from previously published work. Focal p53 staining pattern, in contrast, is related to high G2M and more abnormal tetraploid peaks but less aneuploidy.

Background: Gestational diabetes mellitus (GDM) is an increasing public health problem worldwide. Measuring the level of knowledge in a population at high risk for GDM will highlight the gaps and help in designing appropriate interventions. The objective of this study was to measure the knowledge about GDM and to identify the factors associated with it among pregnant women in Riyadh city, Saudi Arabia. Methodology: A cross-sectional study was conducted with pregnant women seeking antenatal care services in two of the public sector tertiary care hospitals in Riyadh city. The study was performed using a self-administrated predesigned questionnaire. Collected data were analyzed using SPSS program. Results: More than 40% of the participants had poor knowledge about GDM complications, diagnosis and management. Women with lack of exercise [adjusted odds ratio 3.3 (95% CI 1.8, 6.1)]; having past histroy of GDM [3.2 (1.8, 5.7); primigravida [2.9 (1.6, 5.1)]; information on GDM received from doctors [2.0 (1.2, 3.4)] and those with low education level [1.8 (1.1, 2.9)] were more likely to have poor knowledge about GDM. Whereas, women with positive family history were 60 times more likely to have good knowledge about GDM. Conclusion: Primigravida mothers and those with low education level should receive specific information and awareness regarding GDM. Healthy lifestyle is important for the prevention and improvement in the diagnosis and management of GDM among pregnant women in Riyadh. [ABSTRACT FROM AUTHOR]

Background In this study, we assessed the general population’s fears towards various diseases and events, aiming to inform public health strategies that balance health-seeking behaviours. Methods We surveyed adults from 30 countries across all World Health Organization (WHO) regions between July 2020 and August 2021. Participants rated their fear of 11 factors on an 11-point Likert scale. We stratified the data by age and gender and examined variations across countries and regions through multidimensional preference analysis. Results Of the 16512 adult participants, 62.7% (n=10351) were women. The most feared factor was the loss of family members, reported by 4232 participants (25.9%), followed by cancer (n=2248, 13.7%) and stroke (n=1416, 8.7%). The highest weighted fear scores were for loss of family members (mean (x̄)=7.46, standard deviation (SD)=3.04), cancer ( =7.00, SD=3.09), and stroke (x̄  =6.61, SD=3.24). The least feared factors included animals/insects (x̄  =3.72, SD=2.96), loss of a mobile phone (x̄  =4.27, SD=2.98), and social isolation (x̄  =4.83, SD=3.13). Coronavirus disease 2019 (COVID-19) was the sixth most feared factor (x̄  =6.23, SD=2.92). Multidimensional preference analyses showed distinct fears of COVID-19 and job loss in Australia and Burundi. The other countries primarily feared loss of family members, cancer, stroke, and heart attacks; this ranking was consistent across WHO regions, economic levels, and COVID-19 severity levels. Conclusions Fear of family loss can improve public health messaging, highlighting the need for bereavement support and the prevention of early death-causing diseases. Addressing cancer fears is crucial to encouraging the use of preventive services. Fear of non-communicable diseases remains high during health emergencies. Top fears require more resources and countries with similar concerns should collaborate internationally for effective fear management. [ABSTRACT FROM AUTHOR]

Background Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods We surveyed 16512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables’ significantly higher indices through a centrality difference test. Findings Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P<0.05). Conclusion To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies. [ABSTRACT FROM AUTHOR]

Aim of the present study is to investigate the effects of mass diffusion, gravity and magnetic field with Hall current on a photothermoelastic semiconducting medium in the context of Lord-Shulman (L-S) theory. The normal mode analysis method is used to obtain the expressions of physical quantities such as stress, temperature, displacement, concentration and carrier density. A moving mechanical load is applied at the outer free surface of the medium and a complete solution of the physical field distributions is obtained. The numerical results of physical quantities for a particular material are obtained using MATLAB software and illustrated graphically. The nature of variations of the physical quantities with spatial co-ordinate is analyzed. The theory and numerical computations are found to be in close agreement. Some special cases of interest have been inferred from the present study for validation. [ABSTRACT FROM AUTHOR]

Background: Growth performance, which can be evaluated using various body measurements, is crucial for providing red meat for human consumption. This study aims to improve the growth performance of sheep by identifying the different genotypes of leptin and IGFI genes associated with higher body measurements. Methods: In this study, we collected blood samples from Barki (n = 30) and Farafra (n = 30) sheep, and measured their body height, width, length, and weight, and tail width and length to assess their growth performance. We used single strand conformation polymorphism polymerase chain reaction (SSCP-PCR) and sequencing analysis to identify single nucleotide polymorphisms (SNPs) and different genotypes of the leptin and insulin-like growth factor receptor (IGFI) genes associated with sheep body measurements. Results: The leptin gene (209 bp) and IGFR gene (345 bp) were found to have three (TT, TG, and GG) and (TT, TC, and CC) genotypes, respectively, by SSCP-PCR. Sequence analysis revealed a SNP in the leptin gene (200G > T) with two alleles (G allele: OR058867 and T allele: OR058868). This SNP resulted in the substitution of the amino acid valine with leucine, which increased the width, length, and weight of the body and tail width in the heterozygous form (TG). The IGFI gene had three SNPs: 305 G > T in TT genotype (OR260670), 184C > T, 265T > C, and 305G > T in TC genotype (OR260669), and 265T > C in CC genotype (OR260671). The TC genotype of the IGFR gene was correlated with higher values of body measurements. Barki sheep were found to have the highest values for body weight, width, length, and tail width compared to Farafra sheep. Conclusion: We recommend the use of entire Barki sheep in inbreeding programs to improve growth performance in Egyptian sheep. [ABSTRACT FROM AUTHOR]

Aim: Interleukin (IL)‐10 and IL‐12 contribute to immune responses against hepatitis B virus (HBV) infection. Polymorphisms in the IL‐10 and IL‐12A genes might affect the clinical outcome of HBV infection. We evaluated the association of IL‐10 rs1800896 and rs3024490, and IL‐12A rs568408 and rs2243115 with the progression of HBV infection and development of severe liver disease stages in a white European population. Method: A total of 636 white European patients with chronic HBV infection, 239 individuals with spontaneous HBV surface antigen seroclearance, and 254 healthy controls were enrolled. The chronic HBV infection group included patients with hepatitis B envelope antigen (HBeAg) negative chronic hepatitis B (n = 255), with HBeAg positive chronic hepatitis B (n = 99) and with HBeAg negative HBV infection (n = 228). A total of 104 chronically infected patients were diagnosed with liver cirrhosis. Serum levels of cytokines were measured in patients with HBV infection (n = 195) and in healthy controls (n = 160). Results: In adjusted multivariate analysis, the IL‐10 rs1800896 AG/GG genotypes were significantly associated with an increased probability of HBV surface antigen seroclearance (OR = 1.75, 95% CI 1.04–2.94, p = 0.034), with an increased likelihood of HBeAg negative chronic infection (OR = 1.93, 95% CI 1.05–3.54, p = 0.034) and with increased serum cytokines levels in female patients. In contrast, the IL‐12A rs568408 AG/AA genotypes were independently associated with an increased risk to develop liver cirrhosis, with an OR of 1.90 (95% CI 1.07–3.39, p = 0.029) in male patients. Conclusion: The current study shows a sex‐related association of the IL‐10 single‐nucleotide polymorphism rs1800896 and IL‐12A single‐nucleotide polymorphism rs568408 with different stages of HBV infection and with HBV‐related liver cirrhosis in white European patients. [ABSTRACT FROM AUTHOR]

Introduction: Circulating inflammatory cytokines play critical roles in tumor-associated inflammation and immune responses. Recent data have suggested that several interleukins (ILs) mediate carcinogenesis in hepatocellular carcinoma (HCC). However, the predictive and prognostic value of circulating ILs is yet to be validated. Our study aimed to evaluate the association of the serum ILs with overall survival (OS) and clinicopathologic features in a large cohort of HCC patients. Methods: We prospectively collected data and serum samples from 767 HCC patients treated at the University of Texas MD Anderson Cancer Center between 2001 and 2014, with a median follow-up of 67.4 months (95% confidence interval [CI]: 52.5, 83.3). Biomarker association with OS was evaluated by the log-rank method. Results: The median OS in this cohort was 14.2 months (95% CI: 12, 16.1 months). Clinicopathologic features were more advanced, and OS was significantly inferior in patients with high circulating levels of IL1-R1, IL-6, IL-8, IL-10, IL-15, IL-16, and IL-18. Conclusion: Our study shows that several serum IL levels are valid prognostic biomarker candidates and potential targets for therapy in HCC. [ABSTRACT FROM AUTHOR]

In this study, the impact of adding samarium iron garnet (Sm3Fe5O12; SmIG) nanoparticles to the (Bi1.6Pb0.4)Sr1.9Ca0.9Y0.2Cu2.1O8+δ ((Bi, Pb)-2212) superconductor was investigated. The conventional solid-state reaction method was utilized to synthesize (SmIG)x(Bi, Pb)-2212 phase with different concentrations (x = 0, 0.25, 0.5, 0.75, 1, and 2 wt%). The structure, the morphology, and the elemental composition were tested using X-ray powder diffraction spectroscopy (XRD), scanning electron microscopy (SEM), and dispersive X-ray spectroscopy (EDX), respectively. Filling of pores and voids validated the impact of the added nano-SmIG on intergrain connections. The enhancement in oxygen content was verified by iodometric titration analysis. The superconducting transition temperature (Tc) and the critical current density (Jc) showed best enhancement with the addition of nano-SmIG up to x = 0.75 wt%, having values of 91.02 K and 373.95 A/cm2, respectively. The fluctuations in the superconducting properties were explained via X-ray photoelectron spectroscopy (XPS) by studying the elemental composition and oxidation states for all elements. Vickers microhardness (Hv) investigations were carried out at different applied loads and indentation time of 20 s, where Hv reached its highest value at x = 0.25 wt%. Based on Hv values, the modified proportional sample resistance (MPSR) model offered the most suitable theoretical model to elucidate the experimental data. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is among the most prevalent and dangerous cancers in the world, which is associated with hepatitis and fibrosis resulting from different etiologies, such as hepatitis B and C virus, alcohol and diabetes. Chronic inflammation is suggested to promote tumorigenesis and progression by producing inflammatory cytokines and free radicals, triggering malignant transformation of cells, promoting tumor cells proliferation and inducing tumor angiogenesis. Immunosuppressive microenvironment established in the liver also plays a vital role in HCC development. The mechanisms include activation of cancer-associated fibroblasts, upregulation of pattern recognition receptors, inhibition of effector T cells, recruitment of regulatory T cells and myeloid-derived suppressor cells, activation of hepatic stellate cells and immunosuppressive M2 macrophages. In this review, we will summarize the most recent studies and discuss the advanced mechanisms of chronic inflammatory microenvironment and immunosuppressive microenvironment promoting HCC development, aiming to explore potential therapeutic targets. [ABSTRACT FROM AUTHOR]

The genus Phoma has been explored for a wide range of secondary metabolites signifying a huge range of bioactivities. Phoma sensu lato is a major group that secretes several secondary metabolites. The genus Phoma mainly includes Phoma macrostoma, P. multirostrata, P. exigua, P. herbarum, P. betae, P. bellidis, P. medicaginis, P. tropica, and many more species from the genus that are continuously being identified for their potential secondary metabolites. The metabolite spectrum includes bioactive compounds like phomenon, phomin, phomodione, cytochalasins, cercosporamide, phomazines, and phomapyrone reported from various Phoma spp. These secondary metabolites show a broad range of activities including antimicrobial, antiviral, antinematode, and anticancer. The present review is aimed to emphasize the importance of Phoma sensu lato fungi, as a natural source of biologically active secondary metabolites, and their cytotoxic activities. So far, cytotoxic activities of Phoma spp. have not been reviewed; hence, this review will be novel and useful for the readers to develop Phoma-derived anticancer agents. Key points: • Different Phoma spp. contain a wide variety of bioactive metabolites. • These Phoma spp. also secrete cytotoxic and antitumor compounds. • The secondary metabolites can be used for the development of anticancer agents. [ABSTRACT FROM AUTHOR]

Background: A pathogenic filamentous fungus causing eyelid cellulitis was isolated from the secretion from a patient's left eyelid, and a phylogenetic analysis based on the rDNA internal transcribed spacer region (ITS) and single-copy gene families identified the isolated strain as Paraconiothyrium brasiliense. The genus Paraconiothyrium contains the major plant pathogenic fungi, and in our study, P. brasiliense was identified for the first time as causing human infection. To comprehensively analyze the pathogenicity, and proteomics of the isolated strain from a genetic perspective, whole-genome sequencing was performed with the Illumina NovaSeq and Oxford Nanopore Technologies platforms, and a bioinformatics analysis was performed with BLAST against genome sequences in various publicly available databases. Results: The genome of P. brasiliense GGX 413 is 39.49 Mb in length, with a 51.2% GC content, and encodes 13,057 protein-coding genes and 181 noncoding RNAs. Functional annotation showed that 592 genes encode virulence factors that are involved in human disease, including 61 lethal virulence factors and 30 hypervirulence factors. Fifty-four of these 592 virulence genes are related to carbohydrate-active enzymes, including 46 genes encoding secretory CAZymes, and 119 associated with peptidases, including 70 genes encoding secretory peptidases, and 27 are involved in secondary metabolite synthesis, including four that are associated with terpenoid metabolism. Conclusions: This study establishes the genomic resources of P. brasiliense and provides a theoretical basis for future studies of the pathogenic mechanism of its infection of humans, the treatment of the diseases caused, and related research. [ABSTRACT FROM AUTHOR]

Introduction: Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment. Objective: This systematic review was performed to clarify the clinical role and manifestations of illness denial, its impact on health attitudes and behavior, as well as on short- and long-term outcomes in patients with medical disorders. Methods: The systematic search according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was conducted on PubMed, Scopus, and Web of Science. Results: The initial search yielded a total of 14,098 articles; 176 studies met the criteria for inclusion. Illness denial appeared to be a relatively common condition affecting a wide spectrum of health attitudes and behavior. In some cases, it may help a person cope with various stages of illness and treatment. In other situations, it may determine delay in seeking treatment, impaired adherence, and reduced self-management, leading to adverse outcomes. The Diagnostic Criteria for Psychosomatic Research (DCPR) were found to set a useful severity threshold for the condition. An important clinical distinction can also be made based on the DCPR for illness denial, which require the assessment of whether the patient has been provided with an adequate appraisal of the medical situation. Conclusions: This systematic review indicates that patients with medical disorders experience and express illness denial in many forms and with varying degrees of severity. The findings suggest the need for a multidimensional assessment and provide challenging insights into the management of medical disorders. [ABSTRACT FROM AUTHOR]

Endophytic fungi stimulate the production of an enormous number of bioactive metabolites in medicinal plants and affect the different steps of biosynthetic pathways of these secondary metabolites. Endophytic fungi possess a number of biosynthetic gene clusters that possess genes for various enzymes, transcription factors, etc., in their genome responsible for the production of secondary metabolites. Additionally, endophytic fungi also modulate the expression of various genes responsible for the synthesis of key enzymes involved in metabolic pathways of such as HMGR, DXR, etc. involved in the production of a large number of phenolic compounds as well as regulate the expression of genes involved in the production of alkaloids and terpenoids in different plants. This review aims to provide a comprehensive overview of gene expression related to endophytes and their impact on metabolic pathways. Additionally, this review will emphasize the studies done to isolate these secondary metabolites from endophytic fungi in large quantities and assess their bioactivity. Due to ease in synthesis of secondary metabolites and their huge application in the medical industry, these bioactive metabolites are now being extracted from strains of these endophytic fungi commercially. Apart from their application in the pharmaceutical industry, most of these metabolites extracted from endophytic fungi also possess plant growth-promoting ability, bioremediation potential, novel bio control agents, sources of anti-oxidants, etc. The review will comprehensively shed a light on the biotechnological application of these fungal metabolites at the industrial level. [ABSTRACT FROM AUTHOR]

Background The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences. Methods An international cross - -sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic. Results Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction). Conclusions Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation. [ABSTRACT FROM AUTHOR]

Trichomonas gallinae is a protozoan parasite that causes canker in pigeons. Squabs (young pigeons) are frequently infected with T. gallinae and can die because of the infection, while adult pigeons can act as carriers showing no clinical signs. In the present study, 50 squabs, up to 1-month-old, were purchased from pigeon markets in different regions of the Giza governorate, Egypt. Direct wet mount preparations of the oral excretions of the squabs (mouth wash) and Giemsa staining revealed that 64% (32/50) were positive for T. gallinae. Experimental infection of ten squabs with 103 T. gallinae trophozoites/ml resulted in oral lesions on the mouth, tongue, and soft palate, with the presence of yellowish-white nodules (cheese-like) in the oral cavity on the sixth day post-infection in all squabs. A subset of five samples were cultured in modified Diamond's media, their DNA was extracted, and a portion of the ribosomal internal transcribed spacer region (ITS1/5.8S/ITS2) was amplified by polymerase chain reaction (PCR) followed by sequencing. Phylogenetic analysis of the five isolates revealed 64–91% homology with some reference isolates circulating in Egypt and related countries. [ABSTRACT FROM AUTHOR]

Background: The complexity associated with the treatment planning and delivery of stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) volumetric modulated arc therapy (VMAT) plans which employs continuous dynamic modulation of dose rate, field aperture and gantry speed necessitates diligent pre-treatment patient-specific quality assurance (QA). Numerous techniques for pre-treatment VMAT treatment plans QA are currently available with the aid of several different devices including the electronic portal imager (EPID). Although several studies have provided recommendations for gamma criteria for VMAT pre-treatment QA, there are no specifics for SRS/SRT VMAT QA. Thus, we conducted a study to evaluate intracranial SRS/SRT VMAT QA to determine clinical action levels for gamma criteria based on the institutional estimated means and standard deviations. Materials and methods: We conducted a retrospective analysis of 118 EPID patient-specific pre-treatment QA dosimetric measurements of 47 brain SRS/SRT VMAT treatment plans using the integrated Varian solution (RapidArcTM planning, EPID and Portal dosimetry system) for planning, delivery and EPID QA analysis. We evaluated the maximum gamma (γmax), average gamma (γave) and percentage gamma passing rate (%GP) for different distance-to-agreement/dose difference (DTA/DD) criteria and low-dose thresholds. Results: The gamma index analysis shows that for patient-specific SRS/SRT VMAT QA with the portal dosimetry, the mean %GP is ≥98% for 2–3 mm/1–3% and Field+0%, +5% and +10% low-dose thresholds. When applying stricter spatial criteria of 1 mm, the mean %GP is >90% for DD of 2–3% and ≥88% for DD of 1%. The mean γmax ranges: 1·32 ± 1·33–2·63 ± 2·35 for 3 mm/1–3%, 1·57 ± 1·36–2·87 ± 2·29 for 2 mm/1–3% and 2·36 ± 1·83–3·58 ± 2·23 for 1 mm/1–3%. Similarly the mean γave ranges: 0·16 ± 0·06–0·19 ± 0·07 for 3 mm/1–3%, 0·21 ± 0·08–0·27 ± 0·10 for 2 mm/1–3% and 0·34 ± 0·14–0·49 ± 0·17 for 1 mm/1–3%. The mean γmax and mean γave increase with increased DTA and increased DD for all low-dose thresholds. Conclusions: The establishment of gamma criteria local action levels for SRS/SRT VMAT pre-treatment QA based on institutional resources is imperative as a useful tool for standardising the evaluation of EPID-based patient-specific SRS/SRT VMAT QA. Our data suggest that for intracranial SRS/SRT VMAT QA measured with the EPID, a stricter gamma criterion of 1 mm/2% or 1 mm/3% with ≥90% %GP could be used while still maintaining an in-control QA process with no extra burden on resources and time constraints. [ABSTRACT FROM AUTHOR]

Fungal endophytes are considered one of the most important reservoirs of bioactive compounds which defeat resistant microbes. In our study, endophytic Alternaria alternata was isolated from Ziziphus spina-christi and identified morphologically and genetically with accession number OM 331,682. Preliminary phytochemical screening of ethyl acetate (EA) crude extract of A. alternata revealed that this extract contains alkaloids, tannins, flavonoids, glycosides, phenols, and terpenoids. Moreover, the extract was analyzed using gas chromatography-mass spectrometry (GC–MS) which verified the presence of numerous bioactive compounds. Antimicrobial results illustrated that EA crude extract exhibited promising antimicrobial activity against Gram-negative bacteria (Escherichia coli ATCC 11229, Proteus vulgaris RCMB 004, Pseudomonas aeruginosa ATCC 27853, and Klebsiella pneumonia RCMB 003), Gram-positive bacteria (Bacillus subtilis RCMB 015, Staphylococcus aureus ATCC 25923, and Staphylococcus epidermidis ATCC 14990), and unicellular fungi (Candida albicans ATCC 90028). Ultrastructure study of treated K. pneumonia showed remarkably elucidated destruction of the cell wall and cell membrane and leakage of cytoplasmic materials. Furthermore, the extract has potential antioxidant activity where IC50 was 409 µg/mL. Moreover, this extract did not show any toxicity on Vero normal cell line. These findings confirmed that the endophytic A. alternata from Z. spina-christi is a promising source of bioactive compounds which can be used in different biological applications. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis C virus (HCV) infection is one of the major causes of liver cirrhosis and liver carcinoma. Studies have indicated that an imbalance of cytokine activities could contribute to the pathogenesis of chronic HCV infection. This study aimed to investigate serum levels and gene expression of cytokines (IL-6, TNF-a and TGF-β1) in chronic HCV infection among Malay male subjects. Methods: Thirty-nine subjects were enrolled from various health clinics in Kelantan, Malaysia, and divided into two groups: patients with chronic HCV infection (HP) and healthy control (HS). The serum cytokines IL-6, TNF-a—were measured using Luminex assay, and serum TGF-β1 was measured by ELISA. The mRNA gene expression for IL-6, TNF-a and TGF-β1 was measured by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Results: There were statistically significant differences in the mean serum levels of IL-6, and TGF-β1 in HP compared to HS group (p = 0.0180 and p = 0.0005, respectively). There was no significant difference in the mean serum level of TNF-a in HP compared to HS group. The gene expression for the studied cytokines showed no significant differences in HP compared to HS group. Conclusion: Serum IL-6 was significantly associated with chronic HCV infection. [ABSTRACT FROM AUTHOR]

Bioactive compounds of microbial origin remain the frontline for novel drug discovery and development in the pharmaceutical industry. Endophytic fungi are gaining much attention as reservoirs of bioactive compounds with beneficial therapeutic activities. The present study is focused on evaluating the chemical compositions and antimicrobial activity of secondary metabolites produced by Curvularia lunata, an endophytic fungus of Elaeis guineensis. The endophytic fungus was isolated from healthy leaves of E. guineensis using standard methods and identified using internal transcribed spacer (ITS-rDNA) sequence analysis. The fungus was subjected to solid-state fermentation and secondary metabolites extracted using ethyl acetate and concentrated under a vacuum. The crude extracts were screened for antimicrobial activity against selected pathogenic bacteria and Candida albicans using the agar diffusion method. The bioactive components of the fungal extracts were identified using gas chromatography-mass spectrometry (GC-MS) analysis. Crude extract of C. lunata at 1mg/mL displayed potent antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans, with inhibition zones of 8 ± 0.6 mm, 2 ± 1.0 mm, and 10 ± 1.5 mm respectively. GC- MS analysis revealed the presence of compounds, such as 2,4-di-tert-butylphenol, γ-terpinene, heptadecane, 2,6,10,14-tetramethyl, tetradecanoic acid, 2-hydroxy-, methyl ester, p-cymene, oxirane (chloromethyl) among others in the fungal extracts. These compounds are known to possess several beneficial biological properties. Hence from the results of this study, the endophytic fungus C. lunata, isolated from E. guineensis produce interesting bioactive compounds that can be explored in the development of effective antimicrobials and other pharmaceutical agents. [ABSTRACT FROM AUTHOR]

Purpose: To examine the clinical significance of circulating lymphocyte subtypes and cytokines in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Patients and Methods: We enrolled 53 patients and assessed lymphocyte subsets (CD4+ T cells, CD8+ T cells, CD4+/CD8+ cell ratio, natural killer cells, and regulatory T cells) and cytokines (interleukin [IL]-2, IL-4, IL-6, IL-10, and interferon [IFN]-γ) on the day before TACE, and 1 day and 4– 8 weeks thereafter. The correlation between baseline inflammatory markers and IL-6, the differences between clinical subgroups, and the prognostic baseline inflammatory values and changes therein were analyzed. Results: We found that baseline IL-6 was positively correlated with IL-10 and IFN-γ. Univariate analysis revealed that patients with higher baseline IL-6, IL-10, and IFN-γ levels had worse liver function and greater tumor burden, suggesting a poor prognosis. Multivariate analysis showed that higher baseline IFN-γ levels were associated with a shorter time to tumor progression (hazard ratio [HR] = 1.912; 95% confidence interval [CI] = 1.013– 3.607; p = 0.045), and higher IL-10 levels were associated with poor overall survival (HR = 2.576; 95% CI = 1.237– 5.364; p = 0.011). Baseline lymphocyte subtypes and changes therein did not have any significant association with prognosis. Conclusion: This study confirmed the association between inflammation and poor prognosis. The prognostic significance of IFN-γ was different from previous studies, while the prognostic significance of lymphocyte subtypes remains to be verified. [ABSTRACT FROM AUTHOR]