Blastocystis sp. is a common intestinal protozoan parasite that colonises humans and various animals, with rodents identified as significant reservoir hosts for zoonotic transmission. This study aimed to investigate the prevalence and subtype distribution of Blastocystis sp. among wild rats in Pulau Pinang, Malaysia, while evaluating the associations with host demographics and geographic factors. A total of 150 rodent faecal samples from 12 sampling sites across Pulau Pinang, Malaysia, were examined using microscopy, DNA extraction, and PCR amplification of the SSU-rRNA gene. The overall prevalence of Blastocystis was 25.3%, with Rattus norvegicus exhibiting the highest infection rate (34.5%), followed by R. rattus (19.4%), and Bandicota bengalensis (16.7%). No infections were reported in B. indica (0.0%). Statistical analysis revealed a significant association between Blastocystis infection and rodent species (c2 = 11.874, df = 3 and p = 0.008), whereas no association was indicated in gender, development stages, and sampling sites. Due to limited funding, sequencing was conducted on ten positive samples that exhibited well-defined bands. Out of ten, three zoonotic subtypes were identified namely, ST1 (allele 4), ST3 (allele 34), and ST4 (allele 94 and 133). The findings of this study emphasise the role of R. norvegicus as the major reservoir host in Pulau Pinang, Malaysia and highlight the zoonotic potential of Blastocystis in urban settings.

BACKGROUND

Groundwater is an essential resource for domestic use, agricultural needs, and economic activities, yet it is increasingly threatened by contamination and overextraction. To evaluate groundwater quality and identify associated health risks, the Philippine Groundwater Health Index (PGHI) project conducted a comprehensive assessment of selected sites across various regions in the country.

The study analyzed groundwater samples from multiple locations to determine compliance with the Philippine National Standards for Drinking Water. Parameters assessed included organochlorines, heavy metals, microbial indicators, and physical and nonmetal characteristics such as phosphate and ammonia levels. Results were compiled to evaluate overall groundwater safety and identify areas of concern.

No organochlorines were detected in any of the samples, and all heavy metals complied with national drinking water standards. However, significant noncompliance was observed in other parameters. Microbial contamination was widespread, with 79.25% of samples failing to meet microbial standards due to the presence of fecal coliforms and Escherichia coli. Elevated levels of physical and nonmetal parameters were also noted, with 21 of 27 sites exceeding phosphate limits and 8 sites exceeding ammonia levels. These findings indicate substantial health risks associated with fecal contamination and nutrient pollution.

The PGHI project underscores the urgent need for enhanced groundwater treatment processes, regular monitoring, and strengthened policy-making to ensure safe drinking water. While the study provides critical insights, limitations such as lack of seasonal data, absence of emerging contaminant analysis, and limited spatial coverage highlight the necessity for continued improvements in groundwater management. Addressing these gaps is essential to protect public health, preserve environmental quality, and ensure the sustainable availability of safe groundwater for future generations.

The caries-preventive effects of arginine have been attributed to its impact on biofilm composition and pH. Recent in vitro studies suggest that arginine also affects the production of biofilm matrix components that contribute to virulence, but this mechanism has not been investigated clinically. This randomized, placebo-controlled, triple-blind, split-mouth in situ trial assessed arginine's impact on the microbial composition, matrix architecture, and microscale pH of biofilms from caries-active patients (N = 10). We also examined whether individual differences in the pH response to arginine were related to biofilm composition and matrix structure. Biofilms were grown for four days on carriers attached to intraoral splints. Three times daily, the biofilms were treated extraorally with sucrose (5 min), followed by arginine or placebo (30 min), in a split-mouth design. After growth, the microscale biofilm pH response to sucrose was monitored by pH ratiometry. Microbial biofilm composition and carbohydrate matrix architecture were analyzed by 16S rRNA gene sequencing and fluorescence lectin-binding analysis, respectively. Arginine treatment significantly mitigated sucrose-induced pH drops, reduced total carbohydrate matrix production, and altered the spatial distribution of fucose- and galactose-containing carbohydrates. Both arginine- and placebo-treated biofilms were dominated by streptococci and Veillonella spp. Paired analyses showed a significant reduction in mitis/oralis group streptococci and a non-significant increase in several arginine metabolizers in arginine-treated biofilms. Individual pH responses were not significantly associated with the abundance of specific bacterial taxa or carbohydrate matrix components. In conclusion, arginine reduced the virulence of biofilms from caries-active patients through multiple mechanisms, including suppressing matrix carbohydrate production.
Biofilms/drug effects* ; Humans ; Arginine/pharmacology* ; Hydrogen-Ion Concentration ; Dental Caries/prevention & control* ; Male ; Female ; Adult ; Double-Blind Method ; Sucrose/pharmacology*

Background: Echinococcosis is a neglected tropical disease that is severely underdiagnosed in resource-limited settings. In developed countries, diagnosing echinococcosis is challenging, and reliable serological assays are urgently needed. In the Central European Alps, EM is more common than EG; however, data on the diagnostic performance of assays for EM cases are scarce. We evaluated the suitability of nine antibody assays for routine diagnostics. Methods: Nine commercially available serological assays for detecting anti-Echinococcus antibodies were compared head-to-head using samples collected from 50 patients with echinococcosis and 50 age- and sex-matched control subjects. The assays are Anti-Echinococcus ELISA (IgG) (Euroimmun), Echinococcus IgG ELISA (DRG), Echinococcus IgG ELISA (IBL International), Echinococcus Western Blot IgG (LDBIO Diagnostics), EUROLINE WB (Euroimmun), Hydatidosis ELISA IgG (VirCell), Hydatidosis VIRCLIA IgG Monotest (VirCell), Ridascreen Echinococcus IgG (R-Biopharm), and Virapid Hydatidosis (VirCell). The cases were ranked according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) criteria as confirmed, probable, or possible. Results: The performance of the assays varied greatly, with overall sensitivities ranging between 50% and 88% and specificities between 62% and 100%. We observed a trend toward better performance with cases classified as “confirmed” using the WHO-IWGE criteria. Combined analysis with sequential screening and confirmatory testing resulted in a maximum sensitivity of 84% and specificity of 100%. Differentiation between EG and EM infections is clinically relevant but was found to be unreliable. Conclusions Echinococcus serological assays are highly variable in terms of sensitivity and specificity. Knowledge of the pre-test probability in the patient cohort is required to choose a suitable assay. A combined approach with screening and confirmatory assays may be the best diagnostic strategy in many situations.

Chronic pain relief remains an unmet medical need. Current research points to a substantial contribution of glia-neuron interaction in its pathogenesis. Particularly, microglia play a crucial role in the development of chronic pain. To better understand the microglial contribution to chronic pain, specific regional and temporal manipulations of microglia are necessary. Recently, two new approaches have emerged that meet these demands. Chemogenetic tools allow the expression of designer receptors exclusively activated by designer drugs (DREADDs) specifically in microglia. Similarly, optogenetic tools allow for microglial manipulation via the activation of artificially expressed, light-sensitive proteins. Chemo- and optogenetic manipulations of microglia in vivo are powerful in interrogating microglial function in chronic pain. This review summarizes these emerging tools in studying the role of microglia in chronic pain and highlights their potential applications in microglia-related neurological disorders.
Humans ; Optogenetics ; Brain/physiology* ; Microglia ; Chronic Pain/therapy* ; Neurons/physiology*

STUDY DESIGN: Prospective observational cohort study. PURPOSE: This study aims to evaluate the safety and efficacy of bone morphogenetic protein-2 (BMP-2) in transforaminal lumbar interbody fusion (TLIF) with regard to postoperative radiculitis. OVERVIEW OF LITERATURE: Bone morphogenetic protein (BMP) is being used increasingly as an alternative to iliac crest autograft in spinal arthrodesis. Recently, the use of BMP in TLIF has been examined, but concerns exist that the placement of BMP close to the nerve roots may cause postoperative radiculitis. Furthermore, prospective studies regarding the use of BMP in TLIF are lacking. METHODS: This prospective study included 77 patients. The use of BMP-2 was determined individually, and demographic and operative characteristics were recorded. Leg pain was assessed using the Visual Analog Scale (VAS) for pain and the Sciatica Bothersome Index (SBI) with several secondary outcome measures. The outcome data were collected at each follow-up visit. RESULTS: Among the 77 patients, 29 were administered with BMP. Postoperative leg pain significantly improved according to VAS leg and SBI scores for the entire cohort, and no clinically significant differences were observed between the BMP and control groups. The VAS back, Oswestry Disability Index, and Short-Form 36 scores also significantly improved. A significantly increased 6-month fusion rate was noted in the BMP group (82.8% vs. 55.3%), but no significant differences in fusion rate were observed at the 12- and 24-month follow-up. Heterotopic ossification was observed in seven patients: six patients and one patient in the BMP and control groups, respectively (20.7% vs. 2.1%). However, no clinical effect was observed. CONCLUSIONS: In this prospective observational trial, the use of BMP in TLIF did not lead to significant postoperative radiculitis, as measured by VAS leg and SBI scores. Back pain and other functional outcome scores also improved, and no differences existed between the BMP and control groups. The careful use of BMP in TLIF appears to be both safe and effective.
Arthrodesis ; Autografts ; Back Pain ; Bone Morphogenetic Proteins ; Cohort Studies ; Follow-Up Studies ; Humans ; Leg ; Lumbosacral Region ; Ossification, Heterotopic ; Outcome Assessment (Health Care) ; Prospective Studies ; Radiculopathy ; Sciatica ; Spinal Fusion ; Spine ; Visual Analog Scale

PURPOSE: In order to gain an insight into determinants of reported variability in immune responses to respiratory viruses in human bronchial epithelial cells (HBECs) from asthmatics, the responses of HBEC to viral infections were evaluated in HBECs from phenotypically heterogeneous groups of asthmatics and in healthy controls. METHODS: HBECs were obtained during bronchoscopy from 10 patients with asthma (6 atopic and 4 non-atopic) and from healthy controls (n=9) and grown as undifferentiated cultures. HBECs were infected with parainfluenza virus (PIV)-3 (MOI 0.1) and rhinovirus (RV)-1B (MOI 0.1), or treated with medium alone. The cell supernatants were harvested at 8, 24, and 48 hours. IFN-α, CXCL10 (IP-10), and RANTES (CCL5) were analyzed by using Cytometric Bead Array (CBA), and interferon (IFN)-β and IFN-λ1 by ELISA. Gene expression of IFNs, chemokines, and IFN-regulatory factors (IRF-3 and IRF-7) was determined by using quantitative PCR. RESULTS: PIV3 and RV1B infections increased IFN-λ1 mRNA expression in HBECs from asthmatics and healthy controls to a similar extent, and virus-induced IFN-λ1 expression correlated positively with IRF-7 expression. Following PIV3 infection, IP-10 protein release and mRNA expression were significantly higher in asthmatics compared to healthy controls (median 36.03-fold). No differences in the release or expression of RANTES, IFN-λ1 protein and mRNA, or IFN-α and IFN-β mRNA between asthmatics and healthy controls were observed. However, when asthmatics were divided according to their atopic status, HBECs from atopic asthmatics (n=6) generated significantly more IFN-λ1 protein and demonstrated higher IFN-α, IFN-β, and IRF-7 mRNA expressions in response to PIV3 compared to non-atopic asthmatics (n=4) and healthy controls (n=9). In response to RV1B infection, IFN-β mRNA expression was lower (12.39-fold at 24 hours and 19.37-fold at 48 hours) in non-atopic asthmatics compared to atopic asthmatics. CONCLUSIONS: The immune response of HBECs to virus infections may not be deficient in asthmatics, but seems to be modified by atopic status.
Asthma ; Bronchi* ; Bronchoscopy ; Chemokine CCL5 ; Chemokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression ; Humans ; Immunity, Innate* ; Interferons ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Rhinovirus ; RNA, Messenger

PURPOSE: ⁶⁸Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) has shown promising results in patients with biochemical recurrence after primary therapy for prostate cancer. In this study, we evaluated the usefulness of PSMA I&T (imaging and therapy) PET/CT prior to radical prostatectomy.METHODS: The study population consisted of 21 patients with prostate cancer who underwent ⁶⁸Ga-PSMA I&T PET/CT before either open or laparoscopic radical prostatectomy. Intraprostatic tumor extent, extracapsular extension (ECE) and seminal vesicle invasion (SVI) were assessed on the PET/CT scans. Tracer uptake was quantified in terms of standardized uptake values (SUVs). Imaging findings were correlated with final whole-gland histopathology.RESULTS: Of the 21 patients, two had T stage 2b disease, nine stage 2c, six stage 3a and four stage 3b. The median Gleason score was 7. The SUV(mean) of the primary tumors was 9.5 ± 8.8. SUV(mean) was higher in tumors with ECE than in organconfined tumors (13.8 ± 11.0 vs. 5.6 ± 3.2, p = 0.029). Peak tracer uptake was significantly positively correlated with Gleason score (r(s) = 0.49, p = 0.025). Sensitivity, specificity, positive predictive value and negative predictive value were, respectively, 94.7%, 75.0%, 97.3% and 60.0% for tumor infiltration of an individual prostate lobe, 75.0%, 100.0%, 100.0% and 97.4% for SVI, and 90.0%, 90.9%, 90.0% and 90.9% for ECE, using an angulated contour of the prostate as the criterion. Tumor volume derived from ⁶⁸Ga-PSMA I&T PET/CT was significantly correlated with preoperative prostate-specific antigen value (r(p) = 0.75, p < 0.001) and tumor volume on histopathology (r(p) = 0.45, p = 0.039).CONCLUSIONS: ⁶⁸Ga-PSMA I&T PET/CT prior to radical prostatectomy can contribute to presurgical local staging of prostate cancer. In this pilot study, ⁶⁸Ga-PSMA I&T PET/CT showed promising results for prediction of lobe infiltration, ECE and SVI.
Electrons ; Humans ; Membranes ; Neoplasm Grading ; Pilot Projects ; Positron-Emission Tomography and Computed Tomography ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Seminal Vesicles ; Sensitivity and Specificity ; Tumor Burden

PURPOSE: To evaluate the impact of presenting symptoms on survival in a contemporary series of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: We prospectively recorded data on the presenting symptoms, pathology, and RCC-specific survival of 633 consecutive RCC patients who underwent surgery between 2003 and 2012. RESULTS: Four hundred thirty-three RCCs (68%) were incidental, 111 (18%) were associated with local symptoms, and 89 (14%) were associated with systemic symptoms. Among those with incidental RCC, 317 patients (73%) were completely asymptomatic and 116 patients (27%) presented with symptoms not related to the tumor. During a median follow-up interval of 40 months (interquartile range: 39 to 69 months), 77 patients died from RCC. In univariate analyses, symptom classification was significantly associated with RCC-specific survival (p<0.001). Patients with incidental RCC and unrelated symptoms tended to have worse prognosis than did patients who were completely asymptomatic, although this difference was not statistically significant (p=0.057). The symptom classification was associated with advanced TNM stages (p<0.001) and grade (p<0.001). CONCLUSIONS: This study confirms that presenting symptoms are associated with tumor characteristics and survival. The majority of RCCs are diagnosed incidentally in patients without any symptoms or with symptoms not related to RCC. Patients in the latter group tend to have a worse prognosis than do patients who are completely asymptomatic. With the increasing number of incidentally diagnosed RCCs, substratification of patients with incidental tumors may be prognostically relevant.
Aged ; Carcinoma, Renal Cell/*diagnosis/pathology/surgery ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Kidney Neoplasms/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Neoplasm Staging ; Nephrectomy/methods ; Prognosis ; Prospective Studies