Atrial fibrillation (AF) is a common electrical complication in patients with acute myocardial infarction. The HAVOC score was originally proposed as a clinical tool for predicting AF in patients with cryptogenic stroke or transient ischemic attack. This study evaluated the predictive value of the HAVOC score for new-onset AF (NOAF) in patients with ST-segment elevation myocardial infarction (STEMI). Between August 2019 and December 2024, the data of 1640 patients (mean age: 56.3 ± 11.2 years, male: 1134, 69.1%) with STEMI were retrospectively analyzed. Patients were divided into two groups: those with and those without NOAF. All patients underwent electrocardiographic monitoring and echocardiographic evaluation following primary percutaneous coronary intervention. Overall, NOAF was observed in 115 patients. A comparison of the clinical and demographic characteristics between the groups showed that age, hypertension frequency, chronic obstructive pulmonary disease, and history of stroke were higher in the NOAF group. Left ventricular ejection fraction was significantly lower (38.2 ± 10.8 vs. 47.9 ± 10.1%, p < 0.001) and left atrial diameter (42.2 ± 4.5 vs. 37.5 ± 4.1 mm, p = 0.001) was significantly higher in these patients. Furthermore, the incidence of unsuccessful intervention, contrast-induced nephropathy, and in-hospital mortality as well as the HAVOC score were significantly higher in patients with NOAF. A high HAVOC score (odds ratio [OR] = 1.078; 95% confidence interval [CI]: 1.022-1.258; p = 0.001) was identified as an independent predictor of NOAF in patients with STEMI. The HAVOC score appears to be a useful tool for predicting NOAF in patients with STEMI. Identifying individuals with high HAVOC scores may enable early recognition and prevention of AF-related complications. HINTERGRUND: Vorhofflimmern (VF) ist eine häufige elektrische Komplikation bei Patienten mit akutem Herzinfarkt. Der HAVOC-Score wurde ursprünglich als klinisches Instrument zur Vorhersage von VF bei Patienten mit kryptogenem Schlaganfall oder transienten ischämischen Attacken vorgeschlagen. Ziel der vorliegenden Studie war es, den prädiktiven Wert des HAVOC-Scores für neu aufgetretenes VF („new-onset atrial fibrillation“, NOAF) bei Patienten mit ST-Strecken-Hebungs-Infarkt (STEMI) zu untersuchen. Zwischen August 2019 und Dezember 2024 wurden die Daten von 1640 Patienten (Durchschnittsalter: 56,3 ± 11,2 Jahre, davon männlich: 1134; 69,1%) mit STEMI retrospektiv analysiert. Die Patienten wurden in 2 Gruppen aufgeteilt: eine mit und eine ohne NOAF. Bei allen Patienten wurden ein EKG-Monitoring und eine echokardiographische Untersuchung nach der primären perkutanen Koronarintervention durchgeführt. Bei 115 Patienten wurde ein NOAF festgestellt. Der Vergleich klinischer und demografischer Merkmale zwischen den Gruppen zeigte, dass das Alter, die Häufigkeit von Hypertonie, chronisch obstruktiver Lungenerkrankung und Schlaganfall in der Anamnese in der NOAF-Gruppe höher waren. Die linksventrikuläre Ejektionsfraktion war signifikant niedriger (38,2 ± 10,8 vs. 47,9 ± 10,1%; p < 0,001), und der linksatriale Durchmesser (42,2 ± 4,5 vs 37,5 ± 4,1 mm; p = 0,001) war signifikant höher bei diesen Patienten. Außerdem waren bei Patienten mit NOAF die Inzidenz erfolgloser Interventionen, kontrastmittelinduzierter Nephropathien und die Krankenhausmortalität sowie der HAVOC-Score signifikant höher. Ein hoher HAVOC-Score (Odds Ratio [OR] = 1,078; 95%-Konfidenzintervall [95%-KI]: 1,022–1,258; p = 0,001) stellte sich als unabhängiger Prädiktor von NOAF bei Patienten mit STEMI heraus. Der HAVOC-Score scheint ein nützliches Instrument zur Vorhersage von NOAF bei Patienten mit STEMI zu sein. Die Identifizierung von Personen mit hohen HAVOC-Scores kann eine Früherkennung und Prävention von VF-bedingten Komplikationen ermöglichen.
The HAVOC score is an emerging tool for estimating the risk of atrial fibrillation (AF), which has attracted growing interest. However, the use of the HAVOC score to predict in-hospital new-onset AF (NOAF) among patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. Therefore, this study aimed to examine whether the HAVOC score is associated with NOAF during the index hospitalization following primary percutaneous coronary intervention (PCI) in patients with a STEMI. We studied a consecutive cohort of patients presenting with STEMI from January 2023 to March 2025. After primary PCI, each participant underwent continuous electrocardiogram monitoring for at least 72 hours. The HAVOC score was calculated based on hypertension, age ≥75 years, valvular heart disease, peripheral vascular disease, obesity, and heart failure. In total, 725 patients were analyzed, with a mean age of 63.37 ± 13.16 years; of whom 72.97% were male. During the hospital stay, 70 patients (9.66%) experienced NOAF. Multivariate logistic regression analysis showed that the HAVOC score (odds ratio (OR) = 1.42, 95% confidence interval (CI): 1.28-1.59) was independently associated with NOAF. Restricted cubic spline (RCS) analysis revealed a linear dose-response relationship between the HAVOC score and NOAF (p for overall <0.001). Integrating left ventricular ejection fraction (LVEF) and the presence of left anterior descending artery stenosis enhanced the discriminatory ability of the HAVOC score for identifying NOAF (net reclassification index [NRI] = 0.353, 95% CI: 0.114-0.592; p = 0.004) and improved integrated discrimination (0.024, 95% CI: 0.006-0.041; p = 0.008). Higher HAVOC scores were independently linked to the occurrence of in-hospital NOAF among STEMI patients following PCI. NOAF risk increased with the HAVOC score, consistent with a linear dose-response across the score spectrum.
The retrotransposons and endogenous retroviruses (ERVs) that contain long terminal repeat (LTR) sequences are a subset of transposable elements (TEs) that make up around 8% of the human genome. These retroelements (retroTEs) are derived from ancient retroviral infections or retrotransposons that have become permanently integrated into the germline and include domesticated retroTEs, such as the neuronal gene Arc. Until recently, limited tools and difficulties in mapping retroTEs have made it challenging to study these elements in detail. However, recent advances have revealed that retroTEs play a role in both human disease and physiological processes in the brain. Here, we highlight studies showing that retroTE nucleic acid and protein products perform unique functions in intercellular signaling and nervous system dysfunction. We discuss how these elements play critical roles in complex processes such as cognition and how future work will provide insight into neurological disorders.
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Disruption of complex intestinal ecosystem could contribute to diabetes and other health issues, scientists say.
Malignant hypertension (HTN) is defined by a rapid rise in blood pressure exceeding 200/130 mmHg, leading to acute end-organ damage. Although relatively uncommon, malignant HTN can cause thrombotic microangiopathy (TMA), characterized by microangiopathic hemolytic anemia, thrombocytopenia, and elevated serum lactate dehydrogenase (LDH). This presentation can mimic thrombotic thrombocytopenic purpura (TTP), a hematologic emergency characterized by thrombocytopenia, hemolytic anemia, renal and neurologic dysfunction, and fever. We present the case of a 28-year-old male patient who presented with seizures and hypertensive emergency. Imaging showed posterior reversible encephalopathy syndrome (PRES), and labs revealed anemia, thrombocytopenia, low haptoglobin, elevated LDH, and schistocytes. A PLASMIC (platelets, lysis, active cancer, stem cell/solid organ transplant, mean corpuscular volume, international normalized ratio, and creatinine) score of 5 indicated intermediate risk for TTP, prompting empiric treatment with corticosteroids and therapeutic plasma exchange (TPE). Platelets normalized, but hemolysis persisted. When clinical reassessment revealed that lab trends correlated with blood pressure fluctuations, TPE and steroids were discontinued, and aggressive antihypertensive therapy led to the resolution of hemolysis. A normal ADAMTS13 level confirmed the diagnosis of malignant HTN-induced TMA. This case underscores the importance of distinguishing malignant HTN from TTP, as their management differs significantly. This case highlights the diagnostic challenge in distinguishing TTP from malignant HTN-induced TMA and underscores the importance of recognizing this rare manifestation of hypertensive crisis to avoid unnecessary therapies and guide appropriate treatment.
This case report describes a 55-year-old postmenopausal woman who presented with Cushingoid features and progressive weight gain over a year. Evaluation revealed low basal cortisol levels and a suboptimal response to the ACTH stimulation test, indicative of adrenal insufficiency. Further investigation into her medication regimen uncovered her consistent use of approximately 950 mg of ashwagandha daily for over a year, prescribed by a local practitioner for symptomatic relief of bilateral knee osteoarthritis. A review of the existing literature suggested a potential cortisol-suppressing effect of ashwagandha, leading to the establishment of a causal link between the patient's symptoms and her consumption of the ashwagandha extract. She was advised to discontinue the alternative medication and commenced on hydrocortisone replacement, adjusted for her body surface area. A three-month follow-up indicated that her hypothalamic-pituitary-adrenal (HPA) axis suppression had not yet reversed, necessitating continued hydrocortisone supplementation and bimonthly monitoring of her basal and stimulated cortisol levels. This case report underscores the perils of unsupervised exposure to poorly understood compounds prevalent among the general public. It also highlights the role of online platforms and social media in promoting unverified practices and treatments with spurious claims of efficacy and safety, often in contrast to well-researched, modern treatment regimens. Through this case report, we would like to stress upon the importance of imposition of stringent regulations on social media and websites that disseminate unverified information. Furthermore, we emphasize that incentivizing and promoting health literacy among the general population is an urgent imperative. Clinicians should be familiar with commonly used herbal remedies and their potential endocrine and systemic effects, particularly in the context of unexplained hormonal dysfunction. Cushingoid features and secondary adrenal insufficiency in the absence of exogenous steroid use should prompt clinicians to enquire specifically about herbal supplement intake, including dose, formulation, and duration. Both clinicians and the public should be aware that excessive doses and prolonged use of ashwagandha can lead to Cushingoid features and sustained suppression of the HPA axis. The widespread belief that 'natural' always equates to 'safe' needs to be actively challenged through public education campaigns and clinician-led counseling. Herbal products can cause deleterious health effects and are not inherently benign. There is a pressing need for health authorities to establish evidence-based guidelines for the safe use of ashwagandha and other commonly used herbal products, including daily dose limits and duration. International regulatory oversight and policies are essential to counter the growing misinformation around traditional and alternative medicines, especially on digital and social media platforms.
Despite early calls to pay attention to the role of emotions in crime and criminal justice, including in prison studies, empirical research focusing on emotions in the administration of criminal justice has been sporadic. With notable exceptions, little attention has been paid to the role of boredom, meaning, and the labour processes of criminal justice personnel more broadly, and correctional officers specifically. We fill the lacuna in knowledge by examining the relationship between boredom, temporality, the labour process of correctional officers, meaning making, and officer wellness. We first offer an overview of boredom as an emotion and its contribution to meaning making. We then outline the labour process of correctional officers, reviewing literature on the structure of their carceral work environments and their experiences of boredom. We draw on 651 interviews with correctional officer recruits (n = 375) and follow-up interviews with correctional officers (n = 276) within federal prisons across Canada to understand the emotional experiences of correctional work, specifically focusing on boredom as a dominant emotion and its effect on officer wellness. Our study uses a phenomenological approach to consider how boredom plays a role in the daily lives of those providing security within prison spaces, how prison officers make sense of their work in relation to temporality and boredom, and how boredom and havoc contributes to poor officer wellness.
A 15-year-old male presented with an atypical case of hidradenitis suppurativa that began with indurated nodules at the nape of his neck following a haircut. The condition progressively spread over 6 months to involve multiple body areas, including the chest, axillae, and perineal region. Initial treatments with conventional antibiotics proved ineffective, requiring surgical intervention for abscess drainage. The patient's condition continued to deteriorate despite postprocedural antibiotic therapy, ultimately necessitating escalation to combination therapy with high-dose prednisone and adalimumab, which led to clinical improvement. This case highlights an unusual presentation of hidradenitis suppurativa with widespread involvement while serving as a reminder to clinicians of the importance of early recognition and aggressive management in refractory cases. This case demonstrates an atypical presentation of hidradenitis suppurativa in terms of both distribution (involving nonintertriginous areas like chest and shoulders) and rapid progression.The patient’s age of onset during puberty, combined with his comorbidities, highlights the intricate relationship between hormonal changes, metabolic factors, and inflammatory disease progression.When presented with a case of hidradenitis suppurativa, providers should be cognizant of the follicular occlusion triad/tetrad, a clinical concept that interconnects related dermatological conditions, better guiding clinical management.
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Atrial fibrillation (AF) is a common but often undetected cause of cryptogenic stroke (CS) and embolic stroke of undetermined source (ESUS). Implantable cardiac monitors aid in detecting subclinical AF, but their widespread use is limited by cost and logistical challenges. Several scoring systems exist to predict AF in patients with CS/ESUS, though few have been externally validated. This study was designed to externally validate 7 scoring systems for predicting incident AF in patients with CS/ESUS. In this observational study, we analyzed 132 patients with CS or transient ischemic attack who received implantable cardiac monitors. After a comprehensive literature search, 7 prediction models (Coronary Artery Disease or Chronic Obstructive Pulmonary Disease, Hypertension, Elderly, Systolic Heart Failure, Thyroid Disease [C2HEST], Brown ESUS-AF, ESUS-AF, Hypertension, Age, Valvular Heart Disease, Peripheral Vascular Disease, Obesity, Congestive Heart Failure, Coronary Artery Disease [HAVOC], Age, Hypercholesterolemia, Tricuspid Regurgitation, Left Ventricular End-Diastolic Volume, Left Atrium [ACTEL], Age, Stroke Severity, National Institutes of Health Stroke Scale >5 to Find Atrial Fibrillation [AS5F], and Coronary, Heart Failure, Age, Stroke Severity, Lipidemia, Sugar, Prior Stroke [CHASE-LESS]) were applied. The primary outcome was the discriminatory ability to detect AF. Secondary outcomes included evaluating the threshold scores and the performance of such threshold-based criteria for predicting nonoccurrence of AF with high specificity. AF was detected in 40 patients (30.3%) over a mean follow-up of 13±12 months. Area under the receiver operating characteristic curves were C2HEST (0.704), Brown ESUS-AF (0.755), AS5F (0.726), ESUS-AF (0.607), HAVOC (0.661), ACTEL (0.650), and CHASE-LESS (0.671). C2HEST, Brown ESUS-AF, and AS5F showed acceptable predictive performance (area under the receiver operating characteristic curve >0.7). Threshold-based criteria using these scores achieved high specificity and positive predictive value. Combining thresholds across scores improved identification of patients unlikely to develop AF. C2HEST, Brown ESUS-AF, and AS5F scores reliably predicted AF in patients with CS/ESUS and may help identify low-risk individuals, supporting more targeted use of diagnostic tools and guiding stroke prevention strategies.
Sclerotinia sclerotiorum is a formidable soilborne fungus that wreaks havoc on numerous crops globally. While the role of ADP-ribosylation factor-like 1 (Arl1) small GTPases in vesicular trafficking and fungal development is well-documented, their specific impact on S. sclerotiorum remains unclear. Through reverse genetic techniques, we identified and characterized SsArl1, a typical Arl small GTPase conserved across fungi. Deleting SsArl1 hampers the hyphal growth of S. sclerotiorum, but leads to higher oxalic acid buildup and boosts cellulase activity. This speeds up the infection of host plants, yet increases their sensitivity to certain environmental stresses, particularly ionic and cell wall-related stress. Our results reveal that SsArl1 acts as a negative regulator of oxalic acid accumulation and virulence, while playing a positive role in enhancing resistance to environmental stresses in S. sclerotiorum.
Considering the havoc caused by Fusarium oxysporumf. sp. cubense (TR4) at the global level on banana cultivation, especially in India, there is a high demand for an economical bio-immunized tissue culture technique for the sustainable production of disease-resistant plantlets, wherein bio-immunization is achieved through treatment of tissue culture-derived plants with antifungal secondary metabolites to mitigate the impact of Fusarium wilt. In the current investigation, a novel, user-friendly, and cost-effective Double Decker Temporary Immersion Bioreactor (DDTIB) was designed and optimized for the mass multiplication of bio-immunized Grand Naine plantlets to cater to the huge demand of planting material of banana. An immersion frequency of six hours with three minutes duration of media immersion in DDTIB significantly improved the regeneration frequency (22.32 shoots/clump) as compared to the Semi Solid Tissue Culture System (SSTCS), which yielded only 7.86 shoots/clump. Additionally, after three consecutive multiplication cycles, DDTIB produced significantly higher biomass (1112.24 mg) as compared to SSTCS (996.36 mg). A novel primary hardening technique was also introduced in DDTIB-regenerated bio-immunized plantlets, resulting in a 91.52% survival rate. The genetic fidelity of DDTIB-regenerated plants was confirmed using ISSR markers and further confirmed by metabolomics analysis. The DDTIB developed in the current study would be the most suitable bioreactor for the rapid and large-scale commercial multiplication of bio-immunized Grand Naine plantlets.
Double-strand breaks (DSBs) are the most deleterious lesions experienced by our genome. Yet, DSBs are intentionally induced during gamete formation to promote the exchange of genetic material between homologous chromosomes. While the conserved topoisomerase-like enzyme Spo11 catalyzes DSBs, additional regulatory proteins-referred to as 'Spo11 accessory factors'-regulate the number, timing, and placement of DSBs during meiotic prophase, ensuring that SPO-11 does not wreak havoc on the genome. Despite the importance of the accessory factors, they are poorly conserved at the sequence level, suggesting that these factors may adopt unique functions in different species. In this work, we present a detailed analysis of the genetic and physical interactions between the DSB factors in the nematode Caenorhabditis elegans, providing new insights into conserved and novel functions of these proteins. This work shows that HIM-5 is the determinant of X-chromosome-specific crossovers and that its retention in the nucleus is dependent on DSB-1, the sole accessory factor that interacts with SPO-11. We further provide evidence that HIM-5 mediates interactions with the different accessory factors subgroups, providing insights into how components on the DNA loops may interact with the chromosome axis.
Starting in March 2020, the COVID-19 pandemic represented an international public health emergency which greatly impacted healthcare delivery.  Materials and methods: This retrospective analysis of pediatric testicular torsion (TT) over a 10-year period (January 1, 2015- December 31, 2024) was performed at a pediatric children's hospital in a metropolitan community. We divided our cohort into patients who were evaluated prior to COVID-19 (January 1, 2015-February 29, 2020), during COVID-19 (March 1, 2020-April 30, 2023), and after COVID-19 (March 1, 2023-December 31, 2024). We hypothesized whether the TT incidence and orchiectomy rates differed across these three time periods. A total of 286 pediatric patients underwent surgery for TT: 101 (35%) before the start of COVID-19, 129 (45%) during COVID-19, and 56 (20%) after the peak of the COVID-19 pandemic. The mean monthly case volume significantly increased from the pre-COVID-19 period (2.06) to during-COVID-19 (3.69) and post-COVID-19 (2.95) periods (p<0.0001). The median door-to-detorsion time (DTD) was significantly different across these periods, with the shortest DTD occurring during the COVID-19 period (p=0.011). The type of surgery (orchiectomy vs. orchiopexy) and symptom duration were not statistically different between the three time periods.  Conclusions: The number of patients with TT significantly increased during the height of the COVID-19 pandemic, with a subsequent reduction. Our study indicates that pediatric patients and their families realized the importance of seeking prompt medical attention for TT despite the ongoing havoc incurred by the COVID-19 pandemic.
Massive influxes of pelagic Sargassum spp. across the tropical Atlantic and Caribbean regions have created urgent ecological and economic challenges that need to be addressed to stabilize local ecosystems. Use of this abundant biomass feedstock resource for biorefining and bioproducts manufacturing is a promising avenue, but this goal requires elucidating the microbial processes that regulate Sargassum degradation, which are still poorly understood. Here, we investigated the microbial degradation of the benthic Sargassum filipendula by native microbiota using multi-omics approaches. Metagenomic and meta-transcriptomic analyses identified diverse carbohydrate-active enzymes (CAZymes), including alginate lyases, fucoidanases, and cellulases, that were differentially expressed over the course of the in vitro degradation timeline. Furthermore, we identified the need for arsenic detoxification pathways in microbes utilizing Sargassum-derived substrates. We observed a suite of factors influencing microbial dynamics, including prokaryotic competition, arsenic detoxification, viruses, and substrate availability. Lineages potentially capable of degrading recalcitrant polysaccharides such as fucoidan appeared to be rapidly outcompeted by other bacteria that utilized simpler substrates like mannitol. These results highlight the metabolic potential of native marine microbial communities to degrade complex Sargassum polysaccharides and the importance of the in vitro degradation experiment time scale to capture the activities of non-dominant specialists. Our findings elucidate microbial ecosystem dynamics during Sargassum degradation and provide novel insights that can be used to advance the development of biotechnological approaches that leverage renewable Sargassum biomass as a biorefinery feedstock of the future.IMPORTANCEThis work addresses a crisis in the tropical Atlantic and Caribbean regions, the massive population growth and stranding of the floating brown seaweed Sargassum, which is wreaking havoc on ecosystems and fouling beaches vital to local tourism. One solution to this problem is to utilize the seaweed as feedstock to generate useful bioproducts. This approach requires characterizing the microbiome of Sargassum that drives its degradation in nature. To this end, we devised an in-lab degradation assay using Sargassum and identified a variety of carbohydrate-active enzymes, including alginate lyases, fucoidanases, and cellulases which break down seaweed cell wall polysaccharides. We also find that microbes compete in the closed reactors, with diversity being reduced over time. These results highlight the metabolic potential of native marine microbial communities to degrade Sargassum and elucidate microbial ecosystem dynamics during this process. These insights allow the use of renewable Sargassum as a biorefinery feedstock of the future.
Drosophila suzukii, or spotted-wing drosophila (SWD), (Diptera: Drosophilidae), are invasive vinegar flies of East Asian origin that have wreaked havoc on the small fruit and berry industry. In locations where SWD are well established, weekly chemical insecticide applications are necessary, resulting in increased economic costs, unwanted environmental impacts ensuing from loss of non-targeted organisms, and the eventual emergence of populations that are resistant to these insecticides. It is therefore critical that new classes of biorational pesticides and cost-effective technologies for controlling SWD are identified. Here, we used the attractive properties of Saccharomyces cerevisiae, baker's yeast, which was designed to express an RNA interference (RNAi) pesticide that specifically targets the SWD Shaker (Sh) gene, to lure and kill flies that feed on the yeast, which was delivered in a feeder as a component of an attractive targeted sugar bait (ATSB). The yeast, which was heat killed prior to preparation of the ATSB, silenced the Sh gene, resulting in severe neural defects and 96 ± 9% fly mortality in laboratory trials. The RNAi yeast was successfully fed to the flies in an easily assembled soda bottle feeder that continuously rewetted the yeast with soda, which lured and killed the flies in simulated field trials. Despite this toxicity observed in SWD, consumption of the yeast had no impact on the survival of other dipteran insects. This promising ATSB technology, which was prepared with a new class of RNAi yeast insecticides, could one day be an effective component in integrated SWD control programs. © 2025 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Atrial fibrillation detected after stroke (AFDAS) is clinically important, but AFDAS-specific risk tools for patients without known atrial fibrillation (AF) remain limited. We developed and temporally validated the Prediction of AF in Ischemic Stroke (PAFIS) score. We retrospectively analyzed ischemic-stroke patients from the National Taiwan University Hospital Integrative Medical Data Center. The development cohort included patients hospitalized in 2010-2020 (n = 3406), and the temporal validation cohort included those hospitalized in 2021-2023 (n = 1366). Known AF (KAF) was defined as AF documented before stroke or within 14 days after stroke; AFDAS was defined as newly documented AF beyond 14 days among patients without KAF. Multivariable logistic regression restricted to KAF-free patients was used for score derivation. Discrimination, calibration, and time-to-AFDAS risk stratification were assessed. Among KAF-free patients, AFDAS was detected during routine clinical follow-up in 176 of 2175 (8.1%) in the development cohort and 148 of 1366 (10.8%) in the validation cohort. The final PAFIS score included age ≥ 75 years, female sex, valvular heart disease, left atrial diameter ≥ 40 mm, and tricuspid regurgitation peak gradient ≥30 mmHg. AUCs were 0.72 (95% CI, 0.68-0.76) in development and 0.65 (95% CI, 0.60-0.70) in validation. PAFIS outperformed CHA₂DS₂-VASc, HAVOC, and AF-ESUS, but not Brown ESUS-AF. Observed AFDAS detection rates increased across risk groups in both cohorts. PAFIS provides a simple AFDAS-specific tool for selective post-stroke rhythm monitoring. Because AF ascertainment was based on routine clinical care without standardized prolonged monitoring, PAFIS predicts AF detection under routine practice rather than true AFDAS incidence. Prospective multicenter validation with standardized monitoring is warranted.
Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major public health concern globally ranking as the second leading infectious disease and the 13th leading cause of death worldwide. The global healthcare systems have experienced unprecedented challenges in recent years due to COVID-19 pandemic causing widespread disruptions. Delaying TB diagnosis and treatment led to lower reported incidence but could increase mortality, hindering efforts to eradicate TB. Although a few studies have focused on COVID-19 and TB cases to date, most of them are case reports. Since it is unclear whether patients with COVID-TB co-infection have a worse prognosis or more likely to develop severe disease, we believed that doing this study was a necessity. The present systematic review investigates the long-term effects of COVID-19 on TB incidence, reporting follow-up and treatment outcomes. The present study aimed to explore the long-term impact of COVID-19 on TB incidence, presentation and outcome. We conducted our systematic review following PRISMA (Preferred reporting in systematic reviews and meta-analysis) guidelines. We performed a comprehensive literature search of EMBASE, PubMed, Scopus, The Lancet, Web of Science and Cochrane Central Register of Controlled Trials. The search items included "Corona virus disease 19", "impact of COVID-19", "SARS-CoV-2", "Tuberculosis", "TB and COVID-19 co-infection", "comorbidities", "prognosis", "incidence", "outcomes" and "risk factors" for articles published between the 1st of January 2020 and the 31st of June 2024. Searches were limited to English language only. We included articles with primary outcomes including studies which reported TB incidence or notification rates, clinical presentation, treatment interruption or outcomes of TB due to COVID-19 and TB-COVID-19 co-infection. Cohort studies, case-control studies, cross-sectional studies and surveillance or registry-based studies were included. Information regarding COVID-19 and TB was collected from the databases, and out of 1973 articles, 41 articles were included. COVID-19 has had a negative impact on TB control programs leading to decrease in reporting of TB cases. As per the global tuberculosis report by WHO 2025, there has been approximately one-third reduction in incidence rates with TB case notifications declining by 21% of TB cases notification in 2020 compared to 2019. The reports indicated that the number of people diagnosed with TB was 7.5 million in 2022 above the baseline of 7.1 million in 2019 and 5.8 million in 2020. COVID-19 has affected TB diagnosis and control, with a significant decline in TB case notifications leaving many undiagnosed cases, thereby reversing years of progress in TB control. The high-TB burden countries like India should tackle the havoc caused by the COVID-19 pandemic by addressing the needs of the poor and having a concrete agenda and perpetual TB strategy to reach the target by 2030.
Cassava brown streak disease (CBSD), caused by cassava brown streak virus (CBSV; Ipomovirus brunusmanihotis) and Ugandan cassava brown streak virus (UCBSV; Ipomovirus manihotis) (family Potyviridae, genus Ipomovirus), is increasingly becoming a threat to cassava production in several parts of Africa, especially in Eastern, Central and Southern Africa. In Kenya, the disease continues to wreak havoc on cassava production leading to a significant reduction in crop yields and economic losses of up to USD 1 billion. Variation in virus populations make the control of CBSD challenging as virus genomic variation can affect the accuracy of diagnostic tests, lead to resistance breaking isolates and jeopardize strategies of breeding for resistance. CBSV and UCBSV populations obtained from cassava fields in Kenya were characterized. In total, 44 new complete sequences of CBSV and UCBSV were assembled and 40 sequences successfully submitted to GenBank. Single Nucleotide Polymorphism (SNP) analysis revealed that the cylindrical inclusion protein (CI) is the most stable region across the genome of CBSV and UCBSV. In contrast, protein 1 (PI) and the coat protein (CP) were the most hypervariable regions. Phylogenetic analysis showed three major geographical groupings for both UCBSV and CBSV isolates, suggesting a continued spread of the viruses through human-mediated movement of infected planting materials. The data obtained in this study can support the development of disease management strategies through improved molecular diagnostic tests and targets for breeding for resistance against CBSD.