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To describe the clinical presentations, diagnostic findings, anesthetic management, surgical treatment, outcomes, and complications of surgical sterilization in client-owned bearded dragons. Medical records were retrospectively collected for all bearded dragons that underwent ovariectomy or ovariosalpingectomy performed by 3 veterinarians board certified in exotics-related specialties between October 2019 and October 2024 at their institutions. 25 female dragons underwent surgical sterilization; 1 animal had 2 ovariectomies due to an ovarian remnant for a total of 26 procedures. Median age and body weight were 3.5 years and 498 g, respectively. Common reasons for presentation included hyporexia (n = 15) and coelomic distension (8). Twenty-three procedures were considered urgent, 2 were prophylactic, and 1 was emergent. The most common clinical pathologic finding was elevated bile acids (n = 9). Follicles were identified in all cases undergoing ultrasound (n = 18). Anesthetic protocols varied but commonly included dexmedetomidine, ketamine, midazolam, propofol, and isoflurane. Seven animals had additional procedures, including cholecystectomy (n = 2), liver biopsy (2), mass removal/biopsy (2), partial lung resection (1), subtotal fat body removal (1), and enterotomy (1). Of 14 cases evaluated histologically, 8 had abnormal ovarian findings, most commonly oophoritis (n = 6). Intraoperative hemorrhage was the most common complication (n = 11). Of 26 surgical events, 22 (85%) resulted in survival to discharge and for at least 10 days postoperatively. Ovariectomy or ovariosalpingectomy in client-owned bearded dragons may be required for multiple indications. Despite common complications, the surgery has a better prognosis than previously reported in the literature. These findings support ovariectomy or ovariosalpingectomy as a viable surgical option in bearded dragons.
Salmonella spp. is a major zoonotic pathogen. Although reptiles are mostly considered subclinical carriers, clinical disease may develop following immunosuppression. Clinical salmonellosis in reptiles has been extensively reported; however, the condition has been rarely described in bearded dragons (Pogona vitticeps). We retrospectively analyzed six cases of salmonellosis in bearded dragons and characterized the pathological, immunohistochemical, and bacteriological findings. Clinical signs and gross findings were mostly non-specific. Histological findings mainly consisted of fibrinonecrotizing enterocolitis (83.3%); necrotizing or granulomatous hepatitis (66.7%); pneumonia including bronchopneumonia or interstitial pneumonia in one case each (33.3%); tubulointerstitial nephritis with tubular necrosis (16.7%); and coelomitis (16.7%). Salmonella enterica subsp. houtenae was cultured in three cases (33.3%), whereas S. enterica subsp. enterica serovar Rissen, S. enterica subsp. enterica serovar Cotham, and S. enterica subsp. diarizonae were cultured in one case each. Intralesional bacteria were detected via immunohistochemistry in kidneys and colon in two cases (33.3%). The predominance of lesions in the intestines and liver likely reflects initial intestinal colonization followed by hematogenous dissemination to the liver. Hepatic lesions are thought to represent different stages along a continuum, progressing from acute necrosis to discrete granuloma formation. Renal and respiratory involvement was infrequent, as reported in other reptile species. Some of the isolated Salmonella subspecies (S. diarizonae and S. houtenae) are well-recognized causes of clinical disease in other reptile species but not previously identified in bearded dragons. This study provides a comprehensive pathological, immunohistochemical, and bacteriological characterization of salmonellosis in bearded dragons, thus raising awareness and assisting in the identification of this condition.
To evaluate the effects of optimal versus suboptimal sedation/anesthesia temperature and two flumazenil doses, on sedation induced by subcutaneous (SC) midazolam in bearded dragons (Pogona vitticeps). Prospective, randomized, experimental, crossover study. A group of eight (five males and three females) bearded dragons. All bearded dragons (13-14 months old) received four treatments. All treatments involved SC midazolam (1 mg kg-1) injected cranial to a forelimb and occurred under optimal temperature (28-32 °C) (MO: midazolam + saline; MFL: midazolam + flumazenil 0.05 mg kg-1; MFH: midazolam + flumazenil 0.1 mg kg-1) or suboptimal temperature (18-20 °C) (MS: midazolam + saline). Animals were video-recorded before (T0) and for 180 minutes post-injection (T10-T180). A blinded observer scored sedation (scale 0-12). Scores were compared within treatments (Friedman and Dunn's test) and between treatments (Wilcoxon; Friedman with post hoc). Loss of righting reflex (LORR), heart rate (HR) and respiratory rate were reported descriptively. A median difference of up to 3 was observed between MO and MS, but all p values were > 0.08, though LORR occurred in 6/8 animals only during MS. Flumazenil reduced sedation, but median difference between MFL and MFH scores did not exceed 1, with all p > 0.63. The lowest median HR (beats minute-1) observed were 34 for MO, 40 for MFL, 44 for MFH, and 19 for MS. Midazolam (1 mg kg-1 SC) induces moderate sedation in bearded dragons. Suboptimal sedation/anesthesia temperature does not produce clinically relevant difference in sedation scores compared with optimal temperature and exacerbates bradycardia. Flumazenil (0.05 mg kg-1) reduces sedation scores. Increasing flumazenil from 0.05 mg kg-1 to 0.1 mg kg-1 does not add any benefit.
School exclusion in England disproportionately affects pupils with social, emotional, and mental health needs. Tabletop roleplaying games (TTRPGs) may strengthen social emotional learning but are rarely evaluated in UK state schools. Young Dragons, a Dungeons & Dragons based programme, was developed to support emotional regulation, teamwork, and engagement among pupils at risk of exclusion in two London boroughs. A convergent mixed methods realist evaluation was delivered across ten schools. Pupils aged 9-16 attended weekly one-hour sessions for 6-8 weeks in small, consistent groups. Pre/post pupil surveys captured wellbeing, self-concept, peer relations, school belonging, and loneliness; matched pair change (n = 22) used Wilcoxon signed rank tests. Semi-structured interviews with school staff and facilitators and observation of multiagency meetings explored implementation and perceived impact. Findings were integrated using joint displays and context-mechanism-outcome (CMO) mapping. No statistically significant within person change was detected across matched items (all p > 0.10). Distributions showed heterogeneous trajectories: many pupils reported better mood, anger regulation, and confidence, while a minority shifted toward greater disengagement or loneliness. Exploratory analysis of routine school records (n = 30) showed a significant reduction in mean suspensions from 0.7 pre-intervention to 0.0 post-intervention (p = 0.022) and a modest, non-significant increase in mean attendance from 90.6% to 92.7% (p = 0.069). Qualitative accounts described strong engagement, psychological safety, and visible gains in self-management, turn taking, and teamwork, with positive spillover into classroom behaviour when groups were stable and facilitation was consistent. Delivery challenges included timetable pressures, space constraints, and stigma around targeted provision. Integration identified skilled facilitation, small-group safety, and structured reflection as key mechanisms enabling co-regulation, perspective taking, and belonging. Young Dragons was feasible and acceptable in high need school settings. Benefits were mechanism-consistent for many participants but contingent on context and facilitator quality. These pilot data justify a larger, controlled evaluation to test causal pathways and longer-term outcomes for inclusion and emotional wellbeing.
Mud dragons (Kinorhyncha) are an understudied phylum of microscopic marine invertebrates inhabiting a wide range of marine sediments, from shallow coastal habitats to abyssal depths, and occurring from tropical to polar regions. Despite their broad distribution, their minute size often makes them difficult to study. Consequently, molecular resources for the group remain extremely limited and only three complete mitogenomes have been published from this phylum to date. To help fill this substantial gap in genetic data, we sequenced and annotated two new complete mitogenomes from the family Pycnophyidae, Pycnophyes greenlandicus Higgins & Kristensen, 1988 and Cristaphyes cryopygus (Higgins & Kristensen, 1988). Obtained mtDNA sequences were compared with available transcriptomic data from other Kinorhyncha species, providing a more comprehensive basis for the phylogenetic analysis of the phylum. The results showcased unexpected rearrangements in the gene order across all examined taxa, an unusual cox1-tRNA-Glu genes overlap and an unstable phylogenetic position within the Pycnophyidae family. These new sequences not only significantly expand the mitogenomic data available for Kinorhyncha, but also provide an important step toward a better understanding of phylogenetic relationships within the phylum.
Dungeons and Dragons (D&D) is a collaborative roleplaying game that is associated with social and emotional benefits for young adults (YAs). Research has not addressed how YAs' understanding of identity and mental health is explored through D&D. This research explored the impact that playing D&D has on YAs' understanding of their identity and how this relates to their mental health. Eleven YAs (aged 18-25) were interviewed about their experiences of playing D&D. Their interviews were analysed using Reflexive Thematic Analysis. Four main themes were identified: D&D as a safer space; D&D for coping; D&D for exploration; and D&D for growth. The findings demonstrate that YAs use D&D to navigate experiences such as social and emotional difficulties and their evolving sense of self. D&D helped YAs to manage their current circumstances as well as to look to the future. These findings highlight the positive impact D&D has on identity exploration and mental health for YAs. Playing D&D was perceived by participants as improving their wellbeing, relationships, and occupations at a critical time developmentally when they are developing their sense of self. Consideration of how D&D may be incorporated into existing intervention approaches is discussed, including implications for further research.
Seven late juvenile stages or young males, two late juvenile stages or males fixed in the process of moulting, three stage-1 and seven stage-2 females, and 17 juvenile specimens of Campyloderes cf. vanhoeffeni Zelinka, 1913 from various locations as well as a late juvenile or male and a juvenile specimen of Ryuguderes casarrubiosi Cepeda et al., 2022 were studied by light microscopy. The investigation yielded important insights into the life history of mainly the former species, viz, (1) establishment of clear distinctive characters between late juvenile and female as well as more maturated male life history stages, (2) the principal developmental series of juvenile stages, (3) development of spines via anlagen and modified spines, and (4) dissolution of septa in the primary spinoscalids of the head during moulting.
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Insects are the most abundant and ecologically important animal migrants. Yet, we know relatively little about the patterns and processes underlying insect migration. Dragonflies (Anisoptera) and damselflies (Zygoptera) comprise the ancient insect order Odonata, whose ancestors were the first organisms to fly on Earth. Several members of Odonata are known to migrate long distances and have considerable impacts on ecosystems through biomass and nutrient transfer, pest control and species interactions. However, most aspects of odonate migration remain unknown and available data have not been fully reviewed from a global perspective in over two decades. This lack of consensus has repercussions on species monitoring, specialised conservation efforts and scientific progress. Here, we review odonate migration ecology, addressing: (i) what odonate migration is; (ii) why odonates migrate; and (iii) which odonate species migrate. We define two types of odonate migration: multi-generational migration, where back-and-forth migratory journeys are completed over several generations, and single-generational migration, where the same individuals leave and return to the original reproductive habitat. We conclude that within single-generational migration, altitudinal migration is currently the only known strategy, and we present the first complete list of species observed to perform this type of migration, where refuge is temporarily sought at high-altitude sites away from the reproductive habitat. In addition, we generate an exhaustive global list of 85 dragonfly and 15 damselfly species for which migration has been confirmed (total = 100 species) and a list of 85 possible migrants (22 damselfly species; 63 dragonfly species). Consideration of phylogeny suggests that migration has evolved multiple times within Odonata, and is present in four extant dragonfly families and two extant damselfly families. Approximately 1.5% of all odonate species are migratory, with the proportion rising to approximately 2.9% if species deemed to be possible migrants are also included. Thus, overall, migration is a relatively uncommon strategy in Odonata. Among dragonflies, the vast majority (73%) of migratory species occur in the Libellulidae with 62 confirmed migratory species, equating to 5.9% of all libellulids, whereas in damselflies, migrants are divided almost equally between Coenagrionidae (N = 8) and Lestidae (N = 7), with the genus Ischnura in Coenagrionidae having the most migrants of all damselfly genera (N = 5). Biogeographically, the proportion of migratory species is highest in the Palearctic (10.8%), followed by the Nearctic (6.8%), results that may reflect research bias or indicate that migration is an adaptation favoured at high latitudes. Interestingly, most odonate migrants appear to be species of 'Least Concern' according to the IUCN Red List and are potentially resilient to environmental change because of adaptations associated with their migratory strategy, such as opportunism, generalism and long-distance mobility.
The popularity of reptiles as exotic pets has increased over the years. Reptiles can harbor zoonotic pathogens, including Salmonella, posing a significant public health risk. This study evaluated the diversity of hosts affected by non-typhoidal Salmonella infections in reptiles, as well as the antimicrobial resistance (AMR), multidrug resistance (MDR), and virulence factor (VF) genes in whole-genome, plasmid DNA, and RNA in Salmonella isolated from reptiles in Florida, United States. Data on Salmonella culture testing from 2018 to 2025, available at the Bronson Animal Disease Diagnostic Laboratory, were analyzed for host diversity in Salmonella infections. Functional genomic analysis was conducted using whole-genome sequences (WGS), plasmid DNA, and RNA obtained from selected Salmonella isolates, targeting AMR and VF genes. The Salmonella culture case positivity rate in reptiles was 16.41% during the study period. The highest positivity percentage was observed in the order Squamata (35%), which includes lizards, dragons, iguanas, and snakes, followed by the orders Testudines and Crocodilia (12.2%). The antibiotic susceptibility testing of 24 Salmonella enterica isolates revealed that 58.3% were MDR and specifically resistant to beta-lactams (62.5%), aminoglycosides (62.5%), and tetracyclines (8.3%). Genomic analysis confirmed phenotypic AMR and revealed the presence of 55 AMR genes, with the majority showing resistance to fluoroquinolones (18.2%), carbapenems and quinolones (16.4%), tetracyclines and rifamycins (14.5%), amphenicols (12.7%), and other classes. The presence of the tetA gene in both the genomic and plasmid DNA of a tetracycline-resistant isolate highlighted reptiles' role as stable zoonotic reservoirs for highly mobile genetic elements that can facilitate rapid horizontal gene transfer among pathogens. Transcriptomic analysis of isolates with MDR revealed differential expression patterns largely consistent with WGS analysis and identified additional AMR-related genes associated with MDR, efflux pumps, and membrane transport systems. A total of 239 VF genes were identified in isolates. Despite the health status of reptiles, the largest number of genes was associated with the Type III secretory system, invasion, motility, iron uptake, siderophore, fimbrial adherence, endotoxin, and lipopolysaccharides. Findings from this study underscore the importance of ongoing surveillance and improved hygiene practices when handling reptiles to reduce the risk of reptile-associated salmonellosis in humans.
Sampling neustonic nudibranchs is challenging because they live in the open-ocean surface layer, which restricts available microbiome reference data. On July 12, 2025, a mass stranding of the blue dragon nudibranch (Glaucilla marginata) at Karon Beach, Phuket, Thailand, provided a rare opportunity for microbiome sampling. We generated a 16S rRNA gene amplicon dataset from whole-body homogenates of stranded individuals. Ten specimens were sequenced as five pooled samples (two individuals per pool) targeting the V3-V4 region on an Illumina MiSeq. After processing, the dataset contained 43 amplicon sequence variants, dominated by a small number of taxa; most samples were enriched in Firmicutes, largely represented by Mycoplasma. This low bacterial richness suggests host-mediated filtering, potentially driven by host-produced antibacterial compounds or competitive exclusion mediated by resident microbes. In addition, six culturable bacterial isolates were obtained and identified by near full-length 16S rRNA gene sequencing. Some isolates were not detected in the amplicon data, underscoring the importance of integrating culture-dependent and -independent approaches to better characterize host-associated assemblages.
Dragon fruit, also known as pitahaya, has become increasingly popular in Europe and the United States owing to its nutritional value and potential health-promoting properties. This study describes a patient with anaphylaxis after the ingestion of dragon fruit. We present the case of a patient who experienced a systemic reaction requiring hospitalization 1 h after consuming dragon fruit. His medical history includes allergic rhinitis to Salsola kali pollen. The diagnostic worked-up included prick-by-prick testing with fruits, skin prick testing with aeroallergens, and measurement of specific IgE using ImmunoCAP and ISAC. These tests confirmed sensitization to dragon fruit, several pollens including S. kali, and peach allergens. A protein extract was prepared from dragon fruit pulp. In the protein profile, the most intense bands were observed at 9, 26, and 54 kDa. The patient's IgE recognized multiple bands ranging from 16 to >100 kDa. Immunoblot inhibition demonstrated cross-reactivity: S. kali extract almost completely inhibited IgE recognition of dragon fruit proteins, leaving only faint recognition of a 54-kDa band (identified as catalase), while peach peel extract completely inhibited IgE binding to the dragon fruit extract. In conclusion, sensitization to dragon fruit in this patient was probably due to cross-reactivity with S. kali and peach allergens. This case highlights the potential risks associated with the introduction of novel foods into the diet, particularly in patients previously sensitized to pollen or other plant-derived foods.
Background: Dragon's blood (dried resin of Dracaena cochinchinensis (Lour.) S.C.Chen) is a classic traditional medicine for treating ischemic stroke, yet its bioactive components capable of penetrating the blood-brain barrier (BBB) remain ill-defined. This study aims to elucidate its material basis and the synergistic mechanism of Borneol as a "guide drug." Methods: A systematic strategy integrating UHPLC-Q-TOF-MS/MS and metabolomics was employed to map the chemical profile of dragon's blood and identify its migrating constituents in rats. Results: A total of 96 compounds were characterized in vitro. In vivo analysis of the cerebrospinal fluid (CSF) revealed a brain-penetrating profile that was significantly enriched by Borneol, with the number of detected constituents increasing from 11 in the DB group to 16 in the DB + B group. The results demonstrated that demethylation, glycoside hydrolysis, and oxidation are primary metabolic pathways, validating a "pro-drug" mechanism where aglycones and hydroxylated derivatives act as the central effectors. Notably, Borneol not only enhanced the BBB permeability of lipophilic flavonoids but also facilitated unique metabolic transformations, such as the cyclization of berberrubine to coptisine. Conclusions: This study elucidates the brain-penetrating material basis of dragon's blood and reveals the dual synergistic mechanism of Borneol involving both physical permeation enhancement and metabolic modulation, offering scientific evidence for its clinical application in central nervous system diseases.
This study aimed to develop an efficient and green extraction method for recovering anthocyanins from dragon fruit peel using a natural deep-eutectic solvent-based aqueous two-phase system (NADES-ATPS). The effects of temperature, phase volume ratio, and solid-to-liquid ratio on extraction performance were systematically investigated, with total anthocyanin content (TAC) and total betacyanin content (TBC) as primary indicators, and total phenolic content (TPC) and total soluble compounds (TSC) as auxiliary indicators. The optimal conditions were 33 °C, two-phase volume ratio of 1.7:1 mL/mL, and solid-to-liquid ratio of 48:1 mg/mL. Kinetic models showed good predictive reliability, with high fitting accuracy for TAC, TBC, TPC, and TSC. HPLC confirmed Cyanidin-3-glucoside and Cyanidin-3,5-diglucoside as major anthocyanins. These results demonstrate that NADES-ATPS is an effective and environmentally compatible approach for valorizing dragon fruit peel waste.
Leadership research has long focused on the "high-visibility, high-responsibility" heroic leadership paradigm, while systematically neglecting the critical quadrant of "low-visibility, high-responsibility" (HRLV) leadership. Through ethnographic observation and in-depth interviews with Chinese dragon-boat helmsters as an extreme case, this study constructs a Helmsmanship Leadership theoretical framework, revealing the core operating mechanisms of HRLV leadership. The framework comprises 3 interlocking dimensions: Fade-achieving silent coordination through sub-threshold interventions, decoupling influence from visibility; Fail-safe-safeguarding the system's floor through preventive authority, with success marked by the "absence of disaster"; Fit-situational attunement and going with the flow, serving as a conduit for environmental forces rather than a controller. The systemic coupling of these 3 dimensions enables helmsters to sustain collective survival under extreme conditions of zero-error tolerance and high interdependence. This study decouples leadership from visibility, revealing how influence is generated under conditions of "not being seen." It expands the theoretical boundaries of relational leadership, extending relationality from interpersonal interaction to the leader's relationship with the system, with risk, and with the environment. It contributes to leadership theory a "visibility-responsibility" analytical framework, revealing the core characteristics and operating logic of the long-overlooked leadership form of "high-responsibility, low-visibility." In doing so, it provides new analytical tools for understanding governance in high-risk, highly interdependent systems.
Polysaccharides isolated from the peel of Hylocereus undatus exhibit promising anti-inflammatory activity; however, the underlying mechanisms-particularly their modulatory effects on cutaneous microbiota composition and host immune responses-remain incompletely characterized. This study investigates the therapeutic potential of polysaccharides isolated from the peel of Hylocereus undatus in the management of inflammatory cutaneous wounds. The polysaccharide extracted from the peel of Hylocereus undatus via ultrasound-assisted extraction is an acidic heteropolysaccharide, with galacturonic acid and rhamnose as its dominant monosaccharide components. It exhibits low crystallinity, a porous structure, and good thermal stability. In a mouse wound model, treatment with the polysaccharide extracted from the peel of Hylocereus undatus significantly accelerated wound closure as early as day 3 (** p < 0.01). By day 9, the wound closure rate approached that of the positive control group and remained significantly higher than that of the untreated group (** p < 0.01), exceeding 90%. Treatment with the polysaccharide advanced the inflammatory peak, as evidenced by elevated anti-inflammatory cytokines (IL-10 and TGF-β) and suppression of the pro-inflammatory cytokine IL-6. Immunofluorescence staining confirmed that polysaccharide promoted cell proliferation and neovascularization at the wound site. In conclusion, polysaccharides isolated from the peel of Hylocereus undatus accelerate skin wound healing by modulating the skin microbiota, enhancing the anti-inflammatory response, and promoting tissue regeneration, highlighting its potential as a natural wound dressing.
The red pitaya peel (Hylocereus polyrhizus) is an underutilized agro-industrial by-product rich in functional compounds, while hybrid crude palm oil contains high levels of carotenoids and tocopherols but is prone to oxidation. This study developed and characterized hybrid crude palm oil nanoparticles using freeze-dried pitaya peel as an encapsulant. Eight formulations were tested using a 23 factorial design, and the one with 150 mg of oil and 150 mg of peel was selected. The nanoparticles exhibited high encapsulation efficiency (95.6 ± 2.6%), full carotenoid retention (1386.8 ± 21.2 μg/g), and betalain content (2.40 ± 0.01 mg/g). They exhibited psizes of 331.5-351.8 nm, PDI 0.35-0.36, and zeta potential near ±30 mV, with good stability at 4 ± 1 °C over 60 days. Despite some pigment degradation, antioxidant activity remained more stable than in free constituents. These results highlight the feasibility of using pitaya peel as a sustainable encapsulating matrix for functional applications.
The bearded dragon (Pogona vitticeps) is the most commonly kept pet lizard and a promising model organism for studies of sex determination and gonadal development. Despite its potential, the morphological basis of gonadogenesis in this species remains poorly characterized. Here, we provide a comprehensive histological characterization of gonad development in P. vitticeps using serial paraffin and semi-thin sections, supplemented by morphometric analyses. Gonadal ridges first appeared at stage S28 as bilateral thickenings of the coelomic epithelium, coinciding with primordial germ cell colonization; by S28/29, a recognizable cortex and medulla were already present. The first morphological differences between male and female gonads appeared at S29/30. In differentiating testes, well-defined testis cords with a central lumen formed rapidly, while the cortex became thin and retained only scattered germ cells. Testicular development was characterized by rapid lumen formation within the testis cords, resulting in their early transformation into seminiferous tubules, followed by elongation and coiling of the tubules, maintenance of a stable tubule diameter, and a transient mitotic arrest of germ cells, with proliferation resuming at stage S36. In differentiating ovaries, the cortex remained thick and multilayered, with a progressive increase in germ cell number reflecting active oogonial proliferation. The ovarian medulla expanded substantially, and from S36 onward, lacunae developed within the medullary cords. No meiotic cells were observed at any examined stage. These results provide an essential morphological framework for future molecular and experimental studies of sex determination and gonadal differentiation in this species and in squamates more broadly.
Erenumab is a fully human monoclonal antibody targeting the calcitonin gene-related peptide receptor. Several double-blind studies have demonstrated the clinical benefits of erenumab in migraine prevention. However, long-term studies on safety and effectiveness of erenumab are lacking in Asian population. To evaluate the long-term safety and continued clinical benefit of erenumab 70 mg in adult patients with chronic migraine (CM) in China and other Asian countries. This was an open-label extension of the Phase 3 DRAGON study. Upon completion of the 12-week, double-blind treatment phase (DBTP) of the DRAGON study, randomized patients who met the inclusion criteria and provided consent transitioned into an open-label treatment phase (OLTP) lasting until erenumab approval in the patient's country. During OLTP, patients received once-monthly subcutaneous injection of erenumab 70 mg, irrespective of their initial treatment allocation in DBTP. Safety was assessed by collecting all adverse events (AEs) and serious AEs (SAEs) including their severity and relationship to study treatment. Effectiveness outcomes included clinical global impression (CGI) [severity (CGI-S), improvement (CGI-I), and efficacy index (CGI-E)]. Of the 557 randomized patients (DBTP), 456 from 50 centers participated and 226 (49.6%) completed OLTP. The median duration of exposure to erenumab was 79.9 weeks (interquartile range: 39.9-130.5). Overall, 328 (71.9%) patients reported at least one AE during OLTP. AEs suspected to be related to treatment were reported in 69 (15.1%) patients, with constipation (34 [7.5%]) being the most frequent treatment-related AE. There were 13 (2.9%) patients who discontinued the study drug due to AEs. Breast cancer was reported as an AE leading to discontinuation in 2 (0.4%) patients (not treatment related). SAEs were reported in 45 (9.9%) patients during OLTP, of which only 3 (0.7%) were treatment-related (all resolved). Continued clinical benefit with erenumab 70 mg as assessed by CGI E/I/S scores were observed for participating patients during OLTP. Erenumab 70 mg showed a consistent and well-tolerated safety profile observed over a longer treatment duration along with sustained clinical benefit. No new safety signals were observed versus DBTP and prior global phase 3 studies. ClinicalTrials.gov ID (DRAGON) NCT03867201 (registration date 2019-03-07).
Objectives: Red dragon fruit peel is a rich niche for indigenous yeasts with potential applications in feed fermentation. This study aimed to isolate, characterize, and molecularly identify Saccharomyces strains associated with red dragon fruit (Hylocereus polyrhizus) peel from An Giang province, Vietnam, and to assess their suitability as starter cultures for animal feed fermentation. Materials and Methods: A total of thirty yeast strains were isolated, of which 11 exhibited growth on YPDA medium supplemented with sodium bisulfite (NaHSO₃), suggesting sulfite tolerance. Morphological and biochemical characteristics were assessed, and ITS-based DNA sequencing was performed for molecular identification. Results: Six strains (CT6a, CT6b, CT6d, CT6g, CT3e, CT4a) showed high and stable biomass production and efficient fermentation performance in red dragon fruit peel extract. Sequence analysis confirmed all six as Saccharomyces cerevisiae with > 99% identity, and phylogenetic analysis further supported their clustering within the S. cerevisiae clade. Conclusions: Red dragon fruit peel represents a promising substrate for fermentation, and the identified native S. cerevisiae strains demonstrate strong potential as starter cultures in biotechnological applications, particularly for animal feed fermentation.