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 Legg-Calvé-Perthes disease (LCPD) is an uncommon pediatric osteonecrosis of the femoral head with substantial geographic variation in reported incidence. This study estimated the population-based incidence of LCPD in Crete (Greece) and contextualized findings through a narrative review of contemporary international literature.  We conducted a population-based prospective study of children aged 4-16 years in Crete between 2021 and 2024. Disease incidence was calculated using age-specific annual population counts and expressed per 100,000 child-years at risk. Annual population denominators were obtained from the Hellenic Statistical Authority. Incidence rates (per 100,000 child-years) and their 95% confidence intervals (CIs) were calculated assuming a Poisson distribution. In parallel, a narrative review (January 2015-September 2025) was conducted in PubMed/MEDLINE and Ovid to identify population-based studies reporting LCPD incidence or epidemiology following predefined search and selection criteria.  Over the four-year study period, a total of 401,900 child-years at risk were recorded, during which a total of 10 children were diagnosed with LCPD in Crete (11 affected hips; one bilateral case), yielding an overall hip-based incidence of 2.74 per 100,000 child-years (95% CI: 1.37-4.88). Annual incidence was 4.83 per 100,000 child-years in 2021 and approximately 2.00 per 100,000 child-years in 2022-2024. The mean age at presentation was 6.50 years, with a male predominance. The literature review identified eight eligible studies demonstrating marked international heterogeneity in incidence (0.2-29.2 per 100,000) and consistent male predominance.  LCPD incidence in Crete (2021-2024) was low and within the lower-to-mid range of international estimates. Findings reflect a population-based setting but should be interpreted cautiously due to limited case numbers and the absence of a control group.

Gastrointestinal nematodes (GIN) continue to impose substantial health and productivity losses in grazing ruminants, and the accelerating emergence of anthelmintic resistance (AR) underscores the need for SWC strategies. Although multiple SWC approaches have been validated experimentally, their implementation across European livestock systems remains inconsistent, and limited evidence exists regarding the stakeholders' perceptions that affect decision-making. This study conducted a multilingual cross-sectional survey of 1261 respondents, including farmers, veterinarians, advisors, and other professionals, across 13 European countries to evaluate perceived worm-control cost burdens and the economic feasibility of seven SWC strategies. Descriptive and regression analyses revealed that a majority of respondents (56.7%) considered diagnostic testing to be financially reasonable, although perceptions varied significantly between countries. Sustainable anthelmintic use, quarantine and strategic screening, and grazing management were perceived as the most viable strategies, whereas biological control and bioactive compound-based approaches elicited greater uncertainty. An aggregated SWC Attitude Score demonstrated systematically higher acceptance among veterinarians compared to farmers, while male and older respondents exhibited lower levels of agreement across practices. The overall findings suggest that economic considerations may not be perceived as the primary barrier to sustainable worm control adoption, but other practical factors may potentially limit implementation.

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The preservation of fish fillets during storage and distribution remains challenging due to microbial spoilage and quality deterioration. This study validated the industrial-scale application of plasma-activated water (PAW) and plasma-activated ice (PAI) on sea bream fillets, building on previous laboratory-scale findings. PAW was generated using a CAP helium jet (H₂O₂: 30.6 mg/L, NO₃-: 25.0 mg/L), while PAI was produced by freezing diluted PAW (H₂O₂: 3.8 mg/L) to reproduce lab-scale conditions. Two industrial-scale procedures were applied: (i) fillets immersed in PAW for 10 min and packed with conventional ice (PAW-fillets), and (ii) fillets packed with PAI flakes (PAI-fillets). Control fillets were packed with conventional ice. Microbial and physicochemical parameters were monitored during storage and distribution from the processing plant to supermarkets and consumers' refrigerators. Immediately after production, total aerobic bacteria were ∼ 4.00 log CFU/g, with a 0.56 log CFU/g reduction observed in PAW-fillets. PAI-fillets showed microbial reductions during the first two days, reflecting the antimicrobial activity of PAI. Shelf-life analysis indicated a ∼ 73.9% extension for PAI-fillets and ∼ 42.4% for PAW-fillets compared to controls. Physicochemical quality and freshness attributes were maintained throughout storage. A techno-economic assessment demonstrated that CAP unit installation is cost-effective, and the extended shelf life contributes to reduced food waste. Overall, these findings confirm the feasibility and effectiveness of scaling up PAW and PAI applications in industrial fish processing, providing a practical strategy to enhance safety, quality, and sustainability in seafood supply chains.

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Listeria monocytogenes is already a well-known foodborne bacterial pathogen, ubiquitously dispersed not only in the food production environment but also in the primary animal production environment as well. The present study performed whole-genome characterization of the multidrug-resistant (MDR) L. monocytogenes strain BF11, previously isolated from raw pet food and phenotypically described for antimicrobial resistance. To this end, the genomic analysis performed on the isolate confirmed the pathogen's designation as a serotype 1/2b strain belonging to ST5 and CC5 (Lineage I), carrying multiple MDR genes, stress-related genes, and mobile genetic elements, despite the absence of plasmids. The strain is phylogenetically closely related to Lineage I epidemic strains (e.g., F2365), as it has a full-length inlA and a functional prfA, rendering it capable of invading human cells and marking its high virulence. Overall, this strain may represent a potentially novel genomic profile when core genome multilocus sequence typing (cgMLST) is used, although further data from additional isolates would be required to confirm its classification within a new Complex Type, while displaying a hybrid unique profile. It is an evolved ST5 L. monocytogenes strain that has acquired genetic material conferring a "clinical signature" (Lineage I-like) and an extensive resistance network. Therefore, presence of L. monocytogenes strain BF11 in pet food is alarming, since such hybrid strains often evade surveillance monitoring as they do not fit strictly into classical categories, posing a serious food safety and public health threat in the concept of One Health.

Evidence of the relationship between breastfeeding and maternal mental health is mixed and complex, with some studies suggesting breastfeeding may lower the risk for postpartum depressive symptoms, while others report no clear or consistent effects. Given these inconsistencies, we aim to assess the association between the timing of initiation of breastfeeding and postpartum depressive symptoms 90 days after birth in Nepal. This longitudinal multi-centric cohort study included 898 mother-infant pairs in 9 district hospitals of Nepal. Data was collected on timing of initiation of breastfeeding, sociodemographic variables and depressive symptoms assessed through the Edinburg Postnatal Depression Scale. A Directed Acyclic Graph was constructed and multiple logistic regression, generalized mixed linear regression model and Generalized Estimating Equations (GEE) were used to assess the association of timing of breastfeeding with postpartum depressive symptoms. At the 90th day postpartum, 31.4% of women reported depressive symptoms. Compared to women who had immediate breastfeeding, those who had no immediate breastfeeding had 3.47 higher odds of depressive symptoms (cOR: 3.47; 95% CI; 2.40, 5.01). After adjusting for confounding and mediating factors, the odds of depressive symptoms were 2.81 times higher among women who did not immediately breastfeed (aOR, 2.81; 95% CI; 1.76, 4.50). Using GEE modeling, there was a positive association between delayed breastfeeding and postpartum depression at 7 days (β coefficient, 0.583, p = 0.001) and at 45 days (β coefficient, 0.551, p = 0.003). Using the generalized linear mixed model, the prediction to postpartum depression score increased with delay in breastfeeding. This study highlights that the delayed initiation of breastfeeding is associated with higher odds of symptoms for postpartum depression among various groups of women, especially among women from disadvantageous groups and women with no education in Nepal. Improving support to women for early initiation of breastfeeding could help reduce postpartum depression.

Herein, we report a modular palladium-catalyzed carbonylative synthesis of unlabeled and 15N3-labeled epigenetic DNA lesions 5-formyl-2'-deoxycytidine (5fdC) and 5-carboxyl-2'-deoxycytidine (5cadC) via ex situ CO generation from a KOH/CHCl3 surrogate. For 5fdC synthesis, the protected 5-iodo-3',5'-(tert-butyl-dimethylsilyl)-2'-deoxycytidine was converted to the key intermediate, 5-formyl-3',5'-(tert-butyl-dimethylsilyl)-2'-deoxycytidine, through a vial-in-a-vial procedure (vial A: KOH, CHCl3, and toluene; vial B: Pd2(dba)3, xantphos, Bu3SnH [slow addition], toluene, and 65 °C) in a very good yield. An analogous approach was employed for the synthesis of the 5-methoxycarbonyl-2'-deoxycytidine precursor, with the carbonylative coupling conducted under modified conditions (vial A: KOH and CHCl3 toluene; vial B: Pd2(dba)3, xantphos, Et3N, and methanol, 55 °C). The KOH/CHCl3 system provides significant safety advantages over gaseous CO allowing also synthetic efficiency at the microscale level. The 15N3-labeled variants (4-amino-N1, N3-15N)-5fdC and (4-amino-, N1, N3-15N)-5cadC were synthesized with high isotopic purity and characterized by high-resolution mass (HRMS) and tandem mass (MS2) spectrometry. These labeled standards were subsequently employed in liquid chromatography-isotope dilution tandem mass spectrometry (LC-ID-MS/MS) that is used for accurate quantification of endogenous 5fdC and 5cadC in DNA. This methodology provides the synthetic stable isotope "heavy"-labeled compounds needed and a robust analytical platform for investigating the formation and biological roles of these oxidatively generated epigenetic DNA lesions in the dysregulation of gene expression.

Pasteurellosis caused by Phocoenobacter atlanticus subsp. atlanticus has a serious effect on Atlantic salmon welfare and the Norwegian aquaculture industry. Understanding the mechanisms underlying bacterial virulence through bioinformatic and functional analyses is an important contribution to vaccine development and prevention of disease. The genome of a clinical isolate of Ph. atlanticus subsp. atlanticus was sequenced and through in silico analysis 16 proteins were predicted to be adhesins, which are known virulence factors and may serve as potential vaccine targets. Expression levels of two such adhesins, a maltoporin-like protein and a 47 kDa outer membrane protein (Omp47), were studied following broth culture of the bacteria at 15°C, 20°C and 30°C and found to increase significantly over time during exponential growth phase from 20°C and higher (Omp47) and at 30°C (maltoporin). This could reflect field observations indicating higher frequency of pasteurellosis outbreaks following thermal delousing treatments. Further research on these target proteins may provide an important basis for development of vaccines against pasteurellosis in Atlantic salmon.

Gender-affirming hormone therapy (GAHT) alters sex-steroid exposure, raising important questions about skeletal health in transgender and gender-diverse populations. Evidence remains fragmented and centred on areal bone mineral density (BMD), with sparse fracture data and little integration of other parameters such as muscle. This narrative review synthesises evidence on skeletal health in transgender individuals, bone density, fracture risk and the muscle-bone unit, bone health screening, and effects of gonadotropin-releasing hormone (GnRH) agonists during adolescence. We performed a narrative review of clinical studies and guidelines addressing BMD, fractures, puberty suppression, and GAHT in transgender populations, prioritising clinically relevant data. Multiple cohorts report low pre-GAHT BMD, particularly in individuals assigned-male-at-birth (AMAB), likely reflecting minority stress, low physical activity, suboptimal vitamin D status, and sedentary lifestyles. Adequately dosed GAHT generally maintains or modestly improves BMD, especially in individuals assigned-female-at-birth (AFAB) on testosterone, while modest lumbar spine deficits may persist in some AMAB individuals. Fracture data are limited but reassuring. In adolescents, GnRH-agonists predictably reduce BMD Z-scores during hormonal suppression, with partial recovery after GAHT-initiation. However, implications for peak bone mass remain uncertain. Emerging evidence favours risk-stratified rather than universal dual-energy X-ray absorptiometry (DXA) screening, alongside optimisation of GAHT, nutrition, and physical activity. Current evidence does not indicate an increased skeletal risk when GAHT is appropriately managed. Pre-existing vulnerabilities appear central to bone health risk stratification, underscoring the need for risk-based care that integrates bone parameters alongside non-skeletal factors, such as muscle.

Background/Objectives: To evaluate the association between adjunct tendon vibration and changes over 12 months in dual-energy X-ray absorptiometry (DXA)-derived bone mineral density (BMD) T-score and bone turnover markers in older adults with osteoporosis receiving standard care in a non-randomised controlled cohort study. Methods: This 12-month prospective non-randomised controlled cohort study included 100 adults aged &#x2265;60 years with DXA-confirmed osteoporosis recruited from orthopaedic clinics in the Greater Thessaloniki area. Fifty participants received adjunct tendon vibration therapy in addition to usual care, while 50 received usual care alone. Usual care consisted of calcium and vitamin D supplementation. The primary outcome was post-intervention BMD T-score, analysed using analysis of covariance (ANCOVA) adjusted for baseline T-score. Secondary outcomes included changes in bone turnover markers and calcium/phosphate metabolism. Sensitivity analysis was conducted using a linear mixed-effects model with repeated BMD measurements. Results: Baseline characteristics were comparable between groups. Over 12 months, the intervention group showed greater improvement in BMD T-score than controls (median change 0.90 [0.70-1.00] vs. -0.10 [-0.10-0.10], p < 0.001). The adjusted between-group difference was 0.871 (95% CI 0.773-0.968; p < 0.001). Results remained consistent after adjustment for age and sex. The mixed-effects model confirmed a significant group &#xd7; time interaction (&#x3b2; = 0.922, 95% CI 0.806-1.038; p < 0.001). Bone resorption markers decreased more in the intervention group. The magnitude of the observed BMD improvement (~0.9 T-score units) is notable for a non-pharmacological intervention and should be interpreted cautiously. Conclusions: Adjunct tendon vibration was associated with a more favourable BMD trajectory and changes in bone turnover markers in older adults with osteoporosis receiving standard care. Given the non-randomised design and potential residual confounding, these findings should be interpreted as associative rather than causal.

Usutu virus (USUV) is a mosquito-borne flavivirus, widely distributed in Central Europe, where it causes avian outbreaks with large-scale mortality. Although most human infections are asymptomatic or mild, the reports of USUV neurologic infections are increasing, especially among immunocompromised patients. Cross-reactivity in serological and molecular assays is often seen between USUV and the genetically and antigenically related West Nile virus (WNV). Here, we report the first USUV infection in Greece in an asymptomatic blood donor who tested positive in the automated nucleic acid test during screening for WNV, which is endemic in the country. Following the blood donation surveillance plan, a serum sample taken two weeks post-donation was tested for WNV IgM and IgG antibodies. The borderline index of the IgM antibodies, combined with negative result for IgG antibodies, raised the suspicion of molecular cross-reactivity with USUV. Although the USUV-specific PCR in donor's plasma was negative, its result was positive following amplification of the virus in cell culture, as USUV RNA was detected in the culture supernatant confirming the USUV infection. Whole genome sequence was taken using an Ion Torrent next-generation sequencing platform. Phylogenetic analysis showed that the Greek strain clusters within the USUV Europe 2A genetic lineage. The detection of USUV human infection in Greece prompts for surveillance studies to elucidate its epidemiology and ecology in the country.

Ixodid ticks are vectors for a plethora of pathogens, including the Crimean-Congo hemorrhagic fever virus (CCHFV), which causes severe disease in humans. Two autochthonous CCHF human cases were reported in 2025 in Greece. The aim of the present study was to gain a better insight into the geographic distribution and prevalence of CCHFV and the related Aigai virus (AIGV) in ticks in Greece. Therefore, 680 ticks (135 Hyalomma and 545 Rhipicephalus ticks) collected during 2024 from livestock (sheep, goats, cattle) and from the environment were tested for CCHFV and AIGV. AIGV was detected in 12 adult Rhipicephalus bursa ticks (12/511, 2.3%), while all Hyalomma ticks and R. bursa nymphs were negative for both viruses. AIGV-positive ticks were collected in May and June from goats and sheep in two distantly located regional units of Greece. AIGV sequences from partial S RNA segment differ from the prototype AIGV strain (AP-92) by 10.3% and 1.4% at the nucleotide and amino acid level, respectively. Integrated surveillance studies are needed in ticks, humans, wild and domestic animals within a One Health framework to gain a better insight into the epidemiology of CCHF in Greece, while clinical research is needed to elucidate the impact of AIGV in public health.

Obstetric anal sphincter injuries (OASIs) are serious complications of vaginal delivery and the most frequent cause of postpartum anal incontinence. Underdiagnosis during delivery persists due to limited availability of accurate imaging. Transperineal ultrasound (TPUS) and endoanal ultrasound (EAUS) enable structural assessment of the anal sphincter and have growing roles in triage, repair planning, and follow-up.The aim of the present review is to integrate current evidence on diagnostic value, clinical usefulness, and potential implementation of TPUS and EAUS in gynecologic practice.Ultrasound identifies a high burden of occult sphincter trauma in primiparas with normal clinical assessment with rates close to 25%. EAUS is currently the gold standard for accurate imaging of defects. TPUS has excellent diagnostic performance for external anal sphincter (EAS) defects and is practical for bedside use. Improving the diagnosis of OASIs requires structured post-delivery clinical examination combined with selective use of TPUS as a first-line imaging modality and EAUS in cases of diagnostic uncertainty or suspected complex injury.Immediate postpartum ultrasound may help reduce delayed diagnoses and support timely surgical repair. Key barriers include operator dependence, training, availability, and variable image quality, particularly for routine EAUS in the labor ward.Incorporating ultrasound into postpartum management improves detection and classification of OASIs and subsequently repair and prognosis. Currently, judicious application in high-risk deliveries seems to be an appropriate approach until more evidence from prospective and economic studies is available. New technologies (3D/4D imaging, standardized terminology, and decision-support/AI) hold promise to increase reproducibility and use in everyday clinical practice.

The pharyngeal muscular system of polychaetes is highly complex and shows remarkable variation in structure and function among taxa. In this study, the functional anatomy of the pharynx of G. tridactyla was investigated using micro-computed tomography (micro-CT). Sixteen Glycera specimens were imaged in different pharyngeal positions to examine the roles of key muscular structures in pharyngeal movement. The high-resolution imaging provided by micro-CT allowed visualisation of the pharyngeal muscles in their original topography, revealing essential components for pharyngeal function, including the ring muscle, retensor muscles, intestinal retractor muscles, and longitudinal muscles of the buccal tube and oesophagus. Comparison with previous studies addressed gaps in our knowledge of Glyceridae functional anatomy. Specifically, detailed analysis of the muscular system in different pharyngeal positions clarified the mechanisms of proboscis movement, which indicate the rapid and effective responses of these worms during burrowing and feeding behaviour.

TRAF3 (TNF Receptor Associated Factor 3) is a regulator of NF-&#x3ba;B signaling, acting mainly as an inhibitor of the alternative NF-&#x3ba;B pathway. While TRAF3 has a well-established role in immune function, mainly via B- and T-lymphocyte regulation, its roles in cancer remain unclear. Breast cancer is the most common malignancy in women and a neoplasm displaying high levels of intratumoral heterogeneity. Identifying and understanding key molecules at the interface of breast cancer cells and the immune system is crucial for advancing therapeutic strategies for breast cancer patients. Here, by employing publicly available breast cancer datasets, breast cancer cell lines stably expressing TRAF3, mass spectrometry analysis in combination with functional assays, co-culture systems, and signal pathway characterization, we sought to assess the specific role of TRAF3 in breast cancer cells and how TRAF3-expressing breast cancer cells affect their immune microenvironment. Our results indicate that TRAF3 protein overexpression inhibits colony formation through apoptosis regulation. Proteome analysis for TRAF3 interactors and over-representation analysis identified multiple protein complexes related to cell cycle, apoptosis, and immune responses. Furthermore, TRAF3-expressing breast cancer cells displayed reduced levels of PD-L1 and when co-cultured with PBMCs induced a pro-inflammatory profile with increased CD16-NK cells and higher levels of IFN-&#x3b3; and TNF-&#x3b1; and lower IL-10 and Tregs in the culture. These findings further expand the role of TRAF3 in breast cancer, not only as a regulator of EMT and survival of cancer cells, but also as a modulator of the tumor-immune microenvironment.

Objectives: Myelodysplastic syndromes (MDSs) are a heterogeneous group of clonal hematopoietic disorders characterized by ineffective hematopoiesis, genomic instability, and a high risk of progression to acute myeloid leukemia. Oxidative stress (OS) has emerged as a central factor in MDS pathophysiology, contributing to DNA damage, altered cellular signaling, and disease progression. Recent advances in artificial intelligence (AI) and machine learning (ML) offer a transformative approach for integrating multidimensional datasets including oxidative stress markers, hematologic parameters, and molecular profiles to enhance diagnosis, prognostication, and therapeutic monitoring in MDS. Methods: A comprehensive literature search was conducted in PubMed and Scopus, using the keywords "OS biomarkers," "AI," and "MDS''. Results: Modified redox biomarkers can be correlated with oxidative imbalance and disease progression. ML models such as neural networks, decision trees, and support vector machines effectively capture complex relationships among redox biomarkers, enhancing risk stratification and prediction of treatment response. AI-driven proteomic analyses further revealed OS-related protein signatures linked to MDS pathophysiology. Overall, AI and ML enable the transformation of multidimensional OS data into clinically actionable tools for personalized management in MDS. Conclusions: Integrating biomarker research with AI-based analytics holds promise for advancing personalized diagnostics, prognostication, and therapeutic strategies in MDS, paving the way toward precision medicine.

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The stability of fresh Spirulina biomass was investigated performing microbiological and quality analyses for refrigerated and ambiently stored (4&#xb0;C, 10&#xb0;C, and 20&#xb0;C) samples. During a period of 36 days, Spirulina samples were evaluated at different time intervals, in terms of color, pH, total solids, microbial load, moisture content, total and autolysis-induced released C-phycocyanin, lipid oxidation, and sensory characteristics (color, odor, and viscosity). According to the obtained results, a temperature-dependent autolysis of Spirulina cells was observed during storage, leading to a corresponding gradual increase in the concentration of total dissolved solids (by 48.7%-67.9%) in the growing medium. This phenomenon led to a consequent release of C-phycocyanin, causing significant biomass color changes (lightness decrease, redness, and blueness increase) (p&#xa0;<&#xa0;0.05). The concentration in C-phycocyanin, chlorophyll, and carotenoids remained unaffected during the studied period (p&#xa0;>&#xa0;0.05). Secondary lipid oxidation products were increased by 83.7%-91.1% with the maximum value of 2.104&#xa0;&#xb1;&#xa0;&#xa0;0.010&#xa0;mg malondialdehyde (MDA)/kg of wet biomass to be observed after 36 days of storage at 20&#xb0;C. Higher storage times and temperatures led to increased values in the total viable count (TVC) (p&#xa0;<&#xa0;0.05). The sensory acceptability limit of fresh Spirulina (non-characteristic off-odor detected) corresponded to a TVC of approximately 6.0 log&#xa0;CFU/g. At this point, thiobarbituric acid reactive substances (TBARs) values were observed to remain within &#x223c;1.0&#xa0;mg MDA/kg, indicating limited lipid oxidation during storage. On the basis of the TVC data and Baranyi model, the shelf life was estimated as 8, 20, and 36 days for storage at 20&#xb0;C, 10&#xb0;C, and 4&#xb0;C, respectively. PRACTICAL APPLICATIONS: Fresh Spirulina biomass represents a promising ingredient for the development of high-value functional foods, beverages, and nutraceuticals. Unlike the dried form, fresh Spirulina retains its native pigments, proteins, and bioactive compounds with minimal structural degradation, offering superior nutritional and sensory properties. However, its high moisture content makes it highly perishable, posing challenges for handling, storage, and formulation in industrial applications. Understanding its shelf life and quality stability is therefore essential for the food industry to ensure safety, optimize preservation methods, and fully exploit its potential as a sustainable, natural, and nutrient-dense raw material for innovative product development.