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Prevalence, Associated Factors, and Temporal Trends of Brucella Detection Across Human and Animal Hosts in Bangladesh: A 25-Year Meta-Analysis.

Raquib R et al. · Jul 1, 2026

Background Brucellosis remains an important zoonotic disease in Bangladesh, yet evidence on its prevalence across human and animal hosts is fragmented and heterogeneous. Objectives This study aims to synthesize evidence on Brucella detection across human and animal hosts in Bangladesh and to evaluate associated study-level factors and temporal patterns. Methods The data were extracted from eligible studies published between 2000 and 2024 following a systematic review framework. Pooled prevalence was estimated using a random-effects meta-analysis. Heterogeneity was assessed using Cochran's Q and I 2 statistics. Subgroup meta-analyses and univariable meta-regression were conducted to examine variation by host species, diagnostic method, and study-level factors. Forecasting was performed using ARIMA models on annual study-reported Brucella detection, with model performance evaluated using AIC, MAE, and RMSE. Results The pooled Brucella detection across hosts was 3.75% (95% CI: 3.07-4.56), with substantial heterogeneity (I 2 = 89.5%). Detection was the highest in dogs (7.49%) and the lowest in horses (1.78%)). Among evaluated variables, abortion history was the only study-level factorsignificantly associated with higher Brucella positivity, with aborted animals showing approximately 10 times higher odds of detection compared to non-aborted animals (OR = 10.09, 95% CI: 4.64-21.93, p Conclusion Brucella exposure and detection persist across multiple host species in Bangladesh, with variation largely driven by methodological and host-related differences. These findings underscore the need for standardized diagnostic and reporting approaches and support integrated One Health surveillance to improve interpretation and control strategies in Bangladesh.

Veterinary

Maternal serum from 'high-stress' pregnancies demonstrates bioactivity capable of attenuating neurite growth through a TNFα-dependent pathway in SH-SY5Y cells.

Deady C et al. · Jul 1, 2026

Prenatal stress is associated with deleterious neurodevelopmental consequences in affected offspring. Prenatal stress via exposure to high physiological levels of inflammation in utero may induce an inflammatory state in the fetal brain. However, inflammation is not only associated with disease-states but also can be seen in a healthy pregnancy. There is limited research examining the potential that exposure to biological mediators of stress may have on neurodevelopment. We aim to determine whether certain circulating biological markers in maternal serum influence neurite growth in partially differentiated SH-SY5Y cells as a potential mechanism impacting neurodevelopment. Blood was collected at 20-weeks' gestation as part of the SCOPE pregnancy cohort study. These factors, including pro-inflammatory cytokines, markers of tryptophan metabolism, and gut permeability that were previously analysed, were used to stratify women into low (n = 10) and high (n = 10) biological stress groups. Exposure to the serum categorised as 'high-stress' significantly reduced neurite length in comparison to serum categorised as 'low-stress', with tumour necrosis factor-α playing a substantial role in mediating this reduction. The 'high-stress' serum was subsequently found to increase the levels of phospho-Ser536-p65. Phosphorylation of p65 Ser536 has previously been shown to switch NF-κΒ from promoting neuronal growth, to inhibiting it. The reduction in neurite length seen following exposure to the 'high-stress' serum was prevented when NF-κΒ p65 was knocked down. The present study emphasises the potential negative impact that circulating factors may have on neuronal growth, and the mechanism behind it.

Neuroscience

Effect of Small-Quantity Lipid-Based Nutrient Supplementation on Children's Cortisol Concentration.

Nti H et al. · Jul 1, 2026

This study investigated the role of early-life nutrition supplementation in regulating the development of hypothalamic-pituitary-adrenal (HPA) axis activity, as evidenced by hair cortisol concentration (HCC), in the iLiNS-DYAD randomized controlled trial in Ghana. Pregnant women were randomized to one of three conditions: (1) iron and folic acid (IFA) during pregnancy and placebo 0-6 mo postpartum; (2) multiple micronutrients (MMN) during pregnancy and 0-6 mo postpartum; or (3) small-quantity lipid-based nutrient supplements (SQ-LNS) during pregnancy and 0-6 mo postpartum and for their children from 6 to 18 mo. At 9-11 y of age, usable hair samples were obtained from 680 children from which cortisol was assayed. ANCOVA models assessed differences between groups and potential effect modifiers, including maternal education, household asset index, pre-pregnancy BMI, child sex, child BMI, and pubertal stage. HCC did not differ between SQ-LNS and control groups in adjusted and unadjusted models (p > 0.10), but maternal education was a significant effect modifier (P-interaction = 0.043). Children exposed to SQ-LNS had lower HCC than control children among those whose mothers had 0-5 years schooling (Median (interquartile range): 6.3 (4.8, 9.9) vs. 7.8 (5.3, 9.9); p = 0.031) but not among those whose mothers had > 5 years of schooling (p = 0.949). No other interactions were significant. Although these findings should be viewed with caution, they suggest that early-life SQ-LNS may buffer physiological stress in children of less educated mothers, highlighting its potential to compensate for socioeconomic disadvantage with regard to HPA axis regulation. Trial Registration: Clinical Trial Registry number and website: clinicaltrials.gov as NCT00970866 https://clinicaltrials.gov/ct2/show/record/NCT00970866.

Medicine

Understanding Opportunity Costs of Women Participating in Maternal and Child Nutrition Interventions in Southern Angola: Evidence From the MuCCUA Trial.

Martin-Cañavate R et al. · Jul 1, 2026

Stunting remains highly prevalent in Angola. Multisectoral interventions are essential to prevent this public health issue, and while economic evaluations have assessed the costs and consequences of these interventions, they have largely overlooked costs incurred by participants. The MuCCUA trial evaluates the cost-effectiveness of three interventions to prevent stunting during the first 1000 days: standard of care (SOC), SOC plus nutritional supplementation (SOC + NS), and SOC plus cash transfers (SOC + CT). This study aimed to estimate participants' opportunity costs and to explore women's experiences. After 12 months of implementation, data were collected from participant women through focus group discussions, interviews and questionnaires on travel and waiting times, and transport costs for attending health posts and community sessions in the SOC arm, and for quarterly distribution visits in the SOC + NS and SOC + CT arms. Total opportunity costs per participant were estimated by intervention arm and community category (close/far from services and/or distribution points). The total opportunity cost of participants over 1 year were US$9373.91 for SOC, US$16,142.09 for SOC + NS and US$18,231.38 for SOC + CT, corresponding to US$1.69, US$2.80 and US$3.17 per participant per month respectively. Value of travel and waiting times accounted for 75%-85% of opportunity costs, with women in remote villages facing substantially higher burdens. These findings highlight the importance of accounting for opportunity costs, especially time and geographic accessibility, when designing maternal and child health and nutrition interventions. Incorporating a societal perspective in economic evaluations is essential to capture unintended participant burdens and promote equitable, effective participation. Trial Registration: NCT05571280. Registered 7 October 2022.

Nursing

Physical Activity and Metabolic Alterations in Children and Adolescents Across Different Weight Groups: A Systematic Review.

Leppänen MH et al. · Jul 1, 2026

Inadequate physical activity (PA) and increased sedentary time are key drivers of cardiometabolic disorders related to being overweight, and metabolomics offers a promising novel approach to study their associations. The aim of this systematic review was to assess the evidence on metabolites associated with PA and/or sedentary time among children and adolescents in different weight groups, integrating both intervention and observational studies to provide a comprehensive and broad synthesis of existing evidence. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, three databases (PubMed, Web of Science, and Scopus) were systematically searched for studies published from inception to December 2023 conducted in children and adolescents aged ≤ 18 years including metabolomics analyses focusing on PA, sedentary time, or cardiorespiratory fitness. Fifteen studies were included, and half of the studies were conducted in overweight individuals. Notable PA-induced or PA-associated alterations were seen in lipid, branched-chain amino acid and ammonia metabolism, and the citric acid and glucose-alanine cycles. The directions of the alterations seemed consistent across children and adolescents with normal body weight and overweight, but not in trained peers. Several metabolites and metabolite groups were identified as markers of higher PA and better cardiorespiratory fitness, reflecting favorable metabolic states in children and adolescents. However, there is still a great need for more in-depth metabolomics studies using state-of-the-art techniques in the fields of pediatric exercise science and public health. Training status, exercise modalities, and pubertal development are important covariates to consider in future studies.

Biochemistry, Genetics and Molecular Biology

Assessment of Ocular Surface Pathogen Susceptibility to Ultraviolet-C (UVC) Light Treatment With a Novel Prototype Device-An In Vitro Study.

Williams OJ et al. · Jul 1, 2026

Purpose Assess in vitro efficacy of a device emitting 265 nm UVC light against bacteria isolated from veterinary infectious keratitis. Methods Twenty-seven clinically-derived bacterial isolates: Staphylococcus pseudintermedius (n = 10; including n = 2 methicillin-resistant Staphylococcus pseudintermedius [MRSP]), Staphylococcus aureus (n = 1), Streptococcus canis (n = 4), Escherichia coli (n = 4, including n = 2 multidrug-resistant isolates), Pseudomonas aeruginosa (n = 7) and Serratia marcescens. (n = 1), and three type culture strains (n = 1 E. coli, S. aureus, S. pseudintermedius) were lawn cultured. Prototype UVC device (2.50 mW/cm 2 intensity, 23 mm diameter beam) provided triplicate exposures at 1, 2, 3, and 5 s, and plates incubated (37°C, 16-20 h). All experiments were performed in duplicate (n = 6 treatment zones per timepoint, per isolate). Absence of growth in all exposed areas at any time demonstrated complete UVC inhibition; presence of growth was categorized as Results UVC inhibition was complete in 11/30 isolates at ≤ 5 s exposure. Partial efficacy was seen in 18/19 remaining isolates at 5 s; ≥ 33% zones demonstrated absence of bacterial growth. Efficacy against MDR-MRSP and MDR-E. coli was comparable to susceptible counterparts. All P. aeruginosa were completely inhibited at ≤ 5 s; the S. marcescens isolate was least susceptible with ≥ 10 bacterial colonies within 50% zones after 5 s. Conclusion Five seconds of UVC exposure is sufficient to markedly reduce growth of most bacterial species, including MDR-isolates and completely inhibit P. aeruginosa in vitro. These findings support further controlled in vivo safety and efficacy studies of UVC as an adjunct to topical antibiotics in companion animal infectious keratitis.

Medicine

Establishing the Epidemiological Cut-Off Value (ECOFF) for Cefquinome Against Staphylococcus aureus Using Standardised MIC Data.

Ahmad I et al. · Jul 1, 2026

Staphylococcus aureus is a major pathogen responsible for a wide range of infections in both animals and humans, and the increasing emergence of antimicrobial resistance highlights the need for effective surveillance tools. Cefquinome, a fourth-generation cephalosporin, is widely used in veterinary medicine for the treatment of infections caused by Gram-positive and Gram-negative bacteria, including S. aureus. In this study, 110 S. aureus strains were isolated from cattle and subjected to minimum inhibitory concentration (MIC) determination using standardised agar dilution and microdilution methods. MIC values were obtained following 24 h incubation in 96-well plates. The MIC distribution was analysed using goodness-of-fit testing and non-linear least squares regression to establish the wild-type cut-off value (COWT). The MIC range for cefquinome against S. aureus was 0.03-2 µg/mL, and the epidemiological cut-off value (ECV) was determined to be 2 µg/mL, encompassing 99.1% of the wild-type population. An MIC value of 0.5 µg/mL covered 95% of the distribution, indicating its potential relevance for resistance monitoring. These findings provide a scientific basis for cefquinome susceptibility interpretation in cattle and support antimicrobial resistance surveillance. Further studies are warranted to develop population pharmacokinetic models for cefquinome in calves to optimise its therapeutic application.

Medicine

'We Needed a Hell of a Lot More Support, the Emotional Side of It, the Physical Side of It. Every Side of It, We Just Didn't get It.' A Qualitative Study Exploring the Lived Experiences of Healthcare Services Following Discharge for People With a Total Laryngectomy and Their Families.

Watson LJ et al. · Jul 1, 2026

Introduction People with a laryngectomy (PwL) and their families commonly require sustained support from healthcare professionals. But the needs of PwL and their families once they return home following hospital discharge are not well understood. Moreover, community healthcare professionals are not specialists in laryngectomy; they work in pressurised environments and lack time and access to education and training. This could impact safety of care and overall adjustment to life after laryngectomy. To better support healthcare professionals in the community to offer a more tailored approach, we first need to understand the needs of PwL and their families. Aim This study aimed to understand the lived experience of healthcare services following discharge, including how services could improve, from the perspective of PwL and their families. Methods Semi-structured dyadic and individual qualitative interviews were conducted with PwL±family members. Participants were recruited purposively by clinicians from three head and neck centres in the UK. Interviews were audio-recorded, transcribed verbatim and analysed using Braun and Clarke's approach to reflexive thematic analysis. Results Nineteen interviews were conducted with seventeen PwL and thirteen family members. Three inter-related themes were established: 'Immediate Practical and Emotional Demands of Post-Discharge Life, 'I had no idea what to do…you don't know anything. What do I do?'; 'Learning to Cope and Find Acceptance in Everyday Home Life, 'It was just a matter of coming to terms with the fact that socially and physically I was not the same person I was… I cannot change this, so I don't worry about it, I just accept it.'; and Navigating Healthcare Services in the Post-Laryngectomy Journey, 'I understand it's, you know, it's exceptionally difficult to put it all together because there are so many different things…so many different departments all involved in everything.' Conclusion This study has highlighted a greater need for better support and intervention for PwL, and their families once discharged home after laryngectomy. Improved collaboration between healthcare professionals and services is needed, as well as better laryngectomy education and training for community healthcare professionals. Future research should focus on exploring how best to achieve this. What this paper adds What is already known on this subject People with a laryngectomy and their families experience devastating permanent changes to everyday life because of the long-term side effects of surgery. As such, they often require ongoing care following hospital discharge, however their needs are not well understood. What this study adds to existing knowledge This study improves understanding of the specific needs of people with a laryngectomy and their families following discharge after laryngectomy. Overall, people feel alone, anxious about equipment and safety and concerned about the need to carry out specialised care at home without specialist support. As such, they have identified a need for better collaboration between healthcare professionals and services involved in their care after laryngectomy. What are the potential or actual clinical implications of this work? There is a clear need for ongoing education and training for community healthcare professionals to build confidence and competence in managing people with a laryngectomy, particularly in non-specialist settings. Strengthening communication between acute, primary, and community care teams is also essential to ensure continuity of care and reduce gaps in service provision. Clinicians could seek to establish these networks within their local teams.

Medicine

Gluten Analysis and Regulation: Scientific, Analytical, and Economic Dimensions of Gluten-Free Assurance.

Popping B et al. · Jul 1, 2026

Gluten-free regulations require analytical systems that can reliably measure gluten in wheat, rye, and barley, and, in some jurisdictions, in oats across diverse food ingredients and processed foods. Examples include baked goods, fermented products such as beer, and extruded snack foods, where processing can alter gluten extractability and antibody recognition. This review examines the scientific, analytical, and regulatory factors that determine whether gluten quantification can support robust enforcement of the 20 mg gluten/kg threshold used in most jurisdictions, with a focus on method performance criteria (MPCs). The molecular complexity of gluten and the structural changes induced by baking, fermentation, and other processing steps influence extractability and epitope availability. These effects contribute to variable results across enzyme-linked immunosorbent assays that use different antibodies, extraction chemistries, and calibration standards. The widespread use of PWG gliadin (gliadin reference material) as a calibrant supports harmonized calibration for wheat-based analyses. Still, it can introduce bias because it does not reflect the gluten composition in processed or mixed-cereal foods. Improved incurred reference materials offer advantages but are not yet widely accessible. Proficiency testing data from DLA and FAPAS show that interlaboratory agreement is strongest for unprocessed matrices and decreases in baked, fat-rich, or fermented foods. These findings highlight the need for harmonized validation and for statistical criteria that define acceptable assay performance around the regulatory threshold. Advanced techniques such as liquid chromatography-tandem mass spectrometry provide detailed peptide-level information and can support confirmation in matrices where immunoassays lose sensitivity. A coordinated, performance-based framework aligned with Codex guidance would enable analytical methods to be evaluated against common criteria for recovery, precision, and detection capability. Codex alignment also introduces method dependency, as the current Type I Codex approach for gluten relies on the R5 Méndez ELISA as the defining method. Because Type I methods are empirical defining methods, results are comparable to the definition established by that method rather than necessarily being traceable to an independent reference value for gluten. The use of a single Type I method can therefore limit comparability when laboratories use assays based on other antibodies or extraction and calibration systems, particularly in processed matrices. Integrating such MPCs into regulatory practice, proficiency testing, and private certification systems would improve the comparability of gluten testing results and improve the reliability of gluten-free labeling in international markets.

Medicine

'Heroes Were (And Could Be) Created': An Exploration of Adolescents' Perspectives of Portrayals of Pain and Empathy in Media.

Cormier A et al. · Jul 1, 2026

Background Research suggests that media consumption plays a role in socialization, including the socialization of painful experiences. Findings from previous research examining pain depictions in popular adolescent media suggest that violence and injuries are frequently represented, marginalized populations are underrepresented, and observers lack prosocial responses to sufferers' pain. This study was the first to examine how adolescents perceive, internalize, and discuss pain depictions in popular adolescent media. Methods Fourteen adolescents (between 13 and 18 years of age), both with and without chronic pain, participated in focus groups. Participants watched clips depicting pain in popular adolescent media before providing their feedback. Results Using reflexive thematic analysis, three themes were generated: (1) a failure to communicate, but not to empathize-observers may be fearful or lack the tools and confidence to address sufferer pain, (2) media as the metric-media serves as the metric by which we can compare pain experiences, which may contribute to stigma and disbelief, and (3) media as the conduit for transformation-media may be harnessed to properly represent and build empathy for pain. Significance These novel findings suggest that media portrayals of pain may shape youths' beliefs about pain expression, validation, and empathy. Media could therefore serve as a modifiable target for reducing pain-related stigma and improving empathic responses to pain.

Medicine