Diseases (Basel, Switzerland)最新文献

{"title":"Adropin and Endothelin-1 as Complementary Signals Associated with Early Vascular Aging in Middle-Aged Type 2 Diabetes.","authors":"Rooban Sivakumar, Arul Senghor Kadalangudi Aravaanan, Vinodhini Vellore Mohanakrishnan, Janardhanan Kumar","doi":"10.3390/diseases14040140","DOIUrl":"https://doi.org/10.3390/diseases14040140","url":null,"abstract":"<p><p><b>Background</b>: Early vascular aging (EVA) is a common complication of type 2 diabetes mellitus. Early identification is crucial in middle-aged individuals with T2DM, as vascular stiffness can occur gradually for years before cardiovascular disease. However, EVA is rarely considered in routine care. Adropin is a vasoprotective peptide that may counter-regulate endothelin-1 (ET-1). Therefore, this study aims to examine the association between circulating adropin, ET-1, oxLDL, MMP-2, VEGFA, and EVA. <b>Methods</b>: This observational study included 300 adults aged 25-55 years (150 T2DM; 150 age/sex-matched controls). ePWV was calculated from age and mean blood pressure. EVA was classified using a residual-based, age-specific ePWV threshold derived from controls. Associations were tested using correlation and logistic regression. ROC and decision curve analyses were performed to evaluate diagnostic performance and clinical utility. <b>Results</b>: EVA prevalence was 38.6% overall, occurring in 7.3% of controls and increasing across T2DM with good and poor glycemic control (56.1% and 80.95%, respectively, <i>p</i> < 0.001). Compared with normal vascular aging, EVA showed lower adropin and higher ET-1, oxLDL and MMP-2, with lower VEGFA (all <i>p</i> < 0.05). In fully adjusted models, adropin (OR 0.991 per pg/mL; <i>p</i> < 0.001) and ET-1 (OR 1.017 per pg/mL, <i>p</i> = 0.005) remained independently associated with EVA. A combined adropin + ET-1 predictor improved discrimination (AUC 0.901, 95% CI 0.868-0.934), at a predicted-probability cutoff of 0.607, 78.7% sensitivity and 87.0% specificity. <b>Conclusions</b>: In middle-aged T2DM, EVA was associated with lower adropin and higher ET-1 in T2DM. These findings support an association between these biomarkers and the EVA phenotype.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Symptoms After SARS-CoV-2 Infection in a Referred Occupational Clinical Registry: Symptom Patterns and Associated Factors.","authors":"Agnessa Kozak, Jana Wischnat, Corinna Rademacher, Andreas Gonschorek, Ingo Schmehl, Susann Seddigh, Andrea Fürst, Kai Wohlfarth, Lynn Engel, Jakob Wefers, Kerrin Kobes, Olaf Kleinmüller, Majid Essa, Martin Tegenthoff, Albert Nienhaus, Peter Schwenkreis","doi":"10.3390/diseases14040141","DOIUrl":"https://doi.org/10.3390/diseases14040141","url":null,"abstract":"<p><strong>Background/objectives: </strong>Persistent symptoms following SARS-CoV-2 infection pose a substantial burden in occupational settings. This study aimed to characterize symptoms following work-related SARS-CoV-2 infection and to assess their associations with sociodemographic and clinical factors.</p><p><strong>Methods: </strong>Data were obtained from a multicenter clinical registry of insured individuals referred for persistent symptoms 12 weeks after laboratory-confirmed work-related SARS-CoV-2 infection. Participants were assessed within a standardized post-COVID diagnostic program at six specialized clinics for occupational accident insurance in Germany. Persistent symptoms reported by ≥50% of participants were analyzed using generalized linear mixed models with random intercepts for center.</p><p><strong>Results: </strong>A total of 1511 participants (76.7% women; median age 54 years) were included, with a median interval of 16 months between infection and assessment. On average, participants reported ten persistent symptoms. The most frequent complaints were limited physical capacity (95.6%), concentration difficulties (78.8%), dyspnea (70.5%), exhaustion/tiredness (68.9%), and memory difficulties (67.5%). Individuals reporting more than ten acute symptoms had increased odds of persistent complaints (ORs between 2.1 and 4.66). Hospitalization was independently associated with persistent dyspnea (OR 1.62; 95%CI 1.17-2.25). Reinfections were linked to exhaustion and cognitive fatigue. Compared with Omicron, wild-type infection was associated with higher odds of concentration difficulties (OR 1.65; 95%CI 1.17-2.33). Comorbidities demonstrated symptom-specific associations.</p><p><strong>Conclusions: </strong>Among individuals with work-related SARS-CoV-2 infection, limited physical capacity and cognitive impairments were the most frequently reported symptoms, and higher acute symptom burden was strongly associated with the development of persistent symptoms. These findings support course-oriented evaluation and symptom-specific approaches in occupational disease assessment and management.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Skull Base Osteomyelitis of the Clivus Mimicking a Malignant Lesion: A Case Report.","authors":"Magdalena Stocker, Johanna Felber, Patricia Bäck","doi":"10.3390/diseases14040138","DOIUrl":"https://doi.org/10.3390/diseases14040138","url":null,"abstract":"<p><strong>Background/objectives: </strong>Atypical skull base osteomyelitis (ASBO) is a rare disease, typically involving the basisphenoid and basiocciput. Diagnosis consists of clinical examination, imaging methods such as PET-CT scans and MRI, microbiological testing, and possibly native tissue samples. Long-term intravenous antibiotic therapy is the treatment of choice. Methods/Case Report: We present a case of ASBO of the clivus initially suspected to be a malignant lesion due to malignant melanoma in the patient's history. Several tissue biopsies were taken, and microbiological testing of native tissue biopsies in combination with PET-CT and MRI imaging led to the diagnosis of ASBO. The patient received long-term antibiotic therapy with meropenem and drastically improved in his overall health.</p><p><strong>Discussion and conclusions: </strong>This case highlights the challenges encountered in the diagnosis and management of ASBO, especially with relevant possible differential diagnoses.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life, Fear of COVID-19, Psychological Distress, and Resilience Among Individuals with Chronic Conditions: Evidence from the Later Phases and Aftermath of the COVID-19 Crisis.","authors":"Elpida Stratou, Georgia-Nektaria Porfyri, Stavros Antonopoulos, Afroditi Biziou, Aikaterini Kalogeropoulou, Katerina Theodorou, Kalliopi Kalogeropoulou, Aikaterini Kyriaki Timotheou, Maria Kapouralou, Aikaterini Gamvroula, Maria Saridi","doi":"10.3390/diseases14040134","DOIUrl":"https://doi.org/10.3390/diseases14040134","url":null,"abstract":"<p><strong>Background/objectives: </strong>The COVID-19 pandemic posed significant challenges to quality of life, particularly for individuals living with chronic physical and/or mental conditions. Psychological factors such as fear of COVID-19, psychological distress, and resilience may be associated with quality-of-life outcomes during prolonged public health crises. This study aimed to examine quality of life and its psychological correlates among individuals with chronic conditions during the later phases and aftermath of the COVID-19 pandemic crisis.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 293 adults with chronic physical and/or mental conditions attending the General Hospital of Argolida, Greece. Participants completed validated self-report measures assessing quality of life (MVQOLI), fear of COVID-19 (FCV-19S), depression, anxiety, and stress (DASS-21), and psychological resilience (CD-RISC-25). Descriptive statistics, Spearman correlation analyses, and multivariable regression models were used to examine associations and identify factors associated with quality-of-life domains.</p><p><strong>Results: </strong>Higher levels of fear of COVID-19 and depressive symptoms were significantly associated with poorer quality of life across multiple domains. Depressive symptoms showed consistent negative associations with functional, interpersonal, transcendent, and overall quality-of-life scores. In contrast, psychological resilience was positively associated with interpersonal, transcendent, and overall quality of life. Regression analyses showed that depressive symptoms were negatively associated with overall quality of life, while resilience was independently associated with better quality-of-life outcomes.</p><p><strong>Conclusions: </strong>Psychological distress, particularly depressive symptoms and fear related to COVID-19, was associated with lower quality of life among individuals with chronic conditions during the later phases and aftermath of the COVID-19 crisis. Psychological resilience was positively associated with better quality-of-life outcomes, underscoring its relevance for supporting well-being during and after public health crises.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Randomized, Controlled Trial of Nighttime Peanut Butter Supplementation in Firefighters: Blood Pressure and Body Composition Outcomes.","authors":"Austin A Kohler, David H Shuler, Leke O Adeleye, Andrew R Moore, Nicole Peritore, A Maleah Winkler","doi":"10.3390/diseases14040135","DOIUrl":"https://doi.org/10.3390/diseases14040135","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dietary approaches to combating risk factors for cardiovascular disease are valuable, especially for individuals in high-stress occupations like first responders. The purpose of this pilot randomized control trial was to determine the effect of regular peanut butter (PB) supplementation on blood pressure and primary measures of body composition (body fat %, fat mass, and lean mass) in firefighters. <b>Methods</b>: Full-time firefighters (N = 40; 1 woman) were randomly assigned to a control group or a peanut butter group for 7 weeks. Participants in the peanut butter group consumed one serving of peanut butter before bed at least 5 days per week for the intervention period. Participants in the control group continued with their usual diet. Indices of body composition and blood pressure were collected before and after the intervention period and compared using mixed-factorial ANOVAs (α = 0.05). <b>Results</b>: No interaction effects between group and time were observed for blood pressure variables (<i>p</i> = 0.619-0.650). Similarly, the changes among the PB group over time in percent body fat (Δ = -0.53 ± 1.74%), fat mass (Δ = -0.73 ± 2.21 kg), and lean body mass (Δ = 0.04 ± 1.65 kg) were not significantly different than the changes over time in the control group (<i>p</i> ≥ 0.067 for all). <b>Conclusions</b>: Seven-week PB supplementation did not affect male firefighter body composition or blood pressure; however, future studies should investigate longer durations with sophisticated dietary recall methods. ClinicalTrials.gov Identifier: NCT06364202.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycation at the Crossroads of Disease Pathogenesis: Mechanistic Insights and Therapeutic Frontiers.","authors":"Sneha Krishnamoorthi, Rupachandra Saravanakumar, Vivek Kumar","doi":"10.3390/diseases14040137","DOIUrl":"https://doi.org/10.3390/diseases14040137","url":null,"abstract":"<p><p>Protein glycation is a nonenzymatic modification that links sugar chemistry to molecular aging and chronic disease. Sequential reactions involving Schiff bases, Amadori products, and reactive α dicarbonyl intermediates generate advanced glycation end products (AGEs) that irreversibly alter protein structure and function. AGEs also act as ligands for the receptor for advanced glycation end products (RAGE), initiating oxidative stress, inflammation, and tissue remodeling. This review synthesizes the molecular pathways of AGE formation, their structural diversity, and the biological factors influencing glycation kinetics. Advances in analytical detection methods-including fluorescence spectroscopy, LC-MS/MS, and immunochemical approaches-are highlighted for their role in monitoring AGE accumulation. Particular attention is given to the contribution of glycation to diabetes, cardiovascular disease, neurodegeneration, and cancer, alongside emerging therapeutic strategies to limit AGE formation or block AGE-RAGE signaling. Glycation thus represents a central mechanism in human disease pathogenesis and an emerging therapeutic frontier.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Obesity, Overweight, and the Prevalence of Depression and Anxiety Among University Students: Evidence from a Nationally Representative Cross-Sectional Study in Greece.","authors":"Olga Alexatou, Konstantinos Papadimitriou, Exakousti-Petroula Angelakou, Sousana K Papadopoulou, Myrsini Pappa, Apostolia Ntovoli, Aspasia Serdari, Konstantina Apostolidou, Theophanis Vorvolakos, Constantinos Giaginis","doi":"10.3390/diseases14040136","DOIUrl":"https://doi.org/10.3390/diseases14040136","url":null,"abstract":"<p><strong>Background and objectives: </strong>Rates of obesity have been consistently increasing in recent years across all age groups, with a notable rise among young people. Obesity represents a persistent inflammatory condition and a key contributor to various chronic health problems, such as cardiovascular disorders, metabolic abnormalities, cancer, and psychological conditions. The move from high school to university is a transitional phase accompanied by specific pressures that can affect both body weight control and mental health in students. This cross-sectional investigation aimed to investigate potential associations between excess weight and the presence of depressive and anxiety symptoms in university populations.</p><p><strong>Methods: </strong>This cross-sectional analysis included 5298 students enrolled at universities across ten geographic areas of Greece. Participants filled out questionnaires concerning demographic information and lifestyle behaviors. Levels of depression and anxiety were measured using the Beck Depression Inventory (BDI-II) and the short form of the State Anxiety Inventory (STAI-6), respectively. Measurements of height and body weight were obtained to compute Body Mass Index (BMI).</p><p><strong>Results: </strong>The presence of overweight or obesity among students was significantly and independently related to female sex, urban residence, living independently, tobacco use, and lower academic performance (<i>p</i> = 0.0103, <i>p</i> = 0.0102, <i>p</i> = 0.0203, <i>p</i> = 0.0075, and <i>p</i> = 0.0168, respectively). Individuals reporting insufficient physical activity had 85% higher odds of being overweight or obese (<i>p</i> = 0.0068). Similarly, participants experiencing depressive or anxious symptomatology had more than double odds of excess body weight compared with those without such symptoms (<i>p</i> = 0.0015 and <i>p</i> = 0.0012, respectively). Furthermore, poor Mediterranean diet adherence was linked to more than a twofold increase in the odds of overweight or obesity (<i>p</i> = 0.0005).</p><p><strong>Conclusions: </strong>These findings offer considerable evidence that symptoms of depression and anxiety may serve as significant contributors to the development of overweight and obesity among university students. Additional longitudinal studies are strongly encouraged to substantiate these observations.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue Epidemiology in Mexico: Temperature as a Contributing Factor to National Dengue Trends.","authors":"Juan Manuel Bello-López, Dulce Milagros Razo Blanco-Hernández, Andres Emmanuel Nolasco-Rojas, Emilio Mariano Durán-Manuel, Víctor Hugo Gutiérrez-Muñoz, Carol Vivian Moncayo-Coello, Jesus Alberto Meléndez-Ordoñez, José Alberto Díaz-Quiñonez, Magnolia Del Carmen Ramírez-Hernández, Adolfo López-Ornelas, María Concepción Tamayo-Ordóñez, Yahaira de Jesús Tamayo-Ordóñez, Francisco Alberto Tamayo-Ordóñez, Benito Hernández-Castellanos, Luis Gustavo Zárate-Sánchez, Oscar Sosa-Hernández, Julio César Castañeda-Ortega, Claudia Camelia Calzada-Mendoza, Alejandro Cárdenas-Cantero, Clemente Cruz-Cruz, Miguel Ángel Loyola-Cruz","doi":"10.3390/diseases14040133","DOIUrl":"https://doi.org/10.3390/diseases14040133","url":null,"abstract":"<p><p>The increasing burden of dengue represents a growing global public health concern. Among the factors associated with rising dengue incidence, climate change, particularly increasing temperatures, has been frequently highlighted, alongside other environmental, biological, and social determinants. The emergence of dengue in previously non-endemic areas and its sustained increase in incidence have become increasingly common in recent decades.</p><p><strong>Objective: </strong>The aim of this study was to describe national dengue case trends in Mexico from 1990 to 2023 and to assess their association with temperature over the same period using a descriptive, retrospective analysis of epidemiological surveillance and temperature data.</p><p><strong>Methods: </strong>Epidemiological data on confirmed dengue cases and incidence were obtained from the Morbidity Yearbook of the General Directorate of Epidemiology (DGE) of the Mexican Ministry of Health. These data were used to construct epidemic curves and to analyze the geographic distribution of incidence using quartiles. Temperature data were derived from the national annual mean calculated from monthly reports issued by the National Water Commission (CONAGUA). Associations between temperature and dengue cases and incidence were explored over the study period.</p><p><strong>Results: </strong>Temporal analysis revealed a significant increase in both dengue cases and incidence in Mexico, with a positive association with temperature during the same period. Quartile-based geographic analysis showed that state-level classifications remained relatively stable across periods, with several states clustering within or tending toward the group considered endemic.</p><p><strong>Conclusions: </strong>The results of this study show an increase in cases and incidence of dengue over time, as well as a positive association between cases/incidence of dengue in Mexico and the increase in the national average temperature during the study period; however, due to its descriptive and retrospective design, causal inference is not possible. Dengue transmission is inherently multifactorial, and the observed trends likely reflect the combined influence of climatic conditions, historical expansion of transmission cycles, vector establishment, and unmeasured socio-epidemiological factors. The absence of entomological indicators, additional climatic variables, and spatially or seasonally disaggregated analyses limits the ability to capture localized dynamics. Overall, temperature should be interpreted as a contributing factor within a complex system rather than as the sole driver of dengue trends, underscoring the need for integrated surveillance and control strategies in both endemic and non-endemic regions.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Analysis of Drug-Resistant Tuberculosis: Integrating Molecular Markers, Clinical Governance, and Community-Engaged Education in Rural South Africa.","authors":"Siphosihle Conham, Ncomeka Sineke, Ntandazo Dlatu, Lindiwe Modest Faye, Mojisola Clara Hosu, Teke Apalata","doi":"10.3390/diseases14040132","DOIUrl":"https://doi.org/10.3390/diseases14040132","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Drug-resistant tuberculosis remains a major challenge in resource-limited settings, particularly in rural regions of the Eastern Cape Province, where limited laboratory infrastructure, constrained access to advanced molecular diagnostics, shortages of specialized healthcare personnel, and prolonged diagnostic turnaround times can delay appropriate treatment initiation. This study examined whether routinely detectable genomic resistance markers could be integrated with parsimonious machine learning approaches to support early risk stratification for isoniazid (INH) and/or rifampicin (RIF) resistance and multidrug-resistant tuberculosis (MDR-TB).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis of clinical, demographic, and genomic data from 207 &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt; isolates representing 207 unique patients. Resistance was classified as INH and/or RIF resistance or MDR-TB (concurrent resistance to both drugs). Predictors included age, sex, and canonical resistance-associated mutations (&lt;i&gt;katG&lt;/i&gt; S315T, &lt;i&gt;inhA&lt;/i&gt; -15C&gt;T, and &lt;i&gt;rpoB&lt;/i&gt; codon substitutions). Logistic regression was used to estimate adjusted odds ratios (aORs), while Random Forest models were applied to assess non-linear feature importance. Internal validation was performed using 10-fold cross-validation. A systems network analysis mapped the integration of model-derived risk bands into Clinical Governance structures and Community-Engaged Education pathways, including interventions delivered by Community Health Workers (CHWs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;INH and/or RIF resistance was identified in 58.9% of isolates, with 21.7% classified as MDR-TB. The most frequently detected mutations were &lt;i&gt;katG&lt;/i&gt; S315T (29.0%) and &lt;i&gt;rpoB&lt;/i&gt; S450L (26.6%). Logistic regression identified &lt;i&gt;rpoB&lt;/i&gt; S450L (aOR 4.20; 95% CI: 2.10-8.45) and &lt;i&gt;katG&lt;/i&gt; S315T (aOR 2.85; 95% CI: 1.40-5.80) as the strongest independent predictors, while age and sex were not statistically significant. Models demonstrated strong internal discrimination (AUCs of 0.96 for INH and/or RIF resistance and 0.99 for MDR-TB). Risk stratification categorized 18% of patients as high risk. Scenario-based modelling suggested that prioritizing high-risk patients for reflex Line Probe Assay testing could reduce the median time to appropriate treatment from 14 to 3 days and may reduce progression from isoniazid-resistant TB to MDR-TB under specified operational assumptions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Mutation-informed predictive modelling demonstrates strong internally validated discrimination and provides a structured framework for risk-stratified intervention. Integrating probability-based risk thresholds within Clinical Governance systems and community-level support structures, including CHW-led adherence and education strategies, may support earlier treatment optimization in high-burden rural settings. External validation and prospective implement","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and Prognostic Utility of Cell-Surface Vimentin Positive Circulating Tumor Cells in Breast Cancer Using an Automated Negative Selection Platform.","authors":"Ming-Hsin Yeh, Mei-Chun Lin, Hui-Ju Tsai, Yi-Chou Liu, Tzu-Min Wang, Wei-Shan Hung, Chih-Peng Lin, Ching-Hsing Liang, Chih-Jen Tseng","doi":"10.3390/diseases14040130","DOIUrl":"https://doi.org/10.3390/diseases14040130","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Breast cancer (BC) is the most commonly diagnosed cancer in women, and metastasis is the leading cause of BC-related death. Circulating tumor cells (CTCs) are a prerequisite for metastasis. This study examined the diagnostic and prognostic value of CTCs for assessing metastatic risk and recurrence in BC. <b>Methods:</b> The Chiline CATCH^® Circulating Target Cell Enrichment System, an automated negative selection platform, was used to enrich and enumerate CTCs from the peripheral blood of patients with BC. Epithelial cell adhesion molecule (EpCAM) and cell-surface Vimentin (CSV) were used as markers for CTC identification. <b>Results:</b> CSV⁺ CTC counts, but not EpCAM⁺ CTC counts, were increased in patients with BC at higher metastatic risk. A cut-off of >4.5 CSV⁺-CTCs/2 mL blood yielded a sensitivity of 0.56 and specificity of 0.92 for identifying patients at high metastatic risk. CSV⁺-CTCs outperformed conventional serum tumor markers, including cancer antigen 15-3 (CA 15-3), cancer antigen 125 (CA 125), and carcinoembryonic antigen (CEA), in identifying patients with high metastatic risk, and their combined use further improved risk stratification. An elevated CSV⁺-CTC count (≥5 cells/2 mL blood) was significantly associated with worse progression-free survival in patients with BC. <b>Conclusions:</b> These findings suggest that CSV⁺-CTCs may serve as a biomarker for metastatic risk stratification and recurrence monitoring in BC when measured using an automated negative selection platform.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}