Search Results (1,506)

Background: Neurocysticercosis is a parasitic infection of the central nervous system caused by the larval stage of Taenia solium. This disease is endemic in some countries in Central and South America, South and South-East Asia, and sub-Saharan Africa. In North America, Europe, Japan, and Australia, only sporadic cases are documented. Moreover, reports of bacterial superinfection arising within neurocysticercotic lesions remain exceptionally scarce. Methods: We report a clinically severe and diagnostically challenging case of suspected neurocysticercosis with cerebral streptococcal superinfection in a 17-year-old Italian patient with Down syndrome and no history of travel to endemic regions. Results: The patient, with pre-existing epileptic encephalopathy, presented with progressive drowsiness and altered mental status, rapidly deteriorating to cardiorespiratory arrest. Neuroimaging demonstrated multiple ring-enhancing lesions, in conjunction with positive Taenia solium serology. Streptococcus spp. was identified in one neurosurgically drained lesion, consistent with secondary bacterial involvement in association with concurrent pneumonia. Combined antiparasitic therapy and targeted antimicrobial treatment resulted in sustained clinical and radiological improvement. Conclusions: In non-endemic settings, neurocysticercosis should remain within the differential diagnosis of unexplained epilepsy and multifocal CNS lesions. Although rare, bacterial superinfection warrants consideration in atypical presentations, particularly in individuals with concomitant infectious foci and underlying immune dysfunction such as that associated with Down syndrome. Full article

Raillietiella orientalis is an obligate endoparasitic crustacean that is endemic to Southeast Asia and Africa and mainly inhabits the lungs of snake definitive hosts. This pentastomid has emerged as a neozoan parasite in North America, particularly in Florida, where its spread is likely linked to the introduction of nonindigenous Burmese pythons (Python bivittatus), and Australia. In Europe, R. orientalis has previously only been reported in a wild-caught chameleon in Germany. We report a case of R. orientalis infection in a two-year-old male panther chameleon (Furcifer pardalis) which presented with anorexia and respiratory signs. Radiography revealed a diffuse interstitial–alveolar pulmonary pattern, and pulmonoscopy demonstrated numerous adult pentastomids within the lungs and their saccular extensions. Endoscopy-guided removal attempts were unsuccessful. Coprological examination confirmed patent infection through the presence of pentastomid eggs. Morphological assessment and 18S rRNA PCR followed by sequencing identified the parasites as R. orientalis. As antiparasitic treatment with ivermectin and fenbendazole failed and clinical disease persisted, humane euthanasia was performed. This case provides the second description of R. orientalis in a chameleon definitive host and highlights the parasite’s capacity for phenotypic plasticity in host utilization. Our findings underscore the potential role of the international reptile trade in facilitating the introduction and dissemination of this invasive pentastomid in Europe. Full article

Background: Cryoglobulinemia is a rare immune-mediated condition, in which abnormal proteins (cryoglobulins) precipitate at cold temperatures, leading to blood vessel inflammation. It affects approximately 1 in 100,000 individuals globally and often goes undiagnosed due to its overlapping symptoms with common conditions such as stroke. When the central nervous system (CNS) is involved—primarily in Type 2 cryoglobulinemia—it can cause serious neurological events, including seizures, confusion, and stroke-like episodes. Despite this, there is limited awareness and minimal research on this condition in South Africa. Objective: The aims of this study were to describe neurological manifestations of cryoglobulinemia using global case reports, evaluate outcomes associated with delayed diagnosis, and highlight the importance of early detection in patients with unexplained neurological symptoms. Methods: A qualitative systematic review of published case reports (2015–2024) was conducted. The study focused on adults (≥18 years) who were diagnosed with cryoglobulinemia involving CNS manifestations. Reports from hospital-based studies in Europe, North America, and Asia were retrieved from medical databases. Data on symptoms, diagnosis, treatment, and outcomes were summarized numerically and by identifying common patterns. Results: Seventeen relevant cases were identified. The most common neurological symptoms were ischemic stroke (35%), reversible posterior encephalopathy syndrome (24%), seizures (18%), and intracranial hemorrhage (12%). Most cases were associated with Type 2 cryoglobulinemia. Neuroimaging frequently revealed vasculitis, infarcts, or cerebral edema. All patients received immunosuppressive therapy, mainly corticosteroids. Outcomes showed that 76% improved, 12% partially recovered, and 12% died—mostly due to delayed diagnosis. Conclusions: Neurological involvement in cryoglobulinemia is uncommon but potentially fatal. Stroke-like presentations dominate due to vasculitis injury and vascular occlusion. Early diagnosis significantly improves outcomes, while delays can be deadly. Increased clinical awareness is essential in South Africa, where this condition is rarely reported. Clinicians should consider cryoglobulinemia as a possible cause in patients presenting with unexplained neurological symptoms. Full article

Amid growing sustainability and ethical concerns, digital innovation increasingly requires integrating social, environmental, and governance responsibility into technological development. However, little is known about how organizations in emerging economies—particularly in North Africa—operationalize these principles in practice. This study addresses this gap by exploring how institutional and economic actors in Morocco incorporate responsibility principles into their digital innovation strategies. Adopting an exploratory qualitative design, we conducted 27 semi-structured interviews with digital managers from public organizations (ministries, institutions, and local authorities) and private firms (technology companies, start-ups, and large corporations). The central research question guiding this study is: How do Moroccan organizations perceive and implement the principles of responsible digital innovation (RDI)? Data were analyzed using NVivo 14 software through thematic coding and triangulated with policy documents to enhance validity. The results reveal growing awareness of digital sustainability issues—particularly energy efficiency, accessibility, and data protection—yet the degree of responsible practice varies by sector, firm size, and regulatory environment. Key obstacles include limited expertise, absence of ethical performance metrics, and competitive pressures constraining investment in RDI. Conversely, ethical charters, frugal design, and stakeholder engagement emerge as key drivers. The study concludes that embedding responsibility in digital innovation requires shared governance frameworks, supportive public policies, and cross-sector collaboration to promote inclusive and sustainable technological progress. While context-specific, this research opens avenues for comparative and quantitative studies on RDI across emerging economies. Full article

Abortive zoonoses represent a major public-health threat and a significant constraint on small-ruminant production in West Africa, particularly in Benin. Yet they remain largely undocumented from the perspective of frontline actors. This cross-sectional study assessed the levels of knowledge, attitude, and perception (KAP) of Beninese farmers, butchers, meat inspectors, and para-veterinary staff. A structured questionnaire containing 28 items (11 knowledge, 9 attitudes, 8 perception) was administered to four professional groups (small ruminant keeper, para-veterinarian, butcher and meat inspectors) from four communes in the South, Central, and North of Benin. The number of correct and desirable responses was evaluated on a 0–100% scale. Overall, respondents demonstrated limited knowledge (50.4 ± 25.2%), highly undesirable attitudes (71.0 ± 23.2%) (higher attitude score means risky practices), and likely desirable (65.0 ± 24.4%) toward abortive zoonoses. Mixed-effect linear regression revealed that knowledge was generally higher among trained professionals such as meat inspectors and para-veterinarians. On the other hand, farmers and butchers showed larger informational gaps and more frequent risky practices. Respondents with previous experience of livestock abortion tended to be more aware of zoonotic risks but did not consistently translate this awareness into safer behavior. Correlations between knowledge and perception were weak and non-significant (r = 0.14; p = 0.135). Psychometric analysis revealed that the Knowledge scale was robust and effectively discriminated between respondents, while the Attitude scale showed poor validity, likely due to social desirability bias. Most participants perceived abortive diseases as a serious threat, yet this awareness did not translate into safer practices. The findings highlight substantial cognitive gaps, persistent risky practices and an incomplete perception of danger among value-chain actors. They underscore the need for targeted, behavior-change interventions in Benin, prioritizing practical training for farmers and butchers and the scaling-up of flock vaccination within a strengthened One Health framework. Full article

Background/Objectives: Acral melanoma (AM) is a rare and aggressive melanoma subtype that arises on sun-shielded, non-hair-bearing skin of the palms, soles, and nail beds. Although more common among individuals of non-European descent, AM remains underrecognized and understudied in the Middle East and North Africa (MENA). This study presents the first dedicated AM registry from Lebanon, aiming to characterize clinical, histopathological, and molecular features and evaluate diagnostic, referral, treatment approaches, and clinical outcomes over a 12-year period. Methods: This retrospective cohort study was conducted at the American University of Beirut Medical Center (AUBMC), a major tertiary referral center in the MENA region. All melanoma cases diagnosed between January 2012 and January 2024 were identified through electronic health records. From this cohort, all adult patients (≥18 years) with biopsy-confirmed AM or tumors located on the palms, soles, or under the nails were selected. Results: Our cohort consisted of 26 adult AM patients, identified from a total of 331 melanoma cases during the study period (8%). Median age at diagnosis was 58.5 years; 54% were female; and 96% of Middle Eastern origin. Most tumors were plantar (81%), and over half (53%) were diagnosed at early stages (Stage I–II). Surgery was performed in 92% of patients, yet 55% had positive margins. Sentinel lymph node biopsy was performed in 46%, and 35% received immunotherapy. Only 35% underwent molecular testing, identifying BRAF mutations in 11% of those tested; no patients received circulating tumor DNA analysis. At a median follow-up of 24.5 months, recurrence occurred in 27%, and metastasis developed in 23%. At the last follow-up, 92% were alive. Conclusions: Despite early-stage detection, high rates of positive margins and limited molecular testing reveal care gaps. This first national registry highlights the need to improve surgical management and expand access to precision oncology in the region. Full article

The Iberian ribbed newt (Pleurodeles waltl) is a salamander in the Salamandridae family. Endemic to the Iberian Peninsula and North Africa, it is not commonly found in zoological institutions or wildlife rescue centers. As in other species, routine blood analysis of amphibians under human care is highly recommended, forming an essential component of preventive medicine and effective clinical management. However, despite the great utility of hematological parameters for the diagnosis and prevention of diseases in amphibians, the lack of reliable reference values for many species severely limits their clinical use. The aim of this study is to establish preliminary reference values (RV) for the main hematological parameters in the Iberian ribbed newt. Blood samples were taken from healthy adult individuals (n = 30), females (n = 9) and males (n = 21) maintained under controlled conditions in two zoological institutions. A complete hematological analysis was conducted, which included measurements of hematocrit, total erythrocyte and leukocyte counts, as well as a leukocyte differential. The reference intervals were established according to the guidelines provided by the American Society for Veterinary Clinical Pathology (ASVCP) for sample sizes between 20 and 40 individuals. No significant sex-related differences were detected in the hematological parameters analyzed. Despite the broad reference ranges obtained, these preliminary data provide an essential foundation for the clinical assessment and preventive medical management of P. waltl under human care. Expanding the dataset through collaboration with additional institutions will further refine and improve the accuracy and clinical utility of these reference values. Full article

With over 300 species, the genus Eumerus Meigen, 1822 is one of the largest in the Syrphidae family. Regarding its immature stages, information is scarce, since they are described for only 22 species. The known larvae of Eumerus can be phytophagous on the underground parts of live plants or saprophagous in decaying plant materials of many sorts. Eumerus vestitus Bezzi, 1912 is a widely distributed species with records in the Afrotropical, Oriental, and Palearctic Regions. In the Palaearctic, E. vestitus is present in the Arabian Peninsula, Cyprus, Greece, Israel/Palestinian Authority, North Africa, and Syria. It is listed as an endangered species in the IUCN European Red List of Hoverflies due to the destruction of its habitat. Several puparia of E. vestitus were obtained from larvae collected in supermarket plums in Israel. In this work, the E. vestitus puparium is described in detail using a scanning electron microscope and stereomicroscope and compared with those of other members of the Eumerus obliquus (Fabricius, 1805) group, which E. vestitus belongs, and with members of other species groups. Our work also confirms a long-standing and broad occurrence of E. vestitus in Israel and records plum fruit as a new host plant for the species. Full article

Globally, poverty remains a major obstacle to health parity, compromising well-being. This policy analysis aims to examine how poverty affects health inequities and healthcare access in two contexts: Canada, a high-income nation, and Pakistan, a low-income nation. This study employs a grounded approach, integrating a thorough review of the existing critical literature using systematic thematic analysis and synthesis. In Pakistan, chronic underinvestment, rural–urban gaps, inadequate infrastructure, and political instability exacerbate inequities in access to healthcare. Limited coverage, ineffective administrative processes, and gaps in rural healthcare delivery impede growth despite encouraging programs like the Sehat Card and the Ehsaas Program. Conversely, universal healthcare in Canada has lowered financial obstacles to access, but low-income and Indigenous communities are still impacted by service gaps, particularly in dental care, pharmacare, and mental health. Although child poverty rates have been significantly reduced by programs like the Canada Child Benefit, Indigenous children continue to endure disproportionate health risks. Findings underscore a need for equity-driven changes: Pakistan must expand rural health infrastructure and legislate health equity, while Canada should extend coverage to essential but excluded services. Findings underscore the intersecting nature of inequities driven by poverty, gender, geography, and systemic exclusion that highlight opportunities for cross-context policy learning. Canada’s equity monitoring frameworks could strengthen Pakistan’s health data systems, while Pakistan’s community-based Lady Health Worker program offers scalable grassroots models relevant for marginalized Canadian regions. Both countries must prioritize poverty alleviation as a health intervention, integrating justice, sustainability, and accountability to advance global health equity. Full article

Human immunodeficiency virus (HIV), comprising two distinct types, HIV-1 and HIV-2, remains one of the most significant global health challenges, originating from multiple cross-species transmissions of simian immunodeficiency viruses (SIVs) in the early 20th century. This review traces the evolutionary trajectory of HIV from zoonotic spillover to its establishment as a global pandemic. HIV-1, the principal strain responsible for AIDS, emerged from SIVcpz in Central African chimpanzees, with phylogenetic evidence indicating initial human transmission between the 1920s and 1940s in present day Democratic Republic of Congo. The virus disseminated through colonial trade networks, reaching the Caribbean by the 1960s before establishing endemic transmission in North America and Europe. HIV’s extraordinary genetic diversity—driven by high mutation rates (~10⁻⁵ mutations per base per replication cycle) and frequent recombination events—has generated multiple groups, subtypes, and circulating recombinant forms (CRFs) with distinct epidemiological patterns. HIV-1 Group M, comprising subtypes A through L, accounts for over 95% of global infections, with subtype C predominating in sub-Saharan Africa and Asia, while subtype B dominates in Western Europe and North America. The extensive genetic heterogeneity of HIV significantly impacts diagnostic accuracy, antiretroviral therapy efficacy, and vaccine development, as subtypes exhibit differential biological properties, transmission efficiencies, and drug resistance profiles. Contemporary advances, including next-generation sequencing (NGS) for surveillance, broadly neutralizing antibodies for cross-subtype prevention and therapy, and long-acting antiretroviral formulations to improve adherence, have transformed HIV management and prevention strategies. NGS enables near real-time surveillance of drug resistance mutations and inference of transmission networks where it is available, although access and routine application remain uneven across regions. Broadly neutralizing antibodies demonstrate cross-subtype efficacy, while long-acting formulations have the potential to improve treatment adherence. This review synthesizes recent evidence and offers actionable recommendations to optimize clinical and public health responses—including the routine use of genotypic resistance testing where feasible, targeted use of phylogenetic analysis for outbreak investigation, and the development of region-specific diagnostic and treatment algorithms informed by local subtype prevalence. While the understanding of HIV’s evolutionary dynamics has substantially improved and remains essential, translating this knowledge into universally implemented intervention strategies remains a key challenge for achieving the UNAIDS 95-95-95 targets and the goal of ending AIDS as a public health threat by 2030. Full article

West Nile Virus (WNV), a mosquito-borne flavivirus first identified in Uganda in 1937, has emerged over the past quarter century as a major global public health threat. Since its introduction into North America in 1999, WNV has become the leading cause of arboviral neuroinvasive disease, with recurrent outbreaks continuing across Europe, Africa, and the Americas. This review provides a comprehensive overview of the microbiology, epidemiology, and clinical impact of WNV. We discuss the molecular biology of the virus, highlighting its genomic organization, replication strategies, and the structural and non-structural proteins that underpin viral pathogenesis and immune evasion. The complex enzootic transmission cycle, involving Culex mosquitoes and diverse avian reservoir hosts, is examined alongside ecological and climatic determinants of viral amplification and spillover into humans and equines. The clinical spectrum of WNV infection is outlined, ranging from asymptomatic seroconversion to West Nile fever and life-threatening neuroinvasive disease, with particular emphasis on risk factors for severe outcomes in older and immunocompromised individuals. Current approaches to diagnosis, supportive management, and vector control are critically reviewed, while challenges in vaccine development and the absence of effective antiviral therapy are underscored. Finally, we address future research priorities, including therapeutic innovation, predictive outbreak modeling, and genomic surveillance of viral evolution. WNV exemplifies the dynamics of emerging zoonotic diseases, and its persistence underscores the necessity of a coordinated One Health approach integrating human, animal, and environmental health. Continued scientific advances and public health commitment remain essential to mitigate its enduring global impact. Full article

Viral zoonoses or viral pathogens transmitted from animals to humans—constitute a rapidly intensifying global health and economic challenge. They are responsible for an estimated 2.5 billion illnesses and 2.7 million deaths annually, representing nearly 60% of all infectious diseases and 75% of newly emerging infections. Recent outbreaks, including Coronavirus disease 2019 (COVID-19), Ebola, Nipah, and avian influenza, underscore their capacity to overwhelm health systems, with COVID-19 alone projected to reduce global Gross Domestic Product by USD 22 trillion by 2025 and impose annual healthcare costs of USD 2–3 trillion. Beyond mortality and morbidity, zoonotic events disrupt trade, depress rural livelihoods, and inflict agricultural losses exceeding USD 100 billion per outbreak, with impacts disproportionately borne by low- and middle-income countries. Hotspot regions across tropical North and South America, Asia, and Central Africa remain especially vulnerable due to accelerating land use change, climate variability, and intensified wildlife–human interfaces. While the Global One Health Index highlights high regional heterogeneity, with sub-Saharan Africa scoring lowest, a critical gap persists between the conceptual strength of One Health and its operationalization in resource-limited settings. This review synthesizes evidence on drivers, clinical manifestations, and socioeconomic burdens of viral zoonoses, while highlighting novel perspectives on equity gaps, co-infection dynamics, and limitations of global preparedness initiatives. We argue that current strategies remain over-reliant on donor-driven agendas and insufficiently integrated across sectors. Addressing future zoonotic threats requires prioritizing surveillance in high-risk geographies, integrating epidemiological and economic data for preparedness planning, and supporting context sensitive One Health approaches that confront political, financial, and structural barriers to implementation. Full article

This study conducts a diagnostic analysis of an extremely heavy rainfall event and its causative factors that occurred in Libya, North Africa on 10 September 2023. The Weather Research and Forecasting (WRF) model was also employed to perform some sensitivity experiments for this heavy rainfall event and further reveal its causes. Results indicate that the primary synoptic system responsible for this extreme precipitation event was an extratropical cyclone (storm) named “Daniel”. During the formation and development of this cyclone, the circulation at the 500 hPa level from the eastern Atlantic to western Asia exhibited a stable “two troughs and one ridge” pattern, with a upper-level cold vortex over the eastern Atlantic, a high-pressure ridge over central Europe, and a cut-off low over western Asia, collectively facilitating the formation and development of this cyclone. As this cyclone moved southward, it absorbed substantial energy from the Mediterranean Sea; following landfall, the intrusion of weak cold air enabled the cyclone to continue intensifying. Meanwhile, the northwest low-level jet stream to the west of the extratropical cyclone moved alongside the cyclone to the coastal regions of northeastern Libya, where it converged with water vapor transport belts originating from the Ionian Sea, the Aegean Sea, and the coastal waters of northeastern Libya. This convergence provided abundant water vapor for the rainstorm event, and under the combined effects of convergence and orographic lifting on the windward slopes of the coastal mountains, extreme precipitation was generated. In addition, the atmosphere over the coastal regions of northeastern Libya exhibited strong stratification instability, which was conducive to the occurrence of extreme heavy precipitation. Although WRF successfully reproduced the precipitation process, the precipitation amount was underestimated. Sensitivity experiments revealed that both the topography in the precipitation area and the sea surface temperature (SST) of the Mediterranean Sea contributed to this extreme heavy precipitation event. Full article

This study, based on global AERONET observation data from 2023, employs a synergistic inversion algorithm that integrates aerosol optical, microphysical, and chemical properties to retrieve the global distribution of aerosol parameters. We find that the global annual mean aerosol optical depth (AOD), fine-mode AOD (AOD_f), coarse-mode AOD (AOD_c), absorbing aerosol optical depth (AAOD), single scattering albedo (SSA) are 0.20, 0.15, 0.04, 0.024, and 0.87, respectively. From the perspective of spatial distribution, in densely populated urban areas, AOD is mainly determined by AOD_f, while in the areas dominated by natural sources, AOD_c contributes more. Combined with the optical and microphysical properties, fine-mode aerosols dominate optical contributions, whereas coarse-mode aerosols dominate volume contributions. In terms of chemical components, fine-mode aerosols at most global sites are primarily carbonaceous. The mass concentrations of black carbon (BC) exceed 10 mg m⁻² in parts of South Asia, Southeast Asia, and the Arabian Peninsula, while the mass fraction of brown carbon (BrC) accounts for more than 16% in regions such as the Sahara, Western Africa, and the North Atlantic Ocean reference areas. The dust (DU) dominates in coarse mode, with the annual mean DU fraction reaching 86.07% in the Sahara. In coastal and humid regions, the sea salt (SS) and water content (AW_c) contribute significantly to the aerosol mass, with fractions reaching 13.13% and 34.39%. The comparison of aerosol properties in the hemispheres reveals that the aerosol loading in the Northern Hemisphere caused by human activities is higher than in the Southern Hemisphere, and the absorption properties are also stronger. We also find that the uneven distribution of global observation sites leads to a significant underestimation of aerosol absorption and coarse-mode features in global mean values, highlighting the adverse impact of observational imbalance on the assessment of global aerosol properties. By combining analyses of aerosol optical, microphysical, and chemical properties, our study offers a quantitative foundation for understanding the spatiotemporal distribution of global aerosols and their emission contributions, providing valuable insights for climate change assessment and air quality research. Full article

This bibliometric analysis aims to map the evolution, disciplinary structure, and collaboration dynamics of green hydrogen (GH) research in North Africa from 2019 to 2025. Drawing on a corpus of ~39,000 global publications, indexed in Scopus and analysed through SciVal, we isolate and examine the contributions of Egypt, Morocco, Algeria, Tunisia, and Libya. Egypt leads the region with 842 publications and a field-weighted citation impact of 2.42, followed by Morocco (232 Pubs., FWCI 2.30) and Algeria (184 Pubs., FWCI 1.65). Notably, Tunisia exhibits the highest growth factor (41 times since 2019), while Libya remains marginal with only 18 publications in the GH field. The region is well represented in Energy and Environmental fields but is underrepresented in trendy areas such as Materials and Chemical Engineering, highlighting critical gaps in consistency, sophistication, and technical infrastructure. While international collaboration exceeds 69% for most countries, it rarely translates into a high impact compared to the global average. Conversely, the limited industrial collaboration shows the highest citation impact (e.g., Tunisia: 68 citations/publications). A thematic analysis reveals shared strengths in electrolytic hydrogen production and renewable energy integration, with Egypt showing diversification into microalgae and nanocomposites and Morocco excelling in techno-economic assessments and ammonia-based systems. By revealing patterns in research quality, collaboration, and thematic positioning, this study offers evidence-based insights to inform national science strategies, enhance regional cooperation, and position North Africa more strategically in the emerging global green hydrogen economy. Full article