The alternation between wet and dry seasons in tropical regions can dramatically affect parasite infection dynamics by influencing larval survival, intermediate-host density, definitive-host foraging behaviour, and host immune function. Freshwater chelonians are excellent models for studying parasite-host ecology. Their longevity, site fidelity, and dietary breadth make them valuable sentinel species for aquatic ecosystem health. Here, we identified the gastrointestinal helminth fauna of scorpion mud turtle (Kinosternon scorpioides) from Marajó Island and evaluated seasonal effects on parasite community dynamics. We observed a 71% reduction in parasite load during the dry season and substantial compositional shifts, in addition to species-specific responses: Spiroxys figueiredoi exclusively during floods and Nematophila grandis peaking during dry periods. Parasite species with flexible transmission pathways may thrive while specialists decline. Kinosternon scorpioides and its parasites function as sentinels, and monitoring helminth community composition could more accurately track ecosystem health than measuring host abundance alone.

Syncope in children is commonly benign, yet rare cardiovascular anomalies may be causative. We present a child with recurrent syncope, ultimately diagnosed with an aorto-right atrial connection. Transcatheter closure was successfully performed with an Amplatzer Duct Occluder II. This case emphasizes considering aorto-atrial connections in pediatric syncope with continuous murmurs and highlights the efficacy of percutaneous closure.

Healthcare professionals in Iraq are exposed to war-related stressors that may undermine psychological well-being. This study examined post-traumatic stress disorder (PTSD) and depression and their association with peace of mind (PoM). In a cross-sectional survey, 174 physicians, nurses, pharmacists and allied health workers from multiple Iraqi regions completed an online questionnaire including demographics and validated Arabic measures of PTSD, depression (BDI) and PoM. Reliability was checked using Cronbach’s alpha, and analyses used descriptive statistics, t-tests, Spearman correlations and stepwise regression. Mild-to-moderate PTSD symptoms were reported by 66.1% of participants, and 39.1% reported at least mild depressive symptoms; 54.0% showed moderate PoM. In regression models, higher PTSD and depression scores significantly predicted lower PoM, whereas years of professional experience predicted higher PoM. These findings indicate a substantial burden of trauma- and depression-related symptoms among Iraqi healthcare workers and suggest that workplace-focused mental health supports and organizational policies are needed to protect well-being in conflict-affected settings.

We developed a dynamic COVID-19 Vaccination Barrier Index (CVBI) at the census-tract level in Clark County, Nevada and assessed its geographic disparities and relationship with COVID-19 vaccination rates over time. Using monthly census-tract data from December 2020 to June 2022, the CVBI integrated demographic, socioeconomic, environmental, housing, and transportation variables, alongside surrogates for vaccination accessibility and vaccine hesitancy. Lagged weighted quantile sum regression was applied to construct monthly indices, while a Besag-York-Mollié model assessed associations with vaccination rates. The results revealed consistent vaccination barriers such as living in group quarters, housing inadequacy, and population density across all vaccination statuses (partial, full, booster). Rural and northern Clark County, especially northeastern Las Vegas, exhibited higher CVBI scores that correlated negatively with vaccination rates. Booster vaccination patterns differed, displaying fewer significantly vulnerable tracts. The dynamic nature of barriers is evident, highlighting temporal shifts in the significance of variables like driving distance to vaccine sites. This study emphasizes the importance of dynamic, localized assessments in identifying vaccination barriers, guiding public health interventions, and informing resource allocation to enhance vaccine accessibility during pandemics.

This article presents an overview of the life histories of reared-apart twins from the Philippines. One twin always knew he was a twin, but for the other twin the discovery at age 15 came as a shock. This essay is followed by summaries of recent twin research of interest. Topics include twin discordance for multisystem inflammatory syndrome, in vitro fertilization (IVF) twins and possible associations with impaired hearing, the writings of monozygotic (MZ) twins, and an update on MZ twins with Feingold syndrome whom I have covered in a previous issue of this journal. This essay concludes with several twin-related human interest stories, namely conjoined twin girls from Sri Lanka, conjoined twin boys from Papua, New Guinea, recent information concerning conjoined twins Abby and Brittany Hensel, a twin sentenced for criminal activities, and accurate identification of an identical twin culprit by DNA sequencing.

Marsupials have been the subject of experimental and natural parasitological studies on helminths in the Americas. Brazil has a significant proportion of the American marsupial fauna, with approximately 15 genera and 69 species out of 95 extant. Helminths have been reported for approximately one-third of the Brazilian marsupial species. Consequently, an update of this information is necessary to ensure the correct identification of the species. This work represents the first comprehensive review of the helminths of the Brazilian marsupials, including taxonomic information on both parasites and hosts. The data were extracted and compiled from references published from 1819 to 2023 and organised according to the classification of the helminths by the host name of the original description, followed by the updated host species nomenclature, geographical distribution, site of infection, and references. In total, 1,047 records of helminths parasitising 22 marsupial species in Brazil were compiled. The list included 93 identified species, including five of the phylum Acanthocephala, 58 of the phylum Nematoda, and 30 of the phylum Platyhelminthes. In addition, 51 other morphospecies were reported. This work may serve as a reference for future studies.

This study aims to understand if the American public supports five policies related to the involvement of healthcare providers in immigration enforcement efforts such as documenting legal status in medical charts to actively assisting immigration enforcement. We also seek to establish whether public attitudes are stable on this issue using an experiment highlighting the implications of these policies for immigrants, communities, and the broader public. To assess public attitudes, we fielded a survey (N = 6049) from 7 March to 26 March 2025. We randomly assigned respondents to one of six treatments highlighting various implications of these policies for immigrants and communities. We found a divided public on the topic, with a substantial number of Americans willing to blur the lines between immigration policy and the provision of healthcare. Respondents were most receptive to tracking the number of undocumented patients served and least supportive of assisting in detaining patients. We found substantial differences based on party affiliation and presidential vote choice but not personal connections or residence inside or outside of border states. Our findings suggest that a majority of Americans support some level of immigration enforcement in healthcare settings while public opinion on this issue is hard to move.

COVID-19 led to a pandemic in 2020, which officially arrived in Colombia on 6 March 2020. As in other parts of the world, the spread of the virus was underestimated due to the lack of diagnostic tests and follow-up protocols. The present study estimates the number of daily cases of COVID-19 infection compatible with theoretical knowledge of the disease, seroprevalence studies, and records of daily deaths due to the disease. To this end, the REMEDID (Retrospective Methodology to Estimate Daily Infections from Deaths) algorithm was applied in nine Colombian cities. On average, official records detected only around 13% of the maximum number of infected persons in the first wave, which they dated with a delay of 25 days. In addition, there was an average delay of 30 days in detecting the first cases. In particular, in Bogotá, the city with the highest number of infections in Colombia, it was observed that (1) the first infected person arrived on 26 January 2020, 40 days before the official registration; (2) the maximum peak of infections was around 6 times higher than that recorded in the official statistics; and (3) this peak was reached on 08 July 2020, 39 days before the official registration date.

CD39 plays a pivotal role in the ATP-to-adenosine signalling pathway, serving as a critical mediator of immune suppression within the tumour microenvironment. Increasing preclinical evidence indicates that its inhibition can restore antitumour immunity and improve the efficacy of established treatments. In this review, we summarise the biology of CD39, its role in shaping the immunosuppressive tumour microenvironment, and therapeutic strategies currently under development. We also discuss early clinical progress and safety considerations, along with major challenges and future perspectives. Targeting CD39 represents a promising strategy to overcome tumour-induced immunosuppression and ongoing advances in therapeutic development could usher in next-generation immunotherapies.

Pulmonary arterial hypertension leads to dyspnoea, fatigue, and oxygen desaturation, limiting activities of daily living and functional capacity. This study aimed to evaluate the impact of pulmonary arterial hypertension on activities of daily living performance, functional capacity, peripheral muscle strength, oxygen dynamics, and energy expenditure. Eighteen adolescents and young adults with pulmonary arterial hypertension (10 females, 8 males; age 9–30 years) and 15 healthy controls (10 males, 5 females; age 9–30 years) were included. Peripheral muscle strength was assessed using a handheld dynamometer, functional capacity via the 6-minute walk test, and muscle oxygenation through near-infrared spectroscopy. Lower-limb endurance was evaluated with the 1-minute sit-to-stand test and activities of daily living performance with the Glittre Activities of Daily Living test. Compared to controls, the pulmonary arterial hypertension group had significantly lower 6-minute walk test distance (441.9 m versus 636.9 m; p < 0.001), reduced sit-to-stand repetitions (28 versus 42.1; p < 0.001), weaker peripheral strength, and lower minimum muscle oxygen saturation (24.9% versus 51.8%; p < 0.001). Glittre Activities of Daily Living test duration was longer (143 s versus 105 s; p < 0.001), with greater oxygen desaturation (−13% versus −1%; p < 0.001), higher dyspnoea scores using modified Borg scale (5 versus 1; p < 0.001), and blunted heart rate response (ΔHR [change in heart rate]: 32 versus 64; p = 0.011). These findings demonstrate that pulmonary arterial hypertension significantly impairs both cardiopulmonary and peripheral muscle function. Protecting muscle health and improving functional capacity should be prioritised to enhance quality of life in this population.