INTRODUCTION: Threats to our survival are often posed by the environment in which humans have evolved or live today. Animal and human ancestors developed complex physiological and behavioral response systems to cope with two types of threats: immediate physical harm from predators or conspecifics, triggering fear, and the risk of infections from parasites and pathogens leading to the evolution of the behavioral immune system (BIS) with disgust as the key emotion. Here we ask whether the BIS has adapted to protect us from pandemic risks or poisoning by modern toxic substances. METHODS: We have developed a survey comprised of 60 vignettes describing threats evoking fear and disgust belonging to one of the three main categories of threats: (1) ancestral, (2) modern, and (3) pandemic of airborne disease. Each vignette was evaluated on a 7-point Likert scale based on fear, disgust, and anger. Respondents also completed an assessment battery. RESULTS: The results show that the strongest fear is triggered by modern threats (electricity, car accidents), while the highest disgust is evoked by ancient threats (body waste products, worms). Disgust does not respond to modern threat stimuli such as toxic substances or radioactivity as these evoke mainly fear and anger. A discriminant factor analysis classified nine out of 10 pandemic disgust vignettes into the ancestral disgust category, convincingly assigning the pandemic disgust threats to the ancestral type. Gender, age, and type of education were significant moderators of emotional responses across all threat categories. DISCUSSION: Our study reveals that while fear is more context-dependent, particularly triggered by modern threats, disgust operates on an evolutionarily hardwired basis, making it less effective against contemporary risks. Furthermore, disgust experienced during a pandemic outbreak is more closely aligned with ancestral disgust-related threats tapping into evolutionary ancient survival circuits of the BIS. However, as disgust declines with age, the brain must adaptatively shift the emotional processing from disgust to fear to protect older adults from contamination risks. Finally, our study reveals that pandemic fear is better predicted by specific behaviors rather than general anxiety, suggesting a need for new assessments.

• Publication type
• Journal Article MeSH

BACKGROUND: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an inflammatory disease affecting the peripheral nerves and the most frequent autoimmune polyneuropathy. Given the lack of established biomarkers or risk factors for the development of CIDP and patients' treatment response, this research effort seeks to identify potential clinical factors that may influence disease progression and overall treatment efficacy. METHODS: In this multicenter, retrospective analysis, we have screened 197 CIDP patients who presented to the University Hospitals in Düsseldorf, Berlin, Cologne, Essen, Magdeburg and Munich between 2018 and 2022. We utilized the respective hospital information system and examined baseline data with clinical examination, medical letters, laboratory results, antibody status, nerve conduction studies, imaging and biopsy findings. Aside from clinical baseline data, we analyzed treatment outcomes using the Standard of Care (SOC) definition, as well as a comparison of an early (within the first 12 months after manifestation) versus late (more than 12 months after manifestation) onset of therapy. RESULTS: In terms of treatment, most patients received intravenous immunoglobulin (56%) or prednisolone (39%) as their first therapy. Patients who started their initial treatment later experienced a worsening disease course, as reflected by a significant deterioration in their Inflammatory Neuropathy Cause and Treatment (INCAT) leg disability score. SOC-refractory patients had worse clinical outcomes than SOC-responders. Associated factors for SOC-refractory status included the presence of fatigue as a symptom and alcohol dependence. CONCLUSION: Timely diagnosis, prompt initiation of treatment and careful monitoring of treatment response are essential for the prevention of long-term disability in CIDP and suggest a "hit hard and early" treatment paradigm.

• MeSH
• Polyradiculoneuropathy, Chronic Inflammatory Demyelinating * diagnosis   therapy   drug therapy   MeSH
• Adult MeSH
• Immunoglobulins, Intravenous therapeutic use   administration & dosage   MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Prednisolone therapeutic use   administration & dosage   MeSH
• Disease Progression MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

INTRODUCTION: Animal and human ancestors developed complex physiological and behavioral response systems to cope with two types of threats: immediate physical harm from predators or conspecifics, triggering fear, and the risk of infections from parasites and pathogens leading to the evolution of the behavioral immune system with disgust as the key emotion. Integration of the evolutionary concepts of the fear module and behavioral immune systems has been infrequent, despite the significant survival advantages of disgust in various contexts. Studies comparing attention to ancestral and modern threats accompanied by fear have yielded ambiguous results and what qualifies as salient modern disgusting stimuli remains unclear. We do not know whether disgust or the behavioral immune system, as inherent aspects of human psychology, have adapted to safeguard us from pandemic risks or poisoning by modern toxic substances. METHODS: To test these effects, we have developed a survey comprised of 60 short vignettes describing threats evoking fear and disgust belonging to one of the three main categories of threats: (1) ancestral (phylogenetic), (2) modern (ontogenetic), and (3) pandemics of airborne disease. Each vignette was evaluated on a 7-point Likert scale based on fear, disgust, and anger. In total, 660 respondents completed the survey. The data were analysed using a factor analysis and general linear model with the respondent as a random factor. RESULTS: The results show that the strongest fear is triggered by modern threats (electricity, car accidents), while the highest disgust is evoked by ancient threats (body waste products, worms, etc.). Interestingly, disgust does not respond to modern threat stimuli such as toxic substances or radioactivity as these evoke mainly fear and anger. Finally, a distinct response pattern was found for pandemic threats, in which both fear (e.g., of disease and death) and disgust (e.g., of used face masks) are employed. DISCUSSION: Our study offers valuable insights into the emotional responses to ancestral and modern threats and their adaptation to pandemic challenges. Ancestral threats are not always more powerful stimuli than adequate threats of the modern type, but they function specifically. Thus, snakes and heights as fear-inducing ancestral threats form separate factors in a multivariate analysis, whereas all ancestral disgust stimuli group together. The threat of a pandemic forms a specific category and people process it emotionally and cognitively. These insights contribute to our understanding of human psychology and behavior in an ever-changing world.

• Publication type
• Journal Article MeSH

Evolutionary and ecological processes affecting the interactions between hosts and parasites in the aquatic environment are at display in the Baltic Sea, a young and ecologically unstable marine ecosystem, where fluctuating abiotic and biotic factors affect the parasitofauna in fish. The dynamic infections of Baltic cod, a subpopulation of the Atlantic cod (Gadus morhua Linnaeus), with third stage anisakid nematode larvae of Pseudoterranova decipiens (Krabbe, 1878) and Contracaecum osculatum (Rudolphi, 1802) have increased following a significant increase of the Baltic grey seal Halichoerus grypus (Fabricius) population in the region. Cod serves as a paratenic host and marine mammals, pinnipeds, are definitive hosts releasing parasite eggs, with faeces, to the marine environment, where embryonation and hatching of the third stage larva take place. The parasite has no obligate intermediate hosts, but various invertebrates, smaller fish and cod act as paratenic hosts transmitting the infection to the seal. Contracaecum osculatum has an impact on the physiological performance of the cod, which optimises transmission of the larva from fish to seal. Thus, a muscle mass decrease of nearly 50% may result from heavy C. osculatum infections, probably amplified by a restricted food availability. The muscle atrophy is likely to reduce the escape reactions of the fish when meeting a foraging seal. In certain regions, where fish and seals are restricted in their migration patterns, such as the semi-enclosed Baltic Sea, the predation may contribute to a severe cod stock depletion. The parasites are zoonotic and represent a human health risk, when consumers ingest insufficiently heat- or freeze-treated infected products. Marked infections of the cod were previously reported during periods with elevated seal populations (late 19th and middle 20th century) and various scenarios for management of risk factors are evaluated in an evolutionary context.

• MeSH
• Ascaridoidea * physiology   MeSH
• Ecosystem MeSH
• Gadus morhua * parasitology   MeSH
• Larva physiology   MeSH
• Humans MeSH
• Fish Diseases * epidemiology   parasitology   MeSH
• Parasites * MeSH
• Fishes MeSH
• Seals, Earless * parasitology   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Kočka patří k nejstarším domestikovaným zvířatům žijícím vedle člověka již několik tisíciletí. Ve spektru endoparazitů u domácích koček dominují druhy parazitů s heteroxenním vývojovým cyklem adaptovaným na vztah mezi predátorem a jeho kořistí. Poznání tasemnic v populacích koček v ÈR zásadně ovlivňuje to, že data z toulavých, městských nebo „outdoorových“ koček je obtížné vůbec získat. Představy o parazitofauně českých koček tak pochází především z vyšetřování koček typicky domácích, kde je výskyt heteroxenních parazitů velmi nízký. Tasemnice koček v ÈR zahrnují především Taenia taeniaeformis a Dipylidium caninum; alarmující je ale riziko možného zapojení kočky do cyklu E. multilocularis, vyvolávající významné orgánové infekce člověka. Odpověď na otázku, jak významným rezervoárem tasemnice Echinococcus multilocularis kočka je, zasluhuje v ÈR intenzivní výzkum.

Cats belong among the oldest domesticated animals, living side by side with humans for several millennia. Spectrum of endoparasites of domestic cats is dominated by parasites with heteroxenous life cycles, cycling among the predators and their prey. Knowledge on tapeworms in cats in Czechia is influenced by a fact, that data from street, stray or feral cats are difficult to obtain. Our knowledge thus originates mostly from indoor cats, where the occurrence of heteroxenous parasites is very low. Most frequently detected tapeworms in cats are Taenia taeniaeformis and Dipylidium caninum. However, there is an alarming risk of involvement of cats in the life cycle of Echinococcus multilocularis, causing severe organ echinococcosis in humans. Yet, answer to the question of the importance of cats as a reservoir of E. multilocularis in Czechia requires intense research.

• MeSH
• Echinococcus multilocularis drug effects   MeSH
• Cats MeSH
• Cat Diseases * MeSH
• Parasitic Diseases pathology   transmission   therapy   MeSH
• Praziquantel therapeutic use   MeSH
• Taenia * drug effects   MeSH
• Animals MeSH
• Check Tag
• Cats MeSH
• Animals MeSH

PURPOSE: Endometrial cancer (EC) incidence has been rising over the past 10 years. Delays in diagnosis reduce survival and necessitate more aggressive treatment. We aimed to develop and validate a simple, noninvasive, and reliable triage test for EC to reduce the number of invasive diagnostic procedures and improve patient survival. METHODS: We developed a test to screen and triage women with suspected EC using 726 cervical smear samples from women with and without EC, and validated the test in 562 cervicovaginal samples using three different collection methods (cervical smear: n = 248; vaginal swab: n = 63; and self-collection: n = 251) and four different settings (case/control: n = 388; cohort of women presenting with postmenopausal bleeding: n = 63; a cohort of high-risk women with Lynch syndrome: n = 25; and a nested case/control setting from a screening cohort and samples taken up to 3 years before EC diagnosis: n = 86). RESULTS: We describe the Women's cancer risk IDentification - quantitative polymerase chain reaction test for Endometrial Cancer (WID-qEC), a three-marker test that evaluates DNA methylation in gene regions of GYPC and ZSCAN12. In cervical, self-collected, and vaginal swab samples derived from symptomatic patients, it detected EC with sensitivities of 97.2% (95% CI, 90.2 to 99.7), 90.1% (83.6 to 94.6), and 100% (63.1 to 100), respectively, and specificities of 75.8% (63.6 to 85.5), 86.7% (79.3 to 92.2), and 89.1% (77.8 to 95.9), respectively. The WID-qEC identified 90.9% (95% CI, 70.8 to 98.9) of EC cases in samples predating diagnosis up to 1 year. Test performance was similar across menopausal status, age, stage, grade, ethnicity, and histology. CONCLUSION: The WID-qEC is a noninvasive reliable test for triage of women with symptoms suggestive of ECs. Because of the potential for self-collection, it could improve early diagnosis and reduce the reliance for in-person visits.

• MeSH
• Early Detection of Cancer methods   MeSH
• Epigenesis, Genetic MeSH
• Papillomavirus Infections * diagnosis   MeSH
• Humans MeSH
• Uterine Cervical Neoplasms * diagnosis   genetics   MeSH
• Endometrial Neoplasms * diagnosis   genetics   MeSH
• Triage MeSH
• Vaginal Smears methods   MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Freshwater ecosystems are negatively impacted by various pollutants, from agricultural, urban and industrial wastewater, with metals being one of the largest concerns. Moreover, freshwater ecosystems are often affected by alien species introductions that can modify habitats and trophic relationships. Accordingly, the threat posed by metals interacts with those by alien species, since the latter can accumulate and transfer these substances across the food web to higher trophic levels. How metals transfer within such communities is little studied. We analysed the concentration of 14 metals/metalloids (Al, As, Cd, Co, Cr, Cu, Fe, Hg, Mg, Mn, Ni, Pb, Se, Zn, hereafter 'metal(s)') of eight fish and three crustacean species co-existing in the Arno River (Central Italy), most of which were alien. To assess the pathway of contaminants within the community, we coupled metal analysis with carbon and nitrogen stable isotope analysis derived from the same specimens. Crustaceans showed higher metal concentration than fish, except for Cd, Hg and Se that were higher in fish. We found evidence of trophic transfer for six metals (Cd, Cr, Hg, Mg, Se, Zn). Additionally, ontogenetic differences and differences among various fish tissues (muscle, liver, and gills) were found in metals concentration. Considerable biomagnification along the trophic chain was found for Hg, while other metals were found to biodilute. Using stable isotopes and Hg as a third diet tracer, we refined the estimations of consumed preys in the diet previously reconstructed with stable isotope mixing models. Alien species reach high biomass and can both survive to and accumulate high pollutants concentrations, potentially posing a risk for their predators and humans. A combined effect of environmental filtering and increased competition may potentially contribute to the disappearance of native species with lower tolerances.

• MeSH
• Water Pollutants, Chemical * analysis   MeSH
• Ecosystem MeSH
• Humans MeSH
• Environmental Monitoring MeSH
• Fresh Water MeSH
• Metals, Heavy * analysis   MeSH
• Introduced Species MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Italy MeSH

Patients with Covid-19 place new challenges on the management of type 2 diabetes, including the questions of whether glucose-lowering therapy should be adjusted during infection and how to manage a return to normal care after resolution of Covid-19 symptoms. Due to the sudden onset of the pandemic, physicians have by necessity made such important clinical decisions in the absence of robust evidence or consistent guidelines. The risk to patients is compounded by the prevalence of cardiovascular disease in this population, which alongside diabetes is a major risk factor for severe disease and mortality in Covid-19. We convened as experts from the Central and Eastern European region to consider what advice we can provide in the setting of type 2 diabetes and Covid-19, considering the evidence before, during and after infection. We review recommendations that have been published to date, and consider the best available-but currently limited-evidence from large observational studies and the DARE-19 randomized control trial. Notably, we find a lack of guidance on restarting patients on optimal antidiabetic therapy after recovering from Covid-19, and suggest that this may provide an opportunity to optimize treatment and counter clinical inertia that predates the pandemic. Furthermore, we emphasize that optimization applies not only to glycaemic control, but other factors such as cardiorenal protection. While we look forward to the emergence of new evidence that we hope will address these gaps, in the interim we provide a perspective, based on our collective clinical experience, on how best to manage glucose-lowering therapy as patients with Covid-19 recover from their disease and return to normal care.

• MeSH
• Time Factors MeSH
• COVID-19 complications   MeSH
• Diabetes Mellitus, Type 2 complications   drug therapy   MeSH
• Hypoglycemic Agents adverse effects   therapeutic use   MeSH
• Insulin therapeutic use   MeSH
• Humans MeSH
• Glycemic Control * MeSH
• Risk Factors MeSH
• Practice Guidelines as Topic MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Patients with Covid-19 place new challenges on the management of type 2 diabetes, including the questions of whether glucose-lowering therapy should be adjusted during infection and how to manage a return to normal care after resolution of Covid-19 symptoms. Due to the sudden onset of the pandemic, physicians have by necessity made such important clinical decisions in the absence of robust evidence or consistent guidelines. The risk to patients is compounded by the prevalence of cardiovascular disease in this population, which alongside diabetes is a major risk factor for severe disease and mortality in Covid-19. We convened as experts from the Central and Eastern European region to consider what advice we can provide in the setting of type 2 diabetes and Covid-19, considering the evidence before, during and after infection. We review recommendations that have been published to date, and consider the best available-but currently limited-evidence from large observational studies and the DARE-19 randomized control trial. Notably, we find a lack of guidance on restarting patients on optimal antidiabetic therapy after recovering from Covid-19, and suggest that this may provide an opportunity to optimize treatment and counter clinical inertia that predates the pandemic. Furthermore, we emphasize that optimization applies not only to glycaemic control, but other factors such as cardiorenal protection. While we look forward to the emergence of new evidence that we hope will address these gaps, in the interim we provide a perspective, based on our collective clinical experience, on how best to manage glucose-lowering therapy as patients with Covid-19 recover from their disease and return to normal care.

• MeSH
• Time Factors MeSH
• COVID-19 complications   MeSH
• Diabetes Mellitus, Type 2 complications   drug therapy   MeSH
• Hypoglycemic Agents adverse effects   therapeutic use   MeSH
• Insulin therapeutic use   MeSH
• Humans MeSH
• Glycemic Control * MeSH
• Risk Factors MeSH
• Practice Guidelines as Topic MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Aflatoxins (AFs) are some of the most agriculturally important and harmful mycotoxins. At least 20 AFs have been identified to this date. Aflatoxin B1 (AFB1), the most potent fungal toxin, can cause toxicity in many species, including humans. AFs are produced by 22 species of Aspergillus section Flavi, 4 species of A. section Nidulantes, and 2 species of A. section Ochraceorosei. The most important and well-known AF-producing species of section Flavi are Aspergillus flavus, A. parasiticus, and A. nomius. AFs contaminate a wide range of crops (mainly groundnuts, pistachio nuts, dried figs, hazelnuts, spices, almonds, rice, melon seeds, Brazil nuts, and maize). Foods of animal origin (milk and animal tissues) are less likely contributors to human AF exposure. Despite the efforts to mitigate the AF concentrations in foods, and thus enhance food safety, AFs continue to be present, even at high levels. AFs thus remain a current and continuously pressing problem in the world.

• MeSH
• Dietary Exposure * adverse effects   MeSH
• Risk Assessment MeSH
• Fungi metabolism   MeSH
• Humans MeSH
• Meat microbiology   MeSH
• Milk microbiology   MeSH
• Mycotoxins adverse effects   analysis   MeSH
• Food Microbiology * MeSH
• Food Chain MeSH
• Crops, Agricultural microbiology   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH