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Researchers at the Unit of Ophthalmology in Coimbra, Portugal have expanded the understanding of Fhonda Syndrome, a rare recessively inherited syndrome. The syndrome is associated with biallelic disease-causing variants in the SLC38A8 gene, which affects the photoreceptor layer of the eye. The researchers included three unrelated female patients with FHONDA syndrome in their study, describing their symptoms and genetic variants. They also observed features of retinitis pigmentosa in one patient, broadening the understanding of the clinical phenotype associated with this rare syndrome. [Extracted from the article]

A recent study conducted in Coimbra, Portugal explored the factors that influence maternal antenatal attachment, which is an important concept in the transition to parenthood. The study involved interviews with 407 pregnant women during their second trimester of pregnancy. The researchers found that factors such as emotional states (depression and anxiety), attitudes towards pregnancy and motherhood, marital satisfaction, and age significantly contribute to maternal antenatal attachment. The study provides valuable insights into understanding and supporting maternal attachment during pregnancy. [Extracted from the article]

A report from the University of Coimbra in Portugal discusses research on the development of starch aerogels as carriers for iron and folic acid delivery. The study aimed to find novel approaches to enhance nutrient absorption and reduce side effects in the prevention of anemia, particularly in pregnancy. The researchers loaded iron and folic acid into starch gels and found that the release of iron was faster than folic acid in intestinal conditions. The proposed starch aerogel shows promise as a solution and may compete with conventional supplements. The research has been peer-reviewed and published in the Journal of Drug Delivery Science and Technology. [Extracted from the article]

New research conducted by the University of Coimbra in Portugal explores the role of neurovascular dysfunction in psychiatric disorders and potential therapeutic approaches. The study focuses on the blood-brain barrier (BBB) and blood-retinal barrier (BRB), which are crucial for maintaining the central nervous system's homeostasis. The researchers examine the neurovascular alterations associated with anxiety, major depressive disorder, attention-deficit/hyperactivity disorder, and drug abuse. They also investigate the role of neuroinflammation and potential biomarkers in these disorders. The study emphasizes the need for a deeper understanding of BBB and BRB function in neuropsychiatric conditions and their potential as therapeutic targets. [Extracted from the article]

A study conducted by researchers at the University of Coimbra in Portugal explores a new multiobjective optimization framework for intensity-modulated radiation therapy (IMRT). The study focuses on the optimization of radiation intensities and beam directions in order to achieve the best tradeoffs between irradiating the tumor and sparing healthy organs. The proposed framework allows for more flexibility in finding solutions and understanding the compromises between different objectives. The research concludes that this approach has the potential to improve the effectiveness of radiation therapy treatment planning. [Extracted from the article]

Researchers from the University of Coimbra in Portugal have conducted a study on congenital skeletal disorders. They found a rare pathological condition in a perinate (birth +/- 2 weeks) from the 17th to 19th centuries, recovered during an excavation at the S & atilde;o Domingos Convent in Lisbon, Portugal. The skeleton exhibited severe shortening and bowing of the long bones, indicating a presumptive diagnosis of skeletal dysplasia. The researchers concluded that the phenotypic features observed were more consistent with thanatophoric dysplasia type 1. This research has been peer-reviewed and published in the International Journal of Osteoarchaeology. [Extracted from the article]

A recent study conducted at the University of Coimbra in Portugal has investigated the properties of 4-hydroxyquinolin-2(1H)-one (4HQ2O) using infrared spectroscopy and quantum chemical calculations. The compound was synthesized and isolated in cryogenic matrices of argon and xenon. The researchers identified two tautomeric forms of the compound and observed the generation of additional tautomers and fragmentation products when the argon matrix was irradiated with ultraviolet light. The study provides a comprehensive assignment of the infrared spectra of all the observed species. The research was supported by the Fundacao para a Ciencia e a Tecnologia (FCT) and has been published in the Journal of Molecular Structure. [Extracted from the article]

A recent study conducted in Coimbra, Portugal, examined the effectiveness of allergen immunotherapy (AIT) in treating local allergic rhinitis (LAR) in children. AIT is the only disease-modifying treatment for allergies, and its efficacy has been demonstrated in adults with LAR. The study included 32 pediatric patients and 10 adult patients who underwent subcutaneous AIT for three years. The results showed a reduction in nasal reactivity and symptom scores after AIT in both pediatric and adult patients, highlighting the potential benefits of this therapeutic approach for LAR in children. [Extracted from the article]

A new study conducted at the University of Coimbra in Portugal explores the feasibility of a 12-session Dialectical Behaviour Therapy (DBT) skills group intervention called Bi-REAL for individuals with Bipolar Disorder (BD). The study aimed to evaluate the acceptability and outcomes of the intervention compared to treatment as usual. The results showed that the Bi-REAL intervention was well-received by participants, with positive feedback and high attendance rates. The intervention group also showed significant improvements in bipolar recovery and quality of life compared to the control group. However, the study faced challenges due to COVID-19 restrictions and high attrition rates in the control group. Further research is needed to confirm feasibility and improve retention rates before progressing to a definitive trial. [Extracted from the article]

A recent study conducted by researchers at the University of Coimbra in Portugal explores the role of brain endothelial cell (BEC) senescence in the dysfunction of the blood-brain barrier (BBB) during aging. The study suggests that the transition from a young to an aged BBB is mediated, at least in part, by BEC senescence. Aged BECs exhibit higher expression of senescent markers and impaired occludin expression, which affects BBB function. The findings contribute to a better understanding of BBB dysfunction in aging. [Extracted from the article]

A report from the University of Coimbra in Portugal discusses the impact of inflammatory bowel disease (IBD) on the quality of life of individuals. The study focuses on therapeutic targets such as experiential avoidance, cognitive fusion, shame, and self-criticism to improve mental health in people with IBD. The researchers propose an online intervention called eLIFEwithIBD, which is based on acceptance, mindfulness, and compassion, to address psychological distress and improve overall well-being in individuals with IBD. The study protocol outlines the structure and contents of the intervention, which aims to empower individuals with IBD and enhance their illness adjustment and mental health. [Extracted from the article]

New research from the University of Coimbra in Portugal explores the production process of alginate/gelatine aerogels for tissue engineering. The study focuses on optimizing the alcogel formation step, which involves solvent exchange, by using high pressures and mild temperatures. The researchers found that high-pressure solvent exchange resulted in a faster process, reducing processing time by 86%. The study also examined the effects of solvent exchange conditions on the aerogel structure and found that it did not significantly affect density, porosity, and surface area. However, it did influence pore distribution and mechanical properties. The research concludes that integrating solvent exchange and supercritical drying is feasible for alginate-gelatine aerogel production. [Extracted from the article]

The article focuses on evaluating the methodological quality of meta-analyses on resistance training for muscle hypertrophy and strength in healthy young adults. Topics include the systematic review of existing meta-analyses, the assessment of evidence quality through A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and the correlation between evidence quality and study publication year.

A recent study conducted at the University of Coimbra in Portugal explored the phytochemical and pharmacological potential of the red seaweed genus Hypnea. The researchers found that different species of Hypnea contain various bioactive compounds, such as polysaccharides, polyphenolics, vitamins, and minerals, which have shown potential in combating different diseases and complications. The study aims to provide detailed information about the different potentials of Hypnea species and their mode of action. The research was supported by the Fundacao para a Ciencia e a Tecnologia (FCT) and has been peer-reviewed. [Extracted from the article]

The article presents a study from the University of Coimbra that explores the medicalization of homelessness and its implications for psychiatric diagnosis. Topics discussed include the role of psychiatric diagnosis in legitimizing societal views of homelessness, the influence of mental health professionals on perceptions of homeless individuals, and the ways in which this medicalized approach obscures the structural causes of homelessness.

A study conducted by researchers at the University of Coimbra in Portugal explores the factors that contribute to public engagement and support for drought disaster risk management. The study found that citizens tend to prefer low-cost measures and policies that do not impose personal burdens. Personal experience with drought, risk perception, perceived urgency, and emotional states were identified as critical factors in citizens' engagement and support for disaster risk management. The findings have implications for risk communication and policymaking in the field of disaster management. [Extracted from the article]

A recent study conducted at the University of Coimbra in Portugal evaluated the tribocorrosion behavior of the Ti-6Al-4V biomedical alloy in simulated oral environments. The study found that when subjected to fluoridated media, the Ti-6Al-4V alloy experienced higher mass loss but no significant roughness variation. The researchers concluded that fluor-containing substances should be avoided over Ti-6Al-4V alloys in areas of mechanical wear, especially if dental amalgam is also present. This research provides valuable insights for dentistry and technology in the field of oral health. [Extracted from the article]

A recent clinical trial conducted at a pediatric hospital in Coimbra, Portugal examined the impact of Pavlik Harness treatment on the motor skills development of children with Developmental Dysplasia of the Hip (DDH). The study included 55 cases of children with DDH and 66 healthy controls. The researchers found that children with DDH achieved gross motor milestones, such as sitting without support, crawling on hands and knees, and walking independently, about one month later than the healthy controls, although this difference was not statistically significant. The study concluded that children with DDH treated with the Pavlik Harness did not experience significant delays in motor skills acquisition. [Extracted from the article]

A study conducted at the University of Coimbra in Portugal has found that increased formation of advanced glycation end products (AGEs) is a significant factor in the pathophysiology of diabetes, increasing the risk of complications. Specifically, the study focused on N epsilon-carboxy-methyl-lysine (CML), one of the most relevant AGEs found in diabetic subjects. The researchers discovered that CML caused pronounced defects in neuronal mitochondria and endoplasmic reticulum (ER) stress, leading to neurodegenerative events. However, the study also found that MitoTempo, a mitochondria-targeted antioxidant, was able to counteract most of the CML-induced mitochondrial defects and neuronal damage. These findings suggest that MitoTempo holds promise as a therapeutic intervention for mitigating CML-induced mitochondrial imbalance and neuronal damage. [Extracted from the article]

A recent report from the University of Coimbra in Portugal discusses the study of consciousness in psychology. The report highlights how advancements in neuroscience have allowed scientists to explore the consciousness of supposedly unconscious patients and identify neural correlates of different states of consciousness. The research also emphasizes the importance of studying complex consciousness experiences in order to understand the mechanisms associated with global consciousness, perceptual consciousness, and self-consciousness. The report concludes by discussing the future of psychology as a science of consciousness. This information was obtained from the International Journal of Clinical and Health Psychology. [Extracted from the article]

A recent study conducted at the University of Coimbra in Portugal explored the effectiveness of an internet-based cognitive behavioral therapy (iCBT) intervention called "Be a Mom" in reducing postpartum depression (PPD) symptoms and improving positive mental health in women at high risk for PPD. The study involved 1,053 postpartum Portuguese women who were allocated to either the intervention group or a waiting-list control group. The results showed that completing the treatment, higher depression scores at baseline, and higher income levels were associated with greater symptom reduction and positive mental health enhancement. The "Be a Mom" intervention was found to be effective in reducing psychological distress and enhancing positive mental health over a 4-month period. [Extracted from the article]

A report from the University of Coimbra in Portugal discusses the use of blended psychological interventions for emotional disorders in youth. The study aimed to explore the acceptability and intention to use these interventions among psychologists working with children with emotional disorders. The results showed that most participants demonstrated moderate to high acceptability of blended interventions and intend to use them in the future. The study emphasizes the importance of sharing the findings of blended interventions, changing professionals' attitudes toward evidence-based practices, and collaborating with organizations and institutions to encourage the adoption of this intervention format. [Extracted from the article]

A recent study conducted by researchers at the University of Coimbra in Portugal explores alternative strategies for stabilizing nateglinide co-amorphous systems, which are used in antidiabetic agents. The study compares two synthetic approaches, cryo-milling and quench-cooling, for a dual-drug system in combination with ranolazine. The researchers also investigate the use of the essential amino acid tryptophan for the synthesis of a cryo-milled nateglinide co-amorphous system. The study finds that both multicomponent systems achieve enhanced kinetical stability for up to 8 months. The research concludes that cryo-milling and quench cooling can be effective alternatives for stabilizing nateglinide co-amorphous systems. [Extracted from the article]

A recent study conducted at Coimbra University Hospital in Portugal explored the relationship between computed tomography (CT) phenotyping of chronic obstructive pulmonary disease (COPD) patients and their ventilatory response during exercise testing. The study classified COPD patients into four phenotypes based on CT metrics of emphysema and airwall thickness. The results showed that emphysema and airways metrics had strong relationships with the different characteristics of ventilatory response to exercise in subjects with mild to moderate COPD. The researchers concluded that CT phenotyping may help predict ventilatory response to exercise in COPD patients. [Extracted from the article]

A recent study conducted by the University of Coimbra in Portugal examined the dental health of a three-year-old child from a medieval site in Southern Portugal. The child's skeleton showed severe dental lesions, including enamel destruction and dentine exposure. Through various analyses, the researchers determined that the most probable diagnosis for these dental lesions was early childhood caries, which may have been caused by factors such as malnutrition and the consumption of sugars in complementary feeding. This research provides valuable insights into the oral health of non-adults in historical contexts. [Extracted from the article]

New research conducted at the University of Coimbra in Portugal focuses on the development and validation of a high-performance liquid chromatography technique (HPLC-DAD) for the quantification of four non-psychoactive phytocannabinoids found in Cannabis sativa: cannabigerol, cannabidiol, cannabinol, and cannabichromene. The study highlights the need for further pre-clinical and clinical data to support the therapeutic applications of these cannabinoids. The HPLC-DAD method was successfully applied for therapeutic monitoring of cannabidiol and preliminary pre-clinical studies with cannabigerol and cannabidiol. This research provides a foundation for future investigations in the field of cannabinoids. [Extracted from the article]

New research from the University of Coimbra in Portugal discusses the potential therapeutic applications of non-psychoactive phytocannabinoids found in Cannabis sativa, including cannabigerol, cannabidiol, cannabinol, and cannabichromene. The study emphasizes the need for further pre-clinical and clinical data to support the use of these cannabinoids in clinical practice. The researchers also developed and validated a new high-performance liquid chromatography technique to quantify these cannabinoids in human plasma and mouse matrices, which could be used for therapeutic monitoring and future investigations. The study was supported by the Fundacao para a Ciencia e a Tecnologia (FCT). [Extracted from the article]

A study conducted by researchers at the University of Coimbra in Portugal explores the impact of high-sensitivity troponin (hsTn) on the diagnosis and treatment of unstable angina (UA) patients. The study found that the use of hsTn has led to a reclassification of UA patients as having non-ST-segment elevation myocardial infarction (NSTEMI), which has changed the clinical features of UA. The researchers developed a risk model to predict significant coronary artery disease (CAD) in UA patients and found that commonly available cardiac tests at hospital admission have limited power in identifying patients at risk of obstructive CAD. The study suggests the need for a revised diagnostic and etiology algorithm for UA patients. [Extracted from the article]

A report from the University of Coimbra in Portugal discusses the findings of a study on the interaction between synthetic 2-substituted-naphtho-1,4-quinones and human serum albumin (HSA). The study used spectroscopic techniques and in silico calculations to investigate the interaction. The results showed that the interaction occurs through a static quenching mechanism and has a moderate binding affinity. The study also revealed the formation of hydrophobic, electrostatic, and hydrogen bond interactions with the surrounding amino acid residues in subdomain IIA of HSA. The researchers suggest that further studies are needed to improve the bioavailability of these compounds in the human bloodstream. [Extracted from the article]

A recent study conducted at the University of Coimbra in Portugal has developed a new scale to measure shame related to sexual orientation among LGB+ (lesbian, gay, bisexual, and other minority sexual orientations) individuals. The study found that LGB+ individuals often experience higher levels of general shame compared to heterosexual individuals due to stigma and discrimination. The Sexual Minority-External and Internal Shame Scale (SM-EISS) demonstrated good reliability and validity, making it a valuable tool for assessing shame in clinical and research settings. The research highlights the importance of understanding and addressing the impact of shame on the mental health and well-being of LGB+ individuals, particularly in Portugal where they continue to face harmful situations. [Extracted from the article]

A study conducted at the University of Coimbra in Portugal examined the use of high-sensitivity troponin (hsTn) assays and coronary angiography in the risk stratification of patients with unstable angina (UA). The study found that patients with UA had a favorable prognosis, particularly within the first year after the index event. The presence of obstructive coronary artery disease (CAD) was the only independent predictor of major adverse cardiac events (MACEs) during follow-up. The study highlights the potential importance of assessing coronary anatomy in the risk stratification of patients with UA. [Extracted from the article]

A recent report from the University of Coimbra in Portugal explores the immunomodulatory properties of glucan particles in human primary cells. Glucan particles, specifically glucan microparticles and glucan nanoparticles, were found to interact with the Dectin-1 receptor on monocytes, leading to the production of reactive oxygen species. Glucan nanoparticles also stimulated the maturation of monocyte-derived dendritic cells, which is important for antigen cross-presentation. The study suggests that beta-glucan-based delivery systems could be used as future vaccine adjuvants. [Extracted from the article]

Researchers at Instituto Superior Miguel Torga in Coimbra, Portugal have developed the European Portuguese version of the Psy-Flex, a tool for assessing psychological flexibility and mental health in adults. The study found that the Psy-Flex had a good fit to the data and demonstrated reliability and validity. The researchers believe that the European Portuguese Psy-Flex version will be useful in both clinical and research settings, and will broaden research possibilities in Portugal and other cultural contexts. The research has been peer-reviewed and published in the Journal of Contextual Behavioral Science. [Extracted from the article]

A study conducted in Coimbra, Portugal, aimed to characterize the occurrence of diabetic macular edema (DME) and abnormal retinal fluid accumulation in nonproliferative diabetic retinopathy (NPDR). The study used optical coherence tomography (OCT) and OCT-Angiography to analyze 122 eyes with type 2 diabetes. The findings showed that eyes with central-involved DME (CI-DME) exhibited increased abnormal retinal fluid and retinal vascular perfusion in the deep capillary plexus (DCP), while eyes with clinically significant macular edema (CSME) showed decreased retinal vascular perfusion and abnormal fluid in the outer retina. The study suggests that CI-DME and CSME may represent different entities. [Extracted from the article]

A recent report from the University of Coimbra in Portugal explores the role of the Association to Protect Poor Diabetics in assisting diabetics in Portugal from 1926 to 1946. The association played a crucial role in structuring diabetology in the country and created a model of assistance based on modern diabetology principles. The report examines the organization of the assistance model, which included treatment and education for poor patients with diabetes. This research provides valuable insights into the historical development of diabetes care in Portugal. [Extracted from the article]

A study conducted at the University of Coimbra in Portugal compared the expression of fatigue in cancer survivors, patients with other chronic diseases, and healthy individuals. The researchers found that fatigue was expressed differently in patients with a history of cancer compared to those without. Cancer survivors on active treatment reported higher levels of fatigue, and some level of cancer-related fatigue persisted even after treatment. Psychological distress and daytime sleepiness were identified as factors associated with fatigue. The study suggests the need for further research to explore interventions targeting these factors to manage cancer-related fatigue. [Extracted from the article]

Researchers from the University of Coimbra in Portugal have published a report on their findings regarding the search for selective p53-activating agents for colorectal cancer therapy. They synthesized a library of novel derivatives and evaluated their antiproliferative activity in human colorectal cancer cells. They identified five compounds that were selective towards p53-expressing cancer cells and two compounds that showed high cytotoxicity against colon cells. The results provide important data for the design of new p53-activating agents for precision therapy of colorectal cancer. [Extracted from the article]

A recent study conducted at a university center in Coimbra, Portugal, examined the prognostic impact of hyperreflective foci (HRF) on spectral-domain optical coherence tomography (SD-OCT) in nonsyndromic retinitis pigmentosa (RP). The study included 175 eyes from 94 RP patients and found that HRF were highly prevalent in RP patients and had a negative impact on visual function and the ellipsoid zone (EZ) area. The research suggests that HRF could be used as a prognostic marker for RP. The study was supported by the Unidade Local de Sade de Coimbra. [Extracted from the article]

A recent study conducted at the University of Coimbra in Portugal examined the psychometric properties of the Portuguese version of the Brief Multidimensional Self-Control Scale (BMSCS). The study found that the BMSCS is a valid and reliable measure of self-control, with adequate fits for both the one-factor and two-factor second-order models. The study also demonstrated convergent validity, divergent validity, and criterion-related validity of the BMSCS. Additionally, the study established measurement invariance across gender, with no significant differences found between male and female participants. This research provides new insights into the measurement of self-control and its relevance in criminology and forensic psychology. [Extracted from the article]

A recent study conducted by researchers at the University of Coimbra in Portugal has shed light on the molecular mechanisms associated with the progression of adipose tissue dysfunction in obesity and diabetes. The study found that insulin resistance, a key factor in metabolic dysregulation, is characterized by the downregulation of genes related to adipose tissue vasculature remodeling. Prediabetes was associated with compensatory growth factor-dependent signaling and increased response to hypoxia, while type 2 diabetes was linked to a loss of cellular response to insulin and hypoxia, along with increased inflammation. This research provides valuable insights into the complex processes underlying adipose tissue dysfunction in obesity and diabetes. [Extracted from the article]

A new report from the University of Coimbra in Portugal examines the characteristics and typologies of rural arsonists, who are responsible for a significant number of fires causing environmental and community damage. The study analyzed the criminal records of 450 rural arsonists and found that 61% had mental health and alcohol problems. The research developed a typology of rural arsonists, categorizing them into three groups: Expressive - Mental Health Problems (39%), Expressive - Alcohol Consumption (38%), and Instrumental - Socially Adjusted (23%). The study aims to increase understanding of rural crime and assist criminal investigations. [Extracted from the article]

A report from Coimbra University Hospital in Portugal discusses a case of descending necrotising mediastinitis (DNM) in a young child. The patient presented with symptoms such as fever, difficulty swallowing, and refusal to eat, which rapidly worsened. Cervicothoracic CT revealed a retropharyngeal abscess extending to the mediastinum, and the patient underwent antibiotic therapy and surgical drainage. The research emphasizes the importance of early diagnosis and multidisciplinary approaches to minimize morbidity and mortality. This information may be useful for researchers and medical professionals studying mediastinal diseases and conditions, particularly in pediatric patients. [Extracted from the article]

A recent study conducted at Centro Hospitalar e Universitario de Coimbra in Portugal examined the safety of direct oral provocation tests (DPT) in infants with mild cutaneous non-immediate reactions to beta-lactam antibiotics. The study analyzed data from 151 infants referred for suspected allergy to beta-lactam antibiotics. The results showed that a direct DPT without prior tests is a safe and effective procedure for delabeling beta-lactam allergy in infants. The researchers emphasized the importance of proper diagnostic procedures to validate allergy suspicions and avoid unnecessary therapeutic restrictions. [Extracted from the article]

Researchers at the University of Coimbra in Portugal have developed a new approach to predict the binding affinity between drugs and their targets. The study proposes an end-to-end binding-region-guided Transformer-based architecture that simultaneously predicts the binding pocket and the binding affinity of drug-target interaction pairs. The results show that this architecture, called TAG-DTA, outperforms existing methods in predicting drug-target affinity. The research highlights the importance of considering the inter-dependency of proteomics, chemical, and pharmacological spaces in drug discovery and demonstrates the applicability of the proposed architecture in this context. The data and source code used in the study are available for further exploration. [Extracted from the article]

A recent study conducted by researchers at the Hospital & University of Coimbra in Portugal examined the prevalence of white matter hyperintensities (WMH) in individuals with bipolar disorder (BD) compared to healthy controls. The researchers conducted a meta-analysis of 22 case-control studies involving 1313 participants and found that BD patients had a higher burden of WMH compared to healthy controls. However, the study had limitations, including the inability to analyze gender differences and bipolar type, moderate heterogeneity between studies, non-representative samples, and a lack of control for major confounders. Further research is needed to better understand the relationship between WMH and BD. [Extracted from the article]

Researchers at the University of Coimbra in Portugal have found that endocrine disrupting chemicals (EDCs) are present in a tropical seabird community, which could pose a threat to wildlife. The study investigated the role of plastic ingestion, foraging patterns, and trophic preferences of five tropical seabird species in relation to EDC exposure. The researchers discovered that microplastics occurrence and EDC detection frequency varied among species, and that trophic position played a key role in EDC accumulation. These findings have implications for marine wildlife conservation and pollution management in sensitive environments. [Extracted from the article]

A recent study conducted by researchers from the University of Coimbra in Portugal examined changes in mortality rates due to tuberculosis in the city of Coimbra between 1861 and 1914. The study analyzed the biographical data of individuals buried in the Coimbra Municipal Cemetery of Conchada who had tuberculosis registered as the cause of death. The findings revealed that mortality from tuberculosis increased over time, with a total of 552 individuals dying from the disease. The researchers suggested that this increase may be attributed to factors such as population growth, deteriorating living conditions, and changes in bacterial virulence and the host immune system. [Extracted from the article]