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30 pages, 12776 KiB  
Article
Multi-Source Data Integration for Sustainable Management Zone Delineation in Precision Agriculture
by Dušan Jovanović, Miro Govedarica, Milan Gavrilović, Ranko Čabilovski and Tamme van der Wal
Sustainability 2025, 17(15), 6931; https://doi.org/10.3390/su17156931 (registering DOI) - 30 Jul 2025
Viewed by 173
Abstract
Accurate delineation of within-field management zones (MZs) is essential for implementing precision agriculture, particularly in spatially heterogeneous environments. This study evaluates the spatiotemporal consistency and practical value of MZs derived from three complementary data sources: electromagnetic conductivity (EM38-MK2), basic soil chemical properties (pH, [...] Read more.
Accurate delineation of within-field management zones (MZs) is essential for implementing precision agriculture, particularly in spatially heterogeneous environments. This study evaluates the spatiotemporal consistency and practical value of MZs derived from three complementary data sources: electromagnetic conductivity (EM38-MK2), basic soil chemical properties (pH, humus, P2O5, K2O, nitrogen), and vegetation/surface indices (NDVI, SAVI, LCI, BSI) derived from Sentinel-2 imagery. Using kriging, fuzzy k-means clustering, percentile-based classification, and Weighted Overlay Analysis (WOA), MZs were generated for a five-year period (2018–2022), with 2–8 zone classes. Stability and agreement were assessed using the Cohen Kappa, Jaccard, and Dice coefficients on systematic grid samples. Results showed that EM38-MK2 and humus-weighted BSP data produced the most consistent zones (Kappa > 0.90). Sentinel-2 indices demonstrated strong alignment with subsurface data (r > 0.85), offering a low-cost alternative in data-scarce settings. Optimal zoning was achieved with 3–4 classes, balancing spatial coherence and interpretability. These findings underscore the importance of multi-source data integration for robust and scalable MZ delineation and offer actionable guidelines for both data-rich and resource-limited farming systems. This approach promotes sustainable agriculture by improving input efficiency and allowing for targeted, site-specific field management. Full article
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14 pages, 355 KiB  
Article
Very Early Transition to Oral Antibiotics in Uncomplicated Enterobacterales Bloodstream Infections: Effectiveness and Impact on Carbon Footprint Saving
by Aina Mateu, Ana Martínez-Urrea, Clara Gallego, Laura Gisbert, Beatriz Dietl, Mariona Xercavins, Maria López-Sánchez, Silvia Álvarez, Sergi García Rodríguez, Toni Roselló, Josefa Pérez, Esther Calbo and Lucía Boix-Palop
Antibiotics 2025, 14(8), 751; https://doi.org/10.3390/antibiotics14080751 - 25 Jul 2025
Viewed by 359
Abstract
Background/Objective: This study aimed to evaluate the effectiveness of very early oral transition in Enterobacterales bloodstream infections (E-BSIs), identify factors associated with it, compare the effectiveness of different oral options, and assess its economic and ecological benefits. Methods: Retrospective, observational cohort [...] Read more.
Background/Objective: This study aimed to evaluate the effectiveness of very early oral transition in Enterobacterales bloodstream infections (E-BSIs), identify factors associated with it, compare the effectiveness of different oral options, and assess its economic and ecological benefits. Methods: Retrospective, observational cohort study including monomicrobial E-BSI in clinically stable adult patients by day 3 of bacteremia with oral antibiotic options. Transition to oral antibiotics by day 3 or earlier (early oral (EO) group) was compared to later transition or remaining on intravenous therapy (nEO group). Early oral transition-associated factors were analyzed. Oral high-dose beta-lactams (BLs) were compared to quinolones (QLs) or trimethoprim/sulfamethoxazole (TS). Economic and ecological costs were assessed. Results: Of 345 E-BSI, 163 (47.2%) were in the EO group, characterized by more urinary tract infections (UTIs) and shorter hospital stays. The nEO group had higher Charlson Comorbidity Index (CCI), extended-spectrum beta-lactamase (ESBL) production, greater source control need, and longer time to clinical stability. There were no significant differences in mortality and relapse. UTIs were associated with early oral transition (OR 2.02, IC 95% 1.18–3.48), while higher CCI (0.85, 0.77–0.95), source control need (0.39, 0.19–0.85), longer time to clinical stability (0.51, 0.39–0.66), and ESBL isolates (0.39, 0.19–0.80) hindered this practice. High-dose BLs and QL/TS were equally effective. Early oral transition resulted in 38.794 KgCO2eq reduction and EUR 269,557.99 savings. Conclusions: Very early oral transition at day 3 or before in stable E-BSI patients is effective, eco-sustainable, and cost-effective; UTI is related with the early oral switch, while comorbidities, ESBL production, source control need, or longer time to clinical stability hinder this practice. Full article
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12 pages, 219 KiB  
Article
Eye Movements During Pareidolia: Exploring Biomarkers for Thinking and Perception Problems on the Rorschach
by Mellisa Boyle, Barry Dauphin, Harold H. Greene, Mindee Juve and Ellen Day-Suba
J. Eye Mov. Res. 2025, 18(4), 32; https://doi.org/10.3390/jemr18040032 - 22 Jul 2025
Viewed by 598
Abstract
Eye movements (EMs) offer valuable insights into cognitive and perceptual processes, serving as potential biomarkers for disordered thinking. This study explores the relationship between EM indices and perception and thinking problems in the Rorschach Performance Assessment System (R-PAS). Sixty non-clinical participants underwent eye-tracking [...] Read more.
Eye movements (EMs) offer valuable insights into cognitive and perceptual processes, serving as potential biomarkers for disordered thinking. This study explores the relationship between EM indices and perception and thinking problems in the Rorschach Performance Assessment System (R-PAS). Sixty non-clinical participants underwent eye-tracking while completing the Rorschach test, focusing on variables from the Perception and Thinking Problems Domain (e.g., WSumCog, SevCog, FQo%). The results reveal that increased cognitive disturbances were associated with greater exploratory activity but reduced processing efficiency. Regression analyses highlighted the strong predictive role of cognitive variables (e.g., WSumCog) over perceptual ones (e.g., FQo%). Minimal overlap was observed between performance-based (R-PAS) and self-report measures (BSI), underscoring the need for multi-method approaches. The findings suggest that EM patterns could serve as biomarkers for early detection and intervention, offering a foundation for future research on psychotic-spectrum processes in clinical and non-clinical populations. Full article
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23 pages, 752 KiB  
Review
Antibiotic Therapy Duration for Multidrug-Resistant Gram-Negative Bacterial Infections: An Evidence-Based Review
by Andrea Marino, Egle Augello, Carlo Maria Bellanca, Federica Cosentino, Stefano Stracquadanio, Luigi La Via, Antonino Maniaci, Serena Spampinato, Paola Fadda, Giuseppina Cantarella, Renato Bernardini, Bruno Cacopardo and Giuseppe Nunnari
Int. J. Mol. Sci. 2025, 26(14), 6905; https://doi.org/10.3390/ijms26146905 - 18 Jul 2025
Viewed by 587
Abstract
Determining the optimal duration of antibiotic therapy for infections caused by multidrug-resistant Gram-negative bacteria (MDR-GNB) is a critical challenge in clinical medicine, balancing therapeutic efficacy against the risks of adverse effects and antimicrobial resistance. This narrative review synthesises current evidence and guidelines regarding [...] Read more.
Determining the optimal duration of antibiotic therapy for infections caused by multidrug-resistant Gram-negative bacteria (MDR-GNB) is a critical challenge in clinical medicine, balancing therapeutic efficacy against the risks of adverse effects and antimicrobial resistance. This narrative review synthesises current evidence and guidelines regarding antibiotic duration for MDR-GNB infections, emphasising bloodstream infections (BSI), hospital-acquired and ventilator-associated pneumonia (HAP/VAP), complicated urinary tract infections (cUTIs), and intra-abdominal infections (IAIs). Despite robust evidence supporting shorter courses (3–7 days) in uncomplicated infections caused by more susceptible pathogens, data guiding optimal therapy duration for MDR-GNB remain limited, particularly concerning carbapenem-resistant Enterobacterales (CRE), difficult-to-treat Pseudomonas aeruginosa (DTR-Pa), and carbapenem-resistant Acinetobacter baumannii (CRAB). Current guidelines from major societies, including IDSA and ESCMID, provide explicit antimicrobial selection advice but notably lack detailed recommendations on the duration of therapy. Existing studies demonstrate non-inferiority of shorter versus longer antibiotic courses in specific clinical contexts but frequently exclude critically ill patients or those infected with non-fermenting MDR pathogens. Individualised duration decisions must integrate clinical response, patient immunologic status, infection severity, source control adequacy, and pharmacologic considerations. Significant knowledge gaps persist, underscoring the urgent need for targeted research, particularly randomised controlled trials assessing optimal antibiotic duration for the most challenging MDR-GNB infections. Clinicians must navigate considerable uncertainty, relying on nuanced judgement and close monitoring to achieve successful outcomes while advancing antimicrobial stewardship goals. Full article
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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13 pages, 1371 KiB  
Article
Multisite Infections Caused by Carbapenem-Resistant Klebsiella Pneumoniae: Unveiling the Clinical Characteristics and Risk Factors
by Jing Li, Shunjun Wu, Huanhuan Zhang, Xingxing Guo, Wanting Meng, Heng Zhao and Liqiang Song
Antibiotics 2025, 14(7), 721; https://doi.org/10.3390/antibiotics14070721 - 18 Jul 2025
Viewed by 379
Abstract
Objectives: There is a scarcity of studies on multisite infections (MSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). The primary objectives of this research were to determine the clinical characteristics of CRKP MSI, and the risk factors of infection and mortality. Methods: [...] Read more.
Objectives: There is a scarcity of studies on multisite infections (MSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). The primary objectives of this research were to determine the clinical characteristics of CRKP MSI, and the risk factors of infection and mortality. Methods: Patients with a CRKP bloodstream infection (BSI) were enrolled retrospectively between January 2017 and December 2021 in Xijing Hospital, China. The risk factors for CRKP MSI and mortality were evaluated. The demographic data, clinical and microbiological characteristics, therapy and outcomes were analyzed. Results: Among 101 patients, 74.3% (75/101) had a diagnosis of CRKP MSI, while 25.7% (26/101) of CRKP non-MSI. The overall case fatality rate was 42.6% (43/101). Multivariate analysis indicated that previous surgery (OR 3.971, 95% CI 1.504–10.480, p = 0.005) and ICU admission (OR 3.322, 95% CI 1.252–8.816, p = 0.016) were independent risk factors for CRKP MSI. ICU admission (OR 4.765, 95% CI 1.192–19.054, p = 0.027), a Pitt bacteremia score (PBS) > 4 (OR 3.820, 95% CI 1.218–11.983, p = 0.022) and thrombocytopenia (OR 8.650, 95% CI 2.573–29.007, p < 0.001) were independent risk factors for mortality due to CRKP MSI. Conclusions: Our findings confirmed that CRKP MSIs were associated with poorer outcomes. To improve prognosis, early screening of individuals at the highest risk is vital. Full article
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16 pages, 1625 KiB  
Article
Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations
by Shihao Liu, Justin T. Tretter, Lama Dakik, Hani K. Najm, Debkalpa Goswami, Jennifer K. Ryan and Elias Sundström
Bioengineering 2025, 12(7), 776; https://doi.org/10.3390/bioengineering12070776 - 17 Jul 2025
Viewed by 423
Abstract
Contemporary evaluation and surgical approaches in congenital aortic valve disease have yielded limited success. The ability to evaluate and understand detailed flow characteristics surrounding surgical repair may be beneficial. This study explores the feasibility and utility of echocardiographic-based blood speckle imaging (BSI) in [...] Read more.
Contemporary evaluation and surgical approaches in congenital aortic valve disease have yielded limited success. The ability to evaluate and understand detailed flow characteristics surrounding surgical repair may be beneficial. This study explores the feasibility and utility of echocardiographic-based blood speckle imaging (BSI) in assessing pre- and post-operative flow characteristics in those with non-stenotic congenital aortic root disease undergoing aortic valve repair or valve-sparing root replacement (VSRR) surgery. Transesophageal echocardiogram was performed during the pre-operative and post-operative assessment surrounding aortic surgery for ten patients with non-stenotic congenital aortic root disease. BSI, utilizing block-matching algorithms, enabled detailed visualization and quantification of flow parameters from the echocardiographic data. Post-operative BSI unveiled enhanced hemodynamic patterns, characterized by quantified changes suggestive of the absence of stenosis and no more than trivial regurgitation. Rectification of an asymmetric jet and the reversal of flow on the posterior aspect of the ascending aorta resulted in a reduced oscillatory shear index (OSI) of 0.0543±0.0207 (pre-op) vs. 0.0275±0.0159 (post-op) and p=0.0044, increased peak wall shear stress of 1.9423±0.6974 (pre-op) vs. 3.6956±1.4934 (post-op) and p=0.0035, and increased time-averaged wall shear stress of 0.6885±0.8004 (pre-op) vs. 0.8312±0.303 (post-op) and p=0.23. This correction potentially attenuates cellular alterations within the endothelium. This study demonstrates that children and young adults with non-stenotic congenital aortic root disease undergoing valve-preserving operations experience significant improvements in flow dynamics within the left ventricular outflow tract and aortic root, accompanied by a reduction in OSI. These hemodynamic enhancements extend beyond the conventional echocardiographic assessments, offering immediate and valuable insights into the efficacy of surgical interventions. Full article
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12 pages, 247 KiB  
Article
Restoring Control: Real-World Success with Imipenem–Relebactam in Critical MDR Infections—A Multicenter Observational Study
by Andrea Marino, Giuseppe Pipitone, Emmanuele Venanzi Rullo, Federica Cosentino, Rita Ippolito, Roberta Costa, Sara Bagarello, Ylenia Russotto, Chiara Iaria, Bruno Cacopardo and Giuseppe Nunnari
Pathogens 2025, 14(7), 685; https://doi.org/10.3390/pathogens14070685 - 11 Jul 2025
Viewed by 410
Abstract
Background: Multidrug-resistant (MDR) Gram-negative infections, particularly those caused by carbapenem-resistant Enterobacterales (CRE) and difficult-to-treat Pseudomonas aeruginosa (DTR-Pa), present a growing global healthcare challenge, especially in critically ill populations. Imipenem–relebactam (I/R), a novel β-lactam/β-lactamase inhibitor combination, has shown efficacy in clinical trials, but [...] Read more.
Background: Multidrug-resistant (MDR) Gram-negative infections, particularly those caused by carbapenem-resistant Enterobacterales (CRE) and difficult-to-treat Pseudomonas aeruginosa (DTR-Pa), present a growing global healthcare challenge, especially in critically ill populations. Imipenem–relebactam (I/R), a novel β-lactam/β-lactamase inhibitor combination, has shown efficacy in clinical trials, but real-world data remain limited. Methods: We conducted a multicenter, retrospective–prospective observational study across tertiary-care hospitals in Italy between January 2020 and May 2025. Adult patients (≥18 years) treated with I/R for ≥48 h for suspected or confirmed MDR Gram-negative infections were included. Primary endpoints were clinical success at the end of therapy and 30-day all-cause mortality. Secondary endpoints included microbiological eradication, recurrence, safety, and predictors of treatment failure. Statistical analysis involved descriptive methods and correlation analysis for mortality predictors. Results: Twenty-nine patients were included (median age 66 years; 58.6% ICU admission; 71.4% mechanical ventilation). Clinical success was achieved in 22/29 patients (75.9%), while 30-day mortality was 24.1% (7/29). The most common pathogen was Klebsiella pneumoniae (62.1%), with 41.4% of infections being polymicrobial. Microbiological eradication was confirmed in all the BSIs. Parenteral nutrition (p = 0.016), sepsis at presentation (p = 0.04), candidemia (p = 0.036), and arterial catheter use (p = 0.029) were significantly more frequent in non-survivors. Survivors showed significant reductions in CRP, PCT, and bilirubin at 48 h, while non-survivors did not. Parenteral nutrition (rho = 0.427, p = 0.023), sepsis (rho = 0.378, p = 0.043), and arterial catheter use (rho = 0.384, p = 0.04) were significantly correlated with mortality. Conclusions: In this Italian multicenter cohort of critically ill patients, imipenem–relebactam demonstrated high clinical success and acceptable mortality rates in the treatment of severe MDR Gram-negative infections, particularly those caused by KPC-producing K. pneumoniae. Early biomarker dynamics may aid in monitoring treatment response. Larger prospective studies are needed to confirm these findings and define optimal treatment strategies. Full article
20 pages, 23317 KiB  
Article
Land Use and Land Cover (LULC) Mapping Accuracy Using Single-Date Sentinel-2 MSI Imagery with Random Forest and Classification and Regression Tree Classifiers
by Sercan Gülci, Michael Wing and Abdullah Emin Akay
Geomatics 2025, 5(3), 29; https://doi.org/10.3390/geomatics5030029 - 1 Jul 2025
Viewed by 571
Abstract
The use of Google Earth Engine (GEE), a cloud-based computing platform, in spatio-temporal evaluation studies has increased rapidly in natural sciences such as forestry. In this study, Sentinel-2 satellite imagery and Shuttle Radar Topography Mission (SRTM) elevation data and image classification algorithms based [...] Read more.
The use of Google Earth Engine (GEE), a cloud-based computing platform, in spatio-temporal evaluation studies has increased rapidly in natural sciences such as forestry. In this study, Sentinel-2 satellite imagery and Shuttle Radar Topography Mission (SRTM) elevation data and image classification algorithms based on two machine learning techniques were examined. Random Forest (RF) and Classification and Regression Trees (CART) were used to classify land use and land cover (LULC) in western Oregon (USA). To classify the LULC from the spectral bands of satellite images, a composition consisting of vegetation difference indices NDVI, NDWI, EVI, and BSI, and a digital elevation model (DEM) were used. The study area was selected due to a diversity of land cover types including research forest, botanical gardens, recreation area, and agricultural lands covered with diverse plant species. Five land classes (forest, agriculture, soil, water, and settlement) were delineated for LULC classification testing. Different spatial points (totaling 75, 150, 300, and 2500) were used as training and test data. The most successful model performance was RF, with an accuracy of 98% and a kappa value of 0.97, while the accuracy and kappa values for CART were 95% and 0.94, respectively. The accuracy of the generated LULC maps was evaluated using 500 independent reference points, in addition to the training and testing datasets. Based on this assessment, the RF classifier that included elevation data achieved an overall accuracy of 92% and a kappa coefficient of 0.90. The combination of vegetation difference indices with elevation data was successful in determining the areas where clear-cutting occurred in the forest. Our results present a promising technique for the detection of forests and forest openings, which was helpful in identifying clear-cut sites. In addition, the GEE and RF classifier can help identify and map storm damage, wind damage, insect defoliation, fire, and management activities in forest areas. Full article
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20 pages, 2514 KiB  
Article
IPT-DCD: Interpolation Predictor for Teleoperation Under Dynamic Communication Delay Using Deep Learning Approach
by Hwanhee Kang, Eugene Kim, Myeonghwan Hwang, Jaeguk Byeon, Jonghyeok An and Hyunrok Cha
Sensors 2025, 25(13), 4118; https://doi.org/10.3390/s25134118 - 1 Jul 2025
Viewed by 275
Abstract
Teleoperation systems experience degraded control stability and safety due to dynamic communication delays. This study proposes an Interpolation Predictor for Teleoperation under Dynamic Communication Delay (IPT-DCD), a predictor that reconstructs asynchronously received control commands via interpolation and predicts future commands using an encoder–decoder [...] Read more.
Teleoperation systems experience degraded control stability and safety due to dynamic communication delays. This study proposes an Interpolation Predictor for Teleoperation under Dynamic Communication Delay (IPT-DCD), a predictor that reconstructs asynchronously received control commands via interpolation and predicts future commands using an encoder–decoder LSTM architecture. To restore the temporal consistency of delayed signals, a signal preprocessing technique called the Backward Shifting and Interpolation (BSI) was applied, enabling the transformation of received data into an undelayed and uniformly sampled format. As a result, the proposed model was capable of generating real-time steering command outputs through a many-to-many time series structure. Furthermore, to evaluate its effectiveness, IPT-DCD was experimentally compared with a baseline model, a Predictor for Teleoperation under Dynamic Communication Delay (PT-DCD). The results reveal that IPT-DCD exhibits significantly greater robustness to large communication delay outliers than the baseline, highlighting its effectiveness in dynamic and unstable teleoperation environments. Full article
(This article belongs to the Special Issue Signal Processing and Machine Learning for Sensor Systems)
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18 pages, 2863 KiB  
Article
Evolution of Microbial Community Structure and Denitrifying Functional Microorganisms in the Biological Sponge Iron System
by Jing Li, Huina Xie, Wei Zhao and Jie Li
Appl. Sci. 2025, 15(13), 7244; https://doi.org/10.3390/app15137244 - 27 Jun 2025
Viewed by 307
Abstract
With the growing problem of global water pollution, nitrogen pollution has become a key factor affecting aquatic ecosystems and human health. The biological sponge iron system (BSIS) has gained attention as a research hotspot due to its efficient denitrification capability. This study focused [...] Read more.
With the growing problem of global water pollution, nitrogen pollution has become a key factor affecting aquatic ecosystems and human health. The biological sponge iron system (BSIS) has gained attention as a research hotspot due to its efficient denitrification capability. This study focused on the changes in microbial community structure and the relative abundance and interrelationships of nitrogen cycle-related functional bacteria at different operational stages of the BSIS with a sponge iron (SFe) dosage of 90 g/L. The results showed that as the operation time of the reactor extended, the relative abundance of denitrifying genera such as Saccharimonadales, Arenimonas, and Acinetobacter significantly increased, while the relative abundance of Proteobacteria showed a trend of initial increase followed by a decrease. The relative abundance of nitrifying bacteria exhibited a more complex variation, whereas the abundance of denitrifying bacteria showed a continuous upward trend. In addition, there were complex interrelationships among different denitrifying bacteria, such as a positive correlation between Saccharimonadales and Acetobacteraceae, and a negative correlation between Rhodothermus and Pseudoxanthomonas. This study not only revealed the changes in the relative abundance and interrelationships of microbial communities and nitrogen cycle-related functional bacteria over time with an SFe dosage of 90 g/L, but also provided a new perspective for understanding the intrinsic mechanism of enhanced biological denitrification by sponge iron. These findings are of great significance for optimizing the operating parameters of the BSIS, improving denitrification efficiency, and promoting the practical application of this technology in the field of environmental engineering. Full article
(This article belongs to the Section Ecology Science and Engineering)
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16 pages, 1363 KiB  
Article
Staphylococcus epidermidis in Acute Myeloid Leukemia: A Comparative Genomic Study Against Non-AML Isolates
by Stephanie McMahon, Samantha Franklin, Maliha Batool, Nitya Sadasivan, Safa Fatima and Jessica Galloway-Peña
Pathogens 2025, 14(7), 627; https://doi.org/10.3390/pathogens14070627 - 24 Jun 2025
Viewed by 444
Abstract
Bloodstream infections (BSIs) are a major cause of morbidity and mortality in acute myeloid leukemia (AML) patients undergoing induction chemotherapy. Staphylococcus epidermidis, typically a skin commensal, is increasingly recognized as a pathogen in these vulnerable individuals. This study investigated whether genomic differences [...] Read more.
Bloodstream infections (BSIs) are a major cause of morbidity and mortality in acute myeloid leukemia (AML) patients undergoing induction chemotherapy. Staphylococcus epidermidis, typically a skin commensal, is increasingly recognized as a pathogen in these vulnerable individuals. This study investigated whether genomic differences exist between infectious and gastrointestinal colonizing S. epidermidis isolates from AML patients and how these compare to colonizing and infectious isolates from other patient groups and biogeographic sites. We analyzed 114 isolates—44 from AML patients (23 infections, 21 GI colonizers) and 70 from public datasets (34 infections, 36 colonizers). Stool samples underwent 16S rRNA sequencing and culture to identify colonization, while bloodstream isolates were sequenced and compared. Genomic profiling using Roary, Scoary, Phyre2, and InterProScan revealed that infectious and GI-colonizing AML isolates were phylogenetically close but genomically distinct. Infectious isolates from AML patients were significantly enriched for resistance genes (e.g., mecA, mecR1, mecI, ANT(4′)-Ib) and the biofilm-associated gene icaA. AML infectious isolates harbored more resistance genes and mobile elements than non-AML strains but lacked widespread classical virulence factors. These results suggest that S. epidermidis pathogenicity in immunocompromised hosts is driven by genomic adaptability and antibiotic tolerance rather than traditional virulence mechanisms. Full article
(This article belongs to the Section Bacterial Pathogens)
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15 pages, 1308 KiB  
Article
Trends in Antimicrobial Resistance of Acinetobacter baumannii and Pseudomonas aeruginosa from Bloodstream Infections: An Eight-Year Study in a Romanian Tertiary Hospital
by Alina Maria Borcan, Elena Rotaru, Laura Georgiana Caravia, Mihai-Cezar Filipescu and Mădălina Simoiu
Pharmaceuticals 2025, 18(7), 948; https://doi.org/10.3390/ph18070948 - 24 Jun 2025
Viewed by 534
Abstract
Background: Bloodstream infections (BSIs) caused by multidrug-resistant non-fermenting Gram-negative bacilli, particularly Pseudomonas aeruginosa and Acinetobacter baumannii, represent a growing public health concern, especially in tertiary care settings. This study aimed to describe the epidemiological and antimicrobial resistance trends of P. aeruginosa [...] Read more.
Background: Bloodstream infections (BSIs) caused by multidrug-resistant non-fermenting Gram-negative bacilli, particularly Pseudomonas aeruginosa and Acinetobacter baumannii, represent a growing public health concern, especially in tertiary care settings. This study aimed to describe the epidemiological and antimicrobial resistance trends of P. aeruginosa and A. baumannii isolated from blood cultures over an eight-year period (2017–2024) at a tertiary infectious disease hospital in Bucharest, Romania, especially in the context of the disruption caused by the SARS-CoV-2 pandemic. Methods: A retrospective study was conducted on 43,951 blood cultures processed at the National Institute of Infectious Diseases. Species identification and antibiotic susceptibility testing (AST) were performed using VITEK2, MALDI-TOF MS, and supplementary phenotypic methods. AST interpretation followed EUCAST guidelines. Results: Out of all of the positive blood cultures, 112 (3.63%) were P. aeruginosa and 158 (5.12%) A. baumannii. Multidrug-resistance (MDR) was identified in 46% of P. aeruginosa and 90.73% of A. baumannii isolates. Resistance trends varied, with P. aeruginosa showing a decrease in MDR rates post-COVID-19 pandemic and following antimicrobial stewardship implementation. In contrast, A. baumannii displayed persistently high resistance, with carbapenem and aminoglycoside resistance rates reaching 100% by 2024. Colistin resistance, though low overall, increased in the latter years. Conclusions: The findings highlight the dynamic nature of antimicrobial resistance among P. aeruginosa and A. baumannii. Effective infection control and antimicrobial stewardship programs are crucial in curbing the rise of MDR strains, particularly amid healthcare system disruptions such as the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Antibiotic Resistance and Misuse)
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16 pages, 302 KiB  
Review
Advances in Neuromodulation and Digital Brain–Spinal Cord Interfaces for Spinal Cord Injury
by Phillip Jaszczuk, Denis Bratelj, Crescenzo Capone, Marcel Rudnick, Tobias Pötzel, Rajeev K. Verma and Michael Fiechter
Int. J. Mol. Sci. 2025, 26(13), 6021; https://doi.org/10.3390/ijms26136021 - 23 Jun 2025
Viewed by 1066
Abstract
Spinal cord injury (SCI) results in a significant loss of motor, sensory, and autonomic function, imposing substantial biosocial and economic burdens. Traditional approaches, such as stem cell therapy and immune modulation, have faced translational challenges, whereas neuromodulation and digital brain–spinal cord interfaces combining [...] Read more.
Spinal cord injury (SCI) results in a significant loss of motor, sensory, and autonomic function, imposing substantial biosocial and economic burdens. Traditional approaches, such as stem cell therapy and immune modulation, have faced translational challenges, whereas neuromodulation and digital brain–spinal cord interfaces combining brain–computer interface (BCI) technology and epidural spinal cord stimulation (ESCS) to create brain–spine interfaces (BSIs) offer promising alternatives by leveraging residual neural pathways to restore physiological function. This review examines recent advancements in neuromodulation, focusing on the future translation of clinical trial data to clinical practice. We address key considerations, including scalability, patient selection, surgical techniques, postoperative rehabilitation, and ethical implications. By integrating interdisciplinary collaboration, standardized protocols, and patient-centered design, neuromodulation has the potential to revolutionize SCI rehabilitation, reducing long-term disability and enhancing quality of life globally. Full article
13 pages, 1966 KiB  
Article
In Vitro Evaluation of Antimicrobial Synergy Against Multidrug-Resistant Gram-Negative Paediatric Bloodstream Pathogens in South Africa
by Prenika Jaglal, Sithembiso Christopher Velaphi, Colin Nigel Menezes and Khine Swe Swe-Han
Antibiotics 2025, 14(7), 630; https://doi.org/10.3390/antibiotics14070630 - 20 Jun 2025
Viewed by 345
Abstract
Background: In vitro synergy testing (ST) is a useful means to gauge the performance ofantibiotic combinations against multidrug-resistant (MDR) Gram-negative bacteria (GNB). This study aimed to determine synergy of antibiotics against paediatric bloodstream (BS) carbapenem-resistant Enterobacterales (CRE) and extremely drug-resistant (XDR) Acinetobacter [...] Read more.
Background: In vitro synergy testing (ST) is a useful means to gauge the performance ofantibiotic combinations against multidrug-resistant (MDR) Gram-negative bacteria (GNB). This study aimed to determine synergy of antibiotics against paediatric bloodstream (BS) carbapenem-resistant Enterobacterales (CRE) and extremely drug-resistant (XDR) Acinetobacter species. Methods: This cross-sectional study was conducted at a public tertiary hospital in South Africa, from January 2023 to December 2023. Sixty-eight isolates from children with bloodstream infections (BSI), comprising 55.9% (38/68) CRE and 44.1% (30/68) XDR Acinetobacter species, were performed ST using the fixed-ratio Epsilometer-test method. Combinations of colistin and meropenem, colistin and fosfomycin, colistin and tigecycline, meropenem and fosfomycin, meropenem and tigecycline, and fosfomycin and tigecycline were tested. Results: In vitro synergy for CRE was best demonstrated with tigecycline and meropenem, at 92.1% (35/38), and fosfomycin and meropenem at 73.7% (28/38). Among the XDR Acinetobacter species, the highest rates of synergy of 76.7% (23/30) were observed with tigecycline and meropenem. The absence of synergy was noted with colistin and meropenem for the CRE, with many displaying indifference and antagonism at rates of 65.8% and 22%. Most XDR Acinetobacter species (56.7%; 17/30) expressed indifference to colistin and meropenem with synergy and antagonism displayed in 23.3% and 10% of isolates. Conclusions: This study highlights tigecycline and meropenem displaying impressive in vitro synergy when compared to the in-use colistin and meropenem for CRE and XDR Acinetobacter species. Tigecycline and meropenem may be a viable salvage therapeutic option for MDR Gram-negative paediatric infections. Future research is warranted to confirm in vivo synergy clinically. Full article
(This article belongs to the Special Issue Combination Therapy against Multidrug-Resistant Pathogens)
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25 pages, 2394 KiB  
Article
Enhancing Safety Performance in UK Metal Manufacturing: A Revised Framework to Reduce Fatal Accidents
by Alexandra Eggleston, Shoaib Sarfraz, Konstantinos Salonitis, Sumit Gupta, Hana Trollman and Sandeep Jagtap
Safety 2025, 11(2), 59; https://doi.org/10.3390/safety11020059 - 18 Jun 2025
Viewed by 572
Abstract
Fatal accidents in UK’s manufacturing sector are expected to remain the same or increase in coming years. This paper has tried to combat this issue by adapting and further developing a previously defined Safety Framework for the Paint Sector, to evaluate the safety [...] Read more.
Fatal accidents in UK’s manufacturing sector are expected to remain the same or increase in coming years. This paper has tried to combat this issue by adapting and further developing a previously defined Safety Framework for the Paint Sector, to evaluate the safety performance of a metal manufacturing facility. To achieve this, the original Safety Framework was updated to align with the current British safety legislation outlined by the British Standards Institution. The framework was based on a three-level multi-attribute value theory (MAVT). Upon reviewing BSI 45001, the Safety Framework was founded upon the concept of Deming’s Plan, Do, Check, Act (PDCA) which is the foundation for the original framework, therefore, the first-level attributes remained consistent. The 13 attributes of the second level and 36 attributes of the third level were derived from the literature review and updated to relevant legislation. To develop the Safety Framework, the Delphi method was used. This included interviews that were conducted with employees and managers from either a Safety or Engineering background. The second part of the paper involved the improvement of the Safety Framework, based on the interview feedback. The main findings of the study revealed that the final Safety Framework has been deemed relevant for the Metal Manufacturing Sector by Industry Suitably Qualified and Experienced Personnel (SQEP). The majority of Interviewees deemed the Safety Framework to have a clear layout and easy to understand. The interviews and final Safety Framework suggested the importance of a company’s emphasis on employee welfare and health, in order to reduce accidents in the workplace. The originality of this paper lies in its application and validation of a sector-specific safety framework, contributing to the body of knowledge by offering a replicable methodology for adapting safety frameworks to other manufacturing sectors. Full article
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