Search Results (794)

Background/Objectives: Intestinal colonization by Enterobacteriaceae, including extended-spectrum β-lactamase-producing (ESBL-E) and carbapenemase-producing (E-CPE) strains, is an early marker of multidrug-resistant infections in neonates, particularly those transferred from lower-complexity hospitals. This study aimed to identify factors associated with intestinal Enterobacteriaceae colonization upon admission to a level IV neonatal referral unit in Colombia, with a focus on prior antibiotic exposure. Methods: We conducted a retrospective case–control study, including all neonates transferred from peripheral hospitals and screened with rectal swabs at admission. Cases were neonates colonized with Enterobacteriaceae, and controls were non-colonized neonates admitted during the same period. Multivariable logistic regression models were used to evaluate three exposure dimensions: prior antibiotic use (yes/no), number of agents, and the WHO AWaRe classification. A secondary analysis was performed to assess the factors associated with ESBL-E and E-CPE colonization. Results: Among the 435 referred neonates, 87 (20.0%) were colonized, predominantly Klebsiella pneumoniae (53.6%) and Escherichia coli (19.5%). Prior antibiotic use (aOR 3.01; 95% CI 1.47–6.37), exposure to two agents (aOR 4.13; 95% CI 1.94–8.89) and use of AWaRe Access antibiotics (aOR 22.2; 95% CI 5.83–101) were strongly associated with colonization. Longer hospitalization and central catheter use were also associated with greater colonization odds, whereas total parenteral nutrition showed a protective association. In the sub-analysis, Access, Watch, and Reserve antibiotics were independently associated with ESBL-E and E-CPE colonization. Conclusions: Among transferred neonates, prior antibiotic exposure, particularly AWaRe-classified agents, showed the strongest association with intestinal colonization by Enterobacteriaceae, including ESBL-E/CPE phenotypes. Strengthening antimicrobial stewardship in referral facilities and implementing risk-based screening at admission may help reduce colonization and limit the spread of resistance. Full article

Hair loss is a prevalent condition with various causes, and effective treatments are in high demand. Cacumen Platycladi (Platycladus orientalis leaves), a traditional Chinese medicine, has been historically used to prevent hair loss. This study aimed to evaluate the efficacy and mechanisms of Cacumen Platycladi extract (CPE) in preventing hair loss. Using a gradient extraction method with 1,3-butanediol, ethanol, and water, bioactive compounds like quercitrin, myricetin, and myricitrin were enriched and identified via Liquid Chromatography–Mass Spectrometry (LC-MS). The results showed that CPE inhibited 5α-reductase activity, enhanced the antioxidant capacity of human dermal papilla cells (HDPCs), and upregulated the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) pathway to promote vascular endothelial growth factor (VEGF) and collagen type XVII (COL17) expression. A 12-week clinical trial demonstrated that CPE significantly reduced hair loss and increased local hair density compared to placebo, with no adverse effects. These findings support the potential of CPE as a safe and effective natural alternative for hair loss prevention. Full article

Background: Caffeine (CAF), whether extracted from plants or synthesised as a chemical compound, is considered the safest among other xanthine alkaloids. Novel nano-cream formulations have been successfully developed and evaluated to increase the potential of caffeine as a skin cosmeceutical, targeting the minimisation of cellulite appearance. Methods: Nano-cream formulations were prepared through a process of hot-temperature emulsification, in a variety of homogeniser combinations. Results: When chemical penetration enhancers (CPEs) (lanolin, transcutol, and propylene glycol), either alone or in combination, were incorporated into the nano-cream formulations, the permeation of CAF through skin increased. All nano-cream formulations achieved sustained delivery of CAF into and through the skin over 8 h (IVPT). Quantification of CAF from skin tissues was achieved using high-performance liquid chromatography (HPLC). The nano-cream formulation containing lanolin (LAN) showed the highest CAF permeation (8.829 ± 1.472 µg/cm²/h) through the skin compared to CAF in an aqueous solution (2.533 ± 0.480 µg/cm²/h) and a commercial CAF cellulite product with the same CAF concentration (2.827 ± 0.555 µg/cm²/h). Therefore, 2% CAF nano-cream formulation containing LAN was chosen for clinical testing. A double-blind, randomised, placebo-controlled paired trial was conducted, in which each volunteer applied active and placebo creams to the upper thighs twice daily for 12 weeks. The effect of the cream on skin appearance was monitored over 12 weeks. The primary outcome measures were reduced cellulite scores from 3.96 (95% CI: 3.16–4.76) to 2.50 (95% CI: 1.70–3.30) (active) compared with placebo from 3.88 (95% CI: 3.08–4.67) to 2.83 (95% CI: 2.03–3.63). The effect sizes (E.S.) indicated a moderate effect for the active CAF nano-cream formulation (E.S. = 0.475), while the placebo (E.S. = 0.286) had a small effect. Conclusion: We concluded that our optimised 2% CAF nano-cream formulation containing LAN offered an effective formulation strategy for enhancing skin penetration in the IVPT study. The LAN nano-cream formulation demonstrated efficacy and tolerability, both objectively and subjectively, in a human clinical trial. Full article

Cardiogenic pulmonary edema (CPE) is a life-threatening manifestation of acute heart failure characterized by rapid accumulation of fluid in the interstitial and alveolar spaces, leading to severe dyspnea, hypoxemia, and respiratory failure. The condition arises from elevated left-sided filling pressures that increase pulmonary capillary hydrostatic pressure, disrupt alveolo-capillary barrier integrity, and impair gas exchange. Neurohormonal activation further perpetuates congestion and increases myocardial workload, creating a vicious cycle of hemodynamic overload and respiratory compromise. Respiratory support is a cornerstone of management in CPE, aimed at stabilizing oxygenation, reducing the work of breathing, and facilitating ventricular unloading while definitive therapies, such as diuretics, vasodilators, inotropes, or mechanical circulatory support (MCS), address the underlying cause. Among available modalities, non-invasive ventilation (NIV) with continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) has the strongest evidence base in moderate-to-severe CPE, consistently reducing the need for intubation and providing rapid relief of dyspnea. High-flow nasal cannula (HFNC) represents an emerging alternative in patients with moderate hypoxemia or intolerance to mask ventilation, and should be considered an adjunctive option in selected patients with less severe disease or NIV intolerance, although its efficacy in severe presentations remains uncertain. Invasive mechanical ventilation is reserved for refractory cases, while extracorporeal membrane oxygenation (ECMO) and other advanced circulatory support modalities may be necessary in cardiogenic shock. Integration of respiratory strategies with hemodynamic optimization is essential, as positive pressure ventilation favorably modulates preload and afterload, synergizing with pharmacological unloading. Future directions include personalization of ventilatory strategies using advanced monitoring, novel interfaces to improve tolerability, and earlier integration of MCS. In summary, respiratory support in CPE is both a bridge and a decisive therapeutic intervention, interrupting the cycle of hypoxemia and hemodynamic deterioration. A multidisciplinary, individualized approach remains central to improving outcomes in this high-risk population. Full article

The severe decrease in natural sturgeon stocks has led to intensified efforts toward the development of sturgeon aquaculture and the application of reproductive biotechnologies to ensure sustainable production. In cultured male Acipenser ruthenus (sterlet), spermiation must be hormonally induced to obtain high-quality semen; however, reducing hormonal dosages while maintaining or improving sperm quality remains a major challenge. In this study, we investigated the effects of reduced doses of carp pituitary extract (CPE) and luteinizing hormone-releasing hormone agonist (LH-RH) combined with Apilarnil supplementation on spermiation and semen quality in A. ruthenus. Semen volume, pH, sperm concentration, total sperm output, total motility, and spermatozoa velocity were evaluated. Administering a reduced CPE dose (1.1 mg·kg⁻¹) combined with 1 g of Apilarnil significantly increased semen volume, sperm concentration, and total sperm output, as well as improved sperm kinematic parameters (total motility and velocity) compared with the conventional hormonal protocol. Furthermore, treatments using 50% of the standard LH-RH dose supplemented with 1 g or 2 g of Apilarnil resulted in significantly higher sperm motility and velocity than observed in the control group. These results demonstrate that Apilarnil supplementation allows for a substantial reduction in exogenous hormonal doses while enhancing spermiation efficiency and semen quality in sterlet, supporting the spermiation-induction protocol for sturgeon aquaculture. Full article

Background: The objective of this work was to support the implementation of the European Health Technology Assessment Regulation (EU HTAR) and optimize performance of the evolving EU HTA system. Therefore, an inclusive multi-stakeholder framework of key performance indicators (KPI) for success measurement was developed. Methods: A modified Delphi-procedure was applied as follows: (1) development of a generic KPI pool at the Fall Convention 2024 of the European Access Academy (EAA); (2) review of initial pool and identification of additional KPIs; (3) development of prioritized KPIs covering patient, clinician, Health Technology Developer (HTD), and System/Member State (MS) perspectives, and (4) consolidation of the stakeholder-centric KPIs after EAA’s Spring Convention 2025. Results: Steps 1 and 2 of the Delphi procedure revealed 14 generic KPI domains. Steps 3 and 4 resulted in four prioritized KPIs for patients (patient input; utilization of patient-centric outcome measures; time to access; equity); six for clinicians (population/intervention/comparator/outcomes (PICO); addressing uncertainty; clinician involvement; transparency; equity and time to access); four for HTDs (PICO; joint scientific consultation (JSC) process; joint clinical assessment (JCA) process; time to national decision making); five from a system/MS perspective (PICO; learning and training the health system; reducing duplication; equity and time to access). The scope of, e.g., the PICO-related KPI, differed between stakeholder groups. Also, several KPIs intentionally reached beyond the remit of EU HTA as they are also dependent on MS-specific factors including national health systems and budgets. Discussion and Conclusions: The KPI framework developed here presents a step towards the generation of systematic multi-stakeholder evidence to support a successful implementation of the EU HTAR. The relevance of the identified stakeholder-centric KPIs is confirmed by their alignment with the Health System Goals suggested in the context of “Performance measurement for health improvement” by the World Health Organisation. Implementation of the framework, i.e., measurement of KPIs, is envisioned to provide evidence to inform the 2028 revision of the EU HTAR. Full article

Background/Objectives: Antimicrobial resistance (AMR) among Enterobacterales poses a major threat to public health in Southern Africa and has led to limited treatment options and increased mortality. Despite Africa bearing the brunt, there is limited data on the epidemiology and molecular epidemiology of the genetic determinants of β-lactam and/or carbapenem resistance. This narrative literature review summarizes the epidemiology and molecular characteristics of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE), carbapenem-resistant Enterobacterales (CRE), and carbapenemase-producing Enterobacterales (CPE) in Southern Africa, while identifying data gaps and surveillance challenges. Methods: A comprehensive literature review was conducted using peer-reviewed articles from ten Southern African countries, including South Africa, Lesotho, Eswatini, Botswana, Namibia, Angola, Zambia, Zimbabwe, Mozambique, and Malawi, reporting the epidemiology and/or molecular characterization of ESBL-PE, CRE, and CPE. Results: ESBL-PE, CRE, and CPE pose an increasing healthcare threat in Southern Africa, with prevalence varying widely by source. Klebsiella pneumoniae and E. coli are the predominant ESBL-PE, CRE, and CPE species. The most frequent resistance genes are bla_CTX-M among ESBLs and bla_NDM and bla_OXA among carbapenemases, reflecting global patterns. However, molecular characterization across the region remains limited, with countries such as Botswana, Lesotho, Eswatini, Zambia, and Zimbabwe lacking sufficient data on the prevalence and diversity of these resistance determinants. Conclusions: Despite the paucity of genomic and epidemiological data, Southern Africa faces an urgent AMR challenge. Strengthening laboratory infrastructure, genomic surveillance, and regional coordination is crucial to mitigate AMR and guide antibiotic stewardship policies. Full article

Metal materials are widely used in power grid infrastructure, but they are prone to metal corrosion due to long-term exposure to various environmental conditions, resulting in significant losses. The existing superhydrophobic coatings have good anti-corrosion performance, but poor wear resistance. Therefore, it is extremely important to improve the wear resistance of superhydrophobic coatings. In this study, a kind of fluorine-modified SiO₂ particle was prepared with pentafluorooctyltrimethoxysilane (FAS-13) as the low surface energy modifier, following the fabrication of a superhydrophobic coating on metal substrate via a PDMS-doped spray deposition method to reinforcement wear resistance property. XPS, FT-IR and Raman spectra confirmed the successful introduction of FAS-13 on SiO₂ particles, as evidenced by the characteristic fluorine-related peaks. TGA revealed that the fluorine modified SiO₂ (F-SiO₂) particles exhibited excellent thermal stability, with an initial decomposition temperature of 354 °C. From the perspective of surface morphology, the relevant data indicated a peak-to-valley height difference of only 88.7 nm, with Rq of 11.9 nm and Ra of 8.86 nm. And it also exhibited outstanding superhydrophobic property with contact angle (CA) of 164.44°/159.48°, demonstrating remarkable self-cleaning performance. And it still maintained CA of over 150° even after cyclic abrasion of 3000 cm with 800 grit sandpaper under a 100 g load, showing exceptional wear resistance. In addition, it was revealed that the coated electrode retained a high impedance value of 8.53 × 10⁸ Ω·cm² at 0.1 Hz after 480 h of immersion in 5 wt% NaCl solution, with the CPE exponent remaining close to unity (from 1.00 to 0.97), highlighting its superior anti-corrosion performance and broad application prospects for metal corrosion prevention. Full article

Kombucha is a millennia-old beverage crafted from green or black tea and saccharides and fermented with a symbiotic culture of bacteria and yeast (SCOBY). This functional drink boasts health benefits, such as improved intestinal flora function, hepatoprotection and inhibition of amyloid fibers. It contains bioactive antioxidants, such as catechins, ascorbic acid, vitamins and other polyphenolic compounds. With kombucha’s rising popularity, the Food and Drug Administration (FDA) has implemented control procedures to ensure the quality and safety of this food product. Due to the antioxidant properties of the major bioactive compounds in kombucha, feasible and low-cost electroanalytical methods emerge as promising alternatives. The objective of this study was to evaluate the voltammetric behavior of kombucha samples to establish and compare their redox profiles and antioxidant activities. Thus, 18 kombucha samples were used, comprising commercial samples and samples prepared in the laboratory from different SCOBYs purchased from different countries, and analyzed by differential pulse voltammetry (DPV) and square wave voltammetry (SWV) on a carbon paste electrode (CPE). The electrochemical index (EI) values determined from the samples were used to establish their antioxidant activities. The EI values were also compared with spectrophotometric data from Folin–Ciocalteu (FC) and Ferric Reducing Antioxidant Power (FRAP) assays. Full article

This study evaluated the properties of two commercial filaments intended for medical and sterile applications: PLACTIVE (Copper 3D, Santiago, Chile) and CPE ANTIBAC (Fiberlogy, Brzezie, Poland). The aim of the research was to compare the dimensional accuracy, repeatability of the fused deposition modeling (FDM) 3D printing process, and the antibacterial properties of the samples using standardized procedures. Four types of samples were manufactured: geometrically differentiated specimens for metrological measurements (S1); cylinders with a diameter of 15 mm and a height of 40 mm for assessing process repeatability (S2); rectangular specimens measuring 40 × 40 × 2 mm for surface topography analysis (S3); and rectangular samples measuring 20 × 20 × 2 mm for biocidal property evaluation (S4). The results demonstrated that PLACTIVE samples exhibited higher dimensional conformity with nominal values and lower variability of diameters than CPE ANTIBAC samples, which may be associated with greater process stability. For both materials, the PSm parameter was correlated with layer height only in the 90° printing orientation. Surface topography analysis showed that increasing the layer height from 0.08 mm to 0.20 mm led to a significant rise in Rsm, Ra, and Sa values, indicating deterioration in the reproduction of micro-irregularities and increased spatial differentiation of the surface. For PLACTIVE samples, a tendency toward more convex structures with positive Rsk values and moderate kurtosis (Rku) was observed, suggesting uniform plasticization and stable interlayer bonding, particularly at the 0° orientation. In contrast, CPE ANTIBAC samples (especially those printed at 90°) were characterized by higher Ra and Sa values and negative skewness (Rsk), indicating valley-dominated, sharper surface morphology resulting from different rheological behavior and faster solidification of the material. PLACTIVE samples did not exhibit antibacterial properties against Escherichia coli (E. coli), while for Staphylococcus aureus (S. aureus), the activity was independent of printing direction and layer height. The CPE ANTIBAC material showed antibacterial effects against both tested strains in approximately 50% of the samples. The findings provide insights into the relationships between material type, printing orientation, and process parameters in shaping the dimensional and biocidal properties of FDM filaments. Full article

Chamaecyparis obtusa (Hinoki cypress) has been extensively studied for its leaves and bark, which are known to contain high levels of polyphenols and flavonoids with potent bioactivities. In this study, the phytochemical transformation and changes in bioactivity of C. obtusa leaves were investigated through bioconversion using the mycelium of Phellinus linteus. Initially, extracts of C. obtusa leaves were prepared using distilled water (COD) and 99% ethanol (COE), and the bioconverted extract, CPE-1. The extracts were evaluated for antioxidant potential (DPPH and ABTS radical scavenging), cytotoxicity, antibacterial efficacy, and anti-inflammatory activity in LPS-stimulated RAW 264.7 macrophages. The results indicated that CPE-1 exhibited the highest overall efficacy among the tested extracts, showing antioxidant activity comparable to that of BHT and ascorbic acid, while presenting relatively lower antimicrobial effects against Staphylococcus aureus and Bacillus spp. However, in an in vitro cellular model, CPE-1 significantly enhanced anti-inflammatory effects, including notable inhibition of nitric oxide (NO) production, suppression of COX-2 and iNOS expression, and inhibition of ERK and JNK phosphorylation. Its antioxidant activity remained strong, exhibiting radical scavenging capabilities comparable to those of synthetic controls (BHT and ascorbic acid). HPLC analysis confirmed that bioconversion successfully modified the phytochemical profile of C. obtusa, yielding metabolites with enhanced potency while preserving stable, beneficial compounds like gallic acid. These findings collectively establish fungal biotransformation as an effective technology for upgrading plant-derived extracts into potent, multifunctional bioactive materials suitable for therapeutic or functional food applications. Full article

Conservatively perturbed equilibrium (CPE) experiments yield transient concentration extrema that surpass steady-state equilibrium values. A physics-informed neural network (PINN) framework is introduced to simulate these over-equilibrium dynamics in linear chemical reaction networks without reliance on extensive time-series data. The PINN incorporates the reaction kinetics, stoichiometric invariants, and equilibrium constraints directly into its loss function, ensuring that the learned solution strictly satisfies physical conservation laws. Applied to three- and four-species reversible mechanisms (both acyclic and cyclic), the PINN surrogate matches conventional ODE integration results, reproducing the characteristic early concentration extrema (maxima or minima) in unperturbed species and the subsequent relaxation to equilibrium. It captures the timing and magnitude of these extrema with high accuracy while inherently preserving total mass. Through the physics-informed approach, the model achieves accurate results with minimal data and a compact network architecture, highlighting its parameter efficiency. Full article

Wastewater-based surveillance is gaining interest worldwide as a complementary tool informing human surveillance of pathogens, among which are antibiotic-resistant bacteria. The current study investigated whether CPE detected within the Dutch human CPE surveillance could be identified among isolates that were independently retrieved from Dutch wastewater. Whole genomes of 203 wastewater- and 1278 human-retrieved isolates were compared using whole-genome multilocus sequence typing (wgMLST), resistome, and plasmid analyses. Overall, 25 clusters (16 E. coli, 9 K. pneumoniae) with genetically highly related variants from both niches were detected. The maximum allelic difference between human- and wastewater-derived isolates in clusters was on average 0.51% (23/4503 alleles, E. coli) and 0.22% (11/4978 alleles K. pneumoniae). For seven clusters, in-depth plasmid analysis was performed, showing highly homologous (87–100%) carbapenemase-containing plasmids from human- and wastewater-retrieved isolates. Six clusters contained wastewater and human isolates that were spatiotemporally related. The sequence identity at chromosomal and plasmid level confirms the presence of human-associated CPE variants in wastewater. Ongoing comparisons between isolates from the national human CPE surveillance and wastewater surveillance will shed more light on the added value of wastewater-based surveillance for monitoring of CPE and other (emerging) antibiotic resistances. Full article

Background/Objectives: The environmental dissemination of antimicrobial-resistant Enterobacteriaceae poses a remarkable threat to public health. This study investigates the environmental presence and dissemination of carbapenemase-producing Enterobacteriaceae (CPE) in 30 important water bodies selected according to their interconnection with and utilization by livestock and community people in central Thailand. Methods: Water samples were collected from 30 selected water bodies. Enterobacteriaceae were isolated and screened for CPE and multidrug resistance. Carbapenemase genes (bla_NDM-5, bla_NDM-1 and bla_IMI-1) were detected and their locations (plasmid and chromosome) determined. Plasmid types were further characterized, and conjugation experiments were performed to assess transferability among bacterial species. Results: From all selected samples, six isolates (20%) were identified as multidrug-resistant CPE including one Escherichia coli, one Klebsiella pneumoniae and four Enterobacter roggenkampii carrying bla_NDM-5, bla_NDM-1 and bla_IMI-1 genes, respectively. The bla_NDM-5 and bla_NDM-1 genes were located on phage-like pO111 type plasmid and IncC plasmid, while bla_IMI-1 was located on chromosomes. The plasmids also consisted of components that closely resembled those found in resistance plasmids obtained from clinical and environmental isolates worldwide. Additionally, through plasmid conjugation experiment, carbapenemase genes were transferable with a high rate among bacterial species. Conclusions: These findings indicated that water bodies are polluted and there is an urgent need for integrated strategies to monitor and mitigate the spread of antibiotic resistance across human, animal and environmental health domains in aquatic environments. Full article