Search Results (10,736)

Mechanical circulatory support (MCS) has transformed the management of advanced heart failure; however, device-related morbidity remains substantially driven by adverse interactions occurring at the blood–material and tissue–device interfaces. Despite progressive miniaturization and the evolution from first-generation pulsatile systems to contemporary continuous-flow devices, thrombotic, hemorrhagic, infectious, and inflammatory complications continue to limit long-term outcomes. This review examines the mechanistic contribution of material properties, surface architecture, and hemodynamic conditions to the pathogenesis of major MCS-associated complications, with particular emphasis on thrombogenicity, biomaterial-induced inflammatory activation, driveline and cannulation-associated infections, hemocompatibility disturbances, and device-related structural failure. The interplay between protein adsorption, platelet activation, complement cascade dysregulation, disturbed shear profiles, and biofilm formation is analyzed as a central determinant of adverse clinical events. Special attention is given to pediatric MCS, in which the continued reliance on extracorporeal pulsatile systems, unique anatomical constraints, and narrow therapeutic margins intensify susceptibility to both thromboembolic and infectious sequelae. Furthermore, the review addresses how material and surface modifications, and emerging biomimetic and anti-thrombogenic coatings may influence complication mitigation. By integrating clinical, engineering, and biomaterials perspectives, this work highlights that many complications traditionally regarded as secondary clinical phenomena are fundamentally rooted in device–material interactions and flow-mediated biological responses. Improved understanding of these mechanisms is essential for optimizing device design, enhancing hemocompatibility, and reducing complication burden in both adult and pediatric MCS populations. Full article

The demineralization of tooth enamel is the primary consequence of dental caries, leading to cavities and finally tooth loss. Erosive tooth wear from acidic beverages and food is another factor that degrades enamel. In both cases, an acidic environment leads to etching and the final dissolution of tooth mineral, i.e., hydroxyapatite. Here, this process is discussed from a chemical perspective, taking into account the solubility of calcium phosphate and the presence of the pellicle (protein layer) and plaque (bacterial biofilms), which both affect the dissolution rate. While low pH is definitely decisive, calcium-binding ligands (e.g., acid anions, proteins) contribute to dissolution by removing calcium ions from the equilibrium. This is an important effect in the oral cavity where the concentration of biomolecules is high. The situation is complicated by the fact that the composition of saliva and the oral microbiome vary considerably between individuals. The state of current knowledge on the demineralization of enamel is summarized and discussed, also in the context of approaches to prevent dental caries and erosive tooth wear. Full article

De novo granulation of autochthonous microorganisms of water and wastewater reduces the start-up periods for cultivating aerobic granular sludge (AGS) and enrichment of degrading strains. However, it has not been demonstrated using refractory carbon compounds. This work investigated the formation of AGS from the seawater microbiome and establishment of pollutant removal pathways by feeding acetonitrile as the sole carbon and nitrogen source. Use of acetonitrile at an organic loading rate of 0.124 kg/m³/day enabled rapid emergence of aggregates and then stable granules (size: 1.3 mm; SVI5: 68 mL/g) within two weeks. TOC removal accompanied by ammonium nitrogen release was consistent and stable at 93% during the 50 days of bioreactor operation. Formation of acetamide and ammonium indicated involvement of nitrile hydratase and amidase enzymes in acetonitrile biodegradation. Ammonium released during acetonitrile biodegradation was removed by partial nitrification and the nitrite denitrification pathway. However, incomplete ammonium removal led to accumulation of up to 120 mg/L NH₄⁺-N by day 50. Phosphate was removed via the enhanced biological phosphate removal pathway. This study shows that de novo granulation permits cultivation of AGS via the de novo granulation approach for simultaneous biodegradation of refractory acetonitrile and biological nutrient removal under saline conditions. Full article

This study aims to elucidate the mechanism by which exogenous guanosine monophosphate (GMP) enhances the stress tolerance of Lactiplantibacillus plantarum Y12. Phenotypic assays demonstrated that GMP supplementation significantly improved biofilm formation, adhesion index, and auto-aggregation ability. The survival ability of Y12 in simulated gastric juice, intestinal juice, and freeze-drying stress was also significantly increased. Transcriptomic results revealed that GMP increased the intracellular content of the second messengers C-di-AMP and C-di-GMP by reducing phosphodiesterase (PDE, RS04640). This, together with the upregulated expression of luxR and rpoN, synergistically promoted biofilm formation. Furthermore, GMP enhanced acid tolerance by increasing glutamate decarboxylase activity (GAD, RS05235). It also significantly elevated the levels of extracellular proteins, exopolysaccharides, membrane polysaccharides, and membrane fatty acids by modulating genes related to proteins (yidC, yajC), polysaccharides (agaB, agaC), and membrane fatty acid synthesis (RS02005, plsY), which was also demonstrated by quantitative determination. Collectively, these regulatory mechanisms substantially improve the stress tolerance of L. plantarum Y12, providing a theoretical basis for its application. Full article

Background/Objectives: This prospective observational cohort study aimed to evaluate the influence of heated tobacco (HT) and electronic cigarettes (ECs) on bone remodeling markers such as receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG), and periodontal status, at baseline and at 3 months after initial periodontal therapy. Methods: The sample comprised 236 participants (130 women, 106 men; mean age 38.96 ± 7.69 years), distributed across non-smokers (n = 72), heated tobacco/HT product users (n = 83), and electronic cigarette/EC users (n = 81). For each patient, the periodontal charting included periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL). Unstimulated saliva samples were analyzed for RANKL and OPG levels. All patients underwent nonsurgical periodontal therapy (scaling and root planing). Between-group comparisons were performed using the Kruskal–Wallis test followed by Bonferroni-adjusted pairwise comparisons, while within-group changes over time were assessed using the Wilcoxon signed-rank test. To complement the primary nonparametric analyses, two-way mixed-design ANOVA and ANCOVA models adjusted for baseline values and periodontitis stage were performed as sensitivity analyses. Statistical significance was set at p < 0.05. Results: At baseline, both product user groups exhibited significantly higher PPD (p = 0.005) and CAL (p = 0.001) compared with non-smokers, with no differences between HT and EC users. Salivary RANKL levels were significantly higher in HT and EC users than in non-smokers, and OPG levels did not differ significantly. Following non-surgical periodontal therapy, all parameters improved significantly across groups (p < 0.001). At the 3-month follow-up, both product user groups maintained higher PPD (p = 0.008), CAL (p = 0.001), and salivary RANKL levels, compared with non-smoking individuals (p < 0.001). The RANKL/OPG ratio remained significantly different only for EC users compared with non-smokers (p < 0.001). Conclusions: HT and EC use were associated with differences in periodontal parameters and higher RANKL levels, while differences in the RANKL/OPG ratio were observed in EC users compared with non-smokers. Non-surgical periodontal therapy improved clinical parameters and reduced the RANKL/OPG ratio, highlighting the importance of biofilm control. Full article

Background: The World Health Organization has identified the growing ineffectiveness of antibiotics against resistant pathogens as a global threat to public health, linked to increased morbidity and mortality. In this context, Pseudomonas aeruginosa stands out as a multidrug-resistant, biofilm-forming pathogen whose biofilm formation increases its tolerance to antimicrobials, which has driven the development of anti-virulence strategies as a therapeutic alternative. In this regard, the present study aimed to evaluate extracts and compounds from Piper species in assays targeting the inhibition of biofilm and virulence factors in Pseudomonas aeruginosa, as well as their anti-quorum sensing activity using Chromobacterium violaceum as a biosensor model. Methods: For this purpose, quorum sensing interference was first assessed through inhibition of violacein production using C. violaceum ATCC 12472 as a biosensor model. The modulation of virulence-associated phenotypes in P. aeruginosa ATCC BAA-47 was subsequently examined through inhibition of biofilm formation by crystal violet staining and spectrophotometric quantification of elastase, protease and pyocyanin production. Results: It was found that extracts from P. aduncum, P. sucrense, P. grande, and P. cumanense inhibited biofilm formation in P. aeruginosa and showed potential activity against quorum sensing in the C. violaceum model, while P. ceanothifolium exhibited only antibiofilm activity. Furthermore, hydroquinone-type compounds and benzoic acid derivatives reduced biofilm formation and virulence factors in P. aeruginosa. Conclusions: The results obtained demonstrate antibiofilm and anti-virulence activity, as well as a possible modulation of quorum sensing in model systems, suggesting that Piper species represent a promising source of bioactive compounds. Full article

Objectives: To compare the adjunctive efficacy of a MicroRepair^® mouthwash containing an antibacterial complex (ABX), composed of cetylpyridinium chloride, magnolol, and honokiol, with 0.12% chlorhexidine (CHX) in the management of generalized plaque-induced gingivitis, assessing clinical periodontal parameters, salivary activated matrix metalloproteinase-8 (aMMP-8) levels, and patient-reported outcomes over 6 months. Methods: A randomized, controlled, parallel-group clinical trial included 40 systemically healthy adults with generalized gingivitis and was reported in accordance with CONSORT 2025 guidelines. Following professional oral hygiene according to the Guided Biofilm Therapy (GBT) protocol, participants were randomly allocated to ABX or 0.12% CHX, used twice daily for 14 days. Clinical parameters, including Full-Mouth Bleeding Score (FMBS, primary outcome), Full-Mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Gingival Recession (REC), and Modified Lobene Stain Index (MLSI), were recorded at baseline, 2 weeks, 1, 3, and 6 months. Salivary aMMP-8 levels were assessed at baseline and 2 weeks. Heavy smokers were excluded, and smoking status was evaluated as a potential covariate. Non-parametric tests were applied (p < 0.05). Results: Both groups showed significant reductions in FMBS and FMPS over time (p < 0.05), with no intergroup differences for the primary outcome at any follow-up at the patient level. Patient-level analyses did not reveal consistent differences across secondary parameters. At the tooth level, lower FMPS values were observed in the trial group at 2 weeks and 1 month (p < 0.05), with earlier PPD reduction. CAL, and REC remained stable. Salivary aMMP-8 levels decreased significantly in both groups without intergroup differences. Patient-reported outcomes were comparable. Smoking status was balanced between groups and was not significantly associated with treatment allocation or the main clinical outcomes. Conclusions: No significant differences were observed between ABX and CHX for the main clinical and molecular outcomes, supporting its potential use as an adjunct in gingivitis management. Full article

Background/Objectives: Numerous natural compounds have been reported to exhibit anti-virulence properties against pathogenic bacteria. Particularly, plants constitute a rich source of anti-quorum-sensing (QS) and anti-biofilm compounds with highly diverse chemical structures. Notably, several studies reported that plant-derived pentacyclic triterpenoids exert anti-biofilm activity against Pseudomonas aeruginosa without affecting bacterial viability, suggesting that this class of naturally occurring chemical compounds may represent a source of potent and clinically relevant anti-biofilm agents. Methods: To further investigate this hypothesis, we evaluated several commercially available pentacyclic triterpenoid acids of the oleanane, ursane and lupane types for their potential impact on QS mechanisms and biofilm formation in the P. aeruginosa PAO1 model strain. Results: Oleanane-type (oleanolic acid and maslinic acid), ursane-type (ursolic acid and corosolic acid) and lupane-type (betulinic acid) triterpenoids inhibited the expression of the QS-regulated lasB and rhlA genes as well as biofilm formation, without affecting bacterial growth. Among tested compounds, oleanolic and ursolic acids, at 400 µM, exhibited the strongest anti-biofilm activities, with 45% and 40% inhibition, respectively. Fluorescence microscopy revealed a marked disorganization of biofilm architectures, with bacterial communities failing to establish compact cell-to-cell attachment and confluent microcolonies. Further analyses indicated that these triterpenoid acids did not affect the expression of QS-regulator genes (lasR/I and rhlR/I), suggesting that their impact on lasB and rhlA expression and biofilm formation is independent of the las and rhl systems. Conclusions: These findings suggest that oleanane and ursane triterpenoid acids represent promising chemical backbones for the development of strategies aimed at inhibiting P. aeruginosa biofilm formation. Full article

Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant multidrug-resistant pathogen, frequently associated with persistent infections and biofilm formation, underscoring the urgent need for alternative antimicrobial strategies. Bioactive compounds derived from fungi have attracted considerable attention due to their structural diversity and demonstrated antibacterial activity against MRSA. This study employed a scientometric approach to assess global research trends, thematic evolution, and collaborative networks concerning fungi-derived anti-MRSA compounds. Bibliographic data were collected from the Scopus database, and a total of 1666 English-language articles and reviews published up to 2025 were analyzed using Bibliometrix/Biblioshiny and VOSviewer. The findings indicate a marked increase in research output after 2010, reflecting heightened scientific interest in fungal natural products for MRSA management. China and the United States emerged as leading contributors in terms of publication volume and international collaboration. Thematic analysis revealed a shift from broad antimicrobial screening to more specialized investigations, including antibiofilm activity, secondary metabolites, endophytic fungi, molecular docking, and antimicrobial resistance. Nonetheless, several challenges persist, such as insufficient mechanistic validation, limited toxicity and pharmacokinetic assessments, and a lack of clinically relevant in vivo studies. Overall, the field is increasingly multidisciplinary, integrating microbiology, natural product chemistry, and computational methodologies to advance the discovery of anti-MRSA agents. Full article

Impaired wound healing arises from interacting biological and material challenges, including persistent infection, biofilm formation, oxidative stress, unresolved inflammation, impaired angiogenesis, defective epithelialization, hemorrhage, and insufficient real-time assessment of wound status. Quantum dot (QD) and nanodot nanosystems have emerged as a versatile class of bioactive wound interfaces capable of addressing these barriers through functions that extend beyond passive coverage. This review synthesizes the design rationale, material composition, validation strategies, functional outcomes, mechanistic interpretation, and translational relevance of QD-enabled platforms for precision wound repair. Across the reviewed literature, carbon dots, graphene QDs, black phosphorus QDs, metal and metal oxide QDs, transition-metal nanodots, and hybrid nanocomposites were incorporated into hydrogels, films, sponges, nanofibers, microneedles, scaffolds, membranes, sprays, and injectable matrices. Their major precision-enabling attributes include localized antimicrobial and antibiofilm activity, redox-adaptive behavior, photothermal and photodynamic activation, inflammatory and macrophage modulation, hemostasis, controlled therapeutic delivery, angiogenic and epithelial support, and fluorescence-based monitoring. The strongest conceptual advance is the transition from static wound dressings toward adaptive biointerfaces that can sense, respond to, or compensate for local wound state abnormalities. Nevertheless, the field remains largely preclinical, with important gaps in long-term safety, standardized characterization, clinically predictive models, manufacturing reproducibility, regulatory alignment, and human validation. Future progress will depend on rationally simplified multifunctional platforms, rigorous comparative testing, wound state-specific evaluation frameworks, and translation-oriented safety and usability studies. QD nanosystems therefore represent a promising foundation for precision wound repair, provided that their multifunctionality is matched by equally rigorous evidence of safety, reproducibility, and clinical relevance. Full article

Intestinal fungal overgrowth (IFO) is an increasingly recognized yet underexplored component of gut dysbiosis with potential implications for gastrointestinal and systemic disease. While bacterial microbiota have historically garnered research attention, recent advances in sequencing technologies have highlighted the importance of the gut mycobiome in maintaining intestinal homeostasis. Disruption of fungal–bacterial balance, particularly involving Candida albicans, C. tropicalis, and C. glabrata, may contribute to symptom generation through immune activation, epithelial barrier dysfunction, biofilm formation, and the production of toxic metabolites such as acetaldehyde and candidalysin. Emerging clinical evidence suggests that IFO is associated with persistent gastrointestinal symptoms, including bloating, abdominal discomfort, and altered bowel habits, particularly in patients who do not respond to conventional therapies targeting bacterial overgrowth. Furthermore, fungal dysbiosis involving Malassezia restricta and Saccharomyces cerevisiae has been associated with inflammatory bowel disease, metabolic disorders, and systemic immune dysregulation; however, the nature and directionality of these relationships remain incompletely understood. Despite increasing recognition, the diagnosis of IFO remains challenging due to a lack of standardized criteria and validated non-invasive tools. Therapeutic strategies, including antifungal agents such as fluconazole and nystatin, as well as microbiome-targeted interventions, show promise but require further validation. This review provides a comprehensive synthesis of current evidence regarding the epidemiology, pathophysiology, clinical manifestations, diagnostic challenges, and therapeutic implications of IFO, with particular emphasis on species-specific mechanisms. Recognition of the intestinal mycobiome as a potentially important component of gut health may provide new perspectives for understanding gastrointestinal disorders and inform future precision medicine approaches. Full article

Invasive candidiasis remains a major cause of morbidity and mortality worldwide, with increasing relevance of non-Candida albicans species, particularly Pichia kudriavzevii, which is associated with high mortality and intrinsic resistance to fluconazole. This study evaluated the effect of voriconazole (VRC) on P. kudriavzevii growth, biofilm formation, and metabolic activity under different nutritional conditions. Planktonic growth and biofilm development were analyzed in Sabouraud dextrose broth (SDB), RPMI-1640, and RPMI-1640 supplemented with glucose (20 g·L⁻¹). Antifungal activity was assessed by optical density (OD₅₇₀) and XTT reduction assays, and biofilm morphology was examined by light microscopy. Glucose consumption was also determined during growth. VRC showed dose-dependent inhibition in SDB, reducing growth and biofilm metabolic activity by up to 94% and 98%, respectively. In contrast, in RPMI-1640, inhibition was significantly lower (≤27% growth and ≤77% biofilm reduction). Glucose supplementation partially restored antifungal susceptibility and increased biofilm metabolic activity. Growth kinetics confirmed VRC-induced delays in proliferation and impaired glucose utilization. These results demonstrate that VRC activity against P. kudriavzevii is strongly dependent on environmental nutrient availability, particularly glucose, which modulates fungal metabolism, biofilm development, and antifungal susceptibility, highlighting the importance of standardized antifungal susceptibility testing conditions and the role of metabolic state in azole efficacy. Full article

Orchid plants, due to their high aesthetic qualities of large inflorescences, long flowering period, and ease of care, have high commercial potential; however, when grown industrially in factories, they are susceptible to infectious diseases. In this study, we isolated from Phalaenopsis spp. plants epiphytic, rhizospheric, and endophytic bacteria associated with soft rot symptoms. Twenty-nine isolates exhibiting pectolytic activity were identified as strains of the genera Bacillus, Klebsiella, Microbacterium, Paenibacillus, Paracidovorax, Pseudomonas, and Psychrobacillus based on 16S rRNA analysis. These isolates were tested for their ability to produce cellulase, amylase, sucrase, proteinase, and lipase; to form biofilms; and to exhibit motility (swimming and swarming). Potato microplants under in vitro conditions were used as a model object for initial screening of the strains’ potential phytotoxicity. Most strains were shown to inhibit plant growth, particularly root development. Injection of suspensions of these strains into orchid leaves caused symptoms of soft rot. Thus, we isolated Gram-positive bacteria for the first time from orchid tissues with soft rot symptoms and demonstrated an association of these strains with plant tissue maceration in potato and orchids. Gram-positive bacteria with pectolytic activity are not typical pathogens of orchid soft rot and may require changes in approaches to the monitoring of phytopathogens for this group of plants. Full article

Untreated dental caries in permanent teeth is the most frequent disease of all 371 diseases and traumas assessed by the Global Burden of Disease Study in 2021, and there are reported to be 2.24 billion cases worldwide. Demineralization is a disintegration process of minerals and apatite crystals in hard tissue, provoked by biofilm activities, dietary factors, and the micro-oral environment—the three main mechanisms of dental caries. Restoration of mineral ions in the crystal structure is defined as remineralization. Remineralization enables the deposition of new minerals within the crystal structure of demineralized enamel, aiming to increase mineral production. Environments suitable for remineralization and inhibiting demineralization could be created by using a caries prevention agent. Objectives: Providing scientific evidence regarding Aloe vera as an alternative agent for caries prevention. Materials and Method: The method used in this study is a scoping review, utilizing the PRISMA-ScR as a guideline to conduct article screening and further analysis, following a thematic analysis approach. Database searches were conducted in PubMed, EBSCOhost, and ScienceDirect, based on the keywords generated. Results: A total of 13 articles were gathered for further analysis. Conclusions: Aloe vera shows promising preliminary potential, but further standardized in vivo and randomized clinical studies are necessary to confirm its remineralizing efficacy and clarify its mechanisms of action as a cavity prevention agent. Clinical Relevance: Using Aloe vera as an alternative caries prevention agent. Full article

Bacterial extracellular vesicles (BEVs) are nanoscale spherical lipid bilayer structures secreted by bacteria, including outer membrane vesicles (OMVs) released by Gram-negative bacteria and membrane vesicles (MVs) produced by Gram-positive bacteria. Although the biogenesis of BEVs requires substantial energy expenditure, these vesicles provide bacteria with strategic advantages in the evolutionary interplay between pathogens and hosts. BEVs contribute to bacterial adaptation to environmental stress by remodeling membrane components, eliminating toxic substances, promoting biofilm formation, and mediating the interbacterial transfer of antibiotic resistance determinants. They can also function as decoys to protect bacteria from bacteriophage or antibiotic attack, deliver virulence factors, modulate host immune responses to facilitate bacterial colonization, and mediate interspecies competition. This review summarizes the central roles of BEVs as bacterial mediators of environmental responses, with particular emphasis on their involvement in immune regulation, environmental adaptation, and interspecies competition, thereby providing new insights into pathogen evolutionary strategies. Full article