Search Results (1,799)

Background: Myocardial perfusion imaging (MPI) plays a central role in the noninvasive evaluation of myocardial ischemia and in guiding clinical management in patients with suspected or known coronary artery disease. While ischemic burden is an established component of MPI interpretation, the relationship between ischemia localization and the procedural strategy recorded among patients undergoing percutaneous coronary intervention (PCI) remains less well defined. This study aimed to evaluate whether the anatomical localization of ischemia identified by MPI was associated with the two PCI procedural categories recorded in the study dataset (Stent versus PTCA + stent). Methods: In this retrospective cohort study, 328 patient records were assessed for eligibility and 268 patients with complete MPI localization and treatment data were included. Seven patients received medical therapy alone and 261 underwent percutaneous coronary intervention (PCI); no patient underwent coronary artery bypass grafting (CABG). Within the PCI subgroup, the mutually exclusive patient-level source labels were Stent (including capitalization variants) and PTCA + STENT; no PTCA-only category was present. Because of the small medical-therapy group, inferential analyses were restricted to the 261 PCI patients. The overall association between the 13 ischemia–localization categories and PCI procedural category was assessed using the Fisher–Freeman–Halton exact test with Monte Carlo estimation. Multivariable logistic regression was performed with Stent as the dependent category and age, sex, anterior involvement, and multiregional ischemia as explanatory variables. Results: Among the 261 patients undergoing PCI, 144 were recorded in the Stent category and 117 in the PTCA + stent category. Across all 13 ischemia–localization categories, no statistically significant overall association was observed between ischemia localization and PCI procedural category (Fisher–Freeman–Halton exact test with Monte Carlo estimation, p = 0.7843). In multivariable analysis, anterior involvement (adjusted OR 1.02, 95% CI 0.58–1.82; p = 0.935) and multiregional ischemia (adjusted OR 0.69, 95% CI 0.33–1.41; p = 0.304) were not significantly associated with procedural category. Age was also not significantly associated with procedural category (adjusted OR 1.00, 95% CI 0.97–1.03; p = 0.993). Male sex was associated with lower adjusted odds of being in the Stent category relative to PTCA + stent (adjusted OR 0.40, 95% CI 0.23–0.70; p = 0.0012). Conclusions: In this cohort of patients undergoing PCI, ischemia localization was not significantly associated with the recorded procedural category (Stent versus PTCA + stent). The observed association with sex was secondary and should be interpreted cautiously. Given the very small medical-therapy group, no reliable conclusions can be drawn from this cohort regarding the likelihood of PCI versus medical management or comparative treatment efficacy. Full article

The intestinal microbiome has emerged as a clinically significant modulator of outcomes across multiple domains of cancer care. In hematopoietic stem cell transplantation (HSCT), loss of microbial diversity and depletion of short-chain fatty acid-producing commensals are independently associated with graft-versus-host disease (GvHD), bloodstream infections, transplant-related mortality, and overall survival. Mechanistic studies have identified interconnected pathways—including butyrate-mediated epithelial protection, tryptophan-derived aryl hydrocarbon receptor signaling, bile acid metabolism, and Paneth cell–intestinal stem cell interactions—through which microbial communities regulate intestinal barrier integrity and immune homeostasis. These insights have provided the biological rationale for therapeutic strategies aimed at restoring microbial ecology. Fecal microbiota transplantation (FMT) has demonstrated promising clinical activity in steroid-refractory acute GvHD, with one meta-analysis reporting a pooled clinical remission rate of 64% (95% CI, 51–77%) across prospective single-arm studies, and proprietary live biotherapeutic products (LBPs) such as MaaT013 met the primary endpoint of the single-arm phase III ARES trial, achieving a day-28 gastrointestinal overall response rate of 62%; however, the CHMP adopted a negative opinion on its conditional marketing authorization application in June 2026, citing limitations of the single-arm design, and a re-examination is pending. In parallel, gut microbiome composition has been associated with immune checkpoint inhibitor (ICI) response, and early-phase FMT studies suggest that microbiome modulation may restore sensitivity to anti-PD-1 therapy in some patients with refractory melanoma and may enhance treatment responses in first-line ICI settings; however, these findings derive primarily from small, uncontrolled or early-phase studies. Defined single-strain approaches, notably Clostridium butyricum MIYAIRI 588 (CBM588), have shown encouraging secondary clinical efficacy signals in two small, randomized phase I trials in metastatic renal cell carcinoma, including significantly prolonged progression-free survival in one trial and a higher objective response rate in another; however, neither trial met its prespecified primary microbiome endpoint of increased Bifidobacterium spp. abundance. Emerging evidence further links antibiotic-induced dysbiosis to impaired chimeric antigen receptor T-cell (CAR-T) therapy outcomes, while short-chain fatty acids have been identified as direct enhancers of CAR-T cell effector function. This review synthesizes the current evidence for microbiome-based therapeutics across HSCT, GvHD, ICI therapy, CAR-T cell therapy, and infection prevention, and addresses cross-cutting translational challenges including antibiotic stewardship, donor selection, safety in immunocompromised populations, and pharmacomicrobiomics. While randomized controlled trial data remain limited and many approaches are investigational, the convergence of mechanistic, observational, and early interventional evidence positions microbiome restoration as a promising frontier in precision oncology. Full article

Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae causes difficult-to-treat bloodstream infections in patients with haematological malignancies, particularly after allogeneic haematopoietic stem cell transplantation (allo-HSCT). Carbapenems remain reliable, but their anti-anaerobic activity may aggravate intestinal dysbiosis and increase selection pressure for carbapenem resistance. Cefepime–enmetazobactam is a novel fourth-generation cephalosporin/β-lactamase inhibitor combination active against many class A ESBL-producing Enterobacterales. We describe a profoundly immunocompromised patient with acute myeloid leukaemia after allo-HSCT, grade III steroid-refractory gastrointestinal graft-versus-host disease, and intestinal colonization by an ESBL-producing K. pneumoniae isolate resistant to ceftolozane–tazobactam. The patient developed persistent bacteraemia and right pyelonephritis with small renal abscess-like lesions. Meropenem was rapidly de-escalated to cefepime–enmetazobactam, with temporary adjunctive fosfomycin and subsequently tigecycline. Blood-culture time to positivity progressively lengthened from 1.18 h to 16 h before cultures became negative. Serial cefepime therapeutic drug monitoring permitted repeated assessment of exposure and neurological toxicity risk. Whole-genome sequencing identified K. pneumoniae ST307 carrying bla_CTX-M-15, bla_TEM-1, bla_SHV-28, and bla_OXA-1, together with multiple resistance determinants and a large conjugative plasmid. This case describes the use of cefepime–enmetazobactam as part of a targeted carbapenem-sparing strategy for invasive ESBL-producing K. pneumoniae infection in a highly immunocompromised allo-HSCT recipient. Full article

Tomato (Solanum lycopersicum L.) is one of the most important solanaceous crops due to its economic and nutritional relevance. It hosts a wide range of plant pathogens, including a recombinant strain of potato virus Y (PVY^C-to), which is considered one of the major threats in tomato cultivation. PVY^C-to, a single-stranded RNA plant virus (family Potyviridae), mainly causes symptoms of mosaic, chlorosis, and vein necrosis in the leaves of horticultural crops, resulting in significant production losses. The ongoing evolution of viral strains, combined with the absence of natural resistance genes in commercial germplasm, requires the exploration of alternative management strategies, such as grafting, and the identification of resistant genetic resources within local biodiversity. This study aims to evaluate the response of five local tomato ecotypes (LTEs) from the Campania region—Corbarino, Giallo determinato da serbo, Pizzutello, San Marzano, and Vesuviano—to PVY^C-to infection. The goal is to identify a naturally tolerant ecotype for use as a rootstock for commercial tomato varieties and expand the pool of resilient genetic resources against viral diseases. Visual symptom evaluation at 14 and 28 days post-inoculation (dpi), quantification of virus accumulation by qDot-blot, and thermal imaging analysis showed that all tested tomato ecotypes were susceptible to PVY^C-to infection, although at different levels among the tested ecotypes. More specifically, Corbarino showed no significant changes in canopy temperature values, fewer symptoms, and reduced virus accumulation upon PVY^C-to infection, compared to the other LTEs, and was therefore selected as a rootstock in subsequent experiments. The reduction in both symptom severity and viral RNA accumulation observed in grafted plants, combined with the mitigation of thermal stress in grafted scions, confirmed the efficacy of grafting as a viable management strategy and eco-friendly cornerstone for safeguarding regional agro-biodiversity against escalating viral pressures. Full article

Grafting is a crucial strategy for improving stress resistance and fruit quality in grape production. However, our understanding of the specific roles of rootstocks in graft establishment, vine growth, and nutrient acquisition remains limited. This study evaluated the relevant traits of three worldwide wine grape cultivars grafted onto eight rootstocks, aiming to clarify the inherent characteristics of individual rootstocks and provide insights for their better understanding and utilization. The rootstock showed significant effects on petiole mineral levels with consistent patterns, even across developmental stages and years. For example, 5BB consistently accumulated Ca at all stages, while Beta demonstrated strong Mn uptake. Additionally, 101-14M and 110R specifically enriched B at the flowering stage. The scion showed a great influence on post-graft growth and mineral absorption. Specifically, ‘Cabernet Sauvignon’ (CS) exhibited superior performance in macronutrient accumulation, whereas ‘Petit Verdot’ (PV) showed distinct advantages in micronutrient. From flowering to veraison, the dominant mineral profile shifted from N, P, and B to Ca, Mg, and Cu, with the scion’s influence becoming evident at veraison. These findings enhance our understanding of rootstocks and provide a reference for their utilization. Full article

Bone defects remain difficult to treat because conventional grafting approaches may cause infection, inflammation, donor-site morbidity, or graft rejection. Mesoporous silica nanoparticles (MSNs) have emerged as versatile nanomaterials for drug delivery owing to their large surface area, tunable pore structure, high loading capacity, and readily modifiable surfaces. However, conventional MSNs are relatively bioinert and provide limited direct stimulation of bone regeneration. Incorporating therapeutic metal ions into the silica framework through in situ co-condensation can improve their biological activity while retaining their drug-delivery advantages. This review highlights recent advances in ion-doped MSNs as multifunctional delivery systems for bone regeneration, focusing on their osteogenic, angiogenic, anti-inflammatory, and antibacterial effects. The review discusses how ion doping influences particle structure, biodegradation, drug loading, and release behavior and the potential of single- and multiple-ion systems to provide complementary or, where experimentally demonstrated, synergistic therapeutic effects. Particular attention is given to controlled and spatiotemporal delivery strategies designed to match the sequential phases of bone healing. Future research should improve synthetic reproducibility, establish ion-specific therapeutic windows, integrate stimuli-responsive release mechanisms, and confirm long-term safety and efficacy in clinically relevant animal models. Full article

Almond expeller is high in protein content and produced in large quantities every year; however, its utilization in the food industry remains limited. To provide new strategies to enhance the performance of protein-based emulsion gels and expand the applications of sweet almond expeller globulin (SAEG) in the food industry, emulsion gels were formed using sweet almond expeller globulin modified by ultrasonication and chlorogenic acid conjugation (SAEG-UCA) in this study. The results showed that ultrasonication and chlorogenic acid grafting improved the emulsifying capacity (from 67.51 to 143.65 m²/g) and emulsion stability (from 70.37% to 87.18%) of SAEG by increasing its solubility and interface sorption capacity and enhancing the zeta potential within the emulsion (p < 0.05). Compared with the SAEG-emulsion gel, the SAEG-UCA-emulsion gel exhibited a more compact and denser gel structure, higher crystallinity (30.71%), bound water content and viscosity, and superior rheological stability (lower loss factor) and elasticity. Furthermore, the SAEG-UCA-emulsion gel showed superior oxidative stability, and higher chewiness (32.35 g), springiness (0.77), hardness (78.63 g), and cohesiveness (0.72) than SAEG-emulsion gel. Additionally, the SAEG-UCA-emulsion gel improved the photostability, encapsulation and loading capacities, and bioaccessibility of curcumin (p < 0.05). However, more specific mechanisms should be investigated in future research. Full article

Background: Renal cell carcinoma (RCC) arising in a kidney allograft is a rare but challenging condition, requiring a careful balance between oncologic control and preservation of graft function. Minimally invasive nephron-sparing approaches may represent a valuable treatment option in selected recipients. Case Presentation: We report the case of a 59-year-old kidney transplant recipient diagnosed with papillary RCC in the renal allograft during routine imaging follow-up. The patient underwent CT-guided percutaneous cryoablation, combined with conversion of immunosuppressive therapy to an mTOR inhibitor-based regimen. The procedure was completed successfully without complications, and graft function was preserved. At 3-year follow-up, no evidence of local recurrence or distant metastasis was detected, with stable renal function maintained throughout the observation period. Conclusions: This case highlights the feasibility and effectiveness of percutaneous cryoablation as a nephron-sparing treatment for RCC arising in a renal allograft. In carefully selected high-risk transplant recipients, this approach may provide durable oncologic control while preserving graft function. Full article

To mitigate clay hydration and wellbore instability during deepwater drilling, a pH/temperature dual-responsive graft copolymer, hyperbranched polyethylenimine-g-poly(2-(dimethylamino)ethyl methacrylate) (HPEI-g-PDMAEMA), was designed and synthesized via free radical polymerization. Optimized synthesis at an HPEI/DMAEMA mass ratio of 1:2 with 2.4% AIBN at 70 °C for 10 h yielded a grafting ratio of 35.2% and a molecular weight of 84.3 kDa. The copolymer exhibits a tunable lower critical solution temperature (LCST) of approximately 48 °C at pH 8, decreasing with increasing pH due to tertiary amine deprotonation. Zeta potential measurements confirm that the polymer retains a positive charge (+5 mV at pH 8) under weakly alkaline conditions, enabling strong electrostatic anchoring onto negatively charged clay surfaces. Above the LCST, dynamic light scattering reveals a sharp increase in hydrodynamic diameter from ~30 nm to >200 nm, confirming a hydrophilic-to-hydrophobic transition of PDMAEMA segments that drives the formation of a hydrophobically associated gel barrier. This thermally triggered gelation is fully reversible, as evidenced by repeated heating–cooling cycles with almost complete transmittance recovery. The gel barrier drastically reduces water uptake, with inhibition performance against clay swelling at 60 °C being 18.5 percentage points higher than that at 25 °C. Hot-rolling tests demonstrate that with only 1.5 wt% inhibitor, shale recovery reaches 94.1% at 150 °C (8.8 percentage points higher than unmodified HPEI) and remains above 60% even in 20 wt% CaCl₂ or MgCl₂ brines, highlighting exceptional resistance to divalent cations. Water contact angle on treated clay surfaces increases from 18.5° to 52.6°, confirming effective surface hydrophobization. This work provides a molecular-level gel-engineering strategy where pH governs electrostatic anchoring and temperature triggers reversible hydrophobic gelation, enabling on-demand switching of clay wettability and hydration resistance under high-temperature, high-salinity conditions. Full article

Tannic acid grafting provides a practical strategy for introducing bioactive phenolic functionality into microbial polysaccharides for multifunctional hydrogel design. Herein, tannic acid-modified succinoglycan (SG-TA) was prepared through an ascorbic acid/ H₂O₂-mediated free-radical process. Spectroscopic, thermal, and purification-control analyses were consistent with covalent incorporation of tannic acid-derived moieties into SG, while characteristic structural features of the SG framework remained evident after modification. SG-TA exhibited tannic acid-equivalent phenolic contents of up to 321.9 mg TAE/g and markedly enhanced antioxidant and antibacterial activities compared with native SG. SG-TA was subsequently incorporated into a poly(vinyl alcohol) (PVA)/borax network to form dynamic SG-TA/PVA/borax (STPB) hydrogels based on reversible interactions. The hydrogels exhibited composition-dependent viscoelasticity, rapid rheological recovery, macroscopic self-rejoining, enhanced deformability, antioxidant and antibacterial functionality, and preliminary cytocompatibility. Time-dependent phenolic release showed that SG-TA-derived phenolic species were partially released from the network, indicating contributions from both matrix-associated and releasable functionality. The reversible network also enabled pH- and glucose-responsive release of 5-fluorouracil as a model small-molecule drug. These findings demonstrate the potential of SG-TA as an intrinsically bioactive microbial polysaccharide for multifunctional, self-healing, and stimuli-responsive drug-delivery hydrogels. Full article

Peripheral nerve injuries are common traumas that are difficult to overcome. Although nerve grafting can quickly recover nearly all sensitivity and function, graft availability remains an issue. Research has focused on ways to directly rebuild and promote the healing of damaged nerves using surgically implanted scaffolds. Nerve regeneration can be further promoted through strategies aimed at enhancing the regenerative microenvironment, such as improving the electrical conductivity of nerve guidance conduits. In this study, composite films of chitosan (Ch) and carboxymethyl cellulose (CMC) nanofibers were prepared. To improve the films’ conductivity, reduced graphene oxide (RGO) was added. Structural analysis indicated interactions between Ch and CMC and showed that incorporation of RGO did not produce additional detectable crystalline phases. ChCMCRGO films showed slightly higher conductivity and greater surface hydrophilicity than ChCMC membranes and supported greater neurite outgrowth. Full article

Background/Objectives: Mastoid obliteration is being increasingly used to reduce cavity-related morbidity after mastoidectomy. Alongside autologous grafts, synthetic biomaterials and tissue-engineering approaches have emerged as potential alternatives. This systematic review synthesized the clinical and preclinical evidence on biomaterials for mastoid obliteration, focusing on efficacy, safety, biological integration, and translational potential. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant search of PubMed, Scopus, and Web of Science identified studies published between January 2010 and May 2026. Eligible studies evaluated biomaterials for mastoid obliteration in clinical settings or experimental models. Data on study design, biomaterial type, intervention, outcomes, complications, and biological endpoints were extracted. Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I), Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB 2), and the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk-of-bias tool. Results: Twenty-eight studies were included (19 clinical, 9 preclinical). Clinical evidence supported mastoid obliteration as an effective strategy for improving cavity stability, reducing chronic otorrhea, promoting epithelialization, and aiding cholesteatoma control. Outcomes appeared to depend more on successful cavity elimination than on the superiority of a specific biomaterial. Autologous materials showed reliable and reproducible results, while S53P4 bioactive glass demonstrated comparable effectiveness with additional antibacterial properties. Hydroxyapatite-based materials and allografts showed more variable outcomes. Biologically enhanced approaches, including concentrated growth factors and composite constructs, yielded promising but limited clinical evidence. Preclinical studies indicated that conventional biomaterials are primarily osteoconductive, whereas composite scaffolds, bone morphogenetic protein-2 (BMP-2) delivery systems, and stem cell-based strategies may enhance osteogenesis and tissue integration. However, clinical translation remains limited. Conclusions: Mastoid obliteration is an effective reconstructive strategy whose success depends mainly on stable cavity reduction and adequate epithelial coverage. Autologous materials and S53P4 bioactive glass currently have the strongest clinical support, whereas advanced tissue-engineering approaches require further validation through prospective comparative studies, standardized outcomes, long-term follow-up, and translational research. Full article

Background: Injectable bone graft substitutes offer a practical alternative to preformed ceramic scaffolds by adapting to irregular bone defects while preserving osteoconductive properties. This study investigated the in vivo performance of hydroxyapatite/tetracalcium phosphate (HA/TTCP) granules, uncoated or alginate-coated, with or without autologous ovine bone marrow concentrate (oBMC), in a standardized sheep bone defect model. Methods: oBMC was characterized for cellular composition, viability, and recovery. Implanted HA/TTCP formulations were evaluated after 6 and 12 weeks by micro-computed tomography and histomorphometry. Results: Uncoated HA/TTCP granules promoted bone formation, integrating with host bone. Alginate coating improved injectability and handling but influenced granule organization and degradation. Uncoated HA/TTCP + oBMC showed a more favorable response than the coated formulation, with higher bone-to-implant contact (p = 0.004) and bone volume (p = 0.031) at 12 weeks. A modest increase in peri-implant bone volume was observed from 6 to 12 weeks in the HA/TTCP + oBMC group, though this did not retain statistical significance once clustering was accounted for. No significant direct effect of oBMC was observed compared with the cell-free formulation. Conclusions: Injectable HA/TTCP granules + oBMC represent a promising single-step strategy for irregular bone defects, although further coating optimization is needed to preserve biological performance while maximizing handling advantages. Full article

Background: Traumatic auricular amputation represents a rare but complex reconstructive challenge, and numerous surgical techniques have been developed over the past century to optimize functional and aesthetic outcomes. This historical review examines current auricular reattachment and replantation strategies by comparing established surgical techniques for traumatic auricular amputation. Methods: A historical literature search was conducted in PubMed to identify relevant case reports on auricular reconstruction following amputation, dating from 1898 to the present. Eligible studies were reviewed according to the surgical technique used: composite graft reattachment, local flap, pocket techniques, rib cartilage reconstruction, microsurgical replantation, and tissue engineering. Key milestones were documented chronologically and visualized in a timeline. Results: A total of six major reconstructive approaches were identified in the literature, highlighting the historical evolution of auricular replantation methods from 1898 to 2018. Compiled data were visualized to underscore the procedural development and categorize surgical innovations over time. Conclusions: This review presents a synthesized treatment algorithm that integrates historical context and modern adaptations of auricular replantation techniques. The integrated approach provides a structured framework for managing auricular amputations and promotes standardized practices to optimize functional and aesthetic outcomes in auricular reconstructive surgery. Full article

Kombucha fermentation generates two fractions of potential relevance to food-packaging applications: a fermented liquid containing organic acids, polyphenols and other metabolites, and a cellulose-rich pellicle formed by cellulose-producing acetic acid bacteria. However, the fermented beverage, raw pellicle and purified kombucha-derived bacterial cellulose (KBC) differ substantially in composition, functionality and food-contact suitability and should not be treated as interchangeable materials. This review critically examines bacterial cellulose formation during kombucha fermentation, purification and modification strategies, packaging-relevant properties, and the application of kombucha-derived materials in films, coatings and composites. Purified KBC provides a continuous nanofibrillar network and can exhibit good mechanical and oxygen-barrier properties under dry conditions. Its hydrophilic character, however, promotes moisture sorption and swelling, which may impair mechanical integrity and barrier performance at elevated relative humidity. Blending, coating, grafting and crosslinking can improve selected material properties, but their effects are formulation-specific and may involve trade-offs between moisture resistance, mechanical performance, biodegradability and food-contact safety. Fermented kombucha liquid and native or mildly washed pellicles may contribute fermentation-derived bioactive compounds; however, antioxidant or antimicrobial activity measured in the beverage or raw pellicle cannot be automatically attributed to purified KBC or the final packaging material. Current evidence supports the use of KBC as a structural matrix, reinforcing phase, coating component or carrier of active substances. Nevertheless, limited migration data, heterogeneous testing conditions, insufficient real-food studies and a lack of pilot-scale, regulatory and life-cycle assessments currently restrict its broader industrial implementation. Full article