Search Results (10,951)

Triple-negative breast cancer (TNBC) lacking androgen receptor (AR) expression defines quadruple-negative breast cancer (QNBC), which is characterized by younger age at diagnosis, high Ki-67 index, and high genomic instability, however a comprehensive description of the genomic characteristics remains poorly defined. A total of 54 TNBC cases were categorized as TNBC with 100% AR expression (TNBC AR-100%) or QNBC, TNBC with 0% AR expression (TNBC AR-0%). Clinical, molecular, and genomic parameters, specifically pathogenic/likely pathogenic (P/LP) variants in homologous recombination repair (HRR) and cancer-related pathways were measured and analyzed. The QNBC cohort exhibited a high homologous recombination deficiency (HRD) score and a greater overall incidence of copy number variants (CNVs). QNBC harbored a higher mutation rate in TP53 and MYC signaling pathway than TNBC AR-100% tumors. P/LP variants corresponding to the HRR, PI3K/AKT, and RTK/RAS pathways were exclusively identified in QNBC. These results suggest that, at both molecular and genomic levels, the two groups are distinct, holding QNBC tumors more aggressive characteristics, genomic instability, and particular impairments in HRR and cancer-related pathways. In terms of actionability, these differences could potentially be leveraged through different combinations of therapies. Full article

Background: Leishmaniasis remains a major public health problem in Peru, and the Apurímac, Ene and Mantaro River Valley (VRAEM) is an endemic area where, despite its epidemiological relevance, information on incidence and circulating Leishmania species remains limited. Methods: We estimated district-level cumulative incidence of leishmaniasis in the 60 districts of the VRAEM during 2015–2024, using national surveillance data and census population figures. In addition, molecular species typing was performed on 112 Giemsa-stained tissue smears obtained in health facilities located in Ayacucho districts belonging to the VRAEM region. Results: A total of 3589 cases were reported, yielding an estimated annual incidence rate of 80.01 cases per 100,000 inhabitants, which is 4.3-fold higher than the national average. Marked spatial heterogeneity was observed, with districts such as Pangoa, Río Tambo, Llochegua, and Pichari reporting estimated annual incidence rates above 130 cases per 100,000 inhabitants. Furthermore, of 55 samples processed by High-Resolution Melting Analysis, Leishmania braziliensis was found in 54.6% of samples, followed by Leishmania guyanensis in 21.8%. Conclusions: The VRAEM constitutes a high-transmission endemic focus of tegumentary leishmaniasis with marked inter-district heterogeneity and circulation of multiple Leishmania species, with Leishmania braziliensis as the predominant species. These findings support the need for targeted surveillance and species-informed clinical management strategies. Full article

Background: Effective fluid management is critical for improving outcomes in patients undergoing chronic hemodialysis (HD). Relative blood volume monitoring (RBVM) supports the optimization of ultrafiltration rate adjustments; however, real-world evidence evaluating its impact on hospitalizations in chronic HD is limited. Methods: We conducted a retrospective, propensity score–matched observational cohort study comparing patient outcomes across 165 Fresenius Kidney Care clinics with high RBVM utilization (HI-RBVM; >90% of treatments) matched to 165 clinics not using RBVM (NO-RBVM). Data were collected from July to December 2022. Primary outcomes were patient-level all-cause and fluid-related hospitalizations and hospitalization days over a 6-month follow-up. Multivariable scaled Poisson regression models were used to estimate adjusted incidence rates, rate ratios, and rate differences. Secondary outcomes included patient-level changes in monthly clinical measurements. Results: 24,958 patients were included (11,840 across HI-RBVM clinics; 13,118 across NO-RBVM clinics). Adjusted incidence rates were lower in the HI-RBVM group compared to the NO-RBVM group for all-cause hospitalizations (1.57 vs. 1.70 per person-year [ppy]), fluid-related hospitalizations (0.30 vs. 0.35 ppy), and hospitalization days (9.60 vs. 10.8 ppy), corresponding to 119 fewer hospital days per 100 patient-years (95% CI: –184, −54; p < 0.001). Among patients with dialysis vintage ≤6 months, those treated in HI-RBVM clinics had smaller increases in pre-HD weight (–0.03 kg vs. +0.46 kg; p = 0.008) and ultrafiltration volume (0.11 L vs. 0.21 L; p = 0.004), and underwent more frequent estimated dry weight (EDW) adjustments (mean 7.73 vs. 6.61; p < 0.001). Conclusions: Among HD patients, high RBVM utilization at the clinic level was associated with lower rates of hospitalization. Prospective or quasi-experimental studies are needed to determine causality. Full article

Background/Objectives: Anal squamous cell carcinoma (SCCA) is an HPV-driven malignancy with rising incidence, yet systematic HPV genotyping across recurrences and metastases is lacking. We characterized the complete HPV genotype distribution across the disease course. Methods: We retrospectively analyzed 213 tumor specimens from 136 patients (82 female, 54 male) with histologically confirmed SCCA, spanning primary, recurrent, and metastatic disease (2009–2019 and from 2020 onwards). Patients contributed one or more specimens depending on the number of sampled disease events; specimens comprised 138 primary biopsies, 55 recurrence biopsies, 2 re-recurrence biopsies, and 18 distant metastases. HPV genotyping was conducted using a validated 28-type multiplex real-time PCR assay (Anyplex™ II HPV28, Seegene Inc.). Results: HPV DNA was detected in 179/213 specimens (84.0%; 95% CI 78.9–88.7) and 125/136 patients (91.9%; 95% CI 86.8–96.3). Across 269 HPV type detections, 24 distinct types were identified, with HPV 16 predominating both per-specimen (90.5%) and per-detection (60.2%) values. Non-HPV-16/18 high-risk types accounted for one in four high-risk detections (54/219; 24.7%; 95% CI 19.4–30.8). HPV positivity differed significantly by specimen type: 90.6% in primary biopsies versus 70.9% in recurrences (p = 0.001) and 72.2% in metastases (p = 0.038). Co-infections occurred in 24.6% of HPV-positive specimens (95% CI 18.5–31.6), with up to eight types. In metastases, the spectrum narrowed to 4 of 24 types; two harbored HPV 33 as the sole high-risk type. Conclusions: SCCA harbors a substantially broader HPV type spectrum than previously recognized. One in four high-risk detections lies beyond HPV 16/18, and high-risk types other than HPV 16 were the sole high-risk genotype detected in individual metastatic specimens. HPV positivity rates are significantly lower across specimen types, while the metastatic type spectrum converges on a few high-risk genotypes. Broad-spectrum HPV genotyping beyond types 16 and 18 warrants adoption as standard practice in SCCA diagnostics and surveillance, and potential stratification for HPV-directed therapies. Full article

The rapid expansion of biologic therapies for immune-mediated inflammatory diseases has raised significant clinical concerns regarding malignancy risk, particularly for patients with a history of cancer. This narrative review explores the safety of targeted therapies across dermatology, rheumatology, respiratory medicine, and gastroenterology to guide clinicians in these therapeutic dilemmas. We conducted a non-systematic review of the literature, prioritising longitudinal registry and real-world cohort data over clinical trials to better capture malignancy outcomes with long latency periods. Results indicate that tumour necrosis factor (TNF) inhibitors, which have the most extensive evidence base, do not consistently demonstrate an increased risk of overall incident malignancy or recurrence across specialties. Newer agents, including interleukin (IL)-17 and IL-23 inhibitors, show reassuring safety profiles in both trial and registry data. While dupilumab is associated with the potential diagnostic ‘unmasking’ of pre-existing cutaneous T-cell lymphoma, overall cancer rates remain stable among users. Most clinical guidelines support an individualised, multidisciplinary approach involving oncology consultation. We conclude that biologic agents can be used cautiously in certain patients with a history of malignancy following multidisciplinary discussion; however, in those with active malignancy there are no meaningful data that exist. Most evidence is heterogenous and excludes patients with a history of malignancy. Future management requires validated decision frameworks and mandatory participation in real-world patient co-created registries which leverage developing artificial intelligence tools to refine long-term safety assessments. Full article

On 14 February 2025, the outer cladding of the Chornobyl New Safe Confinement (NSC) was damaged by an explosion caused by a one-way attack unmanned aerial vehicle (UAV), creating a hole of about 15 m in diameter and requiring about 300 penetrations to be made in the cladding during firefighting. This created an urgent need to assess radiation dose rates above damaged areas to support repair planning and worker radiation protection. This study presents a UAV-based survey of the equivalent gamma dose rate distribution above the damaged northern side of the NSC outer cladding. The survey used a bespoke system, integrating a multirotor UAV, an AccuRad Personal Radiation Detector (PRD), onboard data acquisition and transmission modules, and ground-based and server-side analytical components. Measurements were performed under real post-incident field conditions, including restricted flight zones, wind-induced turbulence, proximity to large metallic structures, and electronic warfare interference. The dataset was filtered for Global Positioning System (GPS) reliability, transformed into a metric coordinate system, and processed for spatial interpolation and mapping. The resulting distribution showed a spatially non-uniform radiation field: the main damage zone had relatively low equivalent gamma dose rates, whereas the highest values, up to 1092 μSv/h, were recorded over areas of the NSC closest to the Shelter Object. The study demonstrates UAV-based radiation mapping of a damaged large-scale confinement structure and provides data supporting Chornobyl Nuclear Power Plant repair planning. Full article

Background/Objectives: Korea has experienced rapid and heterogeneous shifts in cancer epidemiology since 1999. We aimed to characterize divergent incidence trajectories across the 24 major cancer types, quantify sex-specific burdens, and project case counts through 2030. Methods: Annual incidence data—including new case counts and age-standardized incidence rates (ASIRs) per 100,000 (2020 Korean standard population) stratified by sex—were extracted from the KCCR via the Korean Statistical Information Service (KOSIS) for 1999–2023. Annual percent change (APC) was estimated by log-linear regression with 95% confidence intervals (CIs). Holt–Winters damped exponential smoothing generated 2024–2030 projections with 95% prediction intervals (PIs). Changes in case ascertainment and coding over the study period were considered in interpretation. Results: Total incidence increased from 101,854 (1999) to 288,613 cases (2023), a 183.4% increase. Overall ASIR rose from 402.7 to 522.9 per 100,000. Of the 24 cancer types, 15 showed statistically significant increasing ASIR trends, 6 showed significant decreasing trends, and 3 showed no significant change. The highest-APC cancers were thyroid (+7.56%), prostate (+6.98%), testis (+5.39%), breast (+5.03%), and corpus uteri (+5.03%; all p < 0.001). The largest significant declines occurred in cervix uteri (−3.81%), larynx (−3.18%), liver (−2.90%), and stomach (−2.20%; all p < 0.001). Female ASIR increased from 294.7 to 488.9 per 100,000 (+65.9%); male ASIR increased from 573.3 to 587.0 per 100,000 (+2.4%). Total cancer incidence is projected to reach 307,091 (95% PI: 281,200–332,983) in 2026 and 330,213 (95% PI: 290,663–369,763) by 2030, with the steepest projected relative growth for prostate (+48.9%), kidney (+33.7%), and breast (+31.3%) cancers. Conclusions: Korean cancer epidemiology is undergoing a pronounced transition from infection-related toward metabolic, hormonal, and aging-related malignancies, with a marked and widening sex-specific divergence. Cancer-type-resolved projections through 2030 provide an evidence base for strategic capacity planning in Korean oncology. Full article

Head and neck cancer (HNC) comprises a heterogeneous group of tumours, most often of squamous cell origin, characterized by both high morbidity and mortality rates. It is the seventh most common form of cancer diagnosed in humans, accounting for approximately 4.7% of all cancers. Among HNCs, neck squamous cell carcinoma (HNSCC) is predicted to become the most common form of human cancer. Some sources include oesophagus (ESCC) in this group due to their similar histology, being described as upper aerodigestive tract cancers (UADT). Unfortunately, 60–70% of cases are diagnosed late, i.e., at clinical stages III-IV. As a result, despite modern surgical techniques and oncological treatments, the survival rate remains below 40–60% due to frequent lymph node metastases and local tumour recurrence. There is a growing concern that diet and inflammatory dietary components may influence the initiation and development of HNSCC. The inflammatory potential of diets can be quantified by the Dietary Inflammatory Index (DII). The DII was derived from an analysis of 45 dietary constituents that either increase or decrease inflammation. Several recent clinical studies have noted a significant relationship between DII score and many inflammation-associated chronic diseases, such as obesity, cardiovascular and neurodegenerative disorders, and diabetes, and the incidence of various human cancers, i.e., prostate, ovarian, breast, colorectal cancer, and HNC. However, few studies have investigated the relationship between DII and HNSCC, with most being limited to observational, case-control, and cross-sectional studies. Therefore, the aim of this narrative review is to present the substantial oncological aspects of DII, discuss the use of DII and its modification, the Energy-Adjusted Dietary Inflammatory Index (E-DII), as indicators of HNSCC risk. It also introduces key diet-induced pro- and anti-inflammatory mechanisms and the cellular molecular signalling pathways determining the carcinogenesis of HNSCC. It provides a comprehensive overview of the current literature, including key opinion-forming systematic reviews, as well as molecular, observational, cross-sectional and case-control studies, all of which are accessible via scholarly databases such as PubMed/EMBASE/Web of Science. Thus, the work serves as a compendium of up-to-date knowledge on the relationship between DII/ED-II score and HNSCC etiopathogenesis and the influence of a diet-induced persistent inflammatory microenvironment. Full article

Background: Hearing health in Kazakhstan is documented through parallel administrative systems whose indicators are often conflated. We examined three administrative layers of hearing health during 2020–2025: dispensary registration of ear and hearing-loss diagnoses, disability certification as a severe administrative endpoint, and cochlear implantation (CI) as the specialised treatment response, with reference to Global Burden of Disease (GBD) 2021 estimates. Methods: We conducted a national ecological, region-year, multi-source administrative registry study across all 20 regions of Kazakhstan from 2020 to 2025. The dataset included 114 region-year observations and integrated Dispensary Report Form No. 12, the State Register of Persons with Disabilities, and the Electronic Register of Inpatient Patients. Dispensary indicators were interpreted as registered healthcare-utilisation measures, not population prevalence or incidence. Trends were assessed using Mann–Kendall tests with Benjamini–Hochberg false-discovery-rate correction. Regional patterns were examined using Spearman correlation, inequality metrics, and exploratory clustering. Results: Among adults, registered H60–H95 annual morbidity increased from 231,209 to 278,897 cases (CAGR +3.8%; FDR p = 0.016), and first-time registrations rose from 126,513 to 167,674 (CAGR +5.8%; FDR p = 0.016). Active dispensary observation declined modestly from 21,840 to 19,881. H65–H66 chronic otitis first-time registration remained stable, while active observation declined sharply. Paediatric H90–H91 registration was stable. In 2025, 31,560 persons were registered with hearing impairment-related disability, including 26,522 adults. CI procedures increased from 285 to 523. Adult CI activity was intermittent between 2012 and 2018 (peak 140 in 2013), ceased in 2019–2020, and was re-established from 2021 (14 → 129 procedures in 2025), reaching 24.7% of all CI. Most procedures were concentrated in Almaty and Astana. Compared with the GBD-2021 estimate of 17,212 per 100,000, administrative indicators captured much narrower service-utilisation and severe-certification layers. Conclusions: Kazakhstan’s administrative data describe distinct hearing-health layers rather than competing prevalence estimates. Adult screening, regional audiology capacity, post-CI rehabilitation, and longitudinal outcome registries are priority areas. Full article

Chronic inflammatory barrier diseases (CIBDs) affect many women of reproductive age, yet the safety of biologics during pregnancy remains inadequately investigated. This retrospective cohort study used the US Collaborative Network of TriNetX to evaluate the risk of adverse pregnancy outcomes (APOs) among women with CIBD receiving tumor necrosis factor inhibitors (TNFis), interleukin-23 inhibitors (IL-23is), or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), compared with untreated CIBD controls and the general pregnant population. Among 1842 pregnant women with CIBD receiving systemic therapy, 1188 were exposed to TNFis, 170 to IL-23is, 370 to azathioprine (csDMARD), and 114 to methotrexate (MTX) (csDMARD). The incidence of any APO ranged from 11% in untreated CIBD controls to 19% with ustekinumab (IL-12/23i). Among treatment groups, rates were 17% with TNFis, 18% with IL-23is, 13% with azathioprine, and 15% with MTX, compared with 17% in the general pregnant population. APO rates were comparable between the overall TNFi group and the TNFi group excluding certolizumab pegol (CZP) (TNFi). In the only non-exploratory comparison, TNFi exposure was associated with higher risks of (pre-)eclampsia and hypertension but a lower risk of abortion or intrauterine death versus CIBD controls, with no significant difference for overall APO. No treatment group showed a markedly increased overall APO risk, supporting tailored decision-making that balances the consequences of uncontrolled maternal disease against individual treatment-associated risks. Full article

The first case of Coronavirus Disease 2019 (COVID-19) in Tunisia was reported on 2 March 2020. This study aimed to describe the epidemiological evolution of the COVID-19 pandemic in Tunisia from March 2020 to December 2022 and to assess changes in key transmission indicators across the different phases and epidemic waves. We conducted a nationwide longitudinal descriptive study based on prospectively collected surveillance data including all laboratory-confirmed COVID-19 cases reported through the national surveillance system between March 2020 and December 2022. Descriptive analyses were performed to estimate screening rates, test positivity rates, cumulative incidence rates, and the time-varying effective reproduction number (Rt). During the three-year study period, Tunisia reported a cumulative incidence of 9562.05 cases per 100,000 inhabitants. The mean daily screening rate was 38.23 tests per 100,000 inhabitants, while the average positivity rate reached 16.03%. The mean effective reproduction number was estimated at 1.14 (95% CI: 1.11–1.17). The epidemic evolved through two distinct transmission phases. The first phase, extending from 2 March to 17 August 2020, was characterized by limited community transmission mainly associated with imported cases. The second phase was marked by sustained autochthonous community transmission and comprised five epidemic waves. Between March and May 2021, genomic surveillance identified the predominance of the Alpha Variant of Concern (VOC). The fourth wave was dominated by the Delta VOC until December 2021, whereas the fifth wave, occurring in 2022, was associated with the Omicron VOC. Continuous monitoring of transmission indicators through the national surveillance system provided timely evidence to support risk assessment, guide public health decision-making, and adapt prevention and control measures throughout the different phases of the pandemic in Tunisia. Full article

Background/Objectives: Miniscrew-assisted rapid palatal expansion (MARPE) is an effective treatment for maxillary transverse deficiency in skeletally mature patients. However, resistance of the midpalatal suture may limit treatment success. Surgical corticopunctures have been proposed to facilitate suture opening, while digital planning and 3D-printed surgical guides may improve procedural accuracy and safety. This study aims to evaluate the clinical effectiveness and safety of MARPE combined with surgically guided midpalatal corticopunctures in adult patients. Methods: A retrospective observational study was conducted on 15 adult patients (at least 20 years old) presenting with maxillary transverse deficiency and midpalatal suture maturation stages D or E. All patients underwent corticopuncture-assisted MARPE using patient-specific 3D-printed surgical guides designed through CBCT-based virtual planning. Treatment success was assessed by postoperative cone-beam computed tomography (CBCT), which evaluated midpalatal suture opening and transverse expansion. Clinical records were reviewed for complications, mini-implant stability, and postoperative outcomes. Results: Successful opening of the midpalatal suture was achieved in 13 of 15 patients, corresponding to a success rate of 86.7%. Among successful cases, the mean suture expansion measured on CBCT was 3.6 ± 0.9 mm. The customized surgical guides demonstrated adequate intraoral fit and enabled accurate execution of the planned corticopunctures in all cases. No intraoperative guide-related complications were reported. Postoperative healing was uneventful, with only mild and transient discomfort observed. No infections, excessive bleeding, significant soft-tissue injuries, damage to adjacent anatomical structures, or adverse events related to the corticopuncture procedure were recorded. Mini-implant stability was maintained in the majority of patients throughout the expansion phase. Conclusions: Within the limitations of this retrospective single-arm study, corticopuncture-assisted MARPE performed using customized 3D-printed surgical guides was feasible and associated with a high rate of successful midpalatal suture opening and few complications. The technique demonstrated a high rate of suture opening, clinically significant skeletal expansion, and a low incidence of complications. Digital planning and guided execution may enhance treatment precision and improve clinical outcomes in MARPE procedures. Full article

The risk of healthcare associated infections (HAIs) among hospitalized patients increased with the severity of COVID-19 disease and duration of hospitalization, especially in intensive care units (ICUs). This study retrospectively investigated HAI trends between March 2020 and December 2022 in patients with a COVID-19 diagnosis admitted to the exclusive ICU for the management of severe COVID-19 patients in the Molise region, central Italy. The clinical records of patients were anonymously coded and examined for the number of HAIs and microbiological isolations. Only infections that occurred after 48 h of ICU admission were included for descriptive, univariate and multivariate statistical analysis. Over the three-year period, 185 patients with a COVID-19 diagnosis (69.7% male, mean age 66.1 ± 10.6 years) were admitted to the hospital ICU: 50 (27.0%) in 2020, 94 (50.8%) in 2021, and 41 (22.2%) in 2022. During ICU stays, a high proportion of patients required at least one invasive device and died (97.2% and 88.1%, respectively). Death outcome was significantly associated with pre-existing comorbidities and related treatment, sex, and devices. During ICU stays, 80% received antimicrobial therapy, which was further related to death. At least one microbiological HAI was detected in 103 (55.9%) patients (76.6% male, mean age 65.4 ± 9.6 years). HAI incidence differed by year (p < 0.001), occurring in 36 (35.0%) patients in 2020, 54 (52.4%) in 2021, and 13 (12.6%) in 2022, respectively, and 80.6%, 96.0%, and 92.3% of patients died. A total of 268 isolations were observed: 99 (36.9%), 139 (51.9%) and 30 (11.2) in 2020, 2021 and 2022, respectively, and were mostly fungi in 2020 and 2022 (46.5% and 36.7%, respectively), while Gram-negative bacteria predominated in 2021 (36.7%). The study revealed higher HAI rates among patients in 2021 according to the increasing number of COVID-19 cases and related hospitalizations due to the Alpha variant at the local level, but also reflected the national epidemiology, while the decline in 2022 could be likely associated with the pandemic evolution and improvements in the management of COVID-19 patients. These findings further underline a high rate of lethality, more likely attributed to severe COVID-19 in patients with advanced age and underlying diseases, to which HAI onset could have undoubtedly contributed. The study provides useful epidemiological data regarding HAIs among critically ill COVID-19 patients during different phases of the pandemic across three years. Full article

Background/Objectives: Linear accelerator (LINAC)-based radiosurgery (SRS) is a well-established, non-invasive treatment for pharmacologically refractory trigeminal neuralgia. Despite its widespread use, long-term efficacy and recurrence rates remain incompletely defined, highlighting the need for extended follow-up studies to assess outcome durability. Methods: All patients diagnosed with trigeminal neuralgia and treated with LINAC-based SRS (60 Gy, 1–2 mm from the nerve root entry zone) between 2012 and 2019 at a single institution, a national reference center, were recruited for this study. Patients were divided into two categories based on the nature of their neuralgia: typical or atypical. Pain control was assessed using the Barrow Neurological Institute (BNI) scale at 12, 36 and 60 months, as well as time to improvement, recurrence, and adverse effects. Results: A total of 112 patients were analyzed, with a mean follow-up period of 105.14 (SD 30.65) months. Statistically significant differences in the success of pain control (BNI I–III) between patients with typical and atypical neuralgia were observed at all evaluated time points (12 months: 87.1% vs. 44.0%, 36 months: 77.0% vs. 22.0%, and 60 months: 60.7% vs. 18.0%) (p < 0.001). The mean time to improvement was 6.32 (SD 6.61) weeks (range 0–50), and the recurrence rate following initial improvement was 47.1%. Treatment-related adverse clinical events occurred in 5.4% of patients. Conclusions: Long-term pain control is achieved in refractory trigeminal neuralgia cases with LINAC-based SRS, especially in typical cases, with a low incidence of complications. Full article

Fruit rot caused by Lasiodiplodia pseudotheobromae poses a serious threat to longan (Dimocarpus longan Lour.) production. The present study evaluated antagonistic and phosphate-solubilizing bacteria for their potential use in environmentally responsible disease and soil management. Two complementary Bacillus isolates were selected. Bacillus amyloliquefaciens UPBA63 exhibited strong antagonistic activity against L. pseudotheobromae, whereas Bacillus subtilis SBP04 demonstrated superior phosphate-solubilizing and plant-growth-promoting traits. Their combined application provided complementary benefits for disease suppression and soil phosphorus availability. Biochemical assays and molecular identification using concatenated 16S rDNA and gyrB sequences assigned UPBA63 to Bacillus amyloliquefaciens and SBP04 to B. subtilis. Both isolates produced extracellular protease, cellulase, and amylase. UPBA63 significantly reduced fruit rot incidence in planta and during field trials, whereas SBP04 exhibited the greatest phosphate-solubilizing activity. Field application of UPBA63 and SBP04 combined with organic matter and a chemical fertilizer and fungicide at half the recommended doses reduced disease incidence to 15.40 ± 7.42% and improved yield relative to the untreated control. The integrated treatment combining Bacillus spp. with organic matter, half-rate chemical fertilizer, and half-rate fungicide resulted in a soil pH of 4.56, an organic matter content of 2.92%, and an available phosphorus of 149.25 mg kg⁻¹. Multifunctional Bacillus strains demonstrated dual capacity for pathogen suppression and nutrient mobilization, supporting their potential application in sustainable disease control and soil fertility management in longan orchards. Full article