Search Results (1,140)

Background: Fragility fractures of the pelvis (FFP) are increasingly encountered in older adults, yet early deterioration is difficult to anticipate because fracture instability interacts with frailty and systemic vulnerability. We developed and validated an admission-based multimodal framework to predict 90-day treatment failure (TF90) before definitive management. Methods: This multicentre retrospective prediction study included 1684 consecutive patients aged ≥65 years with FFP treated at five tertiary hospitals. TF90 was defined as persistent fracture-related pain or immobility, delayed conversion to operative stabilisation, secondary displacement, FFP-related unplanned readmission, revision or unplanned reoperation, or all-cause mortality within 90 days. Only predictors available within 24 h of admission and before the definitive treatment decision were eligible, including CT-defined fracture morphology, frailty, clinical characteristics and routine laboratory biomarkers; DXA and specialised bone metabolism measurements were evaluated separately in an extended model. Four prespecified models were developed in 985 patients, temporally validated in 520 patients and evaluated in a completely held-out Centre E internal–external validation cohort of 179 patients, with additional leave-one-centre-out internal–external cross-validation. Results: TF90 occurred in 307 patients (18.2%) and increased from 8.1% in FFP I to 37.1% in FFP IV. Higher risk was associated with advanced age, greater frailty, impaired prefracture mobility, bilateral posterior ring injury, greater displacement, systemic inflammation, hypoalbuminaemia and renal dysfunction. In temporal validation, AUROCs were 0.732 for the simple logistic model, 0.763 for the core logistic model, 0.759 for the core random forest and 0.755 for the extended random forest. Neither greater algorithmic complexity nor specialised skeletal measurements provided reproducible incremental value. A development-derived high-risk stratum had a TF90 incidence of 32.2% and contained 70.0% of all events. At the fixed threshold of 0.209, sensitivity was 71.3%, specificity 70.0% and negative predictive value 93.1%. Conclusions: Pretreatment integration of pelvic ring mechanics, frailty and routinely available systemic biomarkers enables clinically relevant enrichment of older patients at risk of TF90. The model is best positioned to support intensified surveillance and structured reassessment rather than determine operative treatment. Independent prospective external validation, recalibration and clinical impact evaluation are required before routine implementation. Full article

Dengue is a mosquito-transmitted viral disease caused by the positive-sense RNA dengue virus (DENV), which comprises four antigenically distinct serotypes (1–4). Although DENV circulates predominantly in tropical and subtropical regions, its global incidence continues to increase. As most patients present viremia at the onset of clinical manifestations, real-time RT-PCR has become a widely adopted method for early dengue detection. The AP Biotech Discovery^® Dengue Virus RT-PCR Detection Kit enables qualitative detection of DENV RNA (serotypes 1–4) by real-time RT-PCR in serum or plasma samples. The assay was recently cleared by ANMAT (National Administration of Drugs, Food and Medical Technology) as an in vitro diagnostic (IVD) assay. The Limit of Detection (LoD) was calculated for all 4 serotypes. Clinical validation was conducted among 296 serum and 221 plasma samples previously characterized as DENV-positive and -negative specimens. Among the positive samples, 56 had serotype characterization, including 25 DENV-1 and 31 DENV-2 samples. The resulting clinical sensitivity and specificity were 97.8%, 100.0% and 100.0%, 99.1% respectively. Additional validation studies demonstrated high reproducibility across three independent laboratories, absence of cross-reactivity with other febrile pathogens, and no interference from endogenous and exogenous substances at clinical levels. Collectively, these findings support the AP Biotech Discovery^® Dengue Virus RT-PCR Detection Kit (AP Biotech, Lomas de Zamora, Argentina) as a sensitive, specific, and highly reproducible device for early dengue diagnosis and surveillance. Full article

Real-time monitoring of radioactive liquid effluents from nuclear power plants (NPPs) is essential for environmental safety assurance, yet existing liquid scintillation counting (LSC) instruments are bulky (>200 kg), laboratory-bound, and incapable of autonomous online deployment. This paper presents the design and implementation of a fully automated online LSC monitoring process integrating seawater sampling, distillation pre-treatment, liquid scintillator mixing, dual photomultiplier tube (PMT) coincidence detection, field-programmable gate array (FPGA)-based digital signal processing, and 4G remote data transmission in a single portable unit weighing 21.59 kg. The automated process executes a complete sample-to-result cycle in approximately 45 min without human intervention. The signal processing chain comprises a dual-PMT coincidence system, a custom two-stage pre-amplifier, a 14-bit 40 MSPS analogue-to-digital converter (ADC; AD9245, Analog Devices, Norwood, MA, USA), and a five-stage FPGA pipeline implementing anti-coincidence rejection, pulse amplitude discrimination, charge comparison method (CCM) waveform discrimination, and convolutional neural network (CNN)-based alpha/beta classification achieving 97.4% accuracy on a Geant4-simulated test set. System performance was validated against a PerkinElmer 1220 QUANTULUS reference spectrometer across a five-point calibration range (0–400 Bq/L; R² = 0.9987, recovery 99.4–101.6%), confirmed via third-party environmental testing (−10 °C to +50 °C, GB/T 2423.1-2008), and verified in field measurements at Tianwan Nuclear Power Plant. The experimentally determined system background is (1.83 ± 0.12) cpm; the calculated minimum detectable activity (MDA) for tritium is 0.073 Bq/mL at 30 min counting time (η = 3.4%, V = 10 mL, T_s = 1800 s per the Currie formulation), satisfying the GB 14587 (the Chinese national standard: Limits of Radioactivity for Liquid Effluents from Nuclear Power Plant) regulatory reference limit of 0.5 Bq/mL with a 7× safety margin. The proposed system is, to the authors’ knowledge, the first reported instrument combining full process automation (including distillation pre-treatment), single-person portability, and real-time 4G remote data transmission for continuous NPP liquid effluent surveillance in high-salinity seawater environments. Full article

Background and Objectives: Urinary tract infections are common in clinical practice, but in hospital settings, especially among older and catheterized patients, the microbial ecology and resistance burden may differ substantially from community-acquired infections. Local surveillance is therefore essential to support appropriate empirical treatment and antimicrobial stewardship. The objective is to describe the microbiological epidemiology of urinary isolates in a tertiary hospital and evaluate temporal trends in antimicrobial resistance among the most frequently isolated microorganisms. Materials and Methods: This retrospective observational study analyzed microbiology laboratory data from Tor Vergata University Hospital, Rome, Italy, collected from January 2022 to June 2025. After WHONET-based deduplication using a 30-day repeat-isolate rule, 5788 deduplicated urinary isolates and 85,888 microorganism–drug associations were included. Descriptive analyses, cumulative antibiograms/antimycograms, and quarterly resistance trends were assessed using univariable and multivariable regression analyses. Results: The population was predominantly elderly, inpatient, and catheter-exposed. Gram-negative organisms predominated, followed by Gram-positive bacteria and fungi. The most frequent isolates were E. coli, K. pneumoniae, E. faecalis, and C. albicans. Although microorganism distribution remained broadly stable over time, resistance increased in several clinically relevant organism–drug combinations, especially among major Enterobacterales. Conclusions: In this high-complexity hospital population, urinary isolates showed a relatively stable microorganism distribution but progressive changes in susceptibility among selected urinary isolates. These findings support setting-specific microbiological surveillance and stewardship-informed empirical treatment strategies. Full article

This study presents the results of a completed nationwide, five-year official surveillance programme (2016–2020) conducted in Poland to assess microbiological hazards in retail food products. The programme combined official food control and national monitoring activities targeting major foodborne pathogens and hygiene indicators of public health relevance. Compliance with both EU microbiological criteria and national guidelines was assessed for Salmonella spp., Listeria monocytogenes, Escherichia coli (including Shiga toxin-producing E. coli), Campylobacter spp., and coagulase-positive staphylococci. The programme covered all 16 administrative regions of Poland and included 380,314 retail food samples representing major food categories. Analyses were performed in accredited laboratories using ISO standard methods. Isolates obtained from positive samples were confirmed by the National Reference Laboratory (NIPH NIH-NRI), ensuring high data reliability and consistency. The findings provide a comprehensive and nationally representative assessment of microbiological compliance in retail food over a complete five-year surveillance cycle. The dataset represents one of the largest officially generated microbiological surveillance collections of retail food in Europe, providing robust evidence for risk-based food safety management and regulatory decision-making. Food categories requiring targeted control measures were identified. Full article

Background/Objectives: Influenza infection is a major trigger of pneumonia and acute exacerbations among patients with chronic obstructive pulmonary disease (COPD). However, national laboratory-confirmed evidence on influenza vaccine effectiveness (VE) in this high-risk population remains limited. This study aimed to estimate the effectiveness of seasonal influenza vaccination against influenza-associated pneumonia and COPD exacerbations among patients with COPD in Thailand. Methods: We conducted a nationwide retrospective test-negative design study using administrative healthcare data from the National Health Security Office linked with laboratory-confirmed influenza surveillance data between 1 June 2013 and 31 May 2025, covering twelve influenza seasons (2013–2024). COPD-related clinical episodes among patients aged ≥40 years who presented with pneumonia or acute exacerbation of COPD and underwent RT-PCR testing for influenza were included. Modified Poisson regression with cluster-robust standard errors was used to estimate adjusted risk ratios (RRs), and VE was calculated as (1 − adjusted RR) × 100. Results: A total of 606,072 COPD-related clinical episodes were included, of which 192,224 (31.7%) were influenza-positive. The overall adjusted VE against influenza-associated pneumonia was 55.9% (95% CI: 47.3–63.1), while VE against influenza-associated COPD exacerbations was 67.0% (95% CI: 48.8–78.8). VE estimates were broadly similar across age groups and consistent across COPD severity strata. Conclusions: Seasonal influenza vaccination was associated with substantial protection against influenza-associated pneumonia and COPD exacerbations among patients with COPD in Thailand. Full article

Sweet potato (Ipomoea batatas (L.) Lam) is an important global food crop, but its production is threatened by numerous viral pathogens. More than 30 RNA and DNA viruses have been reported worldwide, making rapid and accurate detection essential for disease management, epidemiological surveillance, germplasm exchange, and resistance breeding. Although previous reviews have addressed sweet potato viruses and individual diagnostic methods, a comprehensive synthesis of emerging molecular technologies remains limited. This review addresses that gap by critically integrating recent advances from PCR-based and isothermal assays to high-throughput sequencing, CRISPR-based diagnostics, biosensors, nanotechnology, and artificial intelligence-driven detection platforms. Conventional approaches, including symptom observation, biological indexing, electron microscopy, and ELISA, have contributed to early virus identification but often lack the sensitivity, specificity, and speed needed for modern diagnostics. Molecular and isothermal techniques have substantially improved detection accuracy and enabled rapid identification and field-deployable diagnostics of diverse and mixed infections, while sequencing, CRISPR, biosensors, and AI-based platforms offer greater capacity for detecting novel and emerging viruses. This review discusses the comparative evaluation of molecular technologies for sweet potato virus detection in terms of diagnostic performance, cost-effectiveness, speed, and suitability for both laboratory and field applications, while highlighting future priorities for next-generation virus diagnostics. Integrating portable and high-throughput diagnostic platforms will strengthen virus surveillance, support virus-free planting material production, and promote sustainable sweet potato production worldwide. Full article

Antimicrobial resistance (AMR) is usually addressed through surveillance, prescribing policy, stewardship programs, infection prevention, and drug development. Less attention is given to an earlier educational question: how future doctors first learn to connect microorganisms, antibiotics, and resistance. In some preclinical medical curricula, microbiology provides essential knowledge of microbial structure, virulence, antimicrobial mechanisms, laboratory diagnosis, and resistance pathways, but opportunities to use this knowledge for antimicrobial reasoning may be limited. Students may therefore recall resistance mechanisms yet remain less prepared to interpret culture and susceptibility reports, consider local resistance patterns, or explain when therapy should be escalated, narrowed, optimized, or discontinued. This Perspective argues that AMR education should begin before students prescribe. Preclinical microbiology should preserve its scientific foundation while more deliberately linking microbial mechanisms to clinical scenarios, stewardship principles, microbiology report interpretation, and assessment design. Implementation should be adapted to local standards, supported by faculty development, and evaluated prospectively. Full article

Catheter-associated urinary tract infections (CAUTIs) are among the most common nosocomial infections globally and represent a significant cause of morbidity and prolonged hospital stays. There is a scarcity of molecular data regarding pathogens and virulence factors linked to CAUTIs, particularly in South Africa. This study aimed to determine the distribution and frequency of uropathogens, including polymicrobial infection patterns, isolated from catheterised patients at the Polokwane National Health Laboratory Services (NHLS), Limpopo Province, from March 2024 to March 2025, and to characterise the prevalence and co-occurrence of six virulence genes (fimH, papC, sfa, hly, cnf, and aer) among Escherichia coli isolates, the predominant uropathogen identified. Specimens from catheterised patients diagnosed with urinary tract infections at the National Health Laboratory Services in Polokwane were used. Uropathogens were isolated on agar and identified using the VITEK^® system. Polymerase chain reaction (PCR) was used for amplification of some virulence genes (fimH, papC, sfa, hly, cnf, and aer) associated with uropathogens. Confirmation of urinary tract infections revealed that Escherichia coli was the predominant uropathogen (32.8%), followed by Klebsiella pneumoniae (17.8%), Enterococcus faecalis, Enterococcus faecium (14%), and others. Among E. coli isolates, virulence gene analysis revealed fimH (79.8%) as the most prevalent, followed by aer (77.4%), sfa (41.7%), hly (27.4%), papC (26.19%), and lastly cnf (9.5%). This study demonstrates that E. coli is the leading cause of CAUTIs in our study population, exhibiting diverse virulence gene combinations that enhance adhesion and overall pathogenicity. The findings emphasise the need for routine molecular surveillance of CAUTI pathogens, reinforcement of catheter-care protocols, and targeted infection prevention strategies. Full article

Background: Salmonellosis is a major global public health concern, commonly caused by serovars such as Salmonella enterica serovar Typhimurium and Salmonella enterica serovar Enteritidis. Rare serovars, however, may represent underrecognized links between environmental reservoirs and human infection. Salmonella enterica serovar Haifa is a sporadic serotype primarily associated with livestock and environmental sources and has previously been reported in Indian poultry but not in human clinical cases to date. Case Presentation: A 70-year-old male with a history of type 2 diabetes, presented with acute watery diarrhea and dehydration. One week prior to symptom onset, the patient reported direct contact with cattle and poultry in a rural setting. Laboratory investigations revealed leucopenia and elevated procalcitonin (3.73 ng/mL). Stool culture yielded non-lactose fermenting colonies on MacConkey agar and H₂S-producing colonies on Hektoen enteric agar. The isolate was identified via VITEK 2 and confirmed as Salmonella enterica serovar Haifa by the National Institute for Research in Bacterial Infections (NIRBI). Antimicrobial susceptibility testing (AST) revealed that the isolate showed resistance to ampicillin, ceftriaxone, and ciprofloxacin. The patient was successfully treated with a three-day course of intravenous Azithromycin (1 g) and achieved rapid clinical recovery. Conclusions: To the best of our knowledge, this case represents the first reported human infection caused by S. Haifa in India. The finding highlights the potential zoonotic risk of rare non-typhoidal Salmonella serovars and emphasizes the importance of surveillance, routine serotyping, and antimicrobial resistance monitoring within a One Health framework. Full article

Background: Limited access to rapid molecular diagnostics remains a major barrier to timely tuberculosis (TB) detection and drug-resistance surveillance in resource-constrained settings. In the Republic of Congo, GeneXpert MTB/RIF platforms remain concentrated in a few laboratories, while peripheral facilities rely predominantly on smear microscopy, highlighting the need for a structured sample referral system. Methods: We conducted a three-year mixed-methods operational study comprising a six-month pilot phase (January–June 2023), initially enrolling 29 TB diagnostic and treatment centers in urban and rural settings followed by a 30-month national roll-out phase (July 2023–December 2025), evaluated retrospectively using routine programmatic surveillance data. Results: During the pilot phase, 962 sputum samples were transported. 294 (30.6%) were TB cases, including 12 (4.1%) RR-TB. Median total turnaround time was 53 h (19–168) in urban and 62 h (26–204) in rural, with 86% overall site participation (92% urban vs. 60% rural). During scale-up, samples increased from 2154 (2023) to 5160 (2024), achieving full national coverage (12/12 departments). Over three years, 2587 TB and 84 RR-TB cases were detected. The system’s contribution to national TB detection grew from 9.2% to 16.0%, and RR-TB detection from 10.4% to 18.7%. Conclusions: Implementation of the structured sample referral system was associated with improved equitable access to molecular TB diagnosis, turnaround times within national targets, and strengthened the RR-TB surveillance. Scalable transport networks integrated into national guidelines may enhance diagnostic equity and drug-resistance detection in centralized laboratory systems. Full article

Clostridioides difficile infection (CDI) is a leading cause of healthcare-associated diarrhoea and a marker of antimicrobial exposure and healthcare quality, yet Central Asia is almost absent from the indexed literature. We reviewed available evidence on CDI epidemiology, antimicrobial use and molecular typing across Kazakhstan, Uzbekistan, Kyrgyzstan, Tajikistan and Turkmenistan, searching PubMed/MEDLINE, Google Scholar and accessible regional sources, and identified priorities for surveillance development. The retrievable evidence is sparse and fragmented. The strongest direct data came from Uzbekistan, where paediatric cohorts documented toxigenic C. difficile in up to 47% of the aetiological structure of antibiotic-associated diarrhoea in early-aged children. Nationwide surveys in Kazakhstan showed substantial antimicrobial use (38.2–40.2% of inpatients) and measurable healthcare-associated infection burdens (2.4–3.8%), indicating environments in which CDI may go unrecognised. No national CDI surveillance, ribotyping or resistance-gene data were identified for any of the five countries, whereas evidence from China, Thailand and other Asian settings indicates that ribotype 017 (sequence type 37) predominates in those countries. This absence appears more consistent with underdiagnosis, fragmented reporting and limited laboratory capacity than with true absence of disease. Sentinel surveillance, standardised diagnostic algorithms, integration with antimicrobial stewardship and infection prevention programmes, and regional typing collaborations are the practical priorities. Full article

Bactrocera dorsalis (Hendel) and Bactrocera correcta (Bezzi) are two globally concerning quarantine pests within the genus Bactrocera (Tephritidae). Both species inflict severe damage on the agricultural industry and international export trade. Their distribution range has expanded due to global warming, posing an increasing threat to fruit production. Heat shock proteins (HSPs), functioning as molecular chaperones, are known to contribute to temperature adaptation in insects. However, the cold adaptation regulatory mechanisms in these two Bactrocera species remain unclear. In this study, eIF4EBP3^−/− mutations were established by the CRISPR-Cas9 system in both species. The survival rate of the mutations was significantly reduced with cold treatments, and qRT-PCR analysis indicated that eIF4EBP3 regulates the expression of several downstream heat shock proteins, suggesting that it may be involved in rapid cold hardening (RCH) adaptability in both fruit fly species. In addition, this work represents the first application of the CRISPR-Cas9 system in B. correcta, which provides methods to further studies on this species. Our results provide insights into the molecular mechanisms underlying rapid cold hardening adaptation in B. dorsalis and B. correcta and a potential molecular marker for monitoring cold tolerance in field populations which could guide the development of novel control strategies that target the RCH adaptation pathways. Full article

Background: Catheter-related bloodstream infections are common in patients receiving hemodialysis through a central venous catheter. Taurolidine, a novel broad-spectrum antimicrobial catheter lock solution, is FDA-approved in combination with heparin for reducing the incidence of such infections. Methods: In vitro activity of taurolidine was assessed against 442 bacterial and 50 yeast clinical bloodstream infection isolates selected from the SENTRY Antimicrobial Surveillance Program and tested according to the Clinical and Laboratory Standards Institute methodology. Multidrug-resistant species and phenotypes were included. Results: Taurolidine was highly active against all isolates, with MIC₅₀/MIC₉₀ values of ≤1024/1024 μg/mL for most species. The highest MICs observed were among isolates of Mycobacterium avium complex and Burkholderia cepacia complex (MIC₉₀, 2048 μg/mL) and Candida albicans (MIC₉₀, 4096 μg/mL). All isolates were inhibited by 13,500 μg/mL of taurolidine, the concentration of the commercially available product. Conclusions: Taurolidine activity was very similar among Gram-positive, Gram-negative, and yeast clinical isolates, with the activity of taurolidine being unaffected by phenotypic resistance to other antimicrobials. Taken together with clinical efficacy data from clinical trials, this provides a theoretical basis for the idea that taurolidine-based lock solutions may be able to reduce the risk of catheter-related bloodstream infections from a wide variety of pathogens and resistance phenotypes. Full article

Background: Surgical site infection (SSI) is a common complication after colorectal cancer (CRC) surgery. We evaluated routinely available perioperative biomarkers for early prediction of superficial SSI after curative CRC surgery. Methods: This retrospective study included 488 patients undergoing elective curative CRC resection. Preoperative and postoperative day (POD) 1 laboratory parameters were evaluated using receiver operating characteristic curve analysis and multivariable logistic regression. Results: Superficial SSI developed in 66 patients (13.5%). In the perioperative multivariable association model, preoperative serum albumin ≤ 3.70 g/dL (odds ratio [OR], 1.918; 95% confidence interval [CI], 1.066–3.449; p = 0.030) and WBC count ≥ 6.30 × 10³/µL (OR, 1.970; 95% CI, 1.123–3.458; p = 0.018) were independently associated with superficial SSI. On POD1, serum albumin ≤ 2.80 g/dL (OR, 3.447; 95% CI, 1.993–5.963; p < 0.001) and WBC count ≥ 10.50 × 10³/µL (OR, 2.822; 95% CI, 1.600–4.976; p < 0.001) remained independently associated with SSI. Although lower POD1 lymphocyte-to-monocyte ratio was associated with SSI in univariable analysis, it was not significant after adjustment. A combined model incorporating dichotomized preoperative and POD1 albumin and WBC counts showed modest discrimination (AUC, 0.731; 95% CI, 0.663–0.800), with 47.0% sensitivity and 89.3% specificity. Conclusions: Perioperative albumin and WBC counts were independently associated with superficial SSI. POD1 assessment may aid early risk stratification; however, the modest performance indicates that these biomarkers should complement rather than replace clinical surveillance. Prospective external validation is required. Full article