Search Results (30,809)

Background: Healthcare-associated infections (HAIs) and antimicrobial resistance are major burdens in tertiary care hospitals. Repeated point prevalence surveys (PPSs) offer a pragmatic approach to monitor temporal changes and guide infection prevention. Objectives: Characterize healthcare-associated infections (HAI) prevalence trends, microbiological profiles, antimicrobial resistance (AMR) patterns, and risk factors to refine prevention strategies and hospital policy. Methods: Four annual cross-sectional PPSs were conducted between 2022 and 2025 using the standardized ECDC protocol. Data from all eligible inpatients present at 08:00 on survey days were collected through systematic medical record review. Multivariable logistic regression was used to identify factors independently associated with HAI, with additional sensitivity analyses evaluating invasive device burden and hospital ward type. Results: Across the surveys, 3314 patients were included. Overall HAI prevalence was 11.3%. Infections were most frequent in intensive care units (31.2%), followed by medical (14.6%) and surgical (14.2%) wards. Bloodstream infections (25.7%) and lower respiratory tract infections (19.8%) were the most common. Multivariable analysis identified invasive device exposure as the strongest predictor, with central venous and urinary catheters showing robust independent associations and a clear dose–response relationship according to the number of devices. Pathogens were predominantly Gram-positive cocci (40.5%) and Enterobacterales (30.8%), with Klebsiella pneumoniae being the most frequent isolate (13.0%). Notably, 57.6% of K. pneumoniae isolates were resistant to third-generation cephalosporins. All tested Acinetobacter baumannii isolates were resistant to carbapenems. Conclusions: This repeated PPS reveals a persistently high HAI burden, associated with invasive device exposure and resistant pathogens. Because of the repeated cross-sectional design, causal inference cannot be established. Hospital-wide device stewardship and integrated surveillance are essential for guiding targeted prevention measures, refining antimicrobial policies, and adapting local responses to evolving resistance profiles. Full article

Bioactive peptides have health benefits, but the intense bitterness associated with their hydrolysis severely restricts their industrial applications. This paper systematically constructs a collaborative theoretical framework that integrates intelligent prediction, targeted debittering, and multi-dimensional evaluation. Firstly, it reviews the core applications of deep learning (such as quantitative structure–activity relationship (QSAR) and graph convolutional network (GCN)) combined with molecular docking technology in the high-throughput identification of bitter peptides and the analysis of target receptor interaction mechanisms. Secondly, it discusses how artificial intelligence and computational simulation can improve the efficiency of traditional debittering processes, emphasizing the advantages of multifunctional composite wall materials in the targeted encapsulation and delivery of bitter peptides, as well as the metabolic regulatory mechanisms behind controlling microbial fermentation for the debittering of specific peptide substrates. Finally, to provide a high-fidelity data closed loop for artificial intelligence (AI) models, a three-dimensional cross-validation system integrating standardized quantitative sensory evaluation and biomimetic electronic tongues was established. Future research should focus on developing large models for flavor generation to drive the green and targeted creation of low-bitterness and highly active peptides. Full article

Background: Seasonal influenza remains a major public health challenge worldwide, causing significant morbidity each year and imposing substantial burdens on individuals, healthcare systems, and national economies. Vaccination is considered the most effective available strategy for prevention; however, uptake rates vary considerably across countries, with many failing to achieve the recommended coverage levels. The aim of this umbrella review is to systematically synthesize and critically appraise the existing evidence on healthcare professionals’ beliefs, attitudes, and behaviors regarding seasonal influenza vaccination. Methods: This umbrella review was conducted in accordance with the PRISMA 2020 statement. A literature search was conducted in PubMed, the Cochrane Library, and Google Scholar. The following search terms were used: beliefs, attitudes, behaviors, influenza vaccination, flu vaccine, healthcare professionals and primary healthcare. The inclusion criteria were as follows: (1) Reviews, (2) Published after 1 January 2000, (3) English language, (4) Healthcare professionals as the target-population. Results: Twenty-five studies met the selection criteria and were included in this review. Twelve out of 25 studies were systematic reviews. Globally, vaccination uptake remains below recommended levels, with reported coverage ranging from approximately 2% to 44% in several settings, while rates can exceed 90% in countries with mandatory vaccination policies. North America demonstrates the highest vaccination coverage, while the lowest coverage is reported in Africa and South America. Overall, low- and middle-income countries show significantly lower vaccination behavior compared with high-income countries. Attitudes and beliefs appear to shape vaccination behavior in high-income countries. The main driver of acceptance is perceived protection of oneself and family, whereas hesitancy is mainly driven by concerns about side effects and vaccine safety. Across studies, non-physician healthcare professionals consistently demonstrated lower influenza vaccine acceptance compared with physicians, while pediatricians and general practitioners were found to receive the influenza vaccine more frequently. In addition, younger physicians and those with fewer years of professional experience showed higher vaccination coverage and a greater likelihood of recommending influenza vaccination to patients. Conclusions: Vaccination coverage, worldwide, is lower than what is recommended by the World Health Organization. Healthcare professionals working in hospital settings tend to be vaccinated at a higher rate compared with those working in primary care or community-based healthcare settings. The recommendations that healthcare professionals give are influenced by whether they accept influenza vaccines themselves. Beliefs and attitudes seem to influence behavior in countries where structural barriers, such as limited access to primary healthcare and socio-economic status are absent. Full article

Extracellular vesicles (EVs) and liposomes are nanoscale drug delivery systems extensively investigated in oncology for their ability to improve pharmacokinetics, biodistribution, and therapeutic efficacy of anticancer agents. Liposomes are clinically validated synthetic nanocarriers characterized by high versatility, scalable production, and established regulatory approval; however, their performance is limited by tumor heterogeneity, vascular barriers, adverse effects and inefficient intracellular drug release. EVs are naturally derived nanoparticles involved in intercellular communication and exhibit intrinsic biocompatibility, low immunogenicity, and biological targeting potential; yet their translation is constrained by heterogeneity, limited loading capacity, and manufacturing challenges. Different studies indicate complementary advantages between both systems, with EVs favoring biological targeting and immune modulation and liposomes enabling controlled formulation and pharmacokinetic optimization. These features have driven the development of hybrid EV–liposome nanovesicles, which integrate synthetic and biological properties to enhance tumor targeting, therapeutic efficacy, and payload diversity, including drugs, nucleic acids, and gene-editing systems. Despite promising preclinical results, challenges remain in scalability, standardization, and mechanistic understanding of in vivo behaviour. Overall, these hybrid strategies represent a promising platform for next-generation precision nanomedicine in cancer therapy and for advancing clinical translation by addressing key limitations of current delivery systems and improving therapeutic index and patient outcomes. Full article

Aspartame is a widely used artificial sweetener, but its possible relationship with rheumatoid arthritis (RA) remains insufficiently understood. This study aimed to explore, rather than prove, potential molecular links between aspartame-related targets and RA-associated gene networks. Three public RA transcriptomic datasets (GSE55235, GSE55457, and GSE77298) from the Gene Expression Omnibus (GEO) database were integrated as discovery/training data. Because these datasets included different tissue origins, batch correction was used to reduce dataset-level technical variation, whereas tissue-origin-related biological variation was not assumed to be fully removable. After differential expression analysis, RA-associated differentially expressed genes (DEGs) were identified. The single-cell dataset GSE200815 was used for cell annotation and cellular expression visualization; because its comparator group consists of psoriatic arthritis (PsA) samples rather than healthy controls, single-cell results were interpreted as RA-vs-PsA observations and were not treated as disease-versus-healthy-control evidence. Potential targets of aspartame were retrieved from ChEMBL, SwissTargetPrediction, and the Similarity Ensemble Approach (SEA), and were intersected with RA-related DEGs to construct an aspartame-gene-RA regulatory network. Diagnostic models were developed using 113 machine-learning algorithm combinations to determine an optimal multigene model and its core genes. HLA-DRB1 was selected for exploratory scTenifoldKnk-based virtual knockout mainly because it was included in the optimal model and has a well-established role in RA immunogenetics; the single-cell analysis was used only to describe cellular distribution in the RA/PsA dataset. Molecular docking was then used to evaluate the possible interaction between aspartame and HLA-DRB1. Forty-four intersected genes linked the predicted aspartame targets with RA DEGs. The random forest plus partial least-squares generalized linear model (RF + plsRglm) identified 16 core genes. Network-level interpretation indicated that these genes were distributed across immune/antigen-processing, inflammatory-signaling, protease/extracellular-matrix-remodeling, adhesion, metabolic, and proliferation-related modules; therefore, HLA-DRB1 was treated as a prioritized immune-module candidate rather than as the sole driver of the network. Following virtual knockout of HLA-DRB1, affected genes were enriched in extracellular matrix organization, extracellular structure organization, extracellular matrix, collagen trimer, extracellular matrix structural constituent, and collagen binding. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways included integrin signaling, focal adhesion, proteoglycans in cancer, cytoskeleton in muscle, and phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) signaling. Molecular docking showed a minimum binding energy of −6.7 kcal/mol, which was more negative than the preset stability criterion of −5.0 kcal/mol, and the docking pose suggested contacts around ARG-146. This integrative analysis suggests a hypothesis-generating association between aspartame-related predicted targets and RA-relevant molecular networks involving HLA-DRB1 and other core genes. The findings do not establish causality and require experimental, epidemiological, biophysical, and tissue-stratified validation before any causal or clinical inference can be made. Full article

In modern cloud-native systems, a single root cause can trigger cascading anomalies across multiple entities (e.g., microservices, databases, and hosts), generating alert storms with hundreds or thousands of heterogeneous alerts. Alert convergence (automatically grouping these alerts into actionable incident tickets) is critical for reducing operator burden and recovery time. Existing graph-based methods construct a topological graph from known entity dependencies and then leverage Graph Neural Networks (GNNs) for information propagation, but they rely on static physical topologies that fail to capture implicit fault propagation paths. Large Language Model (LLM)-based methods focus on reasoning about the textual information of alerts, yet they do not incorporate global topological structure and struggle with consistency at scale. Motivated by these limitations, we propose LLM-Guided Graph Structure Learning (LLM-GSL), a novel framework that combines the semantic reasoning ability of LLMs with the structural modeling power of GNNs for alert convergence. Specifically, LLM-GSL first leverages an LLM to evaluate pairwise entity relationships and discover implicit fault propagation paths that are absent from static topologies, thereby enhancing the physical-topology graph into a more complete structure. A Graph Attention Network (GAT) then refines alert representations over this enhanced graph via graph message passing, guided by a self-supervised graph affinity loss with continuous multi-modal supervision targets that fuse adjacency structure, textual affinity, and temporal affinity. Finally, density-based clustering groups the learned representations into incident tickets. Experiments on five public datasets, including four LogHub-derived datasets and one RCAEval microservice fault-injection subset, demonstrate that LLM-GSL achieves an average F1-score of 96.2%, outperforming six baselines including both traditional clustering and LLM-based methods by at least 14.0 percentage points. Full article

Fusarium oxysporum-associated disease symptoms in rice (Oryza sativa L.) seedlings represent an experimentally tractable model for evaluating microbiome-mediated disease suppression under controlled conditions. Biological control of Fusarium-associated disease development in rice provides a promising ecological alternative to chemical fungicides. However, the mechanisms underlying the spatial reconfiguration of the host plant multicompartment microbiome in response to complex inoculants remain insufficiently understood. In this study, we investigated the ability of the monoculture Bacillus amyloliquefaciens Bn1 (B. amyloliquefaciens Bn) and phototrophic–heterotrophic consortia composed of Nostoc sp. J-1 and B. amyloliquefaciens Bn1 to suppress Fusarium oxysporum infection, with parallel profiling of bacterial and fungal communities in rhizosphere soil, the root endosphere, and the phyllosphere using 16S rRNA and ITS amplicon sequencing. Phenotypic screening showed that microbial inoculant application significantly reduced the disease index by up to 55% while maintaining plant dry weight. The protective phenotype was not primarily associated with shifts in alpha diversity, but rather with compartment-specific reorganization of microbial communities. These findings suggest that biological control efficacy was associated less with the overall taxonomic scale of microbiome disturbance than with the formation of a functionally balanced, compartment-specific holobiont architecture but by the formation of a functionally balanced, compartment-specific holobiont architecture, providing a conceptual basis for the targeted design of next-generation phototrophic–heterotrophic biopreparations. Full article

Background: The permanence of contemporary coronary stents is associated with chronic complications, particularly in-stent restenosis and stent thrombosis. Poly-L-lactic-acid-based bioresorbable stents were withdrawn given late stent thrombosis risk. Magnesium-based bioresorbable stents (MgBRS) have emerged as promising alternatives. This study documents the safety and efficacy profile of MgBRS generations. Methods: A systematic review was performed using EMBASE, MEDLINE and Web of Science (2007 to August 2025). Studies include individuals requiring percutaneous coronary intervention for coronary artery disease with MgBRS. Primary outcomes were cardiac death, definite/probable scaffold thrombosis and target vessel failure (TVF), organised into ≤12, ≤24, ≤36 and ≤60 months. The secondary outcome was late lumen loss (LLL). Results: Four MgBRS generations were identified: AMS-1, DREAMS 1G, Magmaris and Freesolve; and 25 studies were included. Cardiac death and stent thrombosis rates were under 1.0% up to 24 months for all, and 0% with Freesolve at 36 months. AMS-1 had the highest TVF rate at 44.4% at 12 months, improving to 3.6% at 36 months in Freesolve. Only Magmaris had 60-month data, showing 3.4% cardiac death, 2.7% stent thrombosis and 16.4% TVF rates. The data suggest improvement in 12-month LLL: DREAMS 1G (0.4 ± 0.3 mm), Magmaris (0.5 ± 1.1 mm) and Freesolve (0.2 ± 0.4 mm). Conclusions: Each successive generation demonstrated improvement in all studied outcomes since the underperformance of AMS-1. The favourable performance of Freesolve is comparable to contemporary drug-eluting stents. Results of randomised head-to-head trials are anticipated. Full article

Few-shot font generation can be viewed as a challenging conditional image generation task, where the goal is to synthesize target glyphs from only a few reference samples while preserving structural fidelity and style consistency. This problem becomes particularly difficult for characters with complex spatial layouts and fine-grained stroke topology, where existing methods often struggle to simultaneously maintain structural integrity, local continuity, and stylistic coherence under sparse-reference conditions. To address this issue, we propose a skeleton-aware deformable alignment framework for few-shot font generation. Specifically, explicit skeleton priors are introduced into the diffusion-based generation process to provide structural supervision during denoising. In addition, a structure-constrained deformable content alignment module is designed to improve local feature correspondence while suppressing unreasonable geometric deformation. We further develop a multi-module content aggregation strategy to jointly model global layout patterns and local stroke details through complementary multi-level representations. Extensive experiments demonstrate that the proposed method consistently outperforms state-of-the-art approaches in both quantitative and qualitative evaluations. The results show that our method provides stronger structural preservation, better perceptual quality, and improved generalization in structurally complex glyph generation and cross-lingual style transfer. Full article

Mycobacterium abscessus subsp. massiliense (Mabs) is an emerging nontuberculous mycobacterium associated with difficult-to-treat infections due to intrinsic antimicrobial resistance, intracellular persistence, biofilm formation, and limited responsiveness to currently available therapeutic regimens. In this context, adjuvant strategies targeting iron-dependent metabolic pathways and metal homeostasis may enhance the efficacy of conventional antimicrobials. This study investigated deferoxamine (DFO), a clinically approved iron chelator, as a potential adjuvant against Mabs using integrated in vitro and in silico approaches. Cytocompatibility was assessed using an MTT assay in RAW 264.7 macrophages and a hemolysis assay in human erythrocytes. Antimicrobial activity was evaluated through minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays, while interactions with clarithromycin (CLA) and amikacin (AMK) were assessed using the checkerboard method. Effects on virulence-associated phenotypes were examined through biofilm formation assays and protein quantification in extracellular vesicle-enriched fractions. Intracellular activity and modulation of inflammatory mediator gene expression were investigated in Mabs-infected RAW 264.7 macrophages through colony-forming unit (CFU) recovery and reverse transcription quantitative polymerase chain reaction (qPCR). DFO exhibited low cytotoxicity and negligible hemolytic activity under the tested conditions. Direct antimicrobial testing revealed a predominantly bacteriostatic profile (MIC = 9.75 µg/mL; MBC > 10 mg/mL), whereas checkerboard analysis suggested a synergistic interaction with CLA (FICI = 0.047), which requires further confirmation by time-kill or CFU-based combination assays. Furthermore, DFO reduced biofilm biomass, decreased protein levels in vesicle-enriched fractions, lowered intracellular bacterial burden, and modulated cytokine gene expression in infected macrophages. Molecular docking, ADME/Tox, and PASS analyses generated exploratory hypotheses regarding potential molecular interactions and pharmacological properties. Overall, these findings support DFO as a promising experimental adjuvant candidate for further investigation against Mabs, particularly in combination with clarithromycin. However, confirmation of a putative iron-restriction-associated mechanism and its translational relevance will require validation in additional clinical isolates, iron-rescue experiments, mature biofilm models, and in vivo studies. Full article

In this paper, a reconfigurable multi-form radar compound coherent jamming signal generator is proposed based on a dual-polarization quadrature phase shift keying (DP-QPSK) modulator cascaded with an intensity modulator (IM). The radar signal and jamming seed signal are loaded on the upper path and the lower path of the DP-QPSK modulator to achieve carrier-suppressed single-sideband (CS-SSB) modulation and phase modulation, respectively. The periodic rectangular pulse (PRP) signal is fed into the IM to achieve interrupted-sampling repeater jamming in the optical domain. In our proposed scheme, cosine phase modulation and interrupted-sampling repeater jamming (CPMJ-ISRJ) and frequency shift and interrupted-sampling repeater jamming (FSJ-ISRJ) are obtained only by changing the form of the jamming seed signal, without changing the overall structure of the scheme. The jamming effectiveness of the above schemes is evaluated through simulation. Multiple false targets are obtained after cross-correlation with the original radar signal. The number of generated false targets can reach 18. We also conducted a detailed simulation to analyze the impact of different parameters on the jamming effect. Because the scheme is filter-free, it has a large frequency tuning range. Moreover, due to the special CS-SSB modulation, the modulated signals are immune to the chromatic dispersion-induced power fading effect. The proposed scheme has potential application prospects in future electronic countermeasure systems. Full article

Gastric adenocarcinomas with yolk sac tumor (YST) differentiation represent an exceptionally rare and poorly understood phenotype, characterized by the emergence of extraembryonic features within an epithelial malignancy. Their histogenesis remains debated, with increasing evidence supporting somatic lineage plasticity rather than germ cell origin. Here, we performed an integrated histopathologic and genomic characterization of three gastric adenocarcinomas with YST differentiation surgically treated at a tertiary cancer center. Histologically, all tumors showed a predominant adenocarcinoma component associated with variable YST differentiation, displaying reticular/microcystic and papillary patterns and expression of oncofetal markers, including alpha-fetoprotein (AFP) and Glypican-3. Targeted next-generation sequencing using a 523-gene panel revealed microsatellite-stable profiles with intermediate tumor mutational burden and substantial intertumoral heterogeneity. Despite gene-level variability, the detected alterations involved signaling pathways commonly implicated in epithelial tumorigenesis, including PI3K-AKT and RTK/RAS-MAPK signaling. Several recurrent alterations were identified across cases, including CCND3 variants and MDM2 copy number gains; however, their biological significance requires validation in larger cohorts. Functional enrichment analysis identified alterations involving developmental and proliferative signaling programs. Overall, these findings suggest that YST differentiation may represent a phenotypic manifestation of epithelial tumor plasticity arising within gastric adenocarcinoma and is associated with epithelial-related oncogenic programs, although broader genomic and comparative studies are required to clarify its histogenesis. This study provides preliminary molecular and histopathologic insights into this rare entity and supports the integration of molecular profiling into its diagnostic and translational management. Full article

Background: Herpes zoster (HZ), commonly known as shingles, and post-herpetic neuralgia (PHN) represent growing public health concerns, particularly among older adults. Despite the established efficacy of the herpes zoster vaccine (HZV), global uptake remains suboptimal. Objectives: This scoping review maps evidence from Saudi Arabia evaluating the baseline knowledge, awareness, attitudes, acceptance, hesitancy, and clinical uptake of the HZV among general adults, high-risk populations, and healthcare workers (HCWs). Methods: The JBI and PRISMA-ScR methodological frameworks were strictly adhered to during mapping. Eligible sources included peer-reviewed, observational cross-sectional studies conducted in Saudi Arabia and published in English between 2022 and 2026. The search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Data were systematically extracted and charted using a standardized digital piloting framework to capture study characteristics (author, year, and region), sample sizes, target populations, knowledge percentages, actual vaccine uptake rates, and self-reported barriers. Results: Out of 25 retrieved records, 19 unique primary studies were mapped. Public knowledge of HZ complications and vaccine eligibility criteria was consistently low to moderate, falling below 50% across most cohorts. Conversely, while verbal willingness to receive the vaccine was highly favorable (ranging from 60% to 75%), a profound “intention–behavior gap” was observed, with actual clinical uptake being below 10%. Key barriers included a lack of public health campaigns, safety concerns regarding reactogenicity, online misinformation, and a lack of proactive provider communication. For HCWs, barriers included unclear local guidelines and a lack of workplace mandates. Ultimately, a proactive physician recommendation was identified as the single most powerful clinical facilitator, increasing vaccine acceptance by over 80% across all cohorts. Conclusions: While the shingles vaccine is now distributed completely free across Saudi Arabia, high public willingness has not translated into actual vaccination rates (10%) due to low public awareness of disease severity. Free vaccine availability alone is insufficient; primary care systems must shift from a passive delivery model to an active, provider-driven framework to successfully close this gap Full article

Vaccination is one of the most important measures for infectious disease control. Recently, media-generated concern about vaccine-associated adverse effects has produced a rise in both human and animal “anti-vaccination” movements. This study aimed to understand factors involved in dog owner vaccination decisions and explore whether there has been an increase in titer testing. An online survey targeting dog owners received a total of 2585 responses, which showed 79% of respondents had their dogs vaccinated in the last 12 months. A few owners had never vaccinated their dogs, and 13% of owners used titer testing prior to booster vaccinations. The factors with the strongest positive predictors for vaccination were requirements by third party services (e.g., kennels) and, for a negative response, lack of time. For respondents that had not vaccinated, the factors with the strongest predictive powers to determine if they titer test were education/working in the veterinary industry for a positive response and not having heard of negative side effects after vaccinating for a negative response. Overall, no evidence was found that a rise in anti-vaccination attitudes was pervasive in dog owners; however, the study shows that the veterinary profession has work to do to ensure herd immunity is maintained within dog populations. Full article

Postoperative wound complications remain a major cause of morbidity, prolonged hospitalization, increased healthcare costs, and reduced quality of life. While traditional wound dressings functioned primarily as passive barriers against contamination and exudate, advances in wound biology have transformed surgical wound management. Tissue repair is now recognized as a dynamic immunometabolic process involving coordinated interactions among immune cells, stromal populations, extracellular matrix remodeling, mechanotransduction, mitochondrial function, redox balance, microbial ecology, and bioelectrical signaling. Consequently, modern wound dressings are increasingly designed as bioactive systems capable of actively modulating the wound microenvironment. Recent developments in biomaterials science, immunoengineering, nanotechnology, extracellular vesicle biology, bioelectronics, and artificial intelligence have enabled the creation of advanced wound platforms, including stimuli-responsive hydrogels, immunomodulatory biomaterials, nanozyme-based dressings, conductive scaffolds, oxygen-generating matrices, extracellular vesicle-loaded systems, and biosensor-integrated interfaces. Therapeutic strategies are progressively shifting from antimicrobial-focused approaches toward immune-regenerative modulation targeting chronic inflammation, mitochondrial dysfunction, ferroptosis, cellular senescence, and impaired mechanobiological signaling. This review examines emerging surgical wound dressings from mechanistic, translational, and biomaterial perspectives, highlighting current innovations, translational challenges, and future directions. Collectively, these technologies may enable intelligent therapeutic systems capable of sensing and directing tissue regeneration in real time. Full article