Antifungal stewardship in the UK: where are we now?

Background: Antifungal stewardship (AFS) is the judicious use of today's antifungal agents with the aim of improving patient outcomes and preserving their future effectiveness. Antifungal resistance (AFR) is increasing globally, with more patients at risk of Invasive Fungal Disease (IFD), highlighting the urgent need to standardize AFS practices in the UK. The aim of this position paper is to understand the current AFS landscape in the UK.

A multiplex microarray lateral flow immunoassay device for simultaneous determination of five mycotoxins in rice.

Co-occurrence of multiple mycotoxins is a growing global food safety concern due to their harmful effects on humans and animals. This study developed an eco-friendly sample preparation method and an innovative multiplex microarray-based lateral flow immunoassay, using a novel portable reader for on-site simultaneous determination of five regulated mycotoxins-aflatoxin B, T-2 toxin, zearalenone, deoxynivalenol, and fumonisin B in rice. The eco-friendly and ultrafast extraction procedure utilizes a bio-based solvent.

Alterations in gut-derived uremic toxins before the onset of azotemic chronic kidney disease in cats.

Background: Although gut-derived uremic toxins are increased in azotemic chronic kidney disease (CKD) in cats and implicated in disease progression, it remains unclear if augmented formation or retention of these toxins is associated with the development of renal azotemia.

Objectives: Assess the association between gut-derived toxins (ie, indoxyl-sulfate, p-cresyl-sulfate, and trimethylamine-N-oxide [TMAO]) and the onset of azotemic CKD in cats.

Animals: Forty-eight client-owned cats.

Inhibition of AKT enhances chemotherapy efficacy and synergistically interacts with targeting of the Inhibitor of apoptosis proteins in oesophageal adenocarcinoma.

The incidence of oesophageal adenocarcinoma (OAC) has risen six-fold in western countries over the last forty years but survival rates have only marginally improved. Hyperactivation of the PI3K-AKT-mTOR pathway is a common occurrence in OAC, driving cell survival, proliferation and resistance to chemotherapeutic agents. Inhibition of AKT has been explored as a treatment strategy with limited success and current inhibitors have failed to progress through clinical trials.

Radiation therapy, radiosurgery, chemotherapy and targeted therapies for metastatic spine tumors: WFNS Spine committee recommendations.

Objective: This review aims to formulate the most current, evidence-based recommendations regarding radiation therapy, radiosurgery, and chemotherapy for patients with metastatic spine tumors.

Methods: A systematic literature using PRISMA methodology was performed from 2010-2023 using the search terms "radiosurgery," "radiation therapy," "external beam radiation therapy," or "stereotactic body radiation therapy" in conjunction with "spinal," "spine," "metastasis," "metastases," or "metastatic."

Results: Spinal metastases should be managed in a multidisciplinary team consisting of spine surgeons, radiation oncologists, radiologists and oncologists.

Epigenetic and Metabolic Landscape of Dementia with Lewy Bodies.

Background: Lewy body diseases, including dementia with Lewy bodies (DLB), are characterized by α-synuclein accumulation, leading to dementia. Previous studies suggest distinct epigenetic and metabolomic profiles in DLB.

Objective: This study aims to identify diagnostic biomarkers by analyzing the methylome and metabolome in the Brodmann area 7 of postmortem brain tissues from DLB patients and control subjects using multiomics approaches.

A machine learning-assisted systematic review of preclinical glioma modeling: Is practice changing with the times?

Background: Despite improvements in our understanding of glioblastoma pathophysiology, there have been no major improvements in treatment in recent years. Animal models are a vital tool for investigating cancer biology and its treatment, but have known limitations. There have been advances in glioblastoma modeling techniques in this century although it is unclear to what extent they have been adopted.

From automated Raman to cost-effective nanoparticle-on-film (NPoF) SERS spectroscopy: A combined approach for assessing micro- and nanoplastics released into the oral cavity from chewing gum.

Microplastics (MPs) and Nanoplastics (NPs), a burgeoning health hazard, often go unnoticed due to suboptimal analytical tools, making their way inside our bodies through various means. Surface Enhanced Raman Spectroscopy (SERS), although is utilized in detecting NPs, challenges arise at low concentrations due to their low Raman cross section and inability to situate within hotspots owing to their ubiquitous size and shape. This study presents an innovative and cost-effective approach employing household metallic foils (aluminium and copper) as nanoparticle-on-film (NPoF) substrates for targeting such analytes.

Mesenchymal stromal cells reduce inflammation and improve lung function in a mouse model of cystic fibrosis lung disease.

Mesenchymal stromal cells (MSCs) are multipotent adult stem cells which possess immunomodulatory and repair capabilities. In this study, we investigated whether MSC therapy could modulate inflammation and lung damage in the lungs of Scnn1b-transgenic mice overexpressing the β-subunit of the epithelial sodium channel (β-ENaC), a model with features of Cystic Fibrosis lung disease. Human bone marrow derived MSC cells were intravenously delivered to mice, prior to collection of bronchoalveolar lavage (BALF) and tissue.

Integrating Community Engagement in Zero Leprosy Efforts: A Pathway to Sustainable Early Detection, Control and Elimination.

Community engagement has emerged as a critical component in the effective control and elimination of neglected tropical diseases (NTDs), particularly in regions with persistent stigma and limited healthcare access. Drawing on case studies from Brazil, India, and Nigeria, this opinion piece explores how community-driven initiatives have successfully improved leprosy awareness, reduced stigma, and fostered early case detection and treatment adherence. The importance of culturally sensitive, inclusive approaches in health education and stigma reduction campaigns is highlighted, emphasizing the potential for community engagement to enhance national leprosy programs and contribute to the World Health Organization's Zero Leprosy Strategy.

Assessment of bioaerosol composition and public health implications in high-traffic urban areas of Southwest, Nigeria.

Bioaerosols, a significant yet underexplored component of atmospheric particulate matter, pose substantial public health risks, particularly in regions with poor air quality. This study investigates the composition of bioaerosols in public spaces, specifically two interstate motor parks and two marketplaces in Osun State, Nigeria, over six months. Air samples were collected, and bacterial and fungal species were identified, focusing on pathogenic organisms.

Feed additives for methane mitigation: A guideline to uncover the mode of action of antimethanogenic feed additives for ruminants.

This publication aims to provide guidelines of the knowledge required and the potential research to be conducted in order to understand the mode of action of antimethanogenic feed additives (AMFA). In the first part of the paper, we classify AMFA into 4 categories according to their mode of action: (1) lowering dihydrogen (H) production; (2) inhibiting methanogens; (3) promoting alternative H-incorporating pathways; and (4) oxidizing methane (CH). The second part of the paper presents questions that guide the research to identify the mode of action of an AMFA on the rumen CH production from 5 different perspectives: (1) microbiology; (2) cell and molecular biochemistry; (3) microbial ecology; (4) animal metabolism; and (5) cross-cutting aspects.

Feed additives for methane mitigation: Recommendations for testing enteric methane-mitigating feed additives in ruminant studies.

There is a need for rigorous and scientifically-based testing standards for existing and new enteric methane mitigation technologies, including antimethanogenic feed additives (AMFA). The current review provides guidelines for conducting and analyzing data from experiments with ruminants intended to test the antimethanogenic and production effects of feed additives. Recommendations include study design and statistical analysis of the data, dietary effects, associative effect of AMFA with other mitigation strategies, appropriate methods for measuring methane emissions, production and physiological responses to AMFA, and their effects on animal health and product quality.

Pelvis Or Involved Node Treatment: Eradicating Recurrence in Prostate Cancer (POINTER-PC) - study protocol paper for a phase III multicentre, open-label randomised controlled trial.

Introduction: Prostate cancer (PCa) is the most common cancer in men. Recurrence may occur in up to half of patients initially treated with curative intent for high-risk localised/locally advanced PCa. Pelvic nodal recurrence is common in this setting, but no clear standard of care exists for these patients, with potential therapeutic approaches including stereotactic body radiotherapy (SBRT) to the involved node(s) alone, extended nodal irradiation (ENI) to treat sites of potential micrometastatic spread in addition to involved node(s) and androgen deprivation therapy with or without additional systemic anticancer therapies.

Freshness in Salmon by Hand-Held Devices: Methods in Feature Selection and Data Fusion for Spectroscopy.

Salmon fillet was analyzed via hand-held optical devices: fluorescence (@340 nm) and absorption spectroscopy across the visible and near-infrared (NIR) range (400-1900 nm). Spectroscopic measurements were benchmarked with nucleotide assays and potentiometry in an exploratory set of experiments over 11 days, with changes to spectral profiles noted. A second enlarged spectroscopic data set, over a 17 day period, was then acquired, and fillet freshness was classified ±1 day via four machine learning (ML) algorithms: linear discriminant analysis, Gaussian naïve, weighted -nearest neighbors, and an ensemble bagged tree method.

Daily activities change is linked to acute angle closure occurrence in COVID-19 co-infected patients.

Objectives: To analyze the influence of daily activity-related factors associated with COVID-19 infection on the occurrence of acute angle closure (AAC).

Methods: A multicenter hospital-based study was conducted at 23 ophthalmic centers in 17 provincial-level regions across China to recruit patients with confirmed AAC during the post-lockdown time of COVID-19 (P-TOC) from Dec 7, 2022, to Jan 17, 2023, and three lockdown time of COVID-19 (TOC) periods, which included the TOC-2022 (Sep 7, 2022 - Dec 6, 2022), TOC-2021(Sep 7, 2021 - Jan 6, 2022) and TOC-2020 (Sep 7, 2020 - Jan 6, 2021). Patient information, including demographic, a questionnaire on daily activity changes during the AAC period, COVID-19 history, and eye examination results, was collected.

Transforming Households with Refraction and Innovative Financial Technology (THRIFT): study protocol for a randomised controlled trial of vision interventions and online banking among the elderly in Kurigram.

Introduction: Presbyopia, difficulty in seeing close-ups, affects a billion people globally. Mobile financial services (MFS) have been mandated since January 2021 for Bangladesh government social safety net payments, including old age allowance (OAA) and widow allowance (WA). We report the protocol for the Transforming Households with Refraction and Innovative Financial Technology randomised trial assessing the impact on the use of online banking of providing presbyopic safety net beneficiaries with reading glasses, and brief smartphone and mobile banking app training.

New from opposite ends of the world.

The is a group of ancient fungi with global distribution. In the current study we accessed mucoralean fungi isolated from two countries on opposite sides of the Earth and in different hemispheres: South Korea and Brazil. isolates were obtained from freshwater, soil, invertebrates, and fruit seeds and identified using phenotypic techniques combined with the DNA sequence data.

The Interplay Between Visual Traits and Forest in Bumblebee Communities Across Sweden.

Understanding how ecological communities assemble in relation to natural and human-induced environmental changes is critical, particularly for communities of pollinators that deliver essential ecosystem services. Despite widespread attention to interactions between functional traits and community responses to environmental changes, the importance of sensory traits has received little attention. To address this, we asked whether visual traits of bumblebee communities varied at large geographical scales along a habitat gradient of increased tree cover.

Ensuring the Future Pool of Gastroenterologists in the United Kingdom Is Imperative.

This perspective article explores the importance of fostering interest in gastroenterology among medical students and addressing the barriers that deter them from pursuing careers in this specialty. The paper highlights the critical role of early exposure to research, specialized electives, and mentorship in encouraging students to consider gastroenterology as a career choice. Current challenges include limited access to specialized electives and research opportunities within UK medical schools, inadequate hands-on experience, and a perceived lack of stability and control over future training pathways.

Design and characterization of hollow microneedles for localized intrascleral drug delivery of ocular formulations.

Effective drug delivery to the posterior segment of the eye remains a challenge owing to the limitations of conventional methods such as intravitreal injections, which are associated with significant side effects. This study explored the use of hollow microneedles (HMNs) for localized intrascleral drug delivery as a minimally invasive alternative. Stainless steel HMNs with bevel angles of 30°, 45°, 60°, and 75° were fabricated using wire electron discharge machining.