bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–10–18
sixty-five papers selected by
Luca Bolliger, lxBio
  1. Gut microbiota dysbiosis: Pathogenic drivers and emerging phage-based therapeutics.
  2. Isolation of Bacteriophage: An Antibiotic Alternative for the Control of Salmonella Infections.
  3. The Oral Virome in Dental Caries: From Ecological Disruptors to Therapeutic Opportunities.
  4. Genomic Surveillance-Guided Phage Repository Construction and Rational Cocktail Design for Carbapenem-Resistant Klebsiella pneumoniae.
  5. Activity of a three-phage combination against Mycobacterium tuberculosis in disease-relevant conditions.
  6. Hernia, mesh, microbes, and phage promise: Mapping 35 years of evidence through a systematic review.
  7. Farm-adapted multicomponent bacteriophage preparation for environmental biocontrol in commercial dairy cattle housing: A One Health approach.
  8. Research Progress on Artificial Intelligence in the Management of Diabetic Foot Ulcers.
  9. Modulating phage susceptibility with membrane vesicles and bacteriophage cocktails for Acute Hepatopancreatic Necrosis Disease (AHPND) management in shrimp aquaculture.
  10. Diagnostic Accuracy of Salivary Thiols Point-of-Care Test for Detecting Subgingival Dysbiosis in Adults: A Cross-Sectional Study.
  11. How cystic fibrosis modulator therapy could transform Pseudomonas aeruginosa epidemiology.
  12. Oral microbiome and inflammatory bowel disease: A scoping review.
  13. Histone post-translational modifications in diabetic foot ulcer healing: linking immune dysregulation to tissue repair.
  14. Texture-aware diffusion modelling for severity-conditioned synthetic progression-like visualization of diabetic foot ulcers from single images.
  15. Prospective evaluation of the clinical effectiveness of an innovative catalytic wound care technology.
  16. Mind the Gap: A survey of chronic wound datasets, methods, and clinical translation.
  17. Tracking eco-evolutionary patterns among oropharyngeal pathobiome members in a pediatric cystic fibrosis cohort.
  18. Gp38 adhesins of Straboviridae phages recognize specific extracellular loops of outer membrane protein receptors.
  19. Bacteriophage and Antibiotic Resistance Are Positively Associated across a Phylogenetically Diverse Set of Clinical Pseudomonas aeruginosa Isolates.
  20. Selective Synergy Between Phages and Antibiotics Improves Treatment Outcomes in Staphylococci Infections.
  21. Artificial Intelligence in Rapid Diagnostics for Antimicrobial Resistance: From Bench to Bedside.
  22. Screening for multidrug-resistant organism: clinical benefit or unquestioned routine.
  23. Severity-Stratified Healing Outcomes of Nurse-Managed Negative Pressure Wound Therapy in Diabetic Foot Ulcers: A Prospective Comparative Cohort Study.
  24. Microbe Profile: Acinetobacter baumannii: persist and resist.
  25. Hydrogel microneedles for chronic wound microenvironment remodeling: from drug delivery to intelligent treatment.
  26. A population-scale landscape of the subgingival microbiome reveals divergent routes to periodontal dysbiosis.
  27. Recommendations for microbiological sampling in infected hard-to-heal wounds: an Italian association for cutaneous ulcers (AIUC) perspective.
  28. Temperate versus virulent phage lifestyle impacts microdiversity in soil environments.
  29. Protein Language Models Identify Early Folding Residues as Critical Hotspots for Pathogenic Variants and Cancer Prognosis.
  30. Biofilm state transitions: quorum sensing inhibition and network destabilization.
  31. Effectiveness of Negative Pressure Wound Therapies on the Healing Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis.
  32. Antibiotic Stewardship in Cirrhosis: Current Recommendations and Clinical Challenges.
  33. Artificial Intelligence in Echocardiography: A Critical Review of Models, Validation, and Clinical Impact.
  34. The impact of modulator therapy on the Pseudomonas aeruginosa cystic fibrosis lung transcriptome.
  35. Care of the Sexual or Gender Minority Community Living with Cystic Fibrosis: A Survey of United States and Canadian Multidisciplinary Health Care Providers.
  36. IgG sequencing maps systemic antibody binding to oral commensals and pathobionts in health and periodontitis.
  37. The Effect of Teach-Back Education Method on the Self-Efficacy of Foot Wound Care in Patients with Diabetes Mellitus: An Interventional Study.
  38. Viral-Gut Microbiota Interactions: Implications for the Gut Mucosa in Inflammatory Bowel Disease.
  39. Toward routine implementation of phage testing: an inter-laboratory comparison of a disk-based susceptibility testing (Disk-PST).
  40. The Gut Microbiota-Epilepsy Axis: Bibliometric Trends, Mechanistic Insights, and Microbiota-Targeted Next-Generation Therapeutic Opportunities.
  41. Time to Heal: MicroRNA Temporal Dysregulation in Diabetic Foot Ulcers.
  42. A Predict → Confirm → Act Framework for AI-Augmented MDRO Control Across Hospitals and Long-Term Care Facilities.
  43. The role of venoactive drugs in a modern treatment paradigm: evidence review.
  44. Diabetic Foot Ulcers and Curcumin.
  45. The Microbiome-Gut-Lung axis in Respiratory Diseases: From Biological Mechanisms to Clinical Translation.
  46. Early mobilization in neurocritical care as a threshold-regulated intervention: a narrative review of mechanistic integration and implications for neurological recovery and physiological stability.
  47. Death and chemotaxis: Bacterial chemotaxis enables collective escape from phage predation.
  48. MicroRNAs in Cystic Fibrosis: Dual Role in Pathogenesis and Therapeutic Potential.
  49. From Prediction to Mechanism: Explainable AI for Plant-Microbiome Multi-Omics Integration and Biological Discovery.
  50. Gut microbiome intervention in gut-brain axis and effects on vascular dementia with prospects on non-pharmacological intervention.
  51. Nanocarrier-Integrated Topical Dosage Forms for Biofilm-Infected Wounds: Balancing Wound Retention, Biofilm Matrix Penetration, and Translational Feasibility.
  52. Basic science & translational research in cystic fibrosis - insights from the 20th ECFS basic science conference.
  53. SUMO2-mediated SP1 SUMOylation promotes M2 macrophage polarization to facilitate diabetic foot ulcer healing.
  54. Dual-track Parallel and Integrated Innovation: Recent Advancements of Clinical Decision Support Systems in Cardiovascular Diseases from the Perspective of Integrative Chinese and Western Medicine.
  55. From conservation scores to language models: a feature engineering perspective on machine learning for genetic variant interpretation.
  56. Distinct gastrointestinal symptom phenotypes in adults with cystic fibrosis are linked to complications and medication use: the GRAMPUS-CF study.
  57. Delayed standard care in diabetic foot ulcers: the roles of initial response pathways and non-professional health information.
  58. Self-Reported Prebiotics and Probiotics Recognition and Recommendation Practices Among Dentists in Sibiu County, Romania: A Cross-Sectional Questionnaire Survey.
  59. Characteristics of Staphylococcus epidermidis Isolated from Humans and Animals.
  60. Artificial Intelligence in Infectious Diseases and Clinical Microbiology.
  61. Mobile genetic elements drive a plasmid fusion and deletion lifecycle shaping evolution and antimicrobial resistance.
  62. Evaluation of biofilm activity, virulence genes, and antibiotic susceptibility profiles in clinical Proteus mirabilis isolates.
  63. Bridging the Artificial Intelligence Translation Gap in Perioperative Pulmonary and Respiratory Complications: A Practical Framework for Institution-Level Implementation.
  64. Artificial intelligence technologies in pregnancy and childbirth care: a scoping review from a nursing perspective.
  65. Biofilm-Mediated Persistence of Salmonella in Poultry Processing: A Comprehensive Review of Isolate Heterogeneity, Stress Adaptation, and Antimicrobial Resistance.
  1. AIMS Microbiol. 2026 ;12(3): 632-665
    Gut microbiota dysbiosis: Pathogenic drivers and emerging phage-based therapeutics.
    Ahmed Dewan, Débora Brito Goulart, Maria Teresa Mascellino.
      Gut microbiota dysbiosis driven by pathogenic and opportunistic bacteria, including Clostridioides difficile, adherent-invasive Escherichia coli (AIEC), Salmonella enterica serovar Typhimurium, Fusobacterium nucleatum, Klebsiella pneumoniae, Enterococcus faecalis, and Campylobacter spp., disrupts colonization resistance, epithelial barrier integrity, and immune homeostasis, thereby contributing to the development of inflammatory and metabolic diseases. In this review, we summarize the mechanisms through which these microorganisms promote gut dysbiosis and critically evaluate current microbiome-targeted therapeutic strategies, including fecal microbiota transplantation (FMT), live biotherapeutic products (LBPs), probiotics, and bacteriophage (phage) therapy. We review the preclinical and emerging clinical evidence supporting phage-based targeting of major dysbiosis-associated pathogens and examine the principal challenges limiting clinical translation, including phage resistance, immune-mediated clearance, safety considerations related to temperate phages, manufacturing and delivery constraints, and regulatory barriers. Although evidence remains predominantly preclinical, advances in phage engineering, artificial intelligence-guided phage selection, and systems-level microbiome modeling are expanding the potential of personalized phage therapeutics. Collectively, these developments position bacteriophage therapy as a promising addition to future microbiome-directed strategies for restoring gut microbial homeostasis and managing dysbiosis-associated disease.
    Keywords:  bacteriophage (phage) therapy; dysbiosis; fecal microbiota transplantation; gut microbiota; live biotherapeutic products; pathogenic bacteria; precision microbiome medicine
    DOI:  https://doi.org/10.3934/microbiol.2026028
  2. Methods Mol Biol. 2027 ;3078 155-166
    Isolation of Bacteriophage: An Antibiotic Alternative for the Control of Salmonella Infections.
    Nada A Fahmy, Yosra A Helmy.
      The rise of multidrug resistance (MDR) poses a significant challenge to global health, reducing the effectiveness of conventional antibiotics. The World Health Organization (WHO) classifies Salmonella as a priority pathogen due to its global burden in foodborne disease and the escalating threat of MDR strains. Bacteriophages (phages) are gaining attention as alternatives to traditional antibiotics. Their strict host specificity has potential applications in both therapeutic and food safety contexts. However, the first step toward practical application is the successful isolation of phages from appropriate environmental sources. This chapter outlines a detailed protocol for isolating phages targeting Salmonella from different sources and for preparing purified phage stocks. It also covers practical notes to ensure that the methods are applied effectively.
    Keywords:  Lytic phage; Multidrug-resistant Salmonella; Phage isolation; Phage purification; Phage therapy
    DOI:  https://doi.org/10.1007/978-1-0716-5559-7_14
  3. J Microbiol Biotechnol. 2026 Aug 24. 36 e2604028
    The Oral Virome in Dental Caries: From Ecological Disruptors to Therapeutic Opportunities.
    El-Sayed Khafagy, Gillan I El-Kimary, Ahmed Al Saqr, Wael A H Hegazy.
      Dental caries results from ecological dysbiosis of oral biofilms driven by frequent sugar exposure, yet the role of viruses, particularly bacteriophages, in this process remains underexplored. This review synthesizes current evidence on how the oral virome contributes to caries pathogenesis and examines emerging phage-based therapeutic strategies. The oral cavity harbors diverse viral communities, including eukaryotic viruses (herpesviruses, papillomaviruses) and prokaryotic viruses (bacteriophages). While herpesviruses like EBV, CMV, and HSV-1 do not directly demineralize teeth, they may act as ecological stressors by modulating host immunity, altering gingival crevicular fluid composition, and promoting inflammation that favors cariogenic bacterial activity. Bacteriophages function as key ecological regulators through "kill-the-winner" dynamics, maintaining microbial diversity by preying on dominant species. However, temperate phages can horizontally transfer genes encoding acidogenicity, biofilm formation, or antibiotic resistance, potentially accelerating dysbiosis. Metagenomic studies reveal distinct salivary phage signatures associated with caries, suggesting diagnostic potential. Preclinical evidence demonstrates that lytic phages targeting Streptococcus mutans (e.g., SMHBZ8, ΦAPCM01) disrupt biofilms in vitro and prevent caries in ex vivo and murine models. Phage-derived enzymes (endolysins, depolymerases) and peptides offer additional precision antimicrobials with minimal commensal disruption. Despite promising advances, significant translational gaps remain, including limited well-characterized phages, insufficient polymicrobial model testing, and absence of human clinical trials. Integrating virome ecology into caries management represents a paradigm shift from pathogencentric approaches toward ecosystem-based therapeutics, with phages offering targeted, self-replicating, and evolutionarily dynamic tools for restoring oral health.
    Keywords:  Bacteriophages; Dental caries; Ecological dysbiosis; Enzybiotics; Oral virome; Phage therapy
    DOI:  https://doi.org/10.4014/jmb.2604.04028
  4. J Infect. 2026 Oct 14. pii: S0163-4453(26)00208-2. [Epub ahead of print] 106882
    Genomic Surveillance-Guided Phage Repository Construction and Rational Cocktail Design for Carbapenem-Resistant Klebsiella pneumoniae.
    Miao Lei, Haoyu Guo, Yanzhang Guo, Mengdi Cui, Xing Ding, Shan Wang, Anusak Kerdsin, Ranfeng Ye, Jinquan Li.
       OBJECTIVES: Given the treatment delays inherent in reactive phage matching, we aimed to develop a preparedness-oriented strategy linking genomic surveillance of carbapenem-resistant Klebsiella pneumoniae (CRKP)to targeted phage-resource development and rational cocktail design.
    METHODS: We analysed >64,000K. pneumoniae genomes to characterize the geographical and temporal representation of KL types within the genomic dataset. Phages were isolated and prioritized according to host-range profiles, genomic nonredundancy, receptor-binding protein diversity and morphology. Quantitative inhibition profiling and principal component analysis guided the selection of candidate combinations targeting KL64 isolates, followed by in vitro, in vivo, and resistance analyses.
    RESULTS: A limited number of KL types were frequently represented among the analysed CRKP genomes and showed regional variation. From a nonredundant repository of 33 phages, 10 were selected to target 10 frequently represented KL types. In a KL64 clinical isolate panel, selected combinations broadened and prolonged bacterial suppression., The phage cocktail significantly prolonged survival in mice under lethal CRKP challenge and phage-resistant derivatives showed restored susceptibility to multiple antibiotics.
    CONCLUSIONS: This study presents a framework for using genomic data to prioritize phage-resource development and guide cocktail design for KL-defined CRKP groups.
    Keywords:  Antimicrobial resistance; Capsule type; Carbapenem-resistant Klebsiella pneumoniae; Genomic surveillance; Phage cocktail; Phage therapy
    DOI:  https://doi.org/10.1016/j.jinf.2026.106882
  5. J Infect Dis. 2026 Oct 15. pii: jiag516. [Epub ahead of print]
    Activity of a three-phage combination against Mycobacterium tuberculosis in disease-relevant conditions.
    S Janssen, S E Larsen, M Pozuelo Torres, M Beldjenna, C A Guerrero Bustamante, I Florian, T Smytheman, T Guo, R C van Wijk, G F Hatfull, A H Diacon, R N Coler, J van Ingen.
       BACKGROUND: Phage therapy offers promise to combat antimicrobial resistance, including drug-resistant tuberculosis. Understanding phage activity against Mycobacterium tuberculosis (Mtb) in granuloma-like microenvironments that induce non-replicating states, characterized by hypoxia and acidity, is essential.
    OBJECTIVES: To evaluate a phage combination against Mtb under hypoxic, acidic (pH 5.5), and stationary-phase conditions in vitro.
    METHODS: Mtb H37Rv cultures were grown to exponential phase for time-kill studies (106 colony forming units (CFU)/mL) under normal, hypoxic, and acidic conditions. Hypoxia was generated using sealed containers with gas sachets. Stationary-phase cultures were grown for 14-21 days and used undiluted. Treatments included control media, single phages (Fred313cpm-1Δ33, FionnbharthΔ45Δ47and Muddy HRM N0157-2), phage combination (multiplicity of infection 10:1), and rifampicin or isoniazid (0.1 µg/mL each). Phage titers (measured using M. smegmatis overlays) and bacterial counts (CFU on Middlebrook 7H11) were assessed at repeated time-points. Longitudinal phage-bacteria dynamics mixed-effects modelling and simulation was performed.
    RESULTS: In actively growing cultures, phage levels rose by day 7, followed by sustained reductions in Mtb counts over 31 days. Phages prevented regrowth seen with antibiotics alone. Acidic conditions variably affected individual phage stability and activity. Under hypoxic and stationary conditions, phage titers remained stable, but no reduction in Mtb was observed. Model-based predictions adequately captured phage-mycobacterial interactions with and without rifampicin.
    CONCLUSIONS: Productive lytic activity was not observed in assays with non-replicating mycobacteria. Established models can support future experimental designs. This study provides mechanistic insights driving progress in the field of phage therapy development.
    Keywords:  Mycobacteriophages; phage therapy; preclinical; tuberculosis
    DOI:  https://doi.org/10.1093/infdis/jiag516
  6. J Infect Public Health. 2026 Nov;pii: S1876-0341(26)00254-6. [Epub ahead of print]19(11): 103382
    Hernia, mesh, microbes, and phage promise: Mapping 35 years of evidence through a systematic review.
    Braira Wahid, Edward Young, Morgyn Warner, Jinxin Zhao, April Ven Der Kamp, Adam Truskewycz, Melanie MacGregor, Chrys Hensman, Billingsley Kaambwa, Sarah Harmer, Jonathan Iredell, Peter Speck.
       BACKGROUND: Prosthetic mesh is the standard of care for hernia repair; however, mesh-related infections remain a significant biological challenge, with pooled data showing significant morbidity, recurrence, and elevated explantation risk. This study summarises microbiological trends documented over three decades of research, characterises the microbial landscape associated with mesh infections, and investigates how various mesh materials are associated with pathogen colonisation.
    AIMS: The objectives are to (i) analyse the aetiology and microbial distribution in mesh-associated infections, (ii) assess the frequency of infection-related events, including mesh removal and postoperative complications, across mesh types and surgical approaches, (iii) describe study population characteristics and procedural contexts where infections occurred, (iv) identify temporal patterns in published reports, and (v) evaluate variables associated with infection-related outcomes as reported in the literature.
    METHODS: Following PRISMA guidelines, systematic searches (1990-2025) yielded 4000 records; 584 studies met inclusion criteria, and 32 were eligible for meta-analysis, with uniform groupings by mesh type (polypropylene, biologic, composite, biosynthetic) and period (1990-2007, 2008-2025). Analytical outcomes included incisional hernia rates, surgical site infections (SSIs), explantations, and relevant patient factors, using random-effects modelling.
    RESULTS: Of the 1213 studies screened, 584 met the inclusion criteria, and 32 were included in the meta-analysis. Mesh use did not correlate with a consistent reduction of surgical site infections (HR: 0.90; p = 0.396). Mesh explantation was significantly correlated with chronic infections (HR: 6.11; p < 0.0001). Polypropylene meshes are most commonly associated with polymicrobial infections, mostly caused by S. aureus, E. coli, and P. aeruginosa. This trend may be a reporting bias, as polypropylene meshes are the most commonly used meshes worldwide. No clinical studies were found for phage-coated meshes. Preclinical evidence demonstrates the strong antimicrobial potential of phage therapy on mesh materials, but clinical efficacy has not been studied yet.
    CONCLUSION: The review summarises over 3 decades of hernia mesh research covering the use of mesh composition and materials, associated complications and infection management. With the rise of antibiotic resistance, bacteriophages are becoming a promising alternative for the treatment of mesh infections.
    Keywords:  AMR; Hernia mesh infections; Phage therapy; S. aureus; S. epidermidis
    DOI:  https://doi.org/10.1016/j.jiph.2026.103382
  7. Vet World. 2026 Sep 30. 19(9): 3883-3898
    Farm-adapted multicomponent bacteriophage preparation for environmental biocontrol in commercial dairy cattle housing: A One Health approach.
    Ekaterine Tevdoradze, Nusha Diasamidze, Salome Kalandadze, Nino Tvaradze, Nana Japarashvili, Giorgi Gogoladze, Nato Peradze, Mathias Müsken, Irina Papukashvili, Rati Golijashvili, Svetlana Chubinidze.
       Background and Aim: The increasing occurrence of antimicrobial-resistant bacteria in livestock environments highlights the need for sustainable alternatives to conventional antimicrobials. Bacteriophages offer a targeted approach for reducing bacterial contamination while supporting antimicrobial stewardship. This study aimed to develop and evaluate a farm-adapted multicomponent bacteriophage preparation for environmental biocontrol in commercial dairy cattle housing.
    Materials and Methods: Bacterial strains and bacteriophages were isolated from samples collected at a commercial dairy farm. Selected bacteriophages were characterized for host range, efficiency of plating, multiplicity of infection, and host range expansion through phage adaptation. Purified phage clones were subjected to whole-genome sequencing and bioinformatic analysis. A multicomponent bacteriophage preparation was formulated and lyophilized to facilitate storage and field application. The preparation was subsequently applied to selected environmental surfaces in dairy cattle housing, and bacterial recovery before and after treatment was evaluated using microbiological methods.
    Results: Phage screening and adaptation enabled the selection of bacteriophages with complementary activity against bacterial isolates recovered from the dairy farm environment. Adaptation expanded the lytic activity of selected phages against previously less susceptible bacterial hosts. Genomic characterization supported the selection of phages for inclusion in the final preparation, while formulation and lyophilization yielded a preparation suitable for field application. Following environmental application under commercial dairy farm conditions, qualitative changes in bacterial recovery were observed on treated surfaces, demonstrating the feasibility of using a farm-adapted bacteriophage preparation for environmental biocontrol. The findings also demonstrated the practical integration of bacterial surveillance, phage isolation, adaptation, genomic characterization, formulation, and on-farm application within a single biocontrol strategy.
    Conclusion: A farm-adapted multicomponent bacteriophage preparation can provide a practical, targeted approach for environmental bacterial control in commercial dairy cattle housing. The combination of locally isolated phages, host range adaptation, genomic characterization, and a field-applicable lyophilized formulation is a key strength of this approach. These findings provide a foundation for further controlled studies using quantitative microbial assessments to determine efficacy, optimize application protocols, and evaluate the contribution of bacteriophage-based environmental interventions to antimicrobial stewardship and One Health strategies in livestock production.
    Keywords:  One Health; antimicrobial resistance; bacteriophage adaptation; bacteriophage biocontrol; dairy cattle; environmental biocontrol; livestock production; phage therapy
    DOI:  https://doi.org/10.14202/vetworld.2026.3883-3898
  8. Diabetes Metab Syndr Obes. 2026 ;19 637013
    Research Progress on Artificial Intelligence in the Management of Diabetic Foot Ulcers.
    Jinxia Du, Xiaoli Liu, Guihui Wu, Yin Huang, Yan Zhang, Xiang Long, Xiaoyi Yang, Yan Zhou.
      As a typical chronic complication of diabetes, the management of diabetic foot ulcers has long faced multiple challenges, including the highly subjective nature of wound assessment, patients'limited capacity for self-care at home, and the difficulty in predicting healing outcomes. The emergence of artificial intelligence (AI) technology offers new approaches to addressing these challenges. Based on recent domestic and international literature, this paper systematically reviews the research progress of artificial intelligence in the care of diabetic foot ulcers, focusing on four key dimensions: intelligent wound assessment (eg deep learning-based image analysis models achieving an F1 score of 93.1% for infection identification and 92.8% accuracy for area assessment), patient self-health management (eg mobile health applications and wearable monitoring devices), the development and application of smart dressings (eg responsive biomaterials and sensor integration), and the prediction of healing trends (eg machine learning prediction models, with support vector machines achieving 85.3% accuracy and an AUC of 0.922 in predicting complete DFU healing). It summarizes key technological achievements and the current status of clinical translation, provides an in-depth analysis of existing shortcomings (including insufficient algorithm generalizability, lack of prospective clinical validation, and absence of data standardization), and outlines future development directions (encompassing multimodal integration, explainable artificial intelligence, and implementation science research), with the aim of offering guidance for the further application of artificial intelligence technology in the field of chronic wound care.
    Keywords:  artificial intelligence; diabetic foot ulcers; review; smart dressings; wound care
    DOI:  https://doi.org/10.2147/DMSO.S637013
  9. Res Vet Sci. 2026 Oct 09. pii: S0034-5288(26)00390-5. [Epub ahead of print]213 106436
    Modulating phage susceptibility with membrane vesicles and bacteriophage cocktails for Acute Hepatopancreatic Necrosis Disease (AHPND) management in shrimp aquaculture.
    Lusianawati Widjaja, Agustin Indrawati, Christian Marco Hadi Nugroho, Ryan Septa Kurnia, Muhammad Ade Putra.
      Acute Hepatopancreatic Necrosis Disease (AHPND) is one of the most destructive bacterial diseases in shrimp aquaculture and is caused by virulent Vibrio parahaemolyticus strains carrying the pVA1 plasmid encoding the binary toxins PirA and PirB, resulting in severe economic losses and threatening sustainable production worldwide. Although lytic bacteriophages have emerged as promising alternatives to antibiotics because of their specificity and self-amplifying properties, their long-term effectiveness is constrained by the rapid evolution of bacterial resistance through multiple mechanisms, including surface receptor modification. Recent evidence indicates that membrane vesicles (MVs) can modulate phage-bacterium interactions through mechanisms that vary among bacterial systems. In Bacillus subtilis, MVs can transfer phage attachment molecules and transiently restore phage sensitivity, whereas in Vibrio parahaemolyticus, MVs have been reported to enhance phage efficacy, although the underlying mechanism remains unresolved. This review synthesizes current knowledge on AHPND epidemiology, phage infection and resistance, MV biology, phage cocktail design, formulation, and delivery strategies. It further evaluates the potential of MV-assisted phage approaches as a complementary strategy for sustainable AHPND management, while highlighting the need to validate functional receptor restoration in resistant Vibrio and address challenges in MV standardization, biosafety, and field application.
    Keywords:  AHPND; Bacteriophage; Membrane vesicles; Phage resistance; Shrimp aquaculture
    DOI:  https://doi.org/10.1016/j.rvsc.2026.106436
  10. Clin Exp Dent Res. 2026 Oct;12(5): e70485
    Diagnostic Accuracy of Salivary Thiols Point-of-Care Test for Detecting Subgingival Dysbiosis in Adults: A Cross-Sectional Study.
    Ahmed Khocht, Thomas E Rams, Tsute Chen, Jon B Suzuki.
       OBJECTIVES: Many bacteria implicated in the pathogenesis of periodontitis produce thiol compounds containing sulfhydryl (-SH) groups. This cross-sectional study used a prototype chromogenic test strip to investigate the relationship between whole saliva -SH levels and subgingival bacterial species in subjects with and without periodontal disease.
    MATERIALS AND METHODS: Ninety-six subjects were enrolled. Full-mouth comprehensive clinical periodontal evaluations were performed. Subjects were divided into 3 groups: periodontally healthy, gingivitis, and periodontitis. Subgingival plaque samples were collected and analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization. Subgingival dysbiosis severity was determined with a modified Subgingival Microbial Dysbiosis Index (mSMDI). Salivary thiol levels were determined semi-quantitatively with a chromogenic strip dipped in pooled saliva on the tongue surface.
    RESULTS: Low and high strip scores were uniquely associated with contrasting groups of subgingival bacteria. Individuals with high strip scores harbored increased levels of P. gingivalis, P. intermedia, T. forsythia, P. nigrescens, E. nodatum, and T. denticola as well as higher mSMDI scores than individuals with low strip scores. Furthermore, strip scores showed high specificity (93%) in correctly identifying individuals with normobiotic subgingival microbiota.
    CONCLUSIONS: Low salivary thiol levels are useful indicators of subgingival normobiosis.
    Keywords:  biofilms; dental plaque; microbial ecology; periodontal diseases; periodontitis; point‐of‐care test; saliva; sulfide
    DOI:  https://doi.org/10.1002/cre2.70485
  11. Microbiology (Reading). 2026 Oct;172(10):
    How cystic fibrosis modulator therapy could transform Pseudomonas aeruginosa epidemiology.
    James Gurney, Morgana Letizia, Sheyda Azimi, Stephen P Diggle.
      The advent of cystic fibrosis transmembrane conductance regulator modulators has revolutionized cystic fibrosis (CF) care by restoring epithelial ion transport and improving airway physiology in people with CF. These therapies reduce infection burden, especially from Pseudomonas aeruginosa, through enhanced mucociliary clearance and immune responses. Yet, P. aeruginosa often persists, raising concerns about microbial adaptation. Emerging evidence suggests that modulator-altered airways impose novel selective pressures, favouring mutations in genes linked to biofilm formation, iron metabolism and immune evasion. This may drive the emergence of strains adapted to a 'hybrid' airway; neither fully CF-like nor fully healthy. Such adaptations could potentially increase transmissibility or virulence, with implications beyond the CF population. Understanding how pathogens evolve under modulator pressure is essential in this new treatment era. Continued surveillance of microbial dynamics will be key to anticipating shifts in infection risk and informing future clinical and public health strategies.
    Keywords:  CFTR modulators; Pseudomonas aeruginosa; chronic infection; cystic fibrosis; microbial adaptation; pathogen evolution
    DOI:  https://doi.org/10.1099/mic.0.001790
  12. Am J Dent. 2026 Oct;39(5): 253-258
    Oral microbiome and inflammatory bowel disease: A scoping review.
    Caifeng Chen, Hongli Zhang, Tingting Cheng, Feng Zhou, Xiuli Chen, Mengna Fang, Peiwen Qi.
       PURPOSE: To examine the association between the oral microbiome and IBD in terms of microbiota diversity, composition, function, and diagnostic potential through a scoping review of the existing literature.
    METHODS: This scoping review was structured following the PRISMA-ScR guidelines. Literature searches were conducted in PubMed, Embase, and the Cochrane Library, with the time frame restricted from database inception to November 17, 2025.
    RESULTS: This review included 31 studies, among which seven topics for patients with periodontitis and IBD-related periodontitis, three studies assessed single bacterial species, and the remaining 21 articles explored the diversity and phylum-level taxonomic shifts of oral microbiota in IBD patients, functional and metabolic pathway alterations associated with oral dysbiosis, as well as the diagnostic potential and biomarkers derived from oral microbial profiles.
    CLINICAL SIGNIFICANCE: The oral microbiota of IBD patients exhibits characteristic dysbiosis, manifested by the enrichment of pathogenic taxa, depletion of anti-inflammatory species, and metabolic dysfunction, which are closely associated with gut microbial alterations and systemic inflammatory status. The salivary microbiome demonstrates significant diagnostic potential for IBD.
  13. Front Immunol. 2026 ;17 1957976
    Histone post-translational modifications in diabetic foot ulcer healing: linking immune dysregulation to tissue repair.
    JingBo Hou, JunZhe Chen, YueZhong Chen, ZiYi Luo, Shaoxiang Yuan, Chengliang Deng, Shune Xiao.
      Diabetic foot ulcer healing is compromised because metabolic, inflammatory and tissue-repair processes fail to proceed in a coordinated and timely manner. Persistent hyperglycemia, metabolic stress and oxidative imbalance can reshape immune-cell function and the tissue microenvironment, thereby sustaining inflammatory activation and hindering the transition to a reparative state. However, the epigenetic mechanisms that maintain these maladaptive states and link them to defective tissue regeneration remain incompletely understood. Histone post-translational modifications (hPTMs) constitute a dynamic regulatory layer through which metabolic and inflammatory signals are integrated with chromatin structure and gene expression. Persistent alterations in hPTMs may contribute to molecular imprints associated with metabolic memory, thereby sustaining vascular inflammation and remodeling that may further compromise tissue repair in diabetic foot ulcers. This Review summarizes current evidence for the involvement of histone acetylation, methylation, phosphorylation and metabolism-associated histone modifications in immune dysregulation and impaired diabetic foot ulcer healing. We discuss how hPTM-dependent mechanisms regulate inflammatory activation and resolution, macrophage functional transitions and vascular remodeling, and how these alterations influence angiogenesis, fibroblast-to-myofibroblast differentiation, extracellular matrix remodeling and keratinocyte-mediated re-epithelialization. Particular attention is given to the distinction between evidence derived directly from diabetic foot ulcer studies and evidence extrapolated from other diabetic tissues, non-diabetic wound models and in vitro systems. We also discuss recent direct diabetic wound-model interventions targeting acetylation-related pathways, including the p300/CBP-ZEB2 axis and restoration of H3K27ac-associated macrophage regulatory states, as well as lactate-oxidizing strategies that modulate lactylation-related responses. These studies provide intervention-based preclinical support for the functional involvement of acetylation and metabolism-associated chromatin regulation in diabetic wound repair, although the responsible histone sites, causal cell populations, treatment windows and relevance to human DFUs remain incompletely defined. Taken together, current evidence supports hPTMs as an important regulatory interface linking the diabetic microenvironment to persistent immune dysregulation, vascular dysfunction and impaired tissue repair. However, the therapeutic relevance of these mechanisms remains difficult to assess because the available evidence is heterogeneous and predominantly preclinical, while the cell specificity, temporal dynamics and clinical applicability of epigenetic interventions remain uncertain.
    Keywords:  angiogenesis; diabetic foot ulcer; epigenetic regulation; histone post-translational modifications; inflammation resolution; macrophages; therapeutic delivery; wound healing
    DOI:  https://doi.org/10.3389/fimmu.2026.1957976
  14. PLoS One. 2026 ;21(10): e0359540
    Texture-aware diffusion modelling for severity-conditioned synthetic progression-like visualization of diabetic foot ulcers from single images.
    Pratham Kaushik, Vinay Kukreja, Eshika Jain, Modafar Ati, Shanmugasundaram Hariharan.
      Diabetic foot ulcers (DFUs) are serious complications of diabetes associated with delayed healing, infection, and limb amputation. Modelling DFU progression remains challenging because publicly available image datasets generally contain independent single-timepoint images rather than longitudinal follow-up sequences. This study proposes a texture-aware conditional diffusion framework for generating severity-conditioned, progression-like synthetic DFU images from a single RGB input. Instead of claiming patient-specific temporal prediction, the framework models plausible population-level visual transitions across ordinal pseudo-stages derived from clinically relevant severity cues. The full model achieved an SSIM of 0.851 ± 0.020, PSNR of 24.76 ± 1.12 dB, and FID of 44.33 ± 5.02, with higher observed SSIM and PSNR and lower FID values than the evaluated GAN and VAE baselines across structural fidelity and distributional realism. The GAN baseline achieved SSIM 0.782 ± 0.031, PSNR 21.98 ± 1.56 dB, and FID 59.13 ± 6.59, while the VAE baseline achieved SSIM 0.738 ± 0.038, PSNR 19.63 ± 1.83 dB, and FID 69.77 ± 7.44. The framework also obtained a Texture Consistency Score of 0.79 ± 0.04 and a Granulation Tissue Fidelity Score of 0.76 ± 0.05, indicating preservation of fine-grained texture and granulation-related appearance patterns. Ablation results confirmed the contribution of texture conditioning and cross-attention to image fidelity. Advanced severity-state analysis produced SSIM values of 0.674, 0.804, and 0.726 across three pseudo-stages, supporting severity-aligned structural consistency. Since true longitudinal future-state images were unavailable, these metrics indicate synthetic image fidelity and distributional realism, not longitudinal progression accuracy. Longitudinal DFU cohorts and larger clinician-centred validation remain necessary before clinical decision-support use or temporal progression claims can be justified. To assess generalization beyond the primary 493-image dataset, external validation was additionally performed on an independent DFU dataset under a zero-shot setting, demonstrating stable cross-dataset performance with only modest degradation in image fidelity and texture consistency. Therefore, the proposed framework should be interpreted as modelling cross-sectional severity-conditioned appearance interpolation across independent cases, rather than true patient-specific future progression prediction.
    DOI:  https://doi.org/10.1371/journal.pone.0359540
  15. Wounds. 2026 Sep;38(9): 224-236
    Prospective evaluation of the clinical effectiveness of an innovative catalytic wound care technology.
    Anna Bradford, Jill de Grood, Kathryn Ambler, Negar Dehghan Noudeha, Patty Wickson, Chester Ho.
       BACKGROUND: Chronic wounds present a significant health concern due to their prolonged healing time, risk of severe complications, and the burden they place on patients, health care providers, and the health system.
    OBJECTIVE: To prospectively evaluate an advanced wound care treatment that delivers catalytic technology (through polymers engineered to replicate the extracellular matrix) and facilitates copper-dependent cellular signaling pathways involved in wound healing.
    METHODS: This interrupted time series was a multisite, within-patient controlled, clinical evaluation of the catalytic technology involving 25 participants each with at least 1 chronic wound (pressure injury, diabetic foot ulcer, or venous leg ulcer). Participants received standard wound care for 28 days (control phase), followed by 28 days with the catalytic technology replacing the primary dressing (intervention phase). Wound percent area reduction (PAR) was assessed weekly.
    RESULTS: The average wound age prior to study inclusion was 84 weeks. In the control phase, the average PAR was -1.0%. In the intervention phase, the average PAR was 56.6%, showing that the catalytic technology accelerated wound healing (total overall change, 57.6%; P < .0001; > 95% power). The catalytic technology also demonstrated a safety profile equivalent to that of current state dressings.
    CONCLUSION: When used in combination with standard of care practices to promote wound healing, the catalytic technology was shown to be an effective tool in the treatment of chronic wounds compared with other available wound dressings.
    Keywords:  catalytic technology, innovation; chronic wounds; pressure injury; wound healing
    DOI:  https://doi.org/10.25270/wnds/25122
  16. Med Image Anal. 2026 Oct 07. pii: S1361-8415(26)00413-5. [Epub ahead of print]115 104344
    Mind the Gap: A survey of chronic wound datasets, methods, and clinical translation.
    Anum Fatima, Moi Hoon Yap, Neil D Reeves, Michael Odling-Smee, David Bond, Connah Kendrick.
      Chronic wounds, including diabetic foot ulcers, venous ulcers, arterial ulcers and pressure ulcers, represent a growing global health challenge with significant morbidity, mortality, and economic burden. Advancements in medical image analysis have shown promise in automating wound detection, segmentation, and measurement. However, translation of these research advances into clinical practice through mobile applications remains limited. This survey presents systematic analysis of the relationship between chronic wound datasets, deep learning methods, and mobile wound assessment applications. We analyse 20 datasets (14 public/partially public and 6 private), including iterative challenge datasets that extend image pool through synthetic augmentation. We review 50 deep learning methods spanning encoder-decoder architectures to self-supervised learning approaches, and evaluate 13 mobile applications (commercially deployed clinical tools and research prototypes). We examine the alignment between publicly available chronic wound datasets and the documented capabilities of mobile wound assessment mobile applications. Our analysis reveals critical misalignments between datasets, algorithms and mobile applications. Existing datasets are typically designed for algorithm benchmarking rather than clinical deployment, and therefore lack standardised acquisition protocols, scale calibration markers, depth information, detailed tissue composition annotations, and representation of diverse skin types. Conversely, reviewed mobile applications report capabilities, including automatic tissue classification, calibrated wound measurement and depth estimation, for which publicly available data is insufficient. We map documented dataset characteristics to capabilities reported among reviewed mobile applications, identify unresolved methodological challenges, and outline key priorities for the field. Based on these insights, we propose actionable recommendations for developing clinically translatable computer vision system for wound assessment. This survey is intended to serve as a reference for researchers and practitioners seeking to bridge the gap between medical imaging methodologies and practical demands of clinical wound care.
    Keywords:  Chronic Wound; Dataset; Deep Learning; Mobile applications; Segmentation; Survey
    DOI:  https://doi.org/10.1016/j.media.2026.104344
  17. Microbiol Spectr. 2026 Oct 16. e0157726
    Tracking eco-evolutionary patterns among oropharyngeal pathobiome members in a pediatric cystic fibrosis cohort.
    Lukas Schwyter, Roger Kuratli, Serena Provveduto, Phoebe Do Carmo Silva, Philipp Latzin, Freya Harrison, Markus Hilty, Rolf Kümmerli.
      Polymicrobial airway colonization is common in individuals with cystic fibrosis (CF). Pathogen communities typically follow an ecological succession in which early colonizers, such as Haemophilus influenzae and Staphylococcus aureus, are later joined by Pseudomonas aeruginosa. Although adaptation to the lung environment is well described for single pathogens in adult people with CF, much less is known about the role of pathogen interactions and how changes in individual pathogens influence community dynamics at the early stages of disease. To address these questions, we combined genome sequencing with phenotypic screens and pathogen interaction assays using longitudinal clinical isolates (19 P. aeruginosa, 44 S. aureus, and 21 H. influenzae) collected from 23 children with CF (0-7.9 years of age) enrolled in the Swiss Cystic Fibrosis Infant Lung Development (SCILD) cohort. Our analysis suggests that early pathogen communities are characterized by a combination of strain turnover and persistence of specific isolates that go along with cohort-wide, age-associated shifts in pathogen phenotypes and interaction patterns. Most notably, quorum-sensing-deficient P. aeruginosa variants repeatedly emerged, showing reduced protease production and diminished inhibition of S. aureus and H. influenzae. These changes demonstrate that P. aeruginosa isolates from older children exhibit reduced antagonism toward co-occurring pathogens via secreted factors. Together, our results show that ecological and evolutionary dynamics between pathobiome members may play an underappreciated role in shaping CF lung disease during early childhood.
    IMPORTANCE: Our study shows how bacterial communities in the lungs of children with cystic fibrosis change during the earliest stages of disease. By tracking three major pathogens over time, we found that both replacement of strains and persistence shape colonization dynamics and pathogen interaction patterns. In particular, Pseudomonas aeruginosa frequently showed mutations that reduced its production of harmful compounds and weakened its ability to inhibit other bacteria. These changes indicate that interspecies interactions are dynamic during early childhood. Understanding these early interaction patterns provides useful cues about potential future microbial management in cystic fibrosis.
    Keywords:  cystic fibrosis; eco-evolutionary dynamics; pathobiome; polymicrobial infections
    DOI:  https://doi.org/10.1128/spectrum.01577-26
  18. Npj Viruses. 2025 Apr 25. pii: 37. [Epub ahead of print]3(1):
    Gp38 adhesins of Straboviridae phages recognize specific extracellular loops of outer membrane protein receptors.
    Veronika T Lutz, Victor Klein-Sousa, Martin S Bojer, Saar S F Van Overfelt, Sam R Nugen, Nicholas M I Taylor, Michela Gambino, Lone Brøndsted.
      Tailed bacteriophages (phages) depend on specific interactions with their host receptors for efficient infection and propagation. Gp38 is a unique receptor-binding protein located at the distal tail of Straboviridae phages characterized by a defined modular, monomeric structure. Here, we demonstrated that the similarity of Gp38 adhesins, encoded by related yet distinct Straboviridae phages belonging to Tequatrovirus, Mosigvirus, and Krischvirus, determines the recognition of receptors such as Tsx, OmpF, and OmpA. For OmpA, experimental and in silico analysis identified specific outer loops protruding from the receptor required for phage infection by interacting with Gp38. Yet, the loops involved are dependent on the adhesin variant. In-depth in silico analysis identified two groups of Gp38 adhesins differentially interacting with OmpA by expressing specific amino acids. This demonstrates that both partners' diversity affects phage binding and host range. Overall, the phylogeny of Gp38 adhesins can predict receptor binding essential for advancing phage therapy.
    DOI:  https://doi.org/10.1038/s44298-025-00118-9
  19. bioRxiv. 2026 Sep 28. pii: 2026.09.27.754834. [Epub ahead of print]
    Bacteriophage and Antibiotic Resistance Are Positively Associated across a Phylogenetically Diverse Set of Clinical Pseudomonas aeruginosa Isolates.
    Anna L Rodden, Robert W Targ, Zachary N Flamholz, Paul L Bollyky, Jessica C Sacher.
      Co-administration of phages and antibiotics has been proposed as a therapeutic approach against antibiotic-resistant bacteria. The relationship, however, between antibiotic resistance and phage resistance in clinical isolates is unclear. Here, we examine associations between phage and antibiotic resistance profiles across a panel of Pseudomonas aeruginosa clinical isolates from the Centers for Disease Control (CDC) and Food and Drug Administration (FDA) Antimicrobial Resistance Isolate (ARI) Bank comprising 55 clinical strains with full genome sequences and antibiotic susceptibility testing (AST) data for 11 clinically relevant antibiotics. As phages in this study, we use three well-characterized, morphologically distinct phages, OMKO1, Luz19, and PAML31-1. We screen for phage resistance using a growth suppression assay, then conduct statistical analysis against antibiotic MIC (Minimum Inhibitory Concentration) data provided by the CDC to define association patterns across this dataset. We find multiple significant susceptibility correlations between pairs of antibiotics and phages, and a positive overall association between average phage resistance and antibiotic resistance across the 55 strains, even controlling for phylogenetic associations ( r =0.358, p<0.005). We conclude that phage and antibiotic resistance are positively associated across this clinical isolate collection, suggesting that the two resistance phenotypes are not independent in P. aeruginosa . These findings have implications for the development of phage-antibiotic cocktails.
    Importance: Antimicrobial resistance causes substantial and increasing global mortality. Understanding how bacteria develop resistance to different antimicrobial agents, particularly antibiotics and bacteriophages, is essential for identifying shared and distinct resistance mechanisms and developing more effective therapies.
    DOI:  https://doi.org/10.64898/2026.09.27.754834
  20. Indian J Microbiol. 2026 Oct;66(5): 1217-1231
    Selective Synergy Between Phages and Antibiotics Improves Treatment Outcomes in Staphylococci Infections.
    Medhavi Vashisth, Monika Kumari, Karan Bhutani, Prexha Kapoor, Bidhan C Bera, Nitin Virmani, Rajesh K Vaid, Taruna Anand.
      An indiscriminate use of antibiotics in treatment of animal diseases has lead to emergence of antimicrobial resistance in Staphylococcus genus. Bacteriophages are a promising alternative, but it seems challenging to completely replace their use so the current study was undertaken to explore lytic bacteriophages against circulating Staphylococcus species obtained from animal farms and to assess their synergy with antibiotics. Five myophages (φBPA112-116) were isolated and assessed for their growth characteristics, host range, stability at varied physiological conditions of temperature and pH and for carriage of antibiotic resistance genes (ARGs). Only one isolate (φBPA116) was observed to be a broad range phage which was biologically active against (67.92%) of Staphylococcus isolates. Bacteriophages were found to show selective synergy with antibiotics as assessed by antibiotic-disc embedded double-layered agar method. The combined application of phages and cephalothin (0.5 µg/ml) lead to a significant inhibition of bacterial growth (p < 0.001) in liquid cultures compared with controls at all the multiplicity of infections (MOIs) tested and reduced the biofilm formation in a dose dependent manner in suboptimal antibiotic concentration supplemented media. These findings illustrate the potential therapeutic value of phages and support further clinical development of "Phage-Antibiotic synergy" as a treatment option for Staphylococcus infections prevailing in animal farms.
    Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s12088-026-01551-x.
    Keywords:  Bacteriophage; Biofilm; Myovirus; Phage-antibiotic synergy; Staphylococcus
    DOI:  https://doi.org/10.1007/s12088-026-01551-x
  21. Health Sci Rep. 2026 Oct;9(10): e73396
    Artificial Intelligence in Rapid Diagnostics for Antimicrobial Resistance: From Bench to Bedside.
    Nadine Mugisha, Lolita Fawaz, Rawan Noureddine, Pascal Mathew Okorobe, Mohamad Monif Assker, Olivier Uwishema.
       Background: Antimicrobial resistance (AMR) is one of the most urgent global public health threats, especially in low- and middle-income countries. In 2019, bacterial AMR was estimated to have directly caused approximately 1.27 million deaths and to have been associated with 4.95 million deaths worldwide. Rapid identification of resistant infections is important, yet established diagnostics are very slow. In recent years, artificial intelligence (AI) has revolutionized microbiology and infectious disease diagnostics. This review explores the space of AI-enabled diagnostics for AMR detection and characterization.
    Methods: This literature review was conducted from January to September 2026 using PubMed/MEDLINE, Google Scholar, and other electronic databases with keywords including "AI," "AMR," "deep learning," "genomic diagnostics," and "point-of-care (POC) testing." Following screening and full-text assessment, 67 Peer-reviewed articles and systematic reviews were included to support the synthesis presented in the manuscript, while non-peer-reviewed articles and studies lacking direct AI relevance were excluded. Titles and abstracts were screened before full-text review.
    Results: AI-enhanced diagnostics were reported to shorten turnaround time for AMR detection with promising but heterogeneous predictive performance; for example, pooled estimates across antimicrobial stewardship applications indicate an area under the curve of approximately 0.72. They also support improving antimicrobial stewardship and enable early therapeutic optimization in laboratory and POC settings, enabling real-time clinical decision-making. Despite these achievements, evidence for direct improvements in patient outcomes and routine bedside effectiveness remains limited.
    Conclusion: AI-driven diagnostic tools represent a promising strategy to bridge laboratory innovation and bedside application in combating AMR. The tools have the capacity to improve patient outcomes and enhance antimicrobial stewardship as they can accurately detect resistance patterns and support real-time clinical decisions. However, long-term sustainability, long-term success, and global impact can be achieved by continued validation, regulatory alignment, and equitable implementation across diverse healthcare settings.
    Keywords:  antimicrobial resistance; artificial intelligence; deep learning; genomic diagnostics; point‐of‐care testing
    DOI:  https://doi.org/10.1002/hsr2.73396
  22. Curr Opin Infect Dis. 2026 Oct 12.
    Screening for multidrug-resistant organism: clinical benefit or unquestioned routine.
    Alex Soriano, Marta Ulldemolins, Cristina Pitart, Pedro Castro, Mateu Espasa, Josep Mensa.
       PURPOSE OF REVIEW: Current strategies for multidrug-resistant organism (MDRO) screening are primarily intended to support infection prevention programs. However, accumulating evidence indicates that intestinal colonization also provides clinically relevant information for antimicrobial stewardship. This review examines the biological basis and clinical utility of mucosal screening for optimizing empirical antibiotic therapy and proposes a new conceptual framework linking intestinal pathobiont burden with endogenous bloodstream infection.
    RECENT FINDINGS: Recent studies consistently show that the absence of MDRO carriage is associated with a very low risk of subsequent infection, supporting well tolerated antimicrobial de-escalation in patients with negative clinical cultures. Emerging evidence further indicates that prolonged exposure to antianaerobic antibiotics promotes expansion of intestinal pathobionts, whereas preservation or restoration of the gut microbiota limits this process. Experimental and clinical observations suggest that the abundance of pathobionts, rather than simple carriage status, determines the probability of bacterial translocation and invasive infection.
    SUMMARY: We propose that physiological bacterial translocation from the intestinal microbiota is a common phenomenon and may represent one of the mechanisms of bloodstream infection in critically ill and immunocompromised patients. In this model, progression to invasive infection depends on intestinal pathobiont burden exceeding the capacity of host immune clearance. If validated, this concept would support a transition from qualitative MDRO screening to quantitative assessment of intestinal pathobiont burden to guide antimicrobial stewardship and targeted preventive strategies.
    Keywords:  antimicrobial stewardship; bacterial translocation; gut microbiota; multidrug-resistant organisms; pathobionts
    DOI:  https://doi.org/10.1097/QCO.0000000000001248
  23. Nurs Res Pract. 2026 ;2026 8864223
    Severity-Stratified Healing Outcomes of Nurse-Managed Negative Pressure Wound Therapy in Diabetic Foot Ulcers: A Prospective Comparative Cohort Study.
    Suriadi Jais, Kharisma Pratama, Ivan Sujana, Suhaimi Fauzan.
       Aim: To compare healing outcomes of nurse-managed negative pressure wound therapy (NPWT) and standard wound care (SWC) across baseline wound severity levels classified using the Suriadi, Haryanto, Imran Dan Defa (SHID) system in patients with diabetic foot ulcers (DFUs).
    Design: A prospective quasiexperimental comparative cohort study.
    Methods: This study was conducted at Kitamura Clinic between June and December 2025. Sixty-three patients with DFUs were enrolled in this study (NPWT, n = 31; SWC, n = 32). Wound severity was assessed using the SHID classification system, and wound progression was monitored weekly using the depth, maceration, infection, size, tissue type, and tunnelling. The primary outcome was time to complete wound healing within 12 weeks. Kaplan-Meier survival and Cox proportional hazards regression analyses were performed. A multivariable Cox model stratified by SHID stage accounted for baseline wound severity.
    Results: Median healing time was significantly shorter in the NPWT group than in the SWC group (31 [13-70] vs. 81.5 [31-127] days, p < 0.001). All patients in the NPWT group achieved complete healing within 12 weeks compared with 50% in the SWC group (p < 0.001). Survival analysis demonstrated significantly faster healing in the NPWT group (log-rank test, p < 0.001). In the stratified multivariable Cox model adjusting for age, hemoglobin A1c, and sex, NPWT therapy remained independently associated with accelerated wound healing (adjusted hazard ratio 2.77, 95% confidence interval 1.40-5.47; p = 0.003).
    Conclusion: Nurse-managed NPWT was associated with faster wound healing across SHID Stages 3-5. SHID-based severity assessment may provide useful prognostic information for interpreting healing trajectories, treatment planning, and follow-up monitoring.
    Keywords:  SHID classification; diabetic foot ulcer; negative pressure wound therapy; nursing practice; wound healing
    DOI:  https://doi.org/10.1155/nrp/8864223
  24. Microbiology (Reading). 2026 Oct;172(10):
    Microbe Profile: Acinetobacter baumannii: persist and resist.
    Rubén de Dios, Ronan R McCarthy.
      Acinetobacter baumannii is a Gram-negative opportunistic pathogen associated with a wide variety of healthcare-associated infections, including ventilator-associated pneumonia, urinary tract infections, bacteraemia and wound infections. It adopts a 'persist and resist' pathogenic strategy to establish infection in the host. It can form robust biofilms and survive in a desiccated state for months at a time, driving its persistence in the hospital-built environment. It also has a remarkable capacity to rapidly develop antimicrobial resistance, with >90% of contemporary clinical isolates being multidrug-resistant. This combination of pathogenic traits has caused A. baumannii to emerge as a major clinical challenge.
    Keywords:  Acinetobacter baumannii; antibiotic resistance; biofilm; desiccation
    DOI:  https://doi.org/10.1099/mic.0.001787
  25. Burns Trauma. 2026 ;14 tkag051
    Hydrogel microneedles for chronic wound microenvironment remodeling: from drug delivery to intelligent treatment.
    Rong Nie, Liang Zhao, Tao He, Zi-Yuan Feng, Yue-Qi Zhang, Ming-Hui Fan, Li-Ping Mou, Hui-Qi Xie.
      The considerable strain that chronic wounds, including diabetic foot ulcers and pressure sores, place on healthcare systems worldwide is largely attributable to the intricate pathological microenvironment characteristic of these conditions, and conventional therapeutic approaches frequently fall short of desired outcomes, primarily because they cannot effectively disrupt biofilm barriers or adequately adapt to the dynamically changing pathological states involved. Hydrogel microneedles (HMNs) have by contrast emerged as a minimally invasive platform whose distinctive structural features and material properties enable both precise transdermal drug administration and active modulation of the wound microenvironment, and this dual capability is why HMNs are currently transforming chronic wound care by shifting the paradigm from passive occlusive dressings toward more proactive and targeted regenerative interventions. This review summarizes recent progress in HMN-based strategies for chronic wound healing and offers perspectives on future developments, beginning with an examination of fundamental design principles such as material choices, structural arrangements, and the various approaches developed to optimize performance metrics, then tracing the evolution of HMNs from simple drug carriers to intelligent multifunctional systems with special attention to their roles in breaking the pathological cycle through antibacterial effects, reactive oxygen species (ROS) scavenging, immune response modulation, and promotion of angiogenesis. Advances in stimuli-responsive systems that utilize endogenous signals including potential of hydrogen, enzymes, ROS, and glucose or external inputs like light and magnetic fields for on-demand release are also covered, as are combination platforms that integrate different therapeutic strategies for additive benefits. Clinical translation faces a number of challenges despite the considerable promise HMNs exhibit in theranostic applications, regenerative medicine integration, and customized fabrication, with obstacles remaining regarding scalable production that ensures consistent quality across batches, long-term biosafety verification, and unclear regulatory pathways; overcoming these hurdles will depend on sustained interdisciplinary efforts that address both scientific understanding and engineering practicality, and without such collaborative work the meaningful incorporation of HMNs into routine clinical management of chronic wounds along with the consequent availability of more effective, accurate, and intelligent treatment options could be difficult to achieve.
    Keywords:  Chronic wounds; Hydrogel microneedles; Integrated synergy; Intelligent responsiveness; Microenvironment remodeling
    DOI:  https://doi.org/10.1093/burnst/tkag051
  26. bioRxiv. 2026 Sep 28. pii: 2026.09.24.754177. [Epub ahead of print]
    A population-scale landscape of the subgingival microbiome reveals divergent routes to periodontal dysbiosis.
    Lu Li, Moemen Hussein, Karen L Falkner, Robert J Genco, Yijun Sun, Jean Wactawski-Wende, Michael J Buck, Haralampos Hatzikirou, Patricia I Diaz.
      Periodontitis is an archetypical mucosal inflammatory disease in which microbiome dysbiosis at the tooth-epithelial interface interacts with host genetic and behavioral risk factors to drive immune-mediated tissue destruction. Although subgingival microbiome compositional shifts are thought to parallel disease severity, microbiome variation at the population-level and its relationship to periodontal clinical phenotypes and disease-modifying factors remain poorly defined. Here, we use unsupervised manifold learning to map the compositional landscape of the subgingival microbiome in 1,355 adults spanning periodontal health to severe periodontitis. We identified eight latent microbiome states organized along a branching continuum from eubiosis to dysbiosis. An intermediate microbial configuration marked ecological destabilization and bifurcation into two distinct periodontitis-associated dysbiotic trajectories, distinguished by links to gingival inflammation and smoking. Although the microbiome trajectories broadly tracked periodontal destruction, a minority of individuals showed discordant microbiome-clinical phenotypes, with some individuals with periodontitis retaining otherwise eubiotic microbiomes enriched for low-abundance pathobionts, while some cases of health or mild disease had highly dysbiotic communities, suggesting distinct host susceptibility. Together, these findings define a population-scale ecological landscape of the subgingival microbiome, reveal divergent trajectories to periodontal dysbiosis, and highlight heterogeneity in the relationship between microbial community structure and clinical disease expression.
    DOI:  https://doi.org/10.64898/2026.09.24.754177
  27. Front Surg. 2026 ;13 1908843
    Recommendations for microbiological sampling in infected hard-to-heal wounds: an Italian association for cutaneous ulcers (AIUC) perspective.
    Sara Carella, Barbara De Angelis, Barbara Nardi, Francesco Branda, Diego Ceci, Caterina Borghetti, Alessandra Mercuri, Marino Cordellini, Cosimo Maglio, Monica Gonnelli, Riccardo Garcea, Giancarlo Ceccarelli.
      Chronic and hard-to-heal wounds represent a significant and growing healthcare burden, frequently complicated by infection and impaired healing. Despite the availability of international guidelines, microbiological assessment in clinical practice remains highly heterogeneous, with substantial variability in sampling techniques, timing, and interpretation of results. This variability occurs within a broader One Health context, where antimicrobial resistance and microbial ecology are shaped by interconnected human, environmental, and healthcare factors. The present recommendations, developed by the Italian Association for Cutaneous Ulcers (AIUC), aim to provide a structured and operational framework for microbiological sampling in infected hard-to-heal wounds. A multidisciplinary expert panel conducted a structured review of the literature and developed consensus-based recommendations through iterative discussion. The resulting framework addresses key aspects of the diagnostic pathway, including indications for sampling, selection of techniques (swab, tissue biopsy, and fine needle aspiration), standard operating procedures, and principles for the interpretation of microbiological findings. The recommendations emphasise a context-driven approach to sampling, recognising the complementary roles of different techniques according to clinical presentation and depth of infection. Particular attention is given to the distinction between colonisation and infection, the limitations of quantitative thresholds, and the impact of biofilm, polymicrobial interactions, and host-related factors on diagnostic accuracy and antimicrobial response. The document also highlights the importance of integrating microbiological data with clinical assessment to support appropriate antimicrobial stewardship. By translating existing evidence into practical and reproducible procedures, these recommendations aim to reduce variability in clinical practice and improve the quality of microbiological diagnostics in wound care. Within a One Health perspective, standardised and reliable microbiological data may also support surveillance of antimicrobial resistance and inform more integrated infection control strategies. The proposed framework supports more consistent clinical decision-making and may contribute to optimising antimicrobial use and patient outcomes across diverse healthcare settings.
    Keywords:  artificial intelligence; biopsy; infected hard-to-heal wounds; laboratory-methods; medico-legal implications; recommendations; swab
    DOI:  https://doi.org/10.3389/fsurg.2026.1908843
  28. ISME Commun. 2026 Jan;6(1): ycag265
    Temperate versus virulent phage lifestyle impacts microdiversity in soil environments.
    Thomas E P de Bruijn, Hilje M Doekes, Anne Kupczok.
      Bacteriophages are not only the most ubiquitous biological entity on earth, but they also display remarkable genetic diversity across and within populations. While macrodiversity has been extensively studied, the drivers of microdiversity (intra-species genetic diversity) remain poorly understood, particularly in relation to phage lifestyle. The distinguishing ability of temperate phages to integrate themselves into the host genome has an unknown influence on the microdiversity present. This difference in microdiversity could impact the adaptability of phages to (a)biotic factors. To identify a possible association between microdiversity and lifestyle, we analysed 12 existing viromics datasets focusing on soil bacteriophages, including 43 171 viral genomes in total. We found that phages predicted to be temperate consistently exhibit higher microdiversity than their virulent counterparts in 8 of 12 datasets. Of the remaining four datasets, one showed the opposite trend and three datasets did not show a significant trend at all. The detected pattern holds across multiple quality thresholds and lifestyle prediction methods. These findings suggest that lifestyle has a significant impact on genetic variation within phage populations, with potential implications for phage-host coevolution and environmental adaptability.
    Keywords:  bacteriophages; lysogeny; metagenomics; microdiversity; soil virome
    DOI:  https://doi.org/10.1093/ismeco/ycag265
  29. Int J Mol Sci. 2026 Oct 07. pii: 8914. [Epub ahead of print]27(19):
    Protein Language Models Identify Early Folding Residues as Critical Hotspots for Pathogenic Variants and Cancer Prognosis.
    Lisha Guo, Fuchong Yuan, Na Zhou, Minghui Zhao, Ruotong Liu, Ming Jing, K Anton Feenstra, Qingzhen Hou.
      Identifying the specific residues that initiate protein folding is critical for understanding protein stability and the mechanisms of misfolding-related diseases. However, the systematic, proteome-wide identification of these early folding residues (EFRs) has been hampered by both experimental and computational limitations. Here, we present LMEFold, a deep learning framework using protein language models (PLMs) to accurately predict EFRs from amino acid sequence alone. LMEFold outperforms existing sequence-based predictors on the Start2Fold benchmark (ROC AUC = 0.831), and its predicted scores show consistent associations with independent HDX-NMR protection-factor measurements, providing complementary biophysical evidence. Applying LMEFold to annotate over 6.6 million variants across diverse genomic datasets, we find that pathogenic mutations curated in ClinVar are significantly enriched within EFRs (~17%) compared to millions of population variants from large-scale cohorts including the UKB and gnomAD databases (~10%, P < 0.001). Critically, in the MSK-MET pan-cancer clinical cohort, EFR mutations are associated with severe functional disruption and significantly reduced overall patient survival. Structural analysis of hotspot cancer mutations, such as TP53 p.Y163C, suggests a mechanism whereby these variants destabilize protein structure by disrupting the early folding core. Our work establishes EFRs as critical sites of pathogenic vulnerability and provides a powerful framework for the rapid identification of folding-centric prognostic markers using sequence only.
    Keywords:  cancer prognosis; early folding residues; pathogenic variation; protein language model; structural vulnerability
    DOI:  https://doi.org/10.3390/ijms27198914
  30. Appl Microbiol Biotechnol. 2026 Aug 17. pii: 309. [Epub ahead of print]110(1):
    Biofilm state transitions: quorum sensing inhibition and network destabilization.
    Ayşe Nur Yurdcu, Mustafa Akçelik, Nefise Akçelik.
      Biofilms are traditionally viewed as surface-associated, extracellular polymeric substance (EPS)-encased aggregates. Here, we present a theoretical perspective positioning biofilm formation as a coordinated regulatory state transition, drawing on a synthesis of published transcriptomic, proteomic, and metabolic studies that document systemic reprogramming of gene regulatory networks, second-messenger signaling (e.g., cyclic di-GMP), quorum sensing circuits, and metabolic flux distribution. Spatial stratification within biofilms generates metabolically distinct subpopulations-including persisters and dormant cells-that enhance collective robustness. Using Salmonella enterica serovar Typhimurium as a model organism, we formalize quorum sensing inhibition (QSI) as one plausible bifurcation control parameter, with its destabilizing effects described by a coarse-grained phenomenological model governed by cooperativity, population density, and signal decay rates. We show, through bifurcation analysis and cross-referencing with published experimental biofilm disruption studies, that sufficiently strong signal-decay-type QSI can collapse the high-signal biofilm attractor without imposing strong bactericidal pressure. This network-centric perspective elucidates how destabilization of collective regulatory circuits-rather than direct cell killing-can enhance therapeutic susceptibility. Additionally, the framework provides a conceptual basis for combinatorial strategies integrating antivirulence interventions with conventional antimicrobials, with the potential to reduce the pace of resistance evolution by targeting cooperative rather than essential traits. Predictions arising from this framework require direct experimental validation to establish quantitative accuracy. KEY POINTS: • Biofilms can be conceptualized as coordinated regulatory attractor states sustained by multilayered feedback coupling. • QSI is formalized as one plausible bifurcation control parameter capable of destabilizing the high-commitment biofilm state when implemented as signal-degradation-type inhibition. • Network destabilization may enhance antimicrobial susceptibility while imposing lower evolutionary pressure than direct bactericidal approaches.
    Keywords:   Salmonella enterica ; Antivirulence strategies; Biofilms; Dynamical systems modeling; Quorum sensing inhibition; Regulatory networks
    DOI:  https://doi.org/10.1007/s00253-026-14001-x
  31. Iran J Nurs Midwifery Res. 2026 Sep-Oct;31(5):31(5): 731-741
    Effectiveness of Negative Pressure Wound Therapies on the Healing Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis.
    Asmat Burhan, Chrisnawati, Desty W Alfons, Septian M Sebayang, Suci Khasanah, Aloysia Ispriantari, Rahmad Wahyudi, Vijay Kumar.
       Background: Negative pressure wound therapy (NPWT) is a technology-based modality therapy in the treatment of diabetic foot ulcers used by nursing. However, there are variations in its effectiveness among patients, which requires further research to better understand. This systematic study investigated the effect of NPWT on the healing of diabetic foot ulcer (DFU).
    Material and Methods: The databases consulted were CINAHL, ProQuest, PubMed, ScienceDirect, and Wiley, with a date range restriction from September 2003 to July 2022. The inclusion criteria were full-text articles with a randomized controlled trial design and English publication. They were using comprehensive meta-analysis (CMA) version 3.3.070 software to conduct a meta-analysis.
    Results: There were 1.375 participants in 14 trials, and residual heterogeneity analysis indicated wound healing I-squared (I2) of 97.70%, microcirculation I2 of 90.20%, and infection I2 of 98.50% (I2 > 50%), indicating high heterogeneity. The random effect model value showed a significant positive effect on wound healing with z = 0.01, microcirculation with z = 0.01, and negative effect on infected with z = 0.33. The analysis indicated that DFU wound healing had standard mean difference (SMD) = -0.36, 95% with confidence interval (CI): -0.92, -0.18, microcirculation improvement had SMD = 0.33, 95% CI: -0.68, 0.02, while infection control showed a negative result with SMD = 0.41, 95% CI: 0.62, 1.44, with a weak significant effect.
    Conclusions: The findings of this study indicate that NPWT administered by nurses improves wound healing in DFU patients. Regarding infection control, this study did not produce statistically significant results.
    Keywords:  Diabetic; foot ulcer; meta-analysis; negative pressure wound therapies; wound healing
    DOI:  https://doi.org/10.4103/ijnmr.ijnmr_129_23
  32. United European Gastroenterol J. 2026 Oct;14(8): e70317
    Antibiotic Stewardship in Cirrhosis: Current Recommendations and Clinical Challenges.
    Solaiman Ezzafzafi, Kimberly K I M Bot, Lucas H P Bernts, Reinier M van Hest, Alastair O'Brien, Michiel A van Agtmael, Jarne M van Hattem, Marten A Lantinga.
      Bacterial infections are a major cause of mortality in cirrhosis, with antibiotic prophylaxis and empirical treatment embedded in international guidelines. However, the prevalence of multidrug-resistant organisms and the epidemiology of infections have shifted considerably in recent decades. This review critically appraises the evidence underlying guideline recommendations on antibiotic prophylaxis for spontaneous bacterial peritonitis and acute variceal bleeding in cirrhosis, and antimicrobial management in acute liver failure. The evidence-underlying current recommendations is limited and predates the current era of widespread antimicrobial resistance, challenging their applicability in current practice. Emerging evidence suggests that primary prophylaxis should be reconsidered, alternatives such as rifaximin warrant further evaluation against established fluoroquinolone regimens, and shorter antibiotic courses may be non-inferior to standard durations. New double-blind placebo-controlled, non-inferiority and Bayesian trials are needed to evaluate antibiotic regimens and microbiome- and barrier-directed interventions, supported by improved diagnostics, while minimising treatment duration, toxicity and selection for antimicrobial resistance.
    Keywords:  acute liver failure; antibiotic prophylaxis; antimicrobial resistance; antimicrobial stewardship; cirrhosis; spontaneous bacterial peritonitis; variceal bleeding
    DOI:  https://doi.org/10.1002/ueg2.70317
  33. IEEE Trans Biomed Eng. 2026 Oct 14. PP
    Artificial Intelligence in Echocardiography: A Critical Review of Models, Validation, and Clinical Impact.
    Shunkai Xiao, Xianqiang Yang, Jing Chi.
       OBJECTIVE: To critically review artificial intelligence (AI) in echocardiography, linking model design and technical performance to validation and clinical use.
    METHODS: We synthesized literature assembled through Web of Science and Scopus collections and targeted revision searches. Evidence was organized by echocardiographic task, model paradigm, data source, evaluation protocol, and level of clinical validation.
    RESULTS: AI applications span acquisition guidance, image analysis, quantitative measurement, disease assessment, and outcome prediction, with emerging foundation, multimodal, and examination-level models. Most studies assess retrospective task performance; fewer evaluate cross-site transportability or clinical impact. Reproducible performance has been demonstrated for view recognition, segmentation, and selected measurements under aligned protocols, and prospective trials confirm workflow gains. However, evidence linking AI to improved clinical decisions or patient outcomes remains limited. Generalizability is further constrained by uneven dataset coverage and inconsistent evaluation protocols.
    CONCLUSION: Current evidence supports AI assistance in selected echocardiographic tasks; however, clinical use requires external validation, failure reporting, and ongoing monitoring in intended settings.
    SIGNIFICANCE: This review links model development with validation evidence to guide clinical evaluation and identify priorities for prospective studies in echocardiography.
    DOI:  https://doi.org/10.1109/TBME.2026.3743686
  34. Proc Natl Acad Sci U S A. 2026 Oct 20. 123(42): e2622466123
    The impact of modulator therapy on the Pseudomonas aeruginosa cystic fibrosis lung transcriptome.
    Morgana Letizia, Lauren E Whiteley, Frances L Diggle, Angela N Davis, Sarah J Morgan, Brenda Grogan, John Baugh, Edward F McKone, Pradeep K Singh, Marvin Whiteley.
      Chronic lung infection with Pseudomonas aeruginosa is a major complication of cystic fibrosis (CF), contributing to lung function decline and increased morbidity and mortality. Laboratory models are used to study CF infections, but their relevance depends on how accurately they reproduce microbial physiology during human infection. We previously developed a framework that uses bacterial gene expression in human infections to quantify model accuracy. Here, we applied this framework to determine how a major therapeutic intervention impacts P. aeruginosa physiology in the lungs of people with CF (pwCF) and to develop and evaluate refined preclinical models. We focused on elexacaftor/tezacaftor/ivacaftor (ETI), a highly effective CFTR modulator therapy that has improved outcomes for pwCF. However, evidence indicates that P. aeruginosa lung infections persist despite ETI therapy. Analysis of P. aeruginosa transcriptomes from human sputum collected before and after ETI initiation revealed minimal changes in gene expression, indicating that the CF airway continues to support a similar bacterial transcriptional state despite therapy. We then evaluated how strain selection, zinc limitation, and polymicrobial coculture influence the ability of laboratory models to recapitulate P. aeruginosa gene expression in human CF sputum. Growth of CF clinical isolates in zinc-limited synthetic CF sputum medium produced the most accurate model, whereas population-based cultures and coculture with Staphylococcus aureus had limited effects. These findings show that ETI therapy has little impact on the conserved P. aeruginosa transcriptional state in human CF sputum and that refined sputum-like models remain useful for studying persistent infection in the postmodulator era.
    Keywords:  CF modulators; Pseudomonas aeruginosa; cystic fibrosis; model system; transcriptomics
    DOI:  https://doi.org/10.1073/pnas.2622466123
  35. LGBT Health. 2026 Oct 12. 23258292261495120
    Care of the Sexual or Gender Minority Community Living with Cystic Fibrosis: A Survey of United States and Canadian Multidisciplinary Health Care Providers.
    PRIDE CF Community Partner Group,
       PURPOSE: Lesbian, gay, bisexual, transgender, queer, intersex, asexual, or another sexual or gender minority (LGBTQIA+) people face health inequities and commonly report health care avoidance. We examined how multidisciplinary subspecialist providers care for LGBTQIA+ people with pediatric-onset chronic conditions, using cystic fibrosis (CF) as a model.
    METHODS: We conducted a survey of United States and Canadian CF providers regarding their LGBTQIA+ health knowledge, attitudes, comfort, and practices from January-September 2024. We analyzed results descriptively and compared responses by key variables using chi-square tests.
    RESULTS: Among 389 participants, 15% felt that there are only two genders and 6% reported discomfort working with LGBTQIA+ people based on personal beliefs. Nearly all (87%) agreed that asking about gender identity and sexual orientation is important to health care. Thirty percent felt unprepared to discuss concerns related to sexual orientation or gender identity, and 86% felt that they would be a better clinician if they had more training on supporting LGBTQIA+ people. Fifty-one percent reported asking their CF patients about their sexual orientation, 57% about their gender identity, and 73% about their affirmed name/pronouns. Forty-three percent of U.S. and 20% of Canadian respondents reported receiving training on supporting LGBTQIA+ people.
    CONCLUSION: CF providers valued addressing LGBTQIA+ health but lacked expertise, training, and resources to routinely do so. Future research should explore the experiences and health outcomes of LGBTQIA+ people with CF and develop needed provider education.
    Keywords:  LGBTQIA+; cystic fibrosis; pediatric-onset chronic condition; subspecialty care
    DOI:  https://doi.org/10.1177/23258292261495120
  36. bioRxiv. 2026 Oct 03. pii: 2026.09.28.753837. [Epub ahead of print]
    IgG sequencing maps systemic antibody binding to oral commensals and pathobionts in health and periodontitis.
    Ramin Akhi, Drake Winslow Williams, Teresa Greenwell-Wild, Andrew S Burns, Shreni Mistry, Laurie Brenchley, Nicolas Bouladoux, Ivan Vujkovic-Cvijin, Yasmine Belkaid, Akintunde Emiola, Niki M Moutsopoulos.
      The oral cavity harbors one of the body's most diverse microbial communities, which continuously seeds the bloodstream and gastrointestinal tract, particularly in periodontitis, a disease in which both barrier permeability and microbial burden increase. Despite this constant systemic exposure, overt bacteremia from oral organisms is rare, suggesting an active surveillance system that contains this reservoir. Here, we apply IgG-sequencing to comprehensively map mucosal and systemic antibody recognition of the oral microbiome across paired oral fluid and serum from healthy individuals and patients with periodontitis. We find that IgG-binding is only weakly predicted by microbial abundance, suggesting taxon-specific and largely conserved IgG-binding of commensals, many of them streptococci which dominate antibody recognition irrespective of disease state. Periodontitis broadens the repertoire of IgG-bound taxa to include particular disease-associated pathobionts while preserving robust targeting of health-associated symbionts. Comparison of salivary and serum antibody profiles further uncovers a subset of commensal streptococci, including species implicated in infective endocarditis, that acquire disproportionate systemic IgG binding in periodontitis. Together, these findings establish a taxon-level atlas of humoral immunosurveillance at a major mucosal-microbial interface and reveal how periodontal disease reshapes systemic antibody recognition of both pathobionts and commensals.
    DOI:  https://doi.org/10.64898/2026.09.28.753837
  37. Iran J Nurs Midwifery Res. 2026 Sep-Oct;31(5):31(5): 811-818
    The Effect of Teach-Back Education Method on the Self-Efficacy of Foot Wound Care in Patients with Diabetes Mellitus: An Interventional Study.
    Kimia Molodi, Kaveh Bahmanpour, Fateme Rafiei, Mokhtar Mahmoudi.
       Background: Efforts to improve self-efficacy in patients with diabetes can play an effective role in improving treatment outcomes. Therefore, the present study was conducted to determine the effect of teach-back education on patients' self-efficacy in diabetic foot ulcer care.
    Materials and Methods: In this quasi experimental study, 54 patients with diabetic foot ulcers referred to the diabetes clinic in the city of Saghez City, Iran, in 2023 were selected by a convenience sampling method and then randomly assigned to intervention and control groups. In the intervention group, teach-back education was implemented in four 45-minute sessions according to a structured program. The Diabetic Foot Care Self-Efficacy Scale was used to measure self-efficacy before and 30 days after the intervention in both groups. Data were analyzed using Mann-Whitney, Chi-square, Fisher's exact, and Wilcoxon tests using SPSS version 17.
    Results: According to the results, the intervention and control groups were homogeneous in terms of demographic characteristics and levels of self-efficacy before the intervention (p < 0.001). However, after the intervention, the self-efficacy level for diabetic foot ulcer care increased in both groups (p < 0.001). However, the mean difference in self-efficacy score was significantly higher in the intervention group compared to the control group (p < 0.001).
    Conclusions: The present study showed that the teach-back educational method can increase self-efficacy for diabetic foot ulcer care among patients. Therefore, it is recommended to use teach-back education in the educational programs of medical centers to improve the self-efficacy of patients with diabetic foot ulcers.
    Keywords:  Diabetic foot; education; self-efficacy
    DOI:  https://doi.org/10.4103/ijnmr.ijnmr_212_24
  38. Int J Mol Sci. 2026 Sep 29. pii: 8711. [Epub ahead of print]27(19):
    Viral-Gut Microbiota Interactions: Implications for the Gut Mucosa in Inflammatory Bowel Disease.
    Yonghong Wu, Lei Hou, Yue Li, Jiao Li, Xue Hua, Yan He, Sujuan Ding, Jun Fang.
      Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), arises from complex interactions among genetic susceptibility, immune dysregulation, environmental factors, and the gut microbiome. Bacterial dysbiosis has been extensively studied, whereas the gut virome-comprising eukaryotic viruses and bacteriophages-remains less understood. Viruses can affect the intestinal barrier directly by infecting epithelial and immune cells, or indirectly by reshaping bacterial communities and host immunity. However, current evidence is dominated by cross-sectional associations and animal models, and whether virome alterations drive or result from intestinal inflammation remains unresolved. In this review, we provide a focused overview of intestinal barrier components relevant to IBD, synthesize human and animal evidence on IBD-associated viruses, and distinguish direct viral effects, microbiota-mediated effects, and bidirectional virus-microbiota interactions. We highlight bacteriophage-bacteria interactions as a central and potentially causal axis, discuss UC- and CD-specific differences, and outline causality gaps, search methodology, and emerging therapeutic strategies. Finally, we propose key unresolved questions and future research directions.
    Keywords:  bacteriophages; gut microbiota; gut virome; inflammatory bowel disease; intestinal barrier; phageome; virus–bacteria interactions
    DOI:  https://doi.org/10.3390/ijms27198711
  39. J Clin Microbiol. 2026 Oct 12. e0002926
    Toward routine implementation of phage testing: an inter-laboratory comparison of a disk-based susceptibility testing (Disk-PST).
    K Ekat, L Scharnagl, A Hahn, S Deinhardt-Emmer, A Trimborn, J Landtag, M Wietzke, J Elias, F Lestin-Bernstein, W Splettstoesser, I Ramming, J K Knobloch, J Färber, F Szabados, A Podbielski, P Warnke, R Skusa.
      In the context of an emerging post-antibiotic era, phage therapy is gaining increasing attention. Standardized approaches for phage susceptibility testing (PST) are crucial to enable objective and effective phage selection for personalized treatment, yet no standardized reference method currently exists. To overcome this impediment, a standardized disk-based PST protocol was validated in-house (intra-laboratory comparison) involving 28 participants, followed by an inter-laboratory comparison across 12 laboratories in Germany with 39 participants. Preselection testing revealed high concordance between Disk-PST and Spot test, supporting the selection of strains with consistent phage susceptibility profiles for the interlaboratory comparison. An Escherichia coli phage, a Staphylococcus epidermidis phage, and a negative control (SM buffer) were tested on four bacterial strains (two E. coli and two S. epidermidis strains). Testing was blinded and included two technical and two biological replicates per condition. The plaque assay was performed at the coordinating laboratory (University Medical Center Rostock) and served as the reference standard. The in-house validation showed high reliability and strong agreement with the plaque assay, requiring only minor methodological adjustments prior to the inter-laboratory trial. The inter-laboratory comparison confirmed the robustness of the method, showing almost perfect agreement with the plaque assay across all participating laboratories. In the rare event of false-positive or inconclusive results, phage cross-contamination, misinterpretation of microcolonies within lysis zones, and limited information on negative controls due to the blinded test setting were causative. In accordance with its high inter-laboratory reliability, the PST-disk method seems to be highly suitable for easy implementation in routine laboratory settings. Further investigations are necessary to correlate phage test results with clinical therapy outcomes-an issue that should be addressed in future clinical trials.IMPORTANCEThe rapid global spread of multidrug-resistant bacteria has intensified the need for effective alternative therapeutic strategies, including bacteriophage therapy. Because phage activity is highly strain-specific, accurate and standardized phage susceptibility testing (PST) is essential for safe and effective clinical implementation, yet standardized protocols are currently lacking. In this nationwide, blinded inter-laboratory study, we evaluated a routine-diagnostic-adapted single-disk PST method and demonstrated its excellent agreement with the gold-standard double agar layer plaque assay. Importantly, this approach represents a significant improvement over existing PST methods by providing a standardized, reproducible, and easy-to-implement assay with high potential for widespread application in clinical routine microbiology laboratories.
    Keywords:  phage susceptibility testing; spot test; standardized phage testing
    DOI:  https://doi.org/10.1128/jcm.00029-26
  40. Mol Neurobiol. 2026 Oct 10. pii: 959. [Epub ahead of print]63(1):
    The Gut Microbiota-Epilepsy Axis: Bibliometric Trends, Mechanistic Insights, and Microbiota-Targeted Next-Generation Therapeutic Opportunities.
    Ayyaz Khan, Zakir Ullah, Muhammad Siraj, Sonia Younas, Shahid Wahab, Abdul Waris, Seong-Tshool Hong.
      Epilepsy is a complex neurological disorder with diverse underlying causes. Growing evidence suggests that gut dysbiosis may promote epileptogenesis by disrupting short-chain fatty acids, tryptophan-kynurenine metabolism, immune signaling, and neuronal excitability. In this review, we combine findings from human and animal studies to explain how gut dysbiosis may influence seizures through the gut-brain axis. We highlight emerging and less-discussed mechanisms, including vagus nerve signaling, microbial amyloids, bacterial extracellular vesicles (BEVs), the queuosine salvage pathway, and multi-kingdom microbiota interactions. We also summarize microbiota profiling studies and describe dysbiosis patterns linked to seizure. To support translation, we propose a peri-ictal multi-omics strategy for biomarker discovery. This includes standardized sampling and integration of metagenomics, metabolomics, and host transcriptomics. In addition, our bibliometric analysis further shows rapidly growing global interest in this topic. Recent studies increasingly focus on the gut-brain axis, ketogenic diet, and inflammation-driven mechanisms. Finally, we outline both established approaches and emerging next-generation microbiome-based therapeutic strategies, including SCFA-restoring synbiotics, engineered psychobiotics, bacteriophage therapy, and AI-guided personalization. These advances highlight the microbiota as modifiable target for adjunctive epilepsy management and provide a translational roadmap for future mechanistically informed research and clinical interventions.
    Keywords:  Epilepsy; Gut microbiota; Microbiome; Microbiota–gut–brain axis; Next-generation therapeutics
    DOI:  https://doi.org/10.1007/s12035-026-06227-7
  41. Int J Mol Sci. 2026 Sep 23. pii: 8491. [Epub ahead of print]27(19):
    Time to Heal: MicroRNA Temporal Dysregulation in Diabetic Foot Ulcers.
    Lingyu Pan, Lingyun Zhao, Jinfeng Liu, You Mou, Kaili Wang, Xinyi Liu, Wei Hua.
      Diabetic foot ulcers (DFUs) are a severe complication of diabetes characterized by delayed healing, infection susceptibility, and tissue necrosis. During normal healing, microRNA (miRNA) expression changes over time and helps regulate inflammation, tissue formation, and matrix remodeling. The same miRNA can serve opposing roles depending on cell type, timing, and wound context. Hyperglycemia, hypoxia, and oxidative stress disrupt these processes and prolong inflammation. This review examines how altered miRNA regulation may impair wound-healing transitions and vessel maturation in DFUs. We organize findings from experimental models and human samples into three interpretive patterns: delayed or insufficient induction, aberrant persistence, and temporal inversion or phase-inappropriate expression. Angiogenesis provides an example of how disrupted miRNA timing may impair vascular repair and granulation tissue formation. Circadian regulation may further influence these processes, although direct evidence linking circadian regulation, miRNA dynamics, and human DFUs remains limited. Preclinical studies of miRNA combinations, engineered vesicles, and biomaterial carriers suggest opportunities to coordinate local miRNA delivery with repair needs. The human studies reviewed here do not establish clinical efficacy of a defined miRNA mimic or inhibitor in DFUs. Further translation requires miRNA profiling over time, assessment of the wound's biological stage, and delivery to the relevant cells during the appropriate repair window.
    Keywords:  angiogenesis; chronobiology; diabetic foot ulcer; extracellular vesicles; metabolic inflammation; microRNA; temporal regulation; wound healing
    DOI:  https://doi.org/10.3390/ijms27198491
  42. Int J Infect Dis. 2026 Oct 15. pii: S1201-9712(26)00822-2. [Epub ahead of print] 109187
    A Predict → Confirm → Act Framework for AI-Augmented MDRO Control Across Hospitals and Long-Term Care Facilities.
    European Society of Clinical Microbiology and Infectious Diseases Study Group for Artificial Intelligence and Digitalisation (ESGAID)
      Multidrug-resistant organism (MDRO) control depends on identifying colonized patients and emerging transmission events early enough to intervene, without overwhelming infection prevention and control (IPC) teams or unnecessarily isolating patients. Predictive models using electronic health records, microbiology data, patient movement, and genomic information may support this task. We propose a practical Predict → Confirm → Act framework for artificial intelligence (AI)-augmented infection control across hospitals and long-term care facilities. In this framework, AI generates risk signals; microbiology, genomic data, and epidemiological review provide confirmation; and IPC teams apply proportionate actions such as targeted screening, preemptive precautions, cohorting, environmental investigation, or de-escalation. The framework is model-agnostic and is intended to shift attention away from algorithmic performance alone toward bedside and unit-level decisions. Safe implementation requires local threshold calibration, named alert ownership, microbiological confirmation pathways, de-escalation rules, prospective monitoring, and evaluation using IPC-relevant outcomes, including additional carriers detected, time to isolation, MDRO acquisition, isolation days avoided, alert burden, and unintended consequences.
    Keywords:  Clinical decision support; Infection prevention and control; artificial intelligence; multidrug-resistant organisms; predictive modelling
    DOI:  https://doi.org/10.1016/j.ijid.2026.109187
  43. J Cardiovasc Surg (Torino). 2026 Oct 14.
    The role of venoactive drugs in a modern treatment paradigm: evidence review.
    Matthew Tan, Marwah Salih, Sarah Onida, Alun H Davies.
      Chronic venous disease (CVD) causes substantial symptom burden and healthcare cost, driven not only by venous hypertension but by a persistent molecular cascade of endothelial activation, glycocalyx degradation, and inflammation within the vein wall. Venoactive drugs (VADs) - a heterogeneous class of flavonoid, synthetic, animal-derived, and plant-derived compounds - target this cascade and are recommended by international guidelines as adjuncts to compression therapy, endovenous intervention, and wound care in venous leg ulcer (VLU) management. This review synthesizes the pharmacological rationale and clinical evidence for VADs across these three adjunct settings. The evidence base is strongest for VAD use alongside compression, supported by multiple Cochrane-grade meta-analyses; MPFF and ruscus extracts have the most robust symptom evidence, while MPFF, pentoxifylline, and sulodexide have the strongest evidence for VLU healing. Evidence in the peri-interventional setting remains the weakest, limited to open-label studies of MPFF. Priorities for future research include stratified and biomarker-guided prescribing, combination pharmacotherapy, and larger, adequately powered VLU healing trials.
    DOI:  https://doi.org/10.23736/S0021-9509.26.13674-X
  44. Int J Low Extrem Wounds. 2026 Oct 12. 15347346261498938
    Diabetic Foot Ulcers and Curcumin.
    Nikolaos D Karakousis, Dimitrios S Karagiannakis, Nikolaos Papanas.
      
    DOI:  https://doi.org/10.1177/15347346261498938
  45. Respirology. 2026 Oct 12.
    The Microbiome-Gut-Lung axis in Respiratory Diseases: From Biological Mechanisms to Clinical Translation.
    Yuqiong Yang, Xin Tang, Rongchang Chen, Zhang Wang.
      Respiratory diseases exhibit substantial heterogeneity in clinical phenotypes and underlying pathobiology that cannot be fully captured by conventional lung-centred frameworks. Accumulating evidence implicates a role for the microbiome-gut-lung axis in respiratory disease pathogenesis. Within this bidirectional axis, gut-derived microbial metabolites and structural components can modulate pulmonary immunity, whereas respiratory infection and exposures can reciprocally influence the gut microbiota. Dysregulation of the microbiome-gut-lung axis may influence respiratory disease susceptibility, progression, and clinical presentation. In this Review, we outline core mechanisms of gut-lung crosstalk, including metabolite-driven immunomodulation, pattern recognition receptor signalling and reciprocal immune-ecological remodelling. We synthesize phenotype-specific evidence linking the axis to major chronic inflammatory airway diseases (asthma, chronic obstructive pulmonary disease, cystic fibrosis and bronchiectasis) and acute respiratory disorders (pneumonia and sepsis-associated acute respiratory distress syndrome), emphasizing mechanistic and clinical evidence. We discuss the translational promise of gut-lung signatures as biomarkers and treatable traits and review current therapies with microbiome effects and emerging microbiome-targeted interventions. Finally, we address key challenges and propose future research priorities to advance clinical management leveraging the gut-lung axis.
    Keywords:  biomarkers; disease phenotypes; gut–lung axis; immune response; microbiome; respiratory diseases; therapeutic interventions
    DOI:  https://doi.org/10.1002/resp.70329
  46. Front Neurol. 2026 ;17 1837085
    Early mobilization in neurocritical care as a threshold-regulated intervention: a narrative review of mechanistic integration and implications for neurological recovery and physiological stability.
    Ying Hong, WenYan Hu, JiZu Tang, Feng Xiong.
      The integration of early mobilization into neurocritical care remains constrained by uncertainty regarding how heterogeneous physiological systems respond to graded activity during neurological instability. Although early mobilization is increasingly used in intensive care, the relationships between intervention timing, intensity, neurological recovery, functional outcomes, and physiological tolerance remain incompletely defined in acute neurocritical populations. This narrative review integrates clinical and mechanistic evidence to examine how immobility and reactivation may influence interconnected neuromuscular, cerebrovascular, cardiopulmonary, metabolic, and inflammatory domains. Available evidence indicates that immobility is associated with progressive disruption of neural, vascular, and metabolic coordination, whereas early mobilization may provide structured physiological input that supports partial re-engagement of regulatory mechanisms when applied within individual tolerance limits. Low- to moderate-intensity activity has been proposed, based on clinical and mechanistic evidence, to involve pathways related to neurovascular coupling, mitochondrial bioenergetics, and activity-dependent neuroplasticity; however, direct patient-level evidence in acute neurocritical care remains limited. Physiological stability during mobilization should therefore be interpreted as a dynamic process rather than a binary condition, with transient hemodynamic, intracranial, and respiratory fluctuations requiring contextual assessment. Interpretation is further limited by methodological heterogeneity, variable outcome definitions, and differences in patient severity and monitoring approaches. Integrated monitoring and data-informed decision support may help identify patient-specific tolerance thresholds. Overall, early mobilization is best understood as a context-dependent, threshold-sensitive intervention requiring continuous system-level assessment.
    Keywords:  cerebral blood flow; critical care; early ambulation; hemodynamics; intracranial pressure; nervous system diseases; neuromuscular diseases; physiologic
    DOI:  https://doi.org/10.3389/fneur.2026.1837085
  47. Sci Adv. 2026 Oct 16. 12(42): eaeg2358
    Death and chemotaxis: Bacterial chemotaxis enables collective escape from phage predation.
    Victoria G Muir, Alejandro Martínez-Calvo, Ned S Wingreen, Sujit S Datta.
      Bacteriophages ("phage") are viruses that prey on bacteria in diverse environments, from biological tissues to soils. In many of these environments, bacterial hosts are constantly migrating, yet how bacterial migration is influenced by phage predation remains poorly understood. Using transparent granular hydrogels that mimic natural habitats, we directly visualize populations of motile Escherichia coli encountering lytic T4 phage. Unexpectedly, we find that even in phage-rich environments, bacteria successfully form chemotactic fronts that enable them to migrate over large distances without necessarily requiring new phage resistance mutations. At low phage concentrations, the front is indistinguishable from a phage-free control, and the population remains largely susceptible; at higher concentrations, the susceptible population initially collapses, and the front is reestablished by a less susceptible subpopulation enriched under intense predation. Higher phage concentrations delay front formation but not steady-state front speed or shape. By combining our experiments with biophysical modeling, we demonstrate that this phenomenon reflects a competition between collective chemotactic migration and phage predation, quantified by a dimensionless "escape parameter," in which sufficiently rapid migration allows the population to outpace the spreading infection. This work thus provides mechanistic insight into how cell motility shapes phage-bacteria interactions in spatially extended environments.
    DOI:  https://doi.org/10.1126/sciadv.aeg2358
  48. Microrna. 2026 Oct 06.
    MicroRNAs in Cystic Fibrosis: Dual Role in Pathogenesis and Therapeutic Potential.
    Parvaneh Movahhed, Samaneh Ahmadi, Masoume Ghasemzadeh Qazvini, Amir Namvar, Sara Ahmadi Teshnizi, Mohammadreza Saberiyan.
      Cystic fibrosis (CF) is a severe inherited disorder caused by dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR), an epithelial ion channel essential for maintaining airway surface hydration and effective mucociliary clearance. Although over a thousand CFTR mutations have been described, their functional consequences vary widely, with some genotypes retaining partial CFTR activity and presenting as residual-function phenotypes. Despite CFTR modulator therapies substantially improved clinical outcomes in many patients, their efficacy remains incomplete and strongly dependent on the underlying CFTR mutation. Increasing evidence indicates that microRNAs (miRNAs), as key post-transcriptional regulators of gene expression, play a dual role in CF by contributing to disease pathogenesis while also representing potential therapeutic targets. This review provides an overview of the involvement of miRNAs in CF pathophysiology, with emphasis on their roles in CFTR regulation, airway inflammation, epithelial ion transport, and mucus homeostasis. Experimental findings demonstrating that modulation of specific miRNAs enhances CFTR mRNA stability and protein expression, attenuates pro-inflammatory signaling, and improves epithelial function are discussed. Current miRNA-based therapeutic strategies and their translational challenges are discussed, along with their potential integration with emerging CF therapies, including CFTR modulators, mRNA replacement, antisense oligonucleotides, and suppressor tRNA strategies. Given the predominantly preclinical evidence, miRNA modulation may offer a mutation-independent approach to complement existing therapeutic strategies. A combination of miRNA-based approaches with established CF therapies may represent a potential complementary strategy, but the efficacy and safety of such combinations require further experimental and clinical validation.
    Keywords:  CFTR; CFTR modulators; Cystic fibrosis; miRNA-based therapy; microRNAs
    DOI:  https://doi.org/10.2174/0122115366514632260920030936
  49. Int J Mol Sci. 2026 Sep 26. pii: 8615. [Epub ahead of print]27(19):
    From Prediction to Mechanism: Explainable AI for Plant-Microbiome Multi-Omics Integration and Biological Discovery.
    Lupin Deng, Lei Liu, Yu Luo, Mengdi Dai, Ziran Ye, Xingguo Xiong, Yuxiang Li, Dedong Kong, Xiangfeng Tan.
      Predicting complex phenotypes from plant-microbiome multi-omics data has advanced significantly with machine learning and deep learning. However, traditional black-box models remain limited by their focus on predictive performance rather than mechanistic biological understanding. To bridge this gap, explainable artificial intelligence (XAI) has emerged as a key framework to transform biological data analysis from correlation mapping to hypothesis-driven discovery. This review synthesizes current advances in XAI methodologies, including post hoc feature attribution techniques and intrinsically interpretable neural architectures, and their applications in plant-microbiome interactions. We highlight how XAI enables multi-scale insights by mapping model predictions to functional genes, metabolic pathways, and microbial interaction networks. Furthermore, we address critical challenges in distinguishing statistical importance from true biological causality and advocate for a closed-loop framework that continuously integrates computational reasoning with wet-lab experimental validation. Finally, we explore future avenues, including biologically informed neural networks, causal AI, and multi-omics knowledge graphs. By facilitating the transition from predictive analytics to biologically interpretable and experimentally testable hypotheses, XAI may contribute to mechanistic discovery in plant-microbiome systems.
    Keywords:  causal inference; explainable artificial intelligence (XAI); mechanistic discovery; multi-omics integration; plant holobiont; plant-microbiome interactions
    DOI:  https://doi.org/10.3390/ijms27198615
  50. Biochem Biophys Rep. 2026 Dec;48 102827
    Gut microbiome intervention in gut-brain axis and effects on vascular dementia with prospects on non-pharmacological intervention.
    Yash Maurya, Elizabeth Annie George, Arkadeep Roy, Gayathri J Menon, K R Harshitha, K Priyadharshini, Sudha Ramaiah, Anand Anbarasu.
      Vascular dementia (VD) is the second leading cause of cognitive impairment after Alzheimer's disease. Current treatments focus primarily on managing vascular risk factors with no effective interventions for repairing existing brain damage. Recent research underscores a critical link between gut microbiota and brain function through immunological, hormonal and metabolic pathways. Alterations in the gut microbiome influence vascular cognitive impairment via mechanisms such as dysbiosis, induced intestinal permeability, systemic inflammation, oxidative stress and blood-brain barrier disruption. Microbial metabolites including butyrate promote neuroprotection and maintain vascular integrity, whereas trimethylamine N-oxide is associated with vascular injury and cognitive decline. Restoration of microbial balance through probiotics, plant-based bioactive compounds and traditional medicines has shown potential in preclinical models for regulating inflammation, improving cognitive outcomes though clinical validation is limited. Non-pharmacological approaches like electro-acupuncture further modulate the microbiome and serotonin regulation. This review explores how changes in gut microbiome influence vascular cognitive impairment and discusses therapeutic strategies for restoring microbial balance. Integrating contemporary and traditional strategies, gut microbiome modulation emerges as a potential therapeutic target for the prevention and management of VD although its clinical applicability remains to be fully established.
    Keywords:  Ayurveda; Chinese medicines; Gut-brain axis; Gut-microbiome; Vascular dementia
    DOI:  https://doi.org/10.1016/j.bbrep.2026.102827
  51. Int J Nanomedicine. 2026 ;21 643386
    Nanocarrier-Integrated Topical Dosage Forms for Biofilm-Infected Wounds: Balancing Wound Retention, Biofilm Matrix Penetration, and Translational Feasibility.
    Sri Agung Fitri Kusuma.
      Biofilm-infected wounds are difficult to treat because extracellular polymeric substance (EPS) matrices, wound exudate, polymicrobial spatial organization, impaired antimicrobial penetration, persistent inflammation, and antimicrobial tolerance limit the efficacy of conventional topical therapy. Nanocarriers can protect antimicrobial payloads, enable controlled and stimuli-responsive release, and improve interactions with biofilm matrices; however, their clinical performance also depends on the final topical dosage form that governs wound residence, local exposure, usability, and translation. This review critically examines nanocarrier-integrated topical dosage forms for biofilm-infected wounds by linking nanoscale carrier design with macroscale platform performance. Hydrogels and in situ gels, films, membranes, wound dressings, nanofibers, sprays, foams, and multifunctional systems are discussed in relation to wound retention, exudate management, EPS access, and controlled antimicrobial release. Key strategies, including pH-, enzyme-, ROS-, and light-responsive delivery, EPS disruption, matrix penetration, photothermal and photodynamic therapy, ion-mediated killing, quorum-sensing interference, and wound-adaptive regenerative support, are integrated with translational considerations such as polymicrobial biofilm models, cytocompatibility, recurrence prevention, sterilization, storage stability, manufacturing scalability, regulatory classification, and patient-centered usability. By bridging nanocarrier engineering with topical dosage-form design, this review provides a formulation-oriented roadmap for clinically feasible antibiofilm nanomedicine for chronic and infected wounds, supporting control of infectious diseases, healthcare innovation, and sustainable manufacturing considerations.
    Keywords:  biofilm-infected wounds; control of infectious diseases; healthcare innovation; nanocarriers; sustainable manufacturing; topical dosage forms
    DOI:  https://doi.org/10.2147/IJN.S643386
  52. J Cyst Fibros. 2026 Oct 13. pii: S1569-1993(26)03770-7. [Epub ahead of print]
    Basic science & translational research in cystic fibrosis - insights from the 20th ECFS basic science conference.
    Patrick T Harrison, Batsheva Kerem, Dean A Madden.
      The development of CFTR modulators revolutionized the approach to treating Cystic Fibrosis (CF) by targeting the ion channel that causes the disease rather than just the symptoms. For those people with CF who have access and good responses to modulators, their day-to-day health, quality and quantity of life continue to improve. But there are still many people with CF unable to tolerate these medicines, and/or without access, ineligible due to their CF genotype, cost, or lack of approval in their home country. There is a lot more basic science and translational research to be done until the mission of the CF community is complete. A leading platform to promote the process of propagating, peer-review, and ultimately progress work towards this goal is the annual ECFS Basic Science Conference. The aim of this special issue of JCF is to highlight the diverse yet interconnected nature of basic science research in CF and its progress to clinical evaluation. This work is reflected in nine review articles authored by faculty members who presented their findings at the twentieth iteration of the conference, held in Viareggio, Italy.
    DOI:  https://doi.org/10.1016/j.jcf.2026.09.017
  53. Mol Cell Biochem. 2026 Oct 13.
    SUMO2-mediated SP1 SUMOylation promotes M2 macrophage polarization to facilitate diabetic foot ulcer healing.
    Ziping Yi, Qin Tao, Wenjian Pan, Xia Yao.
      Diabetic foot ulcers (DFU) present a severe clinical challenge, marked by poor healing, chronic inflammation, and elevated amputation risk. The M2 macrophage is known to support the wound healing of DFU, and syndecan-4 (SDC4) contributes to this process. However, the upstream regulatory mechanisms involving post-translational modifications and transcriptional networks remain unclear. The related molecule levels were measured by RT-qPCR and Western blot. The M2 macrophage biomarkers (IL-10, Arg-1) were detected by ELISA kits, while the number of F4/80+CD206+ cells was quantified via flow cytometry. The interaction between SP1 and SDC4 was checked by ChIP and dual-luciferase reporter assays. Furthermore, SUMOylation of SP1 was verified through Ni2⁺ pull-down and Co-IP experiments. CCK-8, Transwell assay, and EdU staining were applied to determine the viability, migration, and proliferation of human dermal fibroblasts (HDF). Furthermore, in the wound tissues of diabetic mice, through HE staining, Masson staining, immunohistochemistry and immunofluorescence detection, the relevant molecular mechanisms in the body were verified. SUMO2, SP1, and SDC4 were upregulated in M2 macrophages. SP1 interacted with the promoter region of SDC4 to transcriptionally activate SDC4. Both SDC4 and SP1 overexpression facilitated HDF proliferation and migration by strengthening the polarization of M2 macrophages. However, subsequent knockdown of SDC4 could reverse the promoting effects induced by SP1 overexpression. SUMO2 mediated the SUMOylation of SP1 at the K16 site and increased its protein stability. The inhibition of SP1 SUMOylation impeded M2 phenotype polarization, thereby decreasing HDF viability and suppressing their proliferative and migratory capability under high-glucose conditions. In vivo, topical application of ginkgolic acid (GA) to diabetic mouse wounds significantly decreased the wound healing rate. SUMO2 stabilizes SP1 protein by mediating its SUMOylation at K16, and SP1 subsequently activates SDC4 transcription to facilitate M2 macrophage polarization, thereby promoting wound healing in a diabetic mouse wound model.
    Keywords:  Diabetic foot ulcer; M2 macrophage polarization; SDC4; SP1; SUMOylation
    DOI:  https://doi.org/10.1007/s11010-026-05754-0
  54. Biomed Environ Sci. 2026 Sep 20. 39(9): 1115-1130
    Dual-track Parallel and Integrated Innovation: Recent Advancements of Clinical Decision Support Systems in Cardiovascular Diseases from the Perspective of Integrative Chinese and Western Medicine.
    Zi Han Jia, Lei Zhang, Lin Tong, Hui Fang Zhang, Hong Tao Li, Feng Xia Zhang, Si Wei Tian, Zhuang Guo, Si Qi Zhang, Yan Ma, Bing Li, Hua Min Zhang.
      Cardiovascular diseases (CVDs) are the leading causes of death worldwide, have a growing disease burden, and present multiple challenges for precision management. Clinical Decision Support Systems (CDSS) are tools that leverage information technology to assist clinicians in diagnosis and treatment decisions and provide references for clinical decision-making by offering personalized suggestions, prompts, or reminders. By integrating multisource data, evidence-based guidelines, and artificial intelligence algorithms, CDSS can support diagnosis, prescribing, and comorbidity management. Studies in hypertension have reported improvements in prescribing and blood pressure, while effects on major cardiovascular events and mortality require further evaluation. Notably, with the continuous development of informatization and digitalization of Traditional Chinese Medicine (TCM), traditional Chinese medicine clinical decision support systems (TCM-CDSS), as an innovative achievement integrating traditional medicine with modern information technology, have shown promise in supporting the prevention and treatment of CVDs. TCM-CDSS achieves an intelligent diagnosis and treatment closed loop from "syndrome differentiation" to "formula recommendation" by integrating TCM theory of "principles, methods, formulas, and medicinals," renowned TCM experts' clinical experience, TCM knowledge graphs, and intelligent syndrome differentiation algorithms, providing a new paradigm for individualized diagnosis and treatment of CVDs such as hypertension and coronary heart disease (CHD). However, reviews addressing the integration of Chinese and Western medicine in cardiovascular CDSS remain limited. To address this knowledge gap, this review adopts a conceptual framework of "dual-track parallel and integrated innovation" to systematically elaborate on the current application status of CDSS across major CVDs. We critically stratified current clinical evidence tiers, highlighting the widespread reliance on retrospective studies and the urgent need for large-scale randomized controlled trials (RCTs). Furthermore, we propose that the future paradigm lies in mechanism-data, dual-driven hybrid architectures that quantitatively anchor Western physiological indicators to TCM macrosyndromes. Finally, we provide targeted solutions for the core technical bottlenecks, including Electronic Health Record workflow integration, cross-system comorbidity management, and grassroots application feasibility. These results provide an important reference for the precise treatment of CVDs and a basis for developing new paradigms for CVD prevention and treatment.
    Keywords:  Artificial intelligence; Cardiovascular disease; Clinical decision support system; Integrative Chinese and western medicine
    DOI:  https://doi.org/10.3967/bes2026.094
  55. Brief Bioinform. 2026 Sep 01. pii: bbag552. [Epub ahead of print]27(5):
    From conservation scores to language models: a feature engineering perspective on machine learning for genetic variant interpretation.
    Matteo Bulloni, Martina Vescio, Federico De Mori Bajolin, Linda Pattini.
      The interpretation of genetic variants remains central to precision medicine, and machine-learning-based variant effect prediction tools have become indispensable for supporting decision-making processes. In this review we trace the progression from hand-crafted features and traditional machine learning classifiers, through supervised ensembles, to deep-learning architectures and foundation models that learn representations directly from biological sequences. We classify methods for genetic variant effect prediction by underlying machine learning model and variant type handled, from missense to non-coding and structural, as well as across feature categories, describing their biological rationale, adoption rate, and known limitations. We further examine three cross-cutting methodological challenges-feature orthogonality, data circularity, and training data bias-that affect reliability and clinical applicability, providing a critical overview of the current landscape and the challenges that lie ahead.
    Keywords:  deep learning; evolutionary conservation; feature engineering; genetic variant effect prediction; genomic language models; protein language models
    DOI:  https://doi.org/10.1093/bib/bbag552
  56. J Cyst Fibros. 2026 Oct 16. pii: S1569-1993(26)03767-7. [Epub ahead of print]
    Distinct gastrointestinal symptom phenotypes in adults with cystic fibrosis are linked to complications and medication use: the GRAMPUS-CF study.
    J Holaman, D Sills, H Saumtally, C Johnson, A Recto, R Marsh, A Prayle, K Gathercole, T Monaghan, L Marciani, R Spiller, H L Barr, D G Downey, C van der Gast, D Peckham, I Stewart, A Smyth.
       BACKGROUND: Gastrointestinal symptoms remain common in adults with cystic fibrosis (CF) despite cystic fibrosis transmembrane conductance regulator modulator use, suggesting persistent and heterogeneous gut dysfunction. This prospective observational study tests the hypothesis that distinct gut symptom phenotypes in CF can be observed and linked to underlying mechanisms.
    METHODS: Adults from three UK CF centres completed the Gastrointestinal Symptom Rating Scale, Patient Assessment of Constipation Symptoms and a bowel-habit questionnaire. Latent class analysis using an ordinal logistic model was applied to 36 symptom indicators. Associations between phenotypes and demographic, clinical, and treatment variables were examined using generalised linear models.
    RESULTS: Three hundred participants completed questionnaires (54% male; median 31 years). We identified four symptom phenotypes: mild; moderate-constipation predominant; moderate-diarrhoea predominant and severe. The severe phenotype was associated with gastroesophageal reflux (RRR 2.86; 95%CI: 1.30-6.31; p = 0.009), distal intestinal obstruction syndrome (RRR 2.46; 95%CI: 1.04-5.81; p = 0.04), proton pump inhibitor (RRR 3.29; 95%CI 1.39-7.74; p = 0.007), and laxative use (RRR 6.13; 95%CI 2.54-14.84; p < 0.001). CF-related liver disease was associated with both moderate-constipation and diarrhoea phenotypes, respectively (RRR 2.08; 95%CI 1.13-3.81; p = 0.018; RRR 2.11; 95%CI 1.03-4.29; p = 0.04). There was a lower likelihood of long-term oral antibiotic use in the moderate-constipation phenotype (RRR 0.53; 95%CI 0.3-0.92; p = 0.025) and moderate-diarrhoea phenotype (RRR 0.46; 95%CI 0.24-0.91; p = 0.025).
    CONCLUSIONS: Four distinct symptom phenotypes were identified, independent of demographics and pancreatic status, but associated with specific complications and medication profiles. These phenotypes provide a framework for mechanistic studies within the GRAMPUS-CF cohort and precision management of CF-related gut disease.
    Keywords:  Diet; Inflammation; Magnetic resonance imaging; Microbiome
    DOI:  https://doi.org/10.1016/j.jcf.2026.09.014
  57. Front Public Health. 2026 ;14 1905489
    Delayed standard care in diabetic foot ulcers: the roles of initial response pathways and non-professional health information.
    Wei Shan, Qian Huang, Lin Qiao, Hui Chen, Hao Yan.
       Background: Delayed entry into standard diabetic foot care may reflect non-standard initial actions, inaccurate risk appraisal, and exposure to unreliable health information. Practical concerns about life after amputation may further postpone treatment decisions, but these modifiable processes remain insufficiently characterized.
    Objective: To examine initial response pathways, non-professional health information exposure, and post-amputation living-support concerns in relation to delayed care, disease severity, limb outcomes, and amputation decision-making.
    Methods: A single-center prospective explanatory mixed-methods study included 400 adults with diabetic foot ulcers from August 2024 to February 2026. Questionnaires and records assessed response pathways, information exposure, delay >7 days, clinical outcomes, and amputation concerns. Logistic regression estimated adjusted associations. Interviews with 16 purposively selected participants explained quantitative patterns, and findings were integrated.
    Results: Delayed care occurred in 215 patients (53.8%), and 206 (51.5%) reported non-professional information exposure. Relative to direct standard care, non-specialist care (OR 2.03, 95% CI 1.07-3.85) and home-based or non-standard care (OR 4.61, 95% CI 2.35-9.04) were associated with delay; the information-exposure score was also associated (OR 1.59, 95% CI 1.30-1.94). Delay was associated with Wagner grade 3-5 disease (OR 2.18, 95% CI 1.43-3.32) and amputation (OR 1.85, 95% CI 1.11-3.08). Among 102 amputated patients with complete decision data, 54 (52.9%) delayed the decision; living-support concerns were associated with delay (OR 2.35, 95% CI 1.45-3.81). Interviews linked reduced urgency, competing information, self-treatment, and anticipated dependence or caregiving burden to these patterns.
    Conclusion: Delayed care reflected risk under-recognition, non-standard action, and competing information rather than inaction. Warning-sign education, service guidance, critical appraisal of health information, and structured amputation decision support may improve timely care.
    Keywords:  amputation decision-making; care-seeking behavior; delayed standard care; diabetic foot ulcer; foot ulcer; health communication; health literacy; non-professional health information
    DOI:  https://doi.org/10.3389/fpubh.2026.1905489
  58. Healthcare (Basel). 2026 Oct 02. pii: 3274. [Epub ahead of print]14(19):
    Self-Reported Prebiotics and Probiotics Recognition and Recommendation Practices Among Dentists in Sibiu County, Romania: A Cross-Sectional Questionnaire Survey.
    Tiberiu H Ionaș, Mona Ionaș, Radu Chicea, Albertina Stănilă, Gabriela Boța.
      Background/Objectives: Probiotics and prebiotics are being investigated as adjuncts for the management of oral dysbiosis, but little is known about how dentists understand and recommend them. We describe self-reported recognition of oral microbiome concepts, identification of the definitions of prebiotics and probiotics, and recommendation practices among dentists in Sibiu County, Romania. Methods: A cross-sectional online questionnaire survey (comprising eight closed items; delivered using Google Forms) was distributed through the county professional association WhatsApp messaging channel and to personal contacts between 20 February 2026 and 9 March 2026. Of a target of 630 dentists, 107 completed the questionnaire (response rate: 17.0%), forming a voluntary local sample. Three pre-specified hypotheses (definition accuracy × recommendation; general recommendation × adjunct recommended during antibiotic therapy; and years of experience × definition accuracy and recommendation) were tested with exact tests, odds ratios (ORs), and 95% confidence intervals (CIs) with Holm adjustment; other item associations were exploratory and adjusted within families. Results: A microbial role was recognized for periodontal disease by 98.1% of respondents, for dental caries by 92.5%, for focal infection by 73.8%, and for bone infection of dental origin by 64.5%. Diet, antibiotics, oral hygiene, and smoking were recognized as microbial influencing factors by 78-84%, probiotics by 58.9%, and prebiotics by 52.3%. Definitions of the adjuncts were correctly identified by 83.2% (prebiotics) and 80.4% (probiotics). Prebiotics were recommended by 50.5% and probiotics by 86.0% of respondents. Correct definitions were not associated with recommendation (prebiotics: OR 1.76, 95% CI 0.62-4.95; probiotics: OR 1.60, 95% CI 0.46-5.65). During antibiotic therapy, dentists who recommended prebiotics were more likely to select a prebiotic-probiotic combination than those who did not (57.4% versus 3.8%; exact p < 0.001). No outcome differed by years of experience. Conclusions: In this self-selected sample, biotics were recognized as microbiome-influencing factors less often than classical factors, and knowing the definitions was not associated with recommending the products. The reasons behind recommendation habits were not measured and require dedicated study.
    Keywords:  continuing medical education; cross-sectional survey; dentists; dysbiosis; oral microbiome; prebiotics; probiotics
    DOI:  https://doi.org/10.3390/healthcare14193274
  59. Int J Mol Sci. 2026 Sep 25. pii: 8585. [Epub ahead of print]27(19):
    Characteristics of Staphylococcus epidermidis Isolated from Humans and Animals.
    Paulina Prorok, Magdalena Siedlecka, Magdalena Karwańska, Milena Skrok, Marta Miszczak, Maciej Wernecki, Marta Książczyk, Krzysztof Rypuła, Karolina Bierowiec.
      Staphylococcus epidermidis is an important opportunistic pathogen and a potential reservoir of antimicrobial resistance determinants, yet comparatively little is known about isolates originating from both humans and companion animals. This study characterized 320 S. epidermidis isolates obtained from humans, cats, and dogs within a One Health framework using phenotypic, molecular, proteomic, and genomic approaches. Antimicrobial susceptibility testing revealed high frequencies of resistance to oxacillin (67.19%), erythromycin (66.56%), tetracycline (55.63%), and clindamycin (53.75%) by disk diffusion. PCR-based analysis identified blaZ as the most prevalent resistance determinant (50.63%), whereas whole-genome sequencing of a selected subset revealed a broader and heterogeneous repertoire of resistance-associated genes. Among 67 sequenced isolates, 26 known sequence types were identified, including several STs occurring in isolates from more than one host species. Core-genome phylogenetic analysis demonstrated substantial genomic diversity without complete segregation according to host species or clinical status. Genotype-phenotype concordance was generally limited and gene dependent, and discrepancies were also observed between PCR- and WGS-based detection for selected resistance determinants. Biofilm formation was significantly influenced by incubation temperature, host species, and clinical status, while growth kinetics showed pronounced strain-specific variability and no consistent relationship with biofilm-forming capacity. MALDI-TOF MS profiling and partial rpoB phylogeny likewise showed considerable overlap among isolates from different host groups. In the Galleria mellonella infection model, mortality was inoculum dependent and varied substantially among strains. Overall, the findings demonstrate marked phenotypic and genomic heterogeneity among S. epidermidis isolated from humans and companion animals and indicate that some clonal backgrounds and resistance determinants occur across host species, highlighting the relevance of this species within a One Health context.
    Keywords:  CoNS; One Health; Staphylococcus epidermidis; antimicrobial resistance
    DOI:  https://doi.org/10.3390/ijms27198585
  60. Infect Dis Clin Microbiol. 2026 Sep;8(5): 431-441
    Artificial Intelligence in Infectious Diseases and Clinical Microbiology.
    Elif Agüloğlu Bali, Yasemin Çakır-Kıymaz, İrem Akdemir, Eda Alp, Feyza Nur Akçin Balan, Merve Büyükkörük, Ravi Kumar Chaudhary, Güle Çınar, Daniele Roberto Giacobbe, Ezgi Gülten, Taliha Karakök, Murat Hakan Kır, Oliver Nolte, Ahmet Kağan Özdemir, Özlem Güler, Eren Öztürk, İbrahim Yıldız, Gökmen Zararsız, Önder Ergönül.
      Artificial intelligence (AI) is increasingly influencing healthcare, with growing relevance in infectious diseases and clinical microbiology. This review summarizes current applications of machine learning (ML), deep learning (DL), and large language models (LLMs) in these areas while critically evaluating their strengths and limitations. Although AI has shown promising performance in image analysis, molecular diagnostics, risk prediction, and clinical decision support, its routine implementation remains constrained by limited external validation, heterogeneous datasets, algorithmic bias, and challenges in generalizability and explainability. The review also discusses AI's emerging role in scientific writing and the ethical and practical considerations associated with its clinical adoption. Overall, current evidence suggests that AI should be regarded as a complementary decision-support technology whose safe and effective integration depends on rigorous validation, high-quality data, and appropriate clinical oversight.
    Keywords:  Artificial intelligence; antimicrobial stewardship; clinical decision support; deep learning; machine learning
    DOI:  https://doi.org/10.36519/idcm.2026.1014
  61. Nat Commun. 2026 Sep 15. pii: 10849. [Epub ahead of print]17(1):
    Mobile genetic elements drive a plasmid fusion and deletion lifecycle shaping evolution and antimicrobial resistance.
    Thomas Ipoutcha, Yiqing Wang, Eduardo P C Rocha, José R Penadés.
      Plasmids are key drivers of bacterial adaptation, yet the mechanisms that generate their diversity remain poorly understood. Here, we show that mobile genetic elements (MGEs) orchestrate a fusion-deletion life cycle that repeatedly remodels plasmids in Staphylococcus aureus. Large-scale genomic analyses reveal that multireplicon plasmids are widespread and strongly enriched in transposases. Using experimental assays, we demonstrate that rare MGE-mediated fusion events, via homologous recombination or transposition, combine distinct plasmids into single multireplicon elements, expanding gene content and transfer potential. Antibiotic pressure selectively enriches these fused plasmids, rescuing bacterial populations under stress, whereas opposing selective forces, including phage predation, favour deletion derivatives that preserve essential functions and phage transmissibility. This cyclical process generates dynamic plasmid repertoires with conserved backbones and diverse accessory modules. We propose that MGE-driven fusion-deletion cycles represent a general principle of plasmid evolution, explaining the rapid emergence and persistence of multidrug-resistant plasmids across bacterial pathogens.
    DOI:  https://doi.org/10.1038/s41467-026-77678-8
  62. J Infect Dev Ctries. 2026 Sep 30. 20(9): 1351-1360
    Evaluation of biofilm activity, virulence genes, and antibiotic susceptibility profiles in clinical Proteus mirabilis isolates.
    İrem Unat, Tuğrul Hoşbul.
       INTRODUCTION: Proteus mirabilis is a common opportunistic pathogen in wound and urinary tract infections (UTIs), whose clinical significance is driven by biofilm formation. This virulence-mediated process provides a shield against antimicrobials and host immunity, promoting difficult-to-treat infections. This study aimed to elucidate the relationship between biofilm-forming capacity, presence of virulence genes, and antibiotic resistance profiles in P. mirabilis isolates.
    METHODOLOGY: A total of 76 P. mirabilis isolates from urine and wound samples were analyzed. Isolates were identified using MALDI-TOF MS, antimicrobial susceptibility was tested via VITEK®2, biofilm formation was measured using the crystal violet method, and the presence of virulence genes (ureC, ireA, zapA, rsbA, flaA, atfA, ucaA, and hpmA) was analyzed by PCR.
    RESULTS: Wound isolates showed significantly enhanced biofilm production and higher resistance rates to multiple antibiotics. Moderate-to-strong biofilm production was significantly associated with catheterization, the presence of the zapA, atfA, and ucaA genes, and increased resistance to ciprofloxacin and trimethoprim-sulfamethoxazole (TMP-SXT). The presence of the hpmA gene showed a borderline association with TMP-SXT resistance. The presence of the rsbA gene was significantly associated with a reduced likelihood of ertapenem resistance, suggesting a role in modulating porin-mediated antibiotic uptake.
    CONCLUSIONS: Biofilm-mediated resistance is a significant barrier to managing P. mirabilis infections, particularly in wounds and catheter-associated UTIs. The presence of specific genes in moderate-to-strong biofilm producers indicates their products are integral to the structural integrity and the functional capacity of the biofilm. The inverse relationship between rsbA and carbapenem resistance warrants further investigation as a biomarker for susceptibility.
    Keywords:  Proteus mirabilis; antibiotic resistance; biofilm; virulence factors
    DOI:  https://doi.org/10.3855/jidc.22641
  63. Diagnostics (Basel). 2026 Sep 23. pii: 3082. [Epub ahead of print]16(19):
    Bridging the Artificial Intelligence Translation Gap in Perioperative Pulmonary and Respiratory Complications: A Practical Framework for Institution-Level Implementation.
    Ji-Yeon Lee, Yong-Ho In, Jong-Ho Kim, Sung-Mi Hwang, Jae-Jun Lee, Young-Suk Kwon.
      Perioperative pulmonary and respiratory complications (PPRCs) result in increased morbidity, mortality, and healthcare costs. Recent research has focused on employing artificial intelligence (AI) and machine learning to predict and analyze PPRCs using expansive perioperative datasets. Despite advances in feature engineering, deep learning architectures, and explainable AI, models are rarely implemented in routine clinical practice. In this narrative review, we synthesize evidence from 59 unique publications, corresponding to 63 phenotype-specific study-listings across six PPRC phenotypes (combined postoperative pulmonary complications, pneumonia/pulmonary infection, hypoxemia, respiratory failure, pulmonary embolism/venous thromboembolism, and pulmonary edema) and introduce an integrated analytical and translational framework to bridge translation gap. The proposed paradigm comprises a tiered framework for evaluating outcome ascertainment quality (TIER) (39 of 63 study-listings [61.9%] were classified as TIER A according to the proposed framework), an algorithm-cohort-phenotype fit model, a discrimination-calibration-utility triad for performance assessment, a translation gap framework highlighting interacting challenges across validation, deployment, and evidence generation, and a six-step framework for clinical translation. Most models lacked robust validation, with only 9 of the 59 unique publications (15.3%) reporting true cross-institutional external validation, thereby limiting their generalizability. Near-term clinical translation is more likely through institution-specific development and local adaptation than direct widespread deployment, supported by concrete recommendations for clinicians.
    Keywords:  artificial intelligence; machine learning; perioperative period; postoperative complications; respiratory insufficiency; risk assessment; translational research
    DOI:  https://doi.org/10.3390/diagnostics16193082
  64. Womens Health Nurs. 2026 Sep;32(3): 190-204
    Artificial intelligence technologies in pregnancy and childbirth care: a scoping review from a nursing perspective.
    Hyunjin Cho, Sukhee Ahn.
       PURPOSE: This scoping review examined the applications of artificial intelligence (AI) technologies in pregnancy and childbirth care, including patterns of use and outcomes relevant to nursing practice.
    METHODS: Using Arksey and O'Malley's methodological framework, we comprehensively searched PubMed, CINAHL, Embase, and Web of Science for empirical studies published from 2015 to 2025. Of the 1,282 records identified, 1,191 were screened after duplicates were removed, and 20 studies of pregnancy and childbirth care were included.
    RESULTS: AI applications in the 20 included studies were grouped into four domains: risk prediction models (n=14), fetal/intrapartum monitoring (n=3), clinical decision support (n=1), and patient education and nursing documentation (n=2). Publications increased markedly from 2021 onward. Machine learning algorithms, including random forest, support vector machine, extreme gradient boosting, and logistic regression, were used mainly to predict obstetric complications such as preterm birth, hypertensive disorders of pregnancy, preeclampsia, and gestational diabetes mellitus. AI models also analyzed fetal heart rate and electrocardiogram signals to support intrapartum decisions, including prediction of episiotomy risk and vaginal birth after cesarean delivery. A robot-assisted education system supported patient education, and a large language model supported nursing documentation.
    CONCLUSION: AI is used primarily for risk prediction and clinical decision support in pregnancy and childbirth care, with emerging applications in patient education and psychosocial assessment. Evidence for nurse-led AI interventions is limited. Research should prioritize clinical validation, AI literacy education, nurse-led program development, and ethical guidelines to support safe, equitable, individualized perinatal nursing care.
    Keywords:   Machine learning; Nursing practice; Pregnancy; Pregnancy complications; Artificial intelligence
    DOI:  https://doi.org/10.4069/whn.2026.09.04
  65. Compr Rev Food Sci Food Saf. 2026 Nov;25(6): e70674
    Biofilm-Mediated Persistence of Salmonella in Poultry Processing: A Comprehensive Review of Isolate Heterogeneity, Stress Adaptation, and Antimicrobial Resistance.
    Md Anamul Hasan Chowdhury, Chowdhury Sanat Anjum Reem, Md Furkanur Rahaman Mizan, Md Ashrafudoulla, Sang-Do Ha.
      Salmonella enterica remains a major foodborne pathogen in poultry-processing environments, where its persistence is largely attributed to biofilm formation on food-contact and non-food-contact surfaces. Despite extensive research on Salmonella control, persistent contamination continues to challenge food safety due to the complex interplay among isolate-specific traits, stress adaptation, and antimicrobial resistance (AMR). This review critically examines the phenotypic and genotypic determinants associated with Salmonella biofilm formation and evaluates their contributions to persistence, stress adaptation, and AMR. Emerging evidence also indicates that mixed-species interactions, particularly with Pseudomonas spp., can influence biofilm architecture, stress tolerance, and the long-term persistence of Salmonella in poultry-processing environments. Particular attention is given to processing-associated stresses, including temperature fluctuations, desiccation, nutrient limitation, and sublethal sanitizer exposure, which can induce adaptive responses that enhance biofilm development, promote persistence, and increase tolerance to antimicrobial interventions. The review further evaluates current detection approaches, including viability-based quantification methods such as digital droplet PCR, and discusses their limitations and applications in identifying and quantifying biofilm-associated and viable but nonculturable (VBNC) populations within processing environments. Existing control measures are assessed with emphasis on the challenges posed by mature biofilms and adaptive resistance mechanisms. Emerging antibiofilm technologies, including enzymatic treatments, bacteriophages, and UV-LED systems, are also examined for their potential industrial implementation. By integrating current knowledge on biofilm biology, stress adaptation, and AMR, this review provides a framework for developing targeted and sustainable strategies to mitigate Salmonella persistence in poultry-processing environments.
    Keywords:  Salmonella; antimicrobial resistance; biofilm; food safety; poultry processing; stress adaptation
    DOI:  https://doi.org/10.1111/1541-4337.70674
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