Aminocaproic acid is used to treat hyperfibrinolysis during complex surgery with coagulopathy. We present the first documented case of intraoperative anaphylaxis to aminocaproic acid during liver transplantation. A female in her 50s with hepatitis C-associated and alcohol-associated cirrhosis underwent liver transplantation with a right trisectionectomy allograft. After portal and arterial reperfusion, aminocaproic acid was administered for hyperfibrinolysis. She experienced intraoperative hypotension, hypoxaemia and elevated peak inspiratory pressures. Epinephrine was administered with improvement in haemodynamics and ventilation. Tryptase was elevated after administration of aminocaproic acid and resolved to normal baseline levels which suggested an anaphylaxis to this medication while under anaesthesia. She was extubated post-op day (POD) 1 and was discharged home POD 4. Aminocaproic acid during liver transplantation may cause anaphylactic shock. Haemodynamic and ventilatory changes after administration warrant consideration for empiric treatment and measurement of tryptase levels while other potential aetiologies are also being assessed.

BackgroundThere are currently no effective pharmacological treatments for Sjögren’s disease (SjD). Our study aims to identify potential therapeutic targets for the condition using druggable genome-wide Mendelian randomization (MR).MethodsDruggable genome data were obtained from the Drug-Gene Interaction Database (DGIdb) and the study by Finan et al. We then integrated these druggable genes with blood-derived cis-eQTL, cis-mQTL, and cis-pQTL datasets, each analyzed separately in two-sample MR analyses using SjD GWAS summary statistics as the outcome, applying a genome-wide MR approach focused on druggable targets. Bayesian colocalization was applied to validate shared causal genetic variants. Protein levels of prioritized genes were validated in clinical serum samples from SjD patients and controls using ELISA. Phenome-wide MR (Phe-MR) analysis was conducted across 1359 phenotypes from the UK Biobank to evaluate potential pleiotropic effects and safety profiles of the identified targets, assessed side effects and alternative indications of identified targets.ResultsFourteen druggable genes were identified, with eight (PLAT, SIRPB1, LAIR2, NEU1, SLC22A16, RAD52, PSPH, and CDH23) demonstrating consistent causal relationships with SjD. ELISA validation supported differential protein expression for these targets. Key findings include the protective role of NEU1 and PSPH in systemic immune regulation, the pathogenic impact of PLAT, SIRPB1, BRD2, and LAIR2 on inflammation, and the potential involvement of SLC22A16 and RAD52 in metabolic stress and immune activation. Existing pharmacological compounds targeting these genes, including Aminocaproic acid, Resveratrol, Levocarnitine, Imatinib, and Zinc chloride were identified as potential therapeutic candidates. No significant adverse effects were detected through Phe-MR analysis.ConclusionOur research indicated PLAT, SIRPB1, LAIR2, NEU1, SLC22A16, RAD52, PSPH, and CDH23 may serve as promising targets for SjD, while the effectiveness of Aminocaproic acid, Resveratrol, Levocarnitine, Imatinib, and Zinc chloride for SjD requires further validation.

Tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA) are antifibrinolytic agents commonly used to reduce blood loss in total knee arthroplasty (TKA). Although TXA is widely adopted, EACA offers a potentially more economical alternative. However, head-to-head comparisons using paired designs remain limited. The present randomized controlled trial included 294 patients undergoing bilateral TKA. Each patient received topical TXA in one knee and topical EACA in the contralateral knee in a randomized sequence. Primary outcomes included total perioperative blood loss and total drain output over 3 days. Secondary outcomes included transfusion requirement, postoperative complications, and cost-effectiveness. The statistical analyses included paired t-tests, linear mixed-effects models for effect modification, logistic regression for transfusion and complications, and cost-effectiveness analysis comparing drug costs against blood loss reduction. Data from 294 patients (588 knees) were analyzed. TXA was associated with a statistically significant but modest reduction in total blood loss compared with EACA (mean difference: 10.03 mL, p < 0.001), well below the predefined non-inferiority margin of 200 mL. Similarly, drain output was also found to be lower in TXA-treated knees (mean difference: 10.07 mL; p = 0.0001), but the difference was not considered clinically significant. The rates of transfusion and postoperative complications were low (2.72 and 3.74% respectively). Cost-effectiveness analysis revealed EACA to be more cost effective as compared with TXA. Topical EACA was found to be non-inferior to TXA in reducing perioperative blood loss in TKA, with equivalent clinical outcomes and greater cost-effectiveness. These findings support the use of EACA as a cost-saving alternative to TXA, particularly in resource-limited settings.

The objective of this endeavor was to analyze current evidence comparing tranexamic acid (TXA) with aminocaproic acid (EACA) to determine their relative efficacy and safety in adult patients undergoing cardiopulmonary bypass (CPB). A systematic review and meta-analysis were conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology to assess randomized controlled trials comparing TXA with EACA in adult CPB. Studies were excluded if not randomized, did not directly compare TXA with EACA, or did not involve the adult CPB population. The primary efficacy endpoint was total blood loss in 24 hours (mL). Safety endpoints included the most commonly reported adverse events. The secondary efficacy endpoint was total units of packed red blood cells transfused (units). Nine randomized controlled trials were included. TXA had a statistically significant reduction in 24-hour blood loss compared with EACA [-0.21 (CI, -0.36 to -0.06), P = 0.0070]. TXA also had a statistically significant reduction in total packed red blood cells infused [-0.30 (CI -0.50 to -0.11), P = 0.0025]. There was no significant difference in neurological [1.48 (0.92-2.38), P = 0.9843], renal [0.99 (0.85-1.15), P = 0.2274], cardiac [1.08 (0.88-1.32), P = 0.2068], or thrombotic [1.00 (0.39-2.58), P = 0.4450] events. With synthesized evidence supporting TXA, this review can help guide practitioners to make informed recommendations regarding periprocedural care to minimize blood loss and maximize resource use. This analysis and review supports the preferential use of TXA over EACA in adults undergoing CPB.

Simulated sunlight exposure as a prerequisite for the biodegradation of persistent microplastics.

Silent hemorrhage: Unraveling the insidious rectal bleeding in hermansky-pudlak syndrome

Sepsis frequently progresses to acute lung injury (ALI), characterised by inflammation, extracellular matrix degradation, and mitochondrial dysfunction. This study identifies Enterococcus faecalis as a gut-derived bacterium that exploits the host fibrinolytic system for pulmonary translocation, resulting in mitochondrial damage and exacerbating lung injury. Utilising the cecal ligation and puncture (CLP) mouse model combined with E. faecalis pulmonary infection, we demonstrated that E. faecalis exacerbates lung injury by activating fibrinolysis, disrupting intestinal barrier integrity, and impairing mitochondrial function. Key findings include elevated plasmin activity, increased fibrin degradation products (FDP), and reduced expression of tight junction proteins ZO-1 and occludin. Mitochondrial dysfunction was confirmed by disrupted ultrastructure, impaired ATP synthesis, and increased ROS levels. Histological analyses revealed severe alveolar damage, neutrophil infiltration, and edema. Treatment with the fibrinolysis inhibitor aminocaproic acid or the mitochondrial protector MitoTEMPO alleviated fibrinolytic activity, preserved mitochondrial function, and reduced lung damage. Notably, combination therapy showed the most significant protective effects, improving lung histology and decreasing inflammation markers. This study provides novel insights into sepsis-induced lung injury, highlighting E. faecalis and the fibrinolytic system as potential therapeutic targets.

Evaluating Topical Antifibrinolytics in Cardiac Surgery: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis.

Red blood cell transfusions are commonly required in pediatric cranial vault remodeling (CVR); however, they carry risks and potential complications. This study evaluates the evidence on perioperative blood conservation agents assessing their efficacy in optimizing and reducing transfusion requirements in CVR. A systematic review was conducted using PubMed/MEDLINE, Scopus, Embase, Web of Sciences, and Google Scholar according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to assess articles discussing blood conservation agents in pediatric CVR. A network meta-analysis compared the effectiveness of different agents including tranexamic acid (TXA), aminocaproic acid (ACA), aprotinin, erythropoietin (EPO), and iron. Sixteen studies analyzing 1072 patients with a mean age of 15.6 months and weight of 8.78 kg were included. The most reported craniosynostosis subtypes were sagittal (30.2%) and metopic (13.8%). TXA and ACA were independently associated with lower transfusion rates and volumes compared with placebo (ACA: odds ratio [OR], 0.25; 95% CI, 0.08-0.80; TXA: OR, 0.17; 95% CI, 0.07-0.42). Combination therapy with TXA + EPO + iron (OR: 0.004, 95% CI: 0.002-0.10) or ACA + EPO (OR: 0.04, 95% CI: 0.01-0.32) were associated with reductions in transfusion rates. Network meta-analysis ranking revealed TXA + EPO + iron (Surface Under the Cumulative Ranking [SUCRA]: 98.90%) and ACA + EPO (SUCRA: 75.41%) as the most effective treatments for reducing transfusion rates. While TXA was associated with significant reductions in blood loss compared with placebo (standard mean difference: -1.26, 95% CI: -1.97 to -0.56), ACA ranked highest for blood loss reduction (ACA: SUCRA, 84.58% vs TXA: SUCRA, 72.43%). Combination of TXA + EPO + iron was associated with significantly reduced hospital length of stay (standard mean difference: -1.00, 95% CI: -1.71 to -0.29). No treatment significantly affected the duration of surgery, and there were no reported treatment-associated thromboembolic events. Our meta-analysis reveals that TXA + ACA reduce red blood cell transfusion rates and volumes, with TXA + EPO + iron and ACA + EPO being most effective. This highlights the superiority of combination therapies and underscores the need for structured multimodal protocols in perioperative blood conservation for pediatric CVR.

Efficient recycling of polyamide 6 (PA6) requires selective depolymerization routes that recover monomers under moderate conditions. This study investigates microwave-assisted acid hydrolysis of four PA6 waste streams, two oligomer-rich residues (WS-13, WS-24), an industrial fiber (C-fiber), and a commercial resin (C-resin) to elucidate degradation kinetics, activation energies, and product yields. Thermogravimetric analysis revealed multi-step solid-state decomposition, while microwave hydrolysis (125–200 °C, 15–60 min, 400 W) demonstrated strong dependence on acid type. HCl achieved complete conversion, whereas phosphoric and formic acids exceeded 95%. Kinetic analysis under H3PO4 followed pseudo-first-order behavior, with rate constants (0.015–0.141 min−1 at 200 °C) and activation energies reflecting feedstock structure: 53.1 kJ mol−1 (WS-13), 56.5 kJ mol−1 (WS-24), 87.1 kJ mol−1 (C-resin), and 99.9 kJ mol−1 (C-fiber). Monomer yields varied by substrate: WS-13 achieved 62.4% at 200 °C and 45 min (ACA 46%, CPL 16%), WS-24 yielded 62.0% (primarily ACA), C-fiber reached 69.7% (ACA-dominant), and C-resin produced 53.8%. These results show that oligomer-rich wastes are kinetically favored for rapid hydrolysis at lower energy cost, while C-fiber maximizes aminocaproic acid recovery. Overall, microwave-assisted hydrolysis provides a selective, energy-efficient pathway for PA6 circularity, offering design parameters for reactor operation and process optimization.

Background: Craniosynostosis is a congenital condition characterized by the premature fusion of 1 or more cranial sutures, leading to abnormal skull and facial morphology. Despite significant advancements in its understanding and treatment, variability in clinical practice persists across perioperative care. This underscores the need for evidence-based guidelines to standardize care and improve patient outcomes. The American Society of Craniofacial Surgeons (ASCFS) aims to address this need by presenting a comprehensive clinical practice guideline for the perioperative surgical treatment of craniosynostosis. Methods: American craniofacial centers were surveyed for standardized perioperative care protocols for craniosynostosis. Key topics, including analgesia and preoperative imaging, formed the foundation of this guideline. Literature searches on PubMed and embase were conducted for each topic, with 2 reviewers independently screening titles and abstracts. A third-party reviewer resolved any discrepancies. Full-text reviews identified articles for inclusion. Recommendations were developed using an evidence-based consensus approach and graded using the American Society of Plastic Surgeons’ recommendation grading scale. Results: Recommendations were developed for 23 topics, including antimicrobial prophylaxis, analgesia, steroids, surgical drains, preoperative imaging, postoperative nausea and vomiting, and agents to manage blood loss such as tranexamic acid, epsilon-aminocaproic acid, and fibrinogen. The strength of recommendation to support these components was variable but allows for each institution to implement the aspects of the protocol that are suitable for their practice patterns in an evidence-based manner. Conclusions: This standardized perioperative clinical care pathway represents a synthesis of the current literature available to guide perioperative care of patients undergoing cranial vault repair for the treatment of craniosynostosis. These recommendations can be applied to most patients, although as with any clinical practice guideline, they should be guided by each patient’s clinical circumstances and individual institutional policies.

Bleeding is common after cardiac surgery and is associated with increased morbidity and mortality. The etiology of coagulopathy after cardiopulmonary bypass is complex, involving systemic inflammation, hemodilution, residual heparin effect, platelet activation, hypothermia, and hyperfibrinolysis. Antifibrinolytic agents such as aprotinin and lysine analogs are used to mitigate hyperfibrinolysis. Although epsilon-aminocaproic acid (EACA) is generally considered safe, dosing regimens vary, and thrombotic complications are underreported in national registries. We describe a case of acute intracardiac thrombosis shortly after EACA administration during mitral valve repair in a patient with no known hematologic or hypercoagulable conditions. .

Alkaline phosphatase-streptavidin conjugate (APSA) enzyme and binding activity over time and storage conditions.

Enhanced biosynthesis of 6-aminocaproic acid in engineered Escherichia coli with artificial protein cage-organized enzymatic cascades.

Postoperative abdominal adhesions are the most common complication following abdominopelvic surgery, posing a significant burden on patients, clinicians, and society. However, current physical barriers often involve a tradeoff between preventing these adhesions and inhibiting inflammation. Herein, a one‐stone‐two‐birds strategy is presented to address this challenge through an injectable intertwined hydrogel containing sulfobetaine, modified aminocaproic acid (A6ACA), and ZnO nanoparticles (PSA‐ZnO hydrogel). This intertwined network is stabilized by multiple intermolecular coordination bonds, including hydrogen bonds and electrostatic interactions—enabling facile injection and resistance to abdominal creep stress. Experimental results demonstrate that PSA‐ZnO hydrogel fully reduce the severity of peritoneal adhesions in treated rats at both 7‐ and 14‐days post‐surgery, outperforming commercially available hyaluronic acid (HA) gel due to its superior antifouling, antibacterial (> 95% clearance of E. coli and S. aureus,), hemostatic (55 s), and wound healing properties (IL‐6 and TNF‐α decreased and VEGF increased). Unlike conventional barriers, PSA‐ZnO prevents foreign body formation by inhibiting blood clot organization and pathologic fibrin accumulation at wound sites. This integrated approach offers a clinically translatable solution for complete prevention of postoperative adhesions and inflammation, with the potential to improve patient outcomes and reduce healthcare burdens.

Diffusiophoresis (DP), a physical phenomenon wherein solute gradients drive the migration of suspended colloids, holds significant relevance in the microscale engineering of complex, nonequilibrium colloidal systems. While DP has been extensively studied under electrolyte and nonelectrolyte gradients, how gradients of other solute classes can potentially drive DP migration remains largely unexplored. In particular, zwitterions like amino acids are electrically neutral, like nonelectrolytes, yet carry charges like electrolytes. Here we demonstrate that zwitterion gradients drive DP migration, and develop a simple theory that successfully predicts DP velocities under a series of amino acids. This theory predicts colloidal migration to proceed up concentration gradients of zwitterions, in proportion to the dielectric increment of the zwitterion. Like for electrolyte gradients, the DP mobility depends on the particle zeta potential, yet DP velocity is proportional to the gradient (like nonelectrolytes), rather than the logarithmic gradient expected for electrolytes. Direct measurements of colloidal DP under gradients of three zwitterionic amino acids with decreasing dielectric increments (6-aminohexanoic acid, 4-aminobutyric acid, and glycine), agree quantitatively with the theory. This work establishes the unique characteristics of zwitterion-driven DP, opening avenues for its diverse applications, particularly in the domain of microscale colloidal transport.

Recycling emerges as a pivotal strategy to mitigate plastic waste, particularly for polyamides. This study delves into the chemical recycling of polyamide 6 (PA6) using quantum chemistry calculations. We investigate the molecular mechanisms of hydrolysis, alcoholysis, and ammonolysis as well as acidolysis with acetic acid. Our findings elucidate a two-step process in PA6 recycling: depolymerization and cyclization. PA6 is degraded to 6-aminocaproic acid and its derivatives in the depolymerization step, and these intermediates are then turned into ε-caprolactam in the cyclization step. Each step has several reaction pathways with different energy profiles. In pure solvents, depolymerization is identified as the rate-limiting step. The introduction of acetic acid changes the rate-limiting step and effectively lowers the energy barrier, enhancing the recycling process. Computational results align with prior experimental data and offer a plausible molecular explanation of polyamide recycling. These insights are vital for devising more efficient and sustainable chemical recycling methods for polyamides.

Proteinases of pathogenic bacteria contribute to invasion and pathogenesis by actively degrading the host's extracellular matrix (ECM) components and cellular barriers, modifying the host immune response and degrading the host defense system. This makes the proteinases one of the most virulent molecules and their identification and characterization are essential for preventing and controlling disease. Many bacteria also possess outer membrane-bound proteinases. Isolation and characterization of outer membrane proteins in their active forms present significant challenges due to their localization within the outer membrane. In this study, we demonstrate a single-step method for extracting both cytoplasmic and outer membrane-associated gelatinases from Leptospira and demonstrate their enzymatic activity using zymography. In this method, we use sodium deoxycholate to disrupt the cell membrane and release the bound proteins and 6-aminocaproic acid to solubilize the released membrane protein in its native form. Further, we show a zymographic analysis of the leptospiral gelatinases. This approach provides a versatile framework for isolating, purifying, and characterizing metalloproteases, collagenases, and gelatinases from various bacterial pathogens.

Abstract Nylon is the earliest developed material in the plastics industry and is currently the most widely produced engineering plastic. However, nylon is chemically stable and does not readily degrade in the natural environment. This study aims to study the depolymerization of nylon 6 under hydrothermal conditions using an autoclave reactor with variation of the reaction temperature and reaction time in the range of 260–340 °C and 0–60 min, respectively. The monomer products (caprolactam and aminocaproic acid) were obtained at 8:1, showing the equilibrium between these two molecules. The monomer yield increased with the reaction temperature and time, with negligible decomposition of the product. Because polymer has a repeating structure of the same unit, it is natural to consider the probability of decomposing one peptide bond to be the same as another one. This same probability results in the bond-breaking frequency in proportion to the number of remaining bonds. Then the rate of the bond breaking should be of first order. The first-order reaction model for the breakage of the peptide bonds adequately explained the depolymerization behavior. The reaction rate equation was expressed as an explicit function of time. The reaction rate was not affected by the degree of polymerization. The pre-exponential factor and activation energy for depolymerization of the bond were determined to be 0.002096 /s and 4.002 kJ/mol, respectively.

The development of vaccines represents a promising and safe strategy to combat multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) infections. In this study, we designed and evaluated a dendritic cell (DC)-targeting multiepitope peptide-based biomimetic nanovaccine for its immunogenicity and protective efficacy in a murine model. Bioinformatics tools were employed to predict and screen B- and T-cell epitopes derived from the OmpW protein of A. baumannii, followed by immunological validation. The dominant epitopes were sequentially linked using 6-aminocaproic acid to synthesize a multiepitope peptide, rOmpW. Subsequently, rOmpW was encapsulated within polylactic-co-glycolic acid (PLGA) nanoparticles coated with neutrophil membranes (NM), and the surface was functionalized with a DC-targeting peptide (DCpep) to construct the biomimetic nanovaccine, DCpep-NM-PLGA-rOmpW. This biomimetic nanovaccine elicited robust Th1 and Th17 cellular immune responses, as well as humoral immunity, and demonstrated significant protective efficacy in a murine model of acute lethal pneumonia caused by A. baumannii. These findings underscore the translational potential of this biomimetic nanovaccine as a prophylactic strategy against A. baumannii infections.