While diabetes-related complications have been widely investigated, the burden of infectious diseases across the diabetes spectrum remains relatively understudied. We developed a Bayesian approach to compare infection risk across 9,476 patients with type 1 diabetes (T1D), 74,270 with type 2 diabetes (T2D), and 32,095 with prediabetes. Patients with T1D, T2D, and prediabetes had multifold increased risk for all organ system- and pathogen-based composite infection outcomes. We also quantified risk for 1,401 individual infection outcomes, finding increased risk for most infections among patients with either T1D, T2D, or prediabetes. Patients had increased risk for well-established diabetes-associated infections (e.g., mucormycosis) and less commonly associated infections (e.g., West Nile Virus encephalitis). Finally, we found disparities in risk across sociodemographic subgroups (i.e., age, sex, ethnicity, ancestry, and insurance status). Our comprehensive findings advance previous research by quantifying risk for wide-ranging infection outcomes across diverse patients with T1D, T2D, and prediabetes through an innovative Bayesian approach.

The management of hernia in immunocompromised patients remains a distinct surgical challenge, characterized by complex risk profiles, heightened susceptibility to infectious complications, and ambiguous consensus on optimal mesh selection and perioperative protocols. As the prevalence of immunosuppression continues to rise due to increasing organ transplant rates, autoimmune diseases, oncological therapies, and advanced age, understanding the nuances of mesh repair in this population is of paramount importance. This review synthesizes current evidence on the safety, efficacy, and outcomes of hernia mesh repair in immunocompromised adults, traversing mesh materials, infection mitigation strategies, surgical techniques, recurrence and complication rates, patient-reported outcomes, cost-effectiveness, and future research imperatives. Advanced mesh materials-particularly long-acting resorbable meshes-show superior long-term durability but at elevated cost. The risk for mesh infection and recurrence is proportionate to immunosuppression burden, comorbidities, and operative field contamination. Notably, modern synthetic meshes, when coupled with stringent perioperative infection control and risk-mitigation strategies, offer durable repair with acceptable safety profiles, even in immunocompromised hosts. There is insufficient evidence to support routine use of biologic mesh, except in select contaminated fields. Patient-reported metrics are increasingly recognized as essential for outcome assessment, though standardization remains incomplete. Cost-effectiveness favors synthetics unless contamination risks predominate or patient preference dictates otherwise. Gaps include inconsistent immunocompromised patient definitions, limited long-term data, and lack of tailored guidelines. Prospective, multicenter studies integrating real-world patient-reported and economic data are needed.

Although proper donning and doffing of personal protective equipment (PPE) is critical for infection prevention, detailed characterization of problems encountered during these processes in real-world settings during large-scale infectious disease outbreaks remains insufficient. This study aimed to analyze the characteristics and distribution of interception problems in the process of donning and doffing process in a large cabin hospital during the 2022 COVID-19 pandemic in Shanghai. A prospective, real-world study was designed to collect and analyze data on irregularities observed during personal protective equipment (PPE) donning procedures in cabin hospital operations. The proportion of problems encountered during donning PPE was 5.29% (246/4,652), while during doffing PPE, it was 8.44% (382/4,525) (P < 0.001). The primary problem during donning PPE was related to problems with protective clothing, followed by problems with respirators. There was no significant difference in problem distribution among different posts (P = 0.459). The problems related to protective clothing mainly focused on loose fitting around the head and neck, making them prone to exposure during donning (56.25%, 99/176) and contamination of the inner surface of protective clothing during doffing (46.43%, 91/196). Respirator-related problems included failure of the seal test during donning PPE (61.54%, 24/39) and shifting or loosening of the respirator during PPE doffing (73.68%, 14/19). These findings identify critical gaps in PPE procedures and highlight the need for targeted training to address these issues, thereby reducing the risk of infection among healthcare personnel in mobile cabin hospitals.

With the availability of multiple classes of advanced therapies for the treatment of Crohn disease (CD), understanding the comparative safety of different therapies can inform treatment positioning. To compare the risk of serious infections, venous thromboembolism (VTE), and major adverse cardiovascular events (MACE) with different advanced therapies in patients with CD. This retrospective comparative effectiveness research study was conducted between January 1, 2016, and December 31, 2022, with a mean (SD) follow-up of 26.9 (2.4) months until July 1, 2024. Using an administrative claims database (OptumLabs Data Warehouse), commercially insured patients with CD, who initiated treatment with tumor necrosis factor-α (TNF) antagonists, anti-integrin agents (vedolizumab), interleukin (IL)-12/23p40 antagonists (ustekinumab), IL-23p19 antagonists (primarily risankizumab), or Janus kinase inhibitors (upadacitinib) between 2016 and 2022 and had follow-up for at least 1 year before and after treatment initiation, were included. TNF antagonists vs anti-integrin agents (vedolizumab) vs IL-12/23p40 antagonists (ustekinumab) vs IL-23p19 antagonists (risankizumab) vs Janus kinase inhibitors (upadacitinib). The risk of serious infections, VTE, and MACE was compared with various advanced therapies through multinomial propensity score-based inverse probability treatment weighting, with propensity scores estimated through generalized boosted models, accounting for disease characteristics, health care utilization, comorbidities, and prior and concomitant medications, and through competing risk of mortality. Cause-specific hazard ratios (HRs) and 95% CIs for multiple treatment comparisons were calculated. This study included 12 245 patients with CD (mean [SD] age, 46.5 [17.5] years; 6642 females [54.2%]), who were treated with TNF antagonists (n = 5274), vedolizumab (n = 2716), ustekinumab (n = 3544), risankizumab (n = 559), or upadacitinib (n = 152). Serious infection incidence rates ranged from 5.46 (95% CI, 4.86-6.07) to 9.02 (95% CI, 6.38-11.89) per 100 person-years across therapies. After adjusting for confounding variables, there were no statistically significant differences in the risk of serious infections across different agents, including between risankizumab and ustekinumab (HR, 1.14 [95% CI, 0.78-1.67]), risankizumab and TNF antagonists (HR, 1.00 [95% CI, 0.68-1.47]), or ustekinumab and TNF antagonists (HR, 0.88 [95% CI, 0.74-1.04]). The incidence of VTE (incidence rate, 0.90 [95% CI, 0.71-1.10] to 2.33 [95% CI, 1.06-3.82] per 100 person-years) and MACE (0.68 [95% CI, 0.51-0.85] to 1.49 [95% CI, 0.43-2.76] per 100 person-years) was low, without any significant differences across agents. In this comparative effectiveness research study of patients with CD, no significant differences in the risks of serious infections, VTE, or MACE across various advanced therapies were found. These findings support clinical decision-making on choice of advanced therapies for most individual patients with CD to be driven primarily by comparative treatment effectiveness rather than driven by concerns of serious adverse events.

The use of telemedicine has gained importance in patient care since the COVID-19 pandemic. This study aimed to compare the acceptance of telemedicine in lung cancer patients undergoing thoracic surgery or oncological therapy. Consecutive lung cancer patients, either post-surgery (n = 100) or after oncological therapy (n = 100), were prospectively surveyed between May 2024 and March 2025 at the Asklepios Lung Clinic Gauting, Germany. A 67-item questionnaire covering perceived advantages and disadvantages of telemedicine, personal preferences, and the willingness to use telemedicine was employed. Demographic and clinical characteristics were similar in the surgical and oncological groups (median age 70/66 years, 52/44% females, respectively). Both groups showed a similar attitude towards telemedicine, regardless of education, age, sex, tumour stage, or treatment. Overall, 69% of surgical and 55% of oncological patients were unaware of existing telemedicine services. The majority would accept video/phone consultations for initial assessments, incapacity certificates, and follow-up, although 40% of patients were concerned about the quality of the patient-physician relationship. Perceived advantages were reduced waiting times and infection risk. Among medical specialties, telemedicine was most accepted for General Practice (50%). Compared to a population-based cohort, patients expressed less concern about misdiagnoses and data privacy. Lung cancer patients expressed specific preferences regarding telemedicine, without major differences between surgical and oncological patients. They perceived advantages in its use for follow-up, saving time, and reducing infection risk. These findings can help guide a focused and well-accepted implementation of telemedicine into clinical practice.

Introduction Here, we present the results of a nationwide newborn screening (NBS) program in Russia, covering over 2.3 million newborns and employing TREC and KREC quantification to improve the identification of severe forms of T and/or B cell immunodeficiencies and enable early treatment initiation. Methods A two-tier PCR testing strategy was used to define the screen-positive cohort, followed by confirmatory flow cytometry and genetic diagnostics, including fluorescent in situ hybridization (FISH) and whole-exome sequencing (WES). Results A total of 191 patients were diagnosed with defined forms of primary immunodeficiencies (PID), encompassing several groups of inborn errors of immunity (IEI): severe combined immunodeficiency (SCID), agammaglobulinemia, combined immunodeficiency less severe than SCID, and syndromic forms of PID. The overall birth prevalence of severe forms of T and/or B cell immunodeficiencies was 1 in 12,298 live births (95%CI: 1:10,672–1:14,247), corresponding to 8.13 cases per 100,000 newborns (95%CI: 7.02–9.37). Although the positive predictive value of KREC-based screening was relatively low, its use enabled the detection of a substantial proportion of patients with syndromic forms of PID, including Nijmegen breakage syndrome and ataxia–telangiectasia, along with various forms of agammaglobulinemia. Interestingly, 16% of diagnosed newborns had a positive family history, often with previously undiagnosed affected siblings or parents. Additionally, a considerable number of newborns detected by NBS presented with syndromic disorders not currently classified as IEI, suggesting potential avenues for future expansion of the IEI list. Discussion Importantly, early diagnosis through NBS allowed for the timely initiation of disease-specific treatments, including hematopoietic stem cell transplantation (HSCT), immunoglobulin replacement therapy, and targeted immunosuppressive or supportive care strategies. Early intervention may reduce the risk of severe infections, improve neurodevelopmental outcomes, and prevent irreversible organ damage or malignancies in predisposed syndromes. Overall, our study demonstrates the effectiveness of large-scale implementation of TREC/KREC-based NBS in identifying a broad spectrum of immunodeficiencies and highlights future directions for improving NBS algorithms, follow-up protocols, and individualized medical management for affected infants.

Abstract Vaccine hesitancy was a major concern during the Covid-19 pandemic, and a significant percentage of healthcare workers (HCWs) proved to be hesitant too. Various governments, including that of Greece, reacted aggressively, imposing mandates stipulating dismission of HCWs from work unless vaccinated. Hesitancy was understood as a case of moral failing and against the principle of ‘do no harm’. In this article, we deploy hermeneutics policy analysis based on interviews and analysis of texts to challenge this view. On the basis of qualitative analysis of transcripts of press conferences organized by the Greek Ministry of Health and 74 interviews with hesitant HCWs, we show that government’s and HCWs’ understanding of the risk of infection and the associated threat posed to the public health system were starkly different. For HCWs, hesitancy was linked to distrust toward political institutions, which should be treated in a different manner from a case of moral failing of HCWs. We argue that, rather than mandates, persuasion is a better strategy, since hesitancy raises the question of trust toward the politicoscientific establishment. Therefore, reforming science advice institutions so that they make use of local expertise and engage civil society is key. We focus on Greece, as we consider it to be an interesting case of a newly established science advice system with a distinctive character that we term the ‘look from inside’, based on the model of ‘ethical chief scientist,’ which makes it a brilliant case study for others considering building or reforming their systems.

Postoperative headache and cerebrospinal fluid (CSF) leakage are common complications after meningioma resection, which may prolong hospitalization, increase infection risk, and negatively affect patient recovery. Although maintaining a 30° head-of-bed (HOB) elevation is standard postoperative nursing care to reduce intracranial pressure, the optimal elevation angle remains uncertain. This study aimed to evaluate the efficacy of an improved HOB elevation of 30° to 35° in reducing postoperative headache severity and CSF leakage in patients undergoing meningioma resection. This retrospective cohort study included 128 patients who underwent meningioma resection between January 2021 and December 2023 at our hospital. Patients were allocated to the control group (n = 64, HOB = 30°) or the improved group (n = 64, HOB = 30°-35°). Postoperative headache severity, CSF leakage incidence, wound healing, and patient satisfaction were compared between groups. Statistical analyses were performed using SPSS version 26.0 (IBM Corp., Armonk), and a P value <0.05 was considered statistically significant. An early postoperative HOB elevation of 30° to 35° after meningioma resection significantly reduces postoperative headache severity, reduces CSF leakage, and improves patient satisfaction compared with the conventional 30° position. These findings suggest that slightly increasing the HOB angle could be considered as part of optimized postoperative nursing protocols. Compared with the control group, the improved group exhibited significantly lower headache scores on postoperative day 3 (3.12 ± 1.21 vs 4.58 ± 1.44, t = 5.487, P < .001) and day 7 (2.11 ± 0.93 vs 3.72 ± 1.26, t = 7.023, P < .001). The incidence of CSF leakage was markedly reduced in the improved group (3.13% vs 14.06%, χ2 = 4.398, P = .036), while patient satisfaction was significantly higher (93.75% vs 79.69%, χ2 = 5.184, P = .023).

Conventional annuloplasty rings used in mitral valve repair (MVr) are made of metal or synthetic polymers, which may increase infection risk. This study aimed to develop a mitral annuloplasty ring using decellularised tissue and evaluate its ability to suppress regurgitation in a degenerative mitral regurgitation (DMR) model. A 4 mm diameter annuloplasty ring was created using decellularized bovine tendon. Porcine mitral valve complexes (including the annulus, leaflets, chordae tendineae, and papillary muscles) were obtained from a slaughterhouse. The annulus was enlarged by 4 mm, and the two chordae tendineae of the posterior leaflet (P2) were severed. The DMR model, integrated into a pulsatile flow simulator, was repaired using a commercial-Physio II, Colvin-Galloway (CG) Future, Tailor band, and a decellularised tendon-based ring. Regurgitation control and effective mitral valve area (MVA) were compared (n = 6 for each group). The regurgitation rate of the DMR model was 52.3 ± 3.4%, consistent with severe MR. Post-MVr with each ring, the regurgitation rates were 14.9 ± 3.1% (Physio II), 14.5 ± 1.1% (CG Future), 16.4 ± 1.7% (Tailor band), and 15.5 ± 3.0% (decellularised tendon-based biological ring). All of these rates were significantly reduced, with no significant differences among them. Effective MVA was comparable across groups: 2.46 ± 0.28 cm2 (Physio II), 2.33 ± 0.54 cm2 (CG Future), 2.28 ± 0.12 cm2 (Tailor band), and 2.27 ± 0.53 cm2 (decellularised tendon-based biological ring). The decellularised tendon-based annuloplasty ring demonstrated functional performance comparable to that of current mitral annuloplasty devices.

Overactivation of the complement system plays a role in the pathophysiology of several serious kidney diseases, such as immunoglobulin A nephropathy, complement 3 glomerulopathy, atypical hemolytic uremic syndrome, and antineutrophil cytoplasmic antibody-associated vasculitis. A key focus of recent research has been developing complement inhibitors to target the underlying disease mechanisms of these diseases and thereby improve patient outcomes. Currently, five complement inhibitors are approved by the United States Food and Drug Administration as effective for the treatment of kidney diseases: eculizumab, ravulizumab, avacopan, iptacopan, and pegcetacoplan. However, some of these therapies may increase the risk of serious, potentially life-threatening infections, particularly from encapsulated organisms including Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b. Health care providers must recognize this risk and implement preventive measures when prescribing complement inhibitors. This review summarizes the infectious risks associated with complement inhibitors and highlights key clinical considerations for their safe and effective use in the treatment of kidney diseases. It is intended to serve as an accessible resource for providers utilizing these agents in clinical practice.

Achieving proper skin closure after total knee arthroplasty (TKA) is crucial for minimizing complications, as the surrounding skin is under significant tension during the early postoperative period. Cyanoacrylate, or skin adhesive, supplements subcuticular suture closure, providing a secure, watertight seal while lowering infection risk. This study compared wound healing, complications, and patient-reported outcomes between suture closure and suture plus adhesive. A total of 167 patients undergoing primary TKA were enrolled in a prospective single-blinded protocol change study at a single institution from August 2023 to September 2024. Patients had their wound closed with subcuticular 3-0 Monocryl suture (n = 69) or suture plus cyanoacrylate adhesive (S + C) (n = 98), alternating techniques every 3 months. Scar healing was assessed through photographic review at 1 month, evaluating scabbing and scar length. Wound complications, stiffness, and readmission rates were recorded. Patient satisfaction was measured at 6 months using the Patient and Observer Scar Assessment Scale (POSAS) score. Bivariate analyses evaluated differences between groups. Wound complications occurred at a similar rate between suture (11.6%) and S + C (14.3%; p = 0.784). Stiffness was reported in 6.6% of patients (8.7% suture vs. 5.1% S + C; p = 0.365). A 90-day readmission occurred in 3.6% (4.4% suture vs. 3.1% S + C; p = 0.692). Scar healing assessments showed 19.1% of patients had more than two scabs, with a higher frequency in S + C (24.2%) than sutures (12.5%; p = 0.193). The mean scar length was slightly longer in S + C (15.0 vs. 14.5 cm; p = 0.148). No cosmetic differences were noted between groups according to the mean POSAS score (5.0 ± 4.18 sutures vs. 5.1 ± 5.57 S + C; p = 0.641). Both sutures and cyanoacrylate adhesive demonstrated comparable clinical and patient-reported outcomes following TKA. The cyanoacrylate adhesive group had a slightly higher rate of minor wound healing concerns. Both closure methods are viable options, and the choice of technique can be left to the surgeon.

Abstract Aim Insufficient research focusing on the lived experiences of men who have sex with men and women (MSMW) can lead to a lack of understanding of the specific needs and complexities of this population. A scoping review was conducted to identify the existing evidence and describe the gaps in the literature related to the experiences of MSMW, with particular attention on the intersection between sexual identity, sexual attraction, and sexual behaviour; stigma and discrimination; health-seeking behaviours; health interventions; sexually transmitted infection (STI) and blood-borne virus (BBV) risk and protective behaviours; disclosure; and sexual behaviours. Subject and methods A search was conducted using both academic databases (MEDLINE, PsycINFO, and Web of Science) and grey literature search engines (Google and Google Scholar). Studies were included if they met the following criteria: published since 2013, published in English, and containing literature relating to MSMW and one or more of the focus concepts. Results Forty-six studies were included in the review. A fear of stigma and discrimination was found to have a negative impact on several areas, including sexual identity, disclosure, and health-seeking behaviours. The least represented topic was health-seeking behaviours, with the dominant theme being that accessible and affirming services are necessary to encourage engagement among MSMW. Conclusion Findings highlight the need for accessible and affirming health services to encourage engagement by MSMW, as well as evidence-based training for healthcare professionals. Also highlighted is the need for tailored interventions to reduce STI/BBV risks among this population.

Estimating the proportion of individuals currently infected with Mycobacterium tuberculosis (Mtb) is key for informing global health policies. Although a substantial portion of the global population exhibit tuberculous immunoreactivity, not all have a viable Mtb infection. Moreover, individuals with recent infections are at a higher risk of developing tuberculosis (TB). Here, we present estimates of the global burden of viable Mtb infection, using new insights into the natural history of TB. We constructed country-specific trends in annual risk of infection considering estimates of TB burden, immunoreactivity reversion, and age-specific mixing. We applied these trends to a deterministic mathematical model incorporating reinfection and self-clearance to estimate recent (within 2 years) and total viable Mtb infections. Empirical data on self-clearance are limited, so rates were informed by modelling estimates. In 2022, we estimated that 133.7 million people (95% uncertainty interval [UI]: 104.0, 171.1) had a recent Mtb infection, representing 1.7% (95% UI: 1.3, 2.2) of the global population. In total, 288.9 million people (95% UI: 242.2, 342.7)-or 3.7% (95% UI: 3.1, 4.3) globally-were estimated to harbour a viable Mtb infection. Among those recently infected, 12.0% (95% UI: 11.4, 12.7) were children under 15 years of age. Most recent infections were found in the World Health Organization regions of South-East Asia (49.0%; 95% UI: 37.2, 62.4), the Western Pacific (19.7%; 95% UI: 12.6, 30.5), and Africa (17.9%; 95% UI: 12.9, 24.1). India, Indonesia, and China had the highest burden, with 39.1 million (95% UI: 18.0, 73.6), 12.0 million (95% UI: 5.8, 22.9), and 11.2 million (95% UI: 5.0, 25.5) people, respectively, recently infected with Mtb. Sensitivity analyses of varying self-clearance scenarios showed significant changes in global estimates of viable Mtb infection, particularly in total burden, with lower self-clearance rates. Overall uncertainty in the estimates was considerable, reflecting limitations in the underlying data informing key model parameters. Our findings offer global burden estimates of viable Mtb infection and reveal a sizable population recently infected with Mtb and at high risk of progression to disease. New diagnostic tools that can detect individuals with viable Mtb-particularly those who would benefit from TB preventive therapy-are urgently needed.

Evaluating the non-specific effects of BCG vaccination on the immune system and serological response to influenza vaccination in the elderly: A randomised controlled trial.

While infection is a leading cause of mortality among patients on hemodialysis, there are limited data on patients' infection prevention knowledge and attitudes. We aimed to assess hemodialysis patients' knowledge of their elevated infection risk, their willingness to actively prevent infections, and the acceptability of a long-term intranasal decolonization intervention. We surveyed patients as part of a stepped wedge cluster randomized trial evaluating intranasal povidone-iodine (PVI) decolonization. Sixteen outpatient hemodialysis centers affiliated with 5 academic medical centers. Patients undergoing outpatient hemodialysis. Patients were asked to complete a pre-intervention survey (9 questions) and two intervention surveys (13 questions; only patients interested in PVI) at 1 month and 6 months after starting PVI. We used the chi-squared test to compare responses over time. 469 (∼25%) participants completed at least one survey. Most (55%) participants underestimated their infection risk compared with an average person in the United States. The percentage of participants willing to expend "a lot of effort" to prevent an infection decreased from 79% (pre-intervention) to 63% (final survey) (p < 0.01). Among the 102 participants using PVI at 6 months, 87% said PVI felt neutral or pleasant and 75% used PVI for the past 3 dialysis sessions. Only 9.4% reported side effects. Patients on hemodialysis underestimate their infection risk. Most patients found intranasal PVI to be acceptable. Future research should aim to improve patient education on their infection risk and remove barriers to adherence with infection prevention interventions.Clinical trial information: NCT04210505, https://clinicaltrials.gov/.

Helminth infections are consistently associated with reduced cardiovascular disease (CVD) risk, yet the biological mechanisms underlying this relationship remain unclear. The gut microbiome and metabolome are key regulators of cardiometabolic health and may mediate infection-associated effects on host physiology. Here we show that Schistosoma mansoni infection associates with distinct gut microbial and metabolic profiles linked to CVD risk in people living in Uganda. In a cross-sectional study of 209 individuals living in communities with contrasting S. mansoni endemicity, we profile the gut microbiome using 16S rRNA gene sequencing and the faecal metabolome using liquid chromatography-mass spectrometry. S. mansoni infection associates with increased gut microbial diversity and distinct taxonomic signatures, including enrichment of taxa such as Treponema and depletion of Prevotella and Streptococcus. Several infection-associated microbial taxa statistically mediate the relationships between S. mansoni infection and cardiovascular disease risk. Faecal metabolomic profiling identifies infection-associated metabolites, and integrative analyses showed linked microbe-metabolite networks associated with cardiovascular risk.These findings identify gut microbiome and metabolome signatures associated with S. mansoni infection and cardiovascular disease risk in Uganda. Although causality cannot be inferred, this work provides insight into host-parasite-microbiome interactions and highlights microbial and metabolic pathways relevant to cardiometabolic health.

Oxidised zirconium-on-polyethylene (OxZroP) total hip arthroplasty prostheses are increasing in popularity as an alternative to other bearing types. The surface characteristics and wear properties of OxZroP result in less metal and polyethylene wear which may be protective against microbiological seeding of the synovial joint space. The purpose of this study was to compare the rates of infection and inflammatory diagnoses between THAs using OxZroP heads with ceramic-on-polyethylene (CoP) and metal-on-polyethylene (MoP) designs. This study queried the Premier PINC AI Healthcare Database (PHD) (Premier Inc.) for all primary total hip arthroplasties from 2017 to 2022. Infection-related ICD10 codes were collected at 30 days, 3, 6, 12 months and 2 years postoperatively. Positive results were noted to be either PJI-related diagnosis codes, or the combination of an arthroplasty-related code with infection-related procedure codes. The rates of infection/inflammatory reaction were reported. OxZroP THA bearings demonstrated a decreased rate of prosthetic joint infection or inflammatory reaction diagnoses, at up to 2 years post-surgery, compared to MoP bearings an effect that was maintained when cross-referenced with imaging procedure codes. When compared to CoP hips OxZroP demonstrated lower odds reduction of infection or inflammatory reaction with diagnosis codes at up to 6 months, however, showed equal odds to CoP at later timepoints. OxZroP bearings for primary total hip arthroplasty demonstrated a reduced odds ratio of prosthetic joint infection and inflammatory-related diagnoses than ceramic-on-polyethylene bearings before 6 months and maintained lower odds than metal-on-polyethylene bearings at up to 2 years. Further studies are needed to obtain longer-term follow-up and understand the mechanism for this observed reduction in prosthetic joint infection and inflammatory-related diagnoses.

Abstract Delayed wound healing in diabetic patients poses significant clinical challenges, increasing risks of severe foot infections and potential limb amputation. To address infection risks and antibiotic resistance, we developed an antibiotic‐free composite, “ChitoSilkBioPatch,” integrating maleimide‐releasing chitosan hydrogels with decellularized fetal membrane (dACM) and a biomimetic stretchable silk mesh. This innovative scaffold combines potent antibacterial activity against Gram‐positive ( Staphylococcus aureus ) and Gram‐negative ( Pseudomonas aeruginosa ) bacteria through nanotopographical cues, dACM, oligochitosan, and conjugated maleimides, alongside robust regenerative properties. The silk mesh mimics skin's tensile strength and stretchability, while the hydrogel provides viscoelasticity akin to skin. In vivo, ChitoSilkBioPatch demonstrates strong anti‐inflammatory effects, accelerates epidermal and dermal regeneration, and enhances angiogenesis and immunomodulation, offering a promising solution for chronic diabetic wound healing.

Pathogenic species of the genus Leptospira cause an underdiagnosed zoonosis in humans and animals called leptospirosis. Animal reservoirs often remain asymptomatic yet shed the active spirochete in urine, making the control of leptospirosis transmission to humans more challenging. Asymptomatic leptospirosis in human companions, such as dogs and cats, resulting in unrecognised infections, has been demonstrated in a few countries. Crucially, the current lack of molecular epidemiology data on Leptospira among companion animals in Thailand underscores the urgent need to investigate transmission dynamics for effective regional control. We investigated the prevalence of Leptospira infection in cats and dogs during neutering in seven provinces across Thailand. The urine samples were screened for Leptospira DNA by PCR targeting the rrs gene and further speciation using the Sanger Sequencing Analysis. The 56/567 (9.9%) animals were positive for Leptospira in the Pathogen clade, including 34/303 (11.2%) dogs and 22/264 (8.3%) cats. The partial rrs gene analysis identified L. interrogans, L. weilii, and L. borgpetersenii (4.4%) as well as Pathogen subclade 2 species (1.4%). Notably, this study reports the first molecular detection of L. yasudae (1.0%) in companion animals in Thailand. The identification of these three key pathogenic Leptospira species, common causes of human leptospirosis in Southeast Asia, in clinically healthy owned and free-roaming dogs and cats, suggests the risk of human leptospirosis in the areas investigated. These companion animals, often living in close contact with human, may contribute to daily risks. Therefore, enhanced surveillance and vaccination programs for dogs and cats, coupled with targeted public awareness campaigns, are critical for mitigating the risk of human infections.

Abstract Carpometacarpal (CMC) joint arthroplasty is a common procedure performed by both orthopedic and plastic surgeons to address arthritis of the thumb CMC joint. The purpose of this study was to (1) compare the postoperative outcomes between orthopedic and plastic surgeons and (2) determine how surgeon specialty impacts rates of postoperative complications following CMC arthroplasty. All adult patients (&gt;18 years) undergoing CMC arthroplasty were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2020. Patient demographic data and medical comorbidities were examined. Patients were classified as having a procedure by either an orthopedic surgeon or a plastic surgeon. Univariate analysis and multivariate logistic regression were used to assess the risk of postoperative complications and 30-day readmission based on surgeon specialty. A total of 5,162 patients undergoing CMC arthroplasty were included in our study, with 83.7% of procedures performed by orthopedic surgeons versus 16.3% performed by plastic surgeons. The incidence of surgical complications (p &lt; 0.001), wound complications (p &lt; 0.001), and superficial surgical site infections (SSIs; p &lt; 0.001) was significantly higher when performed by plastic surgery. Additionally, operative time was significantly higher in cases performed by plastic surgeons (p = 0.001). On multivariate logistic regression, plastic surgery was independently associated with an increased risk of all complications (adjusted odds ratio [AORs] 2.70, 95% confidence interval [CI] 1.71–4.26), over four-fold increase in the risk of wound complications (AOR 4.49, 95% CI 2.53–7.97) and superficial SSI (AOR 5.06, 95% CI 2.72–9.39) when compared with orthopedic surgery. Despite similar patient demographics, CMC arthroplasty performed by plastic surgeons is independently associated with an increased risk of total postoperative complications, wound complications, and superficial infections when compared with orthopedic surgeons. Further investigation into perioperative and specialty-specific factors that contribute to discrepancies is warranted to improve outcomes and guide surgeon training. Level III, retrospective cohort study.