To investigate the detection rate, clinical characteristics, and factors associated with intensive care unit (ICU) admission in hospitalized children with acute respiratory tract infection (ARTI) involving Escherichia coli (E. coli). Bronchoalveolar lavage fluid samples from 4,199 hospitalized children were tested using targeted next-generation sequencing (tNGS). Clinical characteristics, laboratory parameters, imaging findings, and outcomes of E. coli-positive children were analyzed, with comparisons between ICU and non-ICU groups. E. coli was detected in 107 cases (2.5%). The median age was 7 months; males accounted for 70.1%, and 29.0% had underlying diseases. Mixed infections occurred in 95.3% of cases, with cytomegalovirus (47.7%), Pneumocystis jirovecii (38.3%), Mycoplasma pneumoniae (28.0%), and rhinovirus (27.1%) being the most common co-pathogens. Chest CT findings mainly showed increased bronchovascular markings (78.2%) and patchy opacities (72.3%). Respiratory support was required in 43.9% of cases, and 18.7% were admitted to the ICU. The median hospital stay was 9 days, and 95.3% were discharged after recovery. Compared with the non-ICU group, the ICU group had higher proportions of children aged ≤ 1 month (25.0% vs. 8.0%), underlying diseases (50.0% vs. 24.1%), fever, tachypnea, and dyspnea, as well as elevated procalcitonin and D-dimer levels (all P < 0.05). The detection rate of E. coli in hospitalized children with ARTI was 2.5%, predominantly affecting young infants and frequently involving underlying comorbidities (29.0%). Mixed infections are common, and 18.7% of patients require admission to the ICU. Young age, underlying diseases, fever, tachypnea, and elevated procalcitonin and D-dimer levels were clinical features significantly associated with ICU admission in affected children.

Traumatic dental injuries (TDIs) in older adults present complex clinical and public health challenges because of frailty, multimorbidity, and antithrombotic therapy. Invasive surgery in anticoagulated patients increases the risk of hemorrhage and delayed healing. Multiwavelength laser systems provide a minimally invasive alternative, combining precise ablation, hemostasis, and disinfection. A 92-year-old woman receiving anticoagulant therapy for atrial fibrillation presented with multiple anterior maxillary fractures following a fall. The right maxillary central incisor (Tooth 11) showed a complete coronal fracture with pulp exposure (Ellis Class 3) and a palatal fracture line extending below the bone crest. Owing to systemic risk, a tooth-preserving laser-assisted approach was adopted instead of extraction. Gingivectomy was performed using an Nd:YAG laser (1064 nm; 3.5 W, 60 Hz, fluence: 72.5 J/cm[2], power density: 4.36 kW/cm[2]) to achieve hemostasis and soft-tissue decontamination. Bone vaporization was completed with an Er:YAG laser (2940 nm; QSP mode, H14 handpiece; 250 mJ, 15 Hz) to expose the fracture margin. Root-canal decontamination used the Er:YAG SWEEPS technique for photoacoustic activation of irrigants (NaOCl: 5%, EDTA: 17%), enhancing biofilm removal and smear-layer disruption. The tooth was reconstructed with fiber-post and composite resin buildup, followed by monolithic zirconia crowns on both central incisors. Soft-tissue healing was complete at 15 days, and functional rehabilitation was achieved without complications. Two-year clinical and radiographic follow-up confirmed stable periapical conditions, preserved gingival contours, and satisfactory aesthetics. The coordinated use of Nd:YAG, Er:YAG, and Er:YAG SWEEPS lasers enabled selective tissue management-hemostasis, bone remodeling, and endodontic disinfection-under continuous anticoagulation, avoiding extraction and minimizing operative trauma. Rapid soft-tissue healing was observed clinically during follow-up. Within the limitations of a single case report, multiwavelength laser-assisted therapy may represent a conservative treatment option for managing dental trauma in anticoagulated geriatric patients, supporting tooth preservation and functional rehabilitation.

Topical antiseptics must control wound bioburden without damaging cells required for tissue repair, yet cytocompatibility data obtained from isolated active compounds or monolayer exposure may not reflect finished formulations under clinically relevant conditions.

Device infection after inflatable penile prosthesis implantation typically mandates explantation and follows 1-3% of primary implants, a central concern as prosthetic surgery migrates to ambulatory surgery centers. We retrospectively studied all primary implantations by one surgeon while the practice operated an ambulatory program (October 2021-February 2024; the ambulatory program ended for non-clinical administrative reasons). Device, systemic prophylaxis, no-touch technique, and incision were identical between the ambulatory center and a contemporaneous hospital outpatient comparison; intraoperative irrigation was concordant between the ambulatory center and its principal hospital comparator but not across all hospital facilities. Device infection was defined as reoperation for infection within 90 days; reoperation at any interval was also screened. Of 547 primary implantations (ambulatory 218; hospital 329), no infections occurred in the ambulatory arm (0.00%, 95% confidence interval 0.00-1.68%); the hospital rate was 0.61% and the overall rate 0.37% (p = 0.52). Assignment to setting was not random, and the covariates ordinarily governing it - American Society of Anesthesiologists class, body mass index, anticoagulation, cardiopulmonary risk - were unavailable, so baseline risk cannot be assumed equal. With two events these data cannot establish non-inferiority or superiority; they characterize outcomes under one standardized protocol in two settings. These preliminary findings suggest that primary inflatable penile prosthesis implantation may be performed in an ambulatory setting without an apparent increase in infection risk when a standardized infection-prevention protocol is adopted; however, larger prospective studies are required.

Human faecal waste can harbour antibiotic residues, creating reservoirs that sustain and spread antimicrobial resistance (AMR). Black soldier fly larvae (BSFL, Hermetia illucens) bioconversion has emerged as a promising strategy for processing organic waste, particularly in settings with inefficient or absent faecal waste management. However, its effects on AMR in human faecal waste remain poorly characterised. In this study, we investigated ARG dynamics and bacterial community composition during BSFL bioconversion of human faecal waste using real-time qPCR and 16S rRNA gene amplicon sequencing. Fresh faecal waste contained multiple clinically relevant ARGs conferring resistance to tetracyclines, beta-lactams, sulfonamides, fluoroquinolones, and trimethoprim. BSFL bioconversion produced time- and ARG-dependent changes, with sustained reductions in blaTEM, dfrA1, and tetA, whereas tetW and qnrB showed late enrichment. These changes occurred alongside substantial restructuring of bacterial communities, with frass developing a composition distinct from untreated faecal waste. Overall, BSFL bioconversion substantially reshaped the resistome and bacterial community but did not uniformly reduce ARGs, highlighting the potential of BSFL bioconversion as a sanitation-linked strategy to mitigate the environmental spread of AMR within a circular bioeconomy, while underscoring the need to assess residual ARGs and biosafety before downstream use of frass or larval biomass as biofertiliser or larvae as animal feed.

Organophosphate flame retardants (OPFRs) are widely used additives that are not chemically bound to consumer products, enabling their continuous release into the environment. This study presents an integrated multi-matrix analytical platform combining automated pressurized solvent extraction (PSE) with liquid chromatography-high-resolution mass spectrometry (LC-HRMS) in SWATH acquisition mode for the determination of nine OPFRs in agricultural soil and indoor dust, together with a direct injection method for reclaimed water samples. The automated PSE method provided recoveries of 70-120% (RSD < 20%) and limits of quantification (LOQs) of 1-50 ng/g in dust and agricultural soils, while direct injection achieved LOQs of 0.2-10 ng/mL (RSD < 20%) for reclaimed waters. The workflow was applied to reclaimed water (n = 92), irrigated soils (n = 22), and indoor dust (n = 10) collected between 2024 and 2026. Reclaimed water samples analysed from an Almeria reclaimed water treatment plant (RWTP) showed that tris(2-butoxyethyl) phosphate (TBOEP) was consistently detected (∼0.7 ng/mL, n = 67), whereas triphenyl phosphate (TPP) was frequently detected below the LOQ. Although concentrations in water were low, both compounds predominated in irrigated soils (2-53 ng/g). Indoor dust represented a major contamination reservoir, with tris(1,3-dichloro-2-propyl) phosphate (TDClPP) and TPP detected in all samples at concentrations up to, 5.0, and 1.1 μg/g, respectively and TBOEP with an estimated concentration of 0.4 μg/g. This work combines automated PSE in soil and dust with direct injection for water and LC-HRMS acquisition (SWATH, with targeted MRM[HR] for dust) for nine OPFRs. The SWATH data allow retrospective screening, as illustrated by the tentative identification of azoxystrobin in agricultural soil, and the platform is expandable to additional emerging contaminants, increasing its applicability to future environmental monitoring studies.

While urban environments are known to extend growing seasons and enhance vegetation growth, whether these benefits also improve resilience to climate stress or instead create productive but vulnerable ecosystems remains uncertain. Using satellite observations from 2001 to 2022 across 751 large cities in 109 countries, we find that urban vegetation is more resilient than surrounding rural vegetation in 78% of cities. This urban-rural resilience gap has widened over time, driven by declining rural resilience alongside slightly improving urban recovery dynamics, particularly in arid regions where rural vegetation shows progressively slower recovery. Among the factors examined, the urban irrigation proxy, quantified as the urban-rural difference in evapotranspiration, was the strongest correlate of the urban resilience advantage, followed by canopy structure. In 32% of cities, predominantly located in arid regions, urban vegetation exhibited a dual advantage, combining smaller disturbance-related greenness losses with faster recovery than rural vegetation, consistent with management-mediated relaxation of the resistance-resilience trade-off. These findings challenge the view of cities as uniformly detrimental to ecosystem stability and suggest that, when supported by sustainable and equitable management, urban green spaces may serve as managed refugia for vegetation resilience under climate change.

Bacterial central nervous system (CNS) infections carry high morbidity and mortality, and their management is complicated by limited antibiotic penetration across the blood brain barrier. The IRRAflow system is a dual-lumen ventricular catheter that enables continuous active cerebrospinal fluid exchange and has been used off-label for antibiotic delivery in refractory CNS infections. This clinical consultation reviews the available evidence, describes the device and its proposed rationale, and offers practical guidance for clinicians. Published experience is limited to case reports, case series, and small retrospective cohorts. In addition, there is no pharmacokinetic data available and clinical dosing is described for only two agents. The available evidence is insufficient to establish efficacy, define safe-use criteria, or support dosing strategies. Continuous antibiotic irrigation via IRRAflow cannot currently be recommended for routine use. Where it is used, it should be reserved for infections refractory to standard care, at experienced centers, with active clinical pharmacist involvement in agent selection, dosing, and monitoring, ideally within a prospective study.

There is limited evidence guiding optimal first aid management for caustic attacks, and this topic has not been systematically evaluated. We aimed to review the available literature to identify first aid treatments that demonstrate benefit. We searched MEDLINE, Embase, Cumulative Index to Nursing & Allied Health Literature, American Psychological Association PsycInfo, and Cochrane Library from inception through September 13, 2025. This scoping review was conducted in accordance with the methodological standards of the International Liaison Committee on Resuscitation Task Force Scoping Reviews, and reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist. We identified six studies that met the inclusion criteria: two prospective cohort studies, three case reports, and one case series. An alkali was used in two studies, an acid in three studies, and an unknown caustic in one study. Three studies had victims with skin and eye involvement, one had a victim with only skin involvement, and two had victims with only eye involvement. The decontaminants included water, water and soap, physiological solution or normal saline, and Diphoterine®. The various outcomes reported for post-decontamination skin exposure included scarring, need for surgical intervention and grafting, re-epithelialization time, vision, and evisceration for eye exposure. Available evidence, despite being limited and of low certainty, consistently supports immediate removal of contaminated clothing and copious irrigation with water as a biologically plausible and clinically accepted first aid intervention.

Soil salinization and sodicity are accelerating worldwide, reducing crop productivity across more than 160 million hectares of farmland and causing production losses approaching USD 27 billion annually. Despite decades of research documenting these impacts, the extent of salt-affected soils continues to expand. Salt-affected soil degradation emerges from feedbacks among physical, biological, and socioeconomic processes that operate across scales and resist intervention when addressed in isolation. This review synthesizes current understanding of these coupled feedbacks. We trace how ion accumulation, soil structural decline, microbial community disruption, and plant stress interact with irrigation practices, land use decisions, and governance systems. These interactions create threshold dynamics in which degradation can appear stable for years before rapid decline. Evidence from diverse regions reveals that effective restoration depends on coordinated interventions matched to the complexity of the system itself. Four research priorities emerge for advancing prediction and prevention. First, quantifying the thresholds that separate reversible from recalcitrant degradation across soil types and climates. Second, expanding predictive capacity through integrated sensor networks and data platforms that enable early warning. Third, improving understanding of how institutional structures influence adoption of restoration practices. Fourth, integrating biophysical and governance models to enable scaling from field trials to basin-wide implementation. By coupling mechanistic understanding with monitoring infrastructure and adaptive governance, reactive remediation can give way to proactive prevention.