Bloodstream infections (BSIs) require rapid identification and susceptibility testing to guide timely antimicrobial therapy. Although paired aerobic and anaerobic blood culture bottles are routinely used, the incremental benefit of anaerobic bottles in settings with low anaerobic bacteremia prevalence remains uncertain. This study compared paired aerobic bottles with paired aerobic anaerobic bottle combinations in terms of pathogen isolation rate, time-to-positivity (TTP), and contaminant recovery. This 12-month descriptive study included 1009 adult inpatients with suspected sepsis. For each patient, 30 mL blood was collected: 20 mL from a single venipuncture site/central line inoculated equally into one aerobic and one anaerobic bottle, and 10 mL from another site inoculated into an additional aerobic bottle. Bottles were incubated in the bioMérieux BacT/Alert Virtuo system for up to five days. Positive bottles were processed, and organisms were identified using MALDI-TOF MS. Analysis compared aerobic-anaerobic pairs with aerobic pairs with one aerobic bottle common for each pair. Isolation rates were analysed using McNemar's chi-square test, and mean TTP using paired t-test. A total of 3027 bottles were analysed. Pathogen isolation rates were similar between aerobic pair (11.49%) and aerobic-anaerobic pairs (10.8%) (P = 0.621). Mean TTP did not differ significantly (14.7 h vs. 14.84 h; P = 0.927). Recovery rates and TTP for Gram-positive bacteria, Gram-negative bacteria, Enterobacterales, non-fermenters, and Candida species were comparable across both combinations. Obligate anaerobes were rarely isolated (0.2%) and were detected only in anaerobic bottles. Contaminant isolation was significantly lower in aerobic-anaerobic pairs (5.15% vs. 7.73%; P = 0.0184), although contaminant TTP was similar. Aerobic pair and aerobic-anaerobic pair demonstrated comparable diagnostic yield and TTP for clinically significant pathogens. In low-prevalence settings, selective rather than routine use of anaerobic bottles may represent a more resource-efficient strategy.
Hot water bottles are widely used for warmth and therapeutic relief, but improper use can lead to burns, ranging from superficial to full-thickness skin injuries. Following the natural gas shortage caused by the complete halt of Russian gas supplies, European countries experienced a sharp increase in hot water bottle-related burns. However, data for Germany were not yet provided. This study examines the incidence of hot water bottle burns over a 10-year period, exploring potential correlations with natural gas prices, natural gas consumption, ambient temperature, and respiratory infection rates. A retrospective single-center analysis of 88 patients who sustained hot water bottle burns from 2014 to 2024 was conducted. Patient data, including burn severity and demographic information, were extracted from hospital records. Monthly counts of acute respiratory infections (ARIs), ambient temperature, natural gas price and gas consumption data were also analyzed. A Poisson regression model was applied to assess the association between hot water bottle burns and the mentioned independent variables. The majority of burns (81.8 %) were second-degree injuries, primarily affecting women (81.8 %). Burns were most common on the lower trunk, thighs, and forearms. The Poisson regression model revealed that for every 1 °C increase in ambient temperature, the incidence of burns decreased by 7 % (IRR=0.93, 95 % CI: 0.88-0.97). However, no significant association was found between ARI incidence, natural gas price and burn occurrence. There was no significant increase of water bottle burns during the recent European energy crisis in Germany. Hot water bottle burns are more frequent during colder months, particularly among women. Natural gas price or natural gas consumption seems like not playing an equivalent role in Germany as in other European countries. Public health efforts should focus on education and prevention strategies to reduce these preventable injuries. Further research should explore additional factors that may influence burn rates.
Activity concentrations of 226Ra, 232Th, and 40K radionuclides were determined in various brands of bottled drinking water commonly available in the local markets of Greater Dhaka City; additionally, the annual effective dose following the ingestion pathway was assessed. Radioactivity of 226Ra in the bottled water (purified, mineral, and drinking) samples varied from 0.61 ± 0.27 Bq L-1 to 10.64 ± 1.34 Bq L-1 with a mean value of 4.73 ± 1.02 Bq L-1. For 232Th, the concentration ranged between 0.35 ± 0.27 Bq L-1 and 5.71 ± 3.37 Bq L-1 with a mean of 2.97 ± 1.61 Bq L-1; for 40K, it ranged from 3.48 ± 2.92 Bq L-1 to 93.58 ± 26.74 Bq L-1 with a mean of 36.31 ± 10.63 Bq L-1. Purified bottled water exhibited the highest activity concentrations of 226Ra and 40K, whereas drinking water showed the highest 232Th concentration compared to purified and mineral bottled water samples. Infants received higher annual ingestion doses compared to children and adults. The average value of the threshold consumption rate remained below the limit. The 226Ra shows statistical significance, whereas 232Th and 40K are the opposite; 226Ra shows greater heterogeneity.
This study aims to deepen the understanding of how oxygen transfers through wine bottle closures and their chemical reactivity and kinetics during storage. A miniaturized bottle system was designed to enable measurements with or without model wine. Different physical and chemical mechanisms, each with its own kinetics, were revealed through oxygen permeability measurements. Four main mechanisms were identified, each occurring over different timescales. In the first days of storage, rapid equilibrium is established between the gas and liquid phases of the model wine. During the early months, oxygen diffuses from the cork cells into the gas phase in the system. Phenolic compounds are then extracted from the cork and react with the oxygen released from the sealing system into the liquid phase, leading to a decrease in oxygen content over several months. Ultimately, long-term oxygen permeation through the closure results in a gradual, continuous increase in oxygen content within the mini-bottle system.
To characterize wines produced from a specific grape variety, it is essential to determine the composition of volatile aroma compounds and their contribution to the wine's overall aroma profile. In this study, effects of bottle ageing period on the volatile aroma profile of red wines obtained from 2020 harvest of Acıkara and Fersun grape varieties grown in vineyards in Elmalı/Antalya province (Türkiye) have been evaluated. According to the results of physicochemical analyses Acıkara wine, which has a higher phenolic, flavonoid and anthocyanin content than Fersun wine, showed higher free radical scavenging activity. The total amount of volatile aroma compounds was found to be 3138.24 µg/L in Acıkara wine and 5701.90 µg/L in Fersun wine. Following a 12-month period of bottle ageing, it was established that the total amount of volatile aroma components of the Acıkara and Fersun wines was 3197.39 µg/L and 3260.40 µg/L, respectively. While volatile acids, C6 alcohols and C13-norisoprenoid compounds exhibited an increase in both of Acıkara and Fersun wines, the level of esters had decreased.
Filtration methods are widely used for microplastic (MP) isolation, yet filter membrane selection can introduce substantial bias into MP quantification. In this study, five types of membranes, classified as single-layer-hole [polycarbonate track-etched (PCTE)], multilayer-fiber [polytetrafluoroethylene (PTFE) and glass fiber (GF)], and multilayer-hole [mixed cellulose esters (MCE) and nylon (NY)], were systematically compared for MP quantification. Particle abundance was quantified by scanning electron microscopy (SEM)-based visual counting on membranes. Polystyrene (PS) microspheres exhibited superior dispersion on single-layer-hole (PCTE) and multilayer-fiber (PTFE) membranes. However, partial particle embedding occurred in multilayer-fiber membranes (PTFE and GF), whereas pronounced aggregation occurred on multilayer-hole membranes (MCE and NY). Accordingly, PCTE exhibited the most stable quantification performance across PS concentrations and pH conditions, with RSD values of 3.05-17.68%. Application to bottled drinks further showed that PCTE improved the differentiation of particle abundance among brands. LDIR analysis indicated that the collected particles from bottled drinks consisted of both MPs, mainly polyethylene terephthalate, polyethylene, polybutadiene rubber, and polyvinyl chloride, as well as non-MPs (54.50% - 81.29%). Overall, selection of appropriate membranes is critical for MP quantification, and single-layer-hole PCTE membranes are recommended for reliable visual counting and improved comparability across studies.
BackgroundAccurate and timely Gram stain interpretation of positively flagged blood culture bottles is crucial for early detection of bloodstream infections and initiation of empirical therapy. However, resin and charcoal particles in culture media may interfere with smear clarity.MethodsA prospective study was conducted on 100 positive blood culture samples. Four smear preparation techniques - conventional, water wash, blood film, and drop and rest - were applied. These were assessed for diagnostic agreement with final culture results and graded for resin/charcoal interference. Kappa (κ) statistics measured concordance.ResultsThe blood film method showed the highest agreement with culture Gram stains (63%, κ = 0.26), followed by conventional (62%, κ = 0.24), drop and rest (61%, κ = 0.22), and water wash (59%, κ = 0.18). It also had the least particle interference and the most deposit-free smears (29/100).ConclusionThe blood film method offers superior diagnostic clarity and is recommended.
Tongue-tie may interfere with infant feeding, but diagnosis remains challenging due to lack of objective criteria. To evaluate the clinical utility of the electronic baby bottle (EBB), a novel device recording intraoral forces during suckling. A prospective cohort study across four ENT clinics included 106 infants under 3 months, assessed at baseline and 1-week follow-up. ENT specialists rated the EBB's diagnostic value; tongue anatomy and mobility were screened using the TABBY scoring system. Eighty-five infants underwent frenotomy; 21 not meeting diagnostic criteria served as controls. The EBB received high diagnostic value scores in both groups, with no significant change following frenotomy. TABBY scores improved significantly post-operatively (mean difference 3.87 (95% CI 3.4-4.3), p < 0.001), consistent with expected anatomical changes. Infant cooperation was positively associated with device utility (p < 0.001). Frenotomy was associated with significant improvements in caregiver-reported symptoms, including latch quality, breast pain, and feeding duration. ENT specialists rated the EBB as subjectively useful, but no signal-level change was detected following frenotomy using clinician-based rating. Subjective interpretation of EBB readouts is insufficient as a standalone diagnostic approach; automated signal analysis on biomechanical responsiveness is required to realise the device's diagnostic potential. Further prospective validation is needed before clinical adoption can be recommended.
To review contemporary evidence supporting selective laser trabeculoplasty (SLT) as an initial and longitudinal therapy for glaucoma and to examine its implications for clinical outcomes, functional disease control, and health system sustainability. Randomized clinical trials and extension studies have demonstrated that SLT-first strategies provide intraocular pressure (IOP) control comparable to medication-first therapy while substantially reducing treatment burden. In the Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial, ∼70% of patients initially treated with SLT remained free from topical therapy and incisional surgery at 6 years. Secondary analyses revealed lower rates of moderate or fast visual field progression among eyes treated with SLT-first pathways compared with medication-first pathways (∼17% vs. 26%). Repeat SLT has been shown to produce IOP reductions similar to initial treatment without increased adverse events. Baseline IOP influences treatment response, with greater absolute pressure reductions observed in eyes with higher pretreatment IOP. SLT-first strategies have also been associated with lower cumulative costs and fewer surgical interventions over long-term follow-up. SLT has established itself as a cornerstone of early glaucoma management. By providing durable and repeatable IOP control, SLT-first strategies may reduce reliance on daily medications and improve functional disease stability. Ongoing studies will further elucidate the role and optimal timing of repeat SLT, refining its integration into long-term glaucoma care.
To describe BC collection practices at a tertiary care university hospital in a prospective observational study and examine the association between blood volume and culture yield. Analysis of all blood cultures collected during a 6-week period in 2023 at St Olav's University Hospital, Norway. Additionally, we analysed impact of antimicrobial treatment prior to sampling, sampling department, bottle type, sampling time and method, microorganisms isolated as well as patient age and sex. Only 19.7% of BC bottles were filled with the recommended 8-10 mL of blood. The overall pathogen positivity rate of all BC bottles was 6.8%, while 13.3% of the patients had at least one positive BC bottle. Patients >60 years were twice as likely to have a positive blood culture as those aged 18-60 years (16.2% vs 8.1%). Recommended filling volumes were positively associated with recovery of microbes, whereas particularly overfilling >14 mL was associated with reduced microbial yield. Overall, bottles with no growth contained a significantly higher mean blood volume than bottles with growth. This study highlights the gap between established recommendations for BC collection and current practice at our hospital. Preanalytical optimisation of BC collection is needed to improve diagnostic yield in this seriously ill patient population. Overfilling of BC bottles was negatively associated with microbial yield and should be avoided.
Water, sanitation, and hygiene (WASH) interventions in resource-constrained communities can improve health outcomes, but uptake and sustainability are influenced by acceptability. We evaluated the acceptability of the Spatap, a portable silicone tap attached to a bottle, as a household handwashing intervention in Fijian communities. We distributed Spataps in three communities and conducted a survey two to seven days later, assessing sociodemographic factors, WASH access, and Spatap acceptability (n = 207). We applied a novel quantitative approach, calculating a total acceptability score from seven Likert-scale questions aligned with the component constructs of the Theoretical Framework of Acceptability (with a maximum score of 35) and asked open-ended questions about barriers and enablers to Spatap use. We analysed scores and used multiple linear models to examine predictors. Five months later, we conducted three focus group discussions (FGD) (n = 22) to supplement the survey data and performed thematic analysis using NVivo (ver 12). Spatap acceptability scores ranged from 18 to 35 (median 29), indicating high overall acceptability. Burden and opportunity cost scored lower than other component constructs. Sociodemographic factors were not meaningfully associated with acceptability scores. Few barriers were reported: ease of use, water saving, and convenience were key enablers. FGDs largely supported the survey findings and additionally highlighted ease of use for children and perceived illness reduction as contributors to acceptability. Time spent refilling bottles was burdensome in some larger households, the cost of larger bottles was prohibitive for some, and minor leakage issues were reported. The Spatap was broadly acceptable in the study communities, particularly where its portability, ease of use, and water-saving potential addressed locally important needs. These findings suggest the Spatap may have value as a household WASH intervention in resource-constrained settings, though its appropriateness relative to lower-cost alternatives should be considered. Future implementations should assess the cost-effectiveness and availability of suitable bottles, provide local language and pictorial instructions, and consider targeted engagement with children. The acceptability score method showed potential as a rapid evaluation tool but requires refinement before reapplication.
Despite known confounds of social isolation on rodent behavior, many investigators rely on singly housing mice to assess alcohol preference in preclinical models of alcohol use disorder (AUD). This protocol describes a social alcohol drinking task that allows for high-throughput, automated assessment of alcohol drinking behaviors in mice without the confounding impacts of stress induced by social isolation. The IntelliCage testing system enables investigators to simultaneously assess operant alcohol drinking behavior in up to 16 same-sex mice, each uniquely identified with a subcutaneously implanted radiofrequency identification (RFID) transponder. Access to sipper bottles is software-controlled and can be adjusted individually for each mouse. In this chronic, intermittent alcohol drinking paradigm, mice voluntarily engage in operant nosepokes to access sipper bottles containing 20% alcohol for six consecutive weeks. Alcohol bottles are only accessible every other day for 24 h at a time and can be optionally adulterated with quinine to assess punishment-insensitive drinking. Visits to each operant corner, nosepokes, and lick data are automatically recorded for each mouse. Detailed experimental methods and the open-source code to analyze the recorded data will allow investigators to assess alcohol drinking behaviors relevant to AUD in an increasingly efficient and ethologically relevant manner.
The emergence and widespread distribution of insecticide resistance in Anopheles gambiae s.l. raise serious concerns regarding the long-term effectiveness of vector control tools. Assessing resistance intensity provides more operationally relevant information than diagnostic-dose bioassays alone. The phenotypic intensity of resistance to pyrethroids (permethrin and deltamethrin), bendiocarb, chlorfenapyr and clothianidin in Anopheles gambiae s.l. was evaluated along a south-north transect in Benin using WHO tube tests and CDC bottle bioassays. Mortality was recorded at diagnostic doses and at higher concentrations, in accordance with WHO guidelines. At diagnostic doses, mortality rates observed with permethrin and deltamethrin were low, ranging approximately from 5-30% to 10-45%, respectively, depending on the study sites. Even at 5 × and 10 × concentrations, pyrethroid-induced mortality often remained below 90%, indicating high-intensity resistance. Resistance levels were consistently higher for permethrin than for deltamethrin, in both WHO tube tests and CDC bottle bioassays. In contrast, bendiocarb induced high mortality rates, generally exceeding 90-98% in most localities, with low to moderate resistance detected in only a few sites. Complete susceptibility of Anopheles gambiae s.l. was observed to chlorfenapyr and clothianidin, with mortality rates ≥ 98% across all communes. The intense and widespread pyrethroid resistance observed in Benin represents a major threat to interventions relying on this insecticide class. WHO tube tests and CDC bottle bioassays showed similar qualitative trends, although differences in mortality levels were observed between the two methods. The relatively preserved susceptibility to bendiocarb, as well as to chlorfenapyr and clothianidin, supports their potential use in insecticide rotation strategies, including bi-treated insecticidal nets (e.g., Interceptor® G2, PermaNet® Dual, Yorkool® G5, and Mont Inari) as well as indoor residual spraying campaigns using bendiocarb or clothianidin.
The goal of this study was to determine the effect of administering arachidonic acid (ARA) with or without the yeast Saccharomyces cerevisiae, on voluntary ethanol consumption by mice. Ethanol consumption was measured using a continuous access two-bottle choice experiment with water and 15% ethanol (vol/vol). Ethanol naïve C57BL/6J mice were orally inoculated with ARA (or acidic PBS as the control), S. cerevisiae, or both each evening for three evenings. Ethanol consumption and preference were measured on the following days. In additional experiments, male and female mice underwent chronic intermittent exposure to ethanol vapor. After a 2-week exposure protocol, these mice were given access to 15% ethanol (vol/vol) via a two-bottle choice and inoculated nightly with ARA and S. cerevisiae (or acidic PBS and mock as the control). Administration of ARA initially reduced ethanol preference and consumption by ethanol naïve female mice but the effects waned. In contrast, administration of ARA together with a fungus had a sustained effect that reduced preference and consumption. The effects of ARA and fungi were statistically significantly different from ARA alone on Day 3 of ethanol access. Chronically exposed mice that showed low initial consumption of ethanol in the two-bottle choice maintained low consumption when administered ARA and S. cerevisiae. These findings support the future development of a therapeutic regimen utilizing ARA and yeast, or targeting eicosanoids, that could be developed as a supplement to current approaches to reduce ethanol consumption.
It is becoming increasingly clear that chronic exposure to lower levels of ethanol impact learning and behavior. To determine the impact of chronic low-dose ethanol exposure on sensitivity to changes in stimulus value, a conditioned taste aversion procedure was used. Adult male and female mice underwent a sucrose two bottle-choice drinking paradigm. Each day, mice received an injection of either low-dose ethanol (0.5g/kg) or saline two hours after sucrose access for 20 days. This was followed by a lithium chloride (LiCl)-induced conditioned taste aversion (CTA) paradigm in which 0.15M LiCl or vehicle injection was administered immediately after sucrose consumption for three days. On the fourth day, changes in sucrose consumption were analyzed. Chronic exposure to low-dose ethanol did not affect sucrose consumption in either female of male mice during two-bottle choice. In female mice, a history of chronic low-dose ethanol exposure blocked the development of LiCl-induced CTA. A history of chronic low-dose ethanol did not impact LiCl-induced CTA in male mice as both ethanol-naïve and -exposed male mice who underwent LiCl pairing reduced sucrose consumption. This suggests that low-dose ethanol alters aversion-related learning in female mice which may have implication for development of aberrant behavior and risk for alcohol use disorder (AUD).
The simultaneous determination of multiple plasticizers in drinking water remains challenging because of their trace concentrations, diverse physicochemical properties, and susceptibility to background contamination. In this study, an automated direct immersion solid-phase microextraction (DI-SPME) method coupled with gas chromatography-triple quadrupole tandem mass spectrometry (GC-MS/MS) was developed for the simultaneous determination of 29 plasticizers from four classes in drinking water, including 17 phthalate esters (PAEs) and 12 non-phthalate plasticizers (NPPs). Cost-effective internal standards were employed for quantification. A 120 µm divinylbenzene/carbon wide range/polydimethylsiloxane (DVB/Carbon WR/PDMS) SPME Arrow exhibited the most balanced extraction performance for the target analytes. Extraction parameters were optimized via a sequential response surface methodology (RSM) strategy considering potential factor interactions. Under the optimized conditions (extraction temperature 66 °C, extraction time 34 min, and desorption time 336 s), the method showed linear dynamic ranges (LDRs) of 0.005-20 µg L-1 with coefficients of determination (R2) ≥ 0.9907 for all analytes. The limits of detection (LODs) ranged from 0.002 to 0.02 µg L-1, and the limits of quantification (LOQs) ranged from 0.005 to 0.05 µg L-1. Recoveries at three spiked levels (0.05, 0.5, and 5 µg L-1) ranged from 82.24% to 119.07%, with relative standard deviations (RSDs) of 1.71-10.89%. Application to 18 end-use and 12 bottled drinking water samples showed total plasticizer concentrations ranging from 1.33 to 19.5 µg L-1 (median: 4.87 µg L-1) and from 1.46 to 11.2 µg L-1 (median: 5.47 µg L-1), with up to 14 analytes simultaneously detected in a single sample. DEHP (di(2-ethylhexyl) phthalate) showed the highest median concentration among the detected plasticizers, followed by DBP (dibutyl phthalate), while end-use water exhibited greater diversity of plasticizer species than bottled water. Greenness and sustainability assessment using multiple complementary tools demonstrated favorable sustainability characteristics of the proposed method. With broad analyte coverage, automated operation, and negligible matrix effects, the proposed method provides a practical and sensitive platform for comprehensive plasticizer monitoring in drinking water.
Rapid and selective detection of Gram-negative bacteria is important for clinical diagnosis and for monitoring environmental and food-related samples. In this study, we developed a label-free ISFET sensor based on a p-type silicon/SiO2 platform modified with ZnO and colistin for the detection of Gram-negative bacteria. The sensor was evaluated against several Gram-negative species, including Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Salmonella enterica serovar Enteritidis, Klebsiella oxytoca, and Klebsiella pneumoniae, with the Gram-positive species Staphylococcus aureus and Enterococcus faecium used as negative controls. The device showed measurable changes in drain-source current upon bacterial binding, and the standard curves indicated a low detection limit and a linear response within the tested concentration range. The calculated limits of detection were approximately 137 CFU/mL for E. coli, 169 CFU/mL for A. baumannii, 188 CFU/mL for S. enterica, 218 CFU/mL for K. oxytoca, 235 CFU/mL for K. pneumoniae, and 289 CFU/mL for P. aeruginosa. The sensor stability was also assessed over 14 days in the E. coli assay. In addition, real-sample experiments in commercial bottled drinking water and human urine spiked with E. coli showed good agreement with PBS measurements, with a recovery of 101.13% ± 3.08% and an RSD of 3.05% in bottled water. These results indicate that the proposed platform has potential for selective detection of Gram-negative bacteria under controlled laboratory conditions and in tested real matrices.
Harmful freshwater cyanobacteria, such as Microcystis, are increasingly reported in brackish estuaries, yet the extracellular mechanisms that allow freshwater colonies to withstand salt stress in nature remain unresolved. This study combined field surveys with in situ bottle and enclosure experiments to examine how colony size, extracellular polysaccharides (EPS), and upstream nitrogen availability shape the salinity tolerance of Microcystis transported from upstream lakes to the brackish water. Larger colonies were more abundant under higher salinity in the estuary, and redundancy analysis showed that salinity and water temperature were the primary correlates of colony size distributions. In situ suspended bottle experiments demonstrated that larger colonies maintained positive growth at higher salinity thresholds than small colonies, and that EPS accumulation increased with colony size. Small colonies showed rapid EPS synthesis under low-salt stress but were unable to sustain this response once salinity exceeded 10-12‰. Enclosure experiments further revealed that low nitrogen availability in upstream freshwater promoted the formation of larger colonies, enhanced EPS production, and strengthened physiological resistance to salt stress during downstream transport. These findings indicate that colony morphology and EPS act as key mediators of Microcystis survival along freshwater-estuarine gradients, and that nitrogen limitation upstream can facilitate bloom persistence in brackish water. Integrating colony size, EPS dynamics, and nutrient regimes into monitoring and management frameworks will improve early warning capacity for bloom propagation in estuaries under increasing anthropogenic and climate-driven pressures.
Gram staining is one of the basic tests to identify the organism in microbiological laboratory, especially in blood culture. However, microbiological specialists are not always available, which can lead to treatment delays. Therefore, we developed a computer-aided diagnosis (CAD) system that uses artificial intelligence to predict causative pathogens from Gram-stained blood culture images, focusing on both morphological (Class 1) and detailed (Class 2) classification. In this retrospective observational study, we compared the accuracy of predictions made by microbiology specialists (MS) and by CAD using iPhone-captured images of clinical samples stained with the Bartholomew and Mittwer method collected from two tertiary care hospitals between 1 October 2022 and 31 January 2023. Among 126 samples (378 images) for aerobic bottles (AE) and 90 samples (270 images) for anaerobic bottles (AN), the accuracy of MS and CAD prediction (95% confidence interval) was 91.5% (90.5%-92.3%) and 75.4% (70.7%-79.7%) for AE and 90.1% (88.9%-91.2%) and 76.7% (71.2%-81.6%) for AN, respectively. Although we could not demonstrate non-inferiority, most of the mispredictions occurred with Gram-negative cocci, Haemophilus influenzae, and Campylobacter spp., while relatively good results were obtained for other species. CAD has the potential to provide early diagnostic results and indicate timely treatment during off-hours and in medical facilities without microbiology specialists. On the other hand, it should be noted that certain bacterial species remain challenging for AI-based identification, and improving accuracy in these areas is an important task for future development. Gram staining of a positive blood culture is essential for early diagnosis and appropriate antibiotic selection, but interpretation requires trained specialists, limiting rapid reporting. While artificial intelligence (AI)-based automation has been explored, most previous studies either focused on a limited range of bacterial species or evaluated only the performance of the device itself. Also, most systems rely on bulky equipment. To address this, we developed a mobile device-based computer-aided diagnosis system for Gram stain interpretation and conducted a non-inferiority trial comparing its accuracy with that of microbiology specialists. Although non-inferiority was not demonstrated, we identified bacterial species that the AI system had difficulty distinguishing. With an appropriate understanding of these limitations, AI-assisted Gram stain interpretation could help reduce turnaround time and support timely clinical decision-making.
Anthropogenic plastic debris has become an increasing environmental concern even in remote Antarctic ecosystems. This study investigated the spatial distribution, composition, and size structure of plastic debris in Cape Shirreff (ASPA 149), Livingston Island, Antarctica. Systematic visual surveys were conducted over 21 days during the austral summer of 2026 along the eastern and western coastal sectors using bidirectional transects. A total of 226 plastic debris items were recorded, with a higher concentration in the western sector (55.3%) compared to the eastern sector (44.7%). Plastic fragments were the dominant category (43.8%), followed by bottles, ropes, ALDFG (abandoned, lost or otherwise discarded fishing gear), and bottle caps. Macroplastics (>200 mm) predominated over mesoplastics (5-200 mm) in both sectors, and significant differences in debris size distribution were observed between coastal sectors (Wilcoxon rank-sum test, p < 0.05). Spatial analyses revealed a highly clustered distribution pattern (NNR = 0.159; p < 0.001), with accumulation hotspots concentrated mainly near the high tide line, with accumulation hotspots concentrated mainly near the high tide line. Plastic ingestion was recorded in skua regurgitations, and marine mammals were observed in proximity to ALDFG and other plastic debris, highlighting potential interactions between wildlife and anthropogenic waste. The results demonstrate that even protected Antarctic areas remain vulnerable to marine plastic pollution, reinforcing the need for long-term monitoring and integrated international mitigation strategies.