Phage therapy: breathing new tactics into lower respiratory tract infection treatments.

Lower respiratory tract infections (LRTIs) present a significant global health burden, exacerbated by the rise in antimicrobial resistance (AMR). The persistence and evolution of multidrug-resistant bacteria intensifies the urgency for alternative treatments. This review explores bacteriophage (phage) therapy as an innovative solution to combat bacterial LRTIs. Phages, abundant in nature, demonstrate specificity towards bacteria, minimal eukaryotic toxicity, and the ability to penetrate and disrupt bacterial biofilms, offering a targeted approach to infection control. The article synthesises evidence from systematic literature reviews spanning 2000-2023, in vitro and in vivo studies, case reports and ongoing clinical trials. It highlights the synergistic potential of phage therapy with antibiotics, the immunophage synergy in animal models, and the pharmacodynamics and pharmacokinetics critical for clinical application. Despite promising results, the article acknowledges that phage therapy is at a nascent stage in clinical settings, the challenges of phage-resistant bacteria, and the lack of comprehensive cost-effectiveness studies. It stresses the need for further research to optimise phage therapy protocols and navigate the complexities of phage-host interactions, particularly in vulnerable populations such as the elderly and immunocompromised. We call for regulatory adjustments to facilitate the exploration of the long-term effects of phage therapy, aiming to incorporate this old-yet-new therapy into mainstream clinical practice to tackle the looming AMR crisis.

Blockchains in IHE-Based Networks.

INTRODUCTION: Interoperability of health information systems is one of the key challenges of modern healthcare systems. A weak spot in this technology stack of interoperability protocols as defined by HL7 and IHE is cross affinity domain exchange of access control information and policies. In several industries the Blockchain technology had a major breakthrough. The goal of this paper is to elaborate how to exchange cross affinity domain access information enhancing well established IHE networks with block chain technology. METHODS: Using literature analysis and research on current interoperability standards the state of the art of securely exchanging medical information was elaborated. We enhanced this system with the capabilities of the peer2peer based Blockchain network elaborating the workflows of exchanging the access control specific information. RESULTS: We extended an IHE based affinity domain by adding a block chain ledger to the deployment. This ledger is fed with XACML based policies which are propagated through the peer2peer based system. Using the Blockchain protocol other affinity domains are informed of the change and can retrieve the information. Acting as an additional source of policies and consents the policy decision point is capable of querying this network and building a decision based on the retrieved information.

Dynamic Creation of Patient Summaries: A CDA and IHE XDS Based Approach for Regional EHRs.

Cooperative healthcare is regarded as one of the major goals for providing adequate health related information to physicians. To achieve this goal, national authorities and large hospital organizations are introducing large scale, standard based transactional EHR systems. Those systems record and distribute a significant amount of medical related data. This raises the concern of information overload for the intended users. The objective is to elaborate on an architecture and consequently a workflow that allows the generation of an automatic patient summary in a standard based IHE XDS environment. A literature review evaluating the current state of research is conducted. Current eHealth projects, laws and technical background are analyzed. An architecture is suggested, prototyped and compared using SAAM (Software Architecture Analysis Method) against alternative approaches. A technical workflow built on IHE XDR and HL7 FHIR observations is suggested introducing two new services within an IHE XDS product for extracting observations from CDA documents and storing the data on domain level scope. The information is published as an OnDemand Document in the IHE XDS infrastructure.

The effect of structural modifications on the solution and interfacial properties of straight and branched aliphatic alcohols: the role of hydrophobic effects.

The effect of structural modifications, such as branching of the hydrocarbon chain on the solution and interfacial properties of short-chain aliphatic alcohols has been investigated. Surface tension measurements have been used to study the adsorption of the alcohols at the aqueous solution/air interface from water/alcohol mixtures, and to determine the aqueous solubilities of the alcohols. The related process of the partitioning behaviour of the alcohols between two immiscible phases has also been studied. Standard free energies of adsorption at the aqueous solution/air interface, standard free energies of transfer between water and hexane, and standard free energies of solution were obtained for the alcohols. A linear "Traube" relationship, an elegant demonstration of the hydrophobic effect, was found to exist between the various free energies for the normal alcohols and the number of carbon atoms in the alcohol molecule. The free energies showed that structurally modified alcohols have less negative free energy of adsorption, transfer or solution compared to the normal alcohol with the same number of carbon atoms. We assign effective numbers of carbon atoms for each branched alcohol for each transfer process. The position of the hydroxyl group relative to the branched part of the molecule was found to be a factor which influences the hydrophobic contribution to the free energy of each transfer process. An attempt has been made to ascertain whether there is a correlation between the molecular surface area, or the molecular volume, and the interfacial and solution thermodynamic properties of an alcohol in aqueous solution. The standard free energies of some of the branched alcohols have been found to be inconsistent with the values expected from the energetic of the adsorption and the water/hexane transfer processes. This is thought to reflect the different modes of association of the branched and normal alcohols in the liquid state as revealed by small and wide angle X-ray scattering which identifies correlation peaks attributable to intermolecular hydrogen bonding and interchain associations consistent with non-polar segmentation.

Effect of the degree of dissociation of molecules in a monolayer at an air/water interface on the force between the monolayer and a like-charged particle in the subphase.

We used the monolayer particle interaction apparatus to measure the force between a monolayer of stearic acid or octadecanol at the air/water interface and a colloidal silica sphere. The silica sphere approached the monolayer from the aqueous subphase. The aim was to analyze how the magnitude of the charge of a deformable interface affects the interaction between that interface and a like-charged hard particle. The charge density of the stearic acid monolayer was controlled by adjusting the pH (5.8-9) and the surface pressure. The octadecanol monolayer acted as a reference; the alcohol headgroup did not dissociate between pH 5.8-9.0. Stable monolayers of dissociated stearic acid molecules were formed at the air/water interface by dissolving stearic acid into the subphase to give a saturated concentration at each pH value studied. The approach force curve showed that the electrostatic repulsion increased with an increasing degree of dissociation and therefore the charge of the monolayer. The strength of the repulsion corresponded to that measured between two like-charged hard surfaces, but the apparent range of the repulsion was larger for a deformable interface. Retracting force curves displayed a significant adhesion, whose magnitude and range depended on the surface pressure and subphase pH.

Impedimetric immunosensor for the specific label free detection of ciprofloxacin antibiotic.

Impedance spectroscopy approaches combined with the immunosensor technology have been used for the determination of trace amounts of ciprofloxacin antibiotic belonging to the fluoroquinolone family. The sensor electrode was based on the immobilization of anti-ciprofloxacin antibodies by chemical binding onto a poly(pyrrole-NHS) film electrogenerated on a solid gold substrate. The electrode surface was modified by electropolymerization of pyrrole-NHS, antibody grafting and ciprofloxacin immunoreaction. The sensitive steps of surface modification, cyclic voltammetry (CV) and atomic force microscopy (AFM) imaging have been used for electrode surface characterization. The immunoreaction of ciprofloxacin on the grafted anti-ciprofloxacin antibody directly triggers a signal via impedance spectroscopy measurements which allows the detection of extremely low concentration of 10 pg/ml ciprofloxacin.

The isoelectric point/point-of zero-charge of interfaces formed by aqueous solutions and nonpolar solids, liquids, and gases.

From our previous work on the role of the electrostatic field strength in controlling the pH of the iso-electric point (iep)/point-of-zero-charge (pzc) of polar solids we have extended the analysis to predict that the pH of the iep/pzc of a nonpolar solid, liquid or gas-aqueous interface should occur at pH 1.0-3.0, dependent on the value assigned to water molecules or clusters at the interface. Consideration of a wide range of experimental results covering nonpolar solids such as molybdenite, stibnite, paraffin, etc. as well as hydrocarbon liquids such as xylene, decalin, and long chain (>C8) alkane oils, as well as nitrogen and hydrogen gases, all in various simple 1:1 electrolyte solutions confirm the general validity of the result. We further consider various models of the origin of the charge on nonpolar material-water interfaces.

Electrical double layer interactions between dissimilar oxide surfaces with charge regulation and Stern-Grahame layers.

Models of surfaces with intrinsic ionisable amphoteric surface sites governed by the dissociation of acid-base potential determining ion species together with the capacity for the adsorption of anion and cations of the supporting electrolyte are required to describe both the results of electrokinetic and titration measurements of inorganic oxides. The Gouy-Chapman-Stern-Grahame (CGSG) model is one such model that has been widely used in the literature. The electrical double layer interaction between two dissimilar CGSG surfaces has been studied by Usui recently [S. Usui, J. Colloid Interface Sci. 280 (2004) 113] where erroneous discontinuities in the slope of the pressure-separation relation were observed. We revisit this calculation and provide a simple general methodology to analyse the electrical double layer interaction between dissimilar ionisable surfaces with ion adsorption.

Adsorption of organic matter at mineral/water interfaces. 6. Effect of inner-sphere versus outer-sphere adsorption on colloidal stability.

The effects of the adsorption modes of several low molecular weight (LMW) organic anions (maleate, oxalate, and citrate) on the colloidal stability of corundum-water suspensions have been examined using electrokinetic and shear yield stress (tau(y)) measurements over a broad range of pH conditions and LMW organic anion concentrations. Consistent with previous studies, increasing concentrations of maleate, oxalate, and citrate progressively shift the electrokinetic isoelectric point and pH of the maximum shear yield stress (tau(y,max)) to more acidic conditions. Due to its predominant electrostatic driving force for adsorption, outer-spherically adsorbed maleate possesses a very limited ability to charge reverse the corundum-water interface or bind to the negatively charged corundum surface. By contrast, inner-spherically adsorbed oxalate and citrate can significantly charge reverse the corundum-water interface, with the extent of charge reversal being related to the relative binding strengths of the oxalate and citrate anions. Adsorbed maleate, oxalate, and citrate generate steric barriers to interparticle approach, leading to substantial reductions in the magnitude of tau(y,max) at low to intermediate concentrations of those LMW anions. At the highest anion concentrations investigated, however, increases in tau(y,max) are observed, and can be attributed to the formation of bridging Al(III)-organic surface precipitates, as suggested by in situ attenuated total reflectance Fourier transform infrared spectroscopic measurements of corundum-oxalate suspensions at high oxalate concentrations. The extent of precipitate formation is greatest for the corundum-oxalate system due to the strong dissolution-enhancing properties of the inner-spherically adsorbed oxalate anion (i.e., its ability to generate enhanced concentrations of dissolved Al(III) which can then participate in precipitate formation). The effects of the LMW organic anion adsorption modes on both the forms of the measured tau(y) versus pH data, and the ability to quantitatively compare tau(y) and zeta potential data measured at different corundum concentrations, are also discussed.

PAA/PEO comb polymer effects on rheological properties and inter-particle forces in aqueous silica suspensions.

The effects of a poly(acrylic acid) (PAA)-poly(ethylene) (PEO) comb polymer dispersant on the rheological properties and inter-particle forces in aqueous silica suspensions have been studied under varying pH conditions. The comb polymer was found to adsorb more strongly under acidic than basic conditions, indicating that the PAA backbone of the copolymer preferentially adsorbs onto silica surfaces with the PEO "teeth" extending out from the surface into the solution. In the presence of low concentrations of copolymer, the silica suspensions were stable due to electrostatic repulsions between the silica surfaces. At higher copolymer concentrations and under neutral and basic conditions, where the copolymer interacted only weakly with silica, the suspensions showed a transition from a dispersed to weakly flocculated state and attractive forces were measured between silica surfaces. Under acidic conditions, the silica dispersion also destabilized at intermediate copolymer adsorbed density and then was re-stabilized at higher adsorbed coverage. The silica suspensions were stable at high copolymer coverage due to steric repulsions between the particles. The destabilization at intermediate coverage is thought to be due to polymer bridging between particles or possibly depletion forces.

Particulate hematite diffusion in sodium polyacrylate solutions. The effect of ionic strength.

The diffusion coefficients of hematite particles in polyelectrolyte solution have been investigated using dynamic light scattering. Two apparent diffusion coefficients, a fast and a slow diffusional mode, are observed for the hematite particles in high-molecular-weight sodium polyacrylate solution at pH 10.5. The slow diffusion coefficient (Dslow) shows a decrease with increase in polyelectrolyte concentration. The fast diffusion coefficient (Dfast) shows an increase to a maximum with increasing polyelectrolyte concentration and then a rapid decrease as the polyelectrolyte concentration increases further. With an increase in ionic strength from 10(-4) to 0.1 M NaNO3, the maximum value of Dfast increased in magnitude, while the polyacrylate concentration at which the maximum occurs is seen to increase. The dependence of Dfast on the measurement angle indicates that it is coupled to the fluctuations of the chains. The observed behavior is attributed to the hematite probe particle sensing both macroscopic (viscous) and elastic fluctuations associated with the polyelectrolyte motion.

The Adsorption of Dodecyltrimethylammonium Bromide on Mica in Aqueous Solution Studied by X-Ray Diffraction and Atomic Force Microscopy.

The adsorption of dodecyltrimethylammonium bromide (DTAB) onto natural muscovite mica and a synthetic expandable mica (EM) in aqueous solution has been investigated using both microscopic and macroscopic surface characterization techniques. The electrokinetic properties of the surfaces were monitored as a function of the concentration of DTAB using atomic force microscopy and microelectrophoresis. The adsorption isotherm of DTAB on EM was measured up to a solution concentration just below the critical micelle concentration of the surfactant. The thickness of the adsorbed layer on EM was determined using X-ray diffraction. Results indicate that the adsorbed layer consists of molecules lying quite flat on the mica surface at low concentrations and adsorbed in interleaved aggregate structures at concentrations approaching the critical micelle concentration of the surfactant in solution. Copyright 2001 Academic Press.