Additive manufacturing (3D printing) is increasingly used in unicompartmental knee arthroplasty (UKA), including patient-specific instrumentation (PSI)/cutting guides, additively manufactured cementless implants, and fully patient-specific implant workflows. However, these applications differ substantially in purpose, evidence level, cost structure, and implementation burden; therefore, their clinical value should not be inferred from technical feasibility alone. This narrative review was updated through December 2025 and was informed by a structured search of PubMed/MEDLINE, Embase, and the Cochrane Library, supplemented by reference screening. Search concepts combined UKA with 3D printing, additive manufacturing, PSI, patient-specific implants, custom implants, porous cementless fixation, osseointegration, navigation/robotics comparators, cost, and implementation. Study selection, eligibility criteria, evidence domains, outcomes, and anticipated sources of bias were predefined to improve reproducibility. Randomized trials and meta-analyses show that PSI in UKA does not consistently reduce alignment outliers or improve patient-reported outcome measures (PROMs), with recurrent technical vulnerability at tibial registration, slope, and rotation. Cadaveric studies support feasibility but mainly report surrogate technical endpoints. For additively manufactured cementless UKA implants, implant-specific long-term cohort data suggest acceptable survivorship and clinically meaningful PROM improvement, but evidence remains implant-specific. Patient-specific implants may improve anatomic fit in selected morphologies, yet comparative studies have not demonstrated consistent short-term clinical or gait advantages over well-executed standard UKA. Current evidence supports selective, indication-driven adoption rather than routine use of 3D-enabled UKA technologies. PSI is best viewed as an execution aid for specific workflows or training contexts, porous cementless 3D-printed implants require implant-specific survivorship surveillance, and patient-specific implants should be reserved for carefully justified morphology-driven indications. Future research should prioritize standardized reporting, surgeon-volume stratification, long-term failure mechanisms, registry linkage, and cost-effectiveness across the complete care pathway.
Antimicrobial resistance (AMR) remains a major challenge in the treatment ofwound infections, particularly those involving multidrug-resistant bacteria. Antimicrobial peptides (AMPs) have attracted attention as potentialalternatives to conventional antibiotics; however, individual peptides may exhibit a limited spectrum of activity or undesirable cytotoxicity.Combining AMPs has been suggested as a possible approach to improve efficacy and selectivity In this study, two cationic α-helicalAMPs, MP1-Q12K and BP52, were evaluated individually and in combination. While each peptide exhibited selective antibacterial activity, theircombination showed improved inhibitory effects against Enterococcus faecalis, Staphylococcus aureus, and Pseudomonas aeruginosa compared tosingle treatments. Notably, co-administration did not increase hemolytic activity and showed a slight reduction at higher concentrations. Thepeptides were further incorporated into a film-forming hydrogel spray, which demonstrated sustained antibacterial activity and limited bacterialregrowth under the tested conditions. These findings suggest that combining structurally distinct AMPs may enhance antibacterialactivity while maintaining an acceptable safety profile. The incorporation into a topical formulation indicates potential for further developmentas an alternative approach for managing wound-associated infections.
OBJECTIVES:This study investigated whether platelets, complete blood count-derived inflammatory ratios-neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), and platelet-to-lymphocyte ratio (PLR) obtained at hospital admission can serve as early warning markers to predict septic shock and in-hospital mortality in adults with bacterial bloodstream infections (BSIs). METHODS:We retrospectively reviewed 1293 adults who underwent bacterial blood culture at a tertiary hospital in Hanoi, Vietnam, from June 2024 to June 2025. Patients diagnosed with BSI at hospital discharge were included. Admission platelet count, NLR, NPR, and PLR were extracted. Associations with septic shock and in-hospital mortality were examined using multivariable logistic regression. Discriminative performance was assessed using receiver operating characteristic curve analysis. RESULTS:Among 192 eligible patients, the in-hospital mortality rate was 23.4% (45), and 33 (17.2%) developed septic shock. Escherichia coli and Klebsiella pneumoniae were the most frequent pathogens. Platelet count was negatively associated with septic shock likelihood (adjusted odds ratio [aOR] = 0.993, 95% CI 0.989-0.998; p = 0.003), and demonstrated good discrimination (AUC 0.727). Higher NLR (aOR = 1.090, 95% CI 1.060-1.121; p < 0.001), NPR (aOR = 1.320, 95% CI 1.047-1.664; p = 0.019), and PLR (aOR = 1.203, 95% CI 1.037-1.394; p = 0.014) were associated with increased mortality likelihood. For mortality prediction, NLR showed the best discrimination (AUC = 0.902), followed by NPR (AUC = 0.854) and PLR (AUC = 0.650). CONCLUSIONS:Admission platelet count, NLR, NPR, and PLR may serve as early prognostic markers for septic shock and in-hospital mortality in Vietnamese adults with BSIs.
Heartworms (Dirofilaria immitis) are parasitic nematodes that cause significant cardiopulmonary-associated morbidity and mortality in canids worldwide. The global spread of heartworms is believed to have occurred alongside the dispersal of modern domesticated dogs over the past few hundred years. However, this conclusion has been based on limited sampling, both geographically and numerically. To test this theory more rigorously, we analyse the whole genomes of 127 adult heartworm specimens collected from mammalian carnivore hosts across Australia, the USA, Central America, Europe, and Asia. Here we show distinct genetic differences between heartworms from different continents, indicating a more ancient dispersal in canid hosts than previously recognised. Using genetic diversity and admixture analyses, we find an Asian origin for Australian heartworms, aligning with the arrival of dingoes into Australia via Asia thousands of years ago; however, we cannot exclude the alternate hypothesis that heartworms were also introduced from Asia in post-colonial times. Finally, the genetic relatedness between European and Central American heartworms suggests that modern dispersal, potentially associated with human colonisation of the Americas by Europeans, occurred with domesticated dogs. This work sheds light on the population dynamics and deep evolutionary history of a globally widespread parasite of veterinary significance.
