The goal of this study was to understand the effect of light intensity on the chlorogenic acid content and biosynthesis-related gene expression in Marsdenia tenacissima. In this study, M. tenacissima plants were treated with different light intensities; the chlorogenic acid content was determined by high-performance liquid chromatography; and transcriptome sequencing was performed. The amount of chlorogenic acid in the control was the highest and differed significantly from that under three different shading treatments. With a decrease in light intensity, the content of chlorogenic acid also showed a decreasing trend. A total of 1149 differentially expressed genes were identified by transcriptome sequencing, and most of the genes were down-regulated under the 90% shading treatment. A weighted gene co-expression network analysis identified the differentially expressed genes associated with light-induced chlorogenic acid biosynthesis. The different shading treatments down-regulated the expression of the chlorogenic acid biosynthesis pathway structural genes (HCTs). The MIKC family genes were the main transcription factors regulating light-induced chlorogenic acid biosynthesis, but the MYB and SBP family genes were also involved. In summary, combined physiological and transcriptome analysis, candidate structural genes, and transcription factors in the biosynthesis pathway of chlorogenic acid were identified in M. tenacissima. Full article

Previous studies have focused on task/ambient illumination for visual effects and eye illumination for non-visual effects. In this context, eye illumination within the non-visual realm was defined as vertical non-visual eye illuminance. Considering the functional specificity of central vision and peripheral vision, this study aims to explore whether the distribution of eye illuminance in the horizontal field of view (FOV) affects human performance in home paper-based learning settings. In this study, a within-subject design was used to investigate the effects of eye illuminance distribution on mental perception, task performance, and physiological health while maintaining constant task illuminance and correlated color temperature (CCT). The findings revealed that eye illuminance and its distribution in the horizontal FOV had complex effects on visual fatigue, Landolt ring performance, heart rate variability, and luminous environment appraisal. A relatively optimal lighting configuration was suggested—Scene 4, which was characterized by an eye illuminance level in central FOV of 186 lx and an “m” shaped eye illuminance distribution pattern. This indicates the importance of considering eye illuminance distribution in the horizontal FOV, rather than solely focusing on vertical eye illuminance. Full article

In a microgrid, load power should be properly shared among multiple distributed generation (DG) units, not only for fundamental power but also for negative sequence and harmonic power. In this paper, the operation of a microgrid under imbalance and nonlinear load conditions is studied, and a consensus algorithm-based distributed control strategy is proposed for the microgrid power allocation, frequency, and voltage restoration. First of all, the output current of DG unit is decomposed by second-order generalized integrator (SOGI) modules to obtain the fundamental power and harmonic power through the power calculation formula. Then, state values of DG units, such as local power, frequency, and voltage, are transmitted on a sparse communication network. Under the action of a consensus algorithm, the real power of DG units is allocated following the equal increment principle; the reactive power, imbalance, and harmonic power are allocated according to the capacities of DG units; and the frequency of the microgrid and the voltage at the point of common coupling (PCC) are rated. In the consensus-based strategy, DG units only communicate with their neighbor units; thus, the “plug and play” function is reserved. Compared with the centralized control strategy, the proposed strategy with a distributed consensus protocol can simplify the maintenance and possible expansions of the system, making the microgrid more flexible. Moreover, as the structure of the detailed network is not required, it is easy to apply in practice. Simulation and experiment results are presented to verify the proposed method. Full article

Perioperative anxiety is common among patients undergoing surgery, potentially leading to negative outcomes. Immersive virtual reality (VR) has shown promise in reducing anxiety in various clinical settings. This study aimed to evaluate the effectiveness of VR in reducing perioperative anxiety in patients undergoing gynecological oncology surgery and was conducted as a single-center, double-arm, single-blinded randomized controlled trial at the Gold Coast University Hospital, Queensland, Australia. Participants were randomized into the VR intervention + care as usual (CAU) group (n = 39) and the CAU group (n = 41). Anxiety scores were assessed using a six-tier visual facial anxiety scale at baseline, after the intervention/CAU on the same day, and, several days up to weeks later, immediately before surgery. There was no significant difference in baseline anxiety scores, type of operation, or suspected cancer between the two groups. The VR intervention significantly reduced anxiety scores from baseline to preoperative assessment (p < 0.001). The median anxiety score in the VR intervention group decreased from 3 (interquartile range 2 to 5) at baseline to 2 (2 to 3) prior to surgery, while the control group’s scores were 4 (2 to 5) and 4 (3 to 5), respectively. Multivariate analysis showed that group assignment was the sole outcome predictor, not age, type of procedure, or the time elapsed until surgery. Thus, VR exposure was effective in reducing perioperative anxiety in patients undergoing gynecological oncology surgery. The use of VR as a preparation tool may improve patient experience and contribute to better surgical outcomes, warranting further research into exploring the potential benefits of VR in other surgical specialties and its long-term impact on patient recovery. Full article

The Revised Cardiac Risk Index (RCRI) and the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) preoperative risk assessment tools are the most widely used methods for quantifying the risk of major negative perioperative cardiac outcomes that a patient may face during and after noncardiac surgery. However, these tools were created to include as wide a range of surgical factors as possible; thus, some predictive accuracy is sacrificed when it comes to certain surgical subpopulations. In this review, we explore the various surgical oncology patient populations for whom these assessment tools can be reliably applied and for whom they demonstrate poor reliability. Full article

In patients with acute coronary syndrome (ACS), lipid-lowering therapy plays an important role in the prevention of the recurrence of cardiovascular disease. Recent guidelines recommend the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in patients with ACS if their low-density lipoprotein cholesterol (LDL-C) levels are not adequately controlled with statins and ezetimibe. Based on this, we report a case in which administering a PCSK9 inhibitor successfully lowered the patient’s LDL-C level to the target level and managed the coronary artery disease (CAD) recurrence. A 39-year-old man who was taking statins presented to the hospital with chest pain and was diagnosed with unstable angina. He started taking maximum doses of statins and ezetimibe to lower his LDL-C. However, the patient’s unstable angina recurred 1 year later, and a de novo lesion with plaque rupture was demonstrated via coronary angiography. The LDL-C failed to reach the target level despite maintaining the maximum dose of statin and ezetimibe. Accordingly, evolocumab was initiated in addition to rosuvastatin/ezetimibe 20/10 mg daily. Subsequently, coronary angiography was performed twice, and on follow-up, the patient remained free of CAD recurrence. This case highlights the efficacy of lipid-lowering therapy with evolocumab in high-risk patients with repeated ACS. Full article

This study aimed to examine post-flood management, with a particular focus on enhancing the inclusivity of marginalised communities through stakeholder analysis. This study was based on an interpretivist mixed method approach, under which 30 semi-structured stakeholder interviews were conducted. Interest versus power versus actual engagement matrix, social network analysis, and thematic analysis techniques were employed under the stakeholder analysis tool to analyse the collected data. The findings highlight the lack of clearly defined responsibilities among key stakeholders. Marginalised communities and community-based organisations have a high level of interests but a low level of power in decision making, resulting in weak engagement and the exclusion of their perceptions. This lack of collaboration and coordination among stakeholders has made marginalised communities more vulnerable in post-flood situations, as their interests are not defended. The findings emphasise the importance of conducting stakeholder analysis in the decision-making process to enhance stakeholder engagement and interaction, as well as promote inclusivity of marginalised communities in the post-flood recovery efforts of the government. Finally, this study recommends developing strategies to improve collaboration among stakeholders, fostering inclusiveness and customising these strategies according to the different types of stakeholders identified through stakeholder analysis. Full article

Although the household healthcare system is one of the cutting-edge application areas of anthropomorphic design, it remains to be further explored whether anthropomorphism is always effective. This article focuses on the context of aging-friendly household healthcare services and explores how anthropomorphic design affects users’ sustained use intention through sentiment feedback mechanisms. With the help of questionnaire surveys, 511 valid samples were randomly collected for empirical analysis and hypothesis testing. The results showed that positive interactions, cultural backgrounds, and appearance could enhance users’ perception of anthropomorphism from large to small. In addition, the positive (negative) sentiment of users plays a positive (negative) full mediating role in the relationship between anthropomorphic design and sustained use intention, and user technology anxiety moderates such relationships. That is, compared to low-level technology anxiety, in high-level states, anthropomorphic design for household healthcare systems and products has a weaker (stronger) positive (negative) effect on sustained use intention through positive (negative) emotions. Full article

Wound infection is one of the most important factors affecting wound healing, so its effective control is critical to promote the process of wound healing. However, with the increasing prevalence of multi-drug-resistant (MDR) bacterial strains, the prevention and treatment of wound infections are now more challenging, imposing heavy medical and financial burdens on patients. Furthermore, the diminishing effectiveness of conventional antimicrobials and the declining research on new antibiotics necessitate the urgent exploration of alternative treatments for wound infections. Recently, phage therapy has been revitalized as a promising strategy to address the challenges posed by bacterial infections in the era of antibiotic resistance. The use of phage therapy in treating infectious diseases has demonstrated positive results. This review provides an overview of the mechanisms, characteristics, and delivery methods of phage therapy for combating pathogenic bacteria. Then, we focus on the clinical application of various phage therapies in managing refractory wound infections, such as diabetic foot infections, as well as traumatic, surgical, and burn wound infections. Additionally, an analysis of the potential obstacles and challenges of phage therapy in clinical practice is presented, along with corresponding strategies for addressing these issues. This review serves to enhance our understanding of phage therapy and provides innovative avenues for addressing refractory infections in wound healing. Full article

As a sustainable construction material, timber is more promoted than steel, concrete, and aluminum nowadays. The building industry benefits from using timber based on several perspectives, including decarbonization, improved energy efficiency, and easier recycling and disposal processes. The cross-laminated timber (CLT) panel is one of the widely utilized engineered wood products in construction for floors, which is an ideal alternative option for replacing reinforced concrete. One single CLT panel has an outstanding flexural behavior. However, CLT cannot be extended independently without external connections, which are normally made of steel. This article proposes two innovative adhesive-free edge connections made of timber, the double surface (DS) and half-lapped (HL) connections. These connections were designed to connect two CLT panels along their weak direction. Parametric studies consisting of twenty models were conducted on the proposed edge connections to investigate the effects of different factors and the flexural behavior of CLT panels with these edge connections under a four-point bending test. Numerical simulations of all the models were done in the current study by using ABAQUS 2022. Furthermore, the employed material properties and other relevant inputs (VUSDFLD subroutines, time steps, meshes, etc.) of the numerical models were validated through existing experiments. The results demonstrated that the maximum and minimum load capacities among the studied models were 6.23 kN and 0.35 kN, respectively. The load–displacement responses, strain, stress, and defection distributions were collected and analyzed, as well as their failure modes. It was revealed that the CLT panels’ load capacity was distinctly improved due to the increment of the connectors’ number (55.05%) and horizontal length (80.81%), which also reinforced the stability. Based on the findings, it was indicated that adhesive-free timber connections could be used for CLT panels in buildings and replace traditional construction materials, having profound potential for improving buildings’ sustainability and energy efficiency. Full article

Background: Frailty has been proven to be associated with mortality after orthotopic heart transplantation (OHT). The aim of our study was to determine the impact of frailty on mortality in the current era using pretransplant mechanical cardiac support (MCS). Methods: We retrospectively calculated the frailty scores of 471 patients undergoing OHT in a single institution between January 2012 and August 2022. The outcome was all-cause mortality. Results: The median survival time was 1987 days (IQR: 1487 days) for all patients. In total, 266 (56.5%) patients were categorized as nonfrail, 179 (38.0%) as prefrail, and 26 (5.5%) as frail. The survival rates were 0.73, 0.54, and 0.28 for nonfrail, prefrail, and frail patients, respectively. The frailty score was associated with mortality [HR: 1.34 (95% CI: 1.22–1.47, p < 0.001)]. Among the components of the frailty score, age above 50 years, creatinine ≥ 3.0 mg/dL or prior dialysis, and hospitalization before OHT were independently associated with mortality. Continuous-flow left ventricular assist devices (CF-LVAD) were associated with an increased risk for all-cause mortality [AHR: 1.80 (95% CI: 1.01–3.24, p = 0.047)]. Conclusions: The components of the frailty score were not equally associated with mortality. Frailty and pretransplant MCS should be included in the risk estimation. Full article

Due to the existence of an inlet elbow, transmission shaft, and other structural components, the inflow of axial-flow pumps as turbines (PATs) becomes non-uniform, resulting in the complexity of internal flow and adverse effects such as structural vibration. In this paper, numerical methods were employed to explore the non-uniform inflow effects on impeller forces and internal flow field characteristics within an axial-flow PAT. The study results indicated that non-uniform inflow caused uneven pressure distribution inside the impeller, which leads to an imbalance in radial forces and offsetting the center of radial forces. With an increasing flow rate, the asymmetry of radial forces as well as the amplitude of their fluctuations increased. Non-uniform inflow was found to induce unstable flow structures inside the impeller, leading to low-frequency, high-amplitude pressure fluctuations near the hub. Using the enstrophy transport equation, it was shown that the relative vortex generation term played a major part in the spatiotemporal evolution of vortices, with minimal viscous effects. Full article

In this study, novel surface engineering strategies to improve the wear performance of AISI 4340 were investigated. The strategies were as follows: (i) NiP deposition on a previously nitrided steel substrate, followed by NiP interdiffusion heat treatment at either 400 °C or 610 °C (referred to as duplex treatment); (ii) the deposition of AlCrN PVD coating on NiP layers on a previously nitrided steel substrate (referred to as triplex treatment). Prior to the deposition of AlCrN, the NiP was subjected to the interdiffusion heat treatment at either 400 °C or 610 °C. These strategies were compared with the performance of the AlCrN coating directly applied on nitrided steel. To characterize the microstructural features of each layer, X-ray diffraction (XRD) and scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS) analysis were conducted. We also carried out mechanical and tribological behavior assessments. The tribological tests were carried out using a ball-on-disc tribometer under a constant load of 20 N and a tangential speed of 25 cm/s; cemented carbide spheres with a diameter of 6 mm were the counterpart body. The friction coefficient was continuously monitored throughout the tests. The results reveal that the wear mechanism for the AlCrN coating is predominantly oxidative. The most wear-resistant surface architecture was the one comprising AlCrN over the NiP layer subjected to interdiffusion heat treatment at either 400 °C or 610 °C. Full article

Glucose-derived carbon hybrids were synthesized by hydrothermal treatment in the presence of oxidized carbon nanotubes. Additionally, iron and nitrogen functionalities were incorporated into the carbon structure using different methodologies. The introduction of iron and nitrogen in a single step under a H₂ atmosphere favored the formation of quaternary nitrogen and oxidized nitrogen, whereas the incorporation of nitrogen under an N₂ atmosphere after doping the hybrids with iron mainly produced pyridinic nitrogen. The samples were characterized by scanning electron microscopy, X-ray spectroscopy, adsorption isotherms, inductively coupled plasma optical emission spectrometry, and Raman spectroscopy. The presence of iron and nitrogen in the carbons increases the onset potential toward oxygen reduction in KOH 0.1 mol L⁻¹ by 130 mV (0.83 V), in comparison to carbonized glucose, whereas the reaction mechanism shifts closer to a direct pathway and the formation of HO₂⁻ decreases to 25% (3.5 electrons). The reaction rate also increased in comparison to the carbonized glucose, as observed by the decrease in the Tafel slope value from 117 to 61 mV dec⁻¹. Furthermore, the incorporation of iron and nitrogen in a single step enhanced the short-term performance of the prepared electrocatalysts, which may also be due to the higher relative amount of quaternary nitrogen. Full article

Given the scarcity of water and land resources, coupled with the competitive nature of aquaculture, the long-term viability of this industry will depend on strategies for vertical development. This involves enhancing production environments, increasing productivity, and advancing aquaculture technologies. The use of biofloc technology offers a potential solution to mitigate the adverse environmental impacts and the heavy reliance on fishmeal in the aquaculture sector. This method is designed to effectively assimilate inorganic nitrogen found in aquaculture wastewater, thereby enhancing water quality. Additionally, this process produces microbial protein, which can serve as a viable supplemental feed for aquatic animals. Furthermore, this technique has the potential to reduce the feed conversion ratio, thereby lowering overall production costs. This article provides an overview of the evolving field of biofloc system technology within aquaculture. In this study, we will examine the historical development and various types of biofloc systems, as well as the factors that influence their effectiveness. Finally, we will explore the economic potential of implementing biofloc systems in aquaculture. Full article

Anticoagulant and antiplatelet therapies are used to prevent life-threatening complications associated with thrombosis. While there are numerous clinical guidelines for antithrombotic medications, there is an incomplete understanding of whether these interventions yield similar effects in preclinical models, potentially impacting their predictive value for translational studies on the development of medical devices, therapies, and surgical techniques. Due to their close physiologic similarities to humans, we employed nonhuman primates (NHPs) using a reverse translational approach to analyze the response to clinical regimens of unfractionated heparin, low-molecular-weight heparin (LMWH) and aspirin to assess concordance with typical human responses and evaluate the predictive validity of this model. We evaluate activated clotting time (ACT) in nine rhesus and six cynomolgus macaques following the intraoperative administration of intravenous unfractionated heparin (100–300 U/kg) reflecting the clinical dose range. We observed a significant dose-dependent effect of heparin on ACT (low-dose average = 114.1 s; high-dose average = 148.3 s; p = 0.0011). LMWH and aspirin, common clinical antithrombotic prophylactics, were evaluated in three rhesus macaques. NHPs achieved therapeutic Anti-Xa levels (mean = 0.64 U/mL) and ARU (mean = 459) via VerifyNow, adhering to clinical guidance using 1.0 mg/kg enoxaparin and 81 mg aspirin. Clinical dosing strategies for unfractionated heparin, LMWH, and aspirin were safe and effective in NHPs, with no development of thrombosis or bleeding complications intraoperatively, postoperatively, or for prophylaxis. Our findings suggest that coagulation studies, performed as an integrative part of studies on biologics, bioengineered devices, or transplantation in NHPs, can be extrapolated to the clinical situation with high predictive validity. Full article

In this study, we investigate micrometer-sized NaYF₄ crystals double-doped with Yb³⁺/Er³⁺ lanthanide ions, designed for temperature-sensing applications. In contrast to previous studies, which focused predominantly on the high-temperature regime, our investigation spans a comprehensive range of both high and ultralow temperatures. We explore the relationship between temperature and the upconversion luminescence (UCL) spectra in both frequency and time domains. Our findings highlight the strong dependence of these spectral characteristics of lanthanide-doped NaYF₄ crystals on temperature. Furthermore, we introduce a dual-mode luminescence temperature measurement technique, leveraging the upconversion emission intensity ratio for both green and red emissions. This study also examines the correlation between temperature sensing, energy level disparities, and thermal coupling in Er³⁺ ions across various temperature scales. Our research contributes to advancing the understanding and application of lanthanide-doped materials, setting a foundation for future innovations in temperature sensing across diverse fields. Full article

Background: Ultrasonography is a primary method used in the evaluation of thyroid nodules, but no single feature of this method predicts malignancy with high accuracy. Therefore, this paper aims to assess the utility of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of thyroid nodules. Methods: The study group comprised 188 adult patients (155 women and 33 men) who preoperatively underwent CEUS of a thyroid nodule classified as Bethesda categories II–VI after fine-needle aspiration biopsy. During the CEUS examination, 1.5 mL of SonoVue contrast was injected intravenously, after which 15 qualitative CEUS enhancement patterns were analysed. Results: The histopathologic results comprised 65 benign thyroid nodules and 123 thyroid carcinomas. The dominant malignant CEUS features, such as hypo- and heterogeneous enhancement and slow wash-in phase, were evaluated, whereas high enhancement, ring enhancement, and a slow wash-out phase were assessed as predictors of benign lesions. Two significant combinations of B-mode and CEUS patterns were noted, namely, hypoechogenicity with heterogeneous enhancement and non-smooth margins with hypo- or iso-enhancement. Conclusions: The preliminary results indicate that CEUS is a useful tool in assessing the risk of malignancy of thyroid lesions. The combination of the qualitative enhancement parameters and B-mode sonographic features significantly increases the method’s usefulness. Full article

Spontaneous Bacterial Peritonitis (SBP) is a serious complication and a common cause of death in patients with liver cirrhosis. Between January 2017 and March 2024, a retrospective study was conducted involving 302 patients (>18 years old) with ascites treated at a tertiary referral center in south-eastern Poland. Microbiological analysis of the ascitic fluids was performed in all patients. The presence of microorganisms was found in samples from 17 patients, and 21 pathogens were isolated, including 15 Gram-positive bacteria and 6 Gram-negative bacteria. Staphylococcus epidermidis, MRCNS (methicillin-resistant coagulase-negative staphylococci, resistant to all beta-lactam antibiotics: penicillins, penicillins with beta-lactamase inhibitor, cephalosporins and carbapenems) was the main pathogen detected (19.05%, 4/21), followed by Enterococcus faecalis (9.52%, 2/21), Enterococcus faecium (9.52%, 2/21), Staphylococcus haemolyticus, MRCNS (4.76%, 1/21), Streptococcus mitis (9.52%, 2/21), Streptococcus parasanguinis (9.52%, 2/21), Micrococcus luteus (4.76%, 1/21) and Bacillus spp. (4.76%, 1/21). The following Gram-negative bacteria were also found in the specimens examined: Escherichia coli, ESBL (extended-spectrum β-lactamase producing E. coli) (4.76%, 1/21), Escherichia coli (4.76%, 1/21), Pseudomonas aeruginosa (4.76%, 1/21), Klebsiella oxytoca (9.52%, 2/21) and Sphingomonas paucimobilis (4.76%, 1/21). Gram-positive bacteria caused nosocomial infections in nine patients with SBP, Gram-negative bacteria caused nosocomial infections in two patients. In six patients with SBP, community-acquired infections caused by Gram-negative bacteria were found in three cases, Gram-positive bacteria in two cases, and in one case, community-acquired infection was caused by mixed Gram-positive and Gram-negative. Bacteria isolated from patients with hospital-acquired SBP showed higher drug resistance than those found in patients with non-hospital SBP. Bacterial infections in cirrhotic patients with complications may be responsible for their deteriorating health. Prompt intervention is critical to reducing mortality. Full article

(1) Background: Serum leucine-rich α2 glycoprotein (LRG) has been reported as a useful biomarker for monitoring disease activity in patients with inflammatory bowel disease (IBD). We investigated whether serum LRG can differentiate patients with normal colonic mucosa from those with IBD or other forms of colitis. (2) Methods: Patients with diarrhea, abdominal pain, or bloody stools were consecutively enrolled at their initial visit to our hospital. Serum LRG and C-reactive protein were measured, and a colonoscopy and histology were performed. (3) Results: We enrolled 317 patients (181 men, 136 women; median age: 51 years). Based on the endoscopic and histological criteria, 260 patients were diagnosed with ulcerative colitis (n = 134), Crohn’s disease (n = 10), infectious colitis (n = 43), diverticular colitis (n = 17), or nonspecific colitis (n = 56). The remaining 57 patients were diagnosed with normal colonic mucosa including histology. The latter group’s median LRG value (9.5 µg/mL, range: 5.8–13.5) was significantly lower than that of the other 260 patients (13.6 µg/mL, range: 6.8–62.7, p < 0.0001). The optimal LRG cut-off value of <10.4 µg/mL was derived from the receiver operating characteristic (ROC) curve, showing a 91% sensitivity and 77% specificity for identifying patients with normal colonic mucosa. (4) Conclusions: serum LRG values < 10.4 µg/mL could be a useful biomarker for predicting patients with normal colonic mucosa. Full article

This paper proposes a new spacecraft in-orbit launch design using a nonlinear configuration to utilize nonlinear dynamics for the enhancement of vibration isolation and launch performance. The in-orbit launch device has four springs, where the stroke directions of two springs are perpendicular to the launch direction so as to produce nonlinearity with negative stiffness for enhancing the launch velocity. The other two springs are designed to counterbalance the above negative stiffness when the launch outlet is shut down, leading to quasi-zero dynamic stiffness for vibration isolation enhancement. The dynamic equations of the in-orbit launch device for both the on- and off-launch are presented. Then the performance enhancement of both the vibration isolation and launch performance is thoroughly investigated via comparative study and parametric study. The resonance peak is reduced by 4.16 dB, the effective vibration isolation bandwidth is increased by 57%, and the launch speed is increased 1.64 times. This validates the performance improvement of the new launch device design and presents a useful guideline for application. Full article

Sepsis is a life-threatening syndrome triggered by infection and accompanied by high mortality, with antimicrobial resistances (AMRs) further escalating clinical challenges. The rapid and reliable detection of causative pathogens and AMRs are key factors for fast and appropriate treatment, in order to improve outcomes in septic patients. However, current sepsis diagnostics based on blood culture is limited by low sensitivity and specificity while current molecular approaches fail to enter clinical routine. Therefore, we developed a suppression PCR-based selective enrichment sequencing approach (SUPSETS), providing a molecular method combining multiplex suppression PCR with Nanopore sequencing to identify most common sepsis-causative pathogens and AMRs using plasma cell-free DNA. Applying only 1 mL of plasma, we targeted eight pathogens across three kingdoms and ten AMRs in a proof-of-concept study. SUPSETS was successfully tested in an experimental research study on the first ten clinical samples and revealed comparable results to clinical metagenomics while clearly outperforming blood culture. Several clinically relevant AMRs could be additionally detected. Furthermore, SUPSETS provided first pathogen and AMR-specific sequencing reads within minutes of starting sequencing, thereby potentially decreasing time-to-results to 11–13 h and suggesting diagnostic potential in sepsis. Full article