Friday, June 26, 2026

Residual effects of Lithium in Muscle and Organ Tissues of Sheep Post-Ingestion of Lithium Chloride- Juniper Publishers

 

Dairy & Veterinary Sciences- Juniper Publishers

Abstract

Conditioned taste aversions (CTA) occur when animals associate gastrointestinal distress with a particular food source. CTA strategy can be used to reduce animal consumption of an undesirable feedstuff. Lithium chloride (LiCl) has been used in wild ungulates as a CTA and could be used in white tail deer (WTD) as a potential CTA. Consumption of LiCl by WTD may leave residue in meat which may be consumed by a human. The objectives of this study were to examine the effect of dietary LiCl on kinetics and depletion of lithium in muscle, kidney, and liver tissue in adult domestic sheep (model for WTD). In experiment1, eleven adult sheep orally received either 150 mg LiCl/kg BW (n = 8) or placebo (n = 3). Using aseptic procedure, muscle biopsies were taken at 4,8,12,24,48,96,192, and 240 hours post LiCl ingestion and lithium concentrations were measured. In experiment2, sixteen adult sheep received either 450mg LiCl/kg BW (n = 14) or placebo (n = 2). In experiment3, nine adult sheep orally received a single dose of 150mg/kg BW. Three-animal groups were euthanized at 7,24, and 96 hours post-LiCl ingestion and muscle, liver, and kidney samples were harvested to measure lithium concentrations. Low dose of LiCl reached a maximum level in muscle 24 hours post-ingestion and returning to basal levels (P = 0.72) by 192 hours. High mortality (12 of 14; 86%) occurred following high dose administration resulting in an inability to determine maximum concentration levels or appreciate differences between muscle, organ tissue types and over time. Lithium concentrations were greater (P<0.01) in liver and kidney compared to muscle at 7 and 24 hours post ingestion, but no difference in lithium concentration was detected in the three tissues at 96 hours (P > 0.05). It appears that a withdrawal period in muscle tissue for low dose LiCl in domestic sheep is 192 hours. The toxic threshold for domestic sheep, and likely other small ruminants, occurs between 150-450mg LiCl/kg body weight.

Keywords:Crop depredation, Deer, Lithium chloride, Lithium chloride toxicity, Small ruminants, Taste aversion

Abbreviations:CTA: Conditioned Taste Aversion; WTD: White-tailed deer; LiCl: Lithium Chloride

Introduction

White-tailed deer (Odocoileus virginianus; WTD, hereafter) are one of the most widespread large mammal species of North America, with correspondingly large impacts on society, both positive (e.g., hunting, wildlife viewing) and negative (e.g., car collisions, crop depredation). White-tailed deer inhabit a variety of areas, occurring almost where digestible forage is available and accessible habitat cover is nearby. In recent years, population numbers have drastically increased in many areas of the Western United States, potentially due to their extreme adaptability and versatility [1]. High population densities have been thought to increase dispersal and movement rates, likely causing them to travel further across the landscape in search of available resources [2]. As deer movement and dispersal rates increase, more encounters with agricultural fields containing nutritious crops occur [2], resulting in an increase in crop depredation rates.

To mitigate costs associated with abundant deer while maintaining recreational and economic benefits, there is a pressing need to find effective deer deterrents. In the past, multiple deterrent methods targeted at reducing deer damage have been tested, including propane exploders and other frightening devices, fencing, and lethal removal [3-5]. Although previously tested deterrents have resulted in a wide range of effectiveness, wildlife managers are still searching for a deterrent method that is cost-effective with high efficacy rates across a multitude of wildlife species. One promising method yet to be tested in an open field setting for deterring WTD is the use of lithium chloride (LiCl), a gastrointestinal toxicant that has successfully been used to create taste aversions to specific food items in both carnivores and ruminants.

Previous studies have shown high efficacy in reducing the amount of food consumed after LiCl was ingested as treated animals associated targeted food sources with gastrointestinal distress [6-9]. However, most of these studies were conducted in controlled, captive feeding trials where ruminants, as well as carnivores, were given the choice to consume food items pre- and post-ingestion of LiCl [8-11]). Due to LiCl creating strong taste aversions across multiple species, it has a potential of being a successful deterrent method in reducing WTD crop depredations.

Before implementation of LiCl as a depredation deterrent in an open field setting can be utilized, key issues regarding toxicity and accumulation in deer tissues needs to be addressed. One challenge with using LiCl is that crop depredation season overlaps with hunting season in many parts of WTD habitat range (i.e., late summer through fall). As a result, it is important to first understand withdrawal factors in different types of animal tissues that may be consumed by humans. Information regarding LiCl and pharmacokinetic data in small ruminants to LiCl is lacking, which compelled the need for this study prior to using LiCl as a deterrent in an open field setting.

Although the eventual intent is to use LiCl as a deterrent on WTD, domestic sheep were used in this study as a surrogate due to logistics and cost. Domestic sheep have been used in a variety of feeding trials to test the efficacy and necessary dosage needed of LiCl to create an effective aversion [12-14]. Higher dosages often result in a greater aversion effect [15], but toxicity levels and tissue withdrawal times have yet to be reported. Thus, we addressed the following research questions:

1) What are the concentration levels of LiCl over time in differing body tissues at a realistic dose range that may be consumed by a deer in an open field setting based on LiCl withdrawal in the sheep model?

2) What is the maximum realistic dosage that could be consumed in a field setting and is this toxic for small ruminants?

Material and Methods

Animal use and protocols were approved by the Institutional Animal Care and Use Committee at the University of Idaho (IACUC-2017-70). The kinetics and toxicity of LiCl was tested using adult domestic sheep located at the University of Idaho Sheep Center in Moscow, Idaho. Suffolk, Targhee, and Targhee/Polypay crossbred sheep were used in this study, and all experiments were conducted at the University of Idaho Sheep Center. All animals were housed in an indoor/outdoor covered barn; feed and water were available ad libitum. Grain was provided once a day after biopsy samples had been collected.

Before each experiment began, sheep were weighed on an electric platform scale (+/- 1 kg), so that the appropriate dosage of LiCl for each experiment and animal could be determined on a per-kg of body weight basis. Subsequently, the appropriate amount of LiCl was dissolved in 240 mLs of cold water, and administered via drenching (i.e., orally inserting a lubricated stomach tube to the level of the abomasum). Control animals were drenched only with 240mLs of cold water minus the LiCl. Three experiments were conducted to analyze and compare lithium concentration in kidney, liver, and muscle tissues at a low (150 mg/kg) and high (450 mg/kg) dosage. In all experiments animals were visually observed for behavioral changes. All tissue samples were analyzed at the University of Idaho toxicology lab.

In the first experiment, eleven adult sheep were used to assess the kinetics and depletion of LiCl in muscle tissue at a 150mg LiCl/kg of body weight dosage, which was considered a low dose [7,9,16]. On the first experimental day each treated sheep (n = 8) was weighed and orally drenched with a single dose of LiCl [7,9]. Controls (n = 3) received a drench of water only. Muscle biopsy samples (~1g per sample) were extracted from the triceps and upper thigh muscle (biceps femoris, vastus lateralis, and semitendinosus) for lithium concentration analysis. Animals were physically restrained during muscle biopsy. Once restrained, the area of biopsy was surgically prepared, and a local anesthetic (Lidocaine 1%) was administered within the area to affect. The skin was incised, and a punch biopsy tool (MiltexS® 6mm, Princeton, NJ.) was used to remove approximately 1g of muscle sample. Each 1g sample of muscle tissue was placed into a sterile, labeled Whirl- Pak® and frozen until analyses for lithium quantification.

It has been reported that the maximum level of lithium in blood occurs 4-8 hours post-ingestion [17,18], and animals were completely cleared of lithium after 240 hours [18]. Collection of muscle biopsy samples were made at 4, 8, 12, 24, 48, 96, 192, and 240 hours post LiCl ingestion to cover the entire time span between maximum peak levels and complete lithium metabolism.

In the second experiment, sixteen adult sheep were used to assess the kinetics and depletion time at 3x the recommended 150mg LiCl/kg body weight dosage. On the first day of the experiment each sheep was weighed and orally drenched with 450mg LiCl/kg body weight in cold water (n = 14) or just cold water (n = 2). Muscle biopsies were once again collected following the protocol previously described for experiment 1. If an animal died during the trial a necropsy was immediately conducted and 1g of kidney, liver, and muscle samples were each collected from the deceased animal. During the necropsy all other major organs and muscle groups were observed by a veterinarian to determine if the ingested LiCl had resulted in reportable necropsy findings.

In the third experiment, nine adult sheep were used to analyze lithium concentrations within kidney, liver, and muscle tissues, at time intervals surrounding the peak lithium concentration for low dose (150 mg/kg) ingestion. Based on the results from experiment 1, the peak lithium concentration occurred ~25 hours post-ingestion. On day one all sheep were weighed and orally received a single dosage of 150 mg LiCl/kg body weight mixed with 240 mL of cold water. Sheep were terminated using a penetrating cap and bolt system with exsanguination at intervals surrounding peak lithium concentration times. Group 1 (n = 3) were terminated 7 hours post LiCl ingestion, group 2 (n = 3) 24 hours post LiCl ingestion, and group 3 (n = 3) 96 hours post LiCl ingestion. Tissue samples (1g) from the kidney, liver, and muscle were collected from each animal. Field necropsies were conducted to assess any notable findings that may have been related to LiCl ingestion.

To measure lithium concentrations in tissues, a Perkin Elmber® Optima 8300 Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) was used. The ICP-OES equipment determined the lithium concentration within each tissue sample using plasma and a spectrometer (operating conditions; plasma: 15 L/min, auxiliary: 0.2 L/min, nebulizer: 0.73 L/min, flow rate: 1.5 mL/min, and wash rate: 2.00 mL/min) [19]. Equipment was calibrated with concentrated redistilled trace metal grade nitric acid and water [19]. Tissue samples were frozen until all samples for the trial had been collected and all samples were tested consecutively to avoid recalibrating equipment multiple times. All samples were analyzed on a wet weight basis, and 1g of tissue sample was added to, and mixed with, 3 mL trace metal grade nitric acid in a 10 mL test tube [19]. The tubes were then heated for 6 hours at 30 °C, then 1 hour at 70 °C, and finally for 8 hours at 120 °C [19]. The tubes were then cooled, vortexed, and centrifuged as needed to produce transparent solutions to prevent clogs from occurring within the nebulizer [19]. If particles remained within the solution a 0.45 Acrodisc filter was used to eliminate the remaining particles [19].

Data on the effects of LiCl on tissue lithium concentration were analyzed using a general linear model (GLM) procedure in SAS [20]. The model included the fixed effect tissue types (muscle, live, kidney), time and their two-way interaction with significance declared at P < 0.05. Using SAS GLM, the effect of low dose LiCl on muscle tissue concentration was also analyzed using GLM. The model included the effect of time.

Results and Discussion

Experiment 1:

Feeding low dose (150 mg/kg) of LiCl caused an increase (P < 0.01) in muscle Lithium at hours 4, 8, 12, 24, 48, and 96 as compared with baseline lithium concentrations. At hours 192 and 240 the muscle concentration of lithium was not different from baseline levels at (P ≤ 0.9). Lithium concentration in muscle tissue peaked at (~24 hours post-ingestion (7.8 μg/g, Figure 1). Lithium concentrations declined thereafter and reached baseline level at 192 hours post-ingestion.

Experiment 2:

Based on the predicted lithium concentration in the muscle tissues after feeding a high dose of LiCl (450 mg/kg), lithium concentration peaked at approximately 100 hours post-ingestion (Figure 2). Lithium concentrations slowly declined thereafter, and never reached basal level by the end of the experiment (240 hours). A high mortality rate at this dosage was observed (12 out of 14 total treated, ~86% mortality) with most of the mortalities occurring after 73 hours post-ingestion. Approximate death times post ingestion of 450 mg/kg LiCl were as follows; 48h - 1 dead; 73h - 2 dead; 97h - 2 dead; 145h - 2 dead; 169h - 5 dead. Kidney, liver, and muscle tissue samples were obtained from all the animals that died. Behavioral observations were once again recorded for treated animals following LiCl ingestion. Treated animals appeared unaffected until 24 hours post-ingestion when they stopped eating, drinking, and moving around the containment area. Because of the high mortality rate, we were unable to construct a complete depletion curve for this concentration.

Experiment 3:

Mean lithium concentrations were different among muscle, kidney, and liver tissues within 7 hours after ingestion. Mean lithium concentrations in both liver and kidney tissues were greater than muscle at 7 and 24 hours post ingestion (P < 0.01; Table 1). There was no difference in lithium concentrations between the three tissues at 96 hours (P > 0.05) (Table 1). Mean lithium concentrations remained elevated (P < 0.01) in both liver and kidney in the first 24 hours after LiCl ingestion but returned to basal level at 96 hours after ingestion. Although, the overall concentration of lithium was less in muscle tissue, lithium concentrations remained elevated (P < 0.01) in muscle in the first 24 hours after LiCl ingestion and returned to basal level at 96 hours after ingestion (Table 1). There was not a tissue type by time interaction effect on Lithium concentrations.

a,b Means with different superscripts within a column differ (P< 0.05)

x,y Means with different superscripts within a row differ (P<0.05)

A 150 mg LiCl/kg body weight was selected as the low dose based on previous reports of effectiveness in creating taste aversion in domestic sheep, cattle, and caribou [9,22,23]. Administering LiCl dosages greater than 300 mg/kg body weight is rare within the literature, and an exact toxic dosage in small ruminants has yet to be determined. The LiCl toxicity in mice occurred at a 600 mg LiCl/kg body weight [24], and to avoid exceeding the toxic threshold for ruminants the high dosage was reduced to 450 mg LiCl/kg body weight in the current study. However, with the multiple mortalities occurring post-ingestion the toxic threshold apparently was exceeded in the sheep indicating the LiCl toxic threshold maybe even less than 450 mg LiCl/kg body weight.

Maximum lithium concentration levels and withdrawal periods within muscle tissue may vary by dosage, and among animals to an extent. Most notably in experiment 1, one sheep at 96 hours had a greater Lithium concentration (9.8 μg/g) causing a larger variation in the data at that time point (Figure 1). Interestingly, mean muscle lithium concentration at 96 hours post ingestion was similar to the pre-ingestion concentration when the data from that sheep was not included in the data analysis. As indicated, at the low dosage, lithium concentration increased within muscle tissue starting with the first biopsy samples taken at 4 hours and continued to increase until the maximum concentration value occurred at approximately 24 hours. Following the peak, lithium concentrations quickly declined and returned to basal levels by 192 hours. (Figure 1) Although lithium in kidney and liver samples did not return to baseline concentrations from the low dose, at 96 hours post-ingestion, there was not a difference between lithium concentrations among the three different tissues suggesting most of the lithium had been metabolized and excreted leaving behind small residual amounts in all tissues. These results are similar to withdrawal periods of lithium in different types of excreta in sheep and goats previously reported [18].

In this study feed and water intake pre- and post-ingestion were not directly quantified, but treated animals were observed for behavioral changes. Although previous studies have observed signs of malaise (head droop and inactivity) [21] and an aversion to food post LiCl ingestion [7,15], we did not observe either of these behavior changes. Treated sheep were consuming provided alfalfa immediately following LiCl drenching and continued to do so throughout the study period. The low dose LiCl may not have been high enough to produce the taste aversion in sheep, and perhaps a greater dose of LiCl (200-300 mg/kg) may produce the taste aversion without producing the toxic effects seen at a LiCl dose of 450 mg/kg.

Only 2 of the 14 individuals that received high dosage (450 mg/kg BW) did not succumb to toxicity, and after 240 hours postingestion muscle tissue samples from the surviving animals had yet to reach basal level. Thus, a complete withdrawal time for a dosage of 450 mg LiCl/kg body weight was not determined. Despite supportive treatment for dehydration animals succumbed within a few hours of clinical signs. As indicated, majority of the mortalities occurred between 36- and 193-hours post-ingestion. Multiple symptoms of toxicity were observed including lack of appetite, malaise, severe dehydration, hypoglycemia, muscular tremors, increased heart rate, and extreme diarrhea. Necropsies were conducted by a veterinarian, and cause of death was determined for each deceased animals. In the absence of any additional postmortem findings, it was determined that all animals had died due to LiCl overdose, and that 450 mg LiCl/kg body weight appears to be a lethal dose for small ruminants.

Although treated animals only received a single dosage of LiCl, the high-level potency of the chemical compound resulted in death as the physiological responses in the body, and especially the kidneys, were not able to process and excrete excess LiCl resulting in accumulation and eventual death [17,25]. Kidneys are the main processing organ that excretes LiCl [17,25], and excess lithium can disrupt the absorption of salt and water, often leading to polyuria [26]. If the kidneys are not able to process and excrete the ingested amount of lithium, excess amounts begin to accumulate in other tissues [17]. This is likely what occurred in the high dose trial and why our results show no difference in lithium concentrations among the tissue types. Once lithium levels in the kidney exceeded maximum intake, surplus lithium may have deposited in the liver and muscle tissues, resulting in all 3 tissue types containing high concentration levels. However, in the low dose, the highest lithium concentrations were in the kidneys, followed by liver, and the least amount of lithium concentration was in muscle tissue. This was likely because of the kidneys being able to function correctly with a manageable intake of lithium. Overdosing was not an issue as the amount of ingested lithium was processed and excreted by the kidneys without excess accumulation.

Conclusion

The muscle concentration of lithium at a low dose of 150 mg/ kg body weight of LiCl administration reached baseline lithium in muscle tissues by 192 hours post-ingestion. Although, the withdrawal period within the liver and kidney for this dosage was not established, the lack of difference in lithium concentration between the three tissues (muscle, liver, kidney) at 96 hours suggests lithium concentrations of liver and kidney would not differ from baseline by 192 hours. Likewise, high dose withdrawal periods for all 3 tissue types were undetermined due to 450 mg LiCl/kg body weight being lethal for many sheep. It appeared that kidney tissues retain the greatest amount of lithium, followed by liver tissues, and lastly muscle tissues. It is important to acknowledge the toxic threshold for domestic sheep, and likely for other small ruminants, lies between 150-450 mg LiCl/kg body weight.

Although we didn’t notice any instant food aversion after ingesting LiCl, this chemical could be a useful deterrent for lowering WTD crop destruction. Although sheep and deer have similar body sizes and rumen capacities, it should be noted that toxicity effects and withdrawal times for each tissue type may differ between species. Based on the results of the current study, a 192-hour withdrawal period in muscle tissue for a low dose of LiCl in domestic sheep may be taken into consideration; however, the analyses for other tissue types at low dosages and for all tissue types at high dosages were inconclusive, hence withdrawal period cannot be recommended.

Therefore, we suggest that before field implementation and human consumption of an animal that has ingested LiCl, more trials are necessary that include using LiCl at a dose range of 200 - 300 mg/kg for longer time periods, with larger samples sizes, and incorporate a variety of ruminant species.

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Tuesday, June 23, 2026

In-vitro Study and In-vivo Application of Rileva IVD System for the Isolation and Cultivation of Bacterial Strains from Biofilm- Juniper Publishers

 

Biotechnology & Microbiology- Juniper Publishers


Summary

Introduction: Diagnosis of infection is often complicated by the inability to isolate the pathogens, due to their ability to aggregate into complex structures known as biofilms. This article collects in-vitro and in-vivo evidence of the efficacy of an in-vitro diagnostic (IVD) (RILEVA, Joint Srl, Venice) for the harvesting of explanted prostheses and peri-implant tissues, specifically designed for biofilm breakdown.

Methods: To prove the in-vitro efficacy of the RILEVA IVD, the biofilm of the bacteria E. coli, P.aeruginosa [Gram+] and S.epidermidis [Gram-] was grown for 14 days both on polyethylene (PE) and titanium (Ti) discs. The discs were then placed in the polyvinyl chloride (PVC) bag of RILEVA with a solution of Dithiothreitol (DTT). The solution was processed and centrifuged; the pellet was cultured for up to 10 days on Petri dishes. Data from the clinical use of IVD in 28 cases were analyzed to confirm the in-vitro evidence.

Results: Colonies of all three tested strains of bacteria grew abundantly on the Petri dishes with high colony density in all six replicates, indicative of RILEVA’s effectiveness in disrupting the biofilm and identifying the pathogen. Results from the clinical use of the IVD demonstrated the efficacy, confirming in 96.4% of the cases the pre/intraoperative diagnosis.

Conclusion: The RILEVA system, an IVD device that uses DTT to dissolve the biofilm matrix and release sessile bacteria present in the prosthesis, effectively identified the causative agent of prosthetic infection, both in-vitro and when used in a clinical setting.

Keywords: RILEVA; IVD; Prosthetic infection; Biofilm; Bacterial species

Abbreviations: IVD: In-Vitro Diagnostic; Ti: Titanium; PJI: Prosthetic Joint Infection; PVC: Polyvinyl Chloride; PE: Polyethylene; BHI: Brain Heart Infusion; CV: Crystal Violet

Introduction

One of the most common complications of orthopedic implants is prosthetic joint infection (PJI). Depending on the anatomic location, PJI occurs in 1% to 2% of primary joint arthroplasties [1-3], and is associated with individual suffering, increased mortality, and a high economic burden on healthcare systems. In addition, PJI is an escalating problem as the world population ages and the need for joint replacement raises due to increased life expectancy and mobility at older ages [4,5]. Diagnosis of PJI is difficult [6,7], and although many different clinical parameters may indicate the presence of infection, only intraoperative identification of the infecting microorganism provides the highest degree of diagnostic certainty and is therefore necessary to make informed decisions about surgical and medical treatment strategies in the event of infection [7]. Intraoperative histopathological examination of the periprosthetic tissue is used to decide if revision arthroplasty vs resection arthroplasty should be performed when the preoperative evaluation has failed to confirm the prosthetic infection. However, the results can be dependent on appropriate sampling of the tissue harboring the infection and the expertise of the pathologist, as no guidelines have been developed to standardize cultures to identify pathogens causing the infection [7]. Periprosthetic tissue sampling and aspiration of synovial fluid for subsequent culture are the currently accepted methods for diagnosing PJI [8] but both diagnosis and treatment are difficult and often unsuccessful: the presence of biofilms covering and protecting bacteria on the surface of implanted biomaterials leads to the failure to detect the pathogen and prevents the selection of the appropriate antimicrobial treatment, resulting in recurrence of infection [9]. Therefore, removing the biofilm is of utmost importance to facilitate a clear diagnosis of the organism responsible for the infection [10]. Among the various biofilm removal techniques developed to improve the diagnosis of PJI, sonication of removed prostheses has been introduced in the last decade and is widely used today [11]. Most published reports have shown a higher sensitivity of sonication over conventional periprosthetic tissue cultures for the microbiological diagnosis of PJI [11,12]. However, sonication also has its limitations, such as the low sensitivity in early infections, the lack of a universal sonication protocol, the risk of bacterial contamination from the water in the sonication device, and the requirement for expensive sonication devices [13- 16].

In recent years, chemical treatment of removed implants and periprosthetic tissue with dithiothreitol (DTT) has been introduced as an effective alternative to sonication [17-19]. DTT is a sulfhydryl compound that acts as a reducing agent to cleave protein disulfide bonds between cysteine groups, allowing removal of bacterial biofilm from prosthetic implants [20]. DTT has been reported to reduce Staphylococcus aureus biofilm formation [21], and several publications have described the advantages of DTT due to its ease of use, low cost and ability to treat both periprosthetic tissue samples and implants [17,20,22]. RILEVA is a new in-vitro diagnostic (IVD) device for the sterile collection and processing of explanted prostheses and/or solid peri-implant tissues that are infected or suspected of being infected. RILEVA is supplied in the form of a bag that allows sterile handling of prostheses and explanted tissues in the operating room and their transport to the microbiology laboratory where they are processed. The risk of contamination is very low as sample manipulation is minimal, reducing the risk of false positive results. The action of RILEVA is based on the ability of the DTT solution in which the explanted prosthesis is bathed to dissolve the biofilm matrix and release the bacteria present in sessile form. In this study, we investigated the efficacy of RILEVA IVD to obtain bacterial strains from biofilms grown in prosthetic-like material in-vitro. In addition, we investigated the performance of RILEVA in a clinical setting, in the collection of intraoperative samples to identify infecting bacteria from surgically explanted prostheses and compared the results with those obtained with conventional microbiological analysis of wound exudate/biological fluid performed pre- and intraoperatively.

Materials and Methods

Biofilm growth

Escherichia coli (ATCC® 39327), Pseudomonas aeruginosa (ATCC® 35695) and Staphylococcus epidermidis (ATCC® 12228) were grown in their specific media, EC broth (Sigma Aldrich), Cetrimide broth (Sigma Aldrich) and Staphylococcus broth (Sigma Aldrich), respectively, at 30 °C in a shaking incubator (300 rpm). After 24 hours, strains (1 mL) were transferred individually to liquid Brain Heart Infusion (BHI) and incubated in a shaking incubator at 30 °C for five days. The strains thus cultured were inoculated individually (500 μl) in triplicate onto customdesigned sterile polyethylene and titanium discs and incubated at 30°C under static conditions. After six days, the discs were again inoculated with the same bacterial broth and incubated at 30 °C for one day. Subsequently, the discs were placed in a shaking incubator (150 rpm) at 30 °C for another seven days to stimulate biofilm growth.

Evaluation of biofilm growth

Biofilm formation was evaluated using a colorimetric method [23]. The biofilm-containing discs were rinsed four times with 500 μl sterile water to remove non-adhering cells. The biofilm was fixed with 500 μl of 96% ethanol and air dried for 15 minutes. 500 μl of a 0.2% (w/v) solution of crystal violet (CV) was poured onto the disc surface which was then stained for 20 minutes. The excess solution was discarded to visually observe the stained biofilm.

RILEVA system for biofilm removal

The IVD RILEVA system includes

i. n. 1 sterile polyvinyl chloride (PVC) bag with an inlet and outlet port with cap

ii. n. 1 polyammide sterile clamp for the hermetic sealing of the bag

iii. n. 4 sterile 60 mL syringes

iv. n. 2 sterile10 mL syringes

v. n. 4 sterile 19 G needles

vi. n. 2 sterile 50 mL Falcon with screw cap

vii. n. 1 apyrogenic 100 mL water bottle

viii. n. 1 1,4-ditiotreitol (DTT) 100 mg bottle

ix. n. 1 bag for biological sample transportation

To test the effect of DTT and RILEVA IVD on biofilm removal, biofilm-containing discs were placed in the PVC bag and sealed with the clamp as indicated by the manufacturer. One bag contained both the polyethylene and titanium discs previously inoculated with one of the selected strains. Then, 10 mL of apyrogenic water was withdrawn with a 10-mL syringe and mixed with DTT, which was then diluted with the remaining water (90 mL). The solution (100 mL) was injected into the disc bag through the inlet port, and the bag was placed on an oscillating plate (40 rpm) for 10 minutes. Then the solution was withdrawn through the outlet port and centrifuged at 4100 rpm for 10 minutes in the two screw-capped Falcon tubes. The supernatant was removed, and the resulting pellet was applied to the specific agar media in Petri dishes and incubated at 30 °C under static conditions for up to 10 days. A control experiment was performed using the same procedure with a 0.9% physiological NaCl solution instead of DTT.

Evaluation of RILEVA in the clinical setting

Implants from 28 patients with overt or suspected implantrelated infections (plates/screws 28.6%, knee 17.8%, hip 14.3%, shoulder 14.3%, elbow 14.3%, other implants 10.7%) were surgically explanted. Intraoperative specimen collection using the RILEVA IVD includes several steps:

a. opening the pouch and clamp using sterile technique and placing them on a cart away from the surgical instruments.

b. placing all explanted material directly into the pouch using clean instruments.

c. sealing the pouch with the clamp after explantation by placing it as close to the material as possible to reduce the internal volume of the pouch.

d. removing the pouch from the sterile field and attaching the patient label ID.

e. placing the pouch in the transport bag for biological samples and sending it to the microbiology laboratory where the specimens are subjected to microbiological testing.

The surgical procedure was performed by the Department of Orthopedics and Traumatology in collaboration with the Department of Microbiology of the Ospedale dell’Angelo di Venezia-Mestre for the processing of the specimens with the RILEVA system. Preoperative and intraoperative microbiological analysis of wound exudate/biological fluid was performed in all patients using conventional culture methods. Microbiological analysis of the removed prostheses was also performed in all patients using the RILEVA system, closely following the manufacturer’s instructions.

Results

E.coli, P. aeruginosa, and S. epidermidis were grown on polyethylene or titanium discs. A colorimetric assay using crystal violet (CV) was performed to evaluate the growth and stability of the bacterial biofilm. Figure 1A shows the E.coli biofilm before and Fig. 1B after the colorimetric assay. The formation and growth of the biofilm on the discs is evident by the presence of a dark purple coloration on the disc surface (Figure1B, center and right Petri dishes), which is not present in the absence of the inoculated bacteria (Figure 1B, left Petri dishes). This result confirms that biofilm formation occurs under our experimental conditions.


Next, we tested whether processing the discs after biofilm growth with RILEVA IVD in strict accordance with the manufacturer’s instructions would allow isolation of the bacterial strains. Discs inoculated with bacteria were exposed to the DTT-containing solution and the solution was then centrifuged. The resulting pellet was then applied to a Petri dish containing an appropriate growth medium, and after culturing, the dishes were examined for the presence of bacteria. Figure 2 shows that colonies of all three strains of bacteria tested grew on the Petri dishes, and the high colony density in all six replicates indicates a good recovery rate. The growth of all strains indicated the successful removal of biofilm from the dishes, suggesting that the use of RILEVA IVD with DTT enables the isolation and cultivation of biofilm bacteria from prosthetic materials such as polyethylene and titanium.


To further investigate the role of DTT in biofilm removal, a control experiment was performed with the RILEVA IVD system, replacing DTT with a physiological solution. Under these conditions, E.coli was detected in only 1 of 3 replicates. The presence of only a few E.coli colonies also suggests that the use of the physiological solution instead of DTT significantly reduces the ability to isolate this strain. S. epidermidis also showed lower growth under control conditions, although colonies were clearly detectable. However, P. aeruginosa was found to grow in all replicates using the physiological solution, like the DTT solution. This strain-dependent growth variability suggests that the use of the physiological solution may not ensure recovery of all bacteria strains and reproducibility, increasing the likelihood of false negative results. Taken together, the above results show that the performance of the DTT-based method for biofilm removal was superior to that of a physiological solution in isolating Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus epidermidis cultures.

Clinical setting

The ability of RILEVA to isolate biofilm bacteria in-vitro was also confirmed in a clinical context by evaluating its diagnostic efficacy in isolating and identifying bacteria from explanted prostheses and comparing it to conventional microbiological analysis of wound exudate/biological fluid performed pre- and intraoperatively. The results obtained on 28 patients, 13 women and 15 males, with a mean age of 65.8±11.1 years, show that 27 cases (n=27/28; 96.4%) were consistent with pre/intraoperative diagnosis. In particular, in 22 cases (n=22/28; 78.6%) the RILEVA system allowed to detect the pathogen involved in the infection: in 17 cases (n=17/22; 77.3.0%) the pathogen(s) was the same detected in previous analysis, in four cases (n=4/22; 18.2%) RILEVA enabled isolation of the infectious microorganism in the presence of negative or absent pre/postoperative diagnosis, and in one case the bacteria detected through the RILEVA system was different from the one observed previously. The five negative cases (n=5/28; 17.9%) obtained with the RILEVA system agreed with clinical data and confirmed the absence of infection. In only one case (n=1/28; 3.6%) the negative result obtained with RILEVA was not consistent with conventional pre/intraoperative testing (Figure 3).

Discussion

In this study, we show that RILEVA, an in-vitro diagnostic (IVD) device that uses DTT to dissolve the biofilm matrix and release sessile bacteria present in the prosthesis, effectively identifies the causative agent of prosthetic infections, both invitro and when used in a clinical setting and is more accurate than conventional culture methods. The pathogenesis of prosthetic infection has been shown to depend on the formation of a biofilm. Biofilms are complex communities of microorganisms embedded in an extracellular matrix that form on the surface of prosthetic implants. Pathogens adhere to orthopedic devices, multiply, and produce exopolysaccharides that coalesce over time to form a biofilm. The biofilm microenvironment serves as a barrier against the host’s endogenous defense system or external agents such as antibiotics [24,25]. In addition, pathogens that colonize biofilm have low metabolic rates that prevent accurate identification in culture. S. epidermidis, Pseudomonas aeruginosa, and S. aureus are the most common biofilm-forming bacteria found in medical devices [26]. Biofilm formation not only plays a role in the pathogenesis and treatment of infection, but also has implications for the diagnosis. Particularly in delayed and late onset of prosthetic infection, the causative pathogens are concentrated on the surface of the prosthesis, which reduces the sensitivity of periprosthetic tissue and fluid cultures. A retrospective evaluation examining 35 patients showed that preoperative joint aspiration is likely to miss some bacterial species [27], and conventional methods of synovial fluid and tissue sample culture have a high rate of false-negative and false-positive results [28].


One strategy to overcome this limitation is to directly sample the surface of the prosthesis taking advantage of techniques such as sonication or DTT treatment to dislodge the microorganisms adhering to the prosthetic joint surface. A study investigating the applicability of DTT for the treatment of periprosthetic and osteoarticular tissues for the diagnosis of bone and joint infections found that treatment with DTT had higher sensitivity and specificity compared with normal saline, suggesting its usefulness in the diagnosis of bone and joint infections [17]. In another study comparing DTT treatment with sonication, it was found that the two methods produced similar results in terms of bacterial yield, with DTT having the same specificity and better sensitivity than sonication [22]. However, in a randomized trial designed to determine whether DTT and sonication are more sensitive and/ or specific than standard culture methods in diagnosing PJI, no differences in sensitivity were observed between DTT and sonication, but both were found to be more sensitive than standard culture methods [29]. In a prospective study examining explanted implants from 73 cases of revision arthroplasty, DTT treatment was also shown to be effective in diagnosing PJI and had higher sensitivity and comparable specificity to sonication [19]. Both sonication and DTT have been shown to be more efficient than conventional bacterial culture. However, sonication requires a specialized and expensive device, whereas DTT is easy to use, very inexpensive, poses fewer environmental risks, and can be applied to both implants and periprosthetic tissue [20]. A disadvantage of DTT is its potential toxicity to bacterial cells, which in principle could bias the results of DTT-based biofilm removal and lead to false-negative results [20]. However, our findings contradict this notion and suggest that DTT is more effective than saline in extracting bacteria that can be cultured from the biofilm of explanted prostheses.

Conclusion

In summary, our study shows that the RILEVA device using DTT is very reliable for the isolation of bacterial strains from biofilm adhering to titanium or polyethylene discs, whereas the isolation of bacteria using conventional methods is less reproducible. In addition, RILEVA also proved easy to use and reliable in the clinic. When tested on explanted implants, it consistently allowed isolation of various contaminating bacterial species, and in most cases the results correlated positively with those obtained with conventional pre/intraoperative microbiological testing and/ or clinical evaluation of the patient. Importantly, in some cases, only RILEVA provided an accurate microbiological diagnosis of PJI. Thus, culturing DTT extracts from removed prostheses could play an important role in the workflow for the diagnosis of PJI, but larger data sets from controlled, multicenter studies are needed to validate these findings.

Friday, February 13, 2026

Is Juniper Publishers Legit in 2025? A Transparent Review for Researchers

 Is Juniper Publishers Legit in 2025? A Transparent Review for Researchers

 

In 2025, the academic publishing landscape continues to evolve rapidly. With the rise of open-access publishing, researchers now have more opportunities than ever to share their findings globally. Among the publishers frequently discussed in this space is Juniper Publishers — often associated with accessibility, faster publication timelines, and international reach.

But an important question many researchers ask is: Is Juniper Publishers legitimate in 2025?
This transparent review examines what the publisher offers, what researchers typically look for, and whether it may align with your academic publishing goals.


Juniper Publishers in 2025: An Overview

As of 2025, Juniper Publishers remains an active open-access academic publisher serving researchers across scientific, medical, and interdisciplinary fields. Many authors choose Juniper for several practical reasons, including:

  • Faster editorial and peer-review timelines
  • A user-friendly manuscript submission system
  • Support for early-career and international researchers
  • Global readership through open-access availability
  • Flexibility for niche and interdisciplinary research topics

For researchers seeking timely publication and wider visibility, this model can be especially appealing.


What Juniper Publishers Offers in 2025

1. Fully Open Access for Global Visibility

Juniper Publishers operates under a full open-access model, allowing published research to be freely available to readers worldwide. This helps eliminate paywalls and ensures broader dissemination across institutions, regions, and disciplines.

2. Fast and Author-Friendly Publishing Processes

Many authors highlight Juniper’s streamlined workflows, clear communication, and relatively fast editorial response times. This can be particularly beneficial for researchers working under grant deadlines, graduation requirements, or time-sensitive projects.

3. Support for Early-Career and International Researchers

Juniper is often viewed as more accessible to:

  • Early-career researchers
  • Scholars from developing regions
  • Interdisciplinary and emerging research fields
  • Practitioners with applied or industry-focused studies

This inclusivity allows newer voices and innovative topics to gain visibility.


What Researchers Should Consider (Transparency Matters)

As with any academic publisher, researchers should evaluate suitability based on discipline-specific standards. Important factors to review include:

  • Editorial board expertise
  • Transparency of the peer-review process
  • Indexing and discoverability
  • Publication fees and cost clarity
  • Journal scope and quality of previously published articles

These considerations apply universally across open-access publishing and help ensure alignment with academic goals.


Is Juniper Publishers Legit? A Balanced Perspective

In 2025, Juniper Publishers functions as a legitimate open-access publishing platform with a broad journal portfolio. Authors often appreciate its:

  • Accessibility and openness
  • Supportive editorial communication
  • Faster publication cycles
  • International readership
  • Flexibility for emerging and interdisciplinary research

For researchers who find traditional publishers slow or overly restrictive, Juniper can offer a practical alternative.


Juniper Publishers vs. Typical Open-Access Publishers

Category

Juniper Publishers

Typical Established OA Publishers

Publication Speed

Faster turnaround and quicker editorial responses

Often slower due to high submission volumes

Accessibility

Welcoming to early-career researchers

Highly competitive environments

Submission Process

Simple and user-friendly

More complex or bureaucratic

Open Access

Fully open access

Open access, sometimes with stricter requirements

Editorial Responsiveness

Generally prompt communication

Can vary significantly

Emerging Fields

Flexible journal scopes

More rigid topic boundaries

Cost Transparency

Fees usually communicated clearly

APCs often higher

Global Author Base

Broad international participation

Often dominated by well-funded institutions

Author Support

More flexible and accommodating

Standardized processes


Conclusion

In 2025, Juniper Publishers represents a legitimate open-access publishing option for researchers seeking global visibility and efficient publication workflows. Its author-centered approach can be particularly valuable for interdisciplinary studies, early-career researchers, and those prioritizing accessibility and speed.

As with any publishing decision, researchers should carefully assess journal scope, editorial practices, and alignment with their academic objectives. When chosen thoughtfully, Juniper Publishers can be a useful part of today’s diverse scholarly publishing ecosystem. 

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