Category: 3. Business

  • Samsung Showcases Industry-Leading Hotel Technology at Hotel and Hospitality Expo Africa 2025 – Samsung Newsroom South Africa

    Samsung Showcases Industry-Leading Hotel Technology at Hotel and Hospitality Expo Africa 2025 – Samsung Newsroom South Africa

     

     

    Samsung, a global leader in innovative technology solutions, took centre stage at the recent Hotel & Hospitality Expo Africa 2025, at the Cape Town International Convention Centre. As a trusted partner to the hospitality industry, Samsung presented a powerful suite of cutting-edge hotel technologies designed to elevate guest experiences and streamline hotel operations.

     

    Visitors to the Samsung exhibition stand experienced first-hand how the brand is shaping the future of smart hospitality. On display was a curated portfolio of Samsung’s premium commercial solutions tailored specifically for hotels, including:

     

    • Samsung Hotel TVs – Commercial TVs built for business, and designed to offer an immersive in-room entertainment or conference experience. These advanced displays allow your guests to enjoy seamless and life-like picture quality. Explore more
    • Samsung Kiosk and Connection Box – Modernise guest self-service with intuitive, secure, all-in-one solutions that simplify check-ins, payments, and more. See details
    • Samsung Flip Screen – Encourage collaboration in conference or event spaces with an interactive whiteboard that brings meetings to life.
    • LED Smart Signage – Find the perfect display solution for any business. Make a striking impression with high-impact indoor and outdoor LED signage, ideal for lobbies, event promotions, or wayfinding. More info | Smart Signage
    • Samsung Tablets – Business-ready tablets that support operations and communication – designed to maximise productivity in the field, classroom, or office. Browse tablets

     

    Samsung’s commitment to innovation, reliability, and seamless integration positions it as a leading technology partner for the hospitality sector. From enhancing operational efficiency to delivering premium guest experiences, Samsung’s hotel solutions are trusted by hotels across South Africa and around the world.

     

    At the expo, Samsung gave visitors an opportunity to discover how technology is reshaping the hospitality landscape, making every stay smarter, safer, and more connected.

     

    For more information about Samsung’s business solutions, visit: https://www.samsung.com/za/business

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  • UK shares trade flat as investors assess latest tariff updates, company news – Reuters

    1. UK shares trade flat as investors assess latest tariff updates, company news  Reuters
    2. FTSE 100 and US markets lower as Trump turns up tariff threat again  Yahoo
    3. Late market roundup: London markets lose midday gains to end Monday lower, 7 Jul 2025 17:25  Shares Magazine
    4. FTSE 100: Can UK GDP, Retail Data Keep the Uptrend Intact as Oil Stocks Cool?  Investing.com UK
    5. FIVE at FIVE: Shell, sportwear, Tesla, FTSE 100  Proactive Investors

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  • Former US IRS Official Donna McComber Returns to Baker McKenzie | Newsroom

    Former US IRS Official Donna McComber Returns to Baker McKenzie | Newsroom

    Leading global law firm Baker McKenzie announced today that Donna McComber has rejoined the Firm as a Principal Economist in Washington, DC.

    Donna is a widely recognized transfer pricing practitioner with more than 25 years of international tax experience in the US Government and private practice, including negotiating Advance Pricing Agreements (APAs) and mutual agreement procedure (MAP) cases with numerous US treaty partners. Donna has extensive experience working with multinational corporations to analyze intercompany transactions and develop creative and practical transfer pricing solutions including detailed market analyses, cost sharing agreements, intellectual property valuations, and intercompany pricing analyses for a wide range of industry sectors including financial services, automotive, technology, consumer, pharmaceutical, medical device, apparel, and retail.

    Donna served in numerous positions including Assistant Director within the Advance Pricing and Mutual Agreement (APMA) Program in the US Internal Revenue Service for over 15 years, and most recently worked at a Big Four accounting firm.

    “The international tax landscape has evolved considerably over the last few years as governments around the world focus on increasing tax revenue, and the result has been a sharp rise in double tax disputes,” said Salim Rahim, Chair of the Firm’s North America Tax Practice Group. “Donna’s government experience, especially her work negotiating APAs with US treaty partners, will be a tremendous asset to our clients who are looking to obtain certainty.”

    Baker McKenzie’s Tax Practice is one of the most highly regarded in the world. With more than 730 tax practitioners in over 40 countries, the practice collaborates across borders and specialties to stay abreast of changing tax landscapes worldwide. The Firm’s Tax advisory practice works closely with the Firm’s M&A Practice on transactions, assisting clients with post-acquisition integrations and pre-disposition restructurings, and consulting with clients on a wide variety of domestic and international tax issues.

    “Donna is a seasoned transfer pricing advisor, who is well known throughout the tax community for her elite technical skills,” said Maurice Bellan, Managing Partner of Baker McKenzie’s Washington, DC office. “More importantly, she has always been a highly-valued member of the Baker team and we are delighted to have her back.”

    “Baker has an unmatched international Tax Practice, which works on some of the most interesting and complex transfer pricing issues in the world today,” Donna added. “I am thrilled to return to the collaborative and collegial work environment at Baker, which feels like home.”

    Donna received her BA in Economics from the University of Mary Washington and her MA in Economics from Vanderbilt University.

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  • Policy uncertainty putting U.S. international investment position at risk

    Policy uncertainty putting U.S. international investment position at risk

    As elegantly put by the Bank of International Settlements in its recent annual report, the soft landing for the global economy suddenly seems more elusive.

    The American retreat from the center of the international economy and the surge in policy uncertainty this year have jolted financial markets and resulted in a sustained depreciation of the American dollar.

    Foreign investment in U.S. financial securities and direct investment in its corporations are outstripping U.S. holdings of foreign assets by $26 trillion as the end of last year.

    This volatility is likely to continue as Washington’s de facto weak dollar policies prompt international investors to diversify away from the dollar and dollar-denominated assets.

    Foreign investment in U.S. financial securities and direct investment in its corporations are outstripping U.S. holdings of foreign assets by $26 trillion as the end of last year.

    It’s a stunning figure, one that has grown in recent years. But even though it is a sign of foreign investors’ confidence in the American economy, there are indications that it is starting to level off, and the pressure is likely to continue.

    The estimated $3 trillion to $4 trillion increase in public debt over the next decade, for example—recently approved by Congress—will raise debt financing costs and add to concerns around the U.S. as the ultimate global safe haven.

    To be sure, this leveling off in the net investment position has happened before, but those periods have occurred during times of economic strain, like the pandemic, or trade tensions, like the 2018 trade war.

    Now, with a weak-dollar policy and increasing protectionism coming on top of rising public debt, foreign investors are poised to find other places to put their money than the U.S.

    No longer so safe

    This deterioration in the U.S. global position comes after a period of historic strength for the American economy.

    For years, American innovation and productivity have attracted foreign investment in its securities and corporations. At the same time, global investors have no viable alternative to the depth of the U.S. Treasury and corporate bond market, even amid the recent shift.

    This enduring strength of U.S. markets is why we think that what is occurring is a rational response to the U.S. attempt to rebalance the global economy.

    In the end, it’s a diversification rather than de-dollarization.

    Get Joe Brusuelas’s Market Minute economic commentary every morning. Subscribe now.

    While the net international investment position of the U.S. is likely to deteriorate further, there is an effective limit to how far that can go.

    We see the surge in investment in the U.S. as a natural progression of an economy that has continued to move beyond basic manufacturing and natural resource extraction.

    In addition, the U.S. offers investors the reliability of centuries-long adherence to contract law.

    So although shocks have rattled the global economy in recent years, foreigners have increased their purchases of U.S. assets at an accelerating rate.

    In just the past five years, as measured its net international investment position, U.S. liabilities (U.S. assets owned by foreigners) grew at an 8.9% average annual rate, while U.S. assets (foreign assets owned by U.S. investors) grew at a 4.5% rate.

    Foreign liabilities have accelerated at twice the speed of U.S. international assets, which goes hand in hand with the rising U.S. trade deficit, the dollar’s strength, the depth of the Treasury and corporate bond markets, and strength of the American equity market.

    For American trading partners, the dollar’s strength served as a hedge until this year. Foreign exporters were able to invest their receipts in U.S. securities, gaining the return advantage of higher-yielding dollar-denominated securities while avoiding the cost of exchanging dollars for their foreign currencies.

    But as the Bank of International Settlements report shows, the receipts from trade with Asia, while important, have not been the only way that the U.S. fiscal and trade deficits have been financed.

    The predominant source of international investment into the U.S. economy has come from the advanced economies, with the Europe leading the way.

    This should not come as a complete surprise. Just as the wealth of the U.S. economy can support both foreign and domestic investment, the financial centers of Europe and Japan are advanced enough to support investment in U.S. government debt and corporations.

    There has been another bright spot for the U.S. On a cash flow basis, the U.S. had until this year maintained a net positive position on investment income, which is the income earned on U.S. investment in foreign assets and vice versa.

    This net positive position was because the return on foreign assets owned by the U.S. exceeded the rate of return on U.S. assets held by foreigners.

    But that’s changing. The cash flow has reversed course in four of the past five quarters. with the income stream now moving in favor of the United States’ foreign creditors. That shift can be attributed to the dollar’s loss of value over the past year, with returns on foreign assets now translated into fewer dollars.

    A changing financial landscape

    Investors over the last 20 years have become accustomed to what has been termed American exceptionalism, which has resulted in an abundance of cheap goods, big cars and the willingness of foreigners to invest in U.S. innovation and productivity.

    But that won’t last forever.

    Consider England after the Second World War. Two world wars and an outdated social structure took its toll on the British economy, with the pound ceding its status as the reserve currency to the American dollar.

    Today, a wealthy U.S. finds itself with a growing U.S. resistance to the global economy and to the perceived stricture of international institutions that allowed for the development of that wealth.

    To that point, the BIS notes the growing connectedness of global financial markets, the increased transmission of financial conditions in the global economy and the increasing role of nonbank financial institutions that have financed the development of the advanced economies.

    Instead of a laissez-faire approach to finance that nearly crushed the global economy in 2008, this connectivity will require that regulatory standards keep pace with the evolving structure of global financial markets.

    The BIS finds that since the financial crisis, the focus has shifted from the activities of global banks engaged in cross-border lending to the activities of international portfolio investors in global bond markets.

    This “second phase of global liquidity” had several key drivers, according to the BIS report.

    On the borrowing side, it was driven by expansive fiscal policies in major jurisdictions and the surge in the supply of sovereign bonds. On the lending side, the growth of nonbank financial institutions and their need for diversification induced them to hold portfolios in a variety of currencies.

    The nonbank accumulation of Treasury securities has considerably outpaced that of foreign official holders to the point that they currently account for more than half of all foreign holdings of Treasuries.

    The largest increase in U.S. bond holdings of around $1.3 trillion is accounted for by European investors. The second-largest increase (of $575 billion) came from investors from other advanced economies.

    The BIS report also notes that changes in bilateral portfolio positions are only loosely related to current account imbalances. Indeed, many of the largest increases in cross-border bond holdings since 2015 were reported by private investors from economies that did not run large current account surpluses.

    This is not surprising considering that the largest nonbank financial institutions are based in advanced economies and tend to direct their investments toward the large bond markets of other advanced economies.

    The focus on net measures like current account imbalances misses the point. It is the role of large gross portfolio positions between advanced economies that are key to the international transmission of financial conditions.

    The foreign exchange swap market

    The development of the foreign exchange swaps market has been a crucial factor fostering the globalization of sovereign bond markets, according to the BIS.

    Given the centrality of the U.S. fixed income market, FX swaps have facilitated greater access to U.S. dollar-denominated bonds.as well as making the universe of bonds more accessible on a hedged basis.

    The FX swap market is large, reaching $111 trillion at end of last year, with FX swaps and forwards accounting for roughly two thirds of that amount.

    Roughly 90% of FX swaps have the dollar on one side, underlining the dollar’s linchpin role in the global financial system. More than three quarters of all outstanding FX swap contracts have a maturity of less than one year.

    The BIS analysis finds that cross-border investment flows shed light on the growing connectedness among advanced economy markets.

    These flows form the channel through which financial conditions in advanced economies including the U.S. can be affected by nonbank portfolio choices.

    The recent episode of South Korean insurance companies’ exposure to long-term U.S. Treasury securities highlights the importance of hedging.

    Interconnected financial conditions
    Can another financial crisis happen again? Only if it is allowed to occur.

    When monetary policy is tightened, risk premiums would be expected to rise.

    Market participants are hedging their investments by requiring higher rates of return in anticipation of an economic slowdown and a greater risk of default. As anxiety over tariffs has grown, long-dated Treasuries have sold off.

    At the same time, the appetite for risk remains elevated, as the quick recovery in the equity market demonstrates.

    Still, the BIS warns that when risk appetite is high and cross-border positions of global investors build up quickly, that can unravel suddenly, leading to fire sales and sharp drops in asset prices in different markets.

    What would it take for the world to lose confidence in U.S. institutions and dollar-denominated investments?

    The takeaway

    The U.S. negative net international position has been a result of the attractiveness of U.S. assets to international investment. The dollar’s sudden reversal and the selloff at the long end of the Treasury curve are reminders of how quickly the investment atmosphere can change.

    While the cash flow derived from foreign investments has been a net positive gain for the U.S., the dollar’s decline has overturned that advantage.

    For international investors, the dollar’s decline is a reminder of the need to hedge currency exposure.

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  • Au@Pt@HP1-HP2@Fe3O4 nanoenzymatic complexes based on CHA signal amplif

    Au@Pt@HP1-HP2@Fe3O4 nanoenzymatic complexes based on CHA signal amplif

    Xiaoyong Wang,1,* Jinxin Sheng,1,* Haifan Yang,2,3 Kang Shen,2,3 Jie Yao,1 Yayun Qian,2,3 Gaoyang Chen4

    1Department of General Surgery, Nantong Haimen People’s Hospital, Nantong, Jiangsu, People’s Republic of China; 2Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 3The Key Laboratory of Syndrome Differentiation and Treatment of Gastric Cancer of the State Administration of Traditional Chinese Medicine, Yangzhou, Jiangsu, People’s Republic of China; 4Department of Oncology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, Jiangsu, People’s Republic of China

    Correspondence: Gaoyang Chen, Department of Oncology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, Jiangsu, People’s Republic of China, Email [email protected]

    Purpose: Early diagnosis of liver cancer requires highly sensitive detection of biomarkers. This study aims to develop a novel method for detecting circulating tumor DNA (ctDNA) in the serum of liver cancer patients, leveraging a catalytic hairpin self-assembly (CHA) signal amplification strategy combined with surface-enhanced Raman scattering (SERS) technology and nano-enzyme catalysis.
    Methods: We synthesized Au@Pt@HP1-HP2@Fe3O4 nano-enzyme complexes, utilizing the SERS-enhancing properties of Pt-coated Au nanoparticles (Au@Pt) and the separation-enrichment capability of Fe3O4 magnetic beads. The complexes catalyzed the oxidation of colorless TMB by H2O2 to produce blue ox-TMB, enabling quantitative detection of PIK3CA E542K mutant ctDNA. The assay’s performance was validated using gold standard qRT-PCR.
    Results: Under optimized conditions, the method achieved a detection limit for PIK3CA E542K as low as 4.12 aM. The assay demonstrated high sensitivity, specificity, and efficient magnetic separation, making it a robust tool for ctDNA detection.
    Conclusion: This study presents a highly sensitive and specific detection platform for liver cancer early diagnosis, characterized by magnetic separation and nano-enzyme catalysis. The method holds significant clinical potential for the accurate and early detection of liver cancer biomarkers.

    Keywords: surface-enhanced Raman scattering, nano-enzymes, circulating tumor DNA, liver cancer, catalytic hairpin self-assembly

    Introduction

    Liver cancer is a highly aggressive malignancy with a poor prognosis, primarily attributable to the absence of early symptoms and frequent late-stage diagnosis.1,2 As a real-time indicator of tumor genetic alterations and progression, circulating tumor DNA (ctDNA) has demonstrated significant value in early cancer detection. Studies reveal markedly elevated ctDNA levels in liver cancer patients, with its short half-life enabling dynamic tumor monitoring, making it an ideal diagnostic marker.3 Notably, PIK3CA gene mutations drive hepatocarcinogenesis by activating the PI3K/AKT/mTOR pathway, establishing this gene as a critical target for diagnosis and personalized therapy.4–6 However, conventional detection methods exhibit significant limitations. Real-time quantitative PCR (qPCR) has restricted applicability for minimal residual disease (MRD) monitoring. Droplet digital PCR (ddPCR) lacks standardized detection protocols and requires interpretation alongside multiparameter flow cytometry (MFC) data, and next-generation sequencing (NGS) demands sophisticated bioinformatics tools that are unavailable in most routine clinical laboratories.7,8 These constraints have accelerated the development of alternative diagnostic technologies, highlighting the urgent need for rapid and sensitive alternatives.9,10

    Surface Enhanced Raman Scattering (SERS), a highly sensitive spectroscopic analysis technique, has been widely used in biomedical detection in recent years.11–13 SERS can dramatically enhance Raman signals by adsorbing target analytes onto nanostructured noble metal surfaces, enabling highly sensitive detection of biomolecules even at trace concentrations.14–16 The latest clinical validation study confirms that SERS technology has significant advantages in the early diagnosis of liver cancer.17,18 Multiple hepatocellular carcinoma biomarkers miRNA122 and miRNA233 based on asymmetric competitive CRISPR (acCRISPR) and surface-enhanced Raman spectroscopy coupled to PTS with LODs of 10.36 and 4.65 fM, respectively.19 In addition, the SERS platform has a detection limit of 952 aM translation for liver cancer-associated long chain non-coding RNA (lncRNA).20 Nevertheless, these approach still face limitations, including suboptimal sensitivity or inadequate target specificity, which may restrict its clinical applicability.

    In recent years, the innovative design of nanomaterials has reinvigorated the development of biosensing technology.21–23 Nano-enzymes, as a kind of nanomaterials with enzyme-like catalytic activity, show great potential for application in the field of biosensing. Compared with natural enzymes, nano-enzymes not only have similar high catalytic activity, but also have the advantages of good stability, low cost and easy modification.24–27 Integrating nano-enzymes with SERS technology enables multiplexed signal amplification of target molecules. The catalytic activity of nano-enzymes synergistically enhances the signal intensity of the reaction system, substantially improving detection sensitivity and specificity.28,29 This combination not only extends the utility of SERS in analytical applications but also introduces an innovative paradigm for ultrasensitive bioanalysis in challenging sample environments. Pt-coated Au nanoparticles (Au@Pt) are ideal materials for SERS detection due to their excellent stability and enhancement effects. The Au@Pt not only inherits the excellent SERS enhancement properties of gold nanomaterials, but also further improves the catalytic activity and chemical stability of the material through the introduction of platinum.30–32 This unique structure enables the Au@Pt nanomaterials to simultaneously exert the surface plasmon resonance effect and the catalytic effect of the nano-enzymes in SERS detection,33,34 thus realizing dual signal amplification. In addition, magnetic beads, as an efficient separation and enrichment tool, can realize efficient capture and enrichment of low-abundance ctDNA in complex biological samples through specific binding to target molecules.35 The integration of magnetic beads with Au@Pt nanomaterials enhances both the capture efficiency of target molecules and the sensitivity and accuracy of SERS-based detection.

    Furthermore, DNA hairpin-based self-assembly has emerged as a prominent nucleic acid amplification strategy due to its operational simplicity and mild reaction requirements.36,37 The catalytic hairpin self-assembly (CHA) reaction, as a non-enzymatic signal amplification method, is capable of signal amplification by constructing a target strand cycling loop at room temperature.38,39 Combining the CHA reaction with SERS technology and nano-enzymes is expected to construct a novel and highly sensitive ctDNA detection platform for liver cancer.40

    In this study, we developed a CHA-based signal amplification system using synthesized Au@Pt@HP1-HP2@Fe3O4 nanozymes for ultrasensitive detection of ctDNA in liver cancer patient serum. As shown in Scheme 1, hairpin DNA1 (HP1) was modified on the surface of platinum-coated gold nanoparticles (Au@Pt) to prepare Au@Pt@HP1. Hairpin DNA2 (HP2) was modified on the surface of Fe3O4 to prepare HP2@ Fe3O4. PIK3CA E542K, as a target, can open its corresponding HP1 by complementary pairing, and HP2 replaces the target to form a large number of HP1-HP2 double-stranded structures, while the replaced ctDNA will continue to participate in the next round of CHA reaction. As the reaction cycle proceeds, more Au@Pt@HP1-HP2@Fe3O4 complex structures are formed with magnetic separation, enzyme-like catalytic activity and SERS-enhancing effect. The complex facilitated the oxidation of colorless TMB by H2O2, producing blue ox-TMB. Quantitative detection of PIK3CA E542K was accomplished by establishing a linear correlation between the SERS signal intensity at ox-TMB’s characteristic peak and the logarithmic concentration of the target ctDNA.

    Materials and Methods

    Materials

    HAuCl4 (≥99.9%), H2PtCl6 (≥99.9%) were purchased from Sinopharm Chemical Reagent Co., Ltd. (China), trisodium citrate (≥99.0%), iron oxide (Fe3O4, ≥90%), acetic acid-sodium acetate buffer (ACS grade), phosphate buffered saline (PBS, molecular biology grade), ethanol (EtOH, ≥99.7%), and 3,3′,5,5′-tetramethylbenzidine (TMB, ≥99%) were purchased from Bioengineering Biotechnology (Shanghai) Co. and used without further purification. The nucleotide sequences were custom-synthesized by Suzhou GeneWise Biotechnology Co. as shown in Table 1, and all experiments were conducted using deionized water with a resistivity exceeding 18.3 MΩ·cm.

    Table 1 Nucleotide Sequences Used in the Experiment

    Samples Collection and Processing

    Serum samples were collected from 30 healthy volunteers and 30 liver cancer patients at the Affiliated Taizhou Second People’s Hospital of Yangzhou University. The study protocol received ethical approval from the hospital’s Institutional Review Board, and all participants provided written informed consent in compliance with the Declaration of Helsinki guidelines. Following collection, blood samples were immediately centrifuged (12,000 rpm, 10 min, 4°C) to isolate serum, which was subsequently aliquoted and stored at −80 °C until analysis. Table 2 summarizes the demographic and clinical characteristics of all study participants.

    Table 2 Statistics of Sample Provider Information

    Synthesis of Platinum-Coated Gold (Au@Pt) and Preparation of Au@Pt@HP1

    First, the Au@Pt core-shell NPs were prepared by following a typical procedure with minor modifications.41 In this strategy, Au NPs were synthesized as the core. The aqueous HAuCl4 solution (0.5 mL, 1.0 wt.%) and ultrapure water (50.0 mL) were mixed. Trisodium citrate solution (0.8 mL, 1.0 wt.%) was rapidly injected into the boiling mixture. After the mixture was stirred for 10 min under boiling, ascorbic acid (1.0 mL, 0.1 M) and aqueous H2PtCl6 solution (1.25 mL, 1.0 wt.%) were introduced successively and were boiled for 25 min. The final solution changed from wine-red to brownish-black. The cooled mixture was washed three times by centrifugation at 10000 rpm/min. The Au@Pt was redispersed into ultrapure water and stored at 4 °C until use.

    To prepare Au@Pt@HP1, fresh TECP buffer (160 μL, 1 mM) was used to activate H1 (0.1 mM) on Au@Pt through a 12-hour reaction. The mixture was then dispersed in 80 μL of BSA solution (1 wt%) and incubated for 60 minutes, followed by purification at 9000 RPM for 25 minutes. This process yielded the final Au@Pt@HP1 complex.

    Synthesis of HP2@Fe3O4

    The capture probe was synthesized by modifying HP on the surface of Fe3O4. First, 500 mL of Fe3O4 (0.5 mg/mL) was measured in a test tube, and a magnet was placed at the bottom of the outer surface of the test tube after tilting the tube. 470 mL of PBS solution (10 mM) was added and the above steps were repeated several times after removing the supernatant. The carboxyl groups on the surface of MBs were activated with EDC (5 mL, 0.1 M) and NHS (5 mL, 0.1 M) at room temperature and incubated with shaking (500 rpm, 30 min). A drop of 10 mL of BSA solution (10 wt%) was added to seal the surface sites of Fe3O4. After rinsing with PBS, Fe3O4 was mixed with 470 mL of PBS solution, then TECP-activated HP2 was added and incubated for 12 hours. After repeated washing, the mixture was dispersed in PBS buffer to obtain HP2@Fe3O4.

    Optimal Peroxidase-Like Activity of Au@Pt@HP1-HP2@Fe3O4 Under Various Reaction Conditions

    To optimize the experimental conditions, the effects of reaction time, pH, TMB concentration, and H2O2 concentration on the SERS signal were systematically investigated. The influence of reaction time was studied by incubating a mixture of 40 mM TMB (40 μL), 10 M H2O2 (100 μL), and Au@Pt@HP1-HP2@Fe₃O₄ (100 μL) in a pH 4.0 buffer (1770 μL) for 0 to 20 minutes, followed by SERS spectra collection of the catalytic product oxTMB. The pH dependence was evaluated by adjusting the buffer pH from 3.0 to 8.0 while maintaining the same reactant concentrations and a 15-minute incubation period. For TMB concentration optimization, TMB solutions ranging from 0.5 to 1.0 mM were prepared in ethanol, mixed with 10 M H2O2 (100 μL) and Au@Pt@HP1@HP2@Fe₃O₄ (100 μL) in pH 4.0 buffer (1770 μL), and incubated for 15 minutes before SERS measurement. Similarly, the effect of H2O2 concentration was examined by varying its concentration from 0.1 to 0.8 mM in the reaction mixture, followed by a 15-minute incubation and SERS spectra acquisition. All SERS spectra of oxTMB were collected using a Raman spectrometer.

    SERS Signal Acquisition

    The SERS spectra of catalytic product oxTMB were collected using Raman spectrometer after incubation of 100 μL of freshly prepared H2O2 solution (10 M), 40 mM TMB solution (40 μL), and 100 μL of Au@Pt@HP1-HP2@Fe3O4 in acetic acid-sodium acetate buffer (1770 μL) at pH 4.0 for 15 min.

    Measurements and Characterization Techniques

    The main instruments used in the experiment included scanning electron microscopy (SEM, Hitachi S-4800), transmission electron microscopy (TEM, Philips Tecnai 12), field emission transmission electron microscopy (FE-TEM, FEI Tecnai G2 F30 S-TWIN), UV-Vis spectrophotometer (Cary 5000, Varian), and Raman spectrometer (Renishaw inVia Raman). Microscope). These instruments are used to characterize the morphology and structure of nanomaterials, as well as to perform SERS spectroscopy measurements and analysis. Raman spectra were obtained using a Renishaw inVia microscope with a 5 mW laser. SERS measurements were performed at 785 nm using a 50× objective, with a fixed exposure time of 10s for all experiments.

    Results and Discussions

    To systematically validate the proposed CHA-nanozyme-SERS integrated strategy (as illustrated in Scheme 1), the experimental results are presented through three hierarchical levels: (1) At the material characterization level, TEM, EDX and etc. analyses confirm the precise assembly of Au@Pt@HP1-HP2@Fe3O4; (2) At the molecular mechanism level, gel electrophoresis and enzyme kinetics verify the synergistic effects between CHA cycling and nanozyme catalysis; (3) At the clinical application level, the high concordance between serum tests from 30 liver cancer patients and qPCR results confirms the method’s reliability. This progressive demonstration directly addresses the two key challenges raised in the Introduction: the sensitivity (LOD=4.12 aM) and specificity of ctDNA detection.

    Scheme 1 Schematic representation of the detection principle and process.

    Characterization of Au@Pt@HP1-HP2@Fe3O4

    Figure 1A demonstrates that the synthesized Au@Pt nanoparticles exhibit uniform spherical morphology with an average diameter of 55 nm. SEM characterization (Figure 1B) reveals the Fe3O4 microspheres display well-defined spherical structures (200 nm diameter) with excellent size uniformity. This morphological consistency enabled the successful preparation of stable Au@Pt@HP1-HP2@Fe3O4 nanocomposites with controlled particle size distribution. The composite structure Au@Pt@HP1 was observed. Au@Pt was homogeneously dispersed on the surface of HP2@Fe3O4 with uniform morphology, structural integrity, and good dispersion, which had an extremely strong SERS enhancement effect (Figure 1C–F). HRTEM images of the Au@Pt@HP1 surface showing clear lattice fringes with a layer spacing of 0.24 nm corresponding to the {111} facets of Au and Pt are shown in Figure 2G. The SAED patterns of Au@Pt@HP1-HP2@Fe3O4 are shown in Figure 2H. The characteristic peak intensity of TMB at 1607 cm−1 was selected to study the SERS enhancement effect of Au@Pt@HP1-HP2@Fe3O4. As shown in Figure 2I, free TMB (1 mM) exhibited only baseline Raman signals, whereas the TMB@Au@Pt@HP1-HP2@Fe3O4 complex at 1 nM concentration generated intense characteristic peaks with significant signal enhancement. This dramatic improvement in SERS response demonstrates the excellent plasmonic activity of our Au@Pt@HP1-HP2@Fe3O4 nanocomposite system.

    Figure 1 Structural characterization diagrams of Au@Pt, Fe3O4 and Au@Pt@HP1@HP2@Fe3O4. (A) TEM images of Au@Pt and (B) SEM Fe3O4. (C and D) SEM and (E and F) TEM images of Au@Pt@HP1@HP2@Fe3O4. (G and H) HRTEM images and (I) SERS spectra of pure TMB and TMB+ Au@Pt@HP1@HP2@Fe3O4.

    Figure 2 Elemental analysis diagram for Au@Pt@HP1@HP2@Fe3O4. (A) HAADF-STEM images of Au@Pt@HP1-HP2@Fe3O4. (B–E) elemental mappings of Au@Pt@HP1-HP2@Fe3O4. (F) EDX spectra of the Au@Pt@HP1-HP2@Fe3O4.

    The HAADF-STEM image in Figure 2A clearly shows the structure of Au@Pt@HP1-HP2@Fe3O4. Figure 2B–E forms composite Au (blue), Fe (orange), Pt (green) and O (red) elemental maps to further show the specific elemental arrangement of Au@Pt@HP1-HP2@Fe3O4 and its structure. Platinum is densely coated on the surface of the gold particles in the form of granules. Figure 2F shows the EDX spectrum of Au@Pt@HP1-HP2@Fe3O4, which reveals that the complex contains the elements Au, Pt, Fe, and O. Among them, Au and Pt are composed of Au@Pt, Fe and O are mainly from Fe3O4, while the Cu peak is caused by the copper mesh that carries the sample.

    Evaluation of CHA Reaction

    To validate the CHA reaction for ctDNA detection and assess its performance, we conducted gel electrophoresis analysis using PIK3CA E542K as the model target (Figure 3). In lane 5, the appearance of HP1-HP2 was observed in the presence of PIK3CA E542K along with HP1 and HP2. Formation of the HP1-PIK3CA E542K product and release of the target strand were clearly observed when PIK3CA E542K and HP1 were placed in lane 6. The above experimental results indicate that CHA reactions were successfully performed in this study.

    Figure 3 Validation of CHA reactions by gel electrophoresis. Lane 1: Marker; Lane 2: PIK3CA E542K; Lane 3: HP1; Lane 4: HP1+HP2; Lane 5: HP1+HP2+PIK3CA E542K; Lane 6: HP1+PIK3CA E542K.

    Experimental Optimization

    Reaction conditions play a crucial role in the activity of Au@Pt@HP1-HP2@Fe3O4. Usually, the influencing factors of enzymatic reaction include temperature, pH and substrate concentration. Firstly, the effect of reaction time was investigated, as shown in Figure 4A. With the increase of time, the Raman characteristic peak intensity of ox-TMB at 1607 cm−1 gradually increased, and basically stopped changing after 15 min, Due to the instability of the oxTMB signal, the SERS signal gradually weakened after 15 min.42,43 Therefore, the optimal reaction time was set at 15 min. The effect of pH on the SERS signals was shown in Figure 4B. The peroxidase-like activity of Au@Pt@HP1-HP2@Fe₃O₄ nanocomposites exhibited strong pH dependence in the H2O2-TMB system. Quantitative SERS analysis revealed optimal catalytic performance at pH 4.0, with signal intensity increasing progressively from pH 3 to 4, then decreasing significantly across the pH 5–8 range. This pH-activity profile aligns with established literature reports demonstrating accelerated TMB oxidation kinetics in weakly acidic conditions (pH 3–5) compared to neutral or alkaline environments.44,45 By analyzing the effect of H2O2 concentration on the catalytic activity of Au@Pt@HP1-HP2@Fe3O4, the results are shown in Figure 4C. The relative activity of H2O2 concentration in the range of 0.1–0.5 mM showed an increasing trend, whereas it began to decrease at a concentration greater than 0.5 mM.46 It indicates that the catalytic activity has reached saturation at H2O2 concentration of 0.5 mM. In order to determine the effect of the concentration of TMB on the reaction, the concentration of TMB was investigated in the range of 0.5 to 1.0 mM. The results are shown in Figure 4D. The SERS signal reached its highest value at a TMB concentration of 0.8 mM. This is mainly due to the poor solubility of TMB in aqueous solution.47 Therefore, 0.8 mM was chosen as the optimal concentration. In summary, the optimal reaction time, pH, TMB concentration and H2O2 concentration were 15 min, 4, 0.8 mM and 0.5 mM, respectively.

    Figure 4 Optimization of H2O2 detection using Au@Pt@HP1-HP2@Fe3O4 in the presence of TMB. (A) Incubation time, (B) solution pH, (C) H2O2 concentration, (D) TMB concentration.

    Enzyme Catalytic Kinetics

    The peroxidase-mimetic activity of Pt@Au@HP1-HP2@Fe3O4was evaluated using the H2O2 -TMB catalytic system. Upon simultaneous addition of both H2O2 and Pt@Au@HP1-HP2@Fe3O4 to the TMB solution, an immediate color transition from colorless to blue was observed (Figure 5A), indicating rapid TMB oxidation. UV-vis spectroscopy confirmed this activity through the appearance of a characteristic absorption peak at 651 nm (Figure 5B), corresponding to the oxidized TMB product (oxTMB). These results unequivocally demonstrate the intrinsic peroxidase-like catalytic capability of the Pt@Au@HP1-HP2@Fe3O4 nanocomposite. The effect of different TMB concentrations on the catalytic reaction in the presence of Au@Pt@HP1-HP2@Fe3O4 was investigated. As shown in the Figure 5C, the absorbance increases with time at different TMB concentrations, and it is clear that the reaction speed increases with increasing TMB concentration. In addition, we evaluated the Michaelis-Menten kinetics of Au@Pt@HP1-HP2@Fe3O4 to gain further insight into its catalytic performance (Figure 5D). Compared with other reported nanozymes,48 Au@Pt@HP1-HP2@Fe3O4 exhibited a relatively lower Km (0.4089 mM) and higher Vmax (0.9533 μM/s), indicating that Au@Pt@HP1-HP2@Fe3O4 has desirable catalytic properties, It has a good affinity for the substrate.

    Figure 5 Characterization of the nanozyme-catalyzed TMB oxidation reaction. (A) Color of the different solutions in the presence and (B) UV−vis spectra of different reaction systems. (C) Plot of initial rate versus concentration of TMB. (D) Michaelis−Menten kinetic of Au@Pt@HP1-HP2@Fe3O4.

    Performance Evaluation

    The magnetic properties of the Au@Pt@HP1-HP2@Fe3O4 nanocomposites were systematically characterized to assess their applicability in SERS-based detection. When exposed to an external magnetic field, the composites were quickly drawn from the solution and aggregated, while the supernatant no longer catalyzed TMB (Figure 6A). This highlights the strong magnetic properties of Au@Pt@HP1-HP2@Fe3O4. The rapid magnetic separation capability simplifies washing and product isolation, enhancing assay efficiency and sensitivity. The system demonstrated excellent SERS signal reproducibility, with oxTMB exhibiting consistent Raman intensities (RSD = 4.1%) across multiple measurements (n=10) over 24 hours (Figure 6B and C). This remarkable stability highlights the robustness of the Au@Pt@HP1-HP2@Fe3O4 platform for quantitative analysis. To verify the homogeneity, SERS spectra of 10 randomly selected points on the same composite material were measured to evaluate uniformity (Figure S1). The results show that the peak intensities at all points are relatively consistent, and the relative standard deviation (RSD) at 1607 cm⁻¹ is 7.88% (Figure S2), indicating good homogeneity. Subsequently, five batches of composites were prepared at different times for the detection of PIK3CA E542K solution. The corresponding SERS spectra are shown in Figure 6D. It can be seen that the spectral waveforms are basically the same with almost no significant difference, and the RSD value of the SERS signal intensity of the characteristic peak at 1607 cm−1 is 4.26%, which demonstrates that the composite material has a good reproducibility and strengthens the confidence of the determination. In addition, the stability of the composite was explored. Over time, the SERS spectral profile showed no notable changes, with only a minor reduction in intensity. The signal stabilized after 6 days and maintained 91.72% of its original intensity even after 18 days (Figure 6E). This sustained signal demonstrates the composite’s long-term stability for assay applications. To evaluate the specificity, experiments included interference sequences such as a single-base mismatch (MT1), a three-base mismatch (MT3), and a random sequence. As shown in Figure 6F, the I1607/I1183 ratio of PIK3CA E542K is much larger than the signal intensity of the interfering sequences, which is the result of the specific binding of HP1 to PIK3CA E542K.

    Figure 6 Performance Evaluation. (A) Photographs of Au@Pt@HP1-HP2@Fe3O4 in a vessel without (left) and with (right) an external magnetic field; (B) Raman intensities of oxTMB at different time intervals (each spectrum in the same time period is the average of 10 acquisitions; (C) Consistency of Raman spectra of oxTMB at 1607 cm−1 wavelength for different time intervals within 60 min; (D) SERS spectra corresponding to different batches of SERS microfluidic chips; (E) line graphs of peak intensity at 1607 cm−1 after different storage times; (F) histograms corresponding to the ratio of peak intensities at 1183 cm−1 and 1607 cm−1 for specificity tests. Errors were calculated based on the standard deviation of three measurements.

    Quantitative Testing

    The assay’s sensitivity is vital for detecting low-abundance biomarkers, particularly in early-stage cancer diagnosis. To evaluate this, varying concentrations of PIK3CA E542K were spiked into serum samples, and the SERS signals were analyzed (Figure 7A). The results revealed a gradual decline in SERS intensity as the concentration increased. A strong linear correlation was observed between the logarithm of PIK3CA E542K concentration and the peak intensity at 1607 cm⁻¹, described by the equation: y = 4985.19x – 2821.85 (R² = 0.9928) (Figure 7B). The LOD was calculated based on the characteristic peaks of the SERS spectra using the following equation: where a and b were the variables obtained with a linear regression of the signal-concentration curve, SD was the standard deviation and Cblank is the SERS intensity of the blank sample.49 The detection limit of PIK3CA E542K was calculated to be 4.12 aM. This sensitivity places the proposed SERS microfluidic chip among the most advanced methods currently available (Table 3).

    Table 3 Comparison of the Proposed Method with Currently Reported Methods

    Figure 7 Quantitative analysis. (A) SERS spectra of different concentrations of PIK3CA E542K in serum; (B) linear relationship between the SERS signal intensity at 1607 cm−1 and the logarithm of PIK3CA E542K concentration.

    Characterization of Clinical Samples

    Magnetic resonance imaging (MRI) can provide multi-parameter, multi-sequence, and multi-directional images to evaluate the extent of liver cancer lesions. Due to its excellent contrast resolution for liver tissue, MRI can accurately and meticulously display the anatomical structure of the liver and its pathological features. Axial plane images can clearly demonstrate the characteristics of liver cancer (Figure 8A–C and 8E–G). On non-contrast T1-weighted sequences, liver cancer typically appears as hypointense or isointense, while on post-contrast scans, it shows significant enhancement in the arterial phase and a “wash-in and wash-out” pattern in the portal venous phase. Coronal plane images can clearly reveal the size, boundaries of the tumor, and its invasion into surrounding tissues or blood vessels (Figure 8D and H). The diagnosis of liver cancer primarily relies on pathological examination. Figure 8I–K shows pathological images of liver cancer, where disordered arrangement of tumor cells can be observed, with large and irregular nuclei, reduced cytoplasm, prominent nucleoli, and areas of necrosis or hemorrhage in some regions. The markedly abnormal cells exhibit an increased nuclear-to-cytoplasmic ratio, unclear intercellular connections, and areas of fibrous tissue hyperplasia or inflammatory cell infiltration.

    Figure 8 Pathologic findings in patients with liver cancer. (AH) MRI images of two patients with liver cancer. (IK) Pathological HE staining of liver cancer tissues.

    Real Sample Analysis

    To further test the reliability and accuracy of this SERS microfluidic chip in the analysis of clinical samples, it was utilized to detect the expression levels of PIK3CA E542K in serum samples from 30 healthy subjects and 30 liver cancer patients. The obtained spectra were processed to obtain the average spectra (Figure 9A), corresponding to the SERS signal intensities at 1607 cm−1 as shown in Figure 9B. It can be seen that the expression level of PIK3CA E542K was significantly elevated in the serum of liver cancer patients compared with that of healthy subjects. After that, the SERS signal intensity at 1607 cm−1 in the SERS spectrum was substituted into the linear regression equation to calculate the expression level of PIK3CA E542K. The accuracy of this assay was verified by comparing the results with those of the qRT-PCR assay (Table 4). The results showed that the assay was highly consistent with the results of qRT-PCR assay and had good detection accuracy.

    Table 4 The Results of SERS and qRT-PCR for Clinical Samples

    Figure 9 Plot of clinical samples tested by this method and comparison with qRT-PCR assay. (A) Average SERS spectra of sera from healthy subjects and liver cancer patients and (B) histograms of SERS signal intensity at the characteristic peaks of 1607 cm−1.

    Conclusion

    In this study, a highly sensitive method for the detection of ctDNA in the serum of liver cancer patients was successfully developed based on the CHA signal amplification strategy using the synthesized Au@Pt@HP1-HP2@Fe3O4 nano-enzyme complex. By modifying HP1 on the surface of Au@Pt and (HP2 with Fe3O4 magnetic beads, a multifunctional detection platform with magnetic separation, catalytic activity of the nano-enzymes, and SERS-enhanced effect was constructed. PIK3CA E542K was used as a target, and complementary pairing of HP1 and HP2 was triggered by CHA reaction. A large number of HP1-HP2 double-stranded structures were formed, while the released ctDNA continued to participate in the next round of cyclic reaction to achieve signal amplification. In comparison with existing detection technologies, we have for the first time organically integrated three techniques: catalytic hairpin assembly (CHA) cyclic amplification, gold-platinum nanozyme catalysis, and magnetic aggregation-based surface-enhanced Raman scattering (SERS), to construct a novel nanozyme-SERS detection platform that achieves multilevel signal amplification. The complex catalyzed the oxidation of colorless TMB by H2O2 to generate blue ox-TMB. A linear relationship between ctDNA concentration and signal intensity was established by detecting the signal intensity of the SERS characteristic peak of ox-TMB. The results showed that the detection limit of this method for PIK3CA E542K was as low as 4.12 aM, 2 orders of magnitude improvement over existing detection technologies. The assay can be completed in just 15 minutes, much faster than the hour-long cycle time of conventional sequencing methods. In addition, the platform exhibits excellent reproducibility, stability and specificity. Analysis of the clinical samples showed that the expression level of PIK3CA E542K in the serum of liver cancer patients was significantly higher than that of healthy subjects, and the detection results were highly consistent with qRT-PCR. In conclusion, the SERS microfluidic chip developed in this study combined with the CHA signal amplification strategy can efficiently and accurately determine the expression level of ctDNA, which provides a new technical means for the early diagnosis of liver cancer, and has an important potential for clinical application.

    Acknowledgments

    This study was financially supported by grants from the Social Development Foundation of Taizhou (TS202225); and the Key Research Institute of State Administration of Traditional Chinese Medicine (202259); General Program of Nantong Municipal Health Commission Research Project (MS2024111, MS2024112); Nantong University Special Research Fund for Clinical Medicine (2024LZ028).

    Disclosure

    There are no conflicts of interest in this study to declare.

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  • Platelet-Rich Plasma Therapy for Infertility Due to Premature Ovarian

    Platelet-Rich Plasma Therapy for Infertility Due to Premature Ovarian

    Introduction

    Infertility, defined as the inability to conceive following 12 months of consistent unprotected sexual activity, affects approximately 15% of couples worldwide and can lead to significant psychological and social consequences.1 The World Health Organization (WHO) reports that female infertility accounts for 37% of cases, male factors 8%, and both partners in 35%. Among women, ovulatory disorders, endometriosis, pelvic adhesions, tubal blockages, and hyperprolactinemia are frequent causes.2

    The European Society of Human Reproduction and Embryology (ESHRE) defines primary ovarian insufficiency (POI) refers to the loss of ovarian function before age 40, characterized by menstrual disturbances (amenorrhea or oligomenorrhea for at least 4 months) and persistently elevated follicle-stimulating hormone (FSH) levels (>25 IU/L on two occasions at least 4 weeks apart).3,4 Unlike menopause, POI may allow intermittent ovulation. The prevalence of POI rises with age, affecting approximately 1% of women by age 40. POI may be spontaneous or induced by medical interventions such as surgery, chemotherapy, or radiation.

    Ovarian failure can be classified as primary, due to intrinsic ovarian dysfunction (eg, surgical removal, hereditary disorders), or secondary, due to disruption in hormonal signalling from the hypothalamus or pituitary gland.5 Management guidelines from ESHRE) guidelines, emphasise a comprehensive, multidisciplinary approach to POI, including hormone replacement therapy (HRT) until the average age of natural menopause, fertility counselling, and monitoring for long-term health risks.3,4

    Despite various assisted reproductive technology (ART) methods, a significant proportion of embryo implantation attempts remain unsuccessful. Platelet-rich plasma (PRP) therapy is emerging as a promising adjunct treatment for patients with diminished ovarian reserve, including those with POI. Derived from autologous blood with platelet concentrations 4–5 times higher than baseline, PRP contains multiple cytokines and growth factors such as vascular endothelial growth factor (VEGF), transforming growth factor (TGF), platelet-derived growth factor (PDGF), and epidermal growth factor (EGF), which may stimulate ovarian tissue regeneration and improve ovarian function.6

    Current guidelines for the management of in vitro fertilization (IVF) and embryo transfer focus on maximizing success rates while minimizing risks such as multiple pregnancies and ovarian hyperstimulation syndrome (OHSS). PRP has been investigated not only for ovarian rejuvenation but also for improving endometrial thickness and implantation rates in cases of thin endometrium. Early studies suggest PRP enhances pregnancy outcomes by promoting a more receptive uterine environment.6

    This case series evaluates the effects of intraovarian PRP therapy on ovarian reserve markers and pregnancy outcomes in two women diagnosed with POI undergoing in vitro fertilization (IVF).

    Case Illustration

    Patient Selection and PRP Preparation

    This case series illustrates two patients with a history of infertility who underwent intraovarian PRP therapy followed by IVF. Both patients included in this case series fulfilled the diagnostic criteria for POI as defined by the ESHRE. These criteria include: age under 40 years, menstrual disturbance (oligomenorrhea or amenorrhea) for at least four months, and elevated follicle-stimulating hormone (FSH) levels >25 IU/L on at least two occasions. In both cases, AMH levels were significantly reduced (<1 ng/mL), and antral follicle count (AFC) was low. Neither patient had undergone bilateral oophorectomy nor had a history of exposure to gonadotoxic agents. Patients were selected for intraovarian PRP therapy based on spontaneous POI diagnosis, absence of identifiable secondary causes such as autoimmune disorders or chromosomal abnormalities, and their eligibility for IVF. Individuals with POI due to surgical causes, prior chemotherapy or radiotherapy, active pelvic infection, or uterine anomalies were excluded.

    PRP was prepared using the T-Lab autologous kit, involving 20–60 mL peripheral blood centrifuged to yield 4–8 mL PRP with platelet concentrations around 900,000/µL. PRP was injected intraovarian under sedation, 2–4 mL per ovary, administered twice per patient with sessions spaced one month apart. The PRP was used within two hours of preparation.

    Case 1

    Patient Characteristics

    A 25-year-old nulliparous woman with a history of ectopic pregnancy in 2021 and right salpingectomy presented to our IVF clinic with infertility concerns. Physical examination was normal, with a BMI of 25.53 kg/m². Initial laboratory tests indicated low AMH at 0.36 ng/mL (normal range: 1.0–4.0 ng/mL), elevated FSH at 13.3 mIU/mL (normal range for Day 2–3 of the menstrual cycle: 2.5–10.2 mIU/mL), and low luteinizing hormone (LH) at 2.48 mIU/mL (normal range: 1.9–12.5 mIU/mL). Transvaginal ultrasound performed on the second day of menstruation revealed an AFC of 2, with one follicle in each ovary (normal range for good ovarian reserve: 6–10 follicles per ovary). Hysterosalpingography indicated a non-patent right tube but a patent left tube. The husband’s semen analysis indicated teratozoospermia. Despite her regular menstrual history, her low AMH, high FSH, and low AFC indicated diminished ovarian reserve, meeting the criteria for POI per ESHRE guidelines. Consequently, ovarian PRP therapy was considered before IVF to enhance her ovarian response.5

    PRP Intervention

    The PRP was prepared using a T-Lab autologous platelet-rich plasma kit. Peripheral blood volumes of 40–60 mL were drawn per session, yielding 6–8 mL of PRP after centrifugation and extraction from the buffy coat layer. The platelet concentration was approximately 900,000/µL. Intraovarian PRP injections were administered under conscious sedation, with 2–4 mL injected per ovary. The patient underwent two PRP sessions spaced one month apart. After the first session, AMH increased to 0.46 ng/mL, FSH rose to 18.09 mIU/mL, and LH increased to 3.23 mIU/mL. Following the second session, AMH further increased to 0.63 ng/mL, and FSH decreased to 2.63 mIU/mL. PRP was prepared fresh for each session, using 20 mL of peripheral blood per procedure, with injections performed within two hours of preparation to maintain viability.

    IVF Outcome

    Patient received growth hormone, DHEA, folic acid, and vitamin D3 for 3 months before IVF stimulation. Controlled ovarian stimulation began on the third day of menstruation with clomiphene citrate for five days, followed by recombinant FSH (300 IU) and LH (150 IU). Cetrorelix acetate (0.25 mg) was administered from day 8. Growth hormone was continued daily until oocyte retrieval. Four oocytes were retrieved from four follicles, yielding one high-quality blastocyst that was cryopreserved. A frozen embryo transfer performed on August 6, 2023, resulted in a positive beta-hCG (547.26 mIU/mL) and ultrasound-confirmed fetal heartbeat, culminating in a successful pregnancy and live birth. Figures 1 and 2 shows an IVF Stimulation Chart Case 1. Figure 3 showed a blastocyst embryo was on good quality in case 1.

    Figure 1 IVF Stimulation Chart Case 1.

    Figure 2 The Frozen-embryo-transfer (FET) chart Case 1.

    Figure 3 The blastocyst embryo was on good quality in the first case-patient (A) thawing (B) assisted hatching.

    Case 2

    Patient Characteristics

    A 36-year-old nulliparous woman, married for seven years, presented with infertility. Her physical examination was normal, with a BMI of 27.38 kg/m². Laboratory evaluation revealed a low AMH of 0.25 ng/mL, elevated FSH of 18.52 mIU/mL, and low LH of 1.88 mIU/mL. Hysterosalpingography demonstrated bilateral tubal blockage. Transvaginal ultrasound on day 2 of menstruation showed an AFC of 3 (one follicle in the right ovary, two in the left), below the normal range of 6–10 follicles per ovary. The husband’s semen analysis indicated severe oligoteratozoospermia. The patient’s hormonal profile and ultrasound findings met the ESHRE diagnostic criteria for POI, characterized by hypergonadotropic hypogonadism. Given her history of regular menstruation earlier in life, secondary amenorrhea consistent with POI was diagnosed.

    PRP Intervention

    The patient received two ovarian PRP treatments administered between days 7 and 12 of the menstrual cycle. Each session involved drawing 20 mL of peripheral blood, centrifuged for 15 to 30 minutes to yield 4 mL of PRP from 10 mL of blood. The PRP was injected intraovarian within two hours of preparation. Following the first PRP treatment, AMH improved to 0.65 ng/mL, FSH decreased to 15.26 mIU/mL, and LH increased to 4.89 mIU/mL. After the second session, AMH rose further to 0.71 ng/mL, and FSH decreased to 8.52 mIU/mL.

    IVF Outcome

    Patient received growth hormone, DHEA, folic acid, and vitamin D3 for 3 months before IVF stimulation. Controlled ovarian stimulation began on the second day of menstruation with clomiphene citrate for five days, followed by recombinant FSH (300 IU) and LH (150 IU). Cetrorelix acetate (0.25 mg) was given starting day 7. Growth hormone administration continued daily until oocyte retrieval. Three oocytes were collected from four follicles, resulting in one high-quality blastocyst that was frozen. Frozen embryo transfer on May 31, 2023, led to a positive beta-hCG (187.08 mIU/mL) and confirmed fetal heartbeat on ultrasound, though the patient later experienced early pregnancy loss. Figures 4 and 5 shows the Frozen-embryo-transfer (FET) chart while Figure 6 shows a blastocyst embryo was on good quality in case 2.

    Figure 4 The Frozen-embryo-transfer (FET) chart Case.

    Figure 5 IVF Stimulation Chart Case 2.

    Figure 6 The blastocyst embryo was on good quality in the second case-patient (A) thawing (B) assisted hatching.

    Discussion

    POI affects 10–28% of cases primary amenorrhea and 4–18% of secondary amenorrhea, with significant psychological as well as physical impacts on affected women.7 Premature ovarian insufficiency (POI) is marked by disrupted folliculogenesis, which may present as a decreased follicle pool, increased follicular atresia, or defective recruitment mechanisms. These abnormalities contribute to a significantly reduced ovarian reserve and are a major cause of infertility in affected individuals.7–9

    The pregnancy rate in POI patients remains low (5–10%), despite advances in reproductive technologies, and traditional treatments such as ovarian stimulation protocols, androgen supplementation, and novel approaches like stem cell therapy or ovarian tissue autotransplantation have shown limited success. Recently, autologous platelet-rich plasma (PRP) ovarian injections have emerged as a promising therapeutic approach. PRP, rich in growth factors and cytokines such as VEGF, IGF, PDGF, and TGF-β, promotes angiogenesis, tissue regeneration, and cellular proliferation, potentially rejuvenating ovarian tissue and improving function.3 Concentrating cytokines and growth factors in PRP and injecting them directly into ovarian tissue is expected to improve ovarian function. Several prior studies reported increased ovarian angiogenesis, folliculogenesis, improved menstrual cycles, and improved ovarian function after PRP injection.3 Several studies have evaluated autologous PRP as proven to increase success in some cases of infertility.10–12

    In this report, we present two cases of POI patients treated with repeated intraovarian PRP injections followed by IVF stimulation. Both patients underwent standardized controlled ovarian stimulation protocols after PRP therapy, leading to the retrieval of oocytes, successful blastocyst formation, and positive pregnancy outcomes. Our findings align with previous studies demonstrating PRP’s potential to increase AMH levels, reduce FSH, enhance folliculogenesis, and improve pregnancy rates in women with diminished ovarian reserve (DOR).13,14

    Treatment Approaches

    Autologous PRP is derived by drawing a person’s blood from a peripheral vein, which is then centrifuged to eliminate red blood cells. This process aims to produce a concentrated platelet sample with growth factor levels 5 to 10 times higher than those released by activated platelets. The typical PRP preparation involves collecting whole blood, an initial centrifugation to separate and remove red blood cells, followed by another centrifugation to concentrate the platelets, and finally, adding a platelet agonist to activate the sample.11,15

    A post-PRP assessment was conducted to evaluate the parameters of AMH, FSH, and AFC. Stimulation is performed for the IVF program if it shows improvement. Following Farimani et al’s research involving 19 participants, it was found that the average number of oocytes before and after PRP injection was 0.64 and 2.1 respectively. Two patients experienced spontaneous pregnancy. The third case achieved clinical pregnancy and delivered a healthy baby. In cases of difficulty getting pregnant due to ovarian dysfunction, action is taken to inject PRP into both ovaries. The effect of PRP is increasing the number of ovarian oocytes, especially in women with poor ovarian reserve and POI, autologous intraovarian PRP therapy increases AMH levels and decreases FSH concentrations, with a trend of increasing live birth rates.16

    Similar effects were also found in women with chronic endometritis and recurrent implantation failure. Case of a 35-year-old woman with POI, six failed attempts after embryo transfer. The patient underwent FET of two blastocysts and succeeded in getting pregnant with twins. Four weeks after a positive β-hCG pregnancy test, clinical pregnancy was confirmed by observing fetal cardiac activity on transvaginal ultrasound. Twins were born at 36 weeks gestation with body weights of 2.28 kg and 2.18 kg.17

    PRP comprises many growth factors involved in the pathophysiology of ligament restoration, including VEGF, IGF-I, PDGF, hepatocyte growth factor (HGF), Transforming Growth Factor Beta (TGF-β), and Fibroblast Growth Factor (FGF).18 The primary benefits associated with the utilization of platelet-rich plasma (PRP) include its inherent autologous properties, absence of immunological responses and potential transmission of germs from the donor, its straightforward and expeditious preparation process (about 30 minutes from blood collection to application), and its cost-effectiveness However, it’s important to note that PRP therapy is contraindicated for patients with coagulation abnormalities, breastfeeding or pregnant women, individuals with cancer, active infections, and those on long-term use of non-steroidal anti-inflammatory drugs (NSAIDs).17

    In a prospective study by Cakiroglu et al, intraovarian injection of autologous platelet-rich plasma (PRP) was found to enhance ovarian response to stimulation and improve in vitro fertilization (IVF) outcomes in women diagnosed with primary ovarian insufficiency (POI). In this cohort, following PRP administration, 23 women (7.4%) achieved spontaneous conception, 201 women (64.8%) developed antral follicles and proceeded to IVF, while 87 women (27.8%) did not form antral follicles and, thus, received no further intervention. However, this study utilized only a single PRP injection without any follow-up interventions until conception was achieved.19

    The current study builds upon this by evaluating the effects of multiple PRP injections in POI patients, allowing us to assess whether repeated treatments lead to improved ovarian function and clinical outcomes. The presentation of these cases typically involved amenorrhea and low serum estrogen levels with elevated gonadotropins, consistent with POI diagnosis. Over the course of treatment, we observed variable responses to repeated PRP injections, with some patients demonstrating sustained follicular development and improved ovarian reserve markers, while others had limited responses.

    The two cases in this series exhibited distinct baseline characteristics, including differences in age, ovarian reserve markers (such as AMH and FSH), and duration of amenorrhea, which likely influenced their respective responses to repeated PRP injections and IVF outcomes. Younger patients with relatively higher AMH levels and shorter duration of amenorrhea tended to show more robust follicular development and better clinical responses, consistent with existing evidence that age and ovarian reserve are key predictors of fertility treatment success in POI. Conversely, patients with more advanced age and lower baseline ovarian reserve demonstrated more modest improvements, underscoring the heterogeneity of POI and the need for individualized treatment protocols.20 Understanding these patient-specific factors is crucial in interpreting clinical outcomes and optimizing PRP therapy for ovarian rejuvenation.

    Comparing our findings with the initial Cakiroglu study and other case reports in the literature, which primarily focus on single PRP administrations,19,21,22 our study suggests that multiple PRP injections may offer a more sustained benefit in follicular activation and ovarian responsiveness. This approach could potentially shift the clinical management of POI by introducing a novel protocol for ongoing ovarian stimulation and improving IVF outcomes for patients with diminished ovarian reserve.

    According to standard operational procedure for PRP injection in our fertility clinic, PRP injection is administered when the AMH level falls below 0.5 ng/mL, indicating an inadequate ovarian reserve.17,19,23,24 AMH levels less than 0.5 ng/mL is predictive of reduced success in management of infertility, therefore the target of AMH >0.5 ng/mL is crucial.25 The choice to administer numerous PRP injections was made since case 1 had a low AMH level (<0.5 ng/mL) after 1 month of follow-up, and case 2 had a low AMH level (<0.5 ng/mL) after 3 months of follow-up.

    Despite the promising observations in this case series, several limitations should be considered. The small sample size of only two patients restricts the generalizability of our findings and limits the ability to draw definitive conclusions about the efficacy of repeated PRP injections. Moreover, as a case series without a control group, it is difficult to exclude the possibility that clinical improvements may be influenced by confounding factors or natural variations in ovarian function. Variability in individual responses to IVF and PRP treatment further complicates interpretation. Larger, controlled studies with longer follow-up are needed to confirm these preliminary findings and to establish standardized treatment protocols.

    To best of our knowledge, no prospective or randomized controlled trials have evaluated the impact of numerous platelet-rich plasma injections on primary ovarian insufficiency in women undergoing in vitro fertilization. Furthermore, there was a lack of established standard protocol for PRP injection in patients with POI. From this case series, we can infer that the timing of the second ovarian PRP injection may also influence the result of pregnancy. Additional research with a prospective approach, involving a large population and multiple centers, is necessary.

    Conclusion

    Platelet-rich plasma (PRP) treatment represents a promising therapeutic approach to enhance ovarian reserve and improve reproductive outcomes in patients with primary ovarian insufficiency (POI), especially those preparing for in vitro fertilization (IVF). Our case series suggests that repeated PRP injections, particularly the timing of the second injection, may influence clinical pregnancy outcomes. However, due to the limited sample size and observational nature of this study, further prospective research with larger cohorts and standardized protocols is essential to validate these findings and clarify the impact of PRP on key clinical endpoints such as pregnancy rates, live birth rates, and ovarian function recovery.

    Informed Consent Patient Statement

    No formal ethical clearance was required for the publication of this case. The authors confirm that written informed consent for publication of this case report and any accompanying images was obtained from the patient and her spouse. The patient was informed in detail about the case content and agreed to its publication. All personal identifiers have been removed to ensure patient anonymity.

    Disclosure

    The authors report no conflicts of interest in this work.

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  • German exports fall more than expected in May as US tariffs hit – Reuters

    1. German exports fall more than expected in May as US tariffs hit  Reuters
    2. German Exports Fall More Than Expected as US Shipments Sink  Bloomberg.com
    3. German Exports Fall Again as Tariffs Drag on Economy  WSJ
    4. German exports drop as US shipments decline ahead of tariff deadline  Yahoo Finance
    5. German Trade Surplus Above Estimates  TradingView

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  • Target ID & Validation in Novel Immune Cells using CRISPR Screening

    Target ID & Validation in Novel Immune Cells using CRISPR Screening

    Target ID & Validation in Novel Immune Cells using CRISPR Screening

    This poster demonstrates the use CRISPR screening in primary human immune cells to identify and validate novel targets in the therapeutic areas of autoimmune & inflammation and immuno-oncology.

    Key highlights of the poster include:

    • details of the CRISPR screening methods in specific immune cells
    • the presentation of a case study based on a CRISPR/Cas9 screening platform in primary human T cells used to identify novel Treg modulating targets
    • information on the functional assays used to validate the relevance of the target in the cell type of interest

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  • Ashes of Risotto Rice Husk in Tires: Continental Focuses on More Sustainable Fillers

    Ashes of Risotto Rice Husk in Tires: Continental Focuses on More Sustainable Fillers

    Continental obtains both materials in proportion from recycled or renewable sources in order to reduce resource consumption. Silica, a filler required to achieve optimal grip and reduced rolling resistance, can be obtained from rice husks instead of quartz sand. The husks are an agricultural by-product from the production of risotto rice, for example. For the raw material carbon black, Continental relies on three innovative processes. Firstly, carbon black can be produced from bio-based alternatives such as tall oil, a waste product from the paper industry, instead of crude oil. Secondly, it can be produced from recycled raw materials such as pyrolysis oil from end-of-life tires. Thirdly, a particularly efficient pyrolysis process enables the recovery of carbon black directly from end-of-life tires. 

    “Innovation and sustainability go hand in hand at Continental. Using silica from the ashes of rice husks in our tires shows that we are breaking completely new ground – without compromising on safety, quality or performance,” says Jorge Almeida, head of Sustainability at Continental Tires.

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