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INTRODUCTION: The Anemia Control Model (ACM) is a certified medical device suggesting the optimal ESA and iron dosage for patients on hemodialysis. We sought to assess the effectiveness and safety of ACM in a large cohort of hemodialysis patients. METHODS: This is a retrospective study of dialysis patients treated in NephroCare centers between June 1, 2013 and December 31, 2019. We compared patients treated according to ACM suggestions and patients treated in clinics where ACM was not activated. We stratified patients belonging to the reference group by historical target achievement rates in their referral centers (tier 1: <70%; tier 2: 70-80%; tier 3: >80%). Groups were matched by propensity score. RESULTS: After matching, we obtained four groups with 85,512 patient-months each. ACM had 18% higher target achievement rate, 63% smaller inappropriate ESA administration rate, and 59% smaller severe anemia risk compared to Tier 1 centers (all p < 0.01). The corresponding risk ratios for ACM compared to Tier 2 centers were 1.08 (95% CI: 1.08-1.09), 0.49 (95% CI: 0.47-0.51), and 0.64 (95% CI: 0.61-0.68); for ACM compared to Tier 3 centers, 1.01 (95% CI: 1.01-1.02), 0.66 (95% CI: 0.63-0.69), and 0.94 (95% CI: 0.88-1.00), respectively. ACM was associated with statistically significant reductions in ESA dose administration. CONCLUSION: ACM was associated with increased hemoglobin target achievement rate, decreased inappropriate ESA usage and a decreased incidence of severe anemia among patients treated according to ACM suggestion.
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Anemia , Eritropoetina , Hematínicos , Humanos , Diálise Renal/efeitos adversos , Hematínicos/uso terapêutico , Hematínicos/efeitos adversos , Estudos Retrospectivos , Anemia/tratamento farmacológico , Anemia/etiologia , Eritropoetina/uso terapêutico , Eritropoetina/efeitos adversos , Hemoglobinas/análiseRESUMO
A major challenge in inverse design of optical splitters is to efficiently reach platform nonspecific designs constrained to multiple functional requirements: arbitrary splitting ratio, low insertion loss, broad bandwidth and small footprint. While the traditional designs fail to fulfill all these requirements, the more successful nanophotonic inverse designs require substantial time and energy resources per device. Here, we present an efficient inverse design algorithm that provides universal designs of splitters compliant with all above constraints. To demonstrate the capabilities of our method, we design splitters with various splitting ratios and fabricate 1 × N power splitters in a borosilicate platform by direct laser writing. The splitters show zero loss within the experimental error, competitive imbalance of <0.5 dB and broad bandwidth in the range 20 - 60 nm around 640 nm. Remarkably, the splitters can be tuned to achieve different splitting ratios. We further demonstrate scaling of the splitter footprint and apply the universal design to silicon nitride and silicon-on-insulator platforms to achieve 1 × 5 splitters with the footprints as small as 3.3 µm × 8 µm and 2.5 µm × 10.3 µm, respectively. Owing to the universality and speed of the design algorithm (several minutes on a standard PC) our approach renders 100 greater throughput than nanophotonic inverse design.
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The current study aimed to phytochemically characterize (including a detailed phenolic profile) two endemic Balkan's species (Hieracium waldsteinii and Onosma stellulata) and determine their possible application as a source of natural antioxidant and antimicrobial agents. The main phenolic compound in both species (in all examined parts) was chlorogenic acid. Eriodictyol, genistein and naringenin were quantified only in H. waldsteinii while isorhamnetin-3-O-rutinoside and sinapic acid were characteristic for O. stellulata. The highest antioxidant activity (98â mg AAE/g dry weight for TAC assay) was ascribed to the flower extract of H. waldsteinii while the lowest results (â¼4.3â mg AAE/g dry weight for FRP assay) were exhibited by the extracts obtained from the plant's stem. Antimicrobial assays showed moderate antibacterial, i. e., moderate/strong activity against several tested fungi (in particular Trichoderma viride). Correlation analysis revealed strong positive connection between phenolic compounds and reducing power of extracts as well as between total phenolic and flavonoid content and the obtained minimal inhibitory concentration recorded in antibacterial assays.
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Asteraceae , Boraginaceae , Antibacterianos/análise , Antibacterianos/farmacologia , Antioxidantes/química , Asteraceae/química , Boraginaceae/química , Fenóis/química , Extratos Vegetais/química , Extratos Vegetais/farmacologiaRESUMO
AIM: Artificial neural network (ANN) development to find optimal carriers (pea protein-P, maltodextrin-M, and inulin-I) mixture for encapsulation of pumpkin waste bioactive (ß-carotene and phenolics). METHODS: Freeze-drying encapsulation and encapsulates characterisation in terms of bioactive contents and encapsulation efficiencies, water activity, hygroscopicity, densities, flowability, cohesiveness, particle size (laser diffraction), solubility, colour (CIELab), morphological (SEM), stability and release properties. RESULTS: Optimal encapsulates, OE-T (with highest total bioactive contents; P, M, and I of 53.9, 46.1, and 0%w/w) and OE-EE (with highest bioactive encapsulation efficiencies; P, M, and I of 45.5, 32.0, and 22.5%w/w) had particle diameters of 94.561 ± 1.341 µm and 90.206 ± 0.571 µm, the span of 1.777 ± 0.094 and 1.588 ± 0.089, highest release at pH 7.4 of phenolics of 71.03%w/w after 72 h and 66.22%w/w after 48 h, and ß-carotene of 43.67%w/w after 8 h and 48.62%w/w after 6 h, respectively. CONCLUSION: ANN model for prediction of encapsulates' preparation, showed good anticipation properties (with gained determination coefficients of 1.000).
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Cucurbita , Antioxidantes/química , Cucurbita/química , Liofilização , Fenóis , beta Caroteno/químicaRESUMO
Research background: By tailoring dietary fibre's structural and physicochemical properties, their functionality and applicability can be remarkably increased. One of the approaches used in this respect is fibre particle size reduction. Accordingly, the present study explores the impact of short-time micronization in a planetary ball mill on structural and thermal changes of modified and commercial sugar beet fibre, inulin and sucrose for their potential application as food excipients. Experimental approach: Short-time micronization in a planetary ball mill (30 and 60 min) was applied for particle size reduction of modified and commercial sugar beet fibre, inulin and sucrose as less energy-consumptive and less destructive approach than long-time micronization. Dietary fibre and sucrose samples were characterised in terms of particle size, morphology, intermolecular bonds and presence of functional groups, crystallinity and thermal properties, before and after the short-time micronization. Results and conclusions: Particle size was successfully reduced to micron-scale already after 30 min of micronization in most of the samples without significant changes in thermal properties and crystallinity or present functional groups. An enhanced particle size decrease with prolonged micronization time (60 min) was noticed in modified sugar beet fibre with slightly wider particle size distribution than in other examined samples. Furthermore, morphology and exposure of the present functional groups in samples were altered by the micronization, which is favourable for their further application as excipients in the food matrix. Novelty and scientific contribution: The corresponding research reports the short-time micronization impact on sugar beet fibre and modified sugar beet fibre, inulin and sucrose for the first time, hence contributing to the widening of their application as excipients in diverse products.
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Resistant starch (RS) is a part of insoluble dietary fiber, and it could be recognized as a functional food ingredient in some types of confectionery products that lack dietary fiber. Unlike dark and milk chocolate, white chocolate does not contain fat-free cocoa solids rich in dietary fiber. In the present study, 5%, 10%, and 15% of white chocolate were substituted with RS in order to improve the nutritional value of enriched white chocolate. The influence of RS on rheological, textural, and thermal properties of the chocolate fat phase was firstly investigated, and then further influence on physical properties, dietary fiber content, and sensory characteristics of enriched white chocolates were investigated. The obtained results showed that enriched chocolates had increased content of total dietary fiber and reduced total fats and protein content in accordance with the added amount of RS. At the same time, RS increased viscosity and reduced the hardness and volume mean diameter in enriched chocolates in accordance with the added amount. RS improved the nutritional composition of white chocolate by increasing the content of dietary fiber. At the same time, RS did not impair the color and sensory characteristics of enriched white chocolates.
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Antioxidantes/metabolismo , Chocolate/análise , Chocolate/classificação , Fibras na Dieta/análise , Amido Resistente/metabolismo , Reologia , Paladar/fisiologia , Alimento Funcional/análise , Humanos , ViscosidadeRESUMO
Influence of the milling parameters on the reduction process of the wheat middlings by the smooth rolls was investigated. Three level and four variables Box-Behnken experimental design with response surface methodology was applied in order to evaluate effects of milling parameters and to optimize grinding conditions for various responses. As independent variables roll gap (0.04-0.1 mm), differential (1.1.-1.9), roll speed (300-500 rpm) and feed rate (0.2-0.4 kg/cm min) were employed. Responsive variables were flour yield, ash content and energy consumption. In order to optimize milling process adequate models were obtained by regression analysis. Possibilities of the optimization of the milling parameters in order to obtain different combination of the desired outputs are illustrated by four examples.
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Petroselinum crispum Mill., Fuss., is a culinary vegetable used as an aromatic herb that garnishes and flavours a great variety of dishes. In the present study, the chemical profiles and bioactivities of leaf samples from 25 cultivars (three types: plain- and curly-leafed and turnip-rooted) from this species were assessed. Seven phenolic compounds were identified in all the varieties, including apigenin and kaempherol derivates. Apigenin-O-pentoside-O-hexoside was the major compound in all the tested parsley types (20, 22 and 13 mg/g of extract, respectively) and responsible for its excellent antioxidant activity, also investigated in this study. Antimicrobial activities were also explored, and the results revealed a good bioactivity against specific tested pathogens, such as bacteria and fungi. In conclusion, the leaves of all the types of P. crispum are a good source of natural bioactive compounds that confer health benefits, and thus, they should be part of a balanced and diversified diet.
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Anti-Infecciosos/farmacologia , Antioxidantes/farmacologia , Brassica rapa/química , Petroselinum/química , Fenóis/farmacologia , Extratos Vegetais/farmacologia , Folhas de Planta/químicaRESUMO
The THz beamline at FLASH, DESY, provides both tunable (1-300â THz) narrow-bandwidth (â¼10%) and broad-bandwidth intense (up to 150 uJ) THz pulses delivered in 1â MHz bursts and naturally synchronized with free-electron laser X-ray pulses. Combination of these pulses, along with the auxiliary NIR and VIS ultrashort lasers, supports a plethora of dynamic investigations in physics, material science and biology. The unique features of the FLASH THz pulses and the accelerator source, however, bring along a set of challenges in the diagnostics of their key parameters: pulse energy, spectral, temporal and spatial profiles. Here, these challenges are discussed and the pulse diagnostic tools developed at FLASH are presented. In particular, a radiometric power measurement is presented that enables the derivation of the average pulse energy within a pulse burst across the spectral range, jitter-corrected electro-optical sampling for the full spectro-temporal pulse characterization, spatial beam profiling along the beam transport line and at the sample, and a lamellar grating based Fourier transform infrared spectrometer for the on-line assessment of the average THz pulse spectra. Corresponding measurement results provide a comprehensive insight into the THz beamline capabilities.
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BACKGROUND: Many studies have described cocoa polyphenols as being bioactive compounds with a potential positive effect on human health. Although dark chocolate is a most powerful source of antioxidants, their content is lower in milk chocolate; conversely, in white chocolate the fat-free cocoa solids are omitted. The aim of this study was to increase polyphenol content and antioxidant capacity of white chocolate by adding encapsulated green tea extract (GTE) in amounts of 60, 80 and 100 g kg-1 . RESULTS: GTE influenced the particle size parameters, increasing the volume weighted mean from 15.43 µm in white chocolate to 19.34 µm in chocolate with 100 g kg-1 GTE. At the same time, the viscosity of enriched chocolate also increased owing to the addition of new solid particles. The surface color of enriched chocolates changed in accordance with the amount of encapsulate, where all enriched chocolates had a slightly lighter color after 12 months of storage. Total polyphenol content (mg gallic acid equivalents (GAE) kg-1 ) increased from 0.41 in white chocolate to 2.73 in chocolate enriched with maximal GTE. This amount of GTE increased antioxidant capacity (mmol Trolox equivalents kg-1 ) from 1.22 in white chocolate to 16.12. After 12 months of storage, degradation of polyphenols was found to be a maximum of 37.27%, while antioxidant capacity decreased up to 44.14%. CONCLUSION: In addition to the impact on chocolate viscosity, GTE added value through the polyphenol content and sensorial profile of the new product with an unusual green tea flavor and a shelf life of at least 12 months. © 2019 Society of Chemical Industry.
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Cacau/química , Camellia sinensis/química , Chocolate/análise , Aditivos Alimentares/análise , Extratos Vegetais/análise , Antioxidantes/análise , Manipulação de Alimentos , Humanos , Polifenóis/análise , Paladar , ViscosidadeRESUMO
In this study sour cherry pomace was extracted with food-grade solvent (50% ethanol), concentrated and stabilized in whey and soy proteins by encapsulation. Soy proteins exhibited higher encapsulation efficiency (94.90%), but not significantly (p < 0.05), from whey (90.10%). Storage properties of whey (WP) and soy protein (SP) encapsulates in terms of total polyphenols, anthocyanins and antioxidant activity were tested for 6 weeks. At the end of storage period the retention of polyphenols in SP and WP was similar (67.33 and 69.30%, respectively), while the content of anthocyanins has increased in SP (for 47.97%) and decreased in WP (for 1.45%). The decrease in antioxidant activity in SP (12.22%) was lower than in WP (35.04%). Colour parameters of encapsulates have followed the similar trend as anthocyanin change during storage. The technique reported herewith can be used for obtaining quality encapsulates for their use as functional food additives, as a way of fruit waste valorization.
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Liofilização , Extratos Vegetais , Prunus avium , Antocianinas , Antioxidantes , Frutas , PolifenóisRESUMO
In this Letter, a multiport directional optical coupler based on periodic energy exchange in a linear waveguide array is proposed. The periodic power transfer is achieved by choosing waveguide separations that render commensurate eigenvalues of the array coupling matrix. This is a general solution and offers a plethora of possibilities. Particularly interesting is an array that can be used to realize different couplers by simply choosing a different input waveguide. The proposed design principle is validated by full numerical simulations of realistic devices and the required fabrication precision is estimated. The proposed couplers are of interest for quantum optics, biosensing, and communications.
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Dispositivos Ópticos , Interferometria , Fenômenos ÓpticosRESUMO
Laetiporus sulphureus is a saprophyte belonging to a specific group of wood-decomposing Basidiomycetes growing on deciduous trees. This fungus has been characterized as a herbal medicine and is also known for its antimicrobial properties. In the present study, high energy extraction techniques using different solvents were compared to obtain maximum yield of the edible fungus Laetiporus sulphureus total lipids. The lipid classes and fatty acid composition of the fruiting bodies' total lipids has been studied using GC-FID and Iatroscan TLC-FID analysis. Among the lipids, the neutral lipids predominated followed by phospholipids and glycolipids. Triglycerides were the most abundant in the neutral lipid fraction, whereas phosphatidylcholine in phospholipids. The existence of relatively high amount of sterols may be correlated to fungus pharmaceutical properties. Total lipids were found to contain high unsaturated degree fatty acids (UFA/SFA>3.4) and dominated of C18:2ω-6, C18:1ω-9 and C16:0 fatty acids. Antibacterial and antifungal properties of mushrooms' lipid extracts from two different solvents were also examined. Results indicated that hexane extracts possessed better antifungal and slightly better antibacterial activity compared to chloroform extracts though both were less active than the commercial antimicrobial agents.
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A very well-known and appreciated mushroom, Agrocybe aegerita (Brig.) Sing, was the subject of chemical profiling, antioxidant assays and sensory evaluation test in cream cheese. Methanolic extract obtained from a wild sample of A. aegerita fruiting body was fully chemically identified. Sample was found to be rich in carbohydrates (84.51 g/100 g dw), ash and proteins (6.69 g/100 g dw and 6.68 g/100 g dw, respectively). Trehalose was the main free sugar while malic acid was the most abundant organic acid. Four isoforms of tocopherols were identified; γ- tocopherol was the dominant isoform with 86.08 µg/100 g dw, followed by ß- tocopherol, δ-tocopherol and α-tocopherol (8.80 µg/100 g dw, 3.40 µg/100 g dw and 2.10 µg/100 g dw, respectively). Polyunsaturated fatty acids were predominant, with linoleic acid as the most prominent one (78.40 %). Methanolic extract of chestnut mushroom exhibited high antioxidant activity. Sensory evaluation test included grading by panelists and comparing the overall acceptability of cream cheese alone and enriched cream cheese with dry powder of A. aegerita. General conclusion of the participants was that the newly developed product was more likeable in comparison to cream cheese alone. Due to the health-beneficial effects of antioxidants and wealth of chemically identified nutrients, A. aegerita is a promising starting material for incorporation on larger scale products.
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Goal: Clinical interpretation of an electrocardiogram (ECG) can be detrimentally affected by noise. Removal of the electromyographic (EMG) noise is particularly challenging due to its spectral overlap with the QRS complex. The existing EMG-denoising algorithms often distort signal morphology, thus obscuring diagnostically relevant information. Methods: Here, a new iterative regeneration method (IRM) for efficient EMG-noise suppression is proposed. The main hypothesis is that the temporary removal of the dominant ECG components enables extraction of the noise with the minimum alteration to the signal. The method is validated on SimEMG database of simultaneously recorded reference and noisy signals, MIT-BIH arrhythmia database and synthesized ECG signals, both with the noise from MIT Noise Stress Test Database. Results: IRM denoising and morphology-preserving performance is superior to the wavelet- and FIR-based benchmark methods. Conclusions: IRM is reliable, computationally non-intensive, fast and applicable to any number of ECG channels recorded by mobile or standard ECG devices.
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Medicinal and aromatic plants' properties, still an interesting research area, are attributed to the presence of various specialized products that possess important pharmacological activities. In the present study, six medicinal/aromatic plants (Sideritis cypria, Origanum dubium, Melissa officinalis, Mentha piperita, Thymus capitatus, and Salvia fruticosa) were evaluated for their phytochemical and nutritive composition, as well as their biological activities, including antioxidant, antimicrobial, and cytotoxic properties. The results obtained indicate that M. piperita was rich in proteins and minerals such as N and Mg, while S. cypria accumulated more K, Na, P, and Ca. The highest content of phenols and flavonoids was observed in M. piperita, followed by O. dubium and T. capitatus, which eventually influenced their high antioxidant capacity. NMR screening revealed the presence of (i) triterpenoids and hydroxycinnamic acid derivatives in M. officinalis; (ii) terpenoids, flavonoids, and phenolic acid derivatives in S. fruticosa; (iii) flavonoids and phenolic acid derivatives in M. piperita; (iv) phenolic monoterpenes in O. dubium and T. capitatus; and (v) terpenoids, flavones, and phenylethanoid glycosides in S. cypria. The results of the antimicrobial activity showed that the tested samples overall had quite good antimicrobial potential. High antibacterial activity was found in O. dubium and T. capitatus, while O. dubium and S. cypria exhibited great antifungal activities. The studied species also had an important effect on the viability of female-derived and colon cancer cells. In particular, in colon cancer cells, the extracts from T. capitatus, M. officinalis, M. piperita, and S. fruticosa exhibited a stronger effect on cell viability in the more metastatic cell line at significantly lower concentrations, indicating an important therapeutic potential in targeting highly metastatic tumors. This finding is worth further investigation. The present study unveiled interesting phytochemical profiles and biological properties of the six medicinal/aromatic plants, which should be further explored, contributing to green chemistry and the possible creation of natural health products for humans' health/nutrition and additives in cosmetics.
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BACKGROUND: Three pure compounds that naturally occur in plants were of particular interest to our study regarding the possibility of using them as food preservatives: p-coumaric acid (found in peanuts, tomatoes, carrots, garlic, wine, vinegar, etc.), caffeic acid (found in argan oil, oats, wheat, rice and olive oil) and rutin (found in asparagus, citrus fruits, berries, apple, apricot, asparagus, beef and beer). In the following study we investigated in situ antioxidant and antimicrobial activities of three pure compounds, namely caffeic acid, p-coumaric acid and rutin, naturally occurring in plants. RESULTS: Two food systems were used in order to obtain information on how these compounds react in actual food systems rather than microbiological media. The results indicated good antioxidant activity in in situ food systems. For tested phenolic compounds it was further shown that they successively inhibited the development of the isolated food contaminant Staphylococcus aureus in chicken soup. Panelist found that organoleptic characteristics of chicken soup and pork meat improved after treatment with phenolics. CONCLUSION: Our findings alone, along with the potential use of phenolic compounds that are widespread in nature, may imply their potential use as preservatives in the food industry.
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Anti-Infecciosos , Antioxidantes , Ácidos Cafeicos , Ácidos Cumáricos , Plantas/química , Rutina , Animais , Ácidos Cafeicos/farmacologia , Galinhas , Ácidos Cumáricos/farmacologia , Microbiologia de Alimentos/métodos , Conservantes de Alimentos , Carne/microbiologia , Propionatos , Rutina/farmacologia , Sensação , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento , SuínosRESUMO
Summary of background: Dementia is among the leading causes of death and disability worldwide, having a major impact not only on the affected person but also on all of society. The Internet is a popular and growing source of health-related information for patients, family members, carriers, and physicians. TikTok, one of the most popular social media platforms, is an important source for knowledge access and adoption. However, the quality of health information on TikTok has not been sufficiently studied. Objective: To evaluate the quality of the information provided in the most popular videos on dementia shared on TikTok. Study design: A cross-sectional study. Methods: The top 100 most popular videos on TikTok obtained by searching the hashtag "dementia" were included in the study and grouped based on their source and content. The popularity of the videos was estimated based on the numbers of likes, comments, and shares. The quality of health-related information was evaluated using the DISCERN score and the Global Quality Score (GQS). Results: Videos had a median duration of 33.29 s; the median number of likes was 635,100, with a total of 93,698,200 likes, 903,859 comments, and 5,310,912 shares. The source (uploader) of 65% of the videos was family members, while only 4% were uploaded by doctors. The content was lifestyle-related in 62% of the videos, while 12% of the videos were for fun. Videos had a median DISCERN score of 22.5 (IQR 20-27) and a median GQS of 2 (IQR 1-3). The videos uploaded by doctors had the highest quality scores and the lowest popularity. Conclusion: The most popular dementia videos on TikTok are mostly shared by family members and are of poor quality. Given the major public health issues associated with dementia, experts must provide appropriate and active assistance to patients in interpreting the information identified.
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Demência , Mídias Sociais , Humanos , Estudos Transversais , Emoções , FamíliaRESUMO
Plant extracts and other plant products have been used as an alternative to synthetic fungicides or an additional way to reduce their use. The choice of plant extracts and their application depends on their functional characteristics, availability, cost-effectiveness, and their impact on phytopathogens, and also on the environment. Therefore, the present study aims to assess the potential of Celtis australis methanolic extracts as source of compounds with antifungal activity. Methanolic extracts prepared from leaves and unripe mesocarps of C. australis collected from different localities of Montenegro (Podgorica-PG, Donja Gorica-DG, and Bar-BR) were evaluated for their phenolic compounds' composition as well as antifungal and cytotoxic properties. Obtained results revealed that extracts contain various bioactive constituents including phenolic acids, flavonoids, and their derivatives. The predominant phenolic acid was ferulic acid, identified in leaf samples from DG (187.97 mg/100 g dw), while isoorientin was the most abundant phenolic compound found in all examined samples. Regarding antifungal potential of the tested samples, all but one (prepared from mesocarp BR) possessed higher activity than Previcur, a commercial systemic fungicide intended to control seedlings. In vitro studies on HaCaT cell line showed that the extracts had no toxic effect toward the tested cell line. These results lead to the conclusion that methanolic extracts of C. australis can become an alternative to the use of synthetic fungicides in agriculture. Those extracts represent natural biodegradable fungicides and enable more efficient control of pathogenic fungi.
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This narrative review paper provides an up-to-date overview of the potential of novel synthetic and semisynthetic compounds as antibacterials that target virulence traits in resistant strains. The review focused on research conducted in the last five years and investigated a range of compounds including azoles, indoles, thiophenes, glycopeptides, pleuromutilin derivatives, lactone derivatives, and chalcones. The emergence and spread of antibiotic-resistant bacterial strains is a growing public health concern, and new approaches are urgently needed to combat this threat. One promising approach is to target virulence factors, which are essential for bacterial survival and pathogenesis, but not for bacterial growth. By targeting virulence factors, it may be possible to reduce the severity of bacterial infections without promoting the development of resistance. We discuss the mechanisms of action of the various compounds investigated and their potential as antibacterials. The review highlights the potential of targeting virulence factors as a promising strategy to combat antibiotic resistance and suggests that further research is needed to identify new compounds and optimize their efficacy. The findings of this review suggest that novel synthetic and semisynthetic compounds that target virulence factors have great potential as antibacterials in the fight against antibiotic resistance.