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24 pages, 6282 KB

Open AccessArticle

CFD–DEM-Based Analysis and Optimization of Biomimetic Jet Hole Design for Pneumatic Subsoiling Performance

by Shuhong Zhao, Changle Jiang, Xize Liu, Yueqian Yang, Mingxuan Du, Bin Lü and Shoukun Dong

Agriculture 2026, 16(9), 949; https://doi.org/10.3390/agriculture16090949 (registering DOI) - 25 Apr 2026

Abstract

Subsoiling can break the plough pan and improve the root growth environment. The effect of the traditional subsoiler is poor, as it relies only on the chisel tine, but pneumatic subsoiling can improve the soil structure more efficiently through the negative pressure generated [...] Read more.

Subsoiling can break the plough pan and improve the root growth environment. The effect of the traditional subsoiler is poor, as it relies only on the chisel tine, but pneumatic subsoiling can improve the soil structure more efficiently through the negative pressure generated by the jet hole. This research used computational fluid dynamics and the discrete element method to optimize the biomimetic structure of the jet hole, model the pneumatic subsoiling process at a depth of 330 mm, and observe the movement of soil particles as airflow passes through. The effect of the jet hole at different positions and sizes on the plough pan soil was analyzed, and fluid domains and measurement areas were set up to observe the upward movement, diffusion, stabilization, and settling of soil particles under the action of airflow. The results of the soil bin experiment validated the accuracy of the simulation model through draft force and vertical force, and the average error between the simulation and experimental data was 2.8%. The study revealed that the increase in the rate of soil porosity reached a maximum of 3.65% when the jet hole was positioned above the chisel tine with a radius of 4 mm. The biomimetic jet hole pneumatic subsoiler designed in this study, along with the established CFD-DEM coupled simulation model capable of predicting pneumatic subsoiling performance, can provide references for the design and application of a pneumatic subsoiler. Furthermore, it also provides a theoretical basis for understanding the mechanism of airflow on soil during pneumatic subsoiling operations. Full article

(This article belongs to the Special Issue Tillage Equipment Management and Its Effects on Grain Crop Productivity)

18 pages, 1985 KB

Open AccessArticle

Association of the C-Reactive Protein–Triglyceride–Glucose Index with Stroke–Heart Syndrome and Clinical Prognosis in Patients Undergoing Endovascular Treatment

by Wenjie Chen, Xuesong Bai, Tao Wang, Liqun Jiao, Liyong Zhang and Hong Li

J. Cardiovasc. Dev. Dis. 2026, 13(5), 179; https://doi.org/10.3390/jcdd13050179 (registering DOI) - 25 Apr 2026

Abstract

Background: Stroke–heart syndrome (SHS), particularly acute myocardial injury, is a critical complication following acute ischemic stroke (AIS). The C-reactive protein–triglyceride–glucose index (CTI) integrates inflammatory and metabolic parameters but remains unexplored in the context of post-stroke cardiac complications. This study investigated whether CTI predicts [...] Read more.

Background: Stroke–heart syndrome (SHS), particularly acute myocardial injury, is a critical complication following acute ischemic stroke (AIS). The C-reactive protein–triglyceride–glucose index (CTI) integrates inflammatory and metabolic parameters but remains unexplored in the context of post-stroke cardiac complications. This study investigated whether CTI predicts cardiac injury patterns and 90-day clinical outcomes in AIS patients. Methods: A two-center retrospective cohort study was conducted in AIS patients undergoing endovascular treatment (EVT). Cardiac troponin I (cTnI) trajectories were classified into: no injury, non-dynamic elevation, and dynamic elevation. The primary endpoint was poor functional status at 90 days (modified Rankin Scale [mRS] 3–6); the secondary endpoint was 90-day all-cause death. Results: Among 493 individuals (median age 69 years, 42% female), higher baseline CTI was associated with a greater likelihood of dynamic troponin elevation (adjusted odds ratio [aOR] per 1-unit increase = 1.56 (1.26–1.94); p < 0.001). Patients with dynamic elevation had significantly worse outcomes compared to those with no injury. Elevated CTI was an independent predictor of 90-day poor functional outcome (Q4: aOR = 3.04 (1.53–6.05); p < 0.001) and mortality (Q4: aOR = 2.82 (1.33–6.00); p = 0.007). Conclusions: In EVT-treated AIS patients, the CTI is a predictor of SHS and adverse 90-day outcomes. This easily calculable index may help identify individuals at higher risk of cardiac complications after AIS. Full article

(This article belongs to the Section Stroke and Cerebrovascular Disease)

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11 pages, 945 KB

Open AccessArticle

Minimally Invasive Antegrade Fixation of Proximal Phalangeal Fractures with Intramedullary Cannulated Compressive Screws

by Seung Yun Oh and Seokchan Eun

J. Clin. Med. 2026, 15(9), 3289; https://doi.org/10.3390/jcm15093289 (registering DOI) - 25 Apr 2026

Abstract

Background/Objectives: Proximal phalangeal fractures account for 38% of all phalangeal fractures, with unstable patterns requiring surgical intervention. Various modalities have been explored, including open reduction and internal fixation, percutaneous K-wire fixation, and intramedullary techniques. This study explores the technical nuances, indication, and [...] Read more.

Background/Objectives: Proximal phalangeal fractures account for 38% of all phalangeal fractures, with unstable patterns requiring surgical intervention. Various modalities have been explored, including open reduction and internal fixation, percutaneous K-wire fixation, and intramedullary techniques. This study explores the technical nuances, indication, and outcomes of antegrade cannulated compressive screw (CCS) fixation of proximal phalangeal fractures. Methods: This retrospective case series involved 18 closed proximal phalangeal fractures in 16 patients who underwent intramedullary headless screw fixation between January 2018 and December 2023. Records were reviewed for demographics, fracture characteristics, and screw type. With the metacarpophalangeal joint flexed at 60–75°, a 1 cm longitudinal incision was made, the extensor tendon split, and a 0.9 mm guidewire advanced anterogradely along the phalangeal axis under fluoroscopy. A 2.2 mm or 3.0 mm SpeedTip CCS was selected based on phalanx size and advanced until fully buried below the cartilage line. Postoperatively, patients were immobilized in a volar intrinsic-plus splint, transitioned to a gutter splint within five to seven days, and commenced on range of motion (ROM) exercises within one week. Primary outcomes included radiographic union, Total Active Motion (TAM), QuickDASH scores, and postoperative complications. Results: All fractures were healed within acceptable radiological parameters and with no postoperative complications. Mean TAM was measured to be 216.0° (SD 7.7°, range 200–230°) and mean QuickDASH was 10.1 (SD 2.8, range 5–16). Conclusions: Antegrade intramedullary headless screw fixation demonstrates feasibility, short-term safety, and excellent early functional outcomes for carefully selected unstable proximal phalanx fractures, supporting its role as a minimally invasive alternative in appropriately indicated cases. Full article

(This article belongs to the Special Issue Innovation in Hand Surgery)

9 pages, 579 KB

Open AccessArticle

Bone Turnover Biomarkers and Hip Fracture Patterns in Older Adults: A Retrospective Cohort Study

by Damian Mifsut, Jorge Baños-Gómez, Javier Hernández-Balada and Vicent Hurtado-Oliver

J. Clin. Med. 2026, 15(9), 3288; https://doi.org/10.3390/jcm15093288 (registering DOI) - 25 Apr 2026

Abstract

Background: Hip fractures represent a major public health challenge in aging populations and are associated with high morbidity, mortality, and healthcare costs. While osteoporosis is the main underlying cause, biochemical markers of bone metabolism may provide additional insight into skeletal remodeling processes. However, [...] Read more.

Background: Hip fractures represent a major public health challenge in aging populations and are associated with high morbidity, mortality, and healthcare costs. While osteoporosis is the main underlying cause, biochemical markers of bone metabolism may provide additional insight into skeletal remodeling processes. However, the relationship between bone turnover biomarkers and specific hip fracture patterns remains poorly understood. Methods: A retrospective observational study was conducted, including patients admitted with hip fractures between January 2022 and December 2023 at our institution. Serum levels of vitamin D, parathyroid hormone (PTH), N-terminal propeptide of type I collagen (PINP), and beta-C-terminal telopeptide of type I collagen (β-CTX) were analyzed. Fractures were classified as intracapsular or extracapsular. Continuous variables were compared using the Mann–Whitney U test. Multivariable logistic regression analysis was performed to identify factors independently associated with extracapsular fractures. Results: A total of 131 patients were included, comprising 57 intracapsular fractures and 74 extracapsular fractures. Patients with extracapsular fractures were significantly older (83 (75–89) vs. 80 (71–86) years; p = 0.0079). No significant differences were observed in vitamin D levels between fracture groups (p = 0.446). PTH levels were higher in extracapsular fractures (p = 0.030), while β-CTX levels tended to be lower (p = 0.080). In multivariable logistic regression analysis, age remained independently associated with extracapsular fracture pattern (OR 1.05, 95% CI 1.01–1.09; p = 0.03). Higher β-CTX levels were inversely associated with extracapsular fractures (OR 0.65, 95% CI 0.43–0.96; p = 0.03), whereas vitamin D levels were not independently associated with fracture type. Conclusions: Extracapsular hip fractures were primarily associated with older age in this cohort. Among bone metabolism biomarkers, β-CTX showed an inverse association with extracapsular fracture pattern after adjustment for confounding factors. These findings should be interpreted with caution and considered exploratory, highlighting the need for prospective studies to clarify their clinical significance. Full article

(This article belongs to the Topic Bone-Related Diseases: From Molecular Mechanisms to Therapy Development—2nd Edition)

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16 pages, 2775 KB

Open AccessArticle

Startup Hubs, Cultural and Creative Industries, and Tourism: A Comparative Analysis of European Cities

by Ainhoa del Pino Rodríguez-Vera, Carlos de las Heras-Pedrosa and Carmen Jambrino-Maldonado

Systems 2026, 14(5), 466; https://doi.org/10.3390/systems14050466 (registering DOI) - 25 Apr 2026

Abstract

This study examines the roles of startup hubs within the cultural and creative industries (CCIs) and their implications for cultural innovation and tourism in European cities. Despite the growing importance of CCIs in urban development and destination branding, few studies have explored the [...] Read more.

This study examines the roles of startup hubs within the cultural and creative industries (CCIs) and their implications for cultural innovation and tourism in European cities. Despite the growing importance of CCIs in urban development and destination branding, few studies have explored the organisational, social and communicative dynamics of cultural startup hubs. To address this gap, a comparative mixed-methods approach is applied to analyse 91 incubated startups in three European hubs: 104factory (Paris, France), Makerversity (London, UK) and A Lab (Amsterdam, The Netherlands). This study integrates structural variables (sustainability and institutionalisation), social variables (gender representation in leadership) and communication variables (activity and engagement on Instagram). The results reveal distinct organisational models, from highly institutionalised structures to more flexible, community-oriented approaches, with notable differences in terms of sustainability and gender distribution. In terms of communication, greater engagement is associated with content focused on community, identity and collective creativity, rather than promotional strategies. These findings highlight the role of startup hubs as hybrid intermediaries that not only support cultural entrepreneurship, but also contribute to the symbolic positioning and tourist appeal of the cities in which they are located. This study offers theoretical and practical insights for the development of more inclusive, sustainable and effectively communicative cultural ecosystems. Full article

(This article belongs to the Special Issue Smart and Sustainable Tourism Systems: Innovation, Management, and Future Challenges)

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19 pages, 1680 KB

Open AccessArticle

Engaging Audiences in Platformized Public Service Media Journalism: User-Generated Content and Editorial Practices in the funk Content Network

by Saskia Prinzler, Sven Stollfuß and Ann-Kathrin Böttke

Journal. Media 2026, 7(2), 90; https://doi.org/10.3390/journalmedia7020090 (registering DOI) - 25 Apr 2026

Abstract

This study examines how user-generated content (UGC) is incorporated and negotiated within platformized public service media (PSM) journalism, using the German content network funk as a case study. Based on a qualitative content analysis of selected formats and their social media posts, the [...] Read more.

This study examines how user-generated content (UGC) is incorporated and negotiated within platformized public service media (PSM) journalism, using the German content network funk as a case study. Based on a qualitative content analysis of selected formats and their social media posts, the study shows that participatory affordances offered by social media platforms (SMPs) are present but rarely foregrounded as central elements of storytelling. Instead, UGC is typically used as illustrative material or selectively embedded within editorial narratives. The analysis investigates how UGC is solicited, incorporated, and visually integrated into editorial storytelling across different formats. The findings identify three recurring patterns of UGC integration that illustrate how audience participation is negotiated within everyday editorial production: (1) illustrative UGC integration, (2) community-oriented UGC integration, and (3) minimalist UGC integration. Overall, the study highlights how platformized PSM journalism integrates UGC in ways that remain strongly editorially moderated rather than fully participatory, demonstrating how participation is enabled, constrained, and strategically applied within platform infrastructures. Full article

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15 pages, 2434 KB

Open AccessArticle

Linear and Nonlinear Dynamics of Crystals with B2 (CsCl) Structure

by Dina U. Abdullina, Sergey V. Dmitriev, Ilya S. Sugonyako, Arseny M. Kazakov and Elena A. Korznikova

Crystals 2026, 16(5), 286; https://doi.org/10.3390/cryst16050286 (registering DOI) - 25 Apr 2026

Abstract

This study investigates the phenomenon of supratransmission in three-dimensional crystals with a B2 (CsCl) structure, employing classical molecular dynamics with β-Fermi–Pasta–Ulam–Tsingou potentials up to fourth-nearest neighbors. We analyze energy transfer from a harmonically driven surface into the crystal bulk across various frequency regimes [...] Read more.

This study investigates the phenomenon of supratransmission in three-dimensional crystals with a B2 (CsCl) structure, employing classical molecular dynamics with β-Fermi–Pasta–Ulam–Tsingou potentials up to fourth-nearest neighbors. We analyze energy transfer from a harmonically driven surface into the crystal bulk across various frequency regimes relative to the phonon spectrum. While low-amplitude excitation results in energy transmission only within the phononic bands, high-amplitude driving triggers supratransmission in the phononic gap and above the optical band. Our results demonstrate that in these nonlinear regimes, energy is transported not by linear phonon waves but by discrete breathers (DBs) emitted quasi-periodically from the surface. A key finding is the distinct sublattice selectivity of these excitations: gap DBs propagate primarily along the heavy atom sublattice, whereas above-spectrum DBs travel along the light atom sublattice. We quantify the velocities and oscillation periods of these localized modes, revealing their critical role in bypassing linear spectral restrictions. These findings provide new insights into nonlinear energy transport in binary alloys and suggest potential applications for controlling heat flow and signal processing in crystals. Full article

(This article belongs to the Section Inorganic Crystalline Materials)

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21 pages, 1894 KB

Open AccessArticle

Measuring Spatial Heterogeneity and Obstacle Factors of Urban–Rural Integration Development in Zhejiang Province, China

by Yanfei Zhang, Peijin Zhang, Zhangwei Lu, Yaqi Wu and Zhonggou Chen

Land 2026, 15(5), 732; https://doi.org/10.3390/land15050732 (registering DOI) - 25 Apr 2026

Abstract

Using panel data from 11 prefecture-level cities in Zhejiang Province (2014–2023), this study applies the entropy method, spatial autocorrelation analysis, and an obstacle-factor diagnosis model to examine the spatiotemporal evolution, regional disparities, and constraints on urban–rural integration. The results show a steady upward [...] Read more.

Using panel data from 11 prefecture-level cities in Zhejiang Province (2014–2023), this study applies the entropy method, spatial autocorrelation analysis, and an obstacle-factor diagnosis model to examine the spatiotemporal evolution, regional disparities, and constraints on urban–rural integration. The results show a steady upward trend in urban–rural integration alongside significant regional disparities. This reveals a complex pattern marked by the coexistence of convergence and divergence. Spatially, a clear “northeast–high, southwest–low” pattern is observed, with local adjustments within a stable framework, reflecting a “stable core and entrenched low-value areas.” Spatial agglomeration is characterized by “dual-core agglomeration with a predominantly non-significant periphery,” dominated by homogeneous “high–high” and “low–low” clusters, with no statistically significant spatial outliers. Obstacle factor diagnosis indicates markedly uneven constraining effects across subsystems, with spatial integration exhibiting the highest degree of obstacles. The composition of primary obstacle factors is highly stable, and obstacle structures differ significantly across city tiers. These findings elucidate the spatiotemporal evolution and core constraints of urban–rural integration in Zhejiang, offering a theoretical and decision-making basis for advancing high-quality urban–rural integration in the region. Full article

(This article belongs to the Section Urban Contexts and Urban-Rural Interactions)

45 pages, 1944 KB

Open AccessReview

The Current Landscape of Adult Neural Stem Cell Research: A Narrative Review

by Jaime Yair Burciaga-Paez, Idalia Garza-Veloz and Margarita L. Martinez-Fierro

Cells 2026, 15(9), 779; https://doi.org/10.3390/cells15090779 (registering DOI) - 25 Apr 2026

Abstract

Adult neural stem cells (NSCs) maintain lifelong neurogenesis, a fundamental process for neuroplasticity, memory and brain homeostasis. Despite decades of research, translating basic NSC biology into effective clinical therapies remains a central challenge. Here we present a narrative review that provides a comprehensive [...] Read more.

Adult neural stem cells (NSCs) maintain lifelong neurogenesis, a fundamental process for neuroplasticity, memory and brain homeostasis. Despite decades of research, translating basic NSC biology into effective clinical therapies remains a central challenge. Here we present a narrative review that provides a comprehensive update on the current landscape of adult NSC research, associating molecular mechanisms with the emerging translational technologies. First, we analyze the biological features and neurogenic sequences within canonical niches such as the subventricular lateral zone and the subgranular zone, emphasizing phylogenetic and migratory differences between rodent models and humans. Second, we integrate these mechanisms with the influence of environmental and pathological modulators, describing how aging, metabolic changes, chronic stress and neuroinflammation disrupt NSC quiescence and lineage progression. Finally, we highlight recent technological advances driving the field toward clinical applications. By examining current NSC isolation strategies, induced pluripotent stem cell modeling, direct somatic reprogramming and the use of CRISPR-Cas9-based gene-editing therapies, this review delineates the pathways to overcome existing methodological limitations. Ultimately, we provide an integrated context that connects the modulation of the neurogenic niches with advanced in vitro technologies, offering new perspectives for regenerative medicine and the treatment of neurological disorders. Full article

(This article belongs to the Special Issue Advances and Breakthroughs in Stem Cell Research)

17 pages, 1041 KB

Open AccessArticle

Gluten-Free Flatbread with Carob Flour and Sourdough: Nutritional Composition, Technological Properties and Storage Stability

by Bojana Voučko, Saša Drakula, Nikolina Čukelj Mustač, Vedrana Pleš, Ljiljana Nanjara, Tomislava Grgić and Dubravka Novotni

Foods 2026, 15(9), 1504; https://doi.org/10.3390/foods15091504 (registering DOI) - 25 Apr 2026

Abstract

The growing demand for clean-label foods has stimulated interest in minimally processed ingredients capable of improving the nutritional and technological quality of gluten-free bakery products. Carob (Ceratonia siliqua L.) is an underutilized Mediterranean crop whose seeds are mainly used for locust bean [...] Read more.

The growing demand for clean-label foods has stimulated interest in minimally processed ingredients capable of improving the nutritional and technological quality of gluten-free bakery products. Carob (Ceratonia siliqua L.) is an underutilized Mediterranean crop whose seeds are mainly used for locust bean gum production, while other fractions of the fruit remain insufficiently valorized. This study investigated the potential of carob seed flour (CSF) and the whole carob fruit flour (pods and seeds; CSPF) as natural structuring ingredients in gluten-free flatbread (GFFB), combined with sourdough fermentation. The initial technological properties (pasting profile, baking loss, specific volume, color, and texture profile) and nutritional composition were evaluated, alongside storage stability, through textural and sensory changes during 72 h. The incorporation of carob ingredients improved the nutritional profile of GFFB, nearly doubling total dietary fiber and iron content without compromising sensory acceptance. CSF use resulted in an improved pasting profile and a 50% softer crumb structure. Sourdough fermentation successfully mitigated the increased hardness and lower sensory freshness perception in CSPF formulations. Carob seed flour, as well as whole carob fruit flour combined with sourdough, represent effective natural strategies for improving the technological properties, nutritional quality, texture profile, and freshness perception of gluten-free flatbread without compromising sensory acceptability. Full article

(This article belongs to the Special Issue Approaches for Improving Nutritional Aspects of Cereals and Cereal-Based Foods)

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15 pages, 3801 KB

Open AccessArticle

Burkholderia gladioli Causing Brown Spot on Leaf Sheath of Sweet Corn (Zea mays L.) in Sinaloa, Mexico: An Emerging Disease

by Rubén Félix-Gastelum, Jesús Ramon Escalante-Castro, Karla Yeriana Leyva-Madrigal, Ignacio Eduardo Maldonado-Mendoza and Gabriel Herrera-Rodríguez

Agriculture 2026, 16(9), 948; https://doi.org/10.3390/agriculture16090948 (registering DOI) - 25 Apr 2026

Abstract

Brown spot on the leaf sheath is an emerging disease of sweet corn (Zea mays L.) in Sinaloa, Mexico, with an unknown etiology. This study aimed to identify the causal agent of the disease and assess its pathogenicity on commercial sweet corn [...] Read more.

Brown spot on the leaf sheath is an emerging disease of sweet corn (Zea mays L.) in Sinaloa, Mexico, with an unknown etiology. This study aimed to identify the causal agent of the disease and assess its pathogenicity on commercial sweet corn hybrids. Bacterial strains were isolated from symptomatic leaf sheaths collected from commercial fields. Identification was performed through biochemical profiling (API 50CHB/E), pathogenicity tests on alternative hosts (potato, onion, celery), and molecular analysis (16S rRNA and recA genes sequencing and phylogenetic reconstruction). Pathogenicity and virulence were confirmed by inoculating four sweet corn hybrids in a greenhouse. The strains were Gram-negative rods, identified as Burkholderia gladioli based on biochemical profiles and molecular data (99% 16S rRNA+ recA similarity; phylogenetic clustering within the B. gladioli clade). In greenhouse trials, the strains induced brown spot lesions on the leaf sheaths of all tested hybrids, replicating field symptoms fulfilling Koch’s postulates. This is the first report of B. gladioli as the causal agent of brown spot on the leaf sheath of sweet corn in Mexico. The pathogen’s broad host range highlights its potential as an emerging threat to horticultural crops in the region. Full article

(This article belongs to the Special Issue Diseases Diagnosis, Prevention and Weeds Control in Crops—2nd Edition)

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23 pages, 2163 KB

Open AccessArticle

Additive Manufacturing of Discontinuous Carbon Fibre-Reinforced Polymer (CFRP): A Study on Parametric Optimization Towards Mechanical Properties

by Ahmed Degnah, Abdulaziz Kurdi, Alokesh Pramanik and Animesh Kumar Basak

Polymers 2026, 18(9), 1048; https://doi.org/10.3390/polym18091048 (registering DOI) - 25 Apr 2026

Abstract

The focus of this work was to investigate the mechanical properties of additively manufactured (AM) discontinuous carbon fibre-reinforced polymer (DCFRP) composites. Towards the specimen’s fabrication, the Fused Filament Fabrication (FFF) additive manufacturing technique was employed. A number of input printing parameters were varied, [...] Read more.

The focus of this work was to investigate the mechanical properties of additively manufactured (AM) discontinuous carbon fibre-reinforced polymer (DCFRP) composites. Towards the specimen’s fabrication, the Fused Filament Fabrication (FFF) additive manufacturing technique was employed. A number of input printing parameters were varied, such as the infill pattern, infill density, layer height, shell configuration, and raster orientation, in a systematic way. The role of these paraments on the mechanical properties, such as tensile, flexural, and impact strength were investigated. The data was analysed in-depth and the “main effect method” was employed for their comparative ranking. The results of this study showed that tensile and bending strengths were strongly correlated with material content and structural reinforcement. The specimens attained up to 76.7 MPa of tensile strength, while the flexural strength was up to 159.4 MPa, with a deflection of up to 8 mm and 16 mm, respectively. Solid infills, higher densities, finer layer heights, and added shells significantly improved the strength and stiffness. Grid-patterned and low-density specimens caused poor load-bearing capacities, while hexagonal and gyroid infills offered a more balanced performance. Full article

(This article belongs to the Section Polymer Processing and Engineering)

15 pages, 587 KB

Open AccessArticle

Natural Language Processing of Unstructured Healthcare Data for Predicting Heart Failure in Individuals with Type 2 Diabetes

by Juan F. Navarro-González, Leopoldo Pérez de Isla, Gloria Cánovas Molina, Miguel Ángel Brito-Sanfiel, David Emilio Barajas Galindo, Luis Ángel Cuellar Olmedo, Dídac Mauricio, Santiago Tofé Povedano, José Antonio Balsa Barro, Matilde Rubio Almanza, José Juan Aparicio Sánchez, Miren Sequera Mutiozabal, Belén Pimentel, Ana Pérez Domínguez, Víctor Latorre Garrido, Claudia Maté, Daniel Salvador, Juan Francisco Merino-Torres and Antonio Jesús Blanco-Carrasco

J. Clin. Med. 2026, 15(9), 3287; https://doi.org/10.3390/jcm15093287 (registering DOI) - 25 Apr 2026

Abstract

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a multisystemic disease with overlapping metabolic, renal, and cardiovascular effects. Within the Diabetic@ project, which aims to characterize individuals with T2DM using real-world data extracted from electronic health records (EHRs), this substudy sought to develop [...] Read more.

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a multisystemic disease with overlapping metabolic, renal, and cardiovascular effects. Within the Diabetic@ project, which aims to characterize individuals with T2DM using real-world data extracted from electronic health records (EHRs), this substudy sought to develop a predictive model for two-year heart failure (HF) risk. Methods: Multicenter, retrospective study including T2DM individuals across eight Spanish hospitals (2013–2018). Data were extracted exclusively from EHRs’ unstructured free text using clinical natural language processing (cNLP) and mapped to SNOMED CT. At inclusion, individuals were categorized as having or not prevalent HF (pHF). Predictive modeling was performed in non-pHF to assess two-year risk of developing HF, termed incident HF (iHF). Logistic regression (LR), decision trees, random forest, and XGBoost were compared, selecting for accuracy and interpretability. Results: Of 588,756 individuals with T2DM, 84,197 (14.3%) had pHF. Among non-pHF, 353,371 (60%) were used for model development (90.7% training, 9.3% validation). iHF occurred in 13.6% of the training set and 11.4% of the validation set. Ischemic heart disease was present in 16.2% overall, 37.9% in pHF, and 12.6% in non-pHF. Glycosylated hemoglobin data was rarely reported (<15%). LR achieved the best performance (AUC-ROC 0.73) using 27 predictors. Reduced 12- and clinically refined 9-predictor models performed similarly, with the latter implemented in a web-based tool. Conclusions: Unstructured data from EHRs enabled development of a two-year HF risk model for individuals with T2DM, underscoring the potential of cNLP for risk stratification across the cardiovascular–renal–metabolic spectrum. Full article

(This article belongs to the Section Machine Learning and Artificial Intelligence in Clinical Medicine)

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28 pages, 1675 KB

Open AccessReview

Cardiac Involvement in Emery–Dreifuss Muscular Dystrophy, from Arrhythmias to Heart Failure and Sudden Death: A Contemporary Review

by Lucio Giuseppe Granata, Maria Claudia Lo Nigro, Fabiana Cipolla, Nicola Ferrara, Anna Rosa Napoli, Marcello Marchetta, Simona Giubilato, Pasquale Crea, Giuseppe Dattilo, Olimpia Trio, Giuseppe Andò, Cesare de Gregorio and Giuseppina Maura Francese

J. Clin. Med. 2026, 15(9), 3286; https://doi.org/10.3390/jcm15093286 (registering DOI) - 25 Apr 2026

Abstract

Emery–Dreifuss muscular dystrophy (EDMD) is a rare inherited neuromuscular disorder within the spectrum of nuclear envelope diseases, classically characterized by early musculo-tendinous contractures, slowly progressive myopathy, and cardiac involvement dominated by conduction disease and arrhythmias, with variable evolution toward cardiomyopathy and heart failure. [...] Read more.

Emery–Dreifuss muscular dystrophy (EDMD) is a rare inherited neuromuscular disorder within the spectrum of nuclear envelope diseases, classically characterized by early musculo-tendinous contractures, slowly progressive myopathy, and cardiac involvement dominated by conduction disease and arrhythmias, with variable evolution toward cardiomyopathy and heart failure. This narrative review provides a comprehensive and clinically actionable synthesis of cardiovascular manifestations across EDMD genotypes and phenotypes, outlining pragmatic diagnostic and therapeutic pathways for real-world care. A targeted literature search was performed in PubMed, Embase, and Web of Science, focusing on studies addressing cardiovascular involvement in EDMD. Relevant original studies, case series, registries, guideline documents, and high-quality reviews were selected and synthesized narratively, with particular emphasis on diagnostic strategies, risk stratification, and management approaches. Cardiac involvement in EDMD encompasses a broad and heterogeneous spectrum, including atrial disease and conduction disturbances, ventricular arrhythmias, dilated cardiomyopathy, thromboembolic complications, and sudden cardiac death. Phenotypic expression varies according to the underlying genetic substrate, with distinct atrial- and ventricular-dominant trajectories. Early recognition and structured cardiovascular surveillance are essential to guide timely intervention, including anticoagulation, device therapy, and heart failure management. Despite growing awareness, significant gaps remain in risk prediction and standardized management strategies. EDMD represents a paradigmatic model of cardiomyopathy characterized by prominent electrical instability and systemic involvement. A structured, genotype- and phenotype-informed approach centered on early surveillance, proactive arrhythmia and thromboembolic risk management and timely device therapy may improve clinical decision-making in real-world settings. Future perspectives include the integration of precision medicine and the development of gene- and pathway-targeted therapies, with the potential to shift from symptomatic management toward disease-modifying strategies. Full article

(This article belongs to the Special Issue Perspectives on the Diagnosis and Treatment of Cardiomyopathies)

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23 pages, 1140 KB

Open AccessArticle

Diet Quality, Nutrition Knowledge, and Social Media-Driven Supplement Use Among Polish Adolescents and Young Adults: A Cross-Sectional Study

by Klaudia Sochacka, Agata Kotowska and Sabina Lachowicz-Wiśniewska

Nutrients 2026, 18(9), 1363; https://doi.org/10.3390/nu18091363 (registering DOI) - 25 Apr 2026

Abstract

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This [...] Read more.

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This study assessed diet quality, nutrition, and psychosomatic knowledge, supplement use, and health-information sources among Polish adolescents and young adults, with emphasis on age-related differences and the role of social media. A cross-sectional, anonymous online survey (October 2025–January 2026) was conducted in Poland (final analytical sample: n = 478; adolescents 15–19 years vs. young adults 20–30 years). Of 591 individuals who accessed the survey, 478 were included in the final analytical sample. Diet quality was estimated from FFQ data using KomPAN-derived indices (pHDI-10, nHDI-14, DQI). Nutrition knowledge (0–25 points), psychosomatic/gut–brain indicators, supplementation, and information sources were analysed using χ²/Fisher tests and Mann–Whitney U tests with effect sizes. The primary outcomes measured were dietary supplement use and excess body weight (BMI ≥ 25 kg/m²). Multivariable logistic regression examined predictors of supplement use and BMI ≥ 25 kg/m². Overall diet quality was low to moderate, with limited intake of whole grains, legumes, and fish, and common nutrition misconceptions. Social media was the most frequently indicated source of diet/supplement information and was independently associated with more frequent supplement use (OR = 2.29; 95% CI: 1.43–3.64). Adolescents reported lower whole-grain intake and more misconceptions than young adults. Predictors of BMI ≥ 25 kg/m² included male sex (OR = 2.46; 95% CI: 1.46–4.15), lower education, and lower nutrition knowledge, while age showed a non-linear positive association with excess body weight. Polish adolescents and young adults show gaps between declared pro-health attitudes and actual diet quality/competencies. Social media reliance appears particularly linked to product-oriented behaviours (supplementation). Prevention should strengthen nutrition and food safety education, digital health literacy, and professional guidance on supplementation, especially in adolescents. Our findings suggest that social media is a primary driver for dietary supplementation among Polish youth, more so than objective nutrition knowledge. While diet quality is linked to weight status, the relationship is complex. These results may inform future public health interventions targeting digital health literacy to promote balanced nutrition and safe supplementation practices. Full article

(This article belongs to the Special Issue Association Between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—3rd Edition)

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17 pages, 1640 KB

Open AccessArticle

Textural Optimization of Plant-Based Patties with Textured Fibrous Soy Protein and Konjac Glucomannan: A Response Surface Methodology Approach Targeting Springiness

by Hao Xu, Dongqin Liu, Weihua Du, Ke Hu, Jing Sun, Zhitong Xia, Zhengfei Yang, Yongqi Yin and Jiangyu Zhu

Foods 2026, 15(9), 1503; https://doi.org/10.3390/foods15091503 (registering DOI) - 25 Apr 2026

Abstract

Replicating the authentic masticatory properties of conventional animal meat remains a primary technical bottleneck for sustainable plant-based analogues. To address critical textural deficiencies like structural fragmentation, this study systematically optimized plant-based patty formulations. The independent and interactive effects of textured fibrous soy protein [...] Read more.

Replicating the authentic masticatory properties of conventional animal meat remains a primary technical bottleneck for sustainable plant-based analogues. To address critical textural deficiencies like structural fragmentation, this study systematically optimized plant-based patty formulations. The independent and interactive effects of textured fibrous soy protein (TFSP), water, and konjac glucomannan (KGM) were quantified using single-factor experiments and Response Surface Methodology (RSM). Single-factor experiments revealed that springiness peaked at 60 g TFSP, 15 g water, and 10 g KGM, respectively, with excessive additions of each component resulting in structural network disruption. Designating springiness as the core metric, a reliable quadratic regression model identified the optimal matrix: 63.36 g TFSP, 14.39 g water, and 8.57 g KGM. Empirical validation achieved a maximum springiness of 1.56 mm and hardness of 5.51 N, with a negligible relative error (1.27%) from theoretical predictions. Mechanistically, KGM functioned as an active polymeric filler, interacting synergistically with hydrated protein fibers via hydrogen bonding and hydrophobic associations to reinforce the structural network. Comparative Texture Profile Analysis demonstrated that the optimized PBP exhibited a tender masticatory profile with hardness and springiness approximating conventional beef patties, while presenting lower chewiness and higher adhesiveness attributable to the water-binding capacity of KGM. Ultimately, this research provides mathematically validated engineering parameters and theoretical insights into protein–polysaccharide phase behaviors to facilitate the industrial manufacturing of premium plant-based meats. Full article

(This article belongs to the Special Issue Plant-Based Functional Foods and Innovative Production Technologies)

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14 pages, 876 KB

Open AccessArticle

Association of the Dedicator of Cytokinesis 2 (DOCK2) Gene Polymorphisms with COVID-19 and Plasma LDH, AST, ALT, and Ferritin Levels

by José Manuel Fragoso, Rosalinda Posadas-Sánchez, Alberto López-Reyes, Laura E. Martínez-Gómez, Julian Ramírez-Bello, Giovanny Fuentevilla-Alvarez and Gilberto Vargas-Alarcón

Biomolecules 2026, 16(5), 643; https://doi.org/10.3390/biom16050643 (registering DOI) - 25 Apr 2026

Abstract

This case-control study investigated the association between polymorphisms in the dedicator of cytokinesis 2 (DOCK2) gene and susceptibility to COVID-19 in a Mexican population. Methods: Genotyping of five single-nucleotide polymorphisms (SNPs) in the DOCK2 gene (rs9307 A/G, rs1045176 G/T, [...] Read more.

This case-control study investigated the association between polymorphisms in the dedicator of cytokinesis 2 (DOCK2) gene and susceptibility to COVID-19 in a Mexican population. Methods: Genotyping of five single-nucleotide polymorphisms (SNPs) in the DOCK2 gene (rs9307 A/G, rs1045176 G/T, rs1045168 C/T, rs2112703 A/C, and rs2287727 A/C) was performed using TaqMan assays in 248 COVID-19 patients and 288 healthy controls. Results: No significant differences were observed in the allelic or genotypic distributions of rs1045176 G/T and rs2287727 A/C between cases and controls. However, under multiple genetic inheritance models (co-dominant, dominant, recessive, heterozygous, and additive), the rs9307 A, rs1045168 C, and rs2112703 A alleles were significantly associated with a reduced risk of COVID-19 (p < 0.05). Furthermore, sub-analyses stratified by genotype in COVID-19 patients revealed that the rs9307 AA, rs1045168 CC, and rs2112703 AA genotypes correlated with altered plasma concentrations of lactic acid dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and ferritin. Conclusions: The DOCK2 SNPs rs9307 A/G, rs1045168 C/T, and rs2112703 A/C are associated with decreased susceptibility to COVID-19 in this population and influence plasma levels of LDH, ALT, AST, and ferritin, suggesting a potential role in disease pathogenesis and severity. Full article

(This article belongs to the Section Molecular Medicine)

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20 pages, 2863 KB

Open AccessArticle

Microbial Drivers of Seed Vigor in Salvia miltiorrhiza: Bacterial Network Stability, Pseudomonas Enrichment, and Identification of Growth-Promoting Strains

by Yate Zhang, Rui Zou, Meng Yu, Jiayi Fu, Hanxin Ye, Xin Chen, Ruiqi Liu, Pengfeng Zhu, Qingdian Han, Ning Sui, Leran Wang and Guoyin Kai

Agronomy 2026, 16(9), 874; https://doi.org/10.3390/agronomy16090874 (registering DOI) - 25 Apr 2026

Abstract

The global demand for Salvia miltiorrhiza Bunge in the botanical medicine market is steadily increasing. However, its production has long relied on asexual root propagation, making it highly susceptible to germplasm degradation. Transitioning to seed reproduction offers the advantage of genetic renewal, yet [...] Read more.

The global demand for Salvia miltiorrhiza Bunge in the botanical medicine market is steadily increasing. However, its production has long relied on asexual root propagation, making it highly susceptible to germplasm degradation. Transitioning to seed reproduction offers the advantage of genetic renewal, yet it is constrained by unstable seed vigor and slow seedling growth. In the present study, comprehensive physiological and microbiome analyses of S. miltiorrhiza seeds from 14 regions across 7 provinces in China were conducted to elucidate the association between the seed microbiome and vigor, and to identify plant growth-promoting (PGP) strains. The results demonstrated: (1) Seed physical traits and germination characteristics varied significantly across geographic origins. Seed vigor, exhibiting the highest coefficient of variation, served as a key parameter reflecting germination quality. (2) High-vigor seeds harbored distinct microbial communities characterized by higher diversity indices, greater network complexity, and the significant enrichment of potentially beneficial bacteria (e.g., Pseudomonas). (3) Through correlation-directed screening of isolated pure cultures, Pseudomonas mendocina P-6 and Enterobacter ludwigii BM-12 were identified as exhibiting robust, multi-trait PGP capacity. In planta validation showed that these two strains significantly promoted the growth of 1-month-old S. miltiorrhiza seedlings, increasing total fresh weight by 33.9–71.3%. This study reveals the microecological drivers of seed vigor and provides candidate strains for inoculant development, thereby supporting the sustainable, seed-based propagation of S. miltiorrhiza. Full article

(This article belongs to the Special Issue Utilization of Microorganisms for Sustainable Agricultural Development)

28 pages, 437 KB

Open AccessArticle

Educational Reform Priorities in Hungary: Prevalence, Gender Differences, and Associations with Teacher Well-Being

by Attila Lengyel, Éva Bácsné Bába, Veronika Fenyves, Katalin Mező, Ferenc Mező and Anetta Müller

Educ. Sci. 2026, 16(5), 687; https://doi.org/10.3390/educsci16050687 (registering DOI) - 25 Apr 2026

Abstract

Hungarian teachers’ reform priorities remain insufficiently mapped, despite their central role in shaping feasible, evidence-based educational change. In a cross-sectional study with 1254 kindergarten, primary, and secondary teachers across Hungary (May 2025), we elicited and analyzed open-ended written responses in which participants identified [...] Read more.

Hungarian teachers’ reform priorities remain insufficiently mapped, despite their central role in shaping feasible, evidence-based educational change. In a cross-sectional study with 1254 kindergarten, primary, and secondary teachers across Hungary (May 2025), we elicited and analyzed open-ended written responses in which participants identified their top three required reforms. Responses were segmented and coded into 18 mutually exclusive categories via a validated codebook, and prevalence was calculated using respondent-normalized weights. We then examined demographic, well-being, and personality correlates of reform priorities using χ² tests, Mann–Whitney tests, and multivariable logistic models with Benjamini–Hochberg false discovery correction. Teachers most frequently prioritized competency development and pedagogical reform, followed by curriculum flexibility and system governance. Reform priorities were not random: female teachers were substantially more likely to prioritize inclusion and SEN support, while male teachers more often prioritized governance and depoliticization; older age predicted governance priorities. Lower educational system satisfaction robustly predicted prioritizing curriculum reform, autonomy, and governance restructuring, and anxiety and depression were positively related to curriculum concerns. Conscientiousness predicted prioritizing salary and material recognition. The results indicate that teachers’ reform demands function as systematic, psychologically grounded signals that can guide more targeted, teacher-centerd educational policy in Hungary. Full article

(This article belongs to the Section Education and Psychology)

20 pages, 4261 KB

Open AccessArticle

Effects of Steam-Explosion Pretreatment on Humification and Bacterial Community Dynamics During Aerobic Composting

by Mingjie Yao, Dan Wei, Jianbin Liu, Liang Jin, Qiang Zuo, Shubin Zhang, Haiying Wang, Xiaojian Hao, Guanhua Wang and Jianli Ding

Agronomy 2026, 16(9), 872; https://doi.org/10.3390/agronomy16090872 (registering DOI) - 25 Apr 2026

Abstract

To investigate how steam-explosion pretreatment affects humification during sawdust composting, an aerobic composting experiment was conducted using sawdust, chicken manure, and spent mushroom substrate as feedstocks. Two treatments were established—a steam-explosion-pretreated sawdust group (SEW) and an untreated sawdust control (CK)—each with three replicate [...] Read more.

To investigate how steam-explosion pretreatment affects humification during sawdust composting, an aerobic composting experiment was conducted using sawdust, chicken manure, and spent mushroom substrate as feedstocks. Two treatments were established—a steam-explosion-pretreated sawdust group (SEW) and an untreated sawdust control (CK)—each with three replicate reactors. Samples were collected dynamically at five key composting stages (initial, heating, thermophilic, cooling, and maturation) for physicochemical, enzymatic, and microbial community analyses. Linear mixed-effects model analysis revealed that enzyme activities were significantly affected by treatment, composting time, and their interaction. SEW significantly enhanced cellulase and polyphenol oxidase activities, and increased laccase and peroxidase activities at specific stages. Compared with CK (humic substances, 75.30 g/kg), SEW promoted higher humic substance accumulation (120.80 g/kg) and altered the dynamics of dissolved organic carbon. Microbial co-occurrence networks in SEW (50 nodes, 602 edges) were more complex than CK (49 nodes, 464 edges), indicating tighter microbial interactions. Path analysis revealed that HS in CK was mainly influenced by DOC and temperature, while HS in SEW was associated with enzyme activities, microbial diversity, and Pseudogracilibacillus. These results suggest that steam-explosion pretreatment enhances substrate transformation and humic substance formation during composting. Full article

(This article belongs to the Special Issue Innovative Agricultural Inputs and Soil–Plant–Microbe Interactions for Sustainable Agronomy)

21 pages, 1024 KB

Open AccessArticle

Export Resilience in Vietnam: A Causal Machine Learning Approach Using Industry-Level Panel Data (2000–2024)

by Thao Huong Phan, Thao Viet Tran and Trang Mai Tran

Economies 2026, 14(5), 151; https://doi.org/10.3390/economies14050151 (registering DOI) - 25 Apr 2026

Abstract

Vietnam’s exports expanded dramatically from $14.5 billion in 2000 to $405 billion in 2024, elevating the country to the world’s 22nd largest exporter despite persistent global shocks. This paper introduces the application of the Causal Machine Learning Approach to Resilience Estimation (CLARE) to [...] Read more.

Vietnam’s exports expanded dramatically from $14.5 billion in 2000 to $405 billion in 2024, elevating the country to the world’s 22nd largest exporter despite persistent global shocks. This paper introduces the application of the Causal Machine Learning Approach to Resilience Estimation (CLARE) to industry-level trade analysis, utilizing a comprehensive panel of 97 HS2 sectors from 2000 to 2024 (2425 observations) drawn from UN COMTRADE and WITS databases. We implement Double Machine Learning to estimate causal effects of the Global Financial Crisis (2008–2009) and COVID-19 pandemic (2020–2021) on export growth. Results reveal stark industry disparities: electrical machinery (HS85) exhibits exceptional resilience, fueled by 72% high-technology content and low product concentration, while knitted apparel (HS61) proves highly vulnerable. Fixed effect regressions substantiate core hypotheses: a 10-percentage-point increase in high-tech share elevates the resilience index by 0.031 points (approximately 4.1% relative to the sample mean); a one-standard-deviation reduction in product HHI (0.14 units) yields a 0.026-point gain (3.6% relative); and each additional FTA contributes 0.047 points (approximately 6.2% relative), with all estimates significant at conventional levels. Robustness encompassing alternative learners, detrended outcomes, and synthetic controls upholds findings. Policy recommendations center on accelerating high-tech global value chain integration—targeting semiconductors and electric vehicles—while optimizing CPTPP and EVFTA utilization (currently 35%) and mitigating US–China market concentration (45% of exports). These insights chart pathways for Vietnam’s Vision 2045 high-income ambition amid intensifying geopolitical and climate risks, providing a replicable framework for other export-reliant emerging economies. Full article

(This article belongs to the Section Economic Development)

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12 pages, 218 KB

Open AccessArticle

Pacific Youth Activists Encountering Climate Change: Implications for Education

by Ali Glasgow

Youth 2026, 6(2), 54; https://doi.org/10.3390/youth6020054 (registering DOI) - 25 Apr 2026

Abstract

The vulnerability of many Pacific communities is impacted by rising sea levels and exposure to extreme weather patterns. This qualitative research study was conducted with focus groups of Māori and Pacific youth in Aotearoa New Zealand. I am a Pacific researcher, and I [...] Read more.

The vulnerability of many Pacific communities is impacted by rising sea levels and exposure to extreme weather patterns. This qualitative research study was conducted with focus groups of Māori and Pacific youth in Aotearoa New Zealand. I am a Pacific researcher, and I examine research and report on findings from Pacific youth focus groups. Employing a Talanoa methodology, a key question posed was how educators in Aotearoa New Zealand supported the wellbeing of Pacific youth in the face of increasing climate extremes within their schools and communities. Engaging a Pacific values framework, this discussion emphasizes the critical role of teachers and education in eliminating concerns, working collectively, listening respectfully, and collaborating with Pacific youth in confronting the complexity of issues surrounding climate change, thereby creating a shift from a position of despair and helplessness to a place of hope and optimism. Findings from the study reveal that, in the education sector, climate change is not well addressed, teachers could do more to acknowledge and address climate crises faced in the Pacific region in the curriculum, and little attention is paid to the wellbeing of Pacific youth facing climate change in the Pacific. An implication is that teachers need to support Pacific youth and understand that education about climatic variance affects Pacific learners’ wellbeing. Full article

(This article belongs to the Special Issue Politics of Disruption: Youth Climate Activisms and Education)

17 pages, 1299 KB

Open AccessArticle

SF-36 Quality of Life Outcomes After Right Transradial Cerebral Angiography: A Prospective Short-Term Follow-Up Study

by Johannes Rosskopf, Jens Dreyhaupt, Bernd Schmitz and Katharina Althaus

Diagnostics 2026, 16(9), 1292; https://doi.org/10.3390/diagnostics16091292 (registering DOI) - 25 Apr 2026

Abstract

Background: Quality of life (QoL) after transradial access in diagnostic cerebral angiography may be shaped by procedural demands as well as by the ambulatory setting itself. This study, for the first time, prospectively explored this dimension through follow-up assessments of QoL after [...] Read more.

Background: Quality of life (QoL) after transradial access in diagnostic cerebral angiography may be shaped by procedural demands as well as by the ambulatory setting itself. This study, for the first time, prospectively explored this dimension through follow-up assessments of QoL after the procedure. Methods: In this prospective study, QoL was assessed using the 36-Item Short Form Survey (SF-36), including the Physical and Mental Component Summary (PCS and MCS) as well as eight domain-specific subscales. After right transradial cerebral angiography, the SF-36 questionnaire was administered at baseline (pre-procedure), as well as at 1-month and 3-month follow-up visits. Mean PCS and MCS values were analyzed over time using linear mixed-effects regression models. In post hoc analyses, univariate and multivariable models were used to assess the influence of potential confounders. For subgroup analysis, patients were classified as transient deteriorators if PCS and/or MCS worsened by more than 0.5 SD at 1 month compared with baseline but not at 3 months. Permanent deteriorators were defined as worsening by more than 0.5 SD at both 1 month and 3 months compared with baseline. Results: A total of 35 patients (62.9% female) were recruited over the 12-month study period, with a mean age of 59.1 ± 10.1 years. No significant overall time effect was observed for mean PCS and MCS (p = 0.970 and p = 0.076). MCS showed a significant increase at 1 month compared with baseline (p = 0.046), with a trend toward significance at 3 months (p = 0.053). In post hoc analyses, sex, neurosurgical status, and dose area product were associated with MCS in univariate analyses (p < 0.05), but these associations did not persist after multivariable adjustment. For PCS, only age showed a significant association in univariate analysis (p < 0.05). In subgroup analyses, transient deterioration was more frequent in PCS than in MCS (11.4% [95% CI 3.2–26.7%] vs. 5.7% [95% CI 0.7–19.2%]), and permanent deterioration was also more common in PCS at 1- and 3-month follow-up (14.3% [95% CI 4.8–30.3%] vs. 8.6% [95% CI 1.8–23.1%]). Impairment predominantly involved the bodily pain subscale (88.9% [95% CI 51.8–99.7%]) within PCS and the vitality (80.0% [95% CI 28.4–99.5%]) and mental health sub-scales (80.0% [95% CI 28.4–99.5%]) within MCS. Conclusions: This short-term follow-up assessment demonstrated preserved QoL following transradial diagnostic cerebral angiography. Transient or permanent deterioration occurred in no more than five patients per subgroup (14%). These findings support the notion that a radial-first approach can be safely considered for diagnostic cerebral angiography without compromising patient-reported outcomes. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

14 pages, 592 KB

Open AccessArticle

Prognostic Value of Arterial Lactate in Predicting In-Hospital Mortality in Acute Pulmonary Embolism

by Hasan Veysel Keskin, Neslihan Ozcelik, Cansu Ağralı Gündoğmuş, Elvan Senturk Topaloglu, Gonul Erkan, Songul Ozyurt and Aziz Gumus

Diagnostics 2026, 16(9), 1293; https://doi.org/10.3390/diagnostics16091293 (registering DOI) - 25 Apr 2026

Abstract

Background: Early risk assessment in acute pulmonary embolism (PE) remains challenging, particularly in normotensive patients. Lactate may offer incremental prognostic value beyond conventional tools. We investigated the association between arterial lactate and in-hospital mortality in acute PE. Methods: In this retrospective [...] Read more.

Background: Early risk assessment in acute pulmonary embolism (PE) remains challenging, particularly in normotensive patients. Lactate may offer incremental prognostic value beyond conventional tools. We investigated the association between arterial lactate and in-hospital mortality in acute PE. Methods: In this retrospective single-center study, 327 adult patients diagnosed with acute PE by computed tomography pulmonary angiography who underwent arterial blood gas analysis within the first six hours of emergency department presentation were included. Patients were categorized according to the occurrence of in-hospital mortality, including 103 (31.5%) non-survivors and 224 (68.5%) survivors, and their demographic, clinical, laboratory, and echocardiographic characteristics were compared accordingly. Results: Arterial lactate levels were significantly higher in non-survivors than survivors [4.1 vs. 1.9 mmol/L; p < 0.001], with a stepwise increase in mortality across lactate categories (<2, 2–4, >4 mmol/L; p < 0.001). In normotensive patients (n = 211), lactate ≥2 mmol/L was associated with higher mortality compared with <2 mmol/L (35.7% vs. 8.7%; OR 5.8, 95% CI 2.7–12.5; p < 0.001). In multivariable logistic regression analysis performed in normotensive patients, arterial lactate level, PESI score, and the presence of cerebrovascular disease were identified as independent predictors of in-hospital mortality, whereas troponin did not retain independent significance. In normotensive patients, lactate showed better discriminative ability than troponin I (AUC 0.718 vs. 0.553). Conclusions: Arterial lactate levels are independently associated with in-hospital mortality in acute PE. Elevated lactate may help identify high-risk patients even in the absence of hypotension and may provide incremental prognostic value beyond existing risk stratification tools. These findings suggest the use of arterial lactate in early risk assessment. Full article

(This article belongs to the Special Issue Pathophysiologic Mechanisms, Diagnosis and Management of Venous Thromboembolism)

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27 pages, 12834 KB

Open AccessReview

Silicon at the Soil–Plant–Microbiome Interface: Rhizospheric Reconfiguration and Crop Resilience to Environmental Stresses

by Aziz Boutafda, Said Kounbach, Ali Zourif, Rachid Benhida and Mohammed Danouche

Plants 2026, 15(9), 1320; https://doi.org/10.3390/plants15091320 (registering DOI) - 25 Apr 2026

Abstract

Silicon is increasingly applied in agriculture to improve plant productivity under both abiotic and biotic stress constraints. Nevertheless, its mechanisms of action are often studied separately at the soil, plant, or microbiome levels, limiting a comprehensive understanding of its overall impact on agroecosystem [...] Read more.

Silicon is increasingly applied in agriculture to improve plant productivity under both abiotic and biotic stress constraints. Nevertheless, its mechanisms of action are often studied separately at the soil, plant, or microbiome levels, limiting a comprehensive understanding of its overall impact on agroecosystem functioning. This review proposes an integrated perspective of the soil–plant–microbiome continuum, linking silicon chemistry in soil solutions with the effects of silicon amendments on soil properties and the processes of uptake, transport, and deposition in the plants. We show that silicon bioavailability depends on maintaining a pool of dissolved silicon dominated by orthosilicic acid, regulated by mineral weathering, adsorption–desorption dynamics, polymerization, pH, iron and aluminum oxides, and organic matter. In soils, silicon inputs can improve structure, modulate acidity and cation exchange balances, influence nutrient availability, and reduce the mobility of certain metals. They may also affect enzymatic activities and microbial community composition. In plants, silicon uptake and transport, mediated by specific transporters, contribute to tissue silicification, the maintenance of leaf architecture, and the regulation of water, ionic, and redox homeostasis. These processes provide a basis for enhanced tolerance to drought, salinity, and metal toxicity, as well as biotic stress caused by pathogens and pests. Finally, we discuss key limitations to the agronomic application of silicon, including the diagnosis of the silicic status of soils, the choice of source and mode of application, and the genotypic variability of acquisition, as well as the need for multi-site tests and more robust mechanistic validations. This synthesis provides a coherent mechanistic framework to better define the conditions under which silicon can serve as a reliable tool for sustainable crop management under climate change. Full article

(This article belongs to the Section Plant–Soil Interactions)

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16 pages, 1149 KB

Open AccessArticle

Ambulatory Holter Findings in Patients with Palpitations and Structurally Normal Heart: A Prospective Study of the Prevalence and Patterns of Ventricular and Supraventricular Arrhythmias

by Khaled Elenizi, Rasha Alharthi, Nasser E. Alotaibi, Talal Alotaibi, Mohammed Alfraikh, Faris Almusayfir and Kamran Ahmad

J. Clin. Med. 2026, 15(9), 3285; https://doi.org/10.3390/jcm15093285 (registering DOI) - 25 Apr 2026

Abstract

Background/Objectives: Palpitations are among the most common reasons for cardiology referrals. Despite widespread use of ambulatory cardiac monitoring, contemporary data from the Middle East are scarce. Extended Holter monitoring provides detailed evaluation of arrhythmia burden, autonomic regulation, and symptom–rhythm correlation in routine clinical [...] Read more.

Background/Objectives: Palpitations are among the most common reasons for cardiology referrals. Despite widespread use of ambulatory cardiac monitoring, contemporary data from the Middle East are scarce. Extended Holter monitoring provides detailed evaluation of arrhythmia burden, autonomic regulation, and symptom–rhythm correlation in routine clinical practice. Methods: We conducted a prospective observational study of consecutive patients presenting with palpitations who underwent 24–96 h ambulatory Holter monitoring at a cardiology outpatient clinic in Saudi Arabia in 2025. Demographic and clinical characteristics, comorbidities, medication use, echocardiographic parameters, heart rate variability (HRV), ventricular and supraventricular ectopy, tachyarrhythmias, and symptom diary activations were systematically evaluated. Results: Among 251 patients (mean age 41.9 ± 16.4 years; 35.5% male), Holter monitoring showed excellent recording quality (mean analyzable time 98.7 ± 9.5%). Premature ventricular contractions (PVCs) were detected in 53.4% of patients, but burden was low (median 0.0%, IQR 0–0.1%), with only 4.4% exceeding 10%. Atrial premature contractions (APCs) were common (92.0%), though usually low-burden (median burden 0.0%, IQR 0–0.1%); atrial fibrillation and supraventricular tachycardia were rare (0.8% each). Symptom diary activation occurred in 116 patients (46.2%), with 996 events; most (87.9%) correlated with sinus tachycardia, while only 8.6% correlated with PVCs and 2.6% with APCs. In the remaining 53.8% of patients, no symptom–rhythm correlation was documented during monitoring. Heart rate variability showed expected age-related changes. Conclusions: In this predominantly young cohort, Holter monitoring revealed frequent low-burden atrial and ventricular ectopy, whereas clinically significant tachyarrhythmias were uncommon. Holter monitoring up to 96 h provided a diagnostic yield in approximately 50% of patients and should be considered a first-line screening tool. Patients without diagnostic findings may require prolonged monitoring using external or implantable devices. Full article

(This article belongs to the Section Cardiology)

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