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15 pages, 4408 KB

Open AccessArticle

Immunohistochemical Expression of Integrin α_vβ₆ in Surgically Resected Pulmonary Inflammatory Lesions Mimicking Malignancy on ¹⁸F-FDG PET/CT: Implications for the Specificity of ⁶⁸Ga-Trivehexin PET/CT

by Muin Tuffaha, Amro Tuffaha, Wael Hananeh, Mohammad Khalifeh, Jenny Sonke and Michael Starke

Biomolecules 2026, 16(4), 602; https://doi.org/10.3390/biom16040602 (registering DOI) - 18 Apr 2026

Abstract

¹⁸F-fluorodeoxyglucose (FDG) PET/CT is widely used for the evaluation of pulmonary lesions but lacks specificity, as increased FDG uptake is frequently observed in inflammatory and reparative processes. This limitation may lead to false-positive interpretations and unnecessary surgical resections. This study aimed to [...] Read more.

¹⁸F-fluorodeoxyglucose (FDG) PET/CT is widely used for the evaluation of pulmonary lesions but lacks specificity, as increased FDG uptake is frequently observed in inflammatory and reparative processes. This limitation may lead to false-positive interpretations and unnecessary surgical resections. This study aimed to evaluate the immunohistochemical expression of integrin α_vβ₆ in 18 surgically resected pulmonary lesions that were falsely classified as malignant on FDG PET/CT, in order to find out if ⁶⁸Ga-Trivehexin PET/CT could have superior preoperative diagnostic specificity. Histopathological examination classified all lesions as non-neoplastic inflammatory processes of varying etiologies. Integrin α_vβ₆ expression was detected in all immunohistochemically examined tissue specimens (18/18 cases (100%)), with moderate membranous overexpression in 2/18 cases (11.11%) and strong membranous overexpression in 16/18 cases (88.89%) observed in the alveolar and bronchial epithelium of inflammatory lung lesions. Our findings indicate that integrin α_vβ₆ is upregulated not only in neoplastic lung tissue but also in inflammatory lesions, suggesting that integrin α_vβ₆ may have limited specificity for distinguishing primary neoplastic from inflammatory pulmonary lesions when used alone. Its interpretation requires integration with other clinical imaging modalities and histopathological data. Full article

(This article belongs to the Section Molecular Medicine)

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11 pages, 480 KB

Open AccessArticle

Body Mass Index Lacks Predictive Influence on Perioperative, Short-Term Follow-Up, and Patient-Reported Outcomes from Holmium Laser Enucleation of the Prostate

by Jack T. Peterson, Jenny N. Guo, Amir Patel, Nabila Khondakar, Perry Xu and Amy E. Krambeck

J. Pers. Med. 2026, 16(4), 225; https://doi.org/10.3390/jpm16040225 (registering DOI) - 18 Apr 2026

Abstract

Background/Objectives: Obesity has been associated with the development and severity of benign prostatic hyperplasia (BPH), yet its influence on outcomes following definitive surgical management, like holmium laser enucleation of the prostate (HoLEP), remains unclear. Furthermore, gradation of body mass index (BMI) severity [...] Read more.

Background/Objectives: Obesity has been associated with the development and severity of benign prostatic hyperplasia (BPH), yet its influence on outcomes following definitive surgical management, like holmium laser enucleation of the prostate (HoLEP), remains unclear. Furthermore, gradation of body mass index (BMI) severity has yet to discern personalized outcome stratification. We evaluated BMI’s influence on perioperative, immediate, short-term follow-up, and patient-reported outcomes for HoLEP patients. Methods: We performed a retrospective review of a prospectively maintained database of patients undergoing HoLEP for BPH at a single institution between January 2021 and August 2025. Outcomes included operative characteristics, post-operative complications, and validated symptom score changes. Analyses treated BMI as both a continuous and categorical variable. Multivariable linear and logistic regression models adjusted for common colinear confounders. Results: Among 1445 patients, BMI was not associated with most immediate, three-month, or patient-reported outcomes. Surgical complications were low across all BMI categories, and post-operative reported outcomes indicating high success rate for HoLEP. Higher BMI correlated with a modest increase in enucleation time (β = 0.197; p = 0.0132), increased odds of dysuria (OR = 1.084; p < 0.001), and change in American Urological Association Symptom Score (β = 0.211; p = 0.0334). All other operative metrics, complication rates, continence outcomes, and symptom scores (17 other total) were independent of BMI. Conclusions: After adjustment for relevant confounders, BMI does not meaningfully predict surgical safety, functional recovery, or patient-reported benefit following HoLEP. BMI alone should not influence candidacy or risk stratification for HoLEP in patients with BPH, instead favoring personalized, risk-stratified approaches. Full article

(This article belongs to the Special Issue Personalized Urologic Surgery: Innovation and Strategies)

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20 pages, 5525 KB

Open AccessArticle

Parishin B Attenuates PTZ-Induced Seizures in Zebrafish and Is Associated with Neurotransmitter Balance and ACLY-Related Metabolic Pathways

by Meng Sun, Haida Liu, Zhiying Hou, Qiong Wang and Wu Zhong

Metabolites 2026, 16(4), 275; https://doi.org/10.3390/metabo16040275 (registering DOI) - 18 Apr 2026

Abstract

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, complex neurochemical, and metabolic disturbances. Parishin B, a major bioactive component of Gastrodia elata, has shown neuroprotective potential, but its systemic mechanisms remain unclear. Methods: A pentylenetetrazol (PTZ)-induced seizure model in zebrafish [...] Read more.

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, complex neurochemical, and metabolic disturbances. Parishin B, a major bioactive component of Gastrodia elata, has shown neuroprotective potential, but its systemic mechanisms remain unclear. Methods: A pentylenetetrazol (PTZ)-induced seizure model in zebrafish larvae was developed and used to evaluate the anti-seizure effects of Parishin B. Behavioral analysis, ELISA-based biochemical assays, integrated untargeted metabolomics with DIA-based proteomics, and qPCR were performed to decipher underlying molecular mechanisms. Results: Parishin B (0.0625–0.25 mg/mL) significantly alleviated PTZ-induced hyperactivity without developmental toxicity. Parishin B restored neurotransmitter balance by increasing GABA, dopamine, and norepinephrine levels while reducing 5-HT. In addition, it suppressed neuroinflammation and enhanced antioxidant capacity. Integrated multi-omics analysis revealed that Parishin B modulated key metabolic pathways, particularly the TCA cycle and lipid metabolism, and reversed the downregulation of ATP-citrate lyase (ACLY). Parishin B was also associated with the regulation of ferroptosis-related pathways, supported by changes in acsl4a and fth1a expression. qPCR results further confirmed the regulation of aclya, unc13c, and GABAergic signaling genes. Conclusions: Parishin B exerts anti-seizure effects through coordinated regulation of neurotransmitter homeostasis, neuroinflammation, and ACLY-associated energy–lipid metabolism, with potential involvement in ferroptosis-related processes. These findings provide molecular insights supporting Parishin B as a promising candidate for epilepsy therapy. Full article

(This article belongs to the Section Pharmacology and Drug Metabolism)

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49 pages, 1098 KB

Open AccessReview

A Review of Probiotic Interventions for Necrotizing Enterocolitis and Sepsis in Preterm Infants

by Angel Yun-Kuan Thye, Hui Xuan Lim, Yatinesh Kumari, Loh Teng-Hern Tan, Vengadesh Letchumanan, Priyia Pusparajah, Kok-Gan Chan, Learn-Han Lee and Jodi Woan-Fei Law

Int. J. Mol. Sci. 2026, 27(8), 3602; https://doi.org/10.3390/ijms27083602 (registering DOI) - 17 Apr 2026

Abstract

Necrotizing enterocolitis (NEC) and sepsis/late-onset sepsis (LOS) are significant contributors to preterm infant morbidity and mortality, with prematurity and low birth weight representing major risk factors for these interconnected conditions. Although the pathogenesis of NEC and LOS is not fully understood, there is [...] Read more.

Necrotizing enterocolitis (NEC) and sepsis/late-onset sepsis (LOS) are significant contributors to preterm infant morbidity and mortality, with prematurity and low birth weight representing major risk factors for these interconnected conditions. Although the pathogenesis of NEC and LOS is not fully understood, there is a clear association with an immature intestinal mucosal barrier, which may enable bacterial invasion and translocation, resulting in an inflammatory cascade. Increasing recognition of the gut microbiome as a marker for health and disease has driven interest in probiotics, particularly Bifidobacterium spp. and Lactobacillus spp., as potential adjunctive agents for the prevention and management of NEC and LOS in preterm infants, which is the area of focus of this review. The focus of this paper was to analyze clinical studies using different probiotic strains, and compare single-strain versus multi-strain probiotic formulations. Several studies support that probiotic supplementation in preterm infants has the potential to decrease NEC incidence and, to a lesser extent, sepsis/LOS. Nonetheless, inconsistent results due to strain differences and clinical heterogeneity limit the widespread adoption of this mode of therapy, as do safety concerns in this vulnerable population. Further high-quality standardized studies are necessary to establish consistent guidelines for probiotic use in preterm infants. Full article

(This article belongs to the Special Issue Gut Microbiota and Nutrition in Human Health (2nd Edition))

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25 pages, 2910 KB

Open AccessReview

Effects of Aging on Determinants of Endurance Performance in Women Masters Athletes: A Scoping Review

by Danica Vangsgaard, Misa Noumi, K. Alix Hayden and Patricia K. Doyle-Baker

Healthcare 2026, 14(8), 1080; https://doi.org/10.3390/healthcare14081080 (registering DOI) - 17 Apr 2026

Abstract

Background/Objectives: Masters athletes are adults aged ≥40 who compete in sport, exhibiting superior physical function and healthier aging than their sedentary peers. However, even highly trained masters athletes experience age-related performance declines. Women masters athletes represent a growing yet understudied population who may [...] Read more.

Background/Objectives: Masters athletes are adults aged ≥40 who compete in sport, exhibiting superior physical function and healthier aging than their sedentary peers. However, even highly trained masters athletes experience age-related performance declines. Women masters athletes represent a growing yet understudied population who may face unique physiological challenges. This scoping review synthesizes literature from 1984 to 2024, examining the impact of age and menopause on determinants of endurance performance in women masters athletes. Methods: Following JBI scoping review methodology, six databases were searched (Medline, Embase, Central, CINAHL, SPORTdiscus, Scopus). Studies were evaluated for population characteristics, methodological approaches, and physiological determinants of performance (i.e., aerobic capacity, lactate kinetics, and exercise economy). Results: Twenty-nine studies were included. Most (n = 28) assessed aerobic capacity, reporting declines between 0.36 and 0.84 mL·kg⁻¹·min⁻¹·year⁻¹ (0.5–2.4%·year⁻¹). These reductions were primarily associated with decreased cardiac output followed by changes in body composition. Training volume emerged as a predictor of aerobic capacity, but the effects of menopause were unclear. Findings on lactate kinetics and exercise economy were mixed but preliminary research indicated that lactate threshold relative to VO₂max generally increased, peak lactate remained stable and energy cost increased with age. Fitness and health characteristics among women athletes differed from sedentary populations, emphasizing the need for athlete-specific data to support training and health decisions. Conclusions: Aging is associated with decreased aerobic capacity and variable changes in lactate kinetics and exercise economy. While training volume may attenuate performance decrements, the impact of menopause remains uncertain, underscoring the need for longitudinal research to better support this growing segment of the population. Full article

(This article belongs to the Special Issue Benefits of Exercise on Reproductive Health)

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48 pages, 24014 KB

Open AccessReview

Red/NIR-Emissive, Cadmium-Free Quantum Dots: Synthesis, Luminescence Mechanisms, and Applications

by Yuna Son, Young Jun Kim, Dong Geun Han, Taesik Eom, Daeyoung Kim, Nahyeon Kim and Minsu Park

Sensors 2026, 26(8), 2473; https://doi.org/10.3390/s26082473 (registering DOI) - 17 Apr 2026

Abstract

Red- and near-infrared (NIR)-emissive quantum dots (QDs) hold great promise in optoelectronic devices, sensors, and biomedicine owing to their advantages of low optical scattering, deep-tissue penetration, and compatibility with advanced photonic technologies. However, the toxicity of conventional cadmium (Cd)- and lead (Pb)-based QDs [...] Read more.

Red- and near-infrared (NIR)-emissive quantum dots (QDs) hold great promise in optoelectronic devices, sensors, and biomedicine owing to their advantages of low optical scattering, deep-tissue penetration, and compatibility with advanced photonic technologies. However, the toxicity of conventional cadmium (Cd)- and lead (Pb)-based QDs has led to growing demand for eco-friendly alternatives. Here, we provide a comprehensive review of sustainable classes of red/NIR-emissive QDs, including indium phosphide (InP), I-III-VI chalcogenides (CuInS₂, AgInSe, and so on), group-IV (Si, Ge, and SiGe) nanocrystals, and carbon-based QDs (graphene QDs or carbon dots). InP QDs are leading candidates for display technologies due to their high efficiencies and narrow bandwidths in emission properties, enabled by advanced core/shell engineering. In contrast, I-III-VI chalcogenides, group-IV, and carbon-based QDs offer advantages for biocompatible NIR bioimaging, photothermal therapy, and silicon photonics integration. We discuss synthesis strategies for achieving long-wavelength emission, the mechanisms of red/NIR photoluminescence (PL), and representative applications in displays, sensors, and bioimaging. Finally, we outline the remaining challenges, such as large-scale manufacturing and long-term stability, which should be addressed for commercial and clinical viability. Full article

(This article belongs to the Special Issue Advances in Sensing Technology: From Photon, Electron to Signal Processing)

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14 pages, 3206 KB

Open AccessArticle

Functional Characterization and Mutagenesis Studies of a Microbial-like Diterpene Synthase from Huperzia serrata

by Ting He, Yao Zhao, Xin Li, Bao Chen, Fangyan Chen and Baofu Xu

Molecules 2026, 31(8), 1329; https://doi.org/10.3390/molecules31081329 (registering DOI) - 17 Apr 2026

Abstract

Over the past decade, an increasing number of functional microbial-like terpene synthases (MTPSLs) have been reported in non-seed plants. However, whether the traditional Chinese medicinal plant H. serrata harbors such enzymes and their corresponding functions remains unexplored. In this study, we mined the [...] Read more.

Over the past decade, an increasing number of functional microbial-like terpene synthases (MTPSLs) have been reported in non-seed plants. However, whether the traditional Chinese medicinal plant H. serrata harbors such enzymes and their corresponding functions remains unexplored. In this study, we mined the transcriptome of H. serrata and identified a microbial-like terpene synthase, HsMTPSL1, which produces multiple diterpene products. Following isolation and structural elucidation, seven distinct compounds were obtained, representing three skeletal types: spatane, prenylkelsoene-type, and biflorane. Among these, compound 7 is a novel biflorane diterpene. Structural analysis and subsequent mutagenesis revealed critical residues governing the formation of distinct skeletons, uncovering the multifunctional nature of this enzyme. Notably, the S224A mutation significantly enhanced the production of spatane diterpene compound 1 by 11.6-fold, demonstrating the potential for protein engineering to improve the yield of this bioactive marine-specific diterpene. Transcriptomic profiling revealed that HsMTPSL1 is highly expressed in sporangia, and co-expression analysis with cytochrome P450s identified the CYP781 subfamily as candidates potentially involved in the downstream modification of these skeletons. Collectively, we report the first MTPSL from H. serrata and characterize it as a multifunctional diterpene synthase. Through structure-guided mutagenesis, we uncovered the molecular basis of its functional versatility, with the S224A mutation providing a powerful tool for enhancing the yields of all three diterpene skeletons, thereby laying a foundation for future protein engineering and synthetic biology applications. Full article

(This article belongs to the Section Chemical Biology)

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34 pages, 7099 KB

Open AccessReview

Research Progress on Prior Lithium Extraction from Spent Lithium-Ion Battery Cathode Materials via Pyrometallurgical Roasting

by Zhanyong Guo, Xiangrui Ren, Zihan Zhang, Zhen Feng and Fachuang Li

Sustainability 2026, 18(8), 4026; https://doi.org/10.3390/su18084026 (registering DOI) - 17 Apr 2026

Abstract

The extensive application of lithium-ion batteries (LIBs) in electronic devices, electric vehicles, and related applications has significantly enhanced the quality of spent LIBs. As a critical component of LIBs, cathode materials contain substantial amounts of valuable metals (e.g., lithium, cobalt, nickel, and manganese), [...] Read more.

The extensive application of lithium-ion batteries (LIBs) in electronic devices, electric vehicles, and related applications has significantly enhanced the quality of spent LIBs. As a critical component of LIBs, cathode materials contain substantial amounts of valuable metals (e.g., lithium, cobalt, nickel, and manganese), and their efficient recovery offers significant environmental and economic advantages. Owing to its simple operating conditions, effective impurity removal, and high reaction efficiency, pyrometallurgical roasting has become an important approach for recycling spent LIB cathode materials. This review focuses on pyrometallurgical roasting technologies for prior lithium extraction from spent LIB cathodes. By examining the structural characteristics of different cathode materials and their property variations during recycling, the fundamental principles and characteristics of pyrometallurgical roasting are clarified. The applications of roasting-based prior lithium extraction in LIB recycling are systematically reviewed, covering conventional processes, emerging high-efficiency roasting routes, and other advanced strategies for prior lithium extraction. Finally, the development trends of pyrometallurgical roasting technologies for spent LIB cathode materials are discussed, with the objectives of supporting technological advancement in LIB recycling and facilitating the establishment of a more sustainable development framework for the battery industry. Full article

(This article belongs to the Special Issue Sustainable Resource Utilization and Management of Electronic Waste: Innovations, Challenges, and Future Directions)

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24 pages, 2800 KB

Open AccessArticle

Genomic Epidemiology of ESBL and Non-ESBL-Producing Escherichia coli Across One Health Interfaces in Oman

by Hibatallah Sultan Al-Habsi, Zaaima Al Jabri, Amina Al-Jardani, Amira ElBaradei, Hafidha Al-Hattali, Faiza Syed, Zakariya Al Muharrmi, Wafa Al Alawi, Hatim Ali Eltahir and Meher Rizvi

Antibiotics 2026, 15(4), 411; https://doi.org/10.3390/antibiotics15040411 - 17 Apr 2026

Abstract

Background: Antimicrobial resistance is a One Health problem driven by the intricate interactions across human, animal, and environmental interfaces that enable microbial exchange and movement of mobile genetic elements encoding resistance and virulence. This study investigated the genomic epidemiology of ESBL and [...] Read more.

Background: Antimicrobial resistance is a One Health problem driven by the intricate interactions across human, animal, and environmental interfaces that enable microbial exchange and movement of mobile genetic elements encoding resistance and virulence. This study investigated the genomic epidemiology of ESBL and non-ESBL Escherichia coli across One Health interfaces in Oman. Methods: This prospective cross-sectional study analyzed 295 non-duplicate Escherichia coli isolates derived from 104 clinical, 173 animal [diseased (123) and healthy (50)], 14 sewage and four water sources. Antimicrobial susceptibility testing was performed phenotypically, and a representative subset of 50 ESBL and non-ESBL Escherichia coli from the three interfaces underwent whole genome sequencing to determine MLST, phylogroups, resistance genes, virulence determinants and plasmid replicons. Results: ESBL prevalence was highest in human isolates (73%), followed by sewage (28.6%) and animals (16.3% diseased; 8% healthy). blaCTX-M-15 predominated in humans, whereas blaCTX-M-55 dominated in animals and sewage, suggesting ecological partitioning with partial overlap. Quinolone resistance was lowest in the animal interface. Sewage isolates harbored the most complex resistome, including rmtB and plasmid-mediated quinolone resistance genes. MLST analysis revealed high diversity in human isolates, including globally recognized ExPEC lineages (ST10, ST38, ST73, ST127, ST131), while ST224 dominated in animals with evidence of possible spillover to humans. ST167 was confined to sewage, consistent with environmental maintenance of high-risk clones. Phylogroup structuring showed predominance of A, B2 and D among human isolates and A, B1, and E among animal and sewage isolates. Virulence profiling demonstrated broader virulome diversity in humans, but shared core determinants (fimH, sitA, traT) across all domains. IncFIB(AP001918) was the dominant plasmid replicon, particularly among ESBL isolates, underscoring its role in horizontal gene dissemination. Alarmingly, mutation in pmrB (V161G) was identified in a healthy animal isolate, pointing to a need for greater colistin restriction in animal husbandry. Conclusions: This study highlights plasmid-mediated resistance and shared virulence determinants linking reservoirs; although AMR profile was quite distinct across the three interfaces, human isolates demonstrated greater resistance than animal isolates, suggesting healthcare-driven AMR in Oman. Continued integrated genomic surveillance is essential to monitor gene flow and inform coordinated antimicrobial stewardship strategies. Full article

(This article belongs to the Special Issue Genomic Surveillance of Antimicrobial Resistance (AMR))

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21 pages, 2518 KB

Open AccessArticle

Schleiferilactobacillus harbinensis JNDM Postbiotics Alleviate Atopic Dermatitis with Concurrent Changes in Gut Microbiota and Fecal SCFAs

by Zhijie Shi, Ke Li, Jiaqian Liang, Laifa Yan, Yuzhen Guo, Zhenming Lu, Xiaojuan Zhang, Hongyu Xu and Jinsong Shi

Microorganisms 2026, 14(4), 913; https://doi.org/10.3390/microorganisms14040913 - 17 Apr 2026

Abstract

Atopic dermatitis (AD) is a chronic inflammatory dermatosis driven by skin barrier dysfunction, immune dysregulation, and gut–skin axis imbalance. While probiotics show promise, the therapeutic potential and mechanisms of topical postbiotics in modulating the gut–skin axis remain understudied. Here, we investigated the efficacy [...] Read more.

Atopic dermatitis (AD) is a chronic inflammatory dermatosis driven by skin barrier dysfunction, immune dysregulation, and gut–skin axis imbalance. While probiotics show promise, the therapeutic potential and mechanisms of topical postbiotics in modulating the gut–skin axis remain understudied. Here, we investigated the efficacy of Schleiferilactobacillus harbinensis JNDM-derived cell-free supernatant (CFS) and lysate (ShL) in a DNFB-induced AD mouse model. Topical application of both CFS and ShL significantly attenuated AD-like symptoms, reduced epidermal thickening, and restored the expression of the barrier protein filaggrin. Immunologically, treatment suppressed the Th2-dominant inflammatory cascade (IL-4, IL-5, IL-13, IL-33, TSLP) and reduced serum IgE and IFN-γ levels. Notably, ShL exhibited superior systemic efficacy, significantly inhibiting mast cell infiltration and reducing the spleen index. 16S rRNA sequencing revealed that topical intervention remotely remodeled the gut microbiota, specifically reversing the depletion of the beneficial genus Alistipes and suppressing the compensatory increase in Odoribacter. This microbial restructuring was accompanied by distinct metabolic changes: ShL treatment resulted in an approximately 4-fold elevation in fecal butyrate concentrations compared with the model group. Correlation analysis further validated a strong positive axis linking Alistipes abundance and butyrate levels to skin barrier integrity. Collectively, our findings demonstrate that S. harbinensis postbiotics—particularly the lysate—ameliorate AD through a dual mechanism of local barrier repair and systemic metabolic modulation via the gut–skin axis, presenting a promising non-steroidal therapeutic strategy. Full article

(This article belongs to the Section Medical Microbiology)

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26 pages, 2247 KB

Open AccessArticle

Sustainability-Oriented Planning of Capacitor Banks for Loss Reduction and Voltage Improvement in Radial Distribution Feeders

by Edwin Albuja-Calo and Jorge Muñoz-Pilco

Sustainability 2026, 18(8), 4025; https://doi.org/10.3390/su18084025 - 17 Apr 2026

Abstract

Radial distribution feeders are especially sensitive to reactive-power deficits, which increase technical losses, deteriorate voltage profiles, reduce energy efficiency, and indirectly raise the emissions associated with the energy required to supply those losses. In this context, this paper proposes a sustainability-oriented planning methodology [...] Read more.

Radial distribution feeders are especially sensitive to reactive-power deficits, which increase technical losses, deteriorate voltage profiles, reduce energy efficiency, and indirectly raise the emissions associated with the energy required to supply those losses. In this context, this paper proposes a sustainability-oriented planning methodology for the location and sizing of capacitor banks in radial distribution feeders, aimed at jointly improving technical performance, economic viability, and sustainability-related energy benefits. The problem is formulated as a discrete multi-objective model and solved through a constructive Greedy heuristic combined with backward/forward sweep load-flow evaluation, considering commercially available capacitor sizes. The methodology is validated on the IEEE 34-bus feeder, a demanding benchmark that remains less frequently used than the IEEE 33- and 69-bus systems in recent capacitor-planning studies. Seven scenarios are analyzed, from the uncompensated base case to configurations with up to six capacitor banks. The results show that all compensated scenarios improve feeder performance, reducing active losses from 25.3327 kW to a minimum of 20.1468 kW, equivalent to a maximum reduction of 20.47%, and increasing the minimum nodal voltage from 0.95528 p.u. to 0.97038 p.u. From a purely financial perspective, the one-bank scenario yields the highest net present value (USD 16,358.86), whereas the two-bank scenario emerges as the most balanced solution within the evaluated set, with annual savings of USD 5432.29 and a net present value of USD 11,497.58. Overall, the results confirm that capacitor-bank planning should be addressed as a trade-off among electrical efficiency, voltage support, profitability, and sustainability-oriented benefits. The proposed framework provides a simple, reproducible, and interpretable planning tool for radial distribution feeders. Full article

(This article belongs to the Special Issue Smart Grid and Sustainable Energy Systems)

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19 pages, 1121 KB

Open AccessArticle

Clinically Robust Deep Learning for Contrast-Enhanced Mammography: Multicenter Evaluation Across Convolutional Neural Network Architectures

by Roberta Fusco, Vincenza Granata, Paolo Vallone, Teresa Petrosino, Maria Daniela Iasevoli, Roberta Galdiero, Mauro Mattace Raso, Davide Pupo, Filippo Tovecci, Annamaria Porto, Gerardo Ferrara, Modesta Longobucco, Giulia Capuano, Roberto Morcavallo, Caterina Todisco, Fabiana Antenucci, Mario Sansone, Mimma Castaldo, Daniele La Forgia and Antonella Petrillo

Bioengineering 2026, 13(4), 475; https://doi.org/10.3390/bioengineering13040475 - 17 Apr 2026

Abstract

Background: This study investigates the impact of anatomically constrained preprocessing and deep learning architecture selection on benign versus malignant breast lesion classification in contrast-enhanced mammography (CEM), with the goal of improving robustness and clinical reliability across heterogeneous data sources. Methods: In this retrospective [...] Read more.

Background: This study investigates the impact of anatomically constrained preprocessing and deep learning architecture selection on benign versus malignant breast lesion classification in contrast-enhanced mammography (CEM), with the goal of improving robustness and clinical reliability across heterogeneous data sources. Methods: In this retrospective multicenter study, CEM images from 300 patients (314 lesions) were combined with 1003 publicly available CEM images, yielding a total of 1120 breast cases. Automatic breast segmentation was performed using the LIBRA framework to generate breast-mask images. Eleven deep learning models, including classical convolutional neural networks, attention-based networks, hybrid convolutional neural networks (CNNs), Transformer architectures, and mammography-specific models, were trained and evaluated using both original DICOM images and breast-mask inputs. Performance was assessed using accuracy, balanced accuracy, sensitivity, specificity, AUROC, and AUPRC on cross-validation and independent test sets. Hyperparameter optimization was conducted for the best-performing architecture. Results: Models trained on breast-mask images consistently outperformed those trained on original DICOM images across all architectures and metrics, with AUROC improvements ranging from +0.06 to +0.21. Among all models, ResNet50 trained on breast-mask images achieved the best performance (AUROC = 0.931; AUPRC = 0.933; balanced accuracy = 0.834), further improved after optimization (balanced accuracy = 0.886; sensitivity = 0.842; specificity = 0.930). Classical CNN architectures demonstrated performance comparable to or exceeding that of more complex hybrid CNN–Transformer models when anatomically focused preprocessing and rigorous optimization were applied. Conclusions: Anatomically constrained preprocessing through breast-mask segmentation substantially enhances deep learning performance and stability in CEM-based breast lesion classification. These findings indicate that input representation quality and training optimization are critical determinants of clinically relevant performance, often outweighing architectural complexity, and may support more reliable AI-assisted decision support in CEM workflows. Full article

(This article belongs to the Special Issue New Sights of Deep Learning and Digital Model in Biomedicine)

19 pages, 4385 KB

Open AccessArticle

Impact of Climate Warming on Cropland Water Use Efficiency in Northeast China Based on BESS Satellite Data

by Fenfen Guo, Haoran Wu, Zhan Su, Yanan Chen, Jiaoyue Wang and Xuguang Tang

Remote Sens. 2026, 18(8), 1223; https://doi.org/10.3390/rs18081223 - 17 Apr 2026

Abstract

Understanding the long-term dynamics of cropland water use efficiency (WUE) and its underlying environmental drivers is essential for ensuring food and water security, particularly for regions facing intensified climate change. Here, we investigated the spatial patterns and long-term trends of gross primary productivity [...] Read more.

Understanding the long-term dynamics of cropland water use efficiency (WUE) and its underlying environmental drivers is essential for ensuring food and water security, particularly for regions facing intensified climate change. Here, we investigated the spatial patterns and long-term trends of gross primary productivity (GPP), evapotranspiration (ET), and WUE in cropland ecosystems across Northeast China during the past two decades as the nation’s primary commodity grain base using the time-series Breathing Earth System Simulator (BESS) products. Subsequently, the ridge regression method was used to quantitatively disentangle the relative contributions of key climatic variables to the observed WUE trends of cropland. Our results revealed a pronounced decreasing gradient in both GPP and ET along the southeast–northwest direction. A significant increase in GPP was observed over the 20-year period (p < 0.01), with 95.94% of the cropland area showing positive trends. ET showed a slight, non-significant increase (p > 0.05), though 82.77% of pixels exhibited positive trends, particularly in the northwest. Consequently, WUE showed a widespread and significant enhancement (p < 0.01), with approximately 98% of cropland pixels exhibiting increasing trends. Attribution analysis identified air temperature as the dominant environmental variable, accounting for 92.4% of the observed WUE increase, while solar radiation and precipitation contributed modestly (3.4% and 3.2%, respectively). Our findings underscore the predominant role of thermal conditions in shaping the carbon–water coupling efficiency of agroecosystems in semi-arid to semi-humid transition zones. This study provides quantitative evidence that warming climate, rather than changes in water availability or radiation, has been the primary climatic factor driving the improved cropland WUE over the past two decades. These insights have important implications for developing adaptive water management strategies to enhance agricultural climate resilience in Northeast China and similar regions worldwide. Full article

(This article belongs to the Section Remote Sensing in Agriculture and Vegetation)

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28 pages, 1083 KB

Open AccessReview

Molecular Biomarkers of Training Responses: A Systems Framework for Exercise Adaptation and Athlete Monitoring

by Dan Cristian Mănescu, Andreea Voinea, Camelia Daniela Plastoi, Alexandra Reta Iacobini, Alina Anca Vulpe, Ancuța Pîrvan, Corina Claudia Dinciu, Bogdan Iulian Vulpe, Cristian Băltărețu and Adrian Iacobini

Int. J. Mol. Sci. 2026, 27(8), 3601; https://doi.org/10.3390/ijms27083601 - 17 Apr 2026

Abstract

Exercise adaptation depends on overload that is resolved by recovery, yet the same biology becomes maladaptive when immune, endocrine, metabolic, and muscle-centered stress signals fail to normalize. Exercise-induced maladaptation represents a systems-level failure of biological resolution, with direct relevance to disease-like dysregulation. Functional [...] Read more.

Exercise adaptation depends on overload that is resolved by recovery, yet the same biology becomes maladaptive when immune, endocrine, metabolic, and muscle-centered stress signals fail to normalize. Exercise-induced maladaptation represents a systems-level failure of biological resolution, with direct relevance to disease-like dysregulation. Functional overreaching, non-functional overreaching, and overtraining syndrome remain difficult to diagnose because no single biomarker provides adequate specificity, temporal stability, or clinical portability. This narrative review synthesizes human and mechanistic evidence across proteomics, transcriptomics, metabolomics, endocrine profiling, extracellular vesicles, and mitochondrial quality-control biology to define the molecular architecture most relevant to athlete monitoring. Across these layers, the most coherent signatures cluster in immune-acute-phase activation, redox-buffering strain, endocrine drift, altered substrate availability, excitation–contraction dysfunction, integrated stress-response signaling, and defects in autophagy–mitophagy and lysosomal remodeling. Three translational elements emerge from this synthesis: a systems-convergence model of recovery failure, a staged biomarker deployment hierarchy, and a provisional recovery failure index. The practical priority is therefore not a solitary marker, but serial phenotype-anchored multimarker panels that connect circulating signals with muscle-centered biology and support decision-making before prolonged recovery failure becomes entrenched. Full article

(This article belongs to the Special Issue Exercise in Health and Diseases: From the Molecular Perspectives)

21 pages, 5473 KB

Open AccessArticle

Reproducibility of 4D Flow MRI-Derived Diastolic Function Testing by Mitral and Pulmonary Venous Flow Indices in Healthy Volunteers

by Thomas in de Braekt, Paul R. Roos, Patrick Houthuizen, Harrie C. M. van den Bosch, Hildo J. Lamb and Jos J. M. Westenberg

Appl. Sci. 2026, 16(8), 3930; https://doi.org/10.3390/app16083930 - 17 Apr 2026

Abstract

Accurate assessment of mitral valve (MV) and pulmonary vein (PV) flow velocities is important for left ventricular diastolic function testing. This study investigated the scan–rescan reproducibility of 4D Flow MRI-assessed MV and PV flow velocities in 21 healthy volunteers (25 ± 4 years). [...] Read more.

Accurate assessment of mitral valve (MV) and pulmonary vein (PV) flow velocities is important for left ventricular diastolic function testing. This study investigated the scan–rescan reproducibility of 4D Flow MRI-assessed MV and PV flow velocities in 21 healthy volunteers (25 ± 4 years). Participants underwent repeated whole-heart 3T 4D Flow MRI involving repositioning and different respiratory compensation strategies (motion-uncompensated free-breathing vs. respiratory motion-compensated navigator gating). MV parameters (net flow volume (NFV), E-wave velocity, A-wave velocity, E/A ratio, E deceleration time (DT), annular e’ velocity, E/e’ ratio) and PV parameters (NFV, S-wave velocity, D-wave velocity, S/D ratio, atrial reversal (AR) wave velocity) were derived from velocity–time curves and compared using intraclass correlation coefficients (ICCs), Bland–Altman analysis, and Pearson’s correlation (r). Results showed significant moderate-to-strong scan–rescan agreement and correlation for most MV and PV parameters (ICC = 0.51–0.92; r = 0.51–0.92; all p < 0.05), except E DT, e’ velocity, E/e’ ratio, PV NFV, and AR velocity (ICC = −0.13–0.47; r = −0.14–0.47). Subanalysis of respiratory motion strategies showed moderate-to-strong agreement and correlation for MV and PV parameters (ICC = 0.61–0.99; r = 0.52–0.99; all p < 0.05 excluding E DT), except E DT (ICC = 0.44) and PV NFV (ICC = 0.46; r = 0.46). While intraobserver agreement was mostly moderate-to-excellent (ICC = 0.58–0.97; ICC = 0.41 for E DT), interobserver agreement was poor for E DT and PV parameters (ICC = −0.12–0.34). Overall, 4D Flow MRI shows acceptable reproducibility for selected diastolic flow parameters, particularly mitral inflow indices, but substantial variability and limited robustness for key indices currently restrict its clinical applicability. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease, 4th Edition)

16 pages, 2060 KB

Open AccessArticle

Comparison of Absolute and Individualized Physical Activity Intensity Thresholds Using Non-Dominant Wrist-Worn Accelerometry in Military Office Workers

by Maaike Polspoel, Tara Reilly, Damien Van Tiggelen and Patrick Calders

Appl. Sci. 2026, 16(8), 3931; https://doi.org/10.3390/app16083931 - 17 Apr 2026

Abstract

Accurate classification of physical activity (PA) intensity is essential for exercise prescription, rehabilitation monitoring, and evaluation of guideline adherence. However, widely used wrist-worn accelerometer cut-points may substantially misclassify physiological intensity. This study evaluated absolute accelerometer thresholds during a maximal 2400 m run in [...] Read more.

Accurate classification of physical activity (PA) intensity is essential for exercise prescription, rehabilitation monitoring, and evaluation of guideline adherence. However, widely used wrist-worn accelerometer cut-points may substantially misclassify physiological intensity. This study evaluated absolute accelerometer thresholds during a maximal 2400 m run in military office workers and examined whether individualized cut-points improve agreement with physiological intensity. Seventy-four military office workers completed the test while wearing a wrist-worn ActiGraph GT9X Link and a chest-worn Zephyr BioHarness. Participants achieved near-maximal physiological effort, with peak heart rate averaging 187 ± 11 bpm (95 ± 4.2% age-predicted HRmax). Despite this high intensity, absolute wrist-worn cut-points classified only 34.5% of participants as performing vigorous activity for most of the test. Individualized cut-points, derived from each participant’s individual reference intensity, calculated as the three highest consecutive one-minute epochs during the 2400 m test, substantially improved agreement between accelerometer-derived classifications and physiological intensity. Agreement with %HRmax increased from fair (κ = 0.31), using absolute thresholds, to good (κ = 0.74), using individualized thresholds, and intraclass correlation increased from 0.52 to 0.81. These findings demonstrate that absolute cut-points markedly underestimate high-intensity activity, potentially leading to inaccurate exercise load monitoring and misinterpretation of training intensity. Individualized calibration during a standardized maximal running test provides a feasible strategy to improve the validity of intensity assessment using wearables. Although the study population consisted of military office workers, the approach may be applicable to other active populations. However, further validation in independent samples is needed. Full article

(This article belongs to the Special Issue Sports Medicine, Exercise, and Health: Latest Advances and Prospects: 2nd Edition)

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15 pages, 593 KB

Open AccessReview

Gypenoside XLIX and Mitochondria-Associated ER Membranes in Non-Alcoholic Fatty Liver Disease: Mechanistic Insights and Emerging Perspectives

by Xinyi Kwan, Muhammad Shahzad Aslam, Huiqing Liang and Shaodong Chen

Molecules 2026, 31(8), 1325; https://doi.org/10.3390/molecules31081325 - 17 Apr 2026

Abstract

Gypenoside XLIX is a bioactive saponin with reported diverse biological activities, including antioxidant, regulation of cell growth, immune responses, and metabolic regulatory properties. The increasing global prevalence of non-alcoholic fatty liver disease (NAFLD) underscores the importance of exploring novel therapeutic agents such as [...] Read more.

Gypenoside XLIX is a bioactive saponin with reported diverse biological activities, including antioxidant, regulation of cell growth, immune responses, and metabolic regulatory properties. The increasing global prevalence of non-alcoholic fatty liver disease (NAFLD) underscores the importance of exploring novel therapeutic agents such as Gypenoside XLIX. NAFLD pathogenesis involves lipotoxicity, oxidative stress, and mitochondrial dysfunction, in which mitochondria-associated endoplasmic reticulum membranes (MAMs) play a critical role in organelle communication, calcium signaling, and lipid metabolism. This narrative review summarizes current evidence indicating that Gypenoside XLIX may modulate oxidative stress, restore mitochondrial membrane potential, and regulate calcium homeostasis, thereby indirectly influencing MAM integrity and function. These effects can reduce lipid accumulation, improve hepatocellular metabolism, and attenuate inflammatory responses. This review evaluates the mechanistic impact and function of Gypenoside XLIX on MAM integrity and its effects on NAFLD. However, there is limited direct experimental evidence linking Gypenoside XLIX to MAM regulation, and further studies are required to validate its mechanisms and therapeutic potential in clinical settings. Full article

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21 pages, 985 KB

Open AccessSystematic Review

Immune Checkpoint Inhibitors in Hepatocellular Carcinoma Before and After Liver Transplantation: A Systematic Review

by Francesco Dituri, Livianna Carrieri, Maria Mosaico, Giusi Caragnano and Erica Villa

Cancers 2026, 18(8), 1282; https://doi.org/10.3390/cancers18081282 - 17 Apr 2026

Abstract

Background/Objectives: Immune checkpoint inhibitors (ICIs) are increasingly used in hepatocellular carcinoma (HCC), but their application around liver transplantation (LT) remains controversial because checkpoint blockade may enhance antitumor immunity while disrupting graft tolerance. We systematically reviewed the available evidence on ICI exposure before LT [...] Read more.

Background/Objectives: Immune checkpoint inhibitors (ICIs) are increasingly used in hepatocellular carcinoma (HCC), but their application around liver transplantation (LT) remains controversial because checkpoint blockade may enhance antitumor immunity while disrupting graft tolerance. We systematically reviewed the available evidence on ICI exposure before LT and ICI therapy after LT for recurrent HCC. Methods: A PRISMA-guided systematic review with qualitative synthesis was performed. PubMed/MEDLINE, Embase, and Web of Science were searched from inception to 15 March 2026. Studies including adult patients with HCC treated with PD-1-, PD-L1-, and/or CTLA-4-targeting ICIs before LT or after LT for recurrent HCC were eligible. Results: Fifty-one studies were included. In the pre-LT setting, 25 studies reported 576 transplanted patients. Acute allograft rejection occurred in approximately 22% and graft loss in 3.8%, and shorter washout intervals were consistently associated with higher rejection risk. In the post-LT setting, 26 studies reported 117 recipients treated with ICIs; at least 22 rejection episodes (18.8%) were described, usually within 2–4 weeks of treatment initiation, with limited and inconsistent antitumor benefit. Conclusions: Pre-LT ICI use appears feasible in selected patients when adequate washout is respected. Post-LT ICI therapy remains high risk and should be reserved for highly selected cases within a multidisciplinary framework. Full article

(This article belongs to the Special Issue Immune Checkpoint Therapy in Liver Cancer: Current Evidence, Underlying Biology, and What's Next)

25 pages, 2436 KB

Open AccessReview

Neglected Tropical Diseases Elimination in the Philippines: Challenges and Gaps

by Josephine Abrazaldo, Patrick de Vera, Sheila Grace Martin, John Leo Dayrit, Daryl Christian Mejos and Ferdinand Mortel

Trop. Med. Infect. Dis. 2026, 11(4), 106; https://doi.org/10.3390/tropicalmed11040106 - 17 Apr 2026

Abstract

Neglected tropical diseases (NTDs) such as soil-transmitted helminthiasis, lymphatic filariasis, schistosomiasis, leprosy, rabies, and food-borne trematodiasis are endemic in the Philippines. Despite global and national elimination efforts, these six NTDs remain a persistent burden to the poor, those living in Geographically Isolated and [...] Read more.

Neglected tropical diseases (NTDs) such as soil-transmitted helminthiasis, lymphatic filariasis, schistosomiasis, leprosy, rabies, and food-borne trematodiasis are endemic in the Philippines. Despite global and national elimination efforts, these six NTDs remain a persistent burden to the poor, those living in Geographically Isolated and Disadvantaged Areas (GIDAs), and other vulnerable groups. This narrative review synthesized data from Field Health Services Information System (FHSIS) reports of the Philippine Department of Health (DOH) from 2020 to 2024, the available literature from electronic databases, and DOH and WHO reports focusing on the challenges, barriers, and gaps in NTD control and elimination in the country. Core challenges include complex epidemiological landscapes, lapses in disease surveillance, infrastructure, and fragmented health care systems. Gaps include access to diagnostics, insufficient funding and human resource training, and scarcity of local studies focusing on endemic NTDs. With these challenges and gaps, this review highlights the need for a real-time feedback loop system in surveillance strategy, community-based interventions, full integration of NTDs in primary health care, and collaboration between government, NGOs and private entities. Addressing these challenges and gaps is key to shifting from control to elimination. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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40 pages, 1631 KB

Open AccessReview

Phosphorus Recovery from Wastewater in the Circular Economy: Focus on Struvite Crystallization

by Gergana Peeva

Biomass 2026, 6(2), 32; https://doi.org/10.3390/biomass6020032 - 17 Apr 2026

Abstract

Phosphorus is an essential and finite resource critical for global food production, yet its inefficient use and discharge from wastewater systems contribute to eutrophication and resource depletion. The transition from conventional wastewater treatment plants to water resource recovery facilities has intensified interest in [...] Read more.

Phosphorus is an essential and finite resource critical for global food production, yet its inefficient use and discharge from wastewater systems contribute to eutrophication and resource depletion. The transition from conventional wastewater treatment plants to water resource recovery facilities has intensified interest in technologies that enable phosphorus recovery within a circular economy framework. This review provides a critical and up-to-date synthesis of phosphorus recovery strategies from wastewater, with primary emphasis on struvite (MgNH₄PO₄·6H₂O) crystallization as one of the most mature and practically implemented recovery routes. The occurrence and chemical forms of phosphorus in wastewater streams are discussed alongside conventional approaches, such as enhanced biological phosphorus removal and chemical precipitation, in order to position struvite recovery within the broader phosphorus management landscape. In addition to struvite crystallization, selected competing and complementary recovery pathways, including electrochemical systems, biochar-assisted processes, and sludge ash recovery, are discussed to compare technological maturity, recovery potential, and practical applicability. Particular attention is given to reactor configurations, full-scale applications, and commercial technologies to assess operational reliability, recovery performance, and fertilizer product quality. Life-cycle assessment results and regulatory developments are also discussed to contextualize sustainability claims, technology selection, and market integration. The review identifies key technical and economic challenges, particularly regarding magnesium supply, competing ions, wastewater matrix effects, and the feasibility of mainstream application. Overall, controlled sidestream struvite crystallization appears to offer the most favorable balance between recovery efficiency, operational reliability, and fertilizer product quality under suitable plant conditions. Full article

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27 pages, 8200 KB

Open AccessArticle

Few-Shot Bearing Fault Diagnosis Based on Multi-Layer Feature Fusion and Similarity Measurement

by Changyong Deng, Dawei Dong, Sipeng Wang, Hongsheng Zhang and Li Feng

Lubricants 2026, 14(4), 172; https://doi.org/10.3390/lubricants14040172 - 17 Apr 2026

Abstract

The running reliability of rolling bearings depends on the effective lubrication state, and poor lubrication will induce abnormal vibration. Therefore, vibration-based fault diagnosis is an important means to evaluate the health of bearings through vibration characteristics. However, the lack of fault samples in [...] Read more.

The running reliability of rolling bearings depends on the effective lubrication state, and poor lubrication will induce abnormal vibration. Therefore, vibration-based fault diagnosis is an important means to evaluate the health of bearings through vibration characteristics. However, the lack of fault samples in actual working conditions seriously restricts the generalization ability and accuracy of an intelligent diagnosis model. A novel few-shot diagnosis method integrating multi-layer feature fusion and adaptive similarity measurement is proposed. This method adopts a meta-learning framework to simulate sample scarcity through numerous N-way K-shot diagnostic tasks. An efficient feature extractor with a cross-task feature stitching mechanism is designed to fuse features from support and query sets. To overcome the limitation of fixed-distance metrics in existing meta-learners, a learnable similarity scheduler adaptively generates optimal pseudo-distance functions. In particular, a multi-layer feature fusion strategy is introduced to compute adaptive similarities at multiple network depths, which significantly enhances feature robustness against operational variations. Experimental results demonstrate the method achieves stable diagnostic accuracy above 90% under extremely few-shot conditions and maintains over 90% accuracy when transferring from laboratory-simulated faults to natural operational faults, validating its strong potential for practical industrial applications where annotated fault data is scarce. Full article

(This article belongs to the Special Issue Advances in Wear Life Prediction of Bearings)

14 pages, 711 KB

Open AccessArticle

Dual Pathways of Online Social Support on Sleep Quality in University Freshmen: The Suppression Effect of Psychological Resilience and the Moderating Role of Digital Literacy

by Xiangying Meng and Shuidong Feng

Behav. Sci. 2026, 16(4), 603; https://doi.org/10.3390/bs16040603 - 17 Apr 2026

Abstract

This study aimed to examine the impact of online social support on sleep quality and the potential roles of psychological resilience and digital literacy in this relationship. A cross-sectional survey was conducted with 606 university freshmen from a college in Hengyang City, Hunan [...] Read more.

This study aimed to examine the impact of online social support on sleep quality and the potential roles of psychological resilience and digital literacy in this relationship. A cross-sectional survey was conducted with 606 university freshmen from a college in Hengyang City, Hunan Province, China, using cluster random sampling. Data were collected using the Online Social Support Questionnaire, Pittsburgh Sleep Quality Index (PSQI; note that higher PSQI scores indicate poorer sleep quality), Connor–Davidson Resilience Scale, and Domestic College Student Digital Literacy Assessment Scale. Statistical analysis was conducted using SPSS 27.0, with mediation effects tested via the PROCESS macro. The analytical results demonstrated that online social support showed a significant negative predictive effect on the sleep quality of university freshmen (β = −0.11, p < 0.01); psychological resilience exhibited a suppression effect (i.e., opposing direct and indirect effects) between online social support and sleep quality; and digital literacy moderated the first half of the mediation pathway (β = 0.18, p < 0.001). Collectively, this study shows that online social support directly harms sleep quality but indirectly benefits it by enhancing psychological resilience. Digital literacy serves as a key moderator that amplifies this beneficial indirect effect. These findings provide significant theoretical and practical insights for developing campus health promotion initiatives. Full article

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17 pages, 3320 KB

Open AccessArticle

Effect of Pre-Coagulation with Hydrolyzed Tannic Acid on Removal of Methylene Blue in a Coagulation–Filtration Process

by Bartosz Libecki, Regina Wardzyńska, Marzanna Kurzawa and Zuzanna Achcińska

ChemEngineering 2026, 10(4), 51; https://doi.org/10.3390/chemengineering10040051 - 17 Apr 2026

Abstract

Textile industry wastewater poses a significant environmental challenge due to the presence of persistent dyes. Cationic dyes are characterized by resistance to the conventional coagulation method. The appropriate properties and combination of chemicals guarantee an effective removal process. This study explains the effect [...] Read more.

Textile industry wastewater poses a significant environmental challenge due to the presence of persistent dyes. Cationic dyes are characterized by resistance to the conventional coagulation method. The appropriate properties and combination of chemicals guarantee an effective removal process. This study explains the effect of modification of methylene blue solution by the addition of a natural biopolymer—hydrolyzed tannic acid (TA). The study assumed that a combination of tannic acid, methylene blue and polyaluminum chloride would provide a synergistic effect and significantly improve the coagulation and sediment filtration process. Coagulation tests were carried out for a range of methylene blue concentrations. The optimal arrangement of solution components and coagulant doses was selected and tested. Over 95% dye removal efficiency was achieved. The maximum dye removal efficiency was determined to be 5 mg/mg Al at pH = 5.0. Based on the analysis of UV-VIS spectroscopy, FTIR and electrokinetic potential, changes in the solutions of tannin-modified dyes and their effect on the precipitation of flocs and the nature of sorption were determined. The main phenomena affecting the removal mechanism are discussed. The results indicate that tannic acid can serve as a sustainable coagulant aid, supporting the development of technologies for treating cationic-dye-laden wastewater. Full article

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11 pages, 571 KB

Open AccessArticle

Frailty Matters: Validation of an Automated Electronic Short Physical Performance Battery (eSPPB) for Predicting 30-Day Mortality in Hospitalized Cardiovascular Patients—A Step-by-Step Study

by Lidia López García, Dohong Kim, Seongjun Yoon, Juan Carlos Gómez Polo, José Antonio Espín Faba, Isidre Vila Costa and Julián Pérez Villacastín Domínguez

J. Clin. Med. 2026, 15(8), 3093; https://doi.org/10.3390/jcm15083093 - 17 Apr 2026

Abstract

Background: Frailty is a major determinant of adverse outcomes in older adults with cardiovascular disease. Automated digital tools may facilitate routine frailty assessment in hospital settings; however, their validity and prognostic relevance in acutely hospitalized patients remain insufficiently established. Methods: In this prospective [...] Read more.

Background: Frailty is a major determinant of adverse outcomes in older adults with cardiovascular disease. Automated digital tools may facilitate routine frailty assessment in hospital settings; however, their validity and prognostic relevance in acutely hospitalized patients remain insufficiently established. Methods: In this prospective cohort study, 113 hospitalized cardiology patients underwent frailty assessment using both manual Short Physical Performance Battery (mSPPB) and an automated electronic SPPB (eSPPB) system. Agreement between methods was evaluated using Pearson correlation, intraclass correlation coefficients (ICCs), and Bland–Altman analysis. Frailty was defined as SPPB < 5. The association between frailty and 30-day mortality was assessed using logistic regression and Kaplan–Meier survival analysis. Results: Seventeen patients (15.0%) were classified as frail. Automated and manual SPPB scores were highly correlated (r = 0.994, p < 0.001) and demonstrated good agreement (ICC = 0.80). Bland–Altman analysis showed a mean difference of −1.63 points (95% limits of agreement −4.41 to 1.16). Frailty was associated with significantly higher 30-day mortality (17.6% vs. 2.1%, p = 0.009), corresponding to a tenfold increase in mortality odds (OR 10.07; 95% CI 1.5–67.5). An exploratory model showed apparent discriminative performance (AUC 0.83; 95% CI 0.71–0.95). Conclusions: Automated eSPPB demonstrated good agreement with manual assessment and was significantly associated with short-term mortality in hospitalized cardiovascular patients. These findings support the validity and potential clinical utility of automated frailty assessment for risk stratification in acute cardiology settings. Full article

(This article belongs to the Special Issue Therapies for Heart Failure: Clinical Updates and Perspectives)

17 pages, 769 KB

Open AccessArticle

Sustainability Consciousness, Green Advocacy, and Work Grit Among Nurses: Implications for Environmentally Sustainable Healthcare and Public Health

by Eman Kamel Hossny, Noura Alsayed Esmeil, Hanan Sayed Younes, Eman Ramadan Abdalfadeel, Ahmed Zinhom Elkady, Hammad S. Alotaibi and Somia Mohamed Abdel Aziz

Int. J. Environ. Res. Public Health 2026, 23(4), 523; https://doi.org/10.3390/ijerph23040523 - 17 Apr 2026

Abstract

Background: Healthcare systems contribute significantly to environmental pollution, energy consumption, and resource depletion, making sustainability an increasingly important environmental and public health priority. Nurses, as frontline healthcare professionals, play a critical role in promoting environmentally responsible practices and advocating for sustainable healthcare within [...] Read more.

Background: Healthcare systems contribute significantly to environmental pollution, energy consumption, and resource depletion, making sustainability an increasingly important environmental and public health priority. Nurses, as frontline healthcare professionals, play a critical role in promoting environmentally responsible practices and advocating for sustainable healthcare within clinical settings. Objective: The study aimed to examine the associations between nurses’ sustainability consciousness, green advocacy, and work grit in hospital settings. Methods: A descriptive cross-sectional correlational study was conducted among 377 nurses working in two university-affiliated hospitals in Egypt. Data were collected using validated instruments assessing sustainability consciousness, green advocacy, and work grit. Descriptive statistics were calculated to summarize participant characteristics and study variables. Associations among sustainability consciousness, green advocacy, and work grit were examined using Pearson correlation analysis. Multiple linear regression analysis was conducted to identify significant predictors of green advocacy, while noting that the study design allows for identification of associations rather than causal relationships. Results: The findings indicated generally high levels of sustainability consciousness among nurses. Significant positive associations were observed between sustainability consciousness, green advocacy, and work grit (p < 0.01). Multiple linear regression analysis identified sustainability consciousness and work grit as significant predictors of green advocacy, explaining 34.2% of its variance. Conclusions: These findings highlight the interconnected roles of sustainability awareness, advocacy behaviors, and psychological resilience in promoting environmentally sustainable healthcare practices. Strengthening nurses’ sustainability consciousness and work grit may enhance green advocacy and contribute to the development of sustainable healthcare systems, supporting global environmental and public health goals aligned with the United Nations Sustainable Development Goals. Full article

19 pages, 3835 KB

Open AccessArticle

Reinforcement of Thermo-Compressed Sodium Alginate Films with Calcium Alginate Powder

by Prasong Srihanam, Wilaiwan Simchuer, Vanseng Chounlamany, Kesiny Phomkeona, Phengxay Deevanhxay and Yodthong Baimark

Mar. Drugs 2026, 24(4), 142; https://doi.org/10.3390/md24040142 - 17 Apr 2026

Abstract

Alginate is a biocompatible and biodegradable polymer derived from seaweed. It has been extensively researched and developed for various applications. However, its poor mechanical properties present a significant drawback that limits its use in multiple fields. Furthermore, the fabrication of reinforced alginate films [...] Read more.

Alginate is a biocompatible and biodegradable polymer derived from seaweed. It has been extensively researched and developed for various applications. However, its poor mechanical properties present a significant drawback that limits its use in multiple fields. Furthermore, the fabrication of reinforced alginate films using conventional melt processing has the potential for scaling up production. This study aimed to enhance the mechanical properties of sodium alginate (SA) films by incorporating calcium alginate (CA) powder. The SA/CA biocomposite films were created using a thermo-compression technique, with glycerol acting as a plasticizer for the SA matrix. Various CA contents—2.5, 5, 10, and 20 wt%—were investigated. Scanning electron microscopy and energy dispersive spectroscopy revealed good interfacial adhesion between the SA film matrix and the CA powder. As the CA content increased, the moisture content of SA/CA biocomposite films decreased. The addition of CA powder significantly improved the tensile properties of the SA films. Based on the tensile test, SA/CA biocomposite films with 20 wt% CA powder exhibited a maximum tensile strength of 11.7 MPa and a Young’s modulus of 234.7 MPa. These results indicate a substantial increase of 208% in maximum tensile strength and 907% in Young’s modulus compared to SA films without CA. These findings indicated that the CA powder serves as an effective reinforcing filler for thermo-compressed SA films, which could lead to the development of high-strength alginate-based products for potential use in various applications, including biomedical, agricultural, and packaging applications. Full article

(This article belongs to the Special Issue Marine Polysaccharides-Based Biomaterials)

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