Search Results (2,511)

This review comprehensively examines the advancements and challenges in anaerobic digestion (AD) for biogas production, emphasising technological, microbial, and policy perspectives. It highlights the AD significant potential for valorising diverse organic substrates, including manure, food waste, and microalgae, thereby contributing to renewable energy generation and greenhouse gas mitigation. Key operational factors influencing biogas yield include substrate composition, temperature (preferably mesophilic conditions), pH (6.5–7.5), and the substrate-to-inoculum ratio (SIR), all of which significantly affect microbial activity and process stability. Co-digestion strategies and pretreatments are examined for their roles in enhancing biodegradability and methane yield, respectively. Microbial community dynamics, particularly responses to feedstock heterogeneity and operational parameters, are integral to process optimisation. Advances in metagenomics have provided insights into microbial resilience and adaptation to conditions such as high ammonium levels. This review also discusses various modelling approaches, including kinetic models and machine learning techniques, for predicting and optimising biogas production. Additionally, policy frameworks within regions such as the European Union and Brazil, along with economic incentives and regulatory hurdles, are also considered crucial for scaling up deployment. Challenges such as digestate management and high capital costs persist, underscoring the need for integrated strategies to enhance the sustainability and viability of AD-based biogas projects. Full article

Careya arborea, commonly known as wild guava, is a deciduous tree native to Asia, including Sri Lanka. Traditionally used to treat various ailments such as skin diseases, tumors, gastrointestinal disorders, and inflammation, it is valued for its notable astringent properties. Rich in phytochemicals, including phenolics, terpenes, sterols, tannins, and saponins, Careya arborea exhibits potent antioxidant, anti-inflammatory, and anticancer activities. Its anticancer effects are primarily attributed to the induction of apoptosis and the inhibition of cancer cell proliferation, with several extracts such as chloroform, ethyl acetate, and methanol demonstrating selective cytotoxicity against cancer cell lines. The high phenolic content of Careya arborea underpins its antioxidant potential, which plays a crucial role in mitigating oxidative stress and associated inflammatory conditions. Despite its medicinal potential, Careya arborea remains an underutilized plant in Sri Lanka. Greater attention should be given to promoting its use in both traditional and modern healthcare systems to harness its therapeutic benefits. Given its therapeutic potential, sustainable harvesting and conservation efforts are essential to protect this plant from overexploitation and habitat loss. Taking all these factors into account, this review emphasizes Careya arborea’s potential as a source of natural therapeutic agent, highlighting the importance of further research and conservation to unlock its full medicinal value for clinical applications. Full article

Background: The last decade has seen transformative changes in burn care, driven by advances in pharmacology, regenerative medicine, surgical techniques, and digital technologies. As management strategies evolve beyond survival to encompass functional and esthetic recovery, this review consolidates current evidence to inform best practice. Methods: A comprehensive narrative review was conducted using PubMed to identify peer-reviewed English-language articles from the past 10 years relevant to acute and long-term burn management. Selection focused on high-level evidence, including randomized controlled trials, systematic reviews, and meta-analyses, emphasizing novel and evolving clinical interventions. Results: Key advances include the integration of propranolol and oxandrolone for metabolic modulation; enzymatic debridement agents such as NexoBrid^®; regenerative approaches like epidermal cell sprays (e.g., RECELL^®) and dermal substitutes (e.g., Integra^®, MatriDerm^®, NovoSorb^® BTM); and innovations in scar modulation, notably fractional CO₂ laser therapy. The emergence of 3D bioprinting, and artificial intelligence further supports a shift toward precision burn medicine. Conclusions: Burn management is evolving from protocol-driven to patient-centred care, underpinned by high-quality evidence and technological innovation. The integration of systemic, local, and rehabilitative strategies is improving outcomes in survival, function, and quality of life. Ongoing challenges include cost, access, and translation of novel therapies into widespread clinical practice. Full article

In-band full-duplex (IBFD) communication systems offer a promising means of improving spectral efficiency by enabling simultaneous transmission and reception on the same frequency channel. Despite this advantage, self-interference (SI) remains a major challenge to their practical deployment. Among the different SI cancellation (SIC) techniques, this paper focuses on digital SIC methodologies tailored for multiple-input multiple-output (MIMO) wireless transceivers operating under digital beamforming architectures. Two distinct digital SIC approaches are evaluated, employing a generalized memory polynomial (GMP) model augmented with Itô–Hermite polynomial basis functions and a phase-normalized neural network (PNN) to effectively model the nonlinearities and memory effects introduced by transmitter and receiver hardware impairments. The robustness of the SIC is further evaluated under both single off-line training and closed-loop real-time adaptation, employing estimation techniques such as least squares (LS), least mean squares (LMS), and fast Kalman (FK) for model coefficient estimation. The performance of the proposed digital SIC techniques is evaluated through detailed simulations that incorporate realistic power amplifier (PA) characteristics, channel conditions, and high-order modulation schemes. Metrics such as error vector magnitude (EVM) and total bit error rate (BER) are used to assess the quality of the received signal after SIC under different signal-to-interference ratio (SIR) and signal-to-noise ratio (SNR) conditions. The results show that, for time-variant scenarios, a low-complexity adaptive SIC can be realized using a GMP model with FK parameter estimation. However, in time-invariant scenarios, an open-loop SIC approach based on PNN offers superior performance and maintains robustness across various modulation schemes. Full article

Background/Objectives: Ustekinumab (UST) is an effective and safe drug for treating Crohn’s disease (CD), but data on disease progression after UST treatment is limited. This study aimed to develop a clinical decision support tool (CDST) to identify Chinese patients with CD less likely to experience disease progression during UST treatment. Methods: A multicenter, retrospective observational study was conducted among Chinese patients with CD who started UST treatment between 1 May 2020 and 20 October 2022. Baseline characteristics, defined as the measurements taken closest to, and prior to, the first dose of UST, were collected. Disease progression, defined as CD-related surgery, hospitalization, and complications, was evaluated by week 52 (±4 weeks). Predictors were identified using logistic regression, and a UST-specific CDST (UST-CDST) was developed. The UST-CDST was then internally and externally validated using the area under the receiver operating characteristic curve (AUC). Results: Among 602 enrolled patients, 533 were included in the analysis. Four factors were suggestively associated with disease progression: prior biologics usage, baseline disease severity, baseline C-reactive protein, and baseline hemoglobin. The prediction model demonstrated an AUC of 0.88 in internal validation and 0.66 in external validation. The UST-CDST effectively stratified patients into low-risk or high-risk groups for disease progression within one year. Conclusions: A UST-CDST was developed and validated to identify patients with CD less or more likely to experience disease progression around week 52 under UST therapy. The scoring system promises to facilitate clinical decision-making and personalized treatment. Full article

Background: Hepatocellular carcinoma (HCC) continues to be a major cause of cancer associated deaths worldwide, highlighting the need for new prognostic biomarkers and treatment strategies. Triaptosis, a recently characterized mode of regulated cell death, has shown potential as a therapeutic target in various malignancies, including HCC. Nevertheless, how long non-coding RNAs (lncRNAs) regulate triaptosis, as well as their function in HCC, is still not well understood. Methods: This study integrates bioinformatics and functional validation to delineate the interplay between lncRNAs and triaptosis in HCC progression. Results: Firstly, we confirm that pharmacologically inducing triaptosis, a process centrally mediated by ROS accumulation, with menadione sodium bisulfite (MSB) can inhibit HCC growth both in vitro and in vivo. Furthermore, single-cell RNA sequencing identifies a specific elevation of the triaptosis-related gene MTM1 in malignant hepatocytes. Through systematic bioinformatics analysis of TCGA data, we develop a 5-lncRNA prognostic signature (LINC01134, HPN-AS1, DDX11-AS1, AC009283.1, AC009005.1) with superior predictive power over conventional clinical parameters. Strikingly, functional studies reveal that LINC01134 acts as a crucial oncogenic driver and its depletion suppresses proliferation, migration, and invasion while sensitizing cells to triaptosis via MTM1-mediated PI(3)P catabolism. Conclusions: Collectively, our study confirms that triaptosis is a therapeutically targetable signaling in HCC and proposes LINC01134 as a biomarker and therapeutic target, offering new insights into lncRNA-mediated regulation of cell death for precision oncology. Full article

Background and Objectives: Post-surgical central nervous system (CNS) infections are severe complications associated with high morbidity and mortality. Vancomycin is a key antibiotic used in their management. However, because of the restrictive properties of the blood–brain barrier (BBB), plasma concentrations may not accurately reflect drug exposure in the brain extracellular fluid (ECF), the presumed site of infection. Cerebral microdialysis enables direct measurement of unbound drug levels in brain ECF. This study aimed to assess vancomycin penetration into brain ECF in patients with suspected or confirmed post-surgical CNS infection. Materials and Methods: Five patients with suspected or confirmed post-surgical CNS infections were enrolled. Paired brain ECF microdialysate and plasma samples (and cerebrospinal fluid (CSF) samples, when available) were collected over two consecutive days at vancomycin steady state. Vancomycin concentrations were determined using a homogeneous enzyme immunoassay and corrected for probe recovery based on in vitro calibration. Pharmacokinetic parameters, including mean concentrations and 24-h area under the concentration–time curve (AUC24), were calculated for plasma and ECF, and ECF-to-plasma ratios were derived. Results: Two subgroups could be identified: patients with negligible ECF concentrations (“low penetrators”), and those with higher ECF levels (“high penetrators”). Mean (SD) ECF-to-plasma concentration ratios were 0.07 (0.04) in “low penetrators” and 0.44 (0.10) in “high penetrators”. The corresponding AUC24 ratios were 0.06 (0.03) and 0.40 (0.03), respectively. The presence of systemic inflammatory response syndrome (SIRS) was considered the most plausible factor differentiating these two subgroups. Conclusions: Vancomycin exposure in brain ECF demonstrated substantial interpatient variability in post-surgical CNS infections, with some patients showing minimal drug penetration. Full article

Hepatocellular carcinoma (HCC) ranks as the second most lethal malignancy worldwide, presenting formidable therapeutic challenges including tumor heterogeneity, complex microenvironment, and inefficient drug delivery. Conventional therapies such as surgery, chemotherapy, and immunotherapy are limited by systemic toxicity, drug resistance, and poor targeting specificity. Mesenchymal stem cells (MSCs) have emerged as promising drug delivery vehicles, leveraging their innate tumor-homing capacity, immunomodulatory properties, and exosome-mediated cargo transport. Preclinical studies demonstrate that MSC-based systems triple drug accumulation in tumors and synergize with immunotherapy, extending survival in HCC models. This review systematically examines recent advances in MSC-based delivery systems for HCC, focusing on engineering strategies to enhance targeting precision and controlled drug release, including genetic modification, exosome engineering, and stimuli-response systems. Despite progress, challenges such as MSC heterogeneity and scalable production persist. Emerging solutions like single-cell RNA sequencing for subpopulation selection and 3D bioprinting for standardized culture are highlighted. This work provides a roadmap for developing MSC-based precision therapies, bridging translational gaps in HCC treatment. Full article

As global emphasis on environmental, social, and governance practices intensifies, sustainability reporting emerges as a critical tool for corporate transparency and accountability. The study aims to assess the impact of sustainability reporting on the financial performance of listed companies in Jordan. Using a quantitative approach, a total of 588 individuals were surveyed from low-pollution and high-pollution industries using purposive sampling techniques. Partial Least Square Structural Equation Modeling (PLS-SEM) was used to conduct analysis of the data with the aid of SMART PLS4 software. The study finds that the impact of sustainability disclosures on firms’ financial performance in Jordan differs significantly by both the type of disclosure and the pollution intensity of the industry the firms belong to. Environmental impact reporting (EIR) and social impact reporting (SIR) both have positive and significant effects on financial performance, especially in low-pollution industries, probably because of a perceived proactive and authentic integration of sustainability practices. However, governance impact reporting (GIR) shows a negative relationship with financial performance, which implies that such disclosures may be perceived as compliance-driven or not authentic. These findings indicate that the context of the sustainability reporting strategy is an important element in determining its effect on financial performance. The multigroup analysis (MGA) results help us to gain a better understanding of how different sectors leverage financial value from disclosing their sustainability activities. The study confirms that sustainability disclosure is not just a compliance requirement, but an instrument that can help firms improve their financial performance. Finally, we recommend that future research should investigate deeper psychological and social mechanisms likely to influence stakeholder responses across different sectors and countries within the region. Full article

Background/Objectives: Extremity trauma represents a significant proportion of battlefield injuries and is prevalent in polytraumatized patients from accidents. Delayed antibiotic treatment and surgical intervention can lead to wound infections, contributing to preventable mortality. This preliminary study aimed to develop a conscious swine model of complex extremity trauma that induces systemic inflammatory response syndrome (SIRS). Methods: All surgical procedures were conducted under anesthesia with sufficient analgesia. All swine were instrumented with a telemetry device and catheters at least 3 days prior to any injury. In phase 1 of model development, a complex extremity injury was performed that consisted of skin and muscle loss, bone defect, severe hemorrhage, and 2 h tourniquet application. In phase 2, multi-drug resistant Gram-positive and Gram-negative bacteria were inoculated topically at the injury site to exacerbate pathophysiological changes towards SIRS. Post-injury, conscious animals were assessed a minimum of twice daily, including pain assessment, neurological response, and vital signs. Blood samples were collected for microbiological testing, complete blood cell counts, and biochemical analysis. Results: After establishing SIRS criteria for Sinclair swine, we developed a model of severe extremity trauma leading to SIRS. During phase 1, resuscitative fluids were reduced and discontinued, with animals surviving 24 h and maintaining SIRS for up to 4 h post-recovery. Phase 2 showed that Gram-negative and Gram-positive pathogens can exacerbate and prolong SIRS. After 72 h, localized infection at the injury site was observed in all animals. Conclusions: We established a new swine model of complex extremity trauma with SIRS. Our model is consistent, reproducible, and relevant to prolonged care scenarios, providing a platform for future research into the evaluation of preventative and therapeutic strategies. Full article

Background: Breast cancer polygenic risk scores (PRS) and traditional risk models (e.g., the Gail model [Gail]) are known to contribute largely independent information, but it is unclear how the overlap varies by ancestry, age, disease type (invasive breast cancer, DCIS), and risk threshold. Methods: In a retrospective case–control study, we evaluated risk prediction performance in 180,398 women (161,849 of European ancestry; 18,549 of Asian ancestry). Odds ratios (ORs) from logistic regression models and the area under the receiver operating characteristic curve (AUC) were estimated. Results: PRS for invasive disease showed a stronger association in younger (<50 years) women (OR = 2.51, AUC = 0.622) than in women ≥ 50 years (OR = 2.06, AUC = 0.653) of European ancestry. PRS performance in Asians was lower (OR range = 1.62–1.64, AUC = 0.551–0.600). Gail performance was modest across groups and poor in younger Asian women (OR = 0.94–0.99, AUC = 0.523–0.533). Age interactions were observed for both PRS (p < 0.001) and Gail (p < 0.001) in Europeans, whereas in Asians, age interaction was observed only for Gail (invasive: p < 0.001; DCIS: p = 0.002). PRS identified more high-risk individuals than Gail in Asian populations, especially ≥50 years, while Gail identified more in Europeans. Overlap between PRS, Gail, and family history was limited at higher thresholds. Calibration analysis, comparing empirical and model-based ROC curves, showed divergence for both PRS and Gail (p < 0.001), which indicates miscalibration. In Europeans, family history and prior biopsies drove Gail discrimination. In younger Asians, age at first live birth was influential. Conclusions: PRS adds value to risk stratification beyond traditional tools, especially in younger women and Asian ancestry populations. Full article

Objectives: Patients with severe to profound sudden sensorineural hearing loss (SSNHL) generally experience poorer hearing recovery; however, the associated risk factors have not been identified. This study synthesizes current evidence to explore prognostic risk factors in this patient group. Methods: Databases were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to 18 October 2025. Three researchers independently extracted and recorded patient information and relevant data from all selected studies. Any inconsistencies were clarified through discussion or by consulting a fourth researcher. Results: The study included 2632 patients from 15 articles published between 2002 and 2025 and evaluated 8 prognostic risk factors. The results showed that profound hearing loss (OR = 4.68; 95% CI: 3.57–6.13; p < 0.001) and vertigo (OR = 1.95; 95% CI: 1.28–2.98; p = 0.002) were correlated with poorer hearing recovery. Subgroup analyses based on different prognostic criteria confirmed the consistent impact of hearing loss severity on poor outcomes. The remaining 6 risk factors did not show statistically meaningful associations. Conclusions: Profound hearing loss and vertigo are significantly associated with poorer prognosis in patients with severe to profound SSNHL. These findings may help identify high-risk patients early and inform the design of personalized therapeutic approaches in clinical settings. Full article

Background: Sepsis remains a major cause of morbidity and mortality in both developed and limited-resource countries. Despite over a century of research, accurate biomarkers for reliable diagnosis and prognosis in critically ill patients have yet to be established. Methods: This multicenter retrospective observational study aims to evaluate serum levels of Calprotectin, Azurocidin, cytokines, chemokines, procalcitonin (PCT) and C-Reactive Protein (CRP) in 15 healthy volunteers (controls), 15 non-infectious SIRS patients, 92 alive septic patients (Sepsis_A) and 29 dead septic patients (Sepsis_D). Results: Most biomarkers showed significantly higher serum concentrations in septic patients compared with controls, with IL-4 being increased only in the Sepsis_D group. In addition, several markers, including Calprotectin, Azurocidin, IL-6, IL-8, IL-10, TNF-α, and IL-35, were progressively elevated from SIRS to Sepsis_A and Sepsis_D cohorts, reflecting disease severity. All biomarkers showed good diagnostic performance for predicting Gram-negative bacteremia, although their accuracy in discriminating survivors from non-survivors was relatively low. Conclusions: In conclusion, calprotectin, azurocidin, IL-8, TNF-α, and IL-35 may assist clinicians in identifying Gram-negative bacteremia in septic patients; however, their prognostic value appears to be limited. Full article

Background: Quality of life (QoL) is a crucial outcome measure in cancer care. This study aimed to identify the association of health-related quality of life (HRQoL) among colorectal cancer (CRC) patients in Malaysia. Methods: The study was conducted from January 2021 to July 2022, recruiting CRC patients from two teaching hospitals in Malaysia. The validated Malay versions of EORTC QLQ-C30 and QLQ-CR29 questionnaires assessed physical, psychological, and social functioning. Patients were evaluated 6 months after diagnosis to determine QoL associations. Anthropometric measurements were recorded at baseline (diagnosis, 0 months) and at follow-up (6 months). Results: Among 87 CRC patients (55.2% male, mean age 59.8 ± 11.8 years), 37.9% had stage III disease and 13.8% had stage IV. Most patients (93%) underwent surgery and 78% received chemotherapy. The mean global health status score was 66.57 ± 20.75. Multiple linear regression analysis revealed that older age (p = 0.03), advanced cancer stage (p = 0.017), lower body weight (p = 0.017), and reduced hip circumference (p = 0.040) are significantly associated with poorer global health status quality of life (GHS QoL). Nutritional parameters specifically predicted functional domains: lower body weight and BMI predicted role and cognitive function, while lower hip circumference predicted emotional function. Conclusions: Advanced age, disease stage, and nutritional status are significant associations of QoL in Malaysian CRC patients. These findings highlight the importance of nutritional assessment and intervention in CRC survivorship care to optimize patient outcomes. Full article

This study examines the effectiveness of pervious concrete pavements as a sustainable and cost-effective stormwater management technique, particularly by incorporating locally sourced recycled materials into their design. It evaluates the stormwater treatment potential of three pervious concrete pavement types incorporating recycled plastic, glass, and crushed concrete aggregates, with six design variations produced using 25% and 50% replacements of coarse aggregates from these materials. The key properties of pervious concrete, namely compressive strength, porosity, unit weight, and infiltration, and key water quality indicators, namely pH, electrical conductivity (EC), total suspended solids (TSS), colour, turbidity, chemical oxygen demand (COD), nitrate (NO₃⁻), and orthophosphate (PO₄³⁻), were analysed. Results indicated an overall improvement in the quality of the stormwater runoff passed through all pervious concrete pavements irrespective of composition. Notable reductions in turbidity, TSS, colour, COD, PO₄³⁻, and NO₃⁻ underscored the effectiveness of pervious concrete containing waste materials in the treatment of stormwater runoff. Pervious concrete pavements with 25% recycled concrete exhibited optimal performance in reducing TSS, COD, and PO₄³⁻ levels, while the 50% recycled concrete variant excelled in diminishing turbidity. However, the study found that the use of recycled materials in pervious concrete pavements affects properties like compressive strength and infiltration rate differently. While incorporating 25% and 50% recycled concrete aggregates did not significantly reduce compressive strength, the effectiveness of stormwater treatment varied based on the mix design and type of recycled material used. Thus, this study highlights the potential of utilizing recycled waste materials in pervious concrete pavements for sustainable stormwater management. Full article