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20 pages, 2384 KB  
Article
Comprehensive Assessment of Prognostic Factors for Immune-Related Adverse Events in Immune Checkpoint Inhibitor-Treated Melanoma
by Julian Kött, Myriam Merkle, Lina Bergmann, Noah Zimmermann, Tim Zell, Isabel Heidrich, Glenn Geidel, Klaus Pantel, Stefan W. Schneider, Christoffer Gebhardt and Daniel J. Smit
Cancers 2025, 17(17), 2806; https://doi.org/10.3390/cancers17172806 (registering DOI) - 27 Aug 2025
Abstract
Background: Immune checkpoint inhibition (ICI) is the standard treatment for advanced melanoma patients. Despite its high efficacy compared to previous treatment options, immune-related adverse events (irAEs) occur frequently. While most of the patients experience mild to moderate irAEs, some patients develop severe [...] Read more.
Background: Immune checkpoint inhibition (ICI) is the standard treatment for advanced melanoma patients. Despite its high efficacy compared to previous treatment options, immune-related adverse events (irAEs) occur frequently. While most of the patients experience mild to moderate irAEs, some patients develop severe to lethal irAEs under ICI treatment; hence, biomarkers are urgently required. Methods: In this retrospective single-center study, 157 advanced melanoma patients treated with ICI at the University Medical Center Hamburg–Eppendorf were included. IrAEs were correlated with clinico-pathological parameters, disease-related outcomes, and irAE-free survival. Results: In our cohort, 130 out of 157 patients receiving immunotherapy experienced irAE, of which more than half experienced irAE Grade ≥ 3. The most common irAE independent of its grade included cutaneous irAE, colitis, endocrine irAE, and hepatitis. Patients experiencing irAE had significantly longer progression-free survival (PFS) and overall survival (OS) compared to patients who did not experience irAE under ICI therapy. Stratification by irAE groups revealed that musculoskeletal irAEs are associated with the longest, whereas myocarditis is associated with the shortest OS and PFS. IrAE was a significant beneficial prognosticator for PFS in univariate, but not in multivariate Cox regression analysis. With respect to OS, the occurrence of irAE was an independent prognostic factor among ECOG status ≥ 2 and uveal melanoma. ROC analysis demonstrated that D-dimers have moderate predictive capability for irAE occurrence. Cox regression analysis demonstrated that elevated D-dimers and PD-1 monotherapy vs. CTLA-4 and PD-1 combination regimen are the only independent prospective prognostic markers for irAE-free survival. Conclusions: Our study demonstrates that different irAE across the irAE spectrum have a different impact on the PFS and OS of advanced melanoma patients. D-dimers may be used as a blood-based biomarker for irAE prediction, warranting future validation in multi-center studies. Full article
(This article belongs to the Section Cancer Immunology and Immunotherapy)
16 pages, 1572 KB  
Article
Electrical Impedance Spectroscopy Reveals Physiological Acclimation in Apple Rootstocks During Recurrent Water Stress Episodes
by Juan Zhou, Shuaiyang Wu, Jianan Chen, Bo Sun, Bao Di, Guilin Shan and Ji Qian
Agronomy 2025, 15(9), 2068; https://doi.org/10.3390/agronomy15092068 (registering DOI) - 27 Aug 2025
Abstract
Waterlogging and drought have become major challenges in many regions worldwide. Under water stress, plants exhibit a range of physiological and electrical responses, including changes measurable by electrical impedance spectroscopy (EIS). Monitoring these parameters can provide valuable insights into plant growth status under [...] Read more.
Waterlogging and drought have become major challenges in many regions worldwide. Under water stress, plants exhibit a range of physiological and electrical responses, including changes measurable by electrical impedance spectroscopy (EIS). Monitoring these parameters can provide valuable insights into plant growth status under adverse conditions. This study investigated changes in relative chlorophyll content (SPAD), maximum photochemical efficiency (Fv/Fm), relative water content (RWC), non-structural carbohydrates (NSC), and EIS parameters in apple rootstocks subjected to different water stress treatments. Results indicated that all physiological indicators, except NSC, showed a declining trend under two water stress episodes. Critically, the initial water stress episode elicited significantly greater physiological disruption than its subsequent counterpart. This suggests that plants developed a degree of physiological adaptation—such as osmotic adjustment and enhanced antioxidant activity—reducing their sensitivity to subsequent stress. Correlation analysis revealed that high-frequency resistivity (r) and intracellular resistivity (ri) were strongly associated with key physiological parameters. Thus, r and ri may serve as effective indicators for assessing plant water stress status. Furthermore, classification algorithms—Fuzzy K-Nearest Neighbors (FKNN) and sparse Linear Discriminant Analysis (sLDA)—were applied to distinguish water status in apple rootstocks, achieving high classification accuracy. These findings provide a theoretical basis for improved water management in apple cultivation. Full article
(This article belongs to the Section Horticultural and Floricultural Crops)
11 pages, 621 KB  
Article
Correlations of Lumbar Interspinous Distance with Neuroforaminal Dimensions, Disc Space Height, and Patient Demographic Factors
by Carson Cummings, Zachary Brandt, Kai Nguyen, Asael Isaac, Jean-Carlos Gutierrez, Ashley Kempf, David Cheng, Joel D. Carson, Emily Novak, Jacob Razzouk, Olumide Danisa and Wayne Cheng
Tomography 2025, 11(9), 100; https://doi.org/10.3390/tomography11090100 (registering DOI) - 27 Aug 2025
Abstract
Background/Objectives: A thorough understanding of spinal anatomy is essential for diagnostic assessment and surgical intervention. Interspinous distance (ISD), neuroforaminal dimensions (NFDs), and disc space height (DSH) have each been studied separately; however, their interrelationship remains unstudied. Given the use of interspinous implants as [...] Read more.
Background/Objectives: A thorough understanding of spinal anatomy is essential for diagnostic assessment and surgical intervention. Interspinous distance (ISD), neuroforaminal dimensions (NFDs), and disc space height (DSH) have each been studied separately; however, their interrelationship remains unstudied. Given the use of interspinous implants as a minimally invasive treatment for lumbar stenosis and degenerative disc disease, defining these relationships is of growing clinical significance. This study investigates the correlation between ISD and both NFDs and DSH in a normative population and whether ISD varies with demographic factors. Methods: A retrospective chart review was performed on 852 patients who underwent CT imaging of the lumbar spine. ISD was measured from L1 to L5 as the shortest distance between the most caudal tip of the superior spinous process and the inferior spinous process. DSH was measured at the anterior, middle, and posterior margins. NFDs were assessed in axial and sagittal views, including axial width, craniocaudal height, and foraminal area. Statistical analysis assessed correlations between ISD, NFDs, DSH, and demographic variables. Results: No strong correlation was observed between ISD and either NFDs or DSH. Slightly greater correlation was present at L1–L3, weakening at L4–L5, where interspinous implants are most commonly placed. Demographic analysis revealed no consistent relationship between ISD and ethnicity, sex, or BMI. While it may be expected that larger ISD correlates with greater NFDs or DSH, our findings do not support this assumption. Conclusions: ISD does not strongly correlate with NFDs or DSH, and demographic factors do not significantly influence ISD in a healthy population. Full article
(This article belongs to the Special Issue Orthopaedic Radiology: Clinical Diagnosis and Application)
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18 pages, 961 KB  
Article
In Vivo (In)Stability Shoulder Assessment in Healthy Active Adults Using Force Plates and a Motion Capture System: A Cross-Sectional Study
by Laura Ramírez-Pérez, Eric Yung-Sheng Su, Antonio Ignacio Cuesta-Vargas and Graham K. Kerr
Sensors 2025, 25(17), 5333; https://doi.org/10.3390/s25175333 (registering DOI) - 27 Aug 2025
Abstract
The assessment of shoulder stability is a great challenge in sports medicine. There is a lack of objective tools to assess functional shoulder stability in sports with high demands on the upper limb. This cross-sectional study recruited twenty healthy adults to analyze the [...] Read more.
The assessment of shoulder stability is a great challenge in sports medicine. There is a lack of objective tools to assess functional shoulder stability in sports with high demands on the upper limb. This cross-sectional study recruited twenty healthy adults to analyze the use of a force platform in a push-up analysis as a valid tool for estimating glenohumeral stability. For this purpose, the subjects performed one strength task based on a maximum lateral abduction against a dynamometer. They also performed three variations of a push-up task on force plates with movements recorded by a 3D motion capture system. The results showed that healthy adults present similar movement patterns during push-ups, without differences in terms of stability between sexes, although males showed greater values in lateral abduction strength (left: 63.2 vs. 36.8; p < 0.001; right: 64.2 vs. 38.9; p < 0.001) and ground reaction force peak in the three push-up tasks (p < 0.005). Moreover, four prediction models were developed based on the use of force plate data to estimate kinematics concerning humerus acceleration (p < 0.001). In conclusion, this research demonstrated that force plates are a valid tool for upper-limb assessment with significant correlations with dynamometer and 3D motion capture measures. Full article
(This article belongs to the Special Issue Novel Optical Biosensors in Biomechanics and Physiology)
16 pages, 942 KB  
Systematic Review
Refractive Outcomes in Keratoconus Patients Following Toric Lens Implantation: A Systematic Review and Single-Group Meta-Analysis
by Tun Giap Tan, Kieran O’Kane and Harry W. Roberts
Life 2025, 15(9), 1362; https://doi.org/10.3390/life15091362 (registering DOI) - 27 Aug 2025
Abstract
This systematic review and meta-analysis evaluated refractive outcomes, particularly astigmatic correction, in keratoconus following toric intraocular lens (tIOL) implantation. A systematic search identified eligible studies reporting pre- and postoperative refractive cylinder, spherical equivalent (SE), uncorrected distance visual acuity (UDVA), and corrected distance visual [...] Read more.
This systematic review and meta-analysis evaluated refractive outcomes, particularly astigmatic correction, in keratoconus following toric intraocular lens (tIOL) implantation. A systematic search identified eligible studies reporting pre- and postoperative refractive cylinder, spherical equivalent (SE), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA). Eight studies, comprising 135 eyes, were included. Outcomes were pooled using a random-effects model with restricted maximum likelihood as the estimator for tau2. Methodological quality was assessed using the MINORS tool for non-comparative studies and the JBI checklist for case series. Postoperative refractive cylinder and SE improved by 2.28 dioptres (95% CI, 1.60–2.96) and 4.17 dioptres (95% CI, 2.32–6.01), respectively. UDVA and CDVA also improved substantially, with pooled gains of 0.87 logMAR (95% CI, 0.71–1.03) and 0.19 logMAR (95% CI, 0.12–0.26), respectively. Most tIOL rotations did not exceed 10 degrees, with only one case requiring realignment surgery. Complications were infrequent and mostly minor. tIOL implantation is effective in reducing astigmatism and improving vision in stable keratoconus patients. However, limitations in vector analysis and methodology heterogeneity underscore the need for standardised reporting to optimise outcomes. Full article
(This article belongs to the Special Issue Vision Science and Optometry: 2nd Edition)
13 pages, 598 KB  
Article
Acute L-Carnitine Supplementation Does Not Improve CrossFit® Performance: A Randomized, Double-Blind, Placebo-Controlled Crossover Study
by Asli Devrim-Lanpir, Lucero Salazar Velasco, Fanny Guadalupe Ramirez Lara, Azucena Ojeda Sanchez, Rachel Kimble, Reza Zare, Fatma Esra Gunes, Beat Knechtle, Katja Weiss, Thomas Rosemann and Katie Heinrich
Nutrients 2025, 17(17), 2784; https://doi.org/10.3390/nu17172784 (registering DOI) - 27 Aug 2025
Abstract
Background: L-carnitine supplementation is thought to enhance exercise performance, particularly in moderate and high-intensity activities, but evidence supporting this is mixed. This study aimed to assess whether acute L-carnitine tartrate supplementation could improve CrossFit® performance, specifically during the “Cindy” workout, a high-intensity [...] Read more.
Background: L-carnitine supplementation is thought to enhance exercise performance, particularly in moderate and high-intensity activities, but evidence supporting this is mixed. This study aimed to assess whether acute L-carnitine tartrate supplementation could improve CrossFit® performance, specifically during the “Cindy” workout, a high-intensity exercise protocol. Methods: In a randomized, double-blind, placebo-controlled crossover design, 20 trained male recreational CrossFit® athletes completed the “Cindy” workout within a 20 min period after ingesting either 3 g of L-carnitine tartrate or a placebo 90 min before exercise. Performance was measured by total repetitions completed. Secondary outcomes included ratings of perceived exertion (RPE), gastrointestinal issues, and blood pressure (BP) measurements. Results: The results showed that L-carnitine supplementation did not significantly affect the number of repetitions performed (202.4 ± 69.9 vs. 204.5 ± 78.8, p = 0.810) compared to the placebo. There were also no significant differences in RPE (6.3 ± 1.5 vs. 6.9 ± 1.4, p = 0.180) or BP changes between groups. However, 10% of participants reported difficulty sleeping after L-carnitine supplementation. Conclusions: The findings suggest that 3 g of L-carnitine tartrate does not enhance CrossFit® performance in recreational athletes. Further research is needed to clarify its potential benefits, especially with larger samples and consideration of factors like sex and carbohydrate co-ingestion. Full article
(This article belongs to the Special Issue Nutritional Supplements and Diet in Athletic Performance)
14 pages, 400 KB  
Review
The Role of Digital Gaming in Addressing Loneliness Among Older Adults: A Scoping Review
by Eunie (Yoon Kyung) Jung and Jiadong Yu
Healthcare 2025, 13(17), 2140; https://doi.org/10.3390/healthcare13172140 (registering DOI) - 27 Aug 2025
Abstract
As the world’s population of older adults continues to grow rapidly, combating loneliness and social isolation has become an emerging health concern for this group. Though there has been increasing interest within the scientific community in exploring digital games as an intervention for [...] Read more.
As the world’s population of older adults continues to grow rapidly, combating loneliness and social isolation has become an emerging health concern for this group. Though there has been increasing interest within the scientific community in exploring digital games as an intervention for loneliness, research on gaming as an intervention is a relatively new field of study. This scoping review examines the current state of research on the impact of digital gaming on loneliness in the older adult population and was conducted in accordance with the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 317 potentially relevant studies were identified through database searches, and of these, 278 studies were excluded due to failure to meet inclusion criteria. The full texts of 39 articles were assessed for eligibility, resulting in 9 articles being included in this scoping review. Some important findings from our study include the central role of social interaction in addressing loneliness and the potential for interventions targeting both physical and mental well-being to have a more significant impact on alleviating loneliness. We also found that while many studies reported positive effects of gaming interventions, some findings were contradictory, suggesting that the relationship between gaming and loneliness is complex and moderated by multiple factors. Recommendations for future research include expanding investigations to outside of East Asia (where the majority of existing studies were conducted) to the United States, Africa, India, or Europe. Full article
(This article belongs to the Section Community Care)
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14 pages, 580 KB  
Article
A Comparative Analysis of Early Ventilator Mechanics in COVID-19 vs. Non-COVID-19 ARDS: A Single-Center ED-Based Cohort Study
by Murtaza Kaya, Ceyda Nur Irk, Mehmed Ulu, Harun Yildirim, Mehmet Toprak and Sami Eksert
Healthcare 2025, 13(17), 2139; https://doi.org/10.3390/healthcare13172139 (registering DOI) - 27 Aug 2025
Abstract
Background and Aim: Mechanical ventilatory support is often required in patients with acute respiratory distress syndrome (ARDS). However, early differences in ventilatory mechanics and severity scores between COVID-19 and non-COVID-19 ARDS patients remain unclear. This study aimed to compare respiratory parameters and clinical [...] Read more.
Background and Aim: Mechanical ventilatory support is often required in patients with acute respiratory distress syndrome (ARDS). However, early differences in ventilatory mechanics and severity scores between COVID-19 and non-COVID-19 ARDS patients remain unclear. This study aimed to compare respiratory parameters and clinical severity scores in COVID-19 and non-COVID-19 ARDS patients managed in the emergency department (ED) and evaluate their association with in-hospital mortality. Methods: In this retrospective cohort study, adult patients with ARDS (PaO2/FiO2 < 300 mmHg) who received mechanical ventilation in the ED were included. Ventilator parameters and clinical severity scores (SOFA, APACHE II, PSI, and Charlson Comorbidity Index) were recorded at the 120th minute after intubation. Patients were categorized as COVID-19 or non-COVID-19 ARDS, and outcomes were compared between survivors and non-survivors. Logistic regression was used to identify independent predictors of in-hospital mortality. Results: A total of 70 patients were enrolled (32 COVID-19, 38 non-COVID). Plateau pressure, driving pressure, and PEEP were significantly higher in COVID-19 patients, while compliance was without statistical significance. Overall, in-hospital mortality did not differ significantly between the COVID-19 (53.1%) and non-COVID-19 groups (71.1%, p = 0.12). Mechanical power (21.6 vs. 16.8 J/min, p = 0.01) and Charlson Comorbidity Index (6 vs. 5.5, p = 0.02) were significantly higher in non-survivors across the full cohort. Among clinical scores, SOFA was significantly higher in the COVID-19 group (p = 0.02), and APACHE II was significantly higher in non-survivors within the COVID-19 subgroup (p = 0.02). In multivariate analysis, mechanical power and Charlson Comorbidity Index were associated with mortality. Conclusions: COVID-19 patients with ARDS exhibited higher early ventilatory pressures than non-COVID-19 patients, yet early respiratory mechanics were not independently associated with mortality. Mechanical power and Charlson Comorbidity Index were significantly associated with in-hospital mortality. These findings underscore the need to consider both ventilatory load and systemic health status in early outcome assessments of ARDS patients. Full article
(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)
23 pages, 999 KB  
Article
Antioxidant Potential and Oxidative Stress Modulation of Geranium macrorrhizum L. Oil Extract in Gentamicin-Induced Nephrotoxicity
by Tsvetelin Georgiev, Galina Nikolova, Viktoriya Dyakova, Silvia Zlateva, Yanka Karamalakova, Ekaterina Georgieva, Kamelia Petkova-Parlapanska, Julian Ananiev, Ana Dobreva and Petya Hadzhibozheva
Pharmaceuticals 2025, 18(9), 1283; https://doi.org/10.3390/ph18091283 - 27 Aug 2025
Abstract
Objectives: The current study focused on the kidney protection and antioxidant properties along with the potential anti-ferroptotic activity of Geranium macrorrhizum L. (G. macrorrhizum) oil to ameliorate the acute renal oxidative tissue damage and toxicity of the aminoglycoside antibiotic gentamicin (GM) [...] Read more.
Objectives: The current study focused on the kidney protection and antioxidant properties along with the potential anti-ferroptotic activity of Geranium macrorrhizum L. (G. macrorrhizum) oil to ameliorate the acute renal oxidative tissue damage and toxicity of the aminoglycoside antibiotic gentamicin (GM) in an experimental murine model. Methods: The research was carried out with mature Balb/c mice distributed into four groups (n = 6). Application of GM (200 mg kg−1 intraperitoneal injection for 10 days) was performed to induce kidney injury. Only saline was administered to the controls. The remaining groups were administered G. macrorrhizum oil (50 mg kg−1 per dose) either used alone or in combination with GM. To assess the renal antioxidant status, the activities of specific antioxidant enzymes, indicators of lipid and DNA peroxidation and renal functional damage were examined using standard commercial kits, ELISA and EPR spectroscopy. Results: G. macrorrhizum oil analysis revealed 20 organic components belonging to mono- and sesquiterpenoids and long-chain hydrocarbons. The antioxidant and anti-inflammatory effects of G. macrorrhizum oil were demonstrated by reduced malondialdehyde, ROS, 8-hydroxy-2′-deoxyguanosine and cytokine levels (especially interleukin-1β) compared with GM. Furthermore, increased activation of superoxide dismutase, catalase and glutathione (GSH) were observed in the kidney homogenates of the animals which received GM in combination with G. macrorrhizum oil compared with the GM group. Additional changes in the GSH/glutathione peroxidase-4 axis were detected, suggesting the possible anti-ferroptotic potential of the oil. Nephroprotection was also demonstrated by elevated PGC-1α expression (peroxisome proliferator-activated receptor γ coactivator 1-alpha) and reduced KIM-1 levels (kidney injury molecule-1) following application of the oil. Conclusions: The preserved kidney antioxidant and functional properties in the groups treated with oil suggest that Geranium macrorrhizum L. could be utilized clinically to mitigate the toxic effects of GM application. Full article
(This article belongs to the Special Issue Natural Products in Health Promotion and Disease Prevention 2025)
33 pages, 893 KB  
Article
Green Finance Policies, Urban Green Energy Efficiency and Regional Relative Disparities—Causality Tests Based on Dual Machine Learning
by Juanjuan Li
Sustainability 2025, 17(17), 7733; https://doi.org/10.3390/su17177733 (registering DOI) - 27 Aug 2025
Abstract
China’s sustained economic growth and industrialisation have led to increasingly serious problems of resource consumption and environmental pressure, making green development an inevitable choice for the country’s transformation and development. Green finance policies are becoming an increasingly important tool for increasing the use [...] Read more.
China’s sustained economic growth and industrialisation have led to increasingly serious problems of resource consumption and environmental pressure, making green development an inevitable choice for the country’s transformation and development. Green finance policies are becoming an increasingly important tool for increasing the use of green energy in cities. Using a dual machine learning (DML) model, this paper assesses the specific impact of green finance policies on green energy efficiency in Chinese cities, the mechanism of action, and regional disparities. The analysis is based on objective and scientific measurement of the level of green finance policies and green energy efficiency in 282 Chinese cities at prefecture level and above from 2006 to 2022. Benchmark regression results show that green finance policies significantly promote green energy efficiency in Chinese cities, passing a rigorous robustness test. Green bond policies are found to have the greatest promotional effect, whereas green support policies are found to have no significant effect. The results of the heterogeneity analysis suggest that green finance policies are more effective in promoting green energy efficiency in resource-based cities, cities with established industrial bases, and more developed cities. The results of the impact mechanism suggest that green finance policies can promote green energy efficiency by allocating the three internal urban factors of labour, capital and technology. The results of the analysis of regional disparities demonstrate that green finance policies effectively reduce disparities in urban green energy efficiency at the national level, between the north and south, and between coastal and inland regions. However, they also widen the disparities between central and peripheral cities within each province, hindering balanced regional development. This paper makes relevant policy recommendations based on this. Full article
16 pages, 643 KB  
Article
The Impact of Basal Inflammatory Status on Post-CABG Atrial and Ventricular Ectopy and Remodeling Pathways
by Dan-Alexandru Cozac, Cristina Somkereki, Adina Huțanu, Tunde Renata Nicoara and Alina Scridon
Medicina 2025, 61(9), 1545; https://doi.org/10.3390/medicina61091545 - 27 Aug 2025
Abstract
Background and Objectives: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) commonly occur after coronary artery bypass grafting (CABG) surgery, with frequent ectopics linked to atrial fibrillation risk and reduced heart function. While CABG-induced inflammation causes arrhythmogenic changes, the connection between preoperative [...] Read more.
Background and Objectives: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) commonly occur after coronary artery bypass grafting (CABG) surgery, with frequent ectopics linked to atrial fibrillation risk and reduced heart function. While CABG-induced inflammation causes arrhythmogenic changes, the connection between preoperative inflammatory markers and postoperative ectopic burden has not been studied. Therefore, the aim of the present study is to evaluate the association between preoperative inflammatory biomarkers and postoperative atrial and ventricular ectopic burden, and to determine their influence on clinical outcomes following elective CABG procedures. Materials and methods: This study assessed preoperative plasma levels of highly sensitive C-reactive protein (hs-CRP), von Willebrand factor (vWF), transforming growth factor-β (TGF-β), interleukin (IL)-2, IL-1β, IL-6, IL-8, and vascular endothelial growth factor (VEGF) using the Multiplex technique in patients undergoing elective CABG. A continuous 24-h ECG Holter monitoring was performed one day before CABG, as well as on days 2, 3, and 4 post-CABG. The PACs and PVCs burdens were quantified, and correlations with clinical parameters were analyzed. Results: Preoperative plasma concentrations of vWF, TGF-β, and IL-8 exhibited significant positive correlations with postoperative PACs (p < 0.001, p = 0.03, and p < 0.001, respectively). Preprocedural hs-CRP, TGF-β, IL-6, and IL-8 levels showed significant positive associations with PVCs (p < 0.0001, p < 0.0001, p = 0.02, and p < 0.0001, respectively). However, none of the tested biomarkers could predict other postoperative outcomes, such as acute kidney injury, acute liver failure, duration of inotropic support, and days of hospitalization. Conclusions: Preoperative inflammatory biomarkers may serve as predictive tools for postoperative ectopic activity following CABG. Early identification of high-risk patients could enable prophylactic strategies and improve post-CABG outcomes. Full article
12 pages, 1512 KB  
Article
Community Structure, Health Status and Environmental Drivers of Coral Reefs in Koh Seh Island of the Kep Archipelago, Cambodia
by Srey Oun Ith, Amick Haissoune, Alex Reid and Ratha Sor
J. Mar. Sci. Eng. 2025, 13(9), 1644; https://doi.org/10.3390/jmse13091644 - 27 Aug 2025
Abstract
Coral reef ecosystems are home to diverse marine flora and fauna. However, these ecosystems are threatened by an array of environmental and anthropogenic factors. Here, we investigated coral reef diversity, structure, and health status, and identified their key environmental drivers. Coral reef data [...] Read more.
Coral reef ecosystems are home to diverse marine flora and fauna. However, these ecosystems are threatened by an array of environmental and anthropogenic factors. Here, we investigated coral reef diversity, structure, and health status, and identified their key environmental drivers. Coral reef data were collected from Koh Seh Island, located inside the Marine Fisheries Management Area in the Kep archipelago. We found that the reef cover largely comprised live corals (64%, mainly Porites and Tubinaria species), followed by Zoanthids (15%) and sand/rubble (15%). Based on Ward’s hierarchical cluster analysis, coral communities were grouped into three zones: East, South, and West zones. Coral diversity was slightly higher in the East zone, though not statistically significant. Zone East showed a positive association with sediment loads and water temperature. Elevated levels of salinity, dissolved oxygen, and pH were characteristic of the East and South zones, whereas the West zone was distinguished by deeper water conditions. We also found that Favites was the key indicator for coral communities in the East zone, which features shallow, high-DO, high-pH waters with more sediments, strong currents, and significant human activities like fishing and transportation. Goniastrea species were abundant in the South and East zones, making it the indicator taxon, while the West zone had no indicator, suggesting that coral species are sparse in this zone. Interestingly, only a few dead corals were found, and no signs of diseases were detected around the Koh Seh coral reefs. This may reflect the effectiveness of joint protection efforts by Marine Conservation Cambodia and the Marine Fisheries Department in Kep province. Overall, our study provides a valuable baseline for assessing future changes in benthic reefs and coral communities on Koh Seh island, throughout the Kep Archipelago and its surrounding areas. Full article
(This article belongs to the Special Issue Marine Biota Distribution and Biodiversity)
22 pages, 815 KB  
Article
Energy and Exergy Assessment of a Solar Driven Single Effect H2O-LiBr Absorption Chiller Under Moderate and Hot Climatic Conditions
by Mamadou Sow and Lavinia Grosu
Energies 2025, 18(17), 4553; https://doi.org/10.3390/en18174553 (registering DOI) - 27 Aug 2025
Abstract
This work mainly focuses on the energy and exergy analysis of a single-effect absorption cooling system operating with the couple H2O-LiBr, under different climatic conditions in Senegal and France. A simulation model was developed, using the Engineering Equation Solver V10 (EES) [...] Read more.
This work mainly focuses on the energy and exergy analysis of a single-effect absorption cooling system operating with the couple H2O-LiBr, under different climatic conditions in Senegal and France. A simulation model was developed, using the Engineering Equation Solver V10 (EES) software. Results indicate that the system can achieve a maximum COP of 0.76 and an exergy efficiency of 56%, which decreases as the generator temperature increases. Increasing the generator temperature from 87 to 95 °C significantly improves COP, but gains become marginal beyond 100 °C. The highest exergy destruction occurs in the generator, followed by the absorber, condenser, and evaporator. A temperature difference above 44 °C between the generator and the absorber is required to maintain H2O-LiBr solution stability. Optimal temperatures for hot climates like Senegal are 90 °C (generator), 42 °C (absorber/condenser), and 7 °C (evaporator), while maximum exergy efficiency (56%) is reached at 81 °C, typical of moderate climates (France). Evaporator exergy efficiency increases from 16 to 52% with rising ambient temperature, while absorber and condenser efficiencies drop. Increasing the cooling water flow rate from 0.2 to 1.4 kg/s reduces exergy losses in the absorber and the condenser by up to 36%. The solution heat exchanger (SHE) optimal effectiveness of 0.75 reduces exergy consumption in the absorber and the generator. Full article
(This article belongs to the Special Issue Solar Energy and Resource Utilization—2nd Edition)
44 pages, 4216 KB  
Article
Legal AI in Low-Resource Languages: Building and Evaluating QA Systems for the Kazakh Legislation
by Diana Rakhimova, Assem Turarbek, Vladislav Karyukin, Assiya Sarsenbayeva and Rashid Alieyev
Computers 2025, 14(9), 354; https://doi.org/10.3390/computers14090354 (registering DOI) - 27 Aug 2025
Abstract
The research focuses on the development and evaluation of a legal question–answer system for the Kazakh language, a low-resource and morphologically complex language. Four datasets were compiled from open legal sources—Adilet, Zqai, Gov, and a manually created synthetic set—containing question–аnswer pairs extracted from [...] Read more.
The research focuses on the development and evaluation of a legal question–answer system for the Kazakh language, a low-resource and morphologically complex language. Four datasets were compiled from open legal sources—Adilet, Zqai, Gov, and a manually created synthetic set—containing question–аnswer pairs extracted from official legislative documents and government portals. Seven large language models (GPT-4o mini, GEMMA, KazLLM, LLaMA, Phi, Qwen, and Mistral) were fine-tuned using structured prompt templates, quantization methods, and domain-specific training to enhance contextual understanding and efficiency. The evaluation employed both automatic metrics (ROUGE and METEOR) and expert-based manual assessment. GPT-4o mini achieved the highest overall performance, with ROUGE-1: 0.309, ROUGE-2: 0.175, ROUGE-L: 0.263, and METEOR: 0.320, and received an expert score of 3.96, indicating strong legal reasoning capabilities and adaptability to Kazakh legal contexts. The results highlight GPT-4o mini’s superiority over other tested models in both quantitative and qualitative evaluations. This work demonstrates the feasibility and importance of developing localized legal AI solutions for low-resource languages, contributing to improved legal accessibility, transparency, and digital governance in Kazakhstan. Full article
(This article belongs to the Special Issue Natural Language Processing (NLP) and Large Language Modelling)
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21 pages, 10466 KB  
Article
Impact of Low-Activity Coal Gangue on the Mechanical Properties and Microstructure Evolution of Cement-Based Materials
by Shiyu Sui, Xianggang Kong, Shaochun Li, Hui Wang, Di Liu, Song Gao, Yongjuan Geng, Jie Chen and Xu Chen
Buildings 2025, 15(17), 3073; https://doi.org/10.3390/buildings15173073 (registering DOI) - 27 Aug 2025
Abstract
With the increasing global demand for sustainable building materials, coal gangue, as a potential supplementary cementitious material (SCM), has attracted widespread attention. Coal gangue is primarily composed of clay minerals, among which the kaolinite content can significantly enhance its cementitious properties after activation. [...] Read more.
With the increasing global demand for sustainable building materials, coal gangue, as a potential supplementary cementitious material (SCM), has attracted widespread attention. Coal gangue is primarily composed of clay minerals, among which the kaolinite content can significantly enhance its cementitious properties after activation. However, there are various grades of coal gangues, which restrain their application, especially for the low kaolinite content coal gangue. This paper investigates the feasibility of using iron-rich coal gangue with low kaolinite content as a cement substitute through high-temperature activation treatment. In the current study, activated coal gangue replaced cement clinker at proportions of 10%, 15%, and 20%, which was further mixed with limestone powder to form a new cementitious material system. The mechanical attributes of the systems were assessed using compressive strength and microhardness tests. The influence of hydration products and microstructural changes on system performance was further explored through electrochemical impedance spectroscopy (EIS) and quantitative X-ray diffraction (XRD) analysis. The findings suggest that a well-balanced addition of coal gangue can effectively substitute for cement clinker, thereby enhancing both the mechanical properties and microstructure of the systems. These results demonstrate that through appropriate activation treatments, coal gangue can be utilized as an effective SCM. While traditional SCMs like fly ash (FA) and ground granulated blast-furnace slag (GGBFS) have near-zero allocated carbon footprints, their global supply is diminishing and increasingly unreliable. In contrast, our approach valorizes a vast industrial waste stream, aligning with circular economy principles and offering a scalable, sustainable, and low-carbon alternative for the construction industry. Full article
(This article belongs to the Section Building Materials, and Repair & Renovation)
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