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34 pages, 3062 KB  
Review
Catalyst Development for Dry Reforming of Methane and Ethanol into Syngas: Recent Advances and Perspectives
by Manshuk Mambetova, Moldir Anissova, Laura Myltykbayeva, Nursaya Makayeva, Kusman Dossumov and Gaukhar Yergaziyeva
Appl. Sci. 2025, 15(19), 10722; https://doi.org/10.3390/app151910722 (registering DOI) - 5 Oct 2025
Abstract
Dry reforming of methane and ethanol is a promising catalytic process for the conversion of carbon dioxide and hydrocarbon feedstocks into synthesis gas (H2/CO), which serves as a key platform for the production of fuels and chemicals. Over the past decade, [...] Read more.
Dry reforming of methane and ethanol is a promising catalytic process for the conversion of carbon dioxide and hydrocarbon feedstocks into synthesis gas (H2/CO), which serves as a key platform for the production of fuels and chemicals. Over the past decade, substantial progress has been achieved in the design of catalysts with enhanced activity and stability under the demanding conditions of these strongly endothermic reactions. This review summarizes the latest developments in catalyst systems for DRM and EDR, including Ni-based catalysts, perovskite-type oxides, MOF-derived materials, and high-entropy alloys. Particular attention is given to strategies for suppressing carbon deposition and preventing metal sintering, such as oxygen vacancy engineering in oxide supports, rare earth and transition metal doping, strong metal–support interactions, and morphological control via core–shell and mesoporous architectures. These approaches have been shown to improve coke resistance, maintain metal dispersion, and extend catalyst lifetimes. The review also highlights emerging concepts such as multifunctional hybrid systems and innovative synthesis methods. By consolidating recent findings, this work provides a comprehensive overview of current progress and future perspectives in catalyst development for DRM and EDR, offering valuable guidelines for the rational design of advanced catalytic materials. Full article
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17 pages, 1484 KB  
Article
Insights from Metabolomics Profiling of MSUD in Pediatrics Toward Disease Progression
by Abeer Z. Alotaibi, Reem H. AlMalki, Rajaa Sebaa, Maha Al Mogren, Mohammad Alanazi, Khalid M. Sumaily, Ahmad Alodaib, Ahmed H. Mujamammi, Minnie Jacob, Essa M. Sabi, Ahmad Alfares and Anas M. Abdel Rahman
Metabolites 2025, 15(10), 658; https://doi.org/10.3390/metabo15100658 (registering DOI) - 4 Oct 2025
Abstract
Background: Maple syrup urine disease (MSUD) is a genetic disorder caused by mutations in the branched-chain α-ketoacid dehydrogenase (BCKDH) complex, leading to toxic buildup of branched-chain amino acids (BCAAs) and their ketoacid derivatives. While newborn screening (NBS) and molecular testing are standard diagnostic [...] Read more.
Background: Maple syrup urine disease (MSUD) is a genetic disorder caused by mutations in the branched-chain α-ketoacid dehydrogenase (BCKDH) complex, leading to toxic buildup of branched-chain amino acids (BCAAs) and their ketoacid derivatives. While newborn screening (NBS) and molecular testing are standard diagnostic tools, they face challenges such as delayed results and false positives. Untargeted metabolomics has emerged as a complementary approach, offering comprehensive metabolic profiling and potential for novel biomarker discovery. We previously applied untargeted metabolomics to neonates with MSUD, identifying distinct metabolic signatures. Objective: This follow-up study investigates metabolic changes and biomarkers in pediatric MSUD patients and explores shared dysregulated metabolites between neonatal and pediatric MSUD. Methods: Dried blood spot (DBS) samples from pediatric MSUD patients (n = 14) and matched healthy controls (n = 14) were analyzed using LC/MS-based untargeted metabolomics. Results: In pediatric MSUD, 3716 metabolites were upregulated and 4038 downregulated relative to controls. Among 1080 dysregulated endogenous metabolites, notable biomarkers included uric acid, hypoxanthine, and bilirubin diglucuronide. Affected pathways included sphingolipid, glycerophospholipid, purine, pyrimidine, nicotinate, and nicotinamide metabolism, and steroid hormone biosynthesis. Seventy-two metabolites overlapped with neonatal MSUD cases, some exhibiting inverse trends between age groups. Conclusion: Untargeted metabolomics reveals that the metabolic profiling of MCUD pediatric patients different from that of their controls. Also, there are valuable age-specific and shared metabolic alterations in MSUD, enhancing the understanding of disease progression in MSUD patients. This supports its utility in improving diagnostic precision and developing personalized treatment strategies across developmental stages. Full article
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29 pages, 2554 KB  
Review
Toxic Alexandrium Treatment in Western Australia: Investigating the Efficacy of Modified Nano Clay
by Cherono Sheilah Kwambai, Houda Ennaceri, Alan J. Lymbery, Damian W. Laird, Jeff Cosgrove and Navid Reza Moheimani
Toxins 2025, 17(10), 495; https://doi.org/10.3390/toxins17100495 (registering DOI) - 4 Oct 2025
Abstract
Alexandrium spp. blooms produce a range of toxins, including spirolides, goniodomins, and paralytic shellfish toxins (PSTs). Of these, PSTs are the most impactful due to their high affinity for voltage-gated sodium ion channels in nerve cell membranes. This interaction can cause neurological effects [...] Read more.
Alexandrium spp. blooms produce a range of toxins, including spirolides, goniodomins, and paralytic shellfish toxins (PSTs). Of these, PSTs are the most impactful due to their high affinity for voltage-gated sodium ion channels in nerve cell membranes. This interaction can cause neurological effects such as paralysis and, in severe cases, may lead to death. Given the implications of Alexandrium blooms on public health, all mitigation, prevention, and treatment strategies aim to reduce their socioeconomic impacts. However, monitoring harmful algal blooms remains difficult due to confounding influences such as pollution, climate change, and the inherent variability of environmental conditions. These factors can complicate early detection and management efforts, especially as the intensity and frequency of blooms continue to rise, further exacerbating their socioeconomic consequences. This review offers insights into several management approaches to prevent and control Alexandrium blooms, focusing on modified nano-clays as a promising emergency mitigation measure for low-density toxic algal blooms, especially in areas predominantly used for recreational fishing. However, it is recommended that treatment be coupled with monitoring to alleviate reliance on treatment alone. Full article
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81 pages, 4442 KB  
Systematic Review
From Illusion to Insight: A Taxonomic Survey of Hallucination Mitigation Techniques in LLMs
by Ioannis Kazlaris, Efstathios Antoniou, Konstantinos Diamantaras and Charalampos Bratsas
AI 2025, 6(10), 260; https://doi.org/10.3390/ai6100260 - 3 Oct 2025
Abstract
Large Language Models (LLMs) exhibit remarkable generative capabilities but remain vulnerable to hallucinations—outputs that are fluent yet inaccurate, ungrounded, or inconsistent with source material. To address the lack of methodologically grounded surveys, this paper introduces a novel method-oriented taxonomy of hallucination mitigation strategies [...] Read more.
Large Language Models (LLMs) exhibit remarkable generative capabilities but remain vulnerable to hallucinations—outputs that are fluent yet inaccurate, ungrounded, or inconsistent with source material. To address the lack of methodologically grounded surveys, this paper introduces a novel method-oriented taxonomy of hallucination mitigation strategies in text-based LLMs. The taxonomy organizes over 300 studies into six principled categories: Training and Learning Approaches, Architectural Modifications, Input/Prompt Optimization, Post-Generation Quality Control, Interpretability and Diagnostic Methods, and Agent-Based Orchestration. Beyond mapping the field, we identify persistent challenges such as the absence of standardized evaluation benchmarks, attribution difficulties in multi-method systems, and the fragility of retrieval-based methods when sources are noisy or outdated. We also highlight emerging directions, including knowledge-grounded fine-tuning and hybrid retrieval–generation pipelines integrated with self-reflective reasoning agents. This taxonomy provides a methodological framework for advancing reliable, context-sensitive LLM deployment in high-stakes domains such as healthcare, law, and defense. Full article
(This article belongs to the Section AI Systems: Theory and Applications)
28 pages, 4335 KB  
Perspective
Time-Restricted Eating, ANGPTL4, and Reduction in Residual Cardiovascular Risk
by Alejandro Gugliucci
J. Clin. Med. 2025, 14(19), 7026; https://doi.org/10.3390/jcm14197026 - 3 Oct 2025
Abstract
Atherosclerotic cardiovascular disease treatment is being reevaluated, since a residual cardiovascular risk (RCR) persists even in patients who achieve optimal LDL-C values. Underlying causes are metabolic dysfunction, lipoprotein(a), inflammation, and triglyceride-rich lipoproteins and their remnants. Dietary treatment options like time-restricted eating (TRE) are [...] Read more.
Atherosclerotic cardiovascular disease treatment is being reevaluated, since a residual cardiovascular risk (RCR) persists even in patients who achieve optimal LDL-C values. Underlying causes are metabolic dysfunction, lipoprotein(a), inflammation, and triglyceride-rich lipoproteins and their remnants. Dietary treatment options like time-restricted eating (TRE) are becoming more widely acknowledged for their potential advantages in metabolic health and weight control, as a treatment of atherosclerosis expanding beyond LDL-C medication. Beyond weight loss, TRE (which restricts meals to a window of 6 to 8 h) appears as the most accessible treatment, and has been shown to improve blood pressure, lipid profiles, and glucose regulation through mechanisms like metabolic switching and circadian synchronization. We hypothesize, and will present our arguments, that a key mechanism underlying the cardiovascular and weight-related benefits of TRE is its impact on the circadian regulation of angiopoietin-like protein 4 (ANGPTL4) activity within adipose tissue. Additionally, lipolysis is accelerated by ANGPTL4 activation. TRE, via its actions on ANGPTL4, therefore not only inhibits adipose fatty acid uptake but stimulates their release as well. Additionally, TRE may increase intravascular very low-density lipoprotein (VLDL) catabolism by muscle due to the reduced exposure of lipoprotein lipase (LPL) to competing chylomicrons, known to slow the rate of VLDL catabolism. During the prolonged fasting, VLDL residence time is thus shortened, limiting the exposure to endothelium and hepatic lipases and thus reducing the amount of atherogenic remnant particles. Larger, longer-term randomized controlled studies in a variety of groups are required to further clarify TRE’s function in RCR prevention and therapy. As knowledge of triglyceride lipoprotein (TRL) metabolism expands, a comprehensive strategy for the management of RCR emerges, and a broader spectrum of LPL regulator-based therapeutics is created. Consequently, it is advisable to prioritize further research into the influence of TRE on LPL modulation via ANGPTL4 and ANGPTL8, which provides a natural, accessible, and low-cost alternative. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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17 pages, 672 KB  
Review
Saying “Yes” to NONO: A Therapeutic Target for Neuroblastoma and Beyond
by Sofya S. Pogodaeva, Olga O. Miletina, Nadezhda V. Antipova, Alexander A. Shtil and Oleg A. Kuchur
Cancers 2025, 17(19), 3228; https://doi.org/10.3390/cancers17193228 - 3 Oct 2025
Abstract
Pediatric tumors such as neuroblastoma are characterized by a genome-wide ‘transcriptional burden’, surmising the involvement of multiple alterations of gene expression. Search for master regulators of transcription whose inactivation is lethal for tumor cells identified the non-POU domain-containing octamer-binding protein (NONO), a member [...] Read more.
Pediatric tumors such as neuroblastoma are characterized by a genome-wide ‘transcriptional burden’, surmising the involvement of multiple alterations of gene expression. Search for master regulators of transcription whose inactivation is lethal for tumor cells identified the non-POU domain-containing octamer-binding protein (NONO), a member of the Drosophila Behavior/Human Splicing family known for the ability to form complexes with macromolecules. NONO emerges as an essential mechanism in normal neurogenesis as well as in tumor biology. In particular, NONO interactions with RNAs, largely with long non-coding MYCN transcripts, have been attributed to the aggressiveness of neuroblastoma. Broadening its significance beyond MYCN regulation, NONO guards a subset of transcription factors that comprise a core regulatory circuit, a self-sustained loop that maintains transcription. As a component of protein–protein complexes, NONO has been implicated in the control of cell cycle progression, double-strand DNA repair, and, generally, in cell survival. Altogether, the pro-oncogenic roles of NONO justify the need for its inactivation as a therapeutic strategy. However, considering NONO as a therapeutic target, its druggability is a challenge. Recent advances in the inactivation of NONO and downstream signaling with small molecular weight compounds make promising the development of pharmacological antagonists of NONO pathway(s) for neuroblastoma treatment. Full article
(This article belongs to the Special Issue Precision Medicine and Targeted Therapies in Neuroblastoma)
46 pages, 3204 KB  
Review
Recent Advances in Sliding Mode Control Techniques for Permanent Magnet Synchronous Motor Drives
by Tran Thanh Tuyen, Jian Yang, Liqing Liao and Nguyen Gia Minh Thao
Electronics 2025, 14(19), 3933; https://doi.org/10.3390/electronics14193933 - 3 Oct 2025
Abstract
As global industry enters the digital era, automation is becoming increasingly pervasive. Due to their superior efficiency and reliability, Permanent Magnet Synchronous Motors (PMSMs) are playing an increasingly prominent role in industrial applications. Sliding Mode Control (SMC) has emerged as a modern control [...] Read more.
As global industry enters the digital era, automation is becoming increasingly pervasive. Due to their superior efficiency and reliability, Permanent Magnet Synchronous Motors (PMSMs) are playing an increasingly prominent role in industrial applications. Sliding Mode Control (SMC) has emerged as a modern control strategy that is widely employed not only in PMSM drive systems, but also across broader power and industrial control domains. This technique effectively mitigates key challenges associated with PMSMs, such as nonlinear behavior and susceptibility to external disturbances, thereby enhancing the precision of speed and torque regulation. This paper provides a thorough review and evaluation of recent advancements in SMC as applied to PMSM control. It outlines the fundamentals of SMC, explores various SMC-based strategies, and introduces integrated approaches that combine SMC with optimization algorithms. Furthermore, it compares these methods, identifying their respective strengths and limitations. This paper concludes by discussing current trends and potential future developments in the application of SMC for PMSM systems. Full article
(This article belongs to the Special Issue Next-Generation Control Systems for Power Electronics in the AI Era)
18 pages, 613 KB  
Article
Promoting Reflection Skills of Pre-Service Teachers—The Power of AI-Generated Feedback
by Florian Hofmann, Tina-Myrica Daunicht, Lea Plößl and Michaela Gläser-Zikuda
Educ. Sci. 2025, 15(10), 1315; https://doi.org/10.3390/educsci15101315 - 3 Oct 2025
Abstract
Reflection skills are a key but challenging element in teacher training. Feedback on reflective writing assignments can improve reflection skills, but it is affected by challenges (high variability in judgments and time investment). AI-generated feedback offers many options. Therefore, the aim of this [...] Read more.
Reflection skills are a key but challenging element in teacher training. Feedback on reflective writing assignments can improve reflection skills, but it is affected by challenges (high variability in judgments and time investment). AI-generated feedback offers many options. Therefore, the aim of this study was to examine the potential of AI-generated feedback compared to that provided by lecturers for developing reflective skills. A total of 93 randomly selected pre-service teachers (70% female) in a course at a German university wrote two reflections and received feedback from either lecturers or ChatGPT 4.0 based on the same prompts. Pre-service teachers’ written reflections were assessed, and an online questionnaire based on standard instruments was applied. Control variables included metacognitive learning strategies and reflection-related dispositions. Based on a linear mixed model, the main effects on reflective skills were identified for time (β^ = 0.41, p = 0.003) and feedback condition (β^ = −0.42, p = 0.032). Both forms of feedback similarly fostered reflective skills over time, with academic self-efficacy emerging as a pertinent disposition (β^ = 0.25, p = 0.014). The limitations of this study and implications for teacher training are discussed. Full article
(This article belongs to the Special Issue The Role of Reflection in Teaching and Learning)
27 pages, 1588 KB  
Article
Toward the Theoretical Foundations of Industry 6.0: A Framework for AI-Driven Decentralized Manufacturing Control
by Andrés Fernández-Miguel, Susana Ortíz-Marcos, Mariano Jiménez-Calzado, Alfonso P. Fernández del Hoyo, Fernando E. García-Muiña and Davide Settembre-Blundo
Future Internet 2025, 17(10), 455; https://doi.org/10.3390/fi17100455 - 3 Oct 2025
Abstract
This study advances toward establishing the theoretical foundations of Industry 6.0 by developing a comprehensive framework that integrates artificial intelligence (AI), decentralized control systems, and cyber–physical production environments for intelligent, sustainable, and adaptive manufacturing. The research employs a tri-modal methodology (deductive, inductive, and [...] Read more.
This study advances toward establishing the theoretical foundations of Industry 6.0 by developing a comprehensive framework that integrates artificial intelligence (AI), decentralized control systems, and cyber–physical production environments for intelligent, sustainable, and adaptive manufacturing. The research employs a tri-modal methodology (deductive, inductive, and abductive reasoning) to construct a theoretical architecture grounded in five interdependent constructs: advanced technology integration, decentralized organizational structures, mass customization and sustainability strategies, cultural transformation, and innovation enhancement. Unlike prior conceptualizations of Industry 6.0, the proposed framework explicitly emphasizes the cyclical feedback between innovation and organizational design, as well as the role of cultural transformation as a binding element across technological, organizational, and strategic domains. The resulting framework demonstrates that AI-driven decentralized control systems constitute the cornerstone of Industry 6.0, enabling autonomous real-time decision-making, predictive zero-defect manufacturing, and strategic organizational agility through distributed intelligent control architectures. This work contributes foundational theory and actionable guidance for transitioning from centralized control paradigms to AI-driven distributed intelligent manufacturing control systems, establishing a conceptual foundation for the emerging Industry 6.0 paradigm. Full article
(This article belongs to the Special Issue Artificial Intelligence and Control Systems for Industry 4.0 and 5.0)
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23 pages, 2885 KB  
Article
Parkia platycephala Pods Modulate Eimeria spp. Parasite Load and Enhance Productive Performance in Naturally Infected Lambs
by Thalia Caldas da Silva, Gabrielle de Melo Oliveira, Osmar Macêdo Fortaleza Neto, Maycon Rodrigo de Souza Diniz, Joana Kellany Gonçalves de Andrade, José Gracione do Nascimento Souza Filho, Janaína Marques do Nascimento, Sara Silva Reis, Michelle de Oliveira Maia Parente, Arlan Araújo Rodrigues, Anderson de Moura Zanine, Henrique Nunes Parente and Ivo Alexandre Leme da Cunha
Animals 2025, 15(19), 2896; https://doi.org/10.3390/ani15192896 - 3 Oct 2025
Abstract
Coccidiosis represents a major constraint to sheep productivity worldwide, with increasing concerns regarding anticoccidial resistance and growing interest in reducing dependency on conventional synthetic anticoccidials. This investigation evaluated the anticoccidial properties of faveira pods (Parkia platycephala pod—PpP) and their influence on productive [...] Read more.
Coccidiosis represents a major constraint to sheep productivity worldwide, with increasing concerns regarding anticoccidial resistance and growing interest in reducing dependency on conventional synthetic anticoccidials. This investigation evaluated the anticoccidial properties of faveira pods (Parkia platycephala pod—PpP) and their influence on productive performance in naturally infected lambs. Eighteen uncastrated Dorper × Santa Inês crossbred males (20.0 ± 2.5 kg, 5 months) were randomly allocated to three groups: G1 (0% PpP; n = 6), G2 (100% PpP replacing roughage, 30.0% of total diet; n = 6), and the control group (0% PpP plus 20 mg/kg toltrazuril; n = 5). Parasitological assessments, productive performance, and behavioral parameters were monitored over 45 days using oocyst counts, morphometric analysis, digestibility trials, and biometric measurements. Nine Eimeria species were identified, with E. crandallis, E. parva, and E. bakuensis representing 53.5% of total oocyst shedding. Group G2 demonstrated a numerical 8.5% reduction in parasite load compared to G1 (p = 0.42), while toltrazuril achieved 36.6% efficacy (p < 0.05). Species-specific effects were significant for E. crandallis, E. parva, and E. ovinoidalis (p < 0.01). A robust correlation emerged between parasite load and water consumption (r = 0.652, p = 0.0045), establishing a novel behavioral biomarker for coccidiosis monitoring. Environmental oocyst elimination decreased by 43.4% in the P. platycephala group. These findings demonstrate that PpPs possess moderate anticoccidial properties, offering a sustainable complementary strategy for integrated coccidiosis management while contributing to environmental sustainability. Full article
(This article belongs to the Special Issue Coccidian Parasites: Epidemiology, Control and Prevention Strategies)
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16 pages, 1182 KB  
Review
Ischemia with No Obstructive Coronary Artery Disease (INOCA): A Review
by Laura Viola, Megan Masters, Umar Shafiq, Krishnam Raju Jujjavarapu and Suvitesh Luthra
Life 2025, 15(10), 1554; https://doi.org/10.3390/life15101554 - 3 Oct 2025
Abstract
Background: Ischemia with no obstructive coronary artery disease (INOCA) is characterized by myocardial ischemia in the absence of significant coronary artery stenosis. Despite the lack of major obstructive lesions, patients often present with chest pain, making diagnosis and management a significant challenge. Materials and [...] Read more.
Background: Ischemia with no obstructive coronary artery disease (INOCA) is characterized by myocardial ischemia in the absence of significant coronary artery stenosis. Despite the lack of major obstructive lesions, patients often present with chest pain, making diagnosis and management a significant challenge. Materials and Methods: A comprehensive search strategy of electronic databases (2000 to 2024) was used to identify studies assessing pathophysiology, diagnosis, surgical treatments, interventions, and outcomes in INOCA. Clinical trials, observational studies, case-control studies, and cohort studies were included. Results: Emerging surgical treatments may have a role in certain subgroups of INOCA patients, particularly those with severe and persistent symptoms or underlying pathophysiological factors that do not respond adequately to pharmacological therapies. Transmyocardial revascularization (TMR) and sympathetic denervation procedures reduce coronary vasospasm in refractory angina. Trials have shown promise for coronary sinus occlusion. Autologous stem cell therapy is an innovative surgical approach that has shown promise in early trials but remains investigational. Selective surgical cardiac vein retroperfusion remains largely experimental, with limited clinical data. Conclusions: This review highlights the need for ongoing research and clinical trials to assess the effectiveness of surgical and nonsurgical options in INOCA. Although current data on surgical interventions is limited, these treatments may offer hope for patients with refractory symptoms. A personalized and multidisciplinary approach to management is essential for optimal patient outcomes. Full article
(This article belongs to the Section Medical Research)
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33 pages, 13185 KB  
Article
Bi-Layer Model Predictive Control with Extended Horizons for Multi-Axis Underactuated Wave Energy Converters
by Xinrui Lu and Yuan Chen
J. Mar. Sci. Eng. 2025, 13(10), 1902; https://doi.org/10.3390/jmse13101902 - 3 Oct 2025
Abstract
In the field of wave energy, multi-axis wave energy converters (WECs) have emerged as a research priority owing to their enhanced energy absorption, leading to increased computational complexity. Conventional model predictive control (MPC) approaches have demonstrated limitations in the trade-off between real-time requirements [...] Read more.
In the field of wave energy, multi-axis wave energy converters (WECs) have emerged as a research priority owing to their enhanced energy absorption, leading to increased computational complexity. Conventional model predictive control (MPC) approaches have demonstrated limitations in the trade-off between real-time requirements and control performance. This paper proposes a bi-layer MPC strategy, including a long-term energy maximization layer and a short-term trajectory-tracking layer. First, a multi-axis underactuated WEC (MU-WEC) is proposed, which incorporates an inertial cable-driven parallel mechanism to absorb energy from multiple directions. In addition, a control-oriented dynamic model of a MU-WEC is established. Then, a bi-layer MPC strategy is proposed, which decouples computationally intensive optimization processes from time-sensitive real-time control, alleviating the computational burden significantly. Therefore, the upper layer achieves enhanced control performance by enabling extended prediction horizons, whereas the lower layer serves to ensure real-time requirements. Moreover, numerical simulations under irregular wave conditions demonstrate the performance of the proposed bi-layer MPC: under different waves, bi-layer MPC improves energy absorption by 127–311% over conventional MPC. This performance enhancement stems from the 5 times extension of the prediction horizon enabled by the reduced computational burden. Full article
(This article belongs to the Section Ocean Engineering)
26 pages, 1645 KB  
Review
Mechanotransduction-Epigenetic Coupling in Pulmonary Regeneration: Multifunctional Bioscaffolds as Emerging Tools
by Jing Wang and Anmin Xu
Pharmaceuticals 2025, 18(10), 1487; https://doi.org/10.3390/ph18101487 - 2 Oct 2025
Abstract
Pulmonary fibrosis (PF) is a progressive and fatal lung disease characterized by irreversible alveolar destruction and pathological extracellular matrix (ECM) deposition. Currently approved agents (pirfenidone and nintedanib) slow functional decline but do not reverse established fibrosis or restore functional alveoli. Multifunctional bioscaffolds present [...] Read more.
Pulmonary fibrosis (PF) is a progressive and fatal lung disease characterized by irreversible alveolar destruction and pathological extracellular matrix (ECM) deposition. Currently approved agents (pirfenidone and nintedanib) slow functional decline but do not reverse established fibrosis or restore functional alveoli. Multifunctional bioscaffolds present a promising therapeutic strategy through targeted modulation of critical cellular processes, including proliferation, migration, and differentiation. This review synthesizes recent advances in scaffold-based interventions for PF, with a focus on their dual mechano-epigenetic regulatory functions. We delineate how scaffold properties (elastic modulus, stiffness gradients, dynamic mechanical cues) direct cell fate decisions via mechanotransduction pathways, exemplified by focal adhesion–cytoskeleton coupling. Critically, we highlight how pathological mechanical inputs establish and perpetuate self-reinforcing epigenetic barriers to regeneration through aberrant chromatin states. Furthermore, we examine scaffolds as platforms for precision epigenetic drug delivery, particularly controlled release of inhibitors targeting DNA methyltransferases (DNMTi) and histone deacetylases (HDACi) to disrupt this mechano-reinforced barrier. Evidence from PF murine models and ex vivo lung slice cultures demonstrate scaffold-mediated remodeling of the fibrotic niche, with key studies reporting substantial reductions in collagen deposition and significant increases in alveolar epithelial cell markers following intervention. These quantitative outcomes highlight enhanced alveolar epithelial plasticity and upregulating antifibrotic gene networks. Emerging integration of stimuli-responsive biomaterials, CRISPR/dCas9-based epigenetic editors, and AI-driven design to enhance scaffold functionality is discussed. Collectively, multifunctional bioscaffolds hold significant potential for clinical translation by uniquely co-targeting mechanotransduction and epigenetic reprogramming. Future work will need to resolve persistent challenges, including the erasure of pathological mechanical memory and precise spatiotemporal control of epigenetic modifiers in vivo, to unlock their full therapeutic potential. Full article
(This article belongs to the Section Pharmacology)
11 pages, 551 KB  
Article
Effectiveness of a Nature Sports Program on Burnout Among Nursing Students: A Clinical Trial
by Inmaculada Pérez-Conde, Nora Suleiman-Martos, María José Membrive-Jiménez, María Dolores Lazo-Caparros, Sofía García-Oliva, Guillermo A. Cañadas-De la Fuente and Jose Luis Gómez-Urquiza
Healthcare 2025, 13(19), 2510; https://doi.org/10.3390/healthcare13192510 - 2 Oct 2025
Abstract
Background/Objectives: Academic burnout is an emerging problem among nursing students, characterized by emotional exhaustion, cynicism, and reduced academic efficacy. Sports interventions have been shown to have a positive effect on nurses as a preventive strategy against burnout. The aim of this study [...] Read more.
Background/Objectives: Academic burnout is an emerging problem among nursing students, characterized by emotional exhaustion, cynicism, and reduced academic efficacy. Sports interventions have been shown to have a positive effect on nurses as a preventive strategy against burnout. The aim of this study was to evaluate the effect of a nature sports program on the levels of academic burnout in nursing students. Methods: A randomized clinical trial was performed. The intervention was a 12-week nature exercise program with two sessions each week. The main dependent variables were burnout (measured using the Maslach Burnout Inventory—Student Survey), stress (measured using the Perceived Stress Scale), and anxiety and depression (measured using the Hospital Anxiety and Depression Scale). The post-intervention sample size was n = 58 in the control group and n = 48 in the intervention group. Results: After the intervention, significant differences were found in respect of emotional exhaustion (p < 0.001; Cohen’s D: 0.483), stress (p < 0.05; Cohen’s D: 0.456), and mean steps per day (p < 0.001; Cohen’s D: −1.09), with the mean values being reduced in the intervention group by around three points in emotional exhaustion and stress; the intervention group also achieved a higher mean number of daily steps compared to the control group. Conclusions: A nature sports program could help to reduce emotional exhaustion and stress, and increase the number of steps per day. Full article
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16 pages, 1564 KB  
Article
Trends in Etiology and Mortality in Severe Polytrauma Patients with Traumatic Brain Injury: A 25-Year Retrospective Analysis
by Olga Mateo-Sierra, Rebeca Boto, Ana de la Torre, Antonio Montalvo, Dolores Pérez-Díaz and Cristina Rey
J. Clin. Med. 2025, 14(19), 6986; https://doi.org/10.3390/jcm14196986 - 2 Oct 2025
Abstract
Background: Polytrauma remains a leading cause of mortality and disability worldwide. Although trauma-related deaths have declined in recent decades, the drivers of this trend remain incompletely understood. Traumatic brain injury (TBI) is the principal cause of death and long-term disability in polytrauma, making [...] Read more.
Background: Polytrauma remains a leading cause of mortality and disability worldwide. Although trauma-related deaths have declined in recent decades, the drivers of this trend remain incompletely understood. Traumatic brain injury (TBI) is the principal cause of death and long-term disability in polytrauma, making it a critical determinant of outcomes. This study aimed to examine long-term trends in clinical characteristics, management strategies, and outcomes of polytraumatized patients with TBI (PTBI), with a particular focus on factors influencing overall and cause-specific mortality. Methods: We conducted a retrospective observational study of a prospectively maintained trauma registry over a 25-year period (1993–2018) at the Gregorio Marañón University General Hospital (Madrid, Spain). Adult patients with PTBI were included. Epidemiological, clinical, and outcome data were analyzed globally and across four time periods. Results: Among 768 patients with PTBI, mean age was 43 years (±20), and 29% were female. Most sustained closed TBIs (96%) with concomitant severe injuries to the head, chest, and extremities (median Injury Severity Score [ISS] 27; median New Injury Severity Score [NISS] 34). Emergency surgery was required in 51%, and 84% were admitted to intensive care. Over time, the incidence of polytrauma decreased, mainly reflecting fewer traffic-related injuries following advances in prevention and legislation. Despite an increasingly older and comorbid population, ISS/NISS and early mortality declined, largely due to improvements in prehospital care and hemorrhage control. Although crude TBI-related mortality appeared unchanged (28%), this pattern likely reflects offsetting influences, including an older and more comorbid patient population, a higher relative burden of severe cases, and the limitations of mortality alone to capture gains in functional outcomes. Conclusions: Advances in trauma systems and preventive policies have substantially reduced the burden of polytrauma and improved survival. However, severe TBI remains the principal unresolved challenge, highlighting the urgent need for innovative neuroprotective strategies and greater emphasis on functional recovery. Full article
(This article belongs to the Special Issue Innovations in Maxillofacial Surgery)
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