Search Results (23,120)

The transition from a linear to a circular, resource-efficient economy is crucial in order to address the growing scarcity of resources, environmental degradation and the rapid increase in electronic waste and end-of-life products. Artificial Intelligence (AI) has emerged as a key enabling technology, capable of enhancing decision making, automation and optimization across Circular Economy (CE) pathways, including reuse, remanufacturing and recycling. This perspective paper presents a comprehensive and critical overview of AI’s role in supporting the transition to a circular, resource-efficient economy, introducing the Digital CE Architecture (DCEA-4) as a novel framework for integrating AI across the circular value chain. Recent advances in machine learning, deep learning and data-driven optimization are analyzed in the context of electronic waste and used battery management. This highlights how AI-based solutions can improve material recovery rates, reduce environmental impact and enhance system-level efficiency. Additionally, we examine major challenges concerning data availability, model generalization, industrial deployment, and explainability, together with relevant industrial case studies. Although AI offers substantial potential for optimizing circular resource systems, its environmental benefits must be balanced against the computational energy demands of large-scale AI models. This perspective discusses the potential rebound effects associated with AI deployment and emphasizes the importance of energy-efficient algorithms and sustainable digital infrastructures. By bringing together current developments and highlighting future opportunities, this paper aims to help researchers, practitioners and policymakers leverage AI to speed up the transition to sustainable, circular and resource-efficient systems. Full article

Vegetation restoration in water-limited regions typically increases evapotranspiration (ET) while reducing runoff. Over the past four decades, Daihai Lake in China’s northwest inland river basin has experienced significant shrinkage. Previous studies attribute this primarily to climate change and water resource exploitation, yet the impact of vegetation dynamics remains insufficiently examined. This study analyzed changes in the water budget across different vegetation types in the Daihai Lake Basin, based on remote sensing-derived precipitation and ET data, and employed correlation analysis to examine the relationships between environmental factors (such as climate change, afforestation projects, and water-saving irrigation) and lake shrinkage. Our findings revealed that afforestation has expanded forest cover by 69.42 km² since 2000, accounting for 73.95% of the total forest area. Notably, forest ET demonstrated the strongest negative correlation (r = −0.89, p < 0.001) with lake area among all vegetation types. Grasslands emerged as the primary water-surplus vegetation, contributing 81.34% to the basin’s total water surplus. The synergistic effects of precipitation reduction, temperature increase, and enhanced ET from forest expansion drove the shrinkage of the lake. These results highlight the need for science-based vegetation management in arid and semi-arid regions, where we recommend adopting shrub-grass combined restoration approaches to enhance the sustainability of ecological restoration. Full article

Background/Objectives: Coffin–Lowry syndrome (CLS) is a rare X-linked disease caused by pathogenic variants in the RPS6KA3 gene. It is generally characterized by syndromic intellectual disability and distinctive facial features, skeletal abnormalities, stimulus-induced drop attacks in males, and variable manifestations in females. Methods: We report clinical and genetic findings in a series of 10 cases, eight males and two females, evaluated at the Regional Centre of Medical Genetics Dolj—Emergency Clinical County Hospital Craiova. Results: Genetic testing identified 10 de novo variants in the RPS6KA3 gene consisting of six missense mutations, one nonsense variant, one frameshift, and two variants in non-coding or intronic regions. Case management requires multidisciplinary coordination and is limited to resources mostly available in reference centers. Conclusions: CLS highlights the importance of molecular diagnosis in rare genetic disorders, particularly when clinical features are subtle or atypical. These findings have practical implications for clinical management, suggesting the need for comprehensive genetic screening and individualized care approaches. Full article

Metagenomic and targeted next-generation sequencing (NGS) technologies are rapidly transforming diagnosis and management for infectious diseases. This review comprehensively examines the current applications of metagenomic NGS (mNGS) and targeted NGS (tNGS) in clinical microbiology, highlighting their roles in pathogen detection, antimicrobial resistance profiling, virulence characterization, and outbreak investigation—particularly in complex cases such as pneumonia, critical illness with pulmonary infections, and pediatric acute respiratory illnesses. We discuss the diagnostic performance, advantages, and limitations of these approaches, including challenges related to sensitivity, specificity, standardization, bioinformatic complexity, and cost-effectiveness. Furthermore, we explore emerging opportunities for integrating NGS-based surveillance with public health strategies, such as wastewater epidemiology, to monitor healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) at the population level. Finally, we outline key steps needed to translate these powerful genomic tools from research settings into routine clinical and public health practice. Full article

Background: Brucella canis is an emerging zoonotic pathogen responsible for canine reproductive disorders and public health concerns. This study assessed the seroprevalence of B. canis in dogs from Campania, Southern Italy (2022–2025). Methods: Serum samples (n = 400) were retrospectively screened using an indirect immunofluorescence assay (IFAT), performed according to the manufacturer’s instructions. Screening was conducted at a 1:40 cut-off, followed by serial dilutions to determine endpoint titres. Statistical analysis included chi-square tests for univariable screening, followed by nominal logistic regression models to evaluate the association between IFAT positivity and predictive factors (year, province, and sex of dogs). Additionally, a general linear model (GLM) was applied to the seropositive subset (n = 69) to analyse the magnitude of the antibody response, expressed as geometric mean titres (GMTs). Results: The overall seroprevalence was 17.3% (95% CI: 13.6–21.0%). Dog’s sex, year of sampling, and province were not significant independent predictors of infection (p > 0.05), but GLM analysis showed that sampling year (p = 0.0024) and province (p = 0.0490) significantly influenced antibody intensity. A significant temporal increase in antibody intensity was observed towards 2025 (p = 0.037), suggesting an intensification of infection pressure. Conclusions: Our results confirm that Brucella canis is an endemic pathogen in the shelter dog population of southern Italy. The high seroprevalence and significant increase in antibody magnitude (GMT) over the study period indicate rising infection pressure, highlighting the urgent need for mandatory screening and a coordinated One Health surveillance strategy to manage zoonotic risk effectively. Full article

Background/Objectives: Despite extensive research on nurses’ knowledge and attitudes toward pain management globally, limited evidence exists regarding the actual implementation of multimodal pain management practices among Vietnamese nurses. This study aimed to (1) assess nurses’ implementation of pharmacological and non-pharmacological postoperative pain management interventions, (2) examine the relationships among knowledge, attitude, and practice (KAP), and (3) identify predictors of competent practice with attention to the relative contributions of formal training versus clinical experience. Methods: A cross-sectional survey was conducted among 230 nurses working in Urology Departments from two tertiary public hospitals in Ho Chi Minh City, Vietnam, between April and June 2024, focusing on postoperative pain management. Pain management knowledge, attitudes, and practices were assessed using validated instruments. Independent samples t-tests compared trained versus untrained nurses. Multiple linear regression identified predictors of practice competency. Effect sizes (Cohen’s d) quantified the magnitude of training effects. Results: Nurses demonstrated moderate-to-good competency, with pharmacological interventions (M = 3.74) implemented more consistently than non-pharmacological interventions (M = 3.48, p < 0.001). Trained nurses significantly outperformed untrained nurses across all domains with large effect sizes (Cohen’s d = 1.34–1.54). A clear hierarchy emerged in non-pharmacological practice: environmental (M = 4.01) > physical (M = 3.69) > cognitive–behavioral (M = 3.27) > spiritual (M = 2.60). Strong KAP correlations were observed (r = 0.70–0.85, p < 0.001). Prior training was the strongest predictor of both pharmacological (β = 1.31, p < 0.001) and non-pharmacological practice (β = 0.58, p < 0.001), while clinical experience showed no significant effect (p > 0.40). Conclusions: This study provides evidence that formal training—not clinical experience—is strongly associated with competent postoperative pain management practice among Vietnamese nurses, with large effect sizes demonstrating practical significance. The strong KAP relationships support targeted educational interventions addressing knowledge gaps to improve practice. These findings have implications for nursing education research in Vietnam and similar healthcare settings. Full article

Background: Fungemia caused by non-Candida yeasts is rare but represents an emerging clinical problem that remains less well recognized and studied. These organisms often exhibit intrinsic resistance or reduced susceptibility to commonly used empirical antifungal agents, such as fluconazole and echinocandins. This poses significant challenges for empirical antifungal therapy. Objectives: To describe the clinical characteristics, antifungal treatments, and outcomes of pediatric patients with bloodstream infections due to non-Candida yeasts and to summarize the antifungal susceptibility profiles of available isolates. Methods: This retrospective study reviewed all episodes of fungemia caused by non-Candida yeasts at a tertiary pediatric center between 1 January 2020 and 1 September 2025. Results: Of the 139 yeast-related fungemia episodes identified during the study period, five (3.6%) were caused by non-Candida yeasts: three by Trichosporon spp., one by Rhodotorula mucilaginosa, and one by Magnusiomyces clavatus (formerly Saprochaete clavatus). Two cases occurred as breakthrough infections under ongoing antifungal treatment. Empirical antifungal treatments most often included amphotericin B, fluconazole, or echinocandins. The median time to species-level identification after the first positive culture result was six days (range 4–7), highlighting a considerable delay that may critically affect clinical management. Overall mortality was 40%, while attributable mortality due to non-Candida fungemia was 20%. Conclusions: Non-Candida yeasts, although infrequent, represent clinically important pathogens in pediatric fungemia due to their potential resistance to standard empirical antifungal agents. Early species-level identification and awareness of expected susceptibility patterns are essential to guide appropriate initial therapy and improve outcomes. Full article

Background/Objectives: Wound management presents a substantial clinical challenge due to the rising incidence of chronic wounds, infections, and the limitations of conventional dressings in creating an ideal healing microenvironment. This review aims to provide a comprehensive overview of advanced smart hydrogel platforms designed to improve wound healing outcomes, focusing on their capacity to respond adaptively to physiological and external stimuli. Methods: This article analyzes the core characteristics of smart hydrogels, specifically examining stimuli-responsive systems (pH, temperature, enzyme, light, and electricity). The review evaluates advanced configurations—including injectable, self-healing, and 3D-printable systems—and functionalized hydrogels integrated with antimicrobials, drugs, and nanocomposites. Additionally, essential characterization methodologies, biological assessments, and regulatory considerations for clinical translation are synthesized. Results: The literature, which is predominantly preclinical in nature, indicates that functionalized hydrogels significantly enhance tissue regeneration, angiogenesis, and infection control compared to traditional methods. Conductive hydrogels utilizing bioelectrical signals show particular promise in accelerating the healing process. While current clinical applications and commercial products demonstrate efficacy, significant barriers remain regarding large-scale manufacturing and regulatory approval. Conclusions: Smart hydrogels represent a transformative approach to precision wound management, offering superior adaptability and therapeutic delivery. To achieve widespread clinical adoption, future research must address manufacturing scalability and focus on emerging trends, such as the integration of biosensors and AI-powered monitoring systems, to create fully intelligent wound care solutions. Full article

Ocular diseases pose significant therapeutic challenges due to the eye’s intricate anatomy and efficient physiological clearance mechanisms, which result in the rapid elimination of topically administered drugs and an overall bioavailability of less than 5%. Anterior segment disorders—including keratitis, glaucoma, and dry eye syndrome—account for the majority of ophthalmic conditions and are primarily managed with pharmacological agents. However, due to extremely low drug bioavailability and poor patient compliance, their therapeutic outcomes often result in a decreased disease control rate or require early surgical interventions. Nebulized drug delivery, particularly employing advanced vibrating mesh technology, has emerged as a promising strategy to overcome these limitations. By converting liquid formulations into a uniform aerosol of micron-sized (1–10 μm) droplets, this approach achieves extensive and consistent coverage of the ocular surface, increases the absorption contact area, prolongs drug residence time, and ultimately enhances drug bioavailability. Preliminary clinical evidence indicates that nebulized therapies outperform traditional eye drops by achieving higher drug concentrations in the aqueous humor and demonstrating superior pharmacodynamic profiles and patient tolerability—particularly in conditions such as dry eye syndrome and glaucoma. This review presents a comprehensive overview of the mechanistic principles, technological advancements, and translational applications of nebulization-based ocular drug delivery systems. We place special emphasis on the integration of next-generation platforms that incorporate microelectromechanical systems (MEMS) and intelligent sensing technologies, enabling precision medicine approaches tailored to individual ocular pathophysiological characteristics. By bridging biomedical engineering and clinical ophthalmology, these innovations not only optimize existing therapeutic regimens but also pave the way for non-invasive delivery of complex biologics and gene therapies—potentially reshaping the landscape of anterior segment drug delivery. Full article

Background: Tessadori–Bicknell–van Haaften syndrome (OMIM #619759) is a rare autosomal dominant neurodevelopmental disorder associated with heterozygous variants in genes encoding histone H4 proteins. The condition is characterized by global developmental delay, craniofacial dysmorphism, hypotrophy, intellectual disability, and ophthalmologic anomalies. More than 30 individuals with variants in histone H4 genes have been reported to date, reflecting the genetic heterogeneity of this emerging disorder. According to OMIM, the association between the H4C11 gene and Tessadori–Bicknell–van Haaften syndrome 2 is currently considered provisional. Methods: We report the case of a 5-year-old female presenting with expressive language delay, social interaction difficulties, and craniofacial features including microcephaly, exophthalmos, and periorbital fullness (“puffy eyes”). Family history revealed two sisters with borderline intellectual functioning who have not undergone genetic testing. The patient’s father carried the same heterozygous H4C11 variant (c.97C > T), while maternal testing was negative. Results: Neuropsychological evaluation revealed borderline intellectual functioning (IQ 73 at first assessment, 85 at follow-up) with persistent expressive language impairment. Ophthalmologic examination confirmed congenital exophthalmos and hypermetropic astigmatism. Laboratory investigations showed low ferritin and mildly elevated TSH levels, which may have contributed to the observed growth delay. At follow-up, the patient showed an increase in IQ score (73 to 85); however, test–retest variability cannot be excluded. Conclusions: This case highlights the importance of careful clinical assessment and cautious interpretation of genetic findings in children with neurodevelopmental delay. Familial segregation of a variant of uncertain significance (VUS), in the absence of functional evidence, should be interpreted conservatively and integrated with detailed phenotypic evaluation to guide clinical management and follow-up. Full article

The remarkable evolution of oncological therapies has dramatically improved cancer survival rates but has simultaneously introduced a significant burden of cardiovascular complications. Cardio-oncology has emerged as a critical multidisciplinary field focused on mitigating the “collateral damage” of life-saving anticancer treatments, ranging from traditional chemotherapeutics to novel immunotherapies. This review provides a comprehensive analysis of the pathophysiological mechanisms, clinical phenotypes, and evolving management strategies for cancer therapy-related cardiac dysfunction (CTRCD). An extensive synthesis of the current literature was conducted, focusing on the molecular pathways of cardiotoxicity, including Topoisomerase IIβ inhibition by anthracyclines, HER2 signaling disruption by targeted agents, and immune-mediated myocarditis triggered by checkpoint inhibitors (ICIs). Cardiotoxicity is increasingly recognized as a spectrum of phenotypes. Heart failure with reduced ejection fraction (HFrEF) remains a primary concern with cytotoxic agents, while heart failure with preserved ejection fraction (HFpEF) is emerging as a critical complication of radiation therapy and tyrosine kinase inhibitors (TKIs). The integration of advanced diagnostic tools—specifically Global Longitudinal Strain (GLS) and Cardiac Magnetic Resonance (CMR) mapping—has shifted the clinical focus toward subclinical detection. Furthermore, pivotal clinical trials such as PRADA and SUCCOUR have validated early pharmacological prophylaxis and strain-guided interventions. Emerging challenges, including the management of CAR-T cell-induced cytokine release syndrome and the specific cardiovascular needs of pediatric and geriatric populations, are also explored. The future of cardio-oncology lies in precision medicine, leveraging genomic profiling and artificial intelligence to identify high-risk individuals. A proactive, multidisciplinary approach is essential to ensure that the success of modern oncology is not compromised by irreversible cardiovascular morbidity. Full article

The two-spot cotton leafhopper (TSCL), Amrasca biguttula (Hemiptera: Cicadellidae), is an emerging invasive pest in the southeastern United States. Although TSCL has historically been associated with cotton and vegetable crops, recent detections on ornamental hibiscus have raised regulatory concern, including “Stop Sale and Hold” orders and an emergency quarantine in Texas. Despite increasing pressure on hibiscus, no insecticide efficacy data exist for ornamental systems. We evaluated the acute (0–24 h) and residual (24–96 h) toxicity of bifenthrin, flupyradifurone, and tolfenpyrad against adult and immature TSCL using a sequential-cohort leaf-disc bioassay. New insects were introduced at 24 h and 72 h to isolate residue-based mortality from prolonged exposure effects. Bifenthrin caused the highest acute mortality at 24 h, whereas flupyradifurone and tolfenpyrad exhibited slower initial activity but strong residual performance. Immatures were more susceptible than adults across all doses. By 72 h, all three insecticides produced near-complete mortality, with significant treatment and dose effects confirmed by ANOVA and binomial GLM analyses. Dose–response curves showed steep concentration-dependent mortality for bifenthrin and tolfenpyrad and a time-dependent response for flupyradifurone. These results provide the first insecticide efficacy data for TSCL on ornamental hibiscus and offer immediate guidance for nursery producers and regulatory agencies. The findings establish a foundation for whole-plant and greenhouse evaluations to support integrated management and interstate plant-movement compliance. Full article

Experimental Governance (EG) has emerged as a strategic framework for managing complexity in high-uncertainty environments. However, its application in the private sector remains fragmented, often conflated with purely operational tools. This study addresses this gap by performing a conceptual transfer of EG principles into the domain of business processes. Through an expanded Systematic Literature Review (SLR) of 41 peer-reviewed articles (covering the period 2004–2026), we identify what we term the ‘Internalization Paradox’: while firms rapidly adopt experimental methodologies like Agile or Lean, they often fail to embed them into formal governance structures that ensure long-term accountability and institutional learning. This updated review incorporates cutting-edge discussions on Artificial Intelligence (AI) governance, experimentalist metagovernance, and the strategic regulation of uncertainty. Our findings suggest that organizational resilience is not merely a byproduct of technological readiness, but an emergence of ‘Institutionalized Experimentalism’. We propose a Conceptual Framework that operationalizes EG through iterative feedback loops, corporate sandboxes, and adaptive decision rights, providing a robust roadmap for future empirical research in management and organizational theory. Full article

Cardiac sarcoidosis (CS) is a critical and frequently underdiagnosed phenotype of sarcoidosis, characterized by non-caseating granulomatous infiltration of the myocardium. This review synthesizes current knowledge regarding the pathogenesis, diagnosis, and management of CS. The disease manifests with a heterogeneous clinical spectrum ranging from asymptomatic conduction abnormalities to life-threatening ventricular arrhythmias and heart failure. Diagnosis remains challenging due to the patchy distribution of granulomas, which limits the sensitivity of endomyocardial biopsy. Consequently, a multimodal diagnostic approach is essential, integrating advanced imaging modalities such as cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) and ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET). These tools not only facilitate detection but also enable the differentiation of active inflammation from chronic fibrosis. Histopathological assessment, supported by specific immunophenotyping and electron microscopy, remains the gold standard for confirming diagnosis and excluding mimics like giant cell myocarditis or infectious granulomatous diseases. Management requires a multidisciplinary strategy combining immunosuppressive therapy, primarily corticosteroids and steroid-sparing agents, with guideline-directed cardiac care, including implantable cardioverter-defibrillators for arrhythmia risk stratification. Emerging biomarkers and artificial intelligence-driven imaging analysis promise to further refine risk stratification and therapeutic monitoring, advancing precision medicine in this complex disorder. Full article

Despite widespread corporate endorsement of the Sustainable Development Goals (SDGs), systematic evidence on how top management in emerging economies prioritizes and frames SDG-related issues over time remains limited. Existing studies are often based on manual or single-year analyses, restricting comparability, scalability, and longitudinal insight. This study examines how corporate managerial communication aligns with and emphasizes SDGs across sectors and over time in two major emerging economies, India and South Africa. Using an AI-driven natural language processing (NLP) pipeline, we analyse 2400 annual reports from 600 publicly listed companies covering the period 2020–2023. A fine-tuned SDG-BERT multi-label classification model is applied to extract and classify SDG-related content from top management communications, enabling sectoral, temporal, and cross-country comparison of SDG relevance. The results reveal a strong and persistent emphasis on SDG 12 (Responsible Consumption and Production) across both countries, alongside sector-specific variation and differing patterns of SDG diversity over time. South African firms exhibit greater variation in SDG emphasis across years, while Indian firms display more concentrated and stable SDG framing. Overall, the findings highlight systematic imbalances in SDG-related managerial communication and persistent underrepresentation of several social SDGs. The study contributes methodologically by demonstrating the value of validated AI-assisted longitudinal text analysis for large-scale SDG research and empirically by providing comparative insights into how corporate SDG narratives evolve in emerging market contexts. Full article