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Search Results (4,756)

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34 pages, 5480 KB  
Article
Metaheuristic Optimization of Treated Sewage Wastewater Quality Parameters with Natural Coagulants
by Joseph K. Bwapwa and Jean G. Mukuna
Water 2026, 18(8), 885; https://doi.org/10.3390/w18080885 (registering DOI) - 8 Apr 2026
Abstract
This study presents a comprehensive multi-objective optimization of sewage wastewater treatment using bio-based coagulants, guided by the Grey Wolf Optimizer (GWO) and its multi-objective variant (MOGWO). Experimental coagulation data, employing Citrullus lanatus and Cucumis melo as natural coagulants, were modeled using multivariate regression [...] Read more.
This study presents a comprehensive multi-objective optimization of sewage wastewater treatment using bio-based coagulants, guided by the Grey Wolf Optimizer (GWO) and its multi-objective variant (MOGWO). Experimental coagulation data, employing Citrullus lanatus and Cucumis melo as natural coagulants, were modeled using multivariate regression techniques, yielding high coefficients of determination (R2 > 0.95) across key water quality parameters. The optimization process targeted maximal reductions in turbidity, total suspended solids (TSS), biochemical oxygen demand (BOD), and chemical oxygen demand (COD) through strategic manipulation of pH and coagulant dosage. The single-objective GWO achieved significant outcomes, including a 96.68% turbidity reduction at pH 5 and 50 mg/L dosage. The MOGWO algorithm identified Pareto-optimal solutions, such as a 94.2% turbidity reduction at pH 5 and 72 mg/L dosage, and a balanced BOD reduction of 52.7% at pH 7. The predictive models indicated that optimal treatment conditions could reduce chemical usage by up to 90% compared to conventional coagulants, resulting in potential cost savings of up to 30%. Moreover, the algorithms demonstrated rapid convergence, averaging 200 iterations, highlighting their computational efficiency and robustness. These findings illustrate that integrating bio-based coagulants with advanced optimization techniques can achieve high treatment efficiency while reducing chemical inputs, thus directly supporting environmental sustainability by minimizing sludge and secondary pollution. In this situation, the wastewater treatment plant will focus on resource-recovery systems with less or no waste at the end of the treatment process. This approach aligns with circular economy principles by promoting eco-friendly, cost-effective wastewater treatment solutions suitable for resource-limited settings. The study offers a forward-looking pathway for environmentally responsible wastewater management practices that significantly reduce chemical dependency and contribute to pollution mitigation efforts. Full article
(This article belongs to the Section Wastewater Treatment and Reuse)
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52 pages, 4035 KB  
Article
In Silico Psycho-Oncology: Understanding Resilience Pathways in Breast Cancer—Determinants of Longitudinal Depression and Quality-of-Life Trajectories
by Eleni Kolokotroni, Paula Poikonen-Saksela, Ruth Pat-Horenczyk, Berta Sousa, Albino J. Oliveira-Maia, Ketti Mazzocco, Haridimos Kondylakis and Georgios S. Stamatakos
J. Pers. Med. 2026, 16(4), 209; https://doi.org/10.3390/jpm16040209 - 7 Apr 2026
Abstract
Background/Objectives: Patients with breast cancer show substantial heterogeneity in terms of psychological adjustment following diagnosis. We aimed to characterize longitudinal trajectories of quality of life (QoL) and depressive symptoms during the first 18 months post-diagnosis and to identify robust clinical, psychosocial, and behavioral [...] Read more.
Background/Objectives: Patients with breast cancer show substantial heterogeneity in terms of psychological adjustment following diagnosis. We aimed to characterize longitudinal trajectories of quality of life (QoL) and depressive symptoms during the first 18 months post-diagnosis and to identify robust clinical, psychosocial, and behavioral predictors associated with distinct adjustment pathways. Methods: Women (N = 538; mean age 55.4 years; range 40–70) with operable breast cancer (stages I–III) were drawn from the multicenter BOUNCE cohort. QoL (Global Health Status/QoL scale of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) and depressive symptoms (depression subscale of the Hospital Anxiety and Depression Scale) were assessed at baseline and months 3, 6, 9, 12, 15 and 18. Latent class growth analysis and growth mixture modeling identified distinct trajectory classes. Associations between early predictors and trajectory membership were examined using logistic regression combined with elastic net regularization. Results: Depression trajectories demonstrated heterogeneity, with groups characterized by persistent resilience (59.7%), stable moderate/high (25.3%), delayed onset (5.0%), and recovery (10.0%). QoL trajectories ranged from stable excellent (13.2%) and stable high (40.7%) to moderate (31.4%) and persistent low/deteriorating (6.9%), as well as a distinct recovering trajectory (7.8%). Trajectory differentiation was primarily driven by psychological resources, symptom burden, functional status, and coping processes, alongside specific contributions from clinical factors. Conclusions: Distinct subgroups of women with breast cancer follow divergent adjustment pathways. These findings highlight the multidimensional nature of resilience and support the need for tailored interventions that promote long-term well-being beyond simple risk reduction. Full article
(This article belongs to the Special Issue Personalized Medicine for Clinical Psychology)
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27 pages, 6807 KB  
Article
Unlocking the Restorative Power of Urban Green Spaces in Summer: The Interplay of Vegetation Structure, Activity Modality, and Human Well-Being
by Yifan Duan, Hua Bai, Le Yang and Shuhua Li
Sustainability 2026, 18(7), 3619; https://doi.org/10.3390/su18073619 - 7 Apr 2026
Abstract
Amidst global urbanization and rising psychological stress, urban green spaces are increasingly recognized as critical infrastructure for sustainable urban development and public health. However, the mechanisms by which summer vegetation structure mediates both physiological and psychological restoration, and the interplay between these two [...] Read more.
Amidst global urbanization and rising psychological stress, urban green spaces are increasingly recognized as critical infrastructure for sustainable urban development and public health. However, the mechanisms by which summer vegetation structure mediates both physiological and psychological restoration, and the interplay between these two dimensions, remain poorly understood. Understanding these mechanisms is essential for designing sustainable, health-promoting urban environments that can support growing urban populations in a warming climate. This study employed a controlled field experiment in Xi’an during summer to examine the effects of five vegetation structure types (Single-Layer Grassland, single-layer woodland, tree–shrub–grass composite woodland, tree–grass composite woodland, and a non-vegetated square) on university students’ physiological (heart rate variability) and psychological (perceived restorativeness and affective states) restoration. Following stress induction, 300 participants engaged with the green spaces through both quiet sitting and walking. The results revealed three key findings: (1) the tree–shrub–grass composite woodland consistently showed the most favorable trends other vegetation types across all psychological restoration dimensions, while also showing favorable trends in physiological recovery, underscoring the importance of structural complexity for restorative quality; (2) walking significantly enhanced physiological recovery compared to seated observation across all settings, confirming the role of physical activity as a critical activator of green space benefits; (3) correlation analysis identified a specific cross-system association: the R-R interval recovery value showed a weak but significant correlation with positive affect (PA) scores, suggesting that physiological calmness and positive emotional experience are linked, yet their weak coupling under short-term exposure indicates they may operate as parallel processes with distinct temporal dynamics. These findings indicate that the restorative potential of summer green spaces emerges from an integrated framework combining vegetation complexity and activity support. We propose that future sustainable landscape design should prioritize multi-layered vegetation structures as nature-based solutions that simultaneously enhance human well-being and urban resilience. These findings provide empirical evidence for integrating health-promoting green infrastructure into sustainable urban planning frameworks, supporting multiple Sustainable Development Goals (SDGs), including SDG 3 (Good Health and Well-being), SDG 11 (Sustainable Cities and Communities), and SDG 13 (Climate Action). Full article
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19 pages, 2658 KB  
Article
Advancements with Photobiomodulation in Post-Burn Management/Rehabilitation: A Comparative Study on Multiwave Locked System (MLS) LASER Therapy Outcomes
by Ruxandra-Luciana Postoiu, Cristina Popescu, Silviu Marinescu and Gelu Onose
Life 2026, 16(4), 611; https://doi.org/10.3390/life16040611 - 7 Apr 2026
Abstract
Background: Severe burn injuries are associated with prolonged consequent wound healing, substantial symptoms burden, and delayed, sometimes incomplete, functional recovery. Photobiomodulation using Multiwave Locked System (MLS) LASER therapy has been proposed as an adjunctive intervention to support tissue repair and thereby improve rehabilitation [...] Read more.
Background: Severe burn injuries are associated with prolonged consequent wound healing, substantial symptoms burden, and delayed, sometimes incomplete, functional recovery. Photobiomodulation using Multiwave Locked System (MLS) LASER therapy has been proposed as an adjunctive intervention to support tissue repair and thereby improve rehabilitation outcomes, but related clinical evidence in burn populations remains limited. Materials and Methods: This comparative study included 65 patients with severe burn injuries, of whom 35 were prospectively treated with adjunctive MLS LASER therapy, in addition to standard care, and 30 retrospectively identified patients, who received standard care alone, served as controls. The primary outcome was the time until complete epithelialization, while secondary outcomes included: reduction in wound surface, pain intensity, pruritus severity, scar quality, and functional improvements. Assessments were performed at baseline and after a standardized follow-up period of up to 20 days. Results: Patients treated with MLS LASER therapy achieved complete epithelialization significantly earlier than controls (median 40 vs. 73 days, p < 0.001) and demonstrated greater wound area reduction (median 434 vs. 137 cm2, p = 0.0012). In multivariable analyses adjusted for burn extent, burn depth, age, and diabetes mellitus, considered as factors worsening evolution, MLS LASER therapy remained independently associated with shorter time to epithelialization and greater reduction in wound dimension. Significant improvements favoring the MLS group were also observed regarding pain, pruritus, scar quality, and functional outcomes, all assessed using specific evaluation tools (p < 0.001). Conclusions: Adjunctive MLS LASER therapy appears to be associated with improved wound healing dynamics and enhanced rehabilitation outcomes in patients with severe burn injuries. These findings should be interpreted with caution given the study limitations, including the non-randomized design and relatively small sample size. MLS LASER therapy may represent a promising adjunctive option in the conservative management of burn injuries; however, further prospective randomized studies are required to confirm these results and to define optimal treatment protocols. Full article
(This article belongs to the Section Medical Research)
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13 pages, 2024 KB  
Systematic Review
Remimazolam Versus Propofol for General Anesthesia in Older Adults Undergoing Colon Cancer Surgery: A Systematic Review and Meta-Analysis of Comparative Studies
by Khalid I. AlHussaini, Ibrahim Abdullah Abalhassan, Eman Toraih and Abdullah Ibrahim Alhussaini
Pharmaceutics 2026, 18(4), 448; https://doi.org/10.3390/pharmaceutics18040448 - 6 Apr 2026
Viewed by 87
Abstract
Background: Propofol is widely used for anesthesia in colorectal cancer surgery, but is frequently associated with hypotension and respiratory depression. Remimazolam, a novel ultra-short–acting benzodiazepine, may offer improved hemodynamic stability with similar anesthetic depth and recovery characteristics. However, evidence directly comparing remimazolam and [...] Read more.
Background: Propofol is widely used for anesthesia in colorectal cancer surgery, but is frequently associated with hypotension and respiratory depression. Remimazolam, a novel ultra-short–acting benzodiazepine, may offer improved hemodynamic stability with similar anesthetic depth and recovery characteristics. However, evidence directly comparing remimazolam and propofol in the setting of colon cancer surgery remains limited. Therefore, the aim of this study was to systematically evaluate the efficacy, safety, perioperative hemodynamic stability, and recovery outcomes of remimazolam versus propofol in older adults undergoing colon cancer surgery. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials and comparative cohort studies evaluating remimazolam versus propofol in adult patients undergoing colon or colorectal cancer surgery. PubMed, Scopus, and Web of Science were searched from the start of each database to October 2025. Outcomes included perioperative hemodynamics (MAP and HR), recovery parameters, intraoperative remifentanil consumption, anesthesia duration, and adverse events. Random-effect models were used to calculate pooled mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). Results: Six studies involving 542 patients (remimazolam n = 276; propofol n = 266) were included. Remimazolam produced significantly higher perioperative MAP (overall MD = 2.86 mmHg, 95% CI 1.52–4.21; p < 0.0001) and slightly higher HR (MD = 2.30 bpm, 0.08–4.52; p = 0.04). Differences were largest immediately after incision and at the end of surgery. No significant differences were found in PACU stay, overall recovery duration, remifentanil consumption, or anesthesia duration. Postoperative nausea and vomiting were comparable (RR = 0.93; p = 0.86), while respiratory depression was numerically lower with remimazolam (RR = 0.49; p = 0.17). Conclusions: Remimazolam provides anesthetic efficacy comparable to propofol in colon cancer surgery while offering modest, but clinically meaningful improvements in intraoperative hemodynamic stability. Recovery times, opioid requirements, and adverse-event rates were similar between agents. Remimazolam may be particularly advantageous for elderly or hemodynamically vulnerable patients undergoing major colorectal procedures. Larger, high-quality trials are warranted to clarify long-term and oncologic outcomes. Full article
(This article belongs to the Section Clinical Pharmaceutics)
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29 pages, 2946 KB  
Article
Sustainable Nitrogen Management in Olive Cultivation Through Chabazite-Zeolite Amendment: Growth Response, Yields and Life Cycle Assessment
by Lucia Morrone, Andrea Calderoni, Giacomo Ferretti, Giulio Galamini and Annalisa Rotondi
Horticulturae 2026, 12(4), 453; https://doi.org/10.3390/horticulturae12040453 - 5 Apr 2026
Viewed by 142
Abstract
Improving nitrogen (N) use efficiency in olive cultivation is essential to address the environmental burden of N fertilizers, whose recovery efficiency rarely exceeds 55%. This study evaluates the agronomic and environmental performance of chabazite-rich zeolite as a soil amendment to enable 50% N-fertilizer [...] Read more.
Improving nitrogen (N) use efficiency in olive cultivation is essential to address the environmental burden of N fertilizers, whose recovery efficiency rarely exceeds 55%. This study evaluates the agronomic and environmental performance of chabazite-rich zeolite as a soil amendment to enable 50% N-fertilizer reduction in olive growing. A seven-year field experiment (2017–2023) was conducted at two sites in Emilia-Romagna (Italy)—one irrigated (Brisighella) and one rainfed (Bertinoro)—comparing four autochthonous varieties under zeolite amendment (ZEO, 50% N) versus conventional fertilization (CNT, 100% N). Vegetative growth, productive parameters, oil quality and environmental impacts (Life Cycle Assessment, ISO 14040/44) were monitored. Under irrigation, ZEO maintained vegetative and productive equivalence with CNT, sustaining commercially viable yields (0.5–2.3 t ha−1). Under rainfed conditions, variety-specific responses emerged: Colombina exhibited 126.2% greater trunk diameter and near-universal fruiting competence (88.9% vs. 29–35% productive plants) under ZEO, while Capolga showed treatment convergence. LCA revealed higher per-unit environmental impacts for ZEO during early orchard phases due to front-loaded extraction burdens, progressively offset by annual N-input reductions. These findings demonstrate that zeolite amendment enables agronomically viable 50% N-fertilizer reduction, with efficacy modulated by water regime and genotype. Full article
(This article belongs to the Section Plant Nutrition)
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20 pages, 1721 KB  
Review
Type A Aortic Dissection: From Diagnosis to Cardiac Rehabilitation
by Monica Loguercio, Maria Grazia Romeo, Buket Akinci, Cristina Andreea Adam, Irfan Ullah, Marta Supervía, Giancarlo Trimarchi, Natalia Świątoniowska-Lonc, Federica Fogacci and Francesco Perone
J. Clin. Med. 2026, 15(7), 2749; https://doi.org/10.3390/jcm15072749 - 5 Apr 2026
Viewed by 207
Abstract
Acute type A aortic dissection is a life-threatening condition requiring emergency surgery and complex postoperative management. Although survival rates have improved, many patients experience long-term functional impairments, reduced quality of life, and an elevated risk of complications. Despite strong evidence supporting cardiac rehabilitation [...] Read more.
Acute type A aortic dissection is a life-threatening condition requiring emergency surgery and complex postoperative management. Although survival rates have improved, many patients experience long-term functional impairments, reduced quality of life, and an elevated risk of complications. Despite strong evidence supporting cardiac rehabilitation in other cardiovascular populations, structured programs remain underutilized in patients with surgically resolved acute type A aortic dissection. Exercise-based cardiac rehabilitation appears feasible and can be delivered safely in carefully selected patients when appropriately adapted to individual needs and conducted under close supervision. Postoperative patients are often physically deconditioned, prone to hospital-acquired disability, and may misjudge exercise intensity. Therefore, individualized exercise prescription, guided by exercise testing when available, is important to support safe training thresholds. Early and gradual introduction of physical activity may help prevent complications associated with immobility, support blood pressure control, and contribute to improvements in functional capacity. However, training volume should be purposefully lower than in conventional program settings to reduce hemodynamic stress. Education on safe exercise parameters and self-monitoring plays a central role in enabling long-term adherence and promoting patient autonomy. Cardiac rehabilitation programs should incorporate dietary, nutritional, and psychological support. Although evidence specific to this patient population remains limited, available data suggest the feasibility and potential benefits of cardiac rehabilitation when delivered with appropriate precautions. Our review underscores the need for a tailored, multidisciplinary CR approach aimed at enhancing physical recovery, supporting cardiovascular stability, and improving overall quality of life in patients following surgery. Further research is required to define optimal program protocols. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Aortic Dissection: Experts' Views)
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38 pages, 1809 KB  
Review
A Review of Organic Municipal Waste Management in Medium Cities in Latin America
by Linda Y. Pérez-Morales, Adriana Guzmán-López, Rita Miranda-López, Micael Gerardo Bravo-Sánchez and José E. Botello-Álvarez
Recycling 2026, 11(4), 73; https://doi.org/10.3390/recycling11040073 - 5 Apr 2026
Viewed by 254
Abstract
Latin America faces growing challenges in the management of municipal solid waste (MSW). This is particularly evident in medium-sized and metropolitan cities where rapid urbanization, limited infrastructure, and high proportions of organic waste (40–70%) converge. This review synthesizes the most recent advances in [...] Read more.
Latin America faces growing challenges in the management of municipal solid waste (MSW). This is particularly evident in medium-sized and metropolitan cities where rapid urbanization, limited infrastructure, and high proportions of organic waste (40–70%) converge. This review synthesizes the most recent advances in organic waste management, valorization strategies, environmental performance, and policy frameworks in Mexico and Latin America. To provide a comprehensive overview, evidence from studies on informal recycling systems, route optimization, sustainable landfill siting, food waste valorization, life cycle assessments (LCAs), and biogas production is integrated. Techno-economic analyses of energy recovery from organic fractions are specifically reviewed. This review highlights that valorization of organic waste through composting, anaerobic digestion, food supplementation, and bioproduct generation can reduce greenhouse gas emissions by 40–70% compared to landfilling, with AD–composting hybrids achieving the highest reductions of 60–70%. Community composting achieved moderate reductions, 30–50%, but at significantly lower cost and with greater social co-benefits. These alternatives for valorizing the organic fraction extend the lifespan of both confined and open landfills. It also contributes to mitigating the public health impacts related to open dumping, disease vectors, and contaminated leachate. In short, this review also highlights shortcomings in policy coherence, financial mechanisms, source separation, and technology adoption. A strategic framework is proposed that prioritizes decentralized treatment systems, the integration of informal recyclers, tax incentives, community-based waste separation, and planning based on Life Cycle Assessment (LCA). The findings point to a viable strategy for transitioning from landfill dependency to circular waste management systems that improve the quality of life for the population of Latin America and the Caribbean. Full article
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33 pages, 947 KB  
Article
Global Dynamics for a Distributed Delay SVEIR Model for Measles Transmission with Imperfect Vaccination: A Threshold Analysis
by Mohammed H. Alharbi and Ali Rashash Alzahrani
Mathematics 2026, 14(7), 1219; https://doi.org/10.3390/math14071219 (registering DOI) - 5 Apr 2026
Viewed by 102
Abstract
Measles remains a significant public health threat despite widespread vaccination, with recent resurgences driven by vaccine hesitancy and coverage gaps. Existing mathematical models often fail to capture the substantial temporal heterogeneity in incubation periods, vaccine-induced protection, and recovery processes that characterize measles transmission. [...] Read more.
Measles remains a significant public health threat despite widespread vaccination, with recent resurgences driven by vaccine hesitancy and coverage gaps. Existing mathematical models often fail to capture the substantial temporal heterogeneity in incubation periods, vaccine-induced protection, and recovery processes that characterize measles transmission. We develop and analyze an SVEIR epidemic model incorporating four independent distributed time delays with exponential survival factors, capturing the realistic variability in these epidemiological processes. The model features compartment-specific mortality rates, disease-induced mortality, and imperfect vaccination with failure probability θ. Using next-generation matrix methods adapted for delay kernels, we derive the delay-dependent reproduction number R0d and prove, via systematic construction of Volterra-type Lyapunov functionals, that it constitutes a sharp threshold: the disease-free equilibrium is globally asymptotically stable when R0d1, while a unique endemic equilibrium emerges and is globally stable when R0d>1. Normalized forward sensitivity analysis reveals that the transmission rate β and recruitment rate Λ exhibit maximal positive elasticity, while the vaccination rate p, vaccine failure probability θ, and incubation delay τ3 possess the largest negative elasticities. Critically, τ3 exerts exponential influence via en3τ3, making interventions that delay infectiousness—such as post-exposure prophylaxis—unusually potent. We derive an explicit expression for the critical delay τ3cr at which R0d=1, demonstrating that prolonging the effective incubation period sufficiently can shift the system from endemic persistence to extinction. Numerical simulations using Dirac delta kernels confirm all theoretical predictions. These findings provide three actionable insights for public health: (1) maintaining high vaccination coverage among new birth cohorts remains paramount; (2) improving vaccine quality (reducing θ) yields substantial returns; and (3) the incubation delay represents a quantifiable, measurable target for evaluating the population-level impact of time-sensitive interventions. The framework is broadly applicable to infectious diseases characterized by significant temporal heterogeneity. Full article
(This article belongs to the Special Issue Advances in Epidemiological and Biological Systems Modeling)
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13 pages, 1939 KB  
Article
Effects of Sleepwear Incorporating a DPV576 Functional Polyester Fabric on Wearable ECG-Derived Sleep Consolidation: A Randomized Two-Period Crossover Study Under Free-Living Conditions
by Hideki Katano, Masaaki Sugita, Shinichi Tokuno, Yumi Nomura, Naoya Nishino, Masakazu Higuchi, Yusuke Iwai, Yuki Matsuki, Pengyu Deng and Seiji Nishino
Sensors 2026, 26(7), 2247; https://doi.org/10.3390/s26072247 - 5 Apr 2026
Viewed by 193
Abstract
Sleep quality is essential for maintaining physical health and psychological resilience. Because sleepwear remains in direct contact with the skin throughout the night, it may affect thermoregulation and comfort and, thereby, influence sleep. This randomized two-period, two-sequence crossover study investigated whether sleepwear infused [...] Read more.
Sleep quality is essential for maintaining physical health and psychological resilience. Because sleepwear remains in direct contact with the skin throughout the night, it may affect thermoregulation and comfort and, thereby, influence sleep. This randomized two-period, two-sequence crossover study investigated whether sleepwear infused with nanodiamond and nanoplatinum particles (DPV576) could improve sleep quality and promote fatigue recovery under free-living conditions. Fourteen healthy men (23.9 ± 1.7 years) wore DPV576 sleepwear and visually indistinguishable standard polyester sleepwear for one week each, separated by a one-week washout. Sleep was assessed using a wearable ECG-based actigraphy device; trained researchers additionally performed manual rescoring to verify automated outputs, including independent determination of sleep onset latency. Subjective sleep was assessed daily using the Sleep Quality Index of Daily Sleep and a visual analog scale; exploratory outcomes included voice-derived biomarkers and pre-/post-sleep grip strength. In manual rescoring, DPV576 was associated with higher sleep efficiency (93.0 ± 0.9% vs. 89.5 ± 1.5%, p < 0.05), fewer awakenings (8.4 ± 1.3 vs. 10.7 ± 1.4, p < 0.01), and shorter wake after sleep onset (30.4 ± 4.7 vs. 41.6 ± 6.0 min, p < 0.01), whereas total sleep time did not differ significantly (p = 0.096). These findings suggest that one-week use of DPV576 sleepwear may improve wearable ECG-derived sleep consolidation in young men, supporting a nonpharmacological wearable strategy to enhance sleep efficiency in everyday settings. Full article
(This article belongs to the Special Issue State of the Art in Wearable Sensors for Health Monitoring)
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18 pages, 594 KB  
Article
Structured Functional Assessment Pathway and Pharmacological Optimization During Cardiovascular Rehabilitation in Chronic Heart Failure: A Retrospective Tertiary Center Study
by Miruna Popovici, Abhinav Sharma, Gabriel Florin Razvan Mogos, Nilima Rajpal Kundnani, Daniel Duda Marius Seiman, Victor Buciu and Simona Ruxanda Dragan
Life 2026, 16(4), 603; https://doi.org/10.3390/life16040603 - 4 Apr 2026
Viewed by 185
Abstract
Introduction: Optimization of guideline-directed medical therapy in chronic heart failure remains challenging in real-world practice, particularly outside settings with routine cardiopulmonary exercise testing. In this context, cardiovascular rehabilitation can improve functional capacity, symptoms, and quality of life, while structured follow-up may also facilitate [...] Read more.
Introduction: Optimization of guideline-directed medical therapy in chronic heart failure remains challenging in real-world practice, particularly outside settings with routine cardiopulmonary exercise testing. In this context, cardiovascular rehabilitation can improve functional capacity, symptoms, and quality of life, while structured follow-up may also facilitate treatment adjustment. We therefore evaluated whether exposure to a structured multimodal functional assessment pathway, embedded within a more intensive follow-up model, was associated with pharmacological optimization and functional change in chronic heart failure. Methods: We conducted a retrospective, single-center cohort study including adults with chronic heart failure with reduced or mildly reduced ejection fraction managed in a tertiary university clinic. Patients were classified according to documented exposure to an integrated pathway that combined standardized 6 min walk testing, heart rate dynamics, oxygen saturation response, perceived exertion, validated quality-of-life assessment, and prespecified interim reassessment, versus usual care. The integrated pathway involved more frequent clinical contact than usual care. The primary outcome was change in 6 min walk distance over 6 months. Secondary outcomes included changes in heart rate recovery, oxygen saturation nadir, Borg perceived exertion score, quality-of-life score, intensity of guideline-directed medical therapy, treatment intensification rates, and heart failure hospitalization. Results: The study included 250 patients with comparable baseline demographic and clinical characteristics. Patients managed within the structured pathway showed greater improvement in 6 min walk distance at 6 months than those receiving usual care, together with more pronounced improvement in secondary functional parameters and quality-of-life scores. Pharmacological optimization, reflected by higher uptake and intensification of guideline-directed medical therapy, also occurred more frequently in the structured pathway group. The integrated group, however, also had higher follow-up intensity, which limits causal interpretation of the observed between-group differences. Conclusions: In this real-world heart failure cohort, exposure to a structured care pathway combining repeated multimodal functional profiling with closer follow-up was associated with greater functional improvement and more intensive pharmacological optimization. These findings should be interpreted as pathway-level associations rather than proof that functional assessment alone drove benefit, and they require prospective validation. Full article
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17 pages, 1273 KB  
Article
Depressive and Anxiety Symptoms Predict Health-Related Quality of Life More than Cognitive Impairment After Minor Stroke or Transient Ischemic Attack: A Hierarchical Regression Analysis
by María Rocío Córdova-Infantes and José María Ramírez-Moreno
Healthcare 2026, 14(7), 948; https://doi.org/10.3390/healthcare14070948 - 4 Apr 2026
Viewed by 246
Abstract
Background: Transient ischemic attack (TIA) and minor stroke often result in excellent functional recovery but are frequently followed by substantial psychological morbidity. It remains unclear whether mood disturbances or cognitive impairment are the primary contributors to reduced health-related quality of life (HRQoL) in [...] Read more.
Background: Transient ischemic attack (TIA) and minor stroke often result in excellent functional recovery but are frequently followed by substantial psychological morbidity. It remains unclear whether mood disturbances or cognitive impairment are the primary contributors to reduced health-related quality of life (HRQoL) in this population. Methods: We conducted a prospective observational case–control study including 90 patients with acute TIA or minor stroke confirmed by diffusion-weighted imaging and 92 age-matched healthy controls. At 90 days, participants completed the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Montreal Cognitive Assessment, and the EQ-5D-5L. Hierarchical multiple regression using standardized z-scores identified independent predictors of HRQoL. Bias-corrected bootstrapped mediation analyses (5000 iterations) assessed whether cognitive impairment mediated the relationship between mood symptoms and HRQoL. Results: Compared with controls, patients exhibited markedly higher rates of depressive symptoms (82.2% vs. 18.5%), anxiety symptoms (81.1% vs. 21.7%), and cognitive impairment (66.7% vs. 13.0%) (all p < 0.001). Psychopathological variables explained an additional 36.6% of HRQoL variance, whereas cognitive and neuroimaging variables contributed only 1.7% (ΔR2 = 0.017; p = 0.523). In the fully adjusted regression model, HAM-A showed the numerically largest standardized coefficient (β = −0.055; p = 0.064), representing a trend toward significance, while HDRS-17 did not individually reach statistical significance (β = −0.043; p = 0.147); cognitive impairment had negligible independent effects (β = −0.001; p = 0.947). Both mood variables collectively accounted for the substantial majority of explained HRQoL variance, far exceeding the contribution of cognitive and neuroimaging predictors. Mediation analyses revealed no significant indirect effects, indicating that mood and cognitive complications are statistically consistent with a model in which mood and cognitive symptoms exert independent effects on HRQoL; temporal ordering cannot be established from these cross-sectional measures. Conclusions: Following TIA or minor stroke, depressive and anxiety symptoms are highly prevalent, persist despite good neurological recovery, and exert a disproportionately negative impact on HRQoL. Anxiety appears particularly influential in determining patient-reported outcomes. The statistical consistency of the mediation models with parallel rather than sequential mood–cognition pathways suggests that these represent independent neurobiological sequelae requiring separate clinical attention, underscoring the need for routine and concurrent assessment of both mood and cognitive function after TIA and minor stroke. Full article
(This article belongs to the Special Issue Focus on Quality of Neurology and Stroke Care for Patients)
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25 pages, 3190 KB  
Article
Forecast-Guided KAN-Adaptive FS-MPC for Resilient Power Conversion in Grid-Forming BESS Inverters
by Shang-En Tsai and Wei-Cheng Sun
Electronics 2026, 15(7), 1513; https://doi.org/10.3390/electronics15071513 - 3 Apr 2026
Viewed by 140
Abstract
Grid-forming (GFM) battery energy storage system (BESS) inverters are becoming a cornerstone of resilient microgrids, where severe voltage sags and abrupt operating shifts can challenge both voltage regulation and controller stability. Finite-set model predictive control (FS-MPC) offers fast transient response and multi-objective coordination, [...] Read more.
Grid-forming (GFM) battery energy storage system (BESS) inverters are becoming a cornerstone of resilient microgrids, where severe voltage sags and abrupt operating shifts can challenge both voltage regulation and controller stability. Finite-set model predictive control (FS-MPC) offers fast transient response and multi-objective coordination, yet conventional designs rely on static cost-function weights that are typically tuned offline and may become suboptimal under disturbance-driven regime changes. This paper proposes a forecast-guided KAN-adaptive FS-MPC framework that (i) formulates the inner-loop predictive control in the stationary αβ frame, thereby avoiding PLL dependency and mitigating loss-of-lock risk under extreme sags, and (ii) introduces an Operating Stress Index (OSI) that fuses load forecasts with reserve-margin or percent-operating-reserve signals to quantify grid vulnerability and trigger resilience-oriented control adaptation. A lightweight Kolmogorov–Arnold Network (KAN), parameterized by learnable B-spline edge functions, is embedded as an online weight governor to update key FS-MPC weighting factors in real time, dynamically balancing voltage tracking and switching effort. Experimental validation under high-frequency microgrid scenarios shows that, under a 50% symmetrical voltage sag, the proposed controller reduces the worst-case voltage deviation from 0.45 p.u. to 0.16 p.u. (64.4%) and shortens the recovery time from 35 ms to 8 ms (77.1%) compared with static-weight FS-MPC. In the islanding-like transition case, the proposed method restores the PCC voltage within 18 ms, whereas the static baseline fails to recover within 100 ms. Moreover, the deployed KAN governor requires only 6.2 μs per inference on a 200 MHz DSP, supporting real-time embedded implementation. These results demonstrate that forecast-guided adaptive weighting improves transient resilience and power quality while maintaining DSP-feasible computational complexity. Full article
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19 pages, 21277 KB  
Article
Near-Bottom ROV-Borne Self-Potential Exploration of Seafloor Massive Sulfide Deposits on the Southwest Indian Ridge
by Zuofu Nie, Chunhui Tao, Zhongmin Zhu and Jianping Zhou
Remote Sens. 2026, 18(7), 1076; https://doi.org/10.3390/rs18071076 - 3 Apr 2026
Viewed by 221
Abstract
Seafloor massive sulfide (SMS) deposits formed by hydrothermal circulation generate measurable self-potential (SP) anomalies in seawater, providing an effective geophysical indicator of sulfide mineralization. In this study, a remotely operated vehicle (ROV)-borne SP survey was conducted at the Yuhuang hydrothermal field on the [...] Read more.
Seafloor massive sulfide (SMS) deposits formed by hydrothermal circulation generate measurable self-potential (SP) anomalies in seawater, providing an effective geophysical indicator of sulfide mineralization. In this study, a remotely operated vehicle (ROV)-borne SP survey was conducted at the Yuhuang hydrothermal field on the Southwest Indian Ridge to investigate the spatial distribution of SMS mineralization. The survey operated at a near-bottom altitude of approximately 10 m, substantially lower than that typically achieved by autonomous underwater vehicles (AUVs) or towed systems, enabling high-resolution data acquisition with improved signal quality. To efficiently discretize complex seafloor topography under irregular data coverage, an adaptive octree mesh was employed, enabling computationally efficient three-dimensional inversion over a large survey area and recovery of the subsurface source current density distribution. The inversion results resolve a main anomaly zone spatially correlated with known SMS mineralization, as well as an additional anomaly zone that was not resolved by previous surveys and suggests potential mineralization. Anomalies associated with known mineralization show good spatial agreement with independent near-bottom observations and drilling results. The results demonstrate that ROV-borne SP surveying combined with adaptive meshing and three-dimensional inversion provides a reliable approach for imaging SMS mineralization in deep-sea environments. Full article
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19 pages, 2780 KB  
Patent Summary
Recycling Installation for Circular SLA Resin and Injection Casting in Microgravity
by Emilia Georgiana Prisăcariu and Iulian Vlăducă
Inventions 2026, 11(2), 36; https://doi.org/10.3390/inventions11020036 - 3 Apr 2026
Viewed by 129
Abstract
Photopolymer-based additive manufacturing processes such as stereolithography (SLA) offer high precision and surface quality but generate cured thermoset waste that is typically non-recyclable. In microgravity environments, conventional recycling approaches—based on gravitational settling, open solvent handling, and buoyancy-driven degassing—are ineffective, motivating the development of [...] Read more.
Photopolymer-based additive manufacturing processes such as stereolithography (SLA) offer high precision and surface quality but generate cured thermoset waste that is typically non-recyclable. In microgravity environments, conventional recycling approaches—based on gravitational settling, open solvent handling, and buoyancy-driven degassing—are ineffective, motivating the development of fully contained, gravity-independent material recovery systems for on-orbit manufacturing. This work presents a conceptual, design-stage closed-loop system architecture for recycling photopolymer resins in microgravity. The system integrates eight subassemblies enabling mechanical fragmentation, solvent-assisted dissolution, filtration, low-pressure degassing, pressurized storage, injection molding, and ultraviolet curing. A hermetically sealed dual-screw shredder produces resin fragments of 1–3 mm, suitable for dissolution. Gas removal is achieved through low-vacuum degassing at approximately 0.1–0.3 bar, with characteristic residence times of 5–10 min, ensuring stable processing prior to injection. Material transport is governed by mechanical conveyance and controlled pressure, eliminating reliance on gravity. The architecture maintains full containment of solids, liquids, and vapors throughout the process. Supported by engineering design considerations, the system establishes a microgravity-compatible pathway for closed-loop recycling of SLA materials. Experimental validation is planned in future work. Full article
(This article belongs to the Section Inventions and Innovation in Advanced Manufacturing)
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