Advancing Open Science

Background: Early cardiopulmonary resuscitation (CPR) and timely use of automated external defibrillators (AEDs) are critical determinants of survival following out-of-hospital cardiac arrest (OHCA). University students enrolled in healthcare degree programs represent a strategic target population for the dissemination of basic life support and defibrillation (BLS-D) skills. However, evidence on their level of knowledge, attitudes, and perceived preparedness remains limited in Southern Italy. Methods: A cross-sectional observational study was conducted between mid-December 2025 and 15 January 2026 among undergraduate healthcare students at the Magna Graecia University of Catanzaro (Italy). Data were collected using a structured, self-administered questionnaire assessing socio-demographic characteristics, CPR/AED knowledge, attitudes, and perceived confidence. Composite knowledge scores were calculated and categorized as poor, sufficient, good, or excellent. Statistical analyses included chi-square tests, Cramér’s V, and Spearman’s rank correlation. Results: A total of 604 students were included (mean age 24.4 ± 6.7 years; 69.9% female), of whom 46.4% reported prior BLS-D training. Knowledge levels were heterogeneous: myocardial infarction was widely recognized as a cause of cardiac arrest (81.1%), whereas recognition of non-shockable rhythms, including asystole and pulseless electrical activity, remained low (<25%). Procedural knowledge, particularly regarding the chain of survival and chest compression rate, improved with academic year and prior BLS-D training. Conversely, ventilation skills and correct AED pad placement were consistently inadequate. Attitudes toward CPR were largely positive; however, perceived confidence in performing resuscitation was moderate to low, especially in complex scenarios. More than 80% of students expressed strong interest in further training and supported mandatory BLS-D education. Conclusions: Healthcare students demonstrated favorable attitudes toward CPR but insufficient and uneven knowledge, particularly in rhythm recognition, ventilation, and AED use. Academic progression and structured BLS-D training were associated with improved competencies, although critical gaps persisted. Integrating mandatory, hands-on BLS-D training with regular refresher sessions into healthcare curricula should enhance preparedness and potentially reduce OHCA-related mortality, especially in high-risk regions such as Calabria.

Background: Does maternal body mass index (BMI) influence embryo morphokinetics in fresh embryo transfer cycles, and how does this relate to clinical outcomes and obstetric complications? Methods: A retrospective cohort study was conducted on 2238 fresh embryo transfer (ET) cycles, categorized into four BMI groups: underweight, normal weight, overweight, and obese. Baseline characteristics, stimulation parameters, hormonal profiles, morphokinetic data, and pregnancy and delivery outcomes were analyzed. Results: Higher BMI was associated with more anovulatory infertility and greater endometrial thickness. Peak estradiol and estradiol-to-oocyte ratios declined progressively with increasing BMI, despite preserved oocyte yield and embryo quality scores. Interestingly, the underweight group exhibited a significantly distinct biphasic morphokinetics developmental pattern compared with the overweight and obese groups. Pregnancy rates, including clinical and live birth, did not differ significantly across BMI groups. However, obese women had markedly higher cesarean section rates (51.9% vs. ~25–28% in other groups) and a non-significant trend toward more gestational diabetes. Other perinatal outcomes, such as preeclampsia and preterm birth, were not significantly different. Conclusions: In fresh IVF cycles, a higher BMI does not impair pregnancy achievement but is linked to altered hormonal response and increased obstetric risk, particularly cesarean delivery. These findings highlight the importance of preconception counseling and targeted obstetric management for women with elevated BMI undergoing fresh ET.

Terminalia arjuna (Arjun) is a tropical deciduous tree species significantly valued for its pharmaceutical properties for various heart diseases, as well as its economic role in the sericulture industry. However, the growth performance and physiological responses of T. arjuna under water stress conditions remain largely unexplored, particularly in the context of increasing climate variability and the growing challenges posed by climate change. Therefore, this study aimed to examine the morpho-physio-biochemical alterations, nutrient uptake changes, and adaptive strategies under different degrees of water stress with respect to field capacity ($F_{wc}$), maintained at 100% $F_{wc}$ (control), 75% $F_{wc}$ (mild), 50% $F_{wc}$ (moderate), and 25% $F_{wc}$ (severe). Key growth parameters, including shoot and root length, leaf traits and shoot dry biomass, were significantly (p < 0.05) reduced under the given water stresses. Root dry biomass showed a distinct response, increasing under mild to moderate water stress but failing to sustain its levels under severe stress. Increasing drought severity resulted in a substantial reduction in stomatal density (15–37%), while stomatal size increased (18–49%) under mild to moderate stress but decreased under severe stress. These responses were associated with significant reductions in gas exchange traits (45–75%), whereas water use efficiency increased by 59–99%, reflecting a survival-focused adaptive mechanism. Moderate water stress triggered the stress responses in T. arjuna through high proline accumulation and increased oxidative stress markers. The most critical impact was found under the severe stress with a substantial reduction in leaf relative water content and membrane stability index (MSI), although MSI was sustained above the critical threshold, reflecting cellular protection. Increased stress intensity also altered mineral uptake, decreased major nutrients, and increased potassium and calcium content, indicating an adaptive strategy. These findings suggest a threshold effect, where T. arjuna tolerates mild stress well and activates adaptive morpho-physiological mechanisms under moderate stress but shifts to survival-focused strategies under severe stress. The demonstrated tolerance of Terminalia arjuna to mild–moderate drought suggests that climate-resilient forestry policies and conservation programs should prioritize its cultivation and restoration in drought-prone landscapes while ensuring adequate water management to prevent severe stress and sustain its medicinal and economic benefits.

Spent carbon cathode (SCC), a hazardous solid waste discharged from aluminum electrolysis, exhibits significant fluoride and cyanide leaching toxicities. Existing high-temperature disposal strategies are constrained by high investment costs for specialized equipment, low product added value, and unclear application scenarios, hindering their large-scale implementation. Consequently, substantial quantities of SCC remain underutilized, resulting in the waste of valuable carbon and fluoride components. This study focuses on the targeted conversion of valuable components in SCC through the innovative integration of simple processes, including atmospheric high-temperature roasting, deep purification, Al-based inducer addition, and pH regulation. Volatilization kinetics and solution equilibrium chemistry were used to investigate impurity removal mechanisms and to guide cryolite synthesis, respectively. The results demonstrate the successful recovery of high-purity regenerated graphite with a high carbon content, low sulfur content, and a high degree of graphitization. Simultaneously, cryolite with a high NaF/AlF₃ molecular ratio was synthesized from the roasting flue gas absorption liquor by controlling ionic composition and pH. Guided by the principles of cleaner production and resource recycling, the entire recovery process generates negligible waste gas, wastewater, or solid residue emissions. In conclusion, the proposed disposal strategy achieved the targeted conversion of SCC into high-value products while mitigating environmental pollution risks, offering both environmental and economic benefits. This innovative design provides a feasible pathway for the large-scale disposal and utilization of SCC.

This systematic integrative review evaluates the effectiveness of SGLT2 inhibitors in relation to improving glycaemic control, reducing cardiovascular events, and preserving renal function based on the latest published evidence. Search for publications referenced in PubMed, from January 2020 to January 2025, was conducted; 48 abstracts were reviewed, and 27 full-text articles were included for analysis—systematic reviews, meta-analyses, narrative reviews and comparative effectiveness studies. SGLT2 inhibitors are effective in reducing glucose levels, but the magnitude of reduction varies compared to other classes of antidiabetics. A noticeable reduction in the risk of major cardiovascular events, cardiovascular and all-cause mortality was reported, particularly compared to DPP-4 inhibitors and placebo. SGLT2 inhibitors demonstrated the most pronounced and consistent benefits in reducing hospitalisation for heart failure among all other evaluated classes. However, outcomes like myocardial infarction and stroke results were inconsistent. Renal outcomes consistently favoured SGLT2 inhibitors in reducing the risk of acute kidney injury, slowing chronic kidney disease and lowering the risk of end-stage kidney disease. SGLT2 inhibitors provide consistent glucose-lowering, cardiovascular and renal benefits. However, heterogeneity in study designs, patient populations, and treatment durations does not allow drawing definitive conclusions and highlights the need for future research focused on conducting well-designed trials with standardised methodology.

Artemisia maritima holds potential applications in the rehabilitation of degraded environments, particularly in salt-affected areas, for biosaline agriculture aimed at biomass production for further valorization and green biotechnology. The aim of the present study was to investigate the response of A. maritima to alterations in soil chemical composition, including differences in mineral supply, the addition of various sodium salts, and contamination with several heavy metals (cadmium, lead, copper, manganese, zinc), in order to establish a scientific basis for further applied research. Under standard fertilization conditions, the growth of A. maritima plants was restrained by nitrogen deficiency. Surplus nitrogen enhanced mineral uptake and growth, especially for shoots, and stimulated clonal development. Low to moderate (50 and 100 mmol L⁻¹) NaNO₃ treatment significantly stimulated shoot growth, while Na₂HPO₄ and NaHCO₃ treatments exhibited the most adverse effects at 200 and 400 mmol L⁻¹, resulting in reduced growth and biomass, and even the deterioration of the aboveground parts. Chlorophyll fluorescence parameters served as reliable early indicators of the detrimental effects of salinity associated with individual anions. Shoot macronutrient levels remained unchanged for phosphorus and calcium, while nitrogen increased in nitrate treatments. Root mineral nutrient content was more susceptible to salinity, with significant changes observed for all macro- and micronutrients, varying depending on the specific element and anion type. The alterations in mineral nutrition observed for each anion treatment exhibited distinct characteristics. A. maritima plants demonstrated high tolerance to all heavy metals, with roots being more susceptible compared to shoots. At the shoot level, statistically significant growth inhibition was evident only for 1000 mg L⁻¹ lead and 1000 mg L⁻¹ zinc treatments. A. maritima plants can be characterized as high accumulators of cadmium, lead, manganese, and zinc, and as extreme accumulators of copper in shoots. Nitrophily, clonal expansion with a help of bud-bearing roots, and the ability to accumulate relatively high concentrations of mineral elements in shoots are among the important physiological characteristics of A. maritima plants, enabling them to exhibit high resilience in environmentally heterogeneous habitats.

Maintaining frequency regulation in interconnected power systems becomes increasingly difficult in the presence of nonlinear operating conditions. To address this issue, this study develops a hybrid load frequency control scheme in which a fuzzy fractional-order FOPI–FOPD controller is incorporated within a PIDF framework for a two-area LFC system. The controller parameters are optimized using the Dwarf Mongoose Optimization Algorithm (DMOA) and the Catch Fish Optimization Algorithm (CFOA), while the Integral of Time-Weighted Absolute Error (ITAE) is adopted as the performance criterion. The proposed strategy is examined under both linear and nonlinear scenarios, including the effects of Governor Dead Band (GDB) and Generation Rate Constraints (GRC). In the linear case, the DMOA-based design achieves an ITAE of 0.02939 with a tie-line settling time of 13.5478 s, whereas the CFOA-based design produces a bounded and convergent response with an ITAE of 0.03937 and a settling time of 14.4947 s. When GDB nonlinearity is introduced, the DMOA-tuned controller exhibits performance deterioration, yielding an ITAE of 0.1098 and a settling time of 19.0416 s, while the CFOA-tuned design shows more favorable time-domain performance with a lower ITAE of 0.05845 and a bounded settling time of 16.3595 s. These findings indicate that the CFOA-optimized PIDF–Fuzzy FOPI–FOPD controller provides an effective LFC solution under the examined nonlinear operating conditions.

This study investigates the combined effect of electrodeposited gold nanoparticles (AuNPs) and AuNP–polypyrrole (PPy)-modified Saccharomyces cerevisiae on electrochemical glucose sensing. AuNPs were deposited onto electrode surfaces by cyclic voltammetry, and the resulting interfaces were characterized using atomic force microscopy, cyclic voltammetry, and electrochemical impedance spectroscopy. AFM analysis confirmed increased surface roughness and height variability after deposition, indicating substantial restructuring of the electrode interface. Electrochemical measurements showed that AuNP deposition altered interfacial charge storage and transfer and increased the measured charge-transfer resistance. Glucose sensing was evaluated in a ferricyanide-mediated system using yeast layers with or without AuNP and PPy modification over a 0–60 mM concentration range. All configurations exhibited saturating, non-linear glucose responses described by Hill fitting. Among the evaluated yeast-modified electrodes, the AuNP–PPy modified yeast produced the strongest glucose-induced current increase and the best low-concentration performance, achieving a limit of detection of 0.540 mM, compared with 1.016 mM and 1.330 mM for single-modified layers and 3.360 mM for unmodified yeast. These results show that combining AuNP electrodeposition with AuNP–PPy yeast modification improves interfacial properties and enhances mediator-assisted electrochemical glucose sensing.