Search Results (467)

Digestate valorization is essential for sustainable waste management and circular economy strategies, yet large-scale adoption faces technical, economic, and environmental challenges. Beyond waste-to-energy conversion, digestate is a valuable soil amendment, enhancing soil structure and reducing reliance on synthetic fertilizers. However, its agronomic benefits depend on feedstock characteristics, treatment processes, and application methods. This study reviews digestate composition, treatment technologies, regulatory frameworks, and environmental impact assessment through Life Cycle Assessment. It analyzes the influence of functional unit selection and system boundary definitions on Life Cycle Assessment outcomes and the effects of feedstock selection, pretreatment, and post-processing on its environmental footprint and fertilization efficiency. A review of 28 JCR-indexed articles (2018–present) analyzed LCA studies on digestate, focusing on methodologies, system boundaries, and impact categories. The findings indicate that Life Cycle Assessment methodologies vary widely, complicating direct comparisons. Transportation distances, nutrient stability, and post-processing strategies significantly impact greenhouse gas emissions and nutrient retention efficiency. Techniques like solid–liquid separation and composting enhance digestate stability and agronomic performance. Digestate remains a promising alternative to synthetic fertilizers despite market uncertainty and regulatory inconsistencies. Standardized Life Cycle Assessment methodologies and policy incentives are needed to promote its adoption as a sustainable soil amendment within circular economy frameworks. Full article

Cancer remains one of the most significant global health challenges due to its high mortality rates and the limited understanding of its progression. Early diagnosis is critical to improving patient outcomes, especially in skin cancer, where timely detection can significantly enhance recovery rates. Histopathological analysis is a widely used diagnostic method, but it is a time-consuming process that heavily depends on the expertise of highly trained specialists. Recent advances in Artificial Intelligence have shown promising results in image classification, highlighting its potential as a supportive tool for medical diagnosis. In this study, we explore the application of hybrid Artificial Intelligence models for melanoma diagnosis using histopathological images. The dataset used consisted of 506 histopathological images, from which 313 curated images were selected after quality control and preprocessing. We propose a two-step framework that employs an Autoencoder for dimensionality reduction and feature extraction of the images, followed by a classification algorithm to distinguish between melanoma and nevus, trained on the extracted feature vectors from the bottleneck of the Autoencoder. We evaluated Support Vector Machines, Random Forest, Multilayer Perceptron, and K-Nearest Neighbours as classifiers. Among these, the combinations of Autoencoder with K-Nearest Neighbours achieved the best performance and inference time, reaching an average accuracy of approximately 97.95% on the test set and requiring 3.44 min per diagnosis. The baseline comparison results were consistent, demonstrating strong generalisation and outperforming the other models by 2 to 13 percentage points. Full article

This study investigated the effect of KOH activation on biochar, with a focus on how porosity and potassium content influence microwave-assisted catalytic biodiesel production, using experimental design approaches. Activated biochar was synthesized from oat hull waste through KOH activation, followed by pyrolysis under controlled conditions. The biochar was characterized through chemical, morphological, and physical analyses, and its catalytic performance in converting used waste cooking oil (WCO) into biodiesel was evaluated using methanol as the acyl acceptor and microwave irradiation to optimize the reaction via experimental design. Results revealed that increasing the KOH/biomass ratio significantly enhanced the specific surface area (SSA) of the catalyst, achieving a maximum SSA of 637.28 m²/g under optimal pyrolysis conditions: 600 °C for 3 h with a KOH/biomass ratio of 2. A maximum fatty acid methyl ester (FAME) yield of 100% was achieved within 1 min of microwave-assisted reaction using an optimized catalyst dosage of 2.5%, a WCO/MeOH molar ratio of 1/12, and a reaction temperature of 150 °C, with the catalyst being successfully recycled across three cycles. An economic and energy evaluation estimated a catalyst production cost of USD 176.97/kg and a biodiesel production cost of USD 8.9/kg of FAMEs. This research provides a straightforward and cost-effective approach for biofuel production. Full article

The great megalithic sites reveal an extended use of their monuments. In Late Prehistory, in Protohistory, and even in historical times, dolmens remained visible references on the landscape and were central for navigating it. The megaliths of Menga, Viera, and Romeral provide quality data to confirm their continued relevance. Our aim here is to understand whether menhirs also played that role, using the area of Tierras de Antequera, which is connected to the sea, as a case study. With that goal in mind, a research project has been initiated through intensive archaeological field surveying, combined with the collection of testimonies from oral tradition and other archaeological tools such as GIS, geophysical prospection, photogrammetry and RTI, for the detection of engravings and paintings on some of the located landmarks. We present in this paper the first geological analyses in the megalithic territory of Antequera to determine the raw material of the menhirs that are studied and the geological outcrops from which they come. Full article

Large quantities of oenological by-products, rich in potentially extracted antioxidant compounds, are generated annually in the winemaking industry. With the purpose of their revalorization, different types of by-products (grape pomace, lees, and grape seed meal) from the winemaking industry from three vinification typologies (red, rosè, and white) and four varieties (Tempranillo, Syrah, Airén, and Zalema) in two grape growing seasons (2022 and 2023) were considered. Attention was focused on the content of protein, individual phenolic compounds (anthocyanins, flavonols, hydroxycinnamic acid derivatives, hydroxybenzoic acids, monomeric flavan-3-ols, and procyanidins), and antioxidant activity (DPPH, ABTS, and cyclic voltammetry). The data obtained showed considerable amounts of protein (around 30%) in red lees and a high concentration of phenolic compounds in the by-products, especially anthocyanins and flavonols in the by-products derived from rosè vinifications and flavan-3-ols, procyanidins, and hydroxybenzoic acids in red grape by-products. The antioxidant activity was different between the by-products. Specifically, the electrochemical behavior evaluated by cyclic voltammetry showed some significant differences. Finally, a linear discriminant analysis based on chemical and antioxidant data allowed for differentiating the samples depending on the type of by-product, type of vinification, and variety. Full article

Hearing impairments (HIs) are clinically and genetically very heterogeneous. Finding the causative mutations in patients is frequently a challenge. We investigated two brothers affected by a sensorineural, moderate non-syndromic HI. Exome sequencing revealed that they carried the heterozygous c.812C>T (p.Ser271Leu) variant in GATA3. This gene encodes a transcription factor involved in embryonic development, its mutations causing the autosomal dominant HDR (hypoparathyroidism, deafness, and renal disease) syndrome. The variant affects a conserved residue within the proximal zinc-finger motif of GATA3. Sanger sequencing confirmed the presence of the variant in the two brothers, but it showed that surprisingly it was not carried by any of the parents. Segregation studies on 20 fully informative microsatellite markers in the family confirmed that the variant arose de novo. A benign SNP in the mother, close to the position of the variant, allowed us to determine that this was inherited from the father. Gene reporter functional assays supported the pathogenicity of the variant. Clinical reassessment of the two brothers did not disclose any additional abnormality. We conclude that mosaicism for this de novo mutation in the father’s germ line explains the pattern of inheritance in this family and that p.Ser271Leu is causing this unexpected phenotype of non-syndromic HI. Full article

This study aimed to compare sperm parameters and reproductive outcomes after sperm selection using microfluidic chips versus conventional techniques (swim-up/density gradients). A systematic review and meta-analysis were performed after the extraction of relevant data from thirty-nine studies that met the inclusion criteria. Mean difference or odds ratio was calculated for each outcome. The analysis revealed that sperm selection using microfluidics yields lower sperm DNA fragmentation (MD = −9.98 [−13.19, −6.76], p < 0.00001), increased progressive motility (MD = 14.50 [7.84, 21.71], p = 0.04), total motility (MD = 10.68 [6.04, 15.31], p < 0.00001) and morphology (MD = 1.41 [0.67, 2.16], p = 0.0002). Significant differences were also found in the fertilization rate/MII oocyte microinjected (OR = 1.22 [1.01, 1.46], p = 0.04), implantation rate/embryo transfer (ET) (OR = 4.51 [1.42, 14.37], p = 0.01), clinical pregnancy/ET (OR = 1.73 [1.22, 2.45], p = 0.002), ongoing pregnancy/ET (OR = 1.99 [1.03, 3.83], p = 0.04), live birth rate/first cycle (OR = 1.59 [1.12, 2.24], p = 0.009) and per all embryo transfer (OR = 1.65 [1.06, 2.55], p = 0.03). No significant differences were found in embryo euploidy/number of biopsied blastocysts (OR = 1.34 [0.88, 2.04], p = 0.77), biochemical pregnancy/ET (OR = 1.23 [0.84, 1.80], p = 0.29), miscarriage rate/cycle (OR = 0.84 [0.54, 1.31], p = 0.35) and per pregnancy (OR = 0.71 [0.50, 1.02], p = 0.07), live birth rate/first embryo transfer (OR = 1.60 [0.80, 3.22], p = 0.18) and per concluded cycle (OR = 1.03 [0.53, 2.00], p = 0.92). To summarize, microfluidics may offer a beneficial approach in certain situations, particularly for patients with elevated sperm DNA fragmentation (SDF) levels. However, its integration into routine clinical practice cannot be justified yet in terms of cost-effectiveness. Additional research is needed to provide more comprehensive data on reproductive outcomes, especially live birth rates, which remain the ultimate goal of assisted reproductive technologies. Full article

Background: In 2015, Spanish scientific societies published a consensus document on managing massive hemorrhage (MH). This study aimed to evaluate the knowledge and application of the Massive Hemorrhage Protocol (MHP) among healthcare professionals and to assess whether an educational intervention could improve compliance and patient outcomes. Methods: A two-phase observational study was conducted in four Spanish university hospitals. In phase one, compliance with MHP recommendations was surveyed. Based on the findings, educational sessions were implemented, focusing on the least known or followed recommendations. Compliance was then reassessed. Primary outcome was adherence to MHP; secondary outcomes included morbidity and 24 h and in-hospital mortality. Results: The MHP was activated in 303 MH episodes, mostly of surgical (42.6%) or traumatic (25%) origin. The most followed recommendation before the intervention was protocol activation (94%), which improved to 98.3% post-intervention (p = 0.049). Lesser-followed recommendations such as requesting a hemorrhage lab panel and correcting hypothermia improved after intervention from 39% to 50.4% (p = 0.05) and 31.3% to 43.8% (p = 0.027), respectively. Overall compliance increased from 68% to 73% (p = 0.05). Mortality remained high in both phases, 24 h (25.4%) and in-hospital (42.2%). Patients who required massive transfusion had higher mortality (53.6%) than those who did not (35.9%, p = 0.03). Survivors had higher protocol compliance (p = 0.003 at 24 h; p = 0.049 in-hospital). Conclusions: Educational intervention modestly improved adherence to MHP recommendations. Higher compliance was associated with better survival outcomes, supporting the need for targeted educational strategies to enhance protocol implementation and improve care in MH cases. Full article

Trans fats are linked to numerous chronic diseases and cellular dysfunction; however, Spain has not implemented effective regulatory measures to restrict their presence in food products. This study addressed these gaps by analyzing trans fat content in commercial pastries sold in Spain and their biological impacts on mesenchymal stem cells, further examining its compliance with international guidelines. Also, a novel and scalable method for extracting fatty acids from pastry samples was developed and applied, enabling precise analysis using gas chromatography alongside sensory property assessments. The findings revealed significant variability in TFA levels across samples. To assess the biological implications of these TFAs, mesenchymal stem cells (MSCs) were cultured to perform dose–response experiments using two selected pastry samples with the highest TFA content. Cellular adhesion, cytotoxicity, and proliferation were evaluated through MTT assays, bright-field, and fluorescence staining using FITC and DAPI markers. Results demonstrated dose-dependent impacts of TFAs on MSC viability, including reduced adhesion and proliferation alongside increased cytotoxicity. This study underlines the need for stricter regulatory frameworks to monitor TFA levels worldwide, including in Spain’s food industry. Additionally, it highlights the potential health risks associated with excessive TFA consumption, particularly concerning cellular health and growth mechanisms, which provide insights into its potential bioaccumulation implications. These findings provide a foundation for further research into dietary guidelines and industrial practices aimed at minimizing TFA exposure while promoting public health safety. Full article

Background: Mastectomy, a common treatment for breast cancer, often leads to complications such as pain, fibrosis, restricted mobility, lymphedema, reduced strength in the affected arm, and emotional distress. Non-pharmacological therapies, including massage therapy, offer a holistic approach to managing these symptoms. The aim of this study was to analyze the effects of massage therapy on the symptomatology in women post-mastectomy for breast cancer. Methods: A systematic review was conducted following PRISMA guidelines. Databases including PubMed, Cochrane, PEDro, Dialnet, Science Direct, and Scopus were searched for relevant studies published in English or Spanish over the past 16 years. The search was conducted in March 2025. Inclusion criteria encompassed controlled and uncontrolled clinical trials, quasi-experimental studies, retrospective analyses, and secondary trial analyses involving women aged 45–64 who received massage therapy as a complementary treatment. Results: Twenty-six studies involving 1522 participants were included. Interventions assessed were manual lymphatic drainage, myofascial release, foot massage, classical massage, and the Cyriax technique. The key findings demonstrated significant benefits, including improved range of motion, reduced arm circumference and lymphedema volume, enhanced quality of life, and increased relaxation. Conclusions: According to the results of this systematic review, massage therapy interventions can have a positive impact on the symptomatology in women post-mastectomy for breast cancer and may represent a suitable complementary approach to post-mastectomy breast cancer treatment. Full article

Background: Adolescence and young adulthood are critical periods during which psycho-emotional factors can significantly influence disease management and increase the risk of complications. This systematic review aims to examine the impact of body image, self-image, self-perception, and other psycho-emotional variables on the management of type 1 diabetes mellitus (T1DM) in this population. Methods: This review follows the Cochrane Handbook, PRISMA 2020 guidelines and the JBI Checklist for Systematic Reviews and Research Syntheses. A comprehensive search was conducted across both general and discipline-specific databases (PubMed, Web of Science, Scopus, Embase, CINAHL, APA PsycInfo, APA PsycArticles) between March and April 2025. The inclusion criteria focused on studies involving adolescents with T1DM that addressed relevant emotional or psychological aspects. Methodological quality was assessed using JBI tools. Data extraction was performed independently by four reviewers, with discrepancies resolved by consensus. A total of 25 studies met the inclusion criteria. Results: Body image concerns were found to be highly prevalent among adolescents and young adults with T1DM, and were associated with adverse outcomes such as disordered eating behaviors and suboptimal glycemic control. Gender differences were consistently reported, with adolescent girls and young women displaying greater body dissatisfaction and engaging more frequently in risky weight management practices, including insulin omission. Other factors, such as self-perception, diabetes-specific stress, and identity formation, also played significant roles in treatment adherence and psychosocial adaptation. Notably, this review reveals a lack of interventions specifically designed to address the psychological dimensions of T1DM. Conclusions: Body image and self-concept exert a substantial influence on T1DM management in adolescents and young adults, affecting both glycemic outcomes and psychosocial well-being. There is a pressing need for gender-sensitive and developmentally appropriate interventions that address body image, self-concept, and disease acceptance. Future research should prioritize longitudinal designs and the development and evaluation of targeted psycho-emotional support strategies. Full article

Questioning motherhood as a social mandate has been one of the main objectives of feminism. Motherhood has traditionally been linked to the idea of femininity and the reproductive function, which has led to women being thought of as “compulsory mothers”. However, this idea is currently changing, despite the fact that judgment is exercised on non-mothers. This research is part of a cross-sectional descriptive study, whose objective is to analyze the barriers and incentives to childbearing in the female population. A questionnaire was designed and administered to a representative sample of 318 women who were selected for our analysis, with a confidence level of 95% and a margin of error of 5%. Results: Economic motives correlate positively with other variables, as well as work motives, the couple’s decision to not want to have children, and not having a stable partner, which suggests that these women have different motives for choosing not to have children. The main conclusions are that social and family pressures appear to have a limited impact on the decision not to have children, suggesting a change in social norms and expectations about the role of women in society, as women continue to gain autonomy and control over their reproductive decisions. Full article

The increase in chronic diseases and climate change in recent decades has been driven by food systems that affect both human health and the environment. This study investigated the interrelation between food consumption, obesity, undernutrition, and climate change, aiming to understand how these factors connect within the global syndemic. The methodology used was a scoping review, in which 12 articles were analyzed after an initial search that resulted in 11,208 references. The references were screened using the Rayyan software (Rayyan Systems Inc. (Doha, Qatar), version 1.6.1 and web-based version), removing duplicates and assessing the studies based on eligibility criteria. The articles addressed different aspects, such as the relationship between food consumption, obesity, undernutrition, and climate change, providing data on how food insecurity and socioeconomic conditions influence these conditions. In sequence, we developed a conceptual model to offer a detailed view of the factors affecting the global syndemic, considering the availability of food, its accessibility, stability in supply, and its use in the diet. The model recognizes that climate change affects food consumption both directly and indirectly. Direct effects include the impact of extreme weather events—such as floods and droughts—on the availability, access, quantity, and quality of food. Indirectly, climate change exacerbates socioeconomic vulnerabilities and disrupts food systems in more structural ways, contributing to increased food insecurity. The findings revealed that food insecurity, in turn, can lead to both obesity and undernutrition, particularly among vulnerable populations. There was a scarcity of studies that integrated the relationship between undernutrition, climate change, and food consumption, especially in certain regional contexts such as Latin America. The evidence gathered in the literature and the conceptual model provide a foundation for future research and the development of more effective public policies that integrate food issues, public health, and climate change in a more holistic and interconnected approach. Full article

Introduction: Idiopathic pulmonaryy fibrosis (IPF) is a progressive interstitial lung disease with a poor prognosis. While comorbidities like pulmonary hypertension and lung cancer have been studied extensively, less attention has been paid to the implications of malnutrition and sarcopenia in patients with IPF. This study aimed to assess the prevalence of malnutrition, sarcopenia, and the combined malnutrition-sarcopenia syndrome in patients with IPF using the latest diagnostic criteria from the Global Leadership Initiative on Malnutrition (GLIM) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Methods: A prospective, observational, multicenter study was conducted, focusing on patients with idiopathic pulmonary fibrosis (IPF). All participants provided informed consent, and the study followed ethical guidelines. Malnutrition was diagnosed based on the GLIM criteria, requiring one phenotypic and one etiological criterion, with muscle mass assessed via bioelectrical impedance analysis (BIA). Sarcopenia was screened following the EWGSOP2 recommendations. The statistical analysis was performed using JAMOVI version 2.3.22, with significance set at p < 0.05. Results: The findings revealed that 77.65% of the participants were malnourished, and 20% had sarcopenia. The malnourished patients had significantly lower body weight, height, and muscle mass compared to the non-malnourished patients. Furthermore, the patients with malnutrition exhibited poorer health-related quality of life scores. This study also identified the malnutrition-sarcopenia syndrome in 8.23% of the participants. Conclusions: Malnutrition, based on the GLIM criteria was identified in three out of four patients with IPF, while sarcopenia according to the EWGSOP2 was present in one out of five. This study underscores the necessity for routine screening for malnutrition and sarcopenia in patients with IPF. Full article

Neuroendocrine transformation in non-small-cell lung cancer (NSCLC) is an uncommon but clinically significant resistance mechanism to targeted therapy, immunotherapy, and chemotherapy. This phenomenon, primarily observed in adenocarcinoma (ADC) with EGFR mutations under tyrosine kinase inhibitor (TKI) treatment, leads to histological transformation into small-cell lung cancer (SCLC), commonly associated with an aggressive clinical course and poor prognosis. Standard platinum–etoposide chemotherapy provides only transient disease control, highlighting the urgent need for improved therapeutic strategies. Early identification of transformation through biopsy, liquid biopsy, or biomarkers like neuron-specific enolase (NSE) and pro-gastrin-releasing peptide (pro-GRP) may allow for early intervention. As targeted therapies continue to develop, understanding the molecular drivers of neuroendocrine transformation is crucial for optimizing treatment. Further research into novel treatment approaches, including combination therapies with TKIs, chemotherapy, immunotherapy, and epigenetic modulators, is required to improve outcomes for these patients. Full article