Search Results (83)

The valorization of vegetable processing by-products is increasingly recognized as a key strategy for improving sustainability and supporting circular economy principles. This study evaluated the effects of freeze–thaw pretreatment and cold-press dewatering prior to dehydration on the energy demand of whole tomato by-product processing. Tomato by-products were divided into different batches and subjected to freezing and thawing and/or to cold-press dewatering before dehydration at 60 °C. Only the cold-pressed samples, with or without freeze–thaw pretreatment, were also evaluated at 50 and 70 °C. A mathematical model previously reported in the literature was applied to estimate water removal during dehydration and quantify the energy demand associated with cold-press extraction, drying, and milling operations, enabling comparison among the investigated processing strategies. The results showed that the inclusion of a cold-press dewatering step decreased the energy demand, as the energy required for dewatering was lower than that needed to evaporate the same amount of water during drying. Freeze–thaw pretreatment further reduced the amount of free water to be removed in the subsequent dehydration stage. Although drying temperature had a limited effect on total energy demand, a slight decrease was calculated when increasing the temperature from 50 to 70 °C. These findings demonstrate the potential of combining freeze–thaw and cold-press dewatering as pretreatments for reducing energy demand throughout tomato by-product processing. Full article

Background/Objectives: The four androgen-receptor pathway inhibitors (ARPIs) for advanced prostate cancer are broadly comparable in efficacy, so the choice between them depends on tolerability and, in elderly patients, on central nervous system (CNS) safety. CNS signals from the FDA Adverse Event Reporting System (FAERS) now inform that choice, yet they rest on uncalibrated disproportionality, which cannot separate pharmacology from reporting. Methods: Across the full FAERS database (20,328,575 reports), we computed reporting odds ratios (ROR) for enzalutamide, apalutamide, darolutamide, and abiraterone over 32 drug–event pairs, recalibrated every estimate against a drug-specific empirical null from 18 negative controls, and corrected for multiplicity. The null was fitted two ways and validated against twelve label-established positive controls. Results: Uncalibrated analysis flagged 22 of 32 pairs, and also 41 of 72 control pairs on events judged to carry no true effect, so its null does not hold. Calibration removes that bias, but the verdict then depends on how the null is fitted: with its dispersion taken as the sample standard deviation of the control estimates, no pair reached q < 0.05, while under the maximum-likelihood fit the framework prescribes six did, three of them being CNS pairs. Positive controls confirmed that calibration retains genuine agent-specific effects, and the detection floor lay above every CNS estimate for the same agent. Conclusions: Comparative ARPI CNS signals in FAERS are not identifiable; the verdict is set by the calibration design rather than by the drugs, so such signals should not stand alone in agent selection. The firmer safety axis remains fall and fracture risk, the class’s dominant serious harm in trials and guidelines. Full article

The COVID-19 pandemic caused sudden changes in school routines, creating conditions that may have been relevant to students’ self-efficacy for self-regulated learning (SESRL). This research investigated high-school students’ SESRL during the initial lockdown (Study 1) and across three pandemic stages (Study 2). Using a cross-sectional retrospective design, Study 1 (N = 802, 32.5% males; M_age [Time1 (T1)] = 16.40, SD = 1.52) revealed a significant difference between retrospectively reported SESRL for the pre-pandemic period and SESRL perceived during the first lockdown. Also, higher perceived teacher support and effortful control were associated with higher SESRL during the lockdown. Latent Growth Curve Analyses in Study 2 [N (T1) = 455, 31.9% males; M_age (T1) = 15.37, SD = 1.10; 71% attrition rate] showed a declining trend for perceived SESRL over time, regardless of gender and school grade, whereas COVID-19-related life disruption showed a significant time-varying effect. Specifically, higher levels of COVID-19-related life disruption were associated with lower SESRL at each time point. These findings highlight the potential value of monitoring students’ SESRL and exploring educational initiatives that support self-regulatory skills and positive teacher–student relationships, particularly during periods of widespread educational disruption. However, the longitudinal findings should be interpreted cautiously given the substantial attrition across waves. Full article

Lutetium-177-PSMA-617 (Lu-PSMA) radioligand therapy (RLT) is established in metastatic castration-resistant prostate cancer (mCRPC), with regulatory approvals based on the VISION and TheraP trials. Subsequent trials have extended the evidence to taxane-naive mCRPC (PSMAfore) and demonstrated that combining Lu-PSMA with enzalutamide yields a significant overall survival benefit over enzalutamide alone (ENZA-p). However, higher and more homogeneous PSMA expression in treatment-naive disease, combined with lower tumor burden and preserved bone marrow reserve, provides a biological rationale for deploying RLT earlier in the disease course. In metastatic hormone-sensitive prostate cancer (mHSPC), the Phase III PSMAddition trial reported improved radiographic progression-free survival when Lu-PSMA was added to standard androgen deprivation therapy (ADT) plus androgen receptor pathway inhibitor (ARPI), and the Phase II UpFrontPSMA trial demonstrated enhanced biochemical responses with Lu-PSMA induction before docetaxel. In oligometastatic and oligorecurrent disease, the BULLSEYE and LUNAR trials have shown progression-free survival benefits, raising the possibility of deferring androgen deprivation therapy and its associated morbidity. Meanwhile, next-generation radionuclides, including actinium-225 (WARMTH) and the dual beta-Auger emitter terbium-161 (VIOLET), are entering clinical development to address the radiobiological limitations of Lutetium-177. This review synthesizes the evidence for PSMA-targeted radioligand therapy across the prostate cancer disease continuum and discusses patient selection, treatment sequencing, and the access and cost-effectiveness considerations that will shape adoption in earlier disease settings. Full article

Background/Objectives: Metastatic prostate cancer is increasing in the Gulf Cooperation Council countries. This study presents a multimodal treatment protocol incorporating radiotherapy to primary and metastatic sites, guided by PSMA PET/CT, combined with systemic therapy for non-metastatic pelvic node-positive and de novo low-volume metastatic prostate cancer. Methods: We conducted a retrospective cohort study of patients treated with radical radiotherapy doses (68 Gy/25 Fr or 78 Gy/39 Fr) to the prostate gland and gross pelvic disease, and SBRT (35–40 Gy/5 Fr) to distant bone metastases. All patients received LHRH agonists ± abiraterone/prednisone or enzalutamide. Results: Twenty-four consecutive patients were analyzed. The median age was 70.1 years (IQR, 65.7–77.7), the median baseline PSA was 27.9 ng/mL (IQR = 19.7–53.8), and median follow up was 24 months (IQR = 20.4–31.2). Clinical staging was cT3b in (46%), cT2 in (25%), cT4 in (17%), cT3a in (13%) of patients. Pelvic nodal involvement (cN1) was present in 91.7% of patients, while 54.1% had metastatic disease. Treatment was well tolerated. Acute toxicity was predominantly grade 1 genitourinary (GU) toxicity, occurring in 87.5% of patients, with grade 2 GU toxicity observed in 8.2% and no acute gastrointestinal (GI) toxicity. Late toxicity remained minimal, with grade 1 and grade 2 GU toxicity reported in 45.8% and 4.2% of patients, respectively, and no late GI toxicity. Mild systemic treatment-related toxicities were reported in 25% of patients, including sexual dysfunction, hypokalemia, muscle weakness, osteoporosis and depression/anxiety. At the six-month follow-up PSMA PET/CT assessment, 85.7% achieved a complete metabolic response, and 14.2% achieved a partial response. Biochemically, 75% of patients achieved undetectable PSA levels (<0.01 ng/mL), with all patients achieving a PSA nadir < 0.2 ng/mL. Conclusions: This first, hypothesis-generating real-world experience from the GCC, suggests that an integrated approach combining systemic therapy with metastasis-directed therapy is feasible. Prospective randomized studies are required to validate these results. Full article

Background and Objectives: Metastatic castration-resistant prostate cancer (mCRPC) remains a clinically heterogeneous condition despite ongoing advances in systemic treatment. Androgen receptor pathway inhibitors (ARPIs), including abiraterone acetate and enzalutamide, have been associated with improved clinical outcomes; however, early identification of patients deriving limited benefit continues to be challenging. Prostate-specific antigen (PSA) kinetics may serve as a practical indicator of treatment response over time. This study aimed to examine the prognostic significance of achieving a ≥50% reduction in PSA levels at three months in patients with mCRPC treated with ARPIs in routine clinical practice. Materials and Methods: In this retrospective single-center study, patients with mCRPC who received abiraterone acetate or enzalutamide between February 2015 and March 2024 were included. Patients were stratified according to PSA decline at three months (≥50% vs. <50%). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method and compared with the log-rank test. Prognostic variables were subsequently examined using univariate and multivariate Cox proportional hazards models. Results: A total of 60 patients were included. At three months, 44 patients (73.3%) achieved a ≥50% decline in PSA levels. Patients reaching this level had longer PFS and OS than those with <50% decline, and the differences between groups were statistically significant. In multivariate analysis, early PSA decline remained significantly associated with improved survival outcomes. Conclusions: A ≥50% decline in PSA levels at three months represents a simple and clinically meaningful indicator of treatment response in patients with mCRPC receiving ARPIs. Early PSA kinetics may assist in timely risk stratification and closer clinical monitoring in routine clinical practice. Full article

This study investigates the Business Model Canvas (BMC) as a visual education tool within a training pathway aimed at enhancing human capital in inner areas. Using a qualitative case study involving 22 participants, data were collected through observations, analysis of four canvases, trainers’ reflections, and jury evaluations. Findings show that the BMC reduces cognitive load, supports distributed cognition, and fosters reflexivity, creativity, and collaborative learning. Moreover, it enables the development of entrepreneurial and strategic skills, contributing to social innovation and sustainable territorial development. Full article

Background: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and a leading cause of cancer-related mortality worldwide. Growing evidence indicates that metabolic syndrome components, including obesity, insulin resistance, and hyperglycemia, contribute to PCa development, and progression to more aggressive form. At the same time, standard treatments such as androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) significantly improve oncologic outcomes but are associated with adverse metabolic effects, including increased fat mass, insulin resistance, and sarcopenia, potentially worsening patients’ overall metabolic profile and quality of life. Tumor progression in PCa is strongly driven by androgen receptor (AR) signaling, which is closely linked to cellular metabolic reprogramming, highlighting metabolism as a potential therapeutic target. Aim: The aim of this study was to evaluate and synthesize current evidence on the role of the ketogenic diet (KD) in PCa, with particular emphasis on its interaction with hormonal therapies, underlying metabolic and endocrine mechanisms, and its potential application as an adjunctive strategy in integrated oncologic care. Results: The KD, characterized by high fat and very low carbohydrate intake, induces a metabolic state of ketosis that reduces circulating glucose, insulin, and insulin-like growth factor 1 (IGF-1), potentially counteracting metabolic alterations associated with PCa and its treatments. Preclinical studies consistently demonstrate that carbohydrate restriction and KD can slow tumor growth, modulate key oncogenic pathways such as PI3K/AKT/mTOR, reduce systemic insulin signaling, and enhance survival in prostate cancer models. Additionally, emerging evidence suggests possible synergistic effects when KD is combined with standard therapies, including ADT and immunotherapy. Clinical data, although limited, indicate that low-carbohydrate dietary interventions may improve metabolic parameters and could delay biochemical progression, as suggested by increased prostate-specific antigen (PSA) doubling time. However, results across studies remain heterogeneous, and robust evidence on long-term oncologic outcomes is lacking. Conclusions: Overall, the KD represents a promising but still experimental strategy in PCa management, requiring careful nutritional supervision to avoid adverse effects such as unintended weight loss or sarcopenia. Further well-designed randomized clinical trials are needed to clarify its safety, efficacy, and role in routine clinical practice. Full article

The representation of the sexuality of people with disabilities in contemporary media is often characterized by stereotypes, omissions, and heteronormative narratives that deny the complexity and richness of their emotional experiences. This essay explores the potential of photovoice-based methodology as a tool of visual empowerment to foster processes of authentic and self-aware self-representation through the immersive dynamic that this methodology can activate. Through an interdisciplinary theoretical approach that combines special pedagogy with recent research on digital media and immersive technologies, the study seeks to understand whether virtual spaces can be configured as protected environments in which people with disabilities have the opportunity to explore and communicate their sexual identity. Photovoice thus becomes a tool of narrative resistance that overcomes barriers and counters mediatized representations, often conveyed through dynamics of ableist cyberbullying and online discrimination. The contribution highlights how the combination of participatory visual storytelling and immersive environments can generate new forms of inclusive media literacy, promoting a Visual Education that recognizes and values the diversity of human experiences. Particular attention is devoted to the educational potential of these tools in the training of educators and social workers, as well as in raising awareness within the broader community. The paper proposes a theoretical and methodological framework for the implementation of visual self-representation projects capable of transforming social perceptions of disability and promoting a culture of authentic and respectful inclusion. Full article

The global transition toward a circular bioeconomy requires the urgent valorization of agro-industrial by-products, specifically fruit and vegetable residues, which represent a significant environmental burden but also a rich source of high-value bioactive compounds. This review critically examines Supercritical Fluid Extraction (SFE) using carbon dioxide (CO₂) as a highly efficient and versatile technological platform for the sustainable recovery of specialty lipids and secondary metabolites. By analysing the thermodynamic foundations of the supercritical state, the study explores how the tuneable density and transport properties of supercritical CO₂ (SC-CO₂) facilitate molecular preservation compared to conventional solvent-based methods. The discussion focuses on the mechanistic aspects of the process, including the role of green co-solvents in overcoming polarity barriers and the application of kinetic models to describe mass transfer phenomena in complex matrices. Unlike general surveys, this work integrates technical-economic considerations with critical analysis of SFE’s role within a multi-stage biorefinery framework, essential for aligning economic profitability with the ecological mandate of strategic molecular recovery. Full article

Treatment intensification with androgen receptor pathway inhibitors (ARPIs) and/or docetaxel in addition to androgen deprivation therapy (ADT) improves survival for men with metastatic hormone-sensitive prostate cancer (mHSPC), yet real-world uptake has historically been low. We conducted a population-based retrospective cohort study of Ontario men aged ≥66 years diagnosed with de novo mHSPC between 2014 and 2022 using linked administrative health data, defining treatment intensification as initiation of an ARPI and/or docetaxel with ADT within six months of diagnosis. Quarterly intensification rates were modeled using autoregressive integrated moving average (ARIMA) time-series methods with nonlinear trend specifications, and competing models were compared using information criteria, out-of-sample hold-out forecast accuracy, and long-horizon extrapolation behaviour to project uptake through 2030. Among 6099 men, 24% received treatment intensification, with quarterly intensification rates increasing from 3% in 2014 to 56% in 2022. A restricted cubic spline ARIMA model (ARIMA(1,0,1) + RCS3) was selected as the primary base-case forecast because it showed superior out-of-sample hold-out accuracy and more tempered long-horizon extrapolation. The cubic specification was retained as an upper-bound scenario, reflecting the possibility of continued aggressive momentum in treatment adoption. Both specifications captured a marked inflection after 2020 that temporally coincided with guideline updates and funding expansions. Near-term base-case projections (through 2026) suggest continued growth in intensification toward 80–85%, with the upper-bound scenario approaching saturation more quickly. Projections beyond 2026 are exploratory and presented for methodological completeness, given the eight-year horizon relative to a nine-year observation window and the widening prediction intervals at extended horizons. Despite substantial growth over time, treatment intensification remains incomplete in routine practice. These findings are temporally consistent with the impact of policy and funding changes on the adoption of evidence-based therapy and underscore the need for ongoing implementation efforts to address persistent clinical and system-level barriers to equitable access. Full article

Visual learning is not merely a form of visual memory—the ability to associate an object of learning with its spatial and temporal context—or simply an explanatory aid or instrumental support, as is often assumed. The kind of visual learning addressed here aligns, more broadly, with the notion of visual thinking as conceived in the 1960s by Rudolf Arnheim, the German psychologist and art historian, for whom art and expressive forms help us understand the world, generate active and creative comprehension, and organize one’s interpretative universe. The aim, therefore, is not to describe didactic practices that employ images, maps, videos, or simulations, but to go beyond the apparent familiarity of the topic and ask: When and how does the visual dimension foster learning? And, above all, what role does the image play within the educational process? Historically, the visual has been assigned an instrumental function—or so it was believed. Yet one might doubt that this fully captures the experiences of Leonardo, Giotto, or Michelangelo. Can we truly think that sketches or elaborated images have ever been mere mnemonic aids? In both art and education, images do far more than illustrate or serve as tools for remembering, orienting, or recognizing. Especially today, in the presence of technological interference, the visual covers broader horizons: it is used to generate information, explain complex concepts, and produce new experiences—and possibly even new forms of knowledge. In a world saturated with images, there emerges a growing risk of simplification and trivialization: images abound, yet meaning often escapes us. We distrust images, and perhaps we have never truly learned how to read them. Here lies a crucial anthropological fracture: between the mnemonic and the constructive functions of the visual, genuine visual literacy is often missing. A broad methodological approach is therefore needed—one that, through theoretical, historical, and pedagogical analyses, can problematize the educational use of images beyond their mere instrumental dimension. Such reflection must draw from aesthetic and philosophical traditions while acknowledging technological influences and maintaining a clear focus on the specific contexts of contemporary teaching and learning. Full article

Background/Objectives: Combinations of PARP inhibitors (PARPi) and androgen receptor pathway inhibitors (ARPi) have led to clinical success in treating advanced prostate cancer. However, it is unclear where in the clinical paradigm these combinations will fare best, and their mechanism of action remains unclear. We sought to address open questions and explore alternative strategies to enhance PARPi efficacy. Methods: Viability and morphology were assessed in response to (1) abiraterone, olaparib, or combination and (2) enzalutamide, talazoparib, or combination in castration-resistant C4-2B cells and abiraterone- or enzalutamide-resistant derivative cell models (ARPi-resistant). The efficacy of the ATM inhibitor lartesertib with and without a PARPi was also determined. Western blots and RNA-sequencing were used to interrogate the mechanistic effects of treatment. Results: PARPi and ARPi combinations were effective in all models but provided the most benefit in ARPi-sensitive C4-2B cells. Mechanistically, ARPi was not found to affect homologous recombination repair gene expression but may increase PARP activity. Prolonged PARP inhibition was found to increase the expression of AR target genes, and PARPi pre-treatment increased sensitivity to enzalutamide. ATM inhibition significantly increases PARPi efficacy and appears to outperform ARPi-containing combinations in ARPi-resistant models. Conclusions: PARPi and ARPi combinations are effective in ARPi-resistant models, but efficacy appears stronger in ARPi-sensitive CRPC cells. Presented findings support a novel hypothesis that PARP inhibition may increase ARPi sensitivity with increasing AR activity. Additionally, ATM inhibition may provide more benefit than an ARPi in combination with a PARPi in ARPi-resistant settings. These findings support continued PARPi development for improving patient outcomes. Full article

Image communication represents a fundamental domain of human experience that intersects cognitive neuroscience, educational psychology, and visual communication theory. The increasing digitalization of contemporary society has amplified the importance of visual literacy, defined as the ability to interpret, use, and create visual media. While neuroscientific research highlights the brain’s proficiency in processing visual information, significant gaps remain in understanding the underlying psychological mechanisms and their practical applications in educational contexts. This study proposes a multidisciplinary research design to systematically analyze these psychological dimensions. The research will integrate cognitive, perceptual, and pedagogical perspectives to understand how visual representations influence learning. The methodological design includes a multi-method approach combining experimental analysis, ethnographic observation, and psychometric evaluation on a stratified sample of 240 participants (aged 16–25) divided into three groups: high school students (n = 80), university students (n = 80), and young professionals (n = 80). The proposed methodology will utilize eye-tracking to analyze visual perception patterns, integrated with semantic differential methods to evaluate cognitive and affective associations with visual imagery. The expected results should clarify how the effectiveness of image communication depends on the coherence between technical and semantic aspects of visual imagery. The research aims to contribute to the theoretical framework of educational neuroscience, offering empirical evidence for optimizing teaching strategies based on multimodal visual communication. Full article

In recent years, Visual Education has emerged as an innovative and interdisciplinary teaching approach aimed at promoting meaningful learning through the conscious use of visual tools and languages. This educational paradigm helps to facilitate the understanding of complex concepts, translating them into clear and intuitive visual representations, while enhancing memorisation skills, critical information processing and the practical application of acquired knowledge. This systematic review, conducted according to the PRISMA (2020) protocol, analyses the most recent empirical evidence on the effectiveness of Visual Education in educational contexts. The main objective is to assess how the intentional use of visual tools—images, concept maps, educational videos, interactive digital materials, and virtual manipulatives—contributes to enhancing learning processes and developing transversal skills. Through a comparative analysis of fourteen international contributions published between 2020 and 2025, selected from the Scopus, Web of Science and EBSCO databases, the research highlights how Visual Education significantly influences the improvement of academic performance, motivation and cognitive and emotional engagement of students. The results also confirm the inclusive function of visual teaching, which can encourage participation, self-esteem and cooperation even in individuals with special educational needs. The discussion emphasises the need for the systematic integration of Visual Education into school curricula as a strategy to enhance soft skills and promote more equitable, effective learning geared towards the integral development of the individual. Full article