Search Results (429)

Introduction: End-of-life (EOL) HIV cure-related research offers a unique opportunity to advance scientific discovery while honoring the values, dignity, and legacy of people with HIV. However, participation remains demographically skewed, mirroring long-standing inequities in who is informed, invited, and supported to take part. Synthesizing eight years of experience, published literature reviews, and community engagement from the University of California San Diego’s Last Gift program, we propose strategies to embed justice, equity, diversity, inclusion, and accessibility (JEDIA) throughout the design and implementation of EOL HIV cure-related studies. Discussion: Using intersectionality as a structural analytic framework, we examine how interlocking systems and social determinants shape access, consent, and participant experience, and we translate ethics into action across three themes and eight domains. As examples, we facilitate equitable access by implementing solutions that address gaps limiting awareness and feasibility of participation. We establish ongoing consent through multi-session consent processes with teach-back methods, clear healthcare proxy pathways, and explicit separation of research activities from clinical care. We center lived experiences by partnering with people with HIV and community groups, customizing participation, and honoring cultural and spiritual needs. We enable real-time course correction by using a dashboard that monitors enrollment patterns and representation. Conclusions: An intersectionality-informed, participant-centered approach is both feasible and essential to ensure HIV cure-related research advances with fairness, trust, and global relevance. Programs such as the Last Gift show that scientific rigor, integrity, and participant dignity can coexist, establishing a model for equitable HIV cure discovery. Full article

The extensive integration of lithium-ion batteries (LIBs) into modern technologies—including portable electronics, electric vehicles (EVs), and battery energy storage systems (BESSs)—has created a critical dependency on the supply of raw materials. The ongoing shift toward clean mobility is expected to further intensify this demand. This trend coincides with a projected increase in battery waste: over the next decade, millions of tons of EV and BESS batteries will reach their end-of-life (EOL), alongside the generation of considerable manufacturing scrap. Recycling is essential for recovering critical materials and reducing dependency on primary mining, thereby benefiting the circular economy and environmental sustainability. However, EOL-LIBs are more prone to thermal runaway due to defects and aging-induced degradation, which can lead to fire and explosion incidents, as well as associated environmental and health hazards. Such incidents have been increasingly reported in recent years during transportation, storage, handling, and illegal disposal, resulting in potential loss of life, property damage, and ecological degradation. To ensure the safe design and operation of the battery recycling industry, this work provides an updated overview of the health, safety and environment (HSE) hazards posed by EOL-LIBs and the safety measures required to mitigate these hazards. First, this work outlines the structures, components, and aging mechanisms of LIBs. Second, it summarizes the state-of-the-art recycling pathways and relevant process risks, such as deactivation, dismantling, and mechanical and thermal pretreatments. Third, it reviews recent safety incidents initiated by thermal runaway of EOL-LIBs and recycling intermediates like black mass, with an emphasis on storage and handling. Fourth, recommendations for future work regarding the safe storage and processing of EOL batteries are provided. Finally, conclusions and perspectives on future research directions are presented. Continued research and development in this field are essential to improve recycling methods, optimize processes, and ensure the safe and sustainable management and legislation of EOL lithium-ion batteries. Full article

Acute myeloid leukemia (AML) is a heterogeneous hematological malignancy with poor prognosis, frequent relapse, and treatment-related toxicity. The discovery of novel anti-leukemic agents with improved selectivity remains an urgent clinical need. In this study, rhizomes of Angiopteris evecta, a medicinal plant used in Thai traditional medicine, were collected from twelve locations in Thailand and extracted using solvents of increasing polarity. Among thirty-six crude fractional extracts, the ethyl acetate crude fractional extract from source No. 003 (AE EtOAc No. 003) exhibited the strongest cytotoxic activity against KG-1a and EoL-1 leukemic cell lines, with low toxicity toward normal peripheral blood mononuclear cells. Bioactivity-guided fractionation yielded the ternary mixture, a furanone-rich mixture dominated by 5-(1-hydroxyethyl)-dihydro-2-furanone. The ternary mixture inhibited leukemic cell proliferation by inducing apoptosis, causing cell cycle arrest, and downregulating WT1 expression in EoL-1 cells. Network pharmacology and molecular docking analyses implicated AKT1, MAPK signaling, apoptosis-related pathways, and WT1 as key molecular targets. In addition, AE EtOAc No. 003 and the ternary mixture suppressed TNF-α and IL-6 production in LPS-stimulated macrophages. Collectively, A. evecta-derived furanone compounds represent promising lead candidates for anti-leukemic drug development. Full article

End-of-Line (EoL) quality control plays a crucial role in ensuring the reliability, safety, and performance of electric motors in modern industrial production. Increasing product complexity, tighter manufacturing tolerances, and rising production quantities have exposed the limitations of conventional EoL inspection systems, which rely primarily on manually crafted features, expert-defined thresholds, and rule-based decision logic. In recent years, artificial intelligence (AI) techniques, including machine learning (ML), deep learning (DL), and transfer learning (TL), have emerged as promising solutions to overcome these limitations by enabling data-driven, adaptive, and scalable quality inspection. This paper presents a comprehensive and structured review of the latest advances in intelligent EoL quality inspection for electric motor production. It systematically surveys the non-invasive measurement techniques that are commonly employed in industrial environments and examines the evolution from traditional signal processing-based inspection to AI-based approaches. ML methods for feature selection and classification, DL models for raw signal-based fault detection, and TL strategies for data-efficient model adaptation are critically analyzed in terms of their effectiveness, robustness, interpretability, and industrial applicability. Furthermore, this work identifies key challenges that prevent the widespread adoption of AI-based EoL inspection systems, including dependence on expert knowledge, limited availability of labeled fault data, generalization between motor variants and production condition, and the lack of standardized evaluation methodologies. Based on the identified research gaps, this review outlines research directions and emerging concepts for developing robust, interpretable, and data-efficient intelligent inspection systems suitable for real-world manufacturing environments. By synthesizing recent advances and highlighting open challenges, this review aims to support researchers and experts in designing next-generation intelligent EoL quality control systems that enhance production efficiency, reduce operational costs, and improve product reliability. Full article

Advance care planning (ACP) is fundamentally important for patients diagnosed with glioblastoma (GBM), a highly aggressive primary brain tumor with a grim prognosis. The urgency for early ACP is profoundly amplified by the characteristic, progressive neurocognitive decline that frequently impairs critical reasoning and leads to the loss of decisional capacity. ACP is a proactive process ensuring that future medical interventions align with a patient’s deeply held values and goals. Proactive ACP discussions are associated with less aggressive end-of-life (EOL) care, improved quality of life for patients and care partners, earlier hospice enrollment, and reduced psychological distress for surrogate decision makers. Despite guidelines recommending early integration, ACP prevalence remains low due to clinician discomfort with EOL discussions, a perceived lack of adequate training, and a widespread “culture of shared avoidance”. Experts recommend initiating ACP at or shortly after diagnosis, normalizing it as standard cancer care. Using structured communication strategies, such as the REMAP tool, and empowering allied health providers to champion these conversations are key integration strategies. Ultimately, early and skillful ACP is an ethical imperative that safeguards patient autonomy and minimizes the burden on loved ones. Full article

Copper is a strategic raw material and an important component in electric motors, widely used across industries because of its excellent conductivity and recyclability. It plays an important role in the transformation from fossil fuel-based systems to green, electrified systems. However, substantial material losses continue throughout the lifecycle of electric motors, even with copper’s intrinsic capacity for circularity. Also, copper’s increasing demand, which is driven by the emergence of electric vehicles, industrial electrification, and renewable energy infrastructure, poses questions regarding its sustainable supply. The recovery of secondary copper sources from end-of-life (EoL) products is becoming more and more important in this context. However, it is still difficult to achieve circularity of copper, especially from industrial electric motors. This study investigates the challenges of closing the loop for copper during the lifecycle of motors in industrial applications. Based on an examination of EoL strategies, material flow insights, and practical investigation, the research pinpoints significant inefficiencies in the current processes. The widespread use of scraping as an approach of end-of-life management is one significant issue. Most of the electric motors are not built to separate their components, which makes both mechanical and manual disassembly difficult. The quality of recovered copper is thus compromised by the dominance of mixed metal shredding methods in the recycling step. This study highlights the need for systemic changes in addition to technical solutions to address copper circularity issues. It requires a focus on circularity in designing, giving disassembly and metal recovery a priority. This study focuses on circularity and its technological challenges in a value chain of copper. It not only identifies different processes such as supply chain disconnections and design constraints, but it also suggests workable solutions to close the copper flow loop in the electric motor sector. Copper quality and recovery is ultimately a problem involving design, technology, and cooperation, in addition to resources. This study supports the transition to a more sustainable and circular electric motor industry by offering a basis for directing such changes in industry practices and prospective EU regulations. Full article

This paper explores recent advancements in end-of-life (EOL) care in Canada, focusing on palliative care (PC) in oncology, advance care planning (ACP), and medical assistance in dying (MAiD). Despite improvements in cancer treatment, cancer remains a leading cause of death in Canada, with patients facing significant physical, psychosocial, and emotional challenges throughout the illness trajectory. Over the past few decades, PC has evolved to address serious illness from diagnosis onward, enhancing symptom management, quality of life, and patient satisfaction, while reducing hospital admissions and unnecessary treatments. However, barriers such as misconceptions about PC, late PC referrals, and limited access to PC, particularly in rural and remote areas, still exist. This perspective paper draws on the authors’ collective clinical and research experience in oncology and PC, complemented by a focused review of key literature. Ongoing education for oncology nurses on EOL care, including on PC, ACP, and MAiD, as well as continued efforts to expand access to PC for all Canadians, are imperative in order to improve the EOL experience for people affected by cancer nationwide. Full article

With rising efforts to enable a circularity of valuable resources of lithium-ion batteries, a growing number of recycling companies in Europe are expanding their capacities and developing new recycling technologies. The European Union (EU) has set a benchmark for battery recycling by publishing recycling targets. These targets require precise mass determination of the individual battery components, making disassembly of the battery mandatory for characterization. The paper puts forth a semi-automated disassembly procedure for determining the composition of the components at the module and cell levels across a range of designs. Our analysis incorporates the introduction of TGA as a novel, direct method for determining the cathode active material with an accuracy above 99%. This approach is intended to define the recycling input for all extant recycling routes by providing quantitative experimental results with statistical significance. The results indicate a black mass proportion of 61.6% at the module level and 53–74% at the cell level. Additionally, there are significant differences in value creation, ranging from 0.80 to 1.81 USD kg⁻¹ black mass, depending on the cell chemistry. The procedure can be used for EoL and scrap material, and enables greater transparency and comparability in battery recycling, opening up new perspectives for the resource-efficient and targeted use of various recycling technologies. Full article

The rapid commercialization of next-generation photovoltaic (PV) technologies, particularly perovskite, thin-film roll-to-roll (R2R) architectures, and tandem devices, requires robust assessment of environmental performance at the level of industrial manufacturing processes. Environmental impacts can no longer be evaluated solely at the device or module level. Although many life-cycle assessment (LCA) studies compare silicon, cadmium telluride (CdTe), copper indium gallium selenide (CIGS), and perovskite technologies, most rely on aggregated indicators and database-level inventories. Few studies systematically compile and harmonize process-level life-cycle inventories (LCIs) for the manufacturing steps that differentiate emerging industrial routes, such as solution coating, R2R processing, atomic layer deposition, low-temperature annealing, and advanced encapsulation–metallization strategies. In addition, inconsistencies in functional units, system boundaries, electricity-mix assumptions, and scale-up modeling continue to limit meaningful cross-study comparison. To address these gaps, this review (i) compiles and critically analyzes process-resolved LCIs for innovative PV manufacturing routes across laboratory, pilot, and industrial scales; (ii) quantifies sensitivity to scale-up, yield, throughput, and electricity carbon intensity; and (iii) proposes standardized methodological rules and open-access LCI templates to improve reproducibility, comparability, and integration with techno-economic and prospective LCA models. The review also synthesizes current evidence on recycling, circularity, and critical-material management. It highlights that end-of-life (EoL) benefits for emerging PV technologies are highly conditional and remain less mature than for crystalline-silicon systems. By shifting the analytical focus from technology class to manufacturing process and life-cycle configuration, this work provides a harmonized evidence base to support scalable, circular, and low-carbon industrial pathways for next-generation PV technologies. Full article

Micro and small enterprises (MSEs) in emerging markets often face resource and capability constraints, highlighting the need to leverage digital innovation for improved performance. Although entrepreneurial orientation (EO) is widely recognized as a driver of firm performance (FP), the capability-based mechanisms linking EO to performance through digital innovation remain underexplored. To address this gap, this study develops and empirically validates a Digital Innovation Opportunity Transformation (DIOT) framework, which explains how EO enhances FP through sequential capability mechanisms—digital opportunity recognition and digital opportunity exploitation—and how IT-environmental support (ITES) strengthens these effects. Using survey data from 286 Ethiopian MSEs and structural equation modeling, the findings reveal that EO has a significant positive impact on FP (β = 0.14, p < 0.05) and generates indirect benefits through internal digital innovation capabilities. Additionally, ITES amplifies these indirect pathways, suggesting that supportive digital infrastructures enhance the outcomes of EO-driven innovation efforts. The study advances theoretical understanding by validating the DIOT framework and elucidating the internal mechanisms linking EO to FP. It also offers practical insights for managers, technology providers, and policymakers seeking to promote EO-led digital innovation in resource-constrained emerging economies. Full article

Introduction: Pediatric palliative care (PPC) improves symptom management and end-of-life (EOL) outcomes. Disparities exist in access to PPC and EOL care related to social determinants of health. Less is known regarding how the content of PPC visits varies by sociodemographic factors like race/ethnicity, socioeconomic status, and language. Methods: This retrospective cohort study included patients 0–27 years old with cancer receiving PPC between 2017 and 2022. After each PPC visit, the documenting clinician selected the domains of care addressed during the visit (Goals of Care, Symptom Management, and Care Coordination with respective subdomains). Differences in frequency of subdomains discussed were compared across patient race/ethnicity, social deprivation index (SDI) score, language, and concordance with clinician race/ethnicity. Chi-square or Fisher’s exact test assessed differences in proportions of visits with each subdomain discussed, and Kruskal–Wallis tests assessed differences in the frequency of total subdomains discussed. Results: Among 467 patients, there were 7548 PPC visits. Most patients were non-Hispanic (n = 384, 82.2%), English-speaking (n = 425, 91.0%), and identified as White (n = 270, 57.8%) or Black (n = 166, 35.5%). A median of 8 (IQR 7, 11) subdomains were addressed per visit. One more subdomain was addressed in non-Hispanic White visits (9) compared to all other races/ethnicities (8, p < 0.001). Certain topics, like symptoms (e.g., nausea/vomiting), were more likely to be addressed in visits with White and Hispanic/Latino patients. One more subdomain was addressed in the intermediate disadvantage group (9, IQR 7, 11) compared to high and low disadvantage (8, IQR 7, 11) (p = 0.092). Both English- and non-English-speaking visits addressed a median of 8 subdomains (p < 0.001). One more subdomain was addressed in patient/clinician race-discordant (9, IQR 7, 11) than race-concordant encounters (8, IQR 7, 10) (p < 0.001). Conclusions: While EOL outcomes often differ for groups of different races, ethnicities, social deprivation indices, and languages, the frequency of subdomains discussed during PPC visits was fairly similar across groups. Disparities in PPC and EOL outcomes likely emerge from a complex interplay of variables beyond visit content, including health literacy, patient preference, historical context, and systemic factors. Full article

Due to their sustainability, lightweight qualities, and simplicity of installation, wood slab systems have gained increasing attention in the building industry. Cross-laminated timber (CLT), an engineered wood product (EWP), improves structural strength and stability, offering a good alternative to conventional reinforced concrete (RC) slab systems. Conventional CLT, however, contains adhesives that pose environmental and end-of-life (EOL) disposal challenges. Adhesive-free CLT (AFCLT) panels have recently been introduced as a sustainable option, but their environmental performance has not yet been thoroughly investigated. In this study, the environmental impacts of five slab systems are evaluated and compared using the life cycle assessment (LCA) methodology. The investigated slab systems include a standard CLT slab (SCLT), three different AFCLT slabs (AFCLT1, AFCLT2, and AFCLT3), and an RC slab. The assessment considered abiotic depletion potential (ADP), global warming potential (GWP), ozone layer depletion potential (ODP), human toxicity potential (HTP), freshwater aquatic ecotoxicity potential (FAETP), marine aquatic ecotoxicity potential (MAETP), terrestrial ecotoxicity potential (TETP), photochemical oxidation potential (POCP), acidification potential (AP), and eutrophication potential (EP), covering the entire life cycle from production to disposal, excluding part of the use stage (B2-B7). The results highlight the advantages and drawbacks of each slab system, providing insights into selecting sustainable slab solutions. AFCLT2 exhibited the lowest environmental impacts across the assessed categories. On the contrary, the RC slab showed the highest environmental impact among the studied products. For example, the RC slab had the highest GWP of 67.422 kg CO₂ eq, which was 1784.3% higher than that of AFCLT2 (3.779 kg CO₂ eq). Additionally, the simulation displayed that the analysis results vary depending on the electricity source, which is influenced by geographical location. Using the Norwegian electricity mix resulted in the most sustainable outcomes compared with Sweden, Finland, and Saudi Arabia. This study contributes to the advancement of low-carbon construction techniques and the development of building materials with reduced environmental impacts in the construction sector. Full article

Wind turbine blades (WTBs) have always been considered one of the greatest engineering achievements. They primarily use glass fiber-reinforced polymers (GFRPs) because of their lightweight nature, impressive strength-to-weight ratio, and durability. Until now, typical disposal methods of End-of-Life (EoL) WTBs are landfill or incineration. However, such practices are neither environmentally sustainable nor compliant with current regulations. This study investigates a low-temperature solvolysis process using a poly(ethylene glycol)/NaOH system under ambient pressure for efficient decomposition of the polyester matrix, promoting the potential of chemical recycling as an alternative to landfilling and incineration by offering a viable method for recovering glass fibers from WTB waste. A parametric study evaluated the influence of reaction time (4–5.5 h) and catalyst-to-resin ratio (0.1–2.0 g NaOH per g resin) on solvolysis efficiency. Optimal conditions (200 g PEG200, 12.5 g NaOH, 10 g GFRP, 5.5 h) achieved an ~80% decomposition efficiency and fibers exhibiting minimal surface degradation. SEM and EDX analyses confirmed limited morphological damage, while excessive NaOH (>15 g) caused notable etching of the glass fibers. ICP-OES of liquid residues detected high Na (780 mg/L) and Si (139 mg/L) concentrations, verifying partial dissolution of the fiber structure under strongly alkaline conditions. After applying a commercial sizing agent (Hydrosize HP2-06), TGA confirmed ~1.2% sizing mass, and nanoindentation analysis showed the interfacial modulus and hardness of re-sized fibers improved by over 70% compared to unsized recycled fibers, approaching the performance of virgin fibers. Full article

This paper examines the sustainability of photovoltaic (PV) panel recycling through a case study in Greece. It traces the evolution of PVs and outlines the main construction characteristics, emphasizing that although PV systems reduce greenhouse gas emissions, they also generate substantial end-of-life (EoL) waste containing both valuable and potentially hazardous materials. The study estimates Greece’s annual PV waste generation and evaluates its environmental, social, and economic impacts. It focuses on advanced disassembly and recycling methods by PV types and calculates material-recovery rates. Using national installation data from 2009–2023, the analysis quantifies the potential mass of recoverable materials and assesses the sustainability of PV recycling in terms of environmental protection, public health, and economic feasibility. Results show high recovery rates: silicon (85%), aluminum (100%), silver (98–100%), glass (95%), copper (97%), and tin (32%). Although current recycling economics remain challenging, the environmental and health benefits are significant. This research contributes to the existing literature by providing the first detailed quantification of recoverable raw materials embedded in Greece’s PV stock and by highlighting the need for technological innovation and supportive policies to enable a circular and sustainable solar economy. Full article

The consumption of electronic products is growing rapidly, resulting in considerable amounts of electronic waste (e-waste). In addition, economic, environmental, and social perspectives increased the need to develop an effective reverse supply chain (RSC). This study, therefore, formulates a stochastic model for a multi-objective, multi-product, multi-period RSC for electronic waste (e-waste) under uncertainty in returns’ quantity, quality, and availability to repair. Three objective functions are considered: maximizing profit, maximizing social impact, and minimizing CO2 emissions. The end-of-life (EOL) household appliance firm was considered for illustration. Results showed that selling products’ parts and generating 123.025 tons of raw materials are expected to generate profit and revenue averages of USD 547,750 and USD 220,207, respectively. The multiple-product RSC is expected to increase profit by 2.3 times that of a single-product RSC. Finally, the effects of uncertainty in model parameters on the objective functions are examined. In conclusion, the proposed RSC of e-waste can effectively enhance sustainability. Full article