Saved Queries

To better understand the impact that multi-scale unsteadiness has on industrial flows, we use Large Eddy Simulation (LES) data representative of a midspan compressor section operating in an idealized multi-stage environment. We collect a large number of three-dimensional flow snapshots and perform a large-scale flow decomposition using a parallel framework based on the Proper Orthogonal Decomposition (POD). Once the flow is split into orthogonal modes, we quantify kinetic energy budgets on a mode-by-mode basis. This enables us to characterize energy exchanges between these modes and analyze the flow in a multi-scale manner. As a result we are able to reconstruct an approximate energy cascade within the domain. The results provide insights into the role that various scales play in modulating the energy transfer within the flow. This work is a stepping stone towards utilizing all the information embedded in the 3D unsteady flowfield and its evolution for the purpose of informing turbulence modeling. Full article

17 pages, 748 KB

Open AccessSystematic Review

Effectiveness of β-TriCalcium Phosphate for Alveolar Ridge Preservation: A Systematic Review

by Vitolante Pezzella, Andrea Blasi, Leopoldo Mauriello, Giuseppe Trapanese, Elio Ramaglia, Michele Basilicata, Vincenzo Iorio-Siciliano and Luca Ramaglia

J. Funct. Biomater. 2026, 17(5), 247; https://doi.org/10.3390/jfb17050247 (registering DOI) - 15 May 2026

Abstract

Alveolar ridge preservation (ARP) aims to reduce post-extraction bone resorption and facilitate implant placement. Among alloplastic grafts, β-tricalcium phosphate (β-TCP) is widely used due to its osteoconductive properties and complete resorbability. This systematic review evaluated the clinical effectiveness of β-TCP for ARP, focusing on ridge dimensional changes assessed by cone–beam computed tomography (CBCT). Electronic searches were performed in major scientific databases up to April 2026. Randomized controlled trials (RCTs) reporting CBCT-based dimensional outcomes after at least 4 months were included. Five RCTs met the inclusion criteria. Considerable heterogeneity was observed in biomaterial formulations, socket management, and outcome assessment. When used alone, β-TCP showed variable results, ranging from greater ridge resorption compared with xenograft to outcomes comparable with those of freeze-dried bone allograft. More consistent findings were reported when β-TCP was used in combination with other biomaterials, with outcomes generally comparable to those of deproteinized bovine bone mineral (DBBM). Overall, β-TCP may have a potential role in alveolar ridge preservation; however, evidence remains limited and heterogeneous. Differences between β-TCP alone and composite formulations should be carefully considered, and no definitive conclusions can be drawn regarding its comparative predictability versus xenografts. Further RCTs are needed to clarify its clinical effectiveness and identify optimal applications. Full article

(This article belongs to the Special Issue Biomaterials Applied in Dental Sciences (2nd Edition))

18 pages, 1817 KB

Open AccessReview

Aspartate–Glutamate Carrier 1 (SLC25A12) Deficiency: Malate–Aspartate Shuttle Failure, Neurodevelopmental Epileptic Encephalopathy, and Ketone-Based Metabolic Therapy

by Manuela Murano, Giorgia Natalia Iaconisi, Magnus Monné, Amer Ahmed, Giuseppe Fiermonte, Loredana Capobianco and Vincenza Dolce

Int. J. Mol. Sci. 2026, 27(10), 4455; https://doi.org/10.3390/ijms27104455 (registering DOI) - 15 May 2026

Abstract

Aspartate–glutamate carrier 1 (AGC1) deficiency is a rare neurometabolic disorder caused by biallelic pathogenic variants in SLC25A12. Clinically, it is characterized by early-onset developmental and epileptic encephalopathy, often associated with hypomyelination and reduced brain N-acetylaspartate. AGC1 loss reduces malate–aspartate shuttle flux, limiting cytosolic NAD⁺ regeneration and impairing neuronal redox coupling, ATP supply, and aspartate-dependent biosynthesis during brain development. We integrate human genetics with mechanistic evidence from mammalian, Drosophila melanogaster, and Saccharomyces cerevisiae models to describe conserved transport principles and species-specific regulation underlying selective central nervous system vulnerability. We review the management of AGC1 deficiency, focusing on ketogenic therapy. Published reports show reproducible seizure reduction and, in some patients, improved myelination and N-acetylaspartate. However, these responses are heterogeneous and appear to depend on the timing, duration, and stability of ketosis. Preclinical evidence suggests that β-hydroxybutyrate may contribute to metabolic support in AGC1 deficiency. Prospective studies should test disease modification using standardized endpoints plus MRI/¹H-MRS and ketosis measures. Full article

(This article belongs to the Special Issue Epilepsy: Exploring the Molecular Mechanisms and Potential Medications)

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Graphical abstract

9 pages, 450 KB

Open AccessArticle

Clinical and Metabolic Predictors of Hypertensive Disorders in Pregnancies Complicated by Gestational Diabetes Mellitus: A Retrospective Cohort Study

by Laura La Fauci, Rosario D’Anna, Ferdinando Antonio Gulino, Cristina Barracato, Eliana Zangla, Chiara Conti Nibali, Antonino Di Benedetto and Francesco Corrado

J. Clin. Med. 2026, 15(10), 3835; https://doi.org/10.3390/jcm15103835 (registering DOI) - 15 May 2026

Abstract

Introduction: Hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM) represent two significant maternal cardiometabolic disorders closely related to each other. This study aims to identify predictive risk factors for gestational hypertension in patients with GDM within our population. Methods: This cohort study was conducted at the Department of Obstetrics and Gynecology, Policlinico “G. Martino” of Messina from January 2012 to December 2019. It included 684 pregnant women diagnosed with GDM by Oral Glucose Tolerance Test (OGTT) according to Italian guidelines. A detailed medical history was taken for each patient to identify potential predictive risk factors for HDP. Patients with pre-existing hypertension or diabetes were excluded. Results: Among 684 women with GDM, 69 (10.1%) developed hypertensive disorders of pregnancy (HDP). Women with HDP had a significantly higher pregestational BMI (30.1 ± 7.7 vs. 26.5 ± 5.6 kg/m², p = 0.001) and a higher prevalence of obesity (51% vs. 34%, p = 0.0001). Post-load glucose at 60 min was higher in the HDP group (178 ± 34 vs. 164 ± 32 mg/dL, p = 0.0001), with more women exceeding the diagnostic threshold (>180 mg/dL: 56% vs. 35%, p = 0.001). Multivariate analysis confirmed that pregestational obesity and higher 60-min glucose levels during OGTT were the strongest independent predictors of HDP. Conclusions: Obesity and glycemia above the cut-off after 1 h during OGTT are predictive risk factors for hypertensive disorders in patients with GDM. Full article

(This article belongs to the Section Obstetrics & Gynecology)

15 pages, 897 KB

Open AccessArticle

Advanced Mathematical Platform for the Control and Manipulation of Magnetized Living Cells

by Vitaly Goranov, Tatiana Shelyakova, Jaroslav Koštál, Alexander Makhaniok, Gianluca Giavaresi and Valentin Alek Dediu

Bioengineering 2026, 13(5), 560; https://doi.org/10.3390/bioengineering13050560 (registering DOI) - 15 May 2026

Abstract

Magnetizing living cells with superparamagnetic iron oxide nanoparticles (SPIONs) enables their remote manipulation using external magnetic field. This lays the foundation for magnetically assembling tissue precursors within cell-friendly, proliferation-permissive environments and holds considerable promise for biomedical applications, particularly in the development of complex single- and multicellular tissue constructs for bone and organ reconstruction. However, progress in this field is limited by the lack of robust mathematical tools for accurate control of ensembles of magnetic nano- and micro-objects. In practical printing scenarios, collective behavior and unavoidable statistical heterogeneity—such as variations in SPION size and shape or deviations in cell magnetization—render traditional equation-based modeling inadequate. We developed a hybrid modeling framework integrating conventional physics-based simulations with artificial intelligence-driven image analysis. Dynamic parameters were extracted from video recordings of magnetized cells moving within model microfluidic devices exposed to well-defined magnetic fields and gradients. The AI-based analysis enabled quantitative characterization of ensemble behavior under heterogeneous conditions. The proposed framework successfully captured the collective dynamics of magnetized cell ensembles and enabled accurate control of their spatial organization under external magnetic actuation. The integration of simulation and data-driven analysis provided robust parameter identification despite statistical heterogeneity within the system. This integrated modeling approach provides a practical and effective tool for controlling the three-dimensional magnetic assembly of living cells, with strong potential for applications in tissue engineering. Full article

(This article belongs to the Special Issue Multimodal AI‑Assisted Bioprinting: From Material Selection to Automated Fabrication)

23 pages, 1991 KB

Open AccessArticle

A Radar-Based Contactless System for Joint Phonocardiogram Reconstruction and Cardiac State Segmentation Using a Self-Attention 1D U-Net

by Giulio Montanari, Marco Mura, Pasquale Di Viesti, Elia Vignoli, Giorgio Guerzoni and Giorgio Matteo Vitetta

Sensors 2026, 26(10), 3151; https://doi.org/10.3390/s26103151 (registering DOI) - 15 May 2026

Abstract

Contactless vital signs monitoring is becoming increasingly relevant in scenarios where conventional sensors are impractical or not recommended. In this manuscript, a radar-based contactless system for the joint reconstruction of phonocardiogram (PCG) waveforms and cardiac state segmentation is illustrated. The proposed method exploits a self-attention one-dimensional (1D) U-Net fed by a pre-processed radar-derived input to estimate a PCG-like waveform, its envelope, and the four main cardiac phases: S1, systole, S2, and diastole. The accuracy of our method has been assessed on a public synchronized radar–PCG dataset acquired by means of a 24 GHz Doppler radar and a digital stethoscope. On the test subset, the proposed model achieved a 13.4885 dB reduction in log-spectral distance relative to the radar input signal, indicating a marked improvement in waveform fidelity. Segmentation performance also improved, with Micro-

F_{1}

increasing from 74.41% to 84.17% and Macro-

F_{1}

from 68.40% to 80.43% on average. Experimental results demonstrated the viability of real-time low-power embedded hardware deployment for contactless auscultation and continuous cardiac monitoring applications. The findings confirm that respiratory interference and low-amplitude signals complicate S2 detection, especially when exacerbated by subject motion. Full article

(This article belongs to the Special Issue Sensor-Based Time-Series Analysis Empowered by Artificial Intelligence)

37 pages, 4112 KB

Open AccessReview

Digitisation of Procurement and Information Modelling—Literature Review on e-Procurement

by Eliana Basile, Francesca Porcellini, Enrico Pasquale Zitiello, Sonia Lupica Spagnolo, Antonio Salzano and Salvatore Antonio Biancardo

Buildings 2026, 16(10), 1969; https://doi.org/10.3390/buildings16101969 (registering DOI) - 15 May 2026

Abstract

In recent decades, the introduction of e-procurement has profoundly transformed the methods of procuring goods, services, and works, redefining traditional procurement processes and significantly impacting global economic, operational, and regulatory dynamics. The construction sector has also been affected by this transition, which has altered the operating models of public procurement and favoured the adoption of digital tools aimed at more efficient, transparent, and automated process management. This study proposes a systematic literature review based on the analysis of 95 scientific contributions, with the aim of outlining the evolution of the e-procurement paradigm in the construction sector and identifying the main directions for research development. Despite the widespread dissemination of studies on the topic, it emerges that the actual maturity of e-procurement systems is still limited, often resulting in a logic of document dematerialization rather than full process digitalization. In this context, the review critically analyses the role of Building Information Modelling as an enabling factor for the evolution of e-procurement, exploring the potential of its integration into procurement flows. Particular attention is paid to the contribution of the Digital Building Logbook, an information tool capable of extending the value of data generated during the tender phase throughout the building’s entire life cycle, supporting advanced management and maintenance strategies. The results highlight how, despite the significant potential of integrating e-procurement and BIM, significant technological, regulatory, and cultural issues persist that limit its large-scale adoption. This underscores the need to develop shared and interoperable methodological approaches capable of transforming procurement from a document-based process to an integrated information system, oriented toward value creation throughout the entire life cycle of projects. Full article

(This article belongs to the Section Construction Management, and Computers & Digitization)

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35 pages, 1628 KB

Open AccessPerspective

The Challenge of Machine Learning and Artificial Intelligence in the Construction Sector: The Lesson Learned from the Rome Technopole Project

by Luca Gugliermetti, Maria Michaela Pani, Marco Cimillo, Fabrizio Tucci and Federico Cinquepalmi

Appl. Sci. 2026, 16(10), 4964; https://doi.org/10.3390/app16104964 (registering DOI) - 15 May 2026

Abstract

Artificial Intelligence (AI) and Digital Twins (DTs) can support the digital and energy transition in the construction sector; however, their application to the built environment presents both opportunities and limitations. This study aims to give a critical perspective on the topic analyzing the related key challenges, including error assessment, model interpretability, data availability, cybersecurity risks, organizational constraints, and lifecycle costs. Where AI is nowadays developed as a context-dependent tool set, it is most effective when embedded within integrated socio-technical systems rather than adopted as a universal solution. Instead, DTs can be intended as an enabling framework, integrating AI, Internet of Things (IoT), Big Data, and Building Management Systems (BMS) to enhance energy performance, indoor environmental quality, safety, maintenance, and decision-making at both building and urban scales. The direction international research on these topics is facing is clear as evidenced by the wide number of research papers published. The future of these technologies moves towards a simulative approach oriented towards the sustainable and fair development goals and will bring a broad transformation of the building environment where they are ever more integrated into each social and technical aspect. The work is supported by a case study developed at Sapienza University of Rome founded by the Italian National Recovery and Resilience Plan within Flagship Project 2 (FP2), “Energy Transition and Digital Transition in Urban Regeneration and Construction,” of the Rome Technopole ecosystem. Full article

(This article belongs to the Special Issue The Rome Technopole Project: Energy Transition and Digital Transition in Urban Regeneration and Construction)

16 pages, 745 KB

Open AccessReview

Determinants of Protein Folding Pathways: Lessons from Metamorphic Proteins

by Valeria Pennacchietti, Mariana Di Felice, Julian Toso, Laura Caldarelli, Eduarda Santos Ventura, Francesca Malagrinò, Angelo Toto and Stefano Gianni

Int. J. Mol. Sci. 2026, 27(10), 4450; https://doi.org/10.3390/ijms27104450 (registering DOI) - 15 May 2026

Abstract

The protein folding problem has traditionally been defined by two complementary challenges: predicting the three-dimensional structure of a protein from its amino acid sequence and understanding the mechanism by which this structure is attained. While recent advances in artificial intelligence have largely addressed the former, the latter remains unresolved. Early studies showed that many small proteins fold in a cooperative two-state manner, shifting attention toward transition states and energy landscapes. Comparative analyses of protein families further revealed that folding mechanisms are often conserved among proteins sharing the same topology, suggesting a dominant role of structure in shaping folding pathways. However, this framework does not explain when and how a protein commits to a specific topology. Metamorphic proteins, in which highly similar sequences adopt distinct native folds, provide a powerful complementary approach. Studies of these systems show that closely related sequences can follow different folding mechanisms without sharing common intermediates. These findings indicate that folding pathways are determined at very early stages and are encoded within the denatured ensemble through subtle structural and energetic biases. Here, we review the evolution of protein folding studies and propose a unified view in which folding mechanisms are selected early, with the denatured state playing a central role in defining both folding pathways and final topology. Full article

(This article belongs to the Section Molecular Biophysics)

24 pages, 14959 KB

Open AccessArticle

Assessment of Basal Crop Coefficient Adjustment in Grapevines with Active Ground Cover: A Case Study

by María Fandiño and Javier J. Cancela

Water 2026, 18(10), 1202; https://doi.org/10.3390/w18101202 - 15 May 2026

Abstract

Competition for water resources makes it necessary to advance research focused on estimating the water needs of row crops, such as vineyards. Following the FAO-56 methodology and the A&P approach, the soil water balance model was applied to a vineyard with continuous vegetation cover in temperate climate conditions (Galicia, Spain). Basal crop coefficients adjusted to local conditions were obtained for both the vineyard and the active vegetation. After SIMDualKc model adjustment, r² values greater than 0.86 were obtained, along with goodness-of-fit indicators that demonstrate the model’s ability to predict soil water content (PBIAS_avg = 1.16; EF_avg = 0.89; dIA_avg = 0.97). A correction factor is proposed that improves the partitioning of the transpiration component in row crops with active cover. The transpiration demand of the vineyard increased by 35% in four study cases (northern Portugal, northwestern Spain, and Italy). The proposed correction factor is shown to be in line with the actual conditions and complex behaviour of a vineyard with active vegetation cover, which opens the way for improved water requirement prediction in complex management situations such as the one studied here. The proposed methodology is expected to improve the efficiency of irrigation management through more accurate determination of the real water amount required by orchards. Full article

(This article belongs to the Special Issue Crop Evapotranspiration, Crop Irrigation and Water Savings)

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11 pages, 523 KB

Open AccessArticle

Pharmacokinetic Profiles of Pentoxifylline and Its 5-Hydroxyhexyl Metabolite Administered by Different Doses in Goats

by Orhan Corum, Tulay Avci, Mustafa Hitit, Pedro Marin, Mario Giorgi, Duygu Durna Corum, Devran Coskun, Serafettin Kartal, Hatice Rumeysa Ceyhan, Fatma Akin, Ibrahim Buyuktaskapulu and Kamil Uney

Animals 2026, 16(10), 1524; https://doi.org/10.3390/ani16101524 - 15 May 2026

Abstract

This study examined dose-dependent alterations in the pharmacokinetics of pentoxifylline (PTX) and its 5-hydroxyhexyl (M-I) metabolite in goats. Goats were administered PTX intravenously at doses of 10, 20, and 40 mg/kg. PTX and M-I plasma concentrations were quantified by HPLC. The t_1/2ʎz values of PTX and its M-I showed significant differences between dose groups. The 40 mg/kg dose of PTX showed lower Cl_T and V_dss values compared to the 10 and 20 mg/kg doses. For PTX and M-I, higher dose-normalized AUC values were obtained at a dose of 40 mg/kg compared to other doses. Compared to other doses, high dose-normalized C_0.08 was obtained for PTX at a dose of 40 mg/kg, and a low dose-normalized C_max was obtained for M-I at a dose of 10 mg/kg. The AUC_0-lastM-I/AUC_0-lastPTX ratios were 8.9%, 9.6%, and 10.6% for dosages of 10, 20, and 40 mg/kg, respectively, with the maximum ratio observed at the highest dosage. The findings indicated that the pharmacokinetics of PTX and M-I at a dosage of 40 mg/kg exhibited considerable variability in goats. This information may be helpful in adjusting the dosage regimen of PTX in goats, but further studies are needed to determine dose-dependent therapeutic efficacy and safety. Full article

(This article belongs to the Section Animal System and Management)

18 pages, 6103 KB

Open AccessArticle

Effect of Flame Retardant (BDE-47) Exposure on Benthic Organisms from Coastal Areas: Experiment on Symbiont-Bearing Foraminifera of Genus Peneroplis

by Marianna Musco, Marilena Vita Di Natale, Marco Torri, Tiziana Masullo, Carmelo Daniele Bennici and Angela Cuttitta

Toxics 2026, 14(5), 441; https://doi.org/10.3390/toxics14050441 (registering DOI) - 15 May 2026

Abstract

Benthic foraminifera, single-cell marine organisms found worldwide, represent an important component of seabed ecosystems. Due to their sensitivity to environmental pollution, they are often used as bioindicators, providing an efficient tool in toxicity studies. Among the pollutants affecting marine coastal and estuarine environments, persistent flame retardants, such as polybrominated diphenyl ethers (PBDEs), are frequently found. Low-level exposure to BDE-47, a PBDE congener, is known to affect organismal development. In this framework, this study aims to assess the effects of BDE-47 exposure on benthic foraminifera from coastal marine environments. Foraminifera specimens belonging to the symbiont-bearing Peneroplidae family were sampled and exposed to two different BDE-47 concentrations for up to 48 h. Vitality indicators such as changes in pseudopodial activity, movement, reproduction, loss of symbiont algae, and occasional mortality events were monitored during the experiment. Exposure to BDE-47 induced alterations in pseudopodial activity, movement, reproduction, and symbiont retention, with the progressive loss of vitality and limited mortality at increasing exposure levels, highlighting the sensitivity of this species to BDE-47. These findings suggest the harmful repercussions of PBDE pollution on marine coastal ecosystems, affecting benthic organisms and potentially contributing to biomagnification processes within the food web, with possible implications for human health. Full article

(This article belongs to the Special Issue Occurrence and Environmental Risks of Organic Pollutants in Aquatic Environment—2nd Edition)

18 pages, 1066 KB

Open AccessArticle

Beyond GLM: Inter-Subject Variability as a Complementary Approach to Detect Longitudinal Changes in Emotion Processing in Multiple Sclerosis

by Alice Pirastru, Valeria Blasi, Diego Michael Cacciatore, Marco Rovaris, Elena Toselli, Francesco Pagnini, Cesare Cavalera, Fabrizio Esposito, Giuseppe Baselli and Francesca Baglio

J. Imaging 2026, 12(5), 210; https://doi.org/10.3390/jimaging12050210 - 15 May 2026

Abstract

Understanding how to reliably capture neural changes induced by treatments in neurological patients remains a major methodological challenge. This issue is particularly evident in the emotional domain—frequently impaired in conditions such as multiple sclerosis (MS) and a key target of rehabilitation—yet not limited to it. Longitudinal neuroimaging studies predominantly rely on group-level analyses (e.g., General Linear Model, GLM), which assume inter-subject homogeneity and treat inter-subject variability (ISV) as noise. Such assumptions may obscure treatment-related neuroplastic changes, especially in domains like emotion processing, where neural responses are intrinsically variable and highly individualized in clinical populations. This study investigates whether modeling ISV can better capture treatment-related neural changes, using emotion-focused rehabilitation as a representative case. We compared GLM with threshold-weighted overlap maps (OM_th-w), which quantify spatial consistency across individuals. Thirty healthy controls (HCs) and thirteen people with MS (pwMS) undergoing EMDR for depression performed an emotional fMRI task (pwMS pre/post-treatment). GLM revealed no longitudinal effects, whereas OM_th-w showed reduced variability in pwMS after treatment, alongside decreased depressive symptoms (p < 0.001). These findings highlight the value of variability-based approaches as a complementary framework to conventional GLM analyses for detecting treatment-related neuroplasticity in neurological populations. Full article

(This article belongs to the Special Issue Advances in Neuroimaging for Human Cognition, Behavior, Brain Modulation and Prediction)

11 pages, 601 KB

Open AccessArticle

The Prognostic Significance of the Second Predominant Histological Pattern in Resected Early-Stage Lung Adenocarcinoma: A Retrospective Cohort Analysis

by Marco Ghisalberti, Alberto Salvicchi, Angela Galgano, Rossella Reale, Chiara Catelli, Luca Luzzi and Piero Paladini

J. Clin. Med. 2026, 15(10), 3815; https://doi.org/10.3390/jcm15103815 - 15 May 2026

Abstract

Background: Lung adenocarcinoma is morphologically heterogeneous, composed of various histological patterns. The International Association for the Study of Lung Cancer (IASLC) grading system, based on the predominant pattern and the presence of high-grade components, underscores this heterogeneity’s prognostic relevance. However, the specific impact of the non-predominant “second component” on survival outcomes in early-stage disease remains inadequately characterized. Methods: We conducted a retrospective, single-center study including 95 patients with pathological stage 0, I, and II (TNM 8th edition) lung adenocarcinoma who underwent complete anatomical resection (lobectomy or segmentectomy) between January 2020 and December 2021. Histopathological evaluation followed the WHO 5th edition classification, with patterns quantified in 5% increments. The second predominant component was defined as the second most represented histological pattern, irrespective of a fixed percentage threshold. Overall survival (OS) and disease-free survival (DFS) were analyzed. Results: A second predominant component was identified in 55 patients (57.9%). The most common second components were lepidic (30.5%), solid (18.9%), and micropapillary (10.5%). With a median follow-up of 36 months, the presence of a lepidic second component was an independent factor for improved OS (Hazard Ratio [HR] 0.70, 95% CI 0.52–0.95, p = 0.022) and DFS (HR 0.62, 95% CI 0.41–0.93, p = 0.021). Conversely, a micropapillary second component was a strong independent predictor of worse OS (HR 1.81, 95% CI 1.24–2.64, p = 0.002) and DFS (HR 2.03, 95% CI 1.32–3.12, p = 0.001). The solid second component showed an intermediate adverse effect on DFS (HR 1.45, 95% CI 1.01–2.08, p = 0.043). Conclusions: The second predominant histological pattern provides additional prognostic information beyond the IASLC grading system and may improve postoperative risk stratification in early-stage lung adenocarcinoma. A lepidic second component portends a favorable prognosis, while micropapillary and solid components denote aggressive tumor biology and higher recurrence risk. Incorporating the evaluation of second components into routine pathological reporting and clinical decision-making could enhance postoperative risk stratification and personalize adjuvant therapy strategies. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Surgical Treatment in Lung Cancer and Related Pulmonary Disorders)

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14 pages, 439 KB

Open AccessReview

High Fidelity Simulations to Improve Pediatric Airway Management: A Narrative Review

by Alessandro Vittori, Cecilia Di Fabio, Marilena Trozzi, Corrado Cecchetti, Massimo Antonio Innamorato, Franco Marinangeli, Giuliano Marchetti and Marco Cascella

Healthcare 2026, 14(10), 1357; https://doi.org/10.3390/healthcare14101357 - 15 May 2026

Abstract

High-fidelity simulations have become an important aid in clinical practice and research. In the pediatric field, they allow for the creation of scenarios involving emergency situations, in which decision-making algorithms must be rapidly applied, as is the case with airway management. Our narrative review examines articles in English indexed in PubMed, using the following search terms: high-fidelity simulation, pediatric, difficult airway management, bag mask ventilation, intubation, mechanical ventilation, tracheostomy, cricothyrotomy, laryngoscopy, fiberoptic bronchoscopy, and emergency situations. Airway management, along with venous access management, has always been one of the most challenging issues in pediatric anesthesia. The scarcity of patients and procedures, combined with the need to ensure high quality standards, necessitates simulations. Using high-performance devices and realistic settings allows us to reproduce not only the desired technical scenario, but also the emotions and group dynamics. High-fidelity simulations therefore prove to be an excellent aid for pediatric airway management, enhancing the hard and soft skills of both the team and the individual. Simulations allow us to replicate scenarios that are uncommon in clinical practice but have a significant impact due to their potential severity. Full article

(This article belongs to the Special Issue Airway Management in Anesthesia: Progress, Precision, and the Path Forward)

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