Search Results (15,193)

Copper contamination in aquatic environments poses significant ecological and health risks, necessitating efficient and resilient treatment strategies. In this study, graphene oxide (GO) and magnetic graphene oxide (MGO) were synthesized and comprehensively evaluated for Cu(II) removal using an integrated multivariate approach combining kinetic and isotherm modelling, Response Surface Methodology (RSM), and advanced statistical analyses. Both adsorbents achieved high removal efficiencies (>90%) under optimized conditions, with Langmuir capacities of 59.2 mg g⁻¹ for GO and 40.1 mg g⁻¹ for MGO. Kinetic modelling confirmed reaction-controlled adsorption, while Freundlich isotherms highlighted heterogeneous surface binding. RSM identified pH as the dominant factor governing removal efficiency, with significant interactions among pH, Cu(II), and DOC reflecting competitive matrix effects. Principal Component Analysis (PCA) revealed that GO performance is strongly influenced by solution chemistry, whereas MGO exhibits reduced sensitivity due to modified physicochemical properties. FTIR analysis confirmed that adsorption proceeds primarily through electrostatic attraction and inner-sphere complexation, with Fe–O sites contributing to MGO’s enhanced affinity. Regeneration studies demonstrated superior reusability of MGO, which retained ~64% efficiency after five cycles compared to ~52% for GO. Collectively, these multivariate and mechanistic insights identify MGO as a more robust, versatile, and regenerable sorbent for Cu(II) removal under realistic water-matrix conditions. Full article

Background: Pediatric Major Depressive Disorder (pMDD) is one of the leading causes of disability in adolescents. There is currently no single explanation that fully accounts for the cause of the disorder, but various factors, including dysregulation of the immune and stress responses, have been linked to its onset. Oxylipins and endocannabinoids, derived from metabolization of n-3 and n-6 polyunsaturated fatty acids (PUFAs), regulate inflammation and have been suggested to attenuate inflammation associated with depression. This study aims to understand whether adolescents with pMDD have altered baseline levels of oxylipins and endocannabinoids compared to healthy adolescents. Methods: In this case–control study, we measured 60 oxylipins and endocannabinoids in plasma from 82 adolescents with pMDD and their matching healthy controls. Results: A Principal Component Analysis revealed substantial variability within each group and only a moderate degree of separation between them. In a paired analysis, the lipid mediators of controls exhibited higher concentrations of n-6 PUFA-derived prostaglandins and thromboxanes (PGE2, PGD2, PGF2a and TXB2), n-3 PUFA-derived TxB3, and the endocannabinoids AEA, EPEA, and DHEA. In contrast, cases had higher concentrations of the n-6 PUFA-derived 6-keto-PGF1a and the n-3 PUFA-derived PGD3. In addition, we observed a higher percentage of oxylipins and endocannabinoids derived from DHA (5.65 ± 5.46% vs. 4.72 ± 4.94%) and AA (16.31 ± 11.10% vs. 12.76 ± 13.46%) in plasma from controls, in line with the higher DHA and AA levels observed in erythrocytes from controls compared to cases. Conclusions: Overall, our results show lower plasma levels of endocannabinoids and lower DHA- and AA-derived oxylipins in adolescents with pMDD, supporting their role in the pathophysiology of pMDD. To infer a causative role of the n-3 and n-6 PUFA-derived oxylipins and endocannabinoids in pMDD, an intervention study with n-3 PUFA supplementation and monitoring of oxylipins and endocannabinoids would be necessary. Full article

N-Acetyl-D-mannosamine (ManNAc) and N-acetylneuraminic acid (Neu5Ac) are important components of glycosylation, affecting numerous physiologic processes. The effects of age, body mass index (BMI), race, or sex on serum levels of ManNAc and Neu5Ac are poorly understood. However, these associations are of substantial interest. Simultaneous quantification of ManNAc and Neu5Ac, using liquid chromatography tandem mass spectrometry (LC-MS/MS), was developed and validated for human serum samples. This method has high sensitivity, specificity, and reproducibility, with limits of detection as low as 1.02 ng/mL for ManNAc or 1.14 ng/mL for Neu5Ac. A set of 155 serum samples from the Adventist Health Study 2 (AHS-2) cohort was analyzed. Concentrations of conjugated Neu5Ac were 35.1 ± 9.4 µg/mL and 33.0 ± 9.5 µg/mL in black and white participants, respectively. Conjugated and total Neu5Ac levels were significantly higher in women, with p-values of 0.029 and 0.026, respectively. The free forms of Neu5Ac were 594 ± 421 ng/mL and 439 ± 168 ng/mL in black and white participants, respectively. Similarly, conjugated and total ManNAc levels were higher in black participants, at 1.81 ± 0.81 µg/mL and 1.90 ± 0.83 µg/mL, compared to 1.32 ± 0.52 µg/mL and 1.41 ± 0.53 µg/mL in white participants (both cases, p < 0.001). Free ManNAc was 93.1 ± 36.2 ng/mL in black and 89 ± 20.2 ng/mL in white participants. Subjects with higher BMI tend to have higher free ManNAc (p = 0.041). Furthermore, older subjects tend to have higher free (p ≤ 0.001) and total (p = 0.045) ManNAc. The improved LC-MS/MS quantification method should facilitate further investigations. Full article

The Indian monsoon is an important component of the tropical climate system. Studies suggest that both precipitation from the NNU-2K AF experiments and Little Ice Age (LIA) proxy data reveal a significant 56-year period in the Indian summer monsoon (ISM). Volcanic activity influences the multi-year and decadal characteristics of Indian monsoon precipitation. A comparative analysis of multi-decadal variations in ISM precipitation from the AF experiments and the single-factor sensitivity experiments shows a correlation of 0.45 (p < 0.05), indicating dependence on volcanic activity. The 56-year period of ISM precipitation in the AF experiments is consistent with both the single-factor sensitivity experiments and precipitation influenced by volcanic activity. Further analysis reveals that cooling over Eurasia and warming of the Indian Ocean weaken the thermal contrast between land and sea, thereby reducing ISM intensity and decreasing ISM precipitation. Conversely, enhanced volcanic activity induces widespread cooling across the Northern Hemisphere, which shifts the Intertropical Convergence Zone (ITCZ) southward. This reduction in evaporative capacity and moisture content within the monsoon region ultimately decreases precipitation across the monsoon belt. Full article

Crabronid wasps (Hymenoptera: Crabronidae) are ecologically important predators that provide various ecological services by regulating the arthropod populations, enhancing soil processes through nesting, serving as sensitive indicators of habitat condition, and providing pollen transfer for plants. However, as other invertebrates face biodiversity threats, these wasps might be under threat from environmental changes, and we need to assess the biodiversity patterns of these wasps in Yunnan Province. Unfortunately, no information is currently available about the pattern and factors responsible for the assemblages of these wasps within our study region. This study provides the first province-level assessment of habitat suitability, species richness, assemblage structure, and environmental determinants for Crabronidae in Yunnan by integrating species distribution modeling (SDM), multivariate clustering, and ordination analyses. More than 50 species were studied to assess habitat suitability in Yunnan using MaxEnt. Model performance was robust (AUC > 0.7). Suitability patterns varied distinctly among regions. Species richness peaked in southern Yunnan, particularly in the counties of Jinghong, Mengla, Menghai, and Jiangcheng Hani & Yi. Land use/land cover (LULC) variables were the dominant predictors for 90% of species, whereas precipitation-related variables contributed most strongly to the remaining 10%. Ward’s hierarchical clustering grouped the 125 counties into three community assemblage zones, with Zone III comprising the most significant area. A unique species composition was found within a particular zone, and clear separation among zones based on environmental variation was supported by Principal Component Analysis (PCA), which explained more than 70% variability among zones. Furthermore, Canonical Correspondence Analysis (CCA) indicated that both LULC and climatic factors shaped community structure assemblages, with axes 1 and 2 explaining 70% of variance (p = 0.001). The most relevant key factors in each zone were precipitation variables (bio12, bio14, bio17), which were dominant in Zone I; for Zone II, temperature and vegetation variables were most important; and urban, wetland, and water variables were most important in Zone III. Full article

This study optimizes fertilization schemes through the emergy analysis of different nutrient reduction treatments in maize cropping ecosystems in Xinjiang, thereby providing technical support for improving chemical fertilizer use efficiency and maintaining the stability of farmland ecosystems. The study was conducted in 2024 at Huaxing Farm in Changji Hui Autonomous Prefecture, Xinjiang Uyghur Autonomous Region. The experiment used the local conventional nitrogen and phosphorus fertilization rates as the control treatment N0P0 (applying P 183 kg·hm⁻² and N 246 kg·hm⁻²), with eight different N and P nutrient reduction treatments: N0P1 (10% reduction in P only), N0P2 (20% reduction in P only), N1P0 (10% reduction in N only), N2P0 (20% N reduction), N1P1 (10% N and P reduction), N1P2 (10% N and 20% P reduction), N2P1 (20% N and 10% P reduction), and N2P2 (20% N and P reduction). Each treatment was replicated three times. Based on biomass data of maize plant components under different fertilization treatments, emergy analysis of farmland ecosystems and integration of economic benefit indicators led to the optimization of an optimal fertilization scheme. Results indicate that the N0P1 treatment performed optimally: maize plant biomass reached 251.09 g, significantly higher than other treatments. The N0P1 treatment exhibited the highest energy output (3.23 × 10¹⁶ sej·hm⁻²), the highest net energy yield ratio (EYR) of 1.45, and an energy sustainability index (ESI) of 3.34, representing a high level. It also delivered the highest economic benefit, with a net profit of 8571.95 CNY·hm⁻² and a production–investment ratio of 1.71. In conclusion, the N0P1 treatment (10% reduction in phosphorus alone) demonstrated superior performance in biomass yield, energy utilization efficiency, ecological sustainability, and economic benefits, making it the optimal fertilization strategy for maize fields in this region. Full article

Rice bran oil (RBO) is increasingly valued for its bioactive constituents and associated health benefits. This study presents a comprehensive comparative analysis of RBOs derived from purple (PRBO), red (RRBO), and white (WRBO) rice bran, focusing on their physicochemical properties, fatty-acid profiles, bioactive components, antioxidant activity, oxidative stability, and lipidomics. Our results demonstrate that PRBO consistently exhibited a more favorable fatty-acid composition, characterized by a higher proportion of unsaturated fatty acids and significantly greater concentrations of bioactive compounds (including tocopherols/tocotrienols, γ-oryzanol, phytosterols, and squalene). Accordingly, PRBO showed the highest radical-scavenging activity and storage oxidative stability, followed by RRBO and WRBO. Additionally, untargeted lipidomics using UPLC–MS–MS identified 2908 lipid species spanning 57 subclasses and revealed distinct variety-specific lipid signatures. PRBO was uniquely enriched in lipid species such as ceramide phosphate (CerP) and monogalactosyldiacylglycerol (MGDG). RRBO was characterized by a distinct abundance of sitosteryl esters (SiE), phosphatidic acid (PA), and cardiolipin (CL), while WRBO was distinguished by phosphatidylethanol (PEt), lysodimethylphosphatidylethanolamine (LdMePE), and sphingomyelin (SM). Overall, PRBO possessed not only a broader repertoire of lipid species but also higher relative abundances of nutritionally significant lipids. These results enable quality evaluation and varietal authentication of colored RBOs and guide their targeted use in health-oriented foods and nutritional interventions. Full article

Background: Post-COVID-19 syndrome (PCS) is defined as the persistence or development of new symptoms 3 months after the initial infection with the SARS-CoV-2 virus, these clinical aspects being most often associated with functional respiratory changes, as well as imagistic modifications. This study aimed to evaluate longitudinal changes in pulmonary function among patients with PCS, in relation to the severity of the acute COVID-19 episode and the time elapsed since infection. Methods: A retrospective, observational study was conducted at the Clinical Hospital of Pulmonary Diseases Iași, Romania, between January 2021 and December 2022, including 97 adult patients with confirmed PCS. Demographic, clinical, and functional data were collected from medical records. Pulmonary function tests (PFTs) were performed according to ATS/ERS standards, assessing Forced Vital Capacity (FVC), Forced Expiratory Volume in the First Second (FEV₁), FEV₁/FVC ratio (Tiffeneau Index), Maximal Expiratory Flow at 50% and 25% of FVC (MEF50, MEF25), Diffusing Capacity of the Lung for Carbon Monoxide (adjusted for haemoglobin) (DLCO), Carbon Monoxide Transfer Coefficient (KCO), Alveolar Volume (AV), Total Lung Capacity (TLC) and Residual Volume (RV). Patients were grouped by time elapsed since infection (1–3, 4–7, 9–12, and up to 22 months). Statistical analyses included the Mann–Whitney U test, Spearman’s correlation, ROC curve analysis, and Principal Component Analysis (PCA). Results: A progressive improvement in FVC was observed up to 9–18 months post-infection (p < 0.05), while FEV₁ remained stable, suggesting a predominantly restrictive ventilatory pattern. Patients with moderate acute COVID-19 presented significantly lower FVC%, FEV₁%, DLCO%, and KCO% values compared with those with mild disease (p < 0.05). Diffusion abnormalities (DLCO and KCO) persisted beyond 12 months, indicating lasting alveolar-capillary impairment. ROC analysis identified TLC (AUC = 0.857), AV (AUC = 0.855), and KCO (AUC = 0.805) as the most discriminative parameters for residual dysfunction. PCA revealed three major functional domains—airflow limitation, diffusion capacity, and lung volume—explaining up to 70% of total variance. Conclusions: We are facing the emergence of a new phenomenon, namely a secondary post-COVID-19 pandemic of patients confronting with persistent post-COVID-19 symptoms who present with functional respiratory changes and who require careful monitoring in dynamics, personalized treatments and a multidisciplinary approach. Full article

To investigate the seasonal characteristics, sources, and regional transport patterns of precipitation components in the high-elevation mountainous regions, field sampling was conducted at Mt. Heng (Hunan, South China) from June 2021 to May 2022. In total, 114 precipitation samples were collected and subjected to chemical analysis, including pH, major inorganic ions, and heavy metals. During the study period, the precipitation at Mt. Heng was generally weakly acidic. The concentrations of metals and acidic anions (NO₃⁻ and SO₄²⁻) were higher in the winter and lower in the summer, whereas the concentration of the primary neutralizing cation, NH₄⁺, peaked during the summer. An association was observed between precipitation pH and metal concentrations, whereby acidic precipitation samples exhibited marginally elevated metal concentrations overall. An additional analysis of winter precipitation chemistry at Mt. Heng revealed an increasing trend of ions from 2015 to 2018, followed by a decrease from 2019 to 2021. This trend coincided with the concentrations of NO₂ and SO₂ in the surrounding cities, reflecting the results of clean air actions. The results of the source analysis revealed five major sources: secondary sources (41.5%), coal combustion (24.7%), a mixed source of biomass burning and aged sea salt (11.6%), dust (10.8%), and industrial emissions (11.4%). Backward trajectory cluster analysis revealed that air masses originating from the northern regions were generally more polluted than those from the southern regions. This study provides fundamental data and scientific support for regional atmospheric pollution control and ecological protection in South China. Full article

This study addresses the ongoing challenge of accurately classifying beers by fermentation type and product category, an issue of growing importance for quality control, authenticity assessment, and product differentiation in the brewing sector. We applied a multiblock chemometric framework that integrates phenolic profiling obtained via GC–MS, antioxidant and antiradical activity derived from in vitro assays, and complementary colorimetric and physicochemical measurements. Principal Component Analysis (PCA) revealed clear compositional structuring within the dataset, with p-coumaric, gallic, syringic, and malic acids emerging as major contributors to variance. Supervised machine-learning classification demonstrated robust performance, achieving approximately 93% accuracy in discriminating top- from bottom-fermented beers, supported by a well-balanced confusion matrix (25 classified and 2 misclassified samples per group). When applied to ale–lager categorization, the model retained strong predictive ability, reaching 90% accuracy, largely driven by the C* chroma value and the concentrations of tyrosol, acetic acid, homovanillic acid, and syringic acid. The integration of multiple analytical blocks significantly enhanced class separation and minimized ambiguity between beer categories. Overall, these findings underscore the value of multi-block chemometrics as a powerful strategy for beer characterization, supporting brewers, researchers, and regulatory bodies in developing more reliable quality-assurance frameworks. Full article

Background and Objectives: Inadvertent perioperative hypothermia is a common and clinically significant complication during laparoscopic surgery, leading to pain, agitation, shivering, and delayed recovery. This randomized controlled trial evaluated the effect of peri-induction active warming with an electric resistive blanket on postoperative pain and agitation—the primary outcomes—compared with passive insulation. Materials and Methods: This study was registered at ClinicalTrials.gov (Identifier: NCT06022926; date of registration: 15 August 2023) prior to the enrollment of the first patient. One hundred and thirty-two American Society of Anesthesiologists I–II adults undergoing laparoscopic cholecystectomy were randomly allocated (1:1) to two groups: one received active warming with a resistive carbon fiber underbody blanket (Group 1), and the other received passive insulation (Group 2). The tympanic core temperature was measured at four perioperative time points (TT1–TT4). Postoperative agitation (Riker Sedation–Agitation Scale, RSAS) and pain (Numerical Rating Scale, NRS) were assessed 20 min after extubation in the post-anesthesia care unit (PACU). Secondary outcomes included intraoperative and postoperative temperature, postoperative shivering, adverse events (bradycardia, tachycardia, hypotension, hypertension, postoperative nausea and vomiting, and respiratory depression), and the PACU length of stay. Results: Baseline core temperatures (TT1) were similar between the groups (36.5 ± 0.55 °C vs. 36.6 ± 0.54 °C; p = 1.00). However, mean core temperatures at TT2, TT3, and TT4 were significantly higher in the active warming group compared with the control group (TT2: 36.7 ± 0.53 °C vs. 36.5 ± 0.54 °C; TT3: 36.6 ± 0.49 °C vs. 36.4 ± 0.54 °C; TT4: 36.6 ± 0.51 °C vs. 36.2 ± 0.52 °C; all p < 0.001). Active warming markedly reduced postoperative agitation (RSAS ≥ 5: 3.1% vs. 19.4%, p = 0.004) and pain (NRS ≥ 4: 15.4% vs. 49.3%, p < 0.001). The incidence of shivering was lower (20.0% vs. 46.3%, p = 0.006), and the PACU stay was shorter (24 [23–28] min vs. 35 [30–40] min, p < 0.001) with active warming. No significant differences in adverse events were observed between groups. Logistic regression identified the intraoperative fentanyl dose as a predictor of agitation and identified shivering and the PACU duration as predictors of pain. Conclusions: Peri-induction active warming effectively maintained normothermia and improved recovery quality by reducing postoperative agitation, pain, shivering, and PACU stays without increasing adverse events. It should be considered a standard component of thermal management in short- and medium-duration laparoscopic surgeries. Full article

Tibia morphology is a significant factor in poultry germplasm and market traits. Copy number variation (CNV) has been identified as a structural source of genetic variation for complex traits. We profiled genome-wide CNVs in Dong Tao chickens and nine other local breeds and performed a breed-based case–control CNV-GWAS (Dong Tao vs. reference breeds). We sequenced 152 chickens, including 46 Dong Tao, and annotated genes and pathways. A total of 22,972 CNVs were detected, of which 2193 were retained after filtration across 33 chromosomes, with sizes ranging from 2 kilobases to 12.8 megabases. Principal component analysis indicated an overall weakness in the breed structure and a sex-related trend within Dong Tao. A deletion on chromosome 3 at 36,529,501 to 36,539,000 was observed in Dong Tao. The exploratory screen identified 44 CNV regions at nominal significance (p < 0.05), distinguishing Dong Tao from other breeds. Thirty-seven regions contained 99 genes, including CHRM3 within the chromosome 3 deletion and CRADD overlapping two CNVs. Enrichment analysis indicated thiamine metabolism and growth hormone receptor signalling as the primary pathways of interest, with TPK1, SOCS2, and FHIT identified as potential candidates. These results provide a CNV landscape for Dong Tao and prioritize variant regions and pathways potentially relevant to its robust tibia morphology; however, no direct CNV–tibia phenotype regression was performed. Full article

Background: Chronic nonbacterial prostatitis (CNP), the major subset of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), imposes a substantial global burden yet lacks satisfactory therapies. Maizibizi Wan (MZBZ) has long been used clinically for prostatitis, but its pharmacodynamic substance basis and mechanisms remain unclear. Methods: Ultra-high-performance liquid chromatography–Q-Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap-HRMS) coupled with Global Natural Products Social Molecular Networking (GNPS) molecular networking profiled MZBZ constituents and rat plasma–exposed prototype components and metabolites was used. Based on blood-absorbable components, network pharmacology predicted core targets/pathways; representative interactions were validated by molecular docking. A λ-carrageenan–induced CNBP rat model underwent histopathology (H&E), serum cytokine assays (TNF-α, IL-1β, IL-6/IL-17), immunohistochemistry (COX-2, TNF-α, MMP-9), and Western blotting (P-p65/p65, p-AKT/AKT, COX-2, TGF-β1, BCL2). Results: A total of 188 chemical constituents were identified in MZBZ (79 flavonoids, 38 organic acids, 30 alkaloids, 15 phenylpropanoids, 7 steroids, 4 phenylethanoid glycosides, 15 others). A total of 35 blood-absorbable components (18 prototype components, 17 metabolites) were identified, mainly involving Phase I oxidation and Phase II glucuronidation/sulfation. Network analysis yielded 54 core targets enriched in NF-κB and PI3K/AKT signaling and apoptosis. Docking indicated stable binding of key flavonoids to COX-2, NFKB1, TNF, IL-6, and BCL2. In vivo, MZBZ ameliorated prostatic inflammation, reduced serum TNF-α/IL-1β/IL-6/IL-17 (p < 0.05 or p < 0.01); decreased P-p65/p65, p-AKT/AKT, COX-2, and TGF-β1; and increased BCL2 in prostate tissue. Conclusions: MZBZ exerts anti-CNBP effects via multi-component synergy (prototypes + metabolites) that suppresses inflammatory cytokines, modulates apoptosis, and inhibits NF-κB and PI3K/AKT pathways. These findings provide a mechanistic basis and quality control cues for the rational clinical use of MZBZ. Full article

Bee bread contains numerous bioactive compounds, including phenolic compounds, which have been associated with antioxidant properties. In this study, we determined the phenolic composition of Polish bee bread collected over three consecutive years using HPLC-DAD. We also measured total phenolic content (TPC) and antioxidant activity, expressed as DPPH radical scavenging activity. The highest concentrations were observed for p-coumaric, trans-ferulic, and caffeic acids, as well as for two flavonoids—rutin and hesperidin. The contents of individual phenolic compounds varied across the years of sample collection, with the exception of p-coumaric and vanillic acids. Despite year-to-year differences in TPC, no significant correlation with antioxidant activity (>90% in all samples) was observed, indicating a substantial contribution of non-phenolic compounds to antioxidant capacity. Principal Component Analysis revealed that almost all samples clustered into three groups according to their year of collection. We conclude that the year-to-year variation in phenolic compound content in bee bread is likely attributable to differences in available pollen sources. Our findings expand the current knowledge of the nutritional value of bee bread produced in Poland and strengthen the premises for its use as a functional food. Full article

Background/Objectives: Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). The purpose of this study was to assess effectiveness and safety of HCTR in women with HF. Methods: This analysis formed part of the TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO₂peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were taken before and after intervention/observation. Results: Women constituted 11.5% of the TELEREH-HF study population. Forty women in the HCTR group and 44 women in the UC group completed program and observation, respectively. HCTR resulted in a significant improvement in VO₂peak (13.4 ± 4.3 vs. 14.3 ± 4.6; 95%CI 0.91 [0.05; 1.77], p = 0.038), workload duration (301 ± 162.3 vs. 334 ± 156.6; 95%CI 33 [5; 60], p = 0.022) and SF-36 overall score (85.9 ± 13.6 vs. 89.9 ± 13.5; 95%CI 4.0 [0.6; 7.4], p = 0.024). These favorable results were not observed in the UC group VO₂peak (14.2 ± 4.8 vs. 14.2 ± 4.8; 95%CI 0.02 [−1.20; 1.24], p = 0.971) and SF-36 overall score (89.1 ± 17.4 vs. 89.5 ± 15.8; 95%CI 4.0 [−2.1; 2.8], p = 0.796), except for an increase workload duration (268 ± 138.4 vs. 300 ± 130.1; 95%CI 32 [2; 62], p = 0.036). The HCTR group showed a significantly greater improvement in the physical component of QoL than the UC group. In neither group were there deaths nor major adverse events related to exercise training. Conclusions: Among women with heart failure, hybrid comprehensive telerehabilitation appears safe and leads to statistically significant although moderate improvements in physical capacity and quality of life. However, due to the small sample size, further studies in larger female populations are needed to confirm these findings. Full article