Search Results (458)

Road freight transport is an important driver of global greenhouse gas (GHG) emissions. Decarbonizing this sector demands a comprehensive assessment of emerging powertrain technologies, which are currently lacking in the literature. To fill this knowledge gap, we performed a life cycle assessment (LCA) on 10 impact categories to evaluate road freight transport in the Netherlands of four truck alternatives, assuming similar performance: fuel-cell electric (FCEV), hydrogen internal combustion engine (HICEV), battery electric (BEV), and diesel internal combustion engine (DICEV). We compared locally produced green hydrogen, according to EU regulations, with electricity and diesel as alternative fuel chains, while also considering the environmental impact of road infrastructure. We found that FCEV and HICEV trucks achieve the lowest global warming impact when green hydrogen is used. We identified discrepancies between the transport alternatives, highlighting key factors influencing NO_x and particulate matter emissions. Our research also showed that water consumption (WC) for green hydrogen is strongly influenced by upstream processes, with solar-powered electricity emerging as a crucial contributor. Our results highlight the need for more exploration on the environmental impact of green hydrogen and can be used by researchers and practitioners to further understand the complexity of reducing emissions in road freight transport. Full article

During the COVID-19 pandemic carbapenem-resistant Acinetobacter baumannii (CRAB) was found to be the major pathogen associated with ventilator-associated pneumonia in mechanically ventilated patients. This prompted us to analyze the post-pandemic mechanisms of carbapenem resistance, antibiotic resistance trends, and molecular epidemiology of CRAB in Croatia. In total, 94 CRAB isolates from two hospital centers, including outpatient settings, were investigated. Antimicrobial susceptibility testing was performed by broth microdilution. PCR was used to detect genes encoding carbapenemases of group A, B and D and extended-spectrum β-lactamases (ESBL). Randomly selected isolates were subjected to whole resistome analysis by Inter-array CarbaResist Kit and whole-genome sequencing (WGS). Phylogenetic tree and sequence types (STs) were retrieved from WGS. Plasmid incompatibility groups were determined by PCR-based replicon typing (PBRT). All isolates were extensively drug resistant (XDR), showing resistance to ceftazidime, cefepime, piperacillin–tazobactam, imipenem, meropenem, gentamicin, amikacin and ciprofloxacin, and 13% (n = 12) were also resistant to colistin. The Hodge and CIM test exhibited poor sensitivity with only 32 and 30% of isolates being identified as carbapenemase producers, respectively. PCR identified bla_OXA-23 as the dominant carbapenemase gene in both hospitals, found in 71% of the isolates (67/94). In an outpatient setting, bla_OXA-24/40 was dominant. bla_OXA-23 and bla_OXA-72 were the only allelic variants. The Inter-array CarbaResist Kit and whole-genome sequencing (WGS) identified a variety of aminoglycoside (armA, ant(3″)-IIa, aph(3″)-Ib, aph(6)-Id) and sulphonamide resistance (sul1 and sul2) genes. The representative bla_OXA-23-positive isolates belonged to ST2, while bla_OXA-72-positive isolates were allocated to ST492. These data show that there are different populations of XDR A. baumannii between hospital and outpatients. Full article

Equine-Assisted Service (EAS) horses can be exposed to stressors that affect their behavior and welfare. Previous studies investigated behavioral and physiological indicators (PI) only during therapy sessions. This study evaluated the frequency of stress and pain behaviors (FSPB) in horses with different riders, while assessing welfare through housing, management, and PI. Ten horses were observed during EAS sessions with three rider groups: able-bodied, clients with significant physical impairment, and clients with no significant physical impairment, totaling twenty-six riders. Behavioral data was collected using video recordings and analyzed with continuous sampling. Time-budget analysis and PI (ACTH, cortisol, WBC) were evaluated. Blood samples were collected at baseline and after 45 and 90 days working on EASs. There was no difference in FSPB/sec between groups, and the clients’ disability did not seem to affect the variable. Four out of ten horses had high ACTH at baseline and had their medication readjusted, highlighting the importance of periodic blood tests. Individual alterations in immune cell numbers and low cortisol could be associated with chronic stress. Horses spent 49.43% of their time budget eating, suggesting adequate feeding behavior. However, their time lying down was reduced and the effect of strong artificial lights at night needs further investigation. Full article

Diet affordability is a critical determinant of food security, health and wellbeing. However, the cost and affordability of diets have not been routinely measured in Queensland (Australia) in over a decade. This study assessed the cost and affordability of healthy (based on national healthy eating guidelines) and habitual (less healthy, based on national reported intake) diets across six Queensland regions. Data were collected in 35 communities, over two years (2023 and 2024), using the evidence-based Healthy Diets Australian Standardised Affordability and Pricing protocol. Data were analyzed relative to a six-person intergenerational Aboriginal and Torres Strait Islander reference household. Results indicate that, across Queensland, healthy diet costs are above the threshold for food stress in Aboriginal and Torres Strait Islander households. On average, healthy diets were 30% cheaper than the habitual diet (which include alcohol and takeaway foods) but cost at least 26% of household income (above the 25% threshold for food stress). In 2023, healthy diets were on average 31% more expensive in remote communities compared to urban and regional centers. In 2024, the cost of a healthy diet in remote communities decreased significantly by 24%, narrowing diet cost differences between remote and non-remote regions. This shift could be associated with the implementation of a freight subsidy in remote Queensland, or other influences on remote food pricing. Findings highlight diet-related cost-of-living challenges for Aboriginal and Torres Strait Islander families, underscore the need for ongoing monitoring and provide insight for policy interventions (such as targeted subsidies) to improve diet affordability and reduce nutrition-related health inequity. Full article

Background: Human wellbeing consists of dynamic interactions and feedback loops across multiple life domains, a perspective increasingly emphasised within positive psychology’s systemic and strengths-based approach to flourishing. This study develops a systemic framework to model these interdependencies and examines how cross-domain investment can optimise both domain-specific and integrated wellbeing across the lifespan. Methods: Using a Cobb–Douglas functional form with associated growth and resource constraints, we formalise the interaction between physical and financial wellbeing as an example and analyse their joint contribution to overall wellbeing. Results: The model demonstrates that improvements in one domain of wellbeing can enhance wellbeing in another, thereby shifting the optimisation frontier. While narrow domain-specific wellbeing strategies are subject to larger diminishing marginal returns, cross-domain investment generates reinforcing effects that elevate both domains simultaneously and increase integrated wellbeing. Conclusions: In line with positive psychology’s focus on leveraging strengths to support areas of relative weakness, the findings show how developing one domain of wellbeing can mitigate constraints in another. These findings align with positive psychology’s emphasis on multidimensional flourishing and resource-building processes, highlighting the importance of systemic resource allocation and suggesting that wellbeing optimisation requires coordinated, contextualised multi-domain strategies rather than siloed approaches. Full article

CRISPR screens are a powerful functional genomics approach for identifying genes that confer sensitivity and resistance to anti-cancer therapies. CFI-402257 (luvixasertib, 2257) is a small molecule inhibitor of threonine tyrosine kinase (TTK), a promising therapeutic target in genomically unstable cancers due to its critical role in establishing the spindle assembly checkpoint (SAC) during mitosis. To inform its ongoing development and evaluation in clinical trials, we sought to use CRISPR activation (i.e., gain of function) screens to identify cellular mechanisms of resistance to 2257 in models of triple-negative breast cancer (TNBC). In vitro screens conducted in two TNBC cell lines nominated ABCG2 as the top resistance-conferring gene in both models. Validation studies assessing clonogenic survival and apoptosis confirmed that ABCG2 overexpression enhanced TNBC resistance to 2257 in vitro, while knockdown enhanced sensitivity. These findings suggest that 2257 is a substrate of ABCG2’s drug efflux activity. However, overexpression of ABCG2 failed to confer resistance to 2257 in TNBC xenografts grown in mice and treated with a moderately active dose and schedule. Our results highlight the potential impact of drug transporters in in vitro CRISPR screens and the importance of confirming the relevance of drug response mechanisms identified in cultured cells using in vivo models that recapitulate drug pharmacokinetics and pharmacodynamics. Full article

The natural resources and local communities of Madre de Dios, Peru, face severe environmental degradation due to illegal mining, deforestation, and the expansion of agricultural activities, threatening one of the most ecologically sensitive regions of the Amazon. This research proposes a low-carbon and bioclimatic architectural design for a Sustainable Interpretation and Research Center dedicated to the conservation of the ecosystems of Manu National Park. The study is based on an analysis of the surrounding environment in terms of flora, fauna, and climate, applying bioclimatic strategies focused on sustainability and supported by specialized digital tools (Revit 2024, Canva, Global Mapper 2024, SketchUp 2024, Photoshop 2022, and Illustrator 2022). The project presents a bioclimatic architectural design that integrates constructive techniques ensuring thermal comfort in a warm-humid climate, while promoting the use of clean technologies such as photovoltaic solar systems generating 15,571.8 kWh per year and a rainwater harvesting system collecting 70,675 L annually. The infrastructure is built with bamboo and locally sourced wood, renewable materials that ensure durability and low environmental impact. In addition, the design includes the reforestation of 17.92% of the total area and 3.46% of public spaces, incorporating native species such as Brazil nut, rosewood, and capirona to reinforce local biodiversity. Overall, this research demonstrates how low-carbon construction, renewable materials, and bioclimatic design can contribute to sustainable development, environmental awareness, and the preservation of natural ecosystems in tropical regions. Full article

Background: Patent ductus arteriosus (PDA) is a common congenital heart defect. While closure of hemodynamically significant PDAs is well established, closure of small, hemodynamically insignificant PDAs for prevention of infective endocarditis or endarteritis (IEE) remains controversial and is supported only by low-level evidence. Methods: A systematic PubMed search was performed in May 2025 to identify published case reports of PDA-associated IEE. Data on PDA characteristics, audibility, vegetation location, and causative pathogens were extracted. In addition, the annual national number of percutaneous PDA closures in The Netherlands was determined using data from the Dutch Society of Pediatrics. Finally, the literature was searched for the incidence of complications of percutaneous ductal closure. Results: Seventy-two PDA-IEE cases were identified, of which fifty-five reported PDA audibility. Most cases involved audible PDAs with high-velocity turbulent flow and vegetations at sites exposed to shear stress, particularly the main pulmonary artery. Silent PDAs demonstrated similar vegetation locations and flow characteristics, suggesting that they had comparable pathophysiology. National data showed an average of 76.6 percutaneous PDA closures annually, of which 61% were hemodynamically insignificant. Adverse events during percutaneous ductal closure occur in 23.3% of procedures and clinically significant complications are reported in 10.1%. Both audible and silent PDAs appear capable of promoting IEE through similar hemodynamic mechanisms. Conclusions: Given the low incidence of PDA IEE relative to procedural risks, the high number needed to treat and the associated costs, routine closure of non-hemodynamically significant PDAs solely for IEE prevention is not clearly justified, and no distinction should be made between audible and silent PDAs. The current guidelines warrant critical reassessment. Full article

The rapid expansion of commercial human spaceflight is forcing a re-examination of how we decide who is “fit to fly” in space. For more than six decades, astronaut selection has been dominated by government programmes employing stringent medical and psychological criteria designed to minimise risk for small cohorts undertaking long-duration, high-consequence missions. Contemporary standards such as NASA-STD-3001 reflect this paradigm, treating astronauts as highly trained national assets expected to perform reliably under extreme physiological and psychological stress. In contrast, commercial operators aim to fly large numbers of spaceflight participants with highly heterogeneous medical and psychological profiles, within regulatory frameworks that emphasise informed consent and currently impose very limited prescriptive health requirements on passengers. This review examines the evolution and structure of traditional astronaut selection, outlines emerging approaches to screening and certifying commercial spaceflight customers, and explores the conceptual and practical gap between “selection” and “screening”. Particular attention is given to the increasing relevance of behavioural and psychological risk in short-duration but high-stress commercial missions, where acute responses, passenger–crew interaction, and behavioural variability can influence safety, especially in mixed-capability crews. Drawing on agency standards, psychological selection research, and recent proposals for commercial medical guidelines, this paper proposes a risk-informed, mission- and role-specific framework that adapts lessons from government astronaut corps to the needs of commercial spaceflight. We argue that future practice must balance safety, inclusion, and commercial viability through proportionate, evidence-based risk management, supported by systematic data collection across government and commercial flights. Full article

Background/Objectives: The PEER beamline at the ANSTO Australian Synchrotron has been developed to enable VHEE FLASH radiotherapy studies, both dosimetric and biological. Featuring a 100 MeV electron linac, it delivers single or multi-pulse irradiations consisting of 100 ps bunches with a 2 ns spacing, resulting in average dose-rates and instantaneous dose-rates as high as ${10}^8$ Gy/s and ${10}^9$ Gy/s, respectively. Much work has been conducted to realise a stable accelerator facility, complete with the tooling and diagnostics required to undertake such studies. However, to truly confirm its suitability required a successful biological benchmarking. Methods: Three cell lines were irradiated utilising real-time dosimetry to compare linear quadratic cell survival curves with other facilities. Also, mouse cadavers were transported and irradiated, mimicking live animals, to assess the feasibility and logistics of small animal experiments. Results: By comparing the trends of the linear quadratic model, evident in the $\alpha$ and $\beta$ parameters, the PEER cell survival results were shown to be in agreement with VHEE results from the ARES beamline at DESY, Hamburg, Germany. Evident in the survival trends, VHEE produced more cell sparing in all cell lines compared to 2 Gy/s X-rays delivered on the IMBL, another beamline at the Australian Synchrotron. The results of the mouse cadaver irradiations showed that PEER can safely and efficiently irradiate small animals. Conclusions: The PEER beamline is shown to possess suitable capabilities, including real-time dosimetry, repeatable alignment, and linac diagnostics, rendering it suitable for future in vivo VHEE UHDR FLASH radiotherapy investigations. Full article

Background: Pulmonary inflammation is a widely recognized characteristic of active tuberculosis (TB). Although standard TB treatment is effective, a substantial proportion of mycobacteriologically cured TB patients experience persistent pulmonary inflammation, which can lead to long-term lung impairment, post-tuberculosis lung disease (PTLD) and potentially TB recurrence. Methods: We conducted a case–control study to compare host serum biomarker profiles in individuals with minimal (TLG < 50 SUVbw*mL, n = 37) versus extensive (TLG ≥ 50 SUVbw*mL, n = 34) persistent lung inflammation following completion of standard drug-sensitive TB treatment. Lung inflammation was measured by 18F-FDG PET/CT scan using total lung glycolysis (TLG) as a surrogate marker. All participants had negative sputum cultures at four months of TB treatment, and blood samples were collected at treatment completion (month six). A Luminex^® multiplex assay performed on the Bio-Plex^® 200 platform was used to analyze 48 host serum biomarkers involved in cytokine/chemokine signaling. Results: Following multiple t-test analysis, fifteen biomarkers were significantly elevated (p < 0.05) in participants with extensive persistent lung inflammation compared to those with minimal inflammation. Among these, 14 demonstrated potential as discriminatory markers, with area under the curve (AUC) values ranging from 0.707 to 0.806, sensitivities ranging from 47.06% to 73.53%, and specificities ranging from 70.27% to 83.78%. Notably, 13 of these 16 candidate biomarkers significantly correlated with TLG values, further supporting their potential clinical utility. Conclusion: We report associations between serum inflammatory mediators and persistent pulmonary inflammation following mycobacterial clearance in TB patients, highlighting their potential as diagnostic biomarkers that could potentially meet the target product profile (TPP) criteria. Full article

This study introduces the Balanced Bending Stiffness (BBS) method, a novel experimental approach to measure the intrinsic Mode-I interfacial fracture toughness (G_IC) in overmolded hybrid composites. Traditional testing methods for these asymmetric systems are complicated by inherent stiffness mismatches that couple opening and shearing failure modes, requiring complex post-analytical corrections. The BBS method addresses this challenge by engineering physically balanced Asymmetric Double Cantilever Beam (ADCB) specimens through comparative stiffness matching, isolating pure mode-I failure conditions and enabling direct toughness measurement. The method is validated using a glass fiber–reinforced polypropylene (GF/PP) system, with parametric studies investigating the effects of fiber content and processing temperatures on interfacial toughness for short-fiber (SFT) and long-fiber (LFT) thermoplastics. Results reveal that higher fiber content and substrate preheating significantly enhance toughness, with particularly strong results for LFTs due to fiber bridging. This work provides a framework for material characterization and insights into optimizing overmolded composite interfaces. Full article

Background/objectives: A rise in infections associated with carbapenem-resistant Providencia species (CRPS) has been observed worldwide. This study presents a genomic analysis of CRPS isolates from four hospitals in Croatia and the outpatient setting, in order to determine the extent of the spread of CRPS in Croatia. In the present study, we applied a combination of phenotypic characterization and molecular analysis of resistance traits to determine the mechanisms and the routes of spread of CRPS. Material and methods: The antibiotic susceptibility testing was performed using disk-diffusion and broth dilution methods. The nature of extended-spectrum β-lactamases (ESBLs), carbapenemases, and fluoroquinolone resistance determinants was investigated by polymerase chain reaction (PCR). In order to obtain an insight into the whole resistome, selected isolates were subjected to the Interarray Genotyping Kit CarbaResist and whole genome sequencing (WGS). Results: In total, 30 isolates were collected from four centers, located in different geographic regions of Croatia. There was uniform resistance to piperacillin-tazobactam, cefuroxime, expanded-spectrum cephalosporins (ESCs), imipenem, ertapenem, meropenem, and ciprofloxacin. Immunochromatographic testing and PCR revealed OXA-48 and NDM carbapenemase in 15 isolates, respectively. Phenotypic tests for ESBLs were positive in all OXA-48 and one NDM-positive organism (16 isolates). The isolates were categorized as extensively drug-resistant (XDR). OXA-48-producing isolates were susceptible only to ceftazidime-avibactam, whereas NDM producers were susceptible to cefiderocol and, in the majority of cases, also to amikacin. WGS identified a plethora of genes encoding resistance to aminoglycosides, such as aadA1 and aadA2, (aph(3″)-Ib and aph(6)-Id, sulfonamides sul1 and sul2, trimethoprim dfrA1, dfrA10, and dfrA12, tetracyclines tet(A) and tet(B), and chloramphenicol catA3 and catA5. Conclusions: Providencia spp., in spite of being a rare pathogen, should be included in the surveillance studies across the medical centers in Croatia. Full article

Background: People living with HIV (PLWH) have historically been excluded from cancer clinical trials, prompting the 2017 ASCO–Friends of Cancer Research recommendations to limit unjustified exclusions and promote equitable access. This study evaluated how Canadian Cancer Trials Group (CCTG) protocols align with these recommendations. Methods: We conducted a cross-sectional review of CCTG active trial protocols, abstracting HIV eligibility language and trial characteristics, and assessing associations using Chi-square tests. Results: Of 136 trials activated between 1999 and 2025, 81.6% involved solid tumors, 63.2% systemic therapy interventions, and 61.5% phase III designs. PLWH were included, not mentioned or excluded in 49/136 (36%), 55/136 (40.4%) and 32/136 (23.5%) respectively, with justification in 7/32 (21.9%). In multivariable analyses, exclusion was more likely in trials of immune checkpoint blockade therapy (p = 0.039) and those with industry support (p = 0.014). Adjusted models showed that both industry sponsorship and immune checkpoint blockade independently reduced HIV trial inclusion. Conclusions: Most CCTG-associated trials were inclusive or neutral toward PLWH; however, a proportion still excluded them, often without justification. This first national assessment evaluating adoption of ASCO Friends of Cancer Research–HIV guidance establishes a Canadian benchmark for equitable trial design and future research as both cancer and HIV therapies continue to evolve. Full article

Background and Objectives: Chest wall recurrence can occur infrequently after mastectomy in breast cancer patients. While wide excision of chest wall recurrence is indicated in operable patients without metastasis elsewhere, management of the axilla remains controversial. We reviewed the literature to determine the role of axillary staging in patients with a preoperative diagnosis of isolated chest wall recurrence. Materials and Methods: A PubMed search was performed for relevant articles dated between 1 January 2000 and 31 December 2024. Only English articles comprising female patients with invasive chest wall recurrence after mastectomy were included. Patients with concomitant metastasis elsewhere, no operation for recurrence and no oncological outcomes were excluded. The outcomes were compared between patients with or without axillary staging during recurrence. Results: A total of 15 studies with 485 eligible patients were analyzed. Of these patients, 242 (49.9%), 182 (37.5%), 53 (10.9%), and 8 (1.6%) patients had sentinel lymph node biopsy (SLNB), no axillary surgery, failed SLNB, and upfront axillary lymph node dissection (ALND), respectively, for restaging. Among operated patients with reported axillary status, 33/231 (14.3%) had metastatic nodes on axillary staging. On follow-up of 38.2 months (range: 10–61.2), 101/485 (20.8%) patients developed a second recurrence, of which 16/447 (3.6%) developed ipsilateral axillary recurrence. Ipsilateral axillary recurrence among patients with and without axillary surgery was 12/182 (6.6%) and 4/265 (1.5%), respectively. Conclusions: Ipsilateral axillary recurrence was low in patients with or without axillary restaging on medium-term follow-up. Due to the heterogeneity of the studies, larger studies with longer follow-up periods are needed to determine the best management for the axilla. Full article