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15 pages, 1603 KB  
Article
Semi-Synthesis of Chondroitin 6-Phosphate Assisted by Microwave Irradiation
by Fabiana Esposito, Sabrina Cuomo, Serena Traboni, Alfonso Iadonisi, Donatella Cimini, Annalisa La Gatta, Chiara Schiraldi and Emiliano Bedini
Polysaccharides 2026, 7(1), 11; https://doi.org/10.3390/polysaccharides7010011 (registering DOI) - 19 Jan 2026
Abstract
Chondroitin sulfate is a glycosaminoglycan polysaccharide, playing key roles in a plethora of physiopathological processes typical of higher animals. The position of sulfate groups within CS disaccharide subunits composing the polysaccharide chain is able to encode specific functional information. In order to expand [...] Read more.
Chondroitin sulfate is a glycosaminoglycan polysaccharide, playing key roles in a plethora of physiopathological processes typical of higher animals. The position of sulfate groups within CS disaccharide subunits composing the polysaccharide chain is able to encode specific functional information. In order to expand such a “sulfation code”, access to non-natural CS variants and mimics thereof can be pursued. In this context, an interesting topic concerns phosphorylated analogs of CS polysaccharides, as the replacement of sulfate groups with phosphates can lead to unreported activities of phosphorylated CS. In light of this, the phosphorylation reaction of a microbial-sourced, unsulfated chondroitin polysaccharide with phosphoric acid is reported in the present study, testing different microwave irradiation conditions and comparing them with conventional heating procedures. The obtained products were subjected to a detailed characterization, in terms of chemical structure and hydrodynamic properties, by 1D- and 2D-NMR spectroscopy and HP-SEC-TDA analysis, respectively. The characterization study showed how different reaction conditions can not only influence the regioselectivity and degree of phosphorylation but also trigger the formation of phosphate diester functionalities acting as cross-linkers between polysaccharide chains. The results from the screening presented in this work could be interesting for any research devoted to the regioselective phosphorylation of a polysaccharide. Full article
(This article belongs to the Collection Bioactive Polysaccharides)
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17 pages, 2331 KB  
Review
Pathways for SDG 6 in Japan: Challenges and Policy Directions for a Nature-Positive Water Future
by Qinxue Wang, Tomohiro Okadera, Satoshi Kameyama and Xinyi Huang
Sustainability 2026, 18(2), 994; https://doi.org/10.3390/su18020994 (registering DOI) - 19 Jan 2026
Abstract
Japan has largely achieved the “first half” of SDG 6—universal access to safe drinking water and sanitation—through decades of intensive investment in water supply and sewerage systems, implementation of the Total Pollutant Load Control System, and stringent regulation of industrial effluents. National indicators [...] Read more.
Japan has largely achieved the “first half” of SDG 6—universal access to safe drinking water and sanitation—through decades of intensive investment in water supply and sewerage systems, implementation of the Total Pollutant Load Control System, and stringent regulation of industrial effluents. National indicators show that coverage of safely managed drinking water and sanitation services is nearly 99%, and domestic statistics report high compliance rates for BOD/COD-based environmental standards in rivers, lakes, and coastal waters. Conversely, the “second half” of SDG 6 reveals persistent gaps: ambient water quality (6.3.2) remains at 57% (2023 data), while water stress (6.4.2) is at approximately 21.6%. Furthermore, SDG 6.6.1 shows that 3% of water basins are experiencing rapid changes in surface water area (2020 data), with ecosystems increasingly threatened by hypoxia in enclosed bays and climate-induced vulnerabilities. Drawing on global comparisons, this review synthesizes Japan’s progress toward SDG 6, elucidates the structural drivers for remaining gaps, and proposes policy pathways for a nature-positive water future. Using national statistics (1970–2023) and the DPSIR framework, our analysis confirms that improvements in BOD/COD compliance plateaued around 2002, reinforcing concerns that point-source measures alone are insufficient to address diffuse pollution, groundwater nitrate contamination, and emerging contaminants like PFAS. We propose six strategic directions: (1) climate-resilient water systems leveraging groundwater; (2) smart infrastructure renewal; (3) advanced treatment for emerging contaminants; (4) basin-scale IWRM enhancing transboundary cooperation; (5) data transparency and citizen engagement; and (6) scaled nature-based solutions (NbS) integrated with green–gray infrastructure. The paper concludes by outlining priorities to close the gaps in SDG 6.3 and 6.6, advancing Japan toward a sustainable, nature-positive water cycle. Full article
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10 pages, 1229 KB  
Proceeding Paper
Electromagnetic Field Parameters in the Coverage Area of a Base Station
by Miroslav Tomov, Michail Malamatoudis, Dimitrios Kazolis, Konstantinos Tramantzas and Stanimir Sadinov
Eng. Proc. 2026, 122(1), 21; https://doi.org/10.3390/engproc2026122021 (registering DOI) - 19 Jan 2026
Abstract
This paper presents an exploration of the electromagnetic field characteristics and parameters in the area of coverage of a particular base station, as well as the radio signal strength and the data speed values for optimal service. Although there are many investigations concerning [...] Read more.
This paper presents an exploration of the electromagnetic field characteristics and parameters in the area of coverage of a particular base station, as well as the radio signal strength and the data speed values for optimal service. Although there are many investigations concerning the influence of the electromagnetic field on the reactions of the people positioned in such areas and general impact on humans’ health, it is worth exploring some specific aspects of that problem. One of them is to focus the investigation on some particular radio frequency ranges. The second is to propose some practical consequences of the steps and ways to perform the measurements, with fast opportunity to collect the results and to compare them with identical measurements performed by different equipment or different algorithms for measurements. As a consequence, approaches should be developed to allow relatively accurate measurements of the electromagnetic background with devices more accessible to ordinary people instead of the expensive specialized measuring instruments used by specialists in this field. Such alternative methods of control of the electromagnetic flux radiation could help reliably to update the permissible parameters set in the existing regulations. Full article
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21 pages, 1923 KB  
Article
Preparedness Without Pedagogy? An AI-Assisted Web Scraping Analysis of Informal Online Disaster Preparedness Resources for the Public
by Sophie Lacher and Matthias Rohs
Educ. Sci. 2026, 16(1), 146; https://doi.org/10.3390/educsci16010146 (registering DOI) - 19 Jan 2026
Abstract
Informal learning increasingly occurs in digital environments, where citizens access, evaluate and apply knowledge outside of formal education. In the context of disaster preparedness, such informal learning is crucial for promoting individual and collective self-protection. This study examines how disaster preparedness knowledge is [...] Read more.
Informal learning increasingly occurs in digital environments, where citizens access, evaluate and apply knowledge outside of formal education. In the context of disaster preparedness, such informal learning is crucial for promoting individual and collective self-protection. This study examines how disaster preparedness knowledge is represented in German-language online resources, and how these materials can be categorised from an adult education perspective. An exploratory mixed-methods design combining expert-guided sampling, a qualitatively developed coding scheme, large-scale web scraping and AI-assisted classification was employed. A total of 7305 webpages were analysed in terms of actor type, topic, media format, and didactic design. The findings suggest that government and commercial organisations dominate the online preparedness landscape, with limited contributions from civil society and individuals. Thematically, most resources focus on general preventive measures and checklists, whereas scenario-specific and procedural content is underrepresented. Didactically rich and interactive formats are rare, with most materials relying on static, text-based communication. From an adult education perspective, these results suggest a gap between raising awareness and active learning. While online resources offer easy access to preparedness knowledge, they rarely facilitate deeper understanding, participation or collaborative learning. Methodologically, the study illustrates how AI-assisted analysis can combine qualitative interpretive depth with computational scalability in educational research. Full article
(This article belongs to the Special Issue Investigating Informal Learning in the Age of Technology)
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14 pages, 345 KB  
Article
Exploring the Diagnostic and Therapeutic Pathways of Women with Dyspareunia: A Mixed-Methods Study
by Joanna Wojtas, Zofia Sotomska, Marek Murawski and Magdalena Emilia Grzybowska
J. Clin. Med. 2026, 15(2), 787; https://doi.org/10.3390/jcm15020787 (registering DOI) - 19 Jan 2026
Abstract
Background/Objectives: This study explores the diagnostic and management pathways for dyspareunia in women seeking specialist care, focusing on gynecologists’ feedback and women’s perceptions of their experience. Methods: An online survey was conducted among 225 sexually active women to explore their perceptions [...] Read more.
Background/Objectives: This study explores the diagnostic and management pathways for dyspareunia in women seeking specialist care, focusing on gynecologists’ feedback and women’s perceptions of their experience. Methods: An online survey was conducted among 225 sexually active women to explore their perceptions of dyspareunia, its impact on relationships, and experiences with healthcare feedback, diagnosis, and treatment. The Numeric Rating Scale (NRS) for pain assessment and the Female Sexual Function Index (FSFI) were used. Gynecologists’ feedback was classified as positive, neutral, or negative based on its influence on the therapeutic pathway. Results: Of 78 women reporting dyspareunia, 12 with pain level ≥5 on NRS were selected for in-depth analysis. The mean pain score was 7.0 ± 1.53, with symptoms lasting from several months to over two years and occurring during most sexual encounters. The mean FSFI score was 24.86 ± 4.54, with half of the participants scoring within the sexual dysfunction range. Qualitative findings revealed frequent dismissive responses from healthcare professionals and limited access to appropriate management. Common self-management strategies included changing sexual positions and using lubricants, while half of the participants had not undergone a formal diagnostic process. Most frequent diagnoses were hormonal disorders and recurrent genital tract infections, and women were advised to undergo pharmacological treatment. Half of the participants were unaware of the possibility of physiotherapeutic management. Conclusions: Women with dyspareunia often face an inadequate diagnostic and therapeutic process. The care received is often insufficient and not aligned with a biopsychosocial model. Full article
(This article belongs to the Special Issue Current Trends in Urogynecology: 3rd Edition)
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20 pages, 1534 KB  
Article
Low-Cost DLW Setup for Fabrication of Photonics-Integrated Circuits
by André Moreira, Alessandro Fantoni, Miguel Fernandes and Jorge Fidalgo
Micromachines 2026, 17(1), 125; https://doi.org/10.3390/mi17010125 (registering DOI) - 19 Jan 2026
Abstract
The development of photonic-integrated circuits (PICs) for data communication, sensing, and quantum computing is hindered by the high complexity and cost of traditional fabrication methods, which rely on expensive equipment, limiting accessibility for research and prototyping. This study introduces a Direct Laser Writing [...] Read more.
The development of photonic-integrated circuits (PICs) for data communication, sensing, and quantum computing is hindered by the high complexity and cost of traditional fabrication methods, which rely on expensive equipment, limiting accessibility for research and prototyping. This study introduces a Direct Laser Writing (DLW) system designed as a low-cost alternative, utilizing an XY platform for precise substrate movement and an optical system comprising a collimator and lens to focus the laser beam. Operating on a single layer, the system employs SU-8 photoresist to fabricate polymer-based structures on substrates such as ITO-covered glass. Preparation involves thorough cleaning, spin coating with photoresist, and pre- and post-baking to ensure material stability. This approach reduces dependence on costly infrastructure, making it suitable for academic settings and enabling rapid prototyping. A user interface and custom slicer process standard .dxf files into executable commands, enhancing operational flexibility. Experimental results demonstrate a resolution of 10 µm, with successful patterning of structures, including diffraction grids, waveguides, and multimode interference devices. This system aims to transform PIC prototype fabrication into a cost-effective, accessible process. Full article
(This article belongs to the Special Issue Laser-Assisted Ultra-Precision Machining)
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2 pages, 111 KB  
Editorial
SynBio: Update on the Journal’s Definition, Aim, Scope, Requirements, and Recommendations for 2025
by Bernd H. A. Rehm
SynBio 2026, 4(1), 2; https://doi.org/10.3390/synbio4010002 (registering DOI) - 19 Jan 2026
Abstract
The open access journal SynBio [...] Full article
16 pages, 4013 KB  
Review
Single-Atom Site Photocatalysts Boosting Organic Synthesis: The Integration of a Metal Active Site and Photosensitive Unit
by Haoyue Sun, Yu Yang, Yanchang Liu, Dongxue Yang, Yichang Liu and Zaicheng Sun
Nanomaterials 2026, 16(2), 129; https://doi.org/10.3390/nano16020129 (registering DOI) - 19 Jan 2026
Abstract
Metallaphotoredox catalysis merges the powerful bond-forming abilities of transition metal catalysis with unique electron or energy transfer pathways accessible in photoexcited states, injecting new vitality into organic synthesis. However, most transition metal catalysts cannot be excited by visible light. Thus, prevalent metallaphotoredox catalytic [...] Read more.
Metallaphotoredox catalysis merges the powerful bond-forming abilities of transition metal catalysis with unique electron or energy transfer pathways accessible in photoexcited states, injecting new vitality into organic synthesis. However, most transition metal catalysts cannot be excited by visible light. Thus, prevalent metallaphotoredox catalytic systems require dual catalysts: a transition metal catalyst and a separate photosensitizer. This leads to inefficient electron transfer between these two low-concentration catalytic species, which often limits overall photocatalytic performance. Single-atom site catalysts (SASCs) offer a promising solution, wherein isolated and quasi-homogeneous transition metal sites are anchored on heterogeneous supports. When semiconductors are employed as the support, the photosensitive unit and transition metal catalytic site can be integrated into one system. This integration switches the electron transfer mode from intermolecular to intramolecular, thereby significantly enhancing photocatalytic efficiency. Furthermore, such heterogeneous catalysts are easier to separate and reuse. This review summarizes recent advances in the application of SASCs for photocatalytic organic synthesis, with a particular focus on elucidating structure–activity relationships of the single-atom sites. Full article
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24 pages, 1250 KB  
Article
A Smartphone-Based Application for Crop Irrigation Estimation in Selected South and Southeast Asia Countries
by Daniel Simonet, Ajita Gupta and Taufiq Syed
Sustainability 2026, 18(2), 990; https://doi.org/10.3390/su18020990 (registering DOI) - 18 Jan 2026
Abstract
Efficient irrigation planning in data-scarce regions remains challenging due to limited access to localized meteorological data, reliance on complex computer-based models, and the technical knowledge required to deploy them at the field scale. Hence, the need for accessible, smartphone-based tools that simplify soil [...] Read more.
Efficient irrigation planning in data-scarce regions remains challenging due to limited access to localized meteorological data, reliance on complex computer-based models, and the technical knowledge required to deploy them at the field scale. Hence, the need for accessible, smartphone-based tools that simplify soil water balance calculations using public data to support practical decision-making in resource-limited contexts. This smartphone-based application estimates Net and Gross Irrigation Requirements using a Soil Water Balance (SWB) framework. The app combines region-specific empirical formulations for Effective Rainfall (Pe) calculation. The application utilizes user-supplied crop and irrigation parameters and meteorological data available in the public domain and operates at multiple temporal scales (daily, 10-day, weekly, and monthly), thereby supporting flexible irrigation schedules. The performance of app was evaluated through simulation-based benchmarking against FAO-CROPWAT 8.0 using harmonized inputs across five representatives agro-climatic region: Central India, Southern Vietnam, Northern Thailand, Western Bangladesh, and Central Sri Lanka. Quantitative comparison showed deviations within ±5% for Effective Rainfall, crop evapotranspiration, Net Irrigation, and Gross Irrigation, and low mean bias values (−2.8% to +3.3%) show the absence of systematic over- or under-estimation compared to CROPWAT model. The application also demonstrated responsiveness to climatic variability. Although the validation is limited to few representative locations and assumed minimal runoff conditions, the results suggest that the proposed method is technically consistent and feasible in practice. This study demonstrates smartphone-based application as a decision support for field-level irrigation planning and water resource management, particularly in data-limited agricultural contexts. Full article
(This article belongs to the Section Sustainable Water Management)
35 pages, 22348 KB  
Article
Performance Assessment of Portable SLAM-Based Systems for 3D Documentation of Historic Built Heritage
by Valentina Bonora and Martina Colapietro
Sensors 2026, 26(2), 657; https://doi.org/10.3390/s26020657 (registering DOI) - 18 Jan 2026
Abstract
The rapid and reliable geometric documentation of historic built heritage is a key requirement for a wide range of conservation, analysis, and risk assessment activities. In recent years, portable and wearable Simultaneous Localization and Mapping (SLAM)-based systems have emerged as efficient tools for [...] Read more.
The rapid and reliable geometric documentation of historic built heritage is a key requirement for a wide range of conservation, analysis, and risk assessment activities. In recent years, portable and wearable Simultaneous Localization and Mapping (SLAM)-based systems have emerged as efficient tools for fast 3D data acquisition, offering significant advantages in terms of operational speed, accessibility, and flexibility. This paper presents an experimental performance assessment of three portable SLAM-based mobile mapping systems applied to the 3D documentation of historic religious buildings. Two historic parish churches in the Lunigiana region (Italy) are used as case studies to evaluate the systems under real-world conditions. The analysis focuses on key performance indicators relevant to metric documentation, including georeferencing accuracy, 3D model accuracy, point cloud density and resolution, and model completeness. The results highlight the capabilities and limitations of the tested systems, showing that all instruments can efficiently capture the primary geometries of complex historic buildings, while differences emerge in terms of accuracy, data consistency, and readability of architectural details. Although the work is framed within a broader research project addressing seismic vulnerability of historic structures, this contribution specifically focuses on the experimental evaluation of SLAM-based surveying performance. The results demonstrate that portable SLAM systems provide reliable geometric datasets suitable for preliminary documentation tasks and for supporting further multidisciplinary analyses, representing a valuable resource for the rapid 3D documentation of historic built heritage. Full article
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15 pages, 1101 KB  
Article
Dynamic Impacts of Rail Transit Investment on Regional Economic Development: A Spatial-System Dynamics Analysis of the Jiangsu Yangtze River City Cluster
by Minlei Qian and Lin Cheng
Sustainability 2026, 18(2), 986; https://doi.org/10.3390/su18020986 (registering DOI) - 18 Jan 2026
Abstract
The Jiangsu Yangtze River city cluster is a key growth pole of the Yangtze River Economic Belt, yet substantial disparities in development levels persist across cities, and the role of rail transit investment in fostering regional economic coordination remains insufficiently understood. This study [...] Read more.
The Jiangsu Yangtze River city cluster is a key growth pole of the Yangtze River Economic Belt, yet substantial disparities in development levels persist across cities, and the role of rail transit investment in fostering regional economic coordination remains insufficiently understood. This study aims to reveal the dynamic mechanisms through which railway transportation investment influences regional economic growth via population migration and service industry agglomeration, and to quantify the economic multiplier effects under different investment scenarios. Considering the close economic linkages among cities, spatial autocorrelation analysis is applied to assess intercity economic dependence, which provides the basis for developing a system dynamics model that links the rail transit system with the regional economy. Using data from eight core cities over the period 2014–2023, the model is employed to simulate long-term economic responses under different investment scenarios. The results indicate that increasing the rail transit investment ratio from 0.0077 to 0.02 is associated with an estimated 13.2% increase in regional GDP by 2030, with a corresponding economic multiplier of approximately 1.8, while simulation errors remain within 4.1–16.2% compared with historical data. The findings suggest that rail transit investment promotes regional growth through improved accessibility, factor agglomeration, and industrial upgrading, and that coordinated planning at the urban agglomeration scale is more effective than isolated city-level strategies. By integrating spatial dependence analysis with system dynamics modeling, this study offers a dynamic perspective on the regional economic impacts of rail transit investment. Full article
(This article belongs to the Special Issue Sustainable Transport Research and Railway Network Performance)
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23 pages, 472 KB  
Article
The Health and Physical Education Curriculum: Does It Address Muscular Fitness?
by Andrew Sortwell, Rodrigo Ramirez-Campillo, Urs Granacher, Christopher Joyce, Pedro Forte, Daniel A. Marinho, Ricardo Ferraz and Kevin Trimble
J. Funct. Morphol. Kinesiol. 2026, 11(1), 40; https://doi.org/10.3390/jfmk11010040 (registering DOI) - 18 Jan 2026
Abstract
Background: The World Health Organization and the Australian physical activity guidelines, in line with contemporary research, recommend regular muscle-strengthening activities for optimal muscular fitness in children and adolescents. However, the extent to which muscle-strengthening or muscular fitness receives curricular emphasis is unknown in [...] Read more.
Background: The World Health Organization and the Australian physical activity guidelines, in line with contemporary research, recommend regular muscle-strengthening activities for optimal muscular fitness in children and adolescents. However, the extent to which muscle-strengthening or muscular fitness receives curricular emphasis is unknown in Australia. Objectives: To examine to what extent the Australian Health and Physical Education Curriculum, Foundation to Year 10 (AHPEC; F–10) addresses and/or promotes muscular fitness. Methods: This study involved a mixed-methods content analysis of the AHPEC F–10 using: (i) conceptual analysis to identify muscular fitness-related terms; and (ii) relational analysis to examine alignment between muscular fitness content and curriculum rationale/aims. A search of national and international physical activity guidelines and school-based muscular fitness intervention literature generated a keyword set to guide abstraction from the AHPEC. Curriculum aim, rationale, level descriptions, achievement standards and content were coded to determine the extent to which muscular fitness was embedded. Intercoder reliability was established via consensus meetings. Muscular fitness content coverage was quantified as the proportion of directly aligned muscular fitness relevant content points per stage and aggregated primary (F–6), secondary (7–10), and F–10 scores. Results: A review of 32 national and one international physical activity guidelines identified 88 muscular fitness activities in total, with some activities appearing in multiple guidelines; 53.1% of national guidelines did not provide explicit muscular fitness examples, and where examples existed, they emphasised accessible modes (e.g., climbing, bodyweight tasks, jumping, and lifting). Additionally, analysis of school-based muscular fitness intervention literature identified 22 distinct muscular fitness activities to guide abstraction. Muscular fitness was absent in the AHPEC rationale and aims, was largely inferred in primary years level description and achievement standards and became more explicit in secondary achievement standards. Direct alignment of content with muscular fitness was non-existent or low across stages of learning (Foundation = 0%, Stage 1 = 0%, Stage 2 = 6.1%, Stage 3 = 9.1%, Stage 4 = 8.6%, Stage 5 = 8.8%). Overall, muscular fitness content coverage averaged 3.8% in primary, 8.7% in secondary, and 5.4% across F–10. Conclusions: The AHPEC treats muscular fitness as a low priority in primary schooling and a minor content area in secondary, yielding developmental messaging that is less aligned with contemporary evidence and physical activity guidelines. Full article
16 pages, 869 KB  
Article
A Retrospective Cohort Study to Determine COVID-19 Mortality, Survival Probability and Risk Factors Among Children in a South African Province
by Asongwe Lionel Ateh Tantoh, Makhutsisa Charlotte Mokoatle and Thokozani P. Mbonane
COVID 2026, 6(1), 20; https://doi.org/10.3390/covid6010020 (registering DOI) - 18 Jan 2026
Abstract
Numerous factors contributed to coronavirus 2019 (COVID-19) disease recovery and death rates. In many countries, socioeconomics, morbidities, the experience of symptoms and access to healthcare services are major contributors to recovery and death rates. A retrospective cohort study was conducted to determine the [...] Read more.
Numerous factors contributed to coronavirus 2019 (COVID-19) disease recovery and death rates. In many countries, socioeconomics, morbidities, the experience of symptoms and access to healthcare services are major contributors to recovery and death rates. A retrospective cohort study was conducted to determine the morbidity, mortality, survival probability, and risk factors associated with COVID-19 among children in the Free State province, South Africa. A total of 846 patients’ records were used in the study. Using SPSS version 28 software, survival probability was determined using Kaplan–Meier estimation curves and Cox regression was used to determine the effect of sociodemographics and clinical manifestation information on time of death. The COVID-19 mortality rate was 13.12% in our study. There were more female patients (60%) than male patients (40%). In total, 71 patients had two or more morbidities, while 414 patients were asymptomatic. Patients between 5 and 18 years old were at twice the risk of dying of COVID-19, and male children were at a higher risk as well. Having more than one symptom was also a risk for dying in this study. Severe COVID-19 is attributed to numerous factors, and these are closely associated with surrounding environments and public health systems. The findings are important for the clinical management of similar diseases and circumstances in the future. Full article
(This article belongs to the Special Issue Post-Acute Infection Syndromes: Lessons from Long COVID and Long Flu)
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36 pages, 1589 KB  
Systematic Review
Technology-Enabled (P)rehabilitation for Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analysis
by Tiffany R. Tsoukalas, Zirong Bai, Claire Jeon, Roy Huynh, Eva Gu, Kate Alexander, Paula R. Beckenkamp, Adrian Boscolo, Kilian Brown, Phyllis Butow, Sharon Carey, Fang Chen, Meredith Cummins, Haryana M. Dhillon, Vesna Dragoje, Kailey Gorman, Matthew Halpin, Abby Haynes, Ilona Juraskova, Sascha Karunaratne, Jamie Keck, Bora Kim, Cherry Koh, Qiang Li, Lara Lipton, Xiaoqiu Liu, Jaime Macedo, Rebecca Mercieca-Bebber, Renee Moreton, Rachael L. Morton, Julie Redfern, Bernhard Riedel, Angus Ritchie, Charbel Sandroussi, Cathy Slattery, Allan Ben Smith, Michael Solomon, Flora Tao, Kate White, Kate Wilson, Kahlia Wolsley, Kun Yu and Daniel Steffensadd Show full author list remove Hide full author list
Cancers 2026, 18(2), 296; https://doi.org/10.3390/cancers18020296 (registering DOI) - 18 Jan 2026
Abstract
Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity [...] Read more.
Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article
21 pages, 1794 KB  
Article
Assessing the Early Impact of InvestEU on Romanian SME Financial Performance
by Emanuel Ciobanu, Ana-Maria Torjescu, Ioana Polec and Carmen Păunescu
Sustainability 2026, 18(2), 982; https://doi.org/10.3390/su18020982 (registering DOI) - 18 Jan 2026
Abstract
This article examines how European funding enhances the financial performance of Romanian SMEs, a sector facing growing regulatory pressure, market volatility, and resource constraints. The study combines a thematic analysis of InvestEU indicators and national SME financing data (2021–2023) with a firm-level difference-in-differences [...] Read more.
This article examines how European funding enhances the financial performance of Romanian SMEs, a sector facing growing regulatory pressure, market volatility, and resource constraints. The study combines a thematic analysis of InvestEU indicators and national SME financing data (2021–2023) with a firm-level difference-in-differences model comparing InvestEU-funded SMEs to a matched control group over 2023–2024. The qualitative evidence shows that InvestEU operates at the EU level as a multidimensional policy instrument fostering competitiveness, social inclusion, and long-term economic and environmental development, while Romanian SMEs continue to rely predominantly on their own funds and national co-financing, a conservative pattern that ensures stability but limits access to external capital and transformative investments. Econometric results indicate that funded SMEs record, on average, higher turnover and net profit growth than comparable non-funded firms and confirm a strong positive association between firm size and financial performance; however, the interaction term capturing the specific InvestEU effect is positive but not statistically significant at the 95% confidence level. The findings suggest that InvestEU has the potential to act as a catalyst for structural change but also highlight the need for longer observation periods, larger samples, and more comprehensive development indicators to assess its medium-and long-term impact on SME competitiveness. Full article
(This article belongs to the Section Economic and Business Aspects of Sustainability)
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