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Search Results (219)

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19 pages, 581 KB  
Article
Order-Aware Energy Recycling for Backscatter-Aided Wireless-Powered Cooperative Communications
by Yuan Zheng, Dongqing Li and Huan Wan
Sensors 2026, 26(14), 4357; https://doi.org/10.3390/s26144357 - 9 Jul 2026
Viewed by 250
Abstract
In wireless-powered sensor networks, active uplink (UL) transmissions can support both sensed-data delivery and order-dependent RF energy recycling among energy-constrained devices. This paper studies a single hybrid access point (HAP) wireless-powered sensor network (WPSN), where one wireless device (WD) is selected as the [...] Read more.
In wireless-powered sensor networks, active uplink (UL) transmissions can support both sensed-data delivery and order-dependent RF energy recycling among energy-constrained devices. This paper studies a single hybrid access point (HAP) wireless-powered sensor network (WPSN), where one wireless device (WD) is selected as the relay, and the remaining WDs act as sources. The HAP first transfers wireless energy to all WDs in the downlink. Then, the source WDs reuse the incident wireless energy signal as a controllable carrier and deliver their information to the relay through passive backscatter communication. In the subsequent active uplink phase, the source WDs transmit according to an optimized order, while later scheduled sources recycle energy from the active signals transmitted by preceding sources. The source order therefore determines not only the transmission sequence but also the directed energy-recycling structure among source WDs, thereby reshaping the energy-causality constraints and the feasible transmit-energy region. The relay finally forwards the decoded source information to the HAP. To improve throughput fairness among sensor devices, a max-min throughput optimization problem is formulated by jointly designing the source transmission order, time allocation, and transmit-power allocation. For a given order, the continuous resource allocation problem is transformed into a convex problem through transmit-energy variables, and the optimal order is obtained by searching over all candidate orders. Numerical results show that the proposed scheme achieves higher minimum throughput than the three representative comparison schemes, demonstrating the benefit of jointly exploiting passive source-to-relay collection, relay-assisted forwarding, and order-aware energy recycling. Full article
(This article belongs to the Section Sensor Networks)
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21 pages, 1863 KB  
Article
Structural Design and Research Analysis of Shared Bicycle Collection and Transfer System
by Jipeng Wang, Sen Liu, Xinyue Jin, Yingxiao Yuan, Bing Shen, Naxi Zhou and Dexin Zhu
Appl. Sci. 2026, 16(13), 6735; https://doi.org/10.3390/app16136735 - 5 Jul 2026
Viewed by 274
Abstract
Shared bikes are frequently parked in disorder, resulting in low efficiency of manual collection and transfer and heavy workload for maintenance staff. Random parking across various areas forces shared bikes to occupy sidewalks and fire exits, damaging urban landscapes and disrupting traffic order. [...] Read more.
Shared bikes are frequently parked in disorder, resulting in low efficiency of manual collection and transfer and heavy workload for maintenance staff. Random parking across various areas forces shared bikes to occupy sidewalks and fire exits, damaging urban landscapes and disrupting traffic order. To tackle these industrial pain points, this paper develops an integrated intelligent robot system equipped with functions of multi-pose grasping, automatic transfer and fixed-point delivery of shared bikes, which can effectively address the drawbacks of low efficiency and high labor costs in traditional manual maintenance. This paper focuses on the completion of the robot’s overall mechanical structure design, stiffness–precision collaborative optimization model construction, finite-element static simulation verification, 1:7 scaled prototype development and performance testing. Firstly, the overall layout design of the multi-posture adaptive floating clamping mechanism, transfer-bearing frame, and Mecanum wheel omnidirectional mobile chassis is completed, and the structural parameters and assembly benchmarks of the core components are clarified. Secondly, a stiffness–precision coupling optimization model is established, and the static analysis under extreme load conditions is carried out through Abaqus finite-element software, which verifies the rationality of 45# carbon steel material selection and the safety of structural strength. Subsequently, a 1:7 scaled principle prototype is developed, and repetitive grabbing and transfer tests are carried out to verify the system operation feasibility, stability and grabbing accuracy. Finally, the statistical analysis of the test data and the horizontal comparison of similar schemes are completed. The test and simulation results show that the maximum stress of the system under extreme working conditions is 131.21 MPa, which is far lower than the allowable stress of 355 MPa of 45# steel, and the safety factor reaches 2.71. The maximum total deformation is 4.0552 mm, which is concentrated at the end of the front-end clamping mechanism, and is within the allowable stiffness deviation range of the transfer system. The average value of the single clamping positioning error of the scaled prototype is 0.476 mm, with a 95% confidence interval of 0.457–0.495 mm, which is converted to a positioning error of ≤3.4 mm for the full-scale prototype, which is far better than similar industry solutions. The average time of a single complete grabbing and transfer operation is 12.38 s, which is more than 45% higher than the traditional manual mode. The structural design, grabbing accuracy and operation stability of the robot designed in this paper all meet the requirements of actual working conditions of urban sidewalks, which can effectively reduce the intensity of manual labor and improve the operation and maintenance efficiency of shared bicycles. It has strong engineering application value and can provide reference for the design and manufacturing of intelligent collection and transfer systems for shared two-wheelers. Full article
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13 pages, 1023 KB  
Article
Impact of a Hospital Information System-Integrated Automated Dispensing Cabinet on Medication Use and Safety in a Tertiary Hospital Emergency Department: A Prospective Before-and-After Study
by Ryang Soon Lim, Woon-Jeong Lee, Hyen Oh La, Yun-Kyoung Song and Kyung Hee Choi
J. Clin. Med. 2026, 15(13), 4908; https://doi.org/10.3390/jcm15134908 - 24 Jun 2026
Viewed by 235
Abstract
Background/Objectives: Emergency departments (EDs) are particularly prone to medication errors because of urgent treatment environments and high decision density. Automated dispensing cabinets (ADCs) integrated with the hospital information system (HIS) may improve medication safety, yet real-world evidence in centralized-pharmacy settings remains limited. [...] Read more.
Background/Objectives: Emergency departments (EDs) are particularly prone to medication errors because of urgent treatment environments and high decision density. Automated dispensing cabinets (ADCs) integrated with the hospital information system (HIS) may improve medication safety, yet real-world evidence in centralized-pharmacy settings remains limited. This study evaluated the impact of an HIS-integrated ADC on medication use, medication errors, and nurses’ perception of safety in the ED of a Korean tertiary hospital. Methods: In this prospective before-and-after study, prescribing patterns, medication storage, and related costs were compared in the two months before (Phase 1; September–October 2019) and after (Phase 2; May–June 2020) ADC installation. Medication errors reported through the hospital safety incident reporting system were analyzed over corresponding 6-month windows from July 2019 to June 2020. Long-term sustainability was assessed using follow-up data collected from October to November 2023 (Phase 3), and all 46 ED nurses completed a 5-point Likert-scale survey on perceived medication safety. Results: Daily injectable prescriptions were unchanged (221.1 ± 34.6 vs. 227.7 ± 35.2; p = 0.301), whereas returned injectable prescriptions increased (17.9 ± 5.9 vs. 25.1 ± 6.0; p < 0.001) and non-injectable prescriptions decreased (163.1 ± 42.2 vs. 140.0 ± 22.7; p < 0.001). The number of medication items stored in the ED storage room declined by 95.6%, with a 92.5% reduction in related maintenance cost. Total medication errors decreased from 41 (74.5%) before to 14 (25.5%) after implementation (p < 0.001), with the largest reduction in delivery errors (17 [30.9%] to 2 [3.6%]). These improvements were sustained at the three-year follow-up. Nurses reported high overall satisfaction with medication safety (4.27 ± 0.62 on a 5-point Likert scale). Conclusions: Implementation of an HIS-integrated ADC in the ED was associated with improved prescription patterns, fewer reported medication errors, and enhanced perceived medication safety. In addition, these improvements were sustained over time, indicating stable and consistent implementation of the ADC system. Nurses also reported improved perceptions of medication safety. Full article
(This article belongs to the Special Issue Advancements in Emergency Medicine Practices and Protocols)
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11 pages, 583 KB  
Article
The Early Implementation of a Hub-and-Spoke Survivorship Pathway for Out-of-Hospital Cardiac Arrest Survivors: A 12-Month Formative Evaluation of the REVIVE Project
by Laura Calabrese, Marco Mion, Alice Mandrini, Roberto Primi, Sara Bendotti, Leila Ulmanova, Alessia Currao, Arianna Morena, Filippo Dossi, Leonardo Fogagnolo, Federica Pizzi, Cristian Fava, Daniele Ghiraldin, Alessio Battioni, Paola Genoni, Elena Maria Paola Madonini, Diego Maffeo, Cinzia Dossena, Silvia Affinito, Giovanni Bertazzoli, Marta Pellegrino, Gioele Papi, Silvia Frattini, Matteo Della Torre, Cecilia Fantoni, Angelica Praderio, Luca Tarantino, Salvatore Mongiovì, Pierluigi Politi, Simone Savastano, Enrico Baldi and All the LombardiaCARe Researchersadd Show full author list remove Hide full author list
J. Clin. Med. 2026, 15(12), 4722; https://doi.org/10.3390/jcm15124722 - 17 Jun 2026
Viewed by 319
Abstract
Background/Objectives: A structured follow-up after out-of-hospital cardiac arrest (OHCA) is recommended, but implementation across regional networks remains challenging. REVIVE introduced a hub-and-spoke survivorship pathway in Lombardy. This 12-month formative implementation evaluation aimed to describe staged pathway progression, operational reach, attrition points, centre-level variation, [...] Read more.
Background/Objectives: A structured follow-up after out-of-hospital cardiac arrest (OHCA) is recommended, but implementation across regional networks remains challenging. REVIVE introduced a hub-and-spoke survivorship pathway in Lombardy. This 12-month formative implementation evaluation aimed to describe staged pathway progression, operational reach, attrition points, centre-level variation, and documented barriers to assessment completion. Methods: Adult OHCA survivors with Cerebral Performance Category (CPC) 1–2 or Modified Rankin Scale (mRS) ≤ 3 were considered eligible. The evaluation was structured using Proctor et al.’s implementation outcomes framework. Implementation outcomes were operationalised using prospectively collected pathway indicators: eligibility ascertainment, successful contact, T0 assessment completion, completion of planned assessment components, timeliness where available, and documented reasons for non-progression. Analyses were descriptive and used chi-square or Fisher’s exact tests for unadjusted centre-level comparisons. Results: Of the 1663 patients hospitalised, 1458 (87.7%) were recorded as deceased or having an unfavourable neurological outcome and were therefore outside the intended REVIVE target population. Among the remaining 205 patients, eligibility could not be determined for 78 (4.7% of the total cohort), and 127 (7.6%) met eligibility criteria. Of eligible survivors, 96 (75.6%) were contacted and 64 completed the T0 assessment (66.7% of contacted; 50.4% of eligible). Pavia showed higher observed rates of eligibility ascertainment, contact, and assessment completion than spoke centres, but these differences were unadjusted and should be interpreted as centre-level implementation variation rather than evidence of causal superiority. Conclusions: REVIVE initiated a structured regional pathway for post-OHCA follow-up, but first-year implementation was partial rather than definitive. The 50.4% T0 completion rate among eligible survivors should be interpreted as an initial internal implementation indicator, not as evidence of established feasibility, effectiveness, or regional benchmarking. Priorities for further optimisation include eligibility ascertainment, transfer of contact information, patient engagement, and spoke-site support for assessment delivery. Full article
(This article belongs to the Special Issue Clinical Novel Research in the Management of Cardiac Arrest)
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18 pages, 862 KB  
Article
Addressing the Impacts of New Racism on Mental Health Service Use Among Culturally and Racially Marginalised (CaRM) Communities: A Q Methodology Study
by Eric Lim, Takeshi Hamamura, Jaya Dantas, Sender Dovchin, Stephanie Dryden and Ana Tankosić
Nurs. Rep. 2026, 16(6), 204; https://doi.org/10.3390/nursrep16060204 - 17 Jun 2026
Viewed by 395
Abstract
Background: Culturally and Racially Marginalised (CaRM) communities in Australia encounter subtle and covert forms of prejudice, commonly referred to as “new racism”. Within healthcare settings, these experiences can shape trust, engagement, and patterns of help-seeking. Mental health nurses are often the first point [...] Read more.
Background: Culturally and Racially Marginalised (CaRM) communities in Australia encounter subtle and covert forms of prejudice, commonly referred to as “new racism”. Within healthcare settings, these experiences can shape trust, engagement, and patterns of help-seeking. Mental health nurses are often the first point of contact in care delivery, and their ability to recognise, respond to, and mitigate the impacts of new racism is critical for fostering therapeutic relationships and supporting equitable access. Understanding how CaRM communities perceive the conditions that influence their mental health service use is fundamental for informing more equitable and culturally responsive care. Objective: This study explored the viewpoints of CaRM community members regarding the factors they consider important for addressing new racism in healthcare systems and supporting engagement with mental health services. Design: Q methodology was used to identify statistically derived viewpoints that reflect shared viewpoints about the conditions perceived as critical for addressing the impacts of new racism on mental health service use. Setting: Participants were recruited from culturally and linguistically diverse communities across Australia through community settings, social media, and professional networks. Participants: Thirty-five individuals from CaRM backgrounds completed the Q-sort. Methods: This Q methodology consisted of five steps: (1) set up of the Q-sorting instrument, (2) selection of participants, (3) data collection, (4) factor analysis, and (5) factor interpretation. Results: Three distinct viewpoints were identified: (1) raising awareness of mental health issues within CaRM communities (community-focused), (2) providing visible anti-racism and culturally safe services (service-focused), and (3) recognising and formally addressing new racism within healthcare systems (policy-focused). Conclusions: This study offers the first empirically derived, community-informed set of viewpoints on addressing new racism in Australian mental healthcare. While exploratory, the findings highlight multi-level considerations that are potentially relevant to mental health nursing practice, and may be useful to inform future research, policy development, and service redesign aimed at strengthening cultural responsiveness and equity in mental health systems. Full article
(This article belongs to the Section Mental Health Nursing)
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2 pages, 147 KB  
Abstract
Venom Biology of the Lesser Weever Fish: Intraspecific Variability, Bioactivity, and Biotechnological Potential
by Ricardo Estevens, Telma Luís, Samuel Ramos Pereira, Vera M. Mendes, Bruno Manadas, Carolina Madeira and Pedro M. Costa
Proceedings 2026, 146(1), 32; https://doi.org/10.3390/proceedings2026146032 - 17 Jun 2026
Viewed by 243
Abstract
Fish venom biology reaches far beyond addressing risks of human envenomation. The critical understanding of venom composition and the drivers that modulate it will enable scientists to deliver a span of novel bioresources with multiple potential biotechnological applications. The lesser weever fish ( [...] Read more.
Fish venom biology reaches far beyond addressing risks of human envenomation. The critical understanding of venom composition and the drivers that modulate it will enable scientists to deliver a span of novel bioresources with multiple potential biotechnological applications. The lesser weever fish (Echiichtys vipera), common in the surf of sandy beaches in Portugal, is a noteworthy case study due to frequent envenomation episodes during summer, albeit the lack of information regarding its venom system and the composition of its venom. We collected about one hundred animals from Costa da Caparica (W Portugal) as beach trawl (arte xávega) by-catch. Histology showed a similar essential microanatomical structure of glands in both venomous spines (dorsal and opercular) and no obvious gender differences. Transversal sections across the spines showed a T-shaped supportive bone structure that harbor masses of large, glandular cells that bear large sacculi. The structure is surrounded by a retractable layer of skin, thicker in the opercular spines comparatively to dorsal. The lack of muscular tissue near the glands and missing venom delivery ducts in the spines suggest that venom secretion in this species is holocrine, i.e., that venom is delivered through rupture of the skin and underlying glandular tissue upon mechanical pressure. Proteomics of the venomous spines (dorsal and opercular) showed a different proteomic signature between males and females, pointing to intersexual variation and suggesting that other biotic and abiotic factors might influence venom composition (maturation stage or geographic distribution). Additionally, protein homology matches performed against known toxins from marine venomous fishes indicated the presence of novel unexplored toxins in this species besides expected cytolysins. Our focus in the future is to identify, isolate and characterize the individual components of this venom. We anticipate new insights on the intraspecific adaptation of fish venom systems to specific ecological needs and advocate for sustainable bioprospecting for novel proteins with high biotechnological potential. Full article
(This article belongs to the Proceedings of The XI Iberian Congress of Ichthyology)
27 pages, 746 KB  
Article
Advancing Sustainable Healthcare in Obstetric and Maternity Nursing: Nurses’ Knowledge, Awareness, and Clinical Practice—A Cross-Sectional Study
by Mirfat Mohamed Labib Elkashif, Doaa Mostafa Sheashaa, Mohamed Sayed Abdellatif, Darelglal Ahmed Gassmelseed, Shimaa Mohamed Mohamed Koabar and Sally Abd-Elrahman Mohamed
Int. J. Environ. Res. Public Health 2026, 23(6), 734; https://doi.org/10.3390/ijerph23060734 - 30 May 2026
Viewed by 805
Abstract
Background: Sustainable healthcare in obstetric and maternity nursing emphasizes the provision of high-quality, safe, and environmentally responsible care for women and newborns. Nurses’ knowledge, awareness, and clinical practices are central to the implementation of sustainable approaches, including efficient resource management, evidence-based interventions, and [...] Read more.
Background: Sustainable healthcare in obstetric and maternity nursing emphasizes the provision of high-quality, safe, and environmentally responsible care for women and newborns. Nurses’ knowledge, awareness, and clinical practices are central to the implementation of sustainable approaches, including efficient resource management, evidence-based interventions, and patient education. Evaluating these dimensions is essential for identifying gaps, informing targeted training, and supporting sustainable and effective maternal care aligned with global health goals. Accordingly, this study aimed to assess obstetric and maternity nurses’ knowledge, awareness, and clinical practices related to sustainable healthcare. Method: A cross-sectional study design was employed. A convenience sampling technique was used to recruit obstetric and maternity nurses working in the selected study settings during the data collection period. A total sample of 120 participants was targeted. The study was conducted at Al-Azhar University Hospital in New Damietta and selected Family Medicine Centers in Damietta Governorate, Egypt. Data were collected using a structured, self-administered questionnaire developed specifically for this study to assess eco-conscious nursing practices in obstetrics and gynecology units. The questionnaire included sections addressing demographic and professional characteristics, knowledge and awareness of sustainable healthcare, eco-conscious clinical practices in maternity settings, perceived barriers and institutional support, attitudes and advocacy toward environmental sustainability, procedure- and material-related environmental concerns, and energy and water conservation behaviors. Responses were measured using standardized 5-point Likert and frequency scales, with composite scores calculated to categorize levels of knowledge, practices, and attitudes toward sustainability; higher scores indicated greater knowledge, awareness, and engagement in sustainable practices. Results: Overall, among the 120 nurses, of whom 62 (51.7%) had reported having heard about sustainability and received training about it, whereas 58 (48.3%) had not. Most participants held a bachelor’s degree (n = 54, 45.0%), nearly half had more than 10 years of nursing experience (n = 58, 48.3%), and the largest proportion worked in delivery rooms (n = 53, 44.2%). Regarding knowledge, attitude, and practice, good knowledge was observed in 61 participants (50.8%), good practice in 46 participants (38.3%), and positive attitudes in 108 participants (90.0%). The findings also showed that trained nurses in obstetrics and gynecology units demonstrated significantly higher knowledge, more positive attitudes, and better eco-conscious practices compared to untrained nurses across all domains (p < 0.001). Conclusions: The study demonstrates that maternity nurses showed moderate to high awareness and positive attitudes toward sustainability, while environmentally sustainable practices were less consistently implemented, indicating a clear knowledge–attitude–practice gap. Nurses who received sustainability-related training consistently achieved significantly higher knowledge, attitude, and practice scores than untrained nurses. Full article
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20 pages, 1981 KB  
Article
Methods of Optimizing the Supply Based on the Distribution Network with Implications for Sustainable Transport
by Jarosław Ziółkowski, Kajetan Płachta, Mateusz Oszczypała and Elżbieta Modrzecka
Sustainability 2026, 18(11), 5287; https://doi.org/10.3390/su18115287 - 25 May 2026
Viewed by 416
Abstract
This work explores the organization of a supply system within a military transportation network. The nodes of the studied network, comprising suppliers and recipients of supplies (representing delivery and collection points), were geographically identified, as well as the volume of cargo transported in [...] Read more.
This work explores the organization of a supply system within a military transportation network. The nodes of the studied network, comprising suppliers and recipients of supplies (representing delivery and collection points), were geographically identified, as well as the volume of cargo transported in each connection. The idea was to improve the efficiency of supply within the network, understood as minimizing total transportation costs. Calculations were performed using three methods: North–West Corner Method (N-WCM), least cost in the matrix method (LCMM), and Vogel’s Approximation Method (VAM). As a result of the calculations, basic feasible solutions (BFS) were obtained for each method, satisfying the constraint conditions. Each BFS was degenerate, because each contained m + n − 1 basic (non-zero) elements. In accordance with the calculation methodology, optimization was performed for each BFS using the potential method. For N-WCM and LCMM, up to five iterations were required, while for VAM, only one iteration was sufficient, confirming the best performance for this method. In addition to the total transport costs, additional criteria such as total distance, fuel consumption and CO2 emissions were considered. Full article
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17 pages, 4489 KB  
Review
Recent Advances in Responsive Microgels for Biomedical Application
by Hongtao Zhang, Wenkai Zhang and Yongfeng Gao
Bioengineering 2026, 13(6), 609; https://doi.org/10.3390/bioengineering13060609 - 23 May 2026
Viewed by 449
Abstract
Responsive microgels have emerged as a versatile class of soft materials for biomedical applications owing to their tunable physicochemical properties, high water content, and ability to respond dynamically to external and biological stimuli. This review summarizes recent advances in the design, synthesis, and [...] Read more.
Responsive microgels have emerged as a versatile class of soft materials for biomedical applications owing to their tunable physicochemical properties, high water content, and ability to respond dynamically to external and biological stimuli. This review summarizes recent advances in the design, synthesis, and biomedical utilization of responsive microgels, with a focus on their functional roles across key application domains. First, the fundamental principles governing microgel responsiveness and structure–property relationships are briefly introduced. The application of responsive microgels in controlled drug delivery is then discussed, highlighting stimulus-triggered release mechanisms, payload protection, and spatiotemporal control of therapeutic delivery. Advances in tissue engineering are reviewed with emphasis on microgel-based scaffolds, injectable constructs, and cell–matrix interactions that promote tissue regeneration. The use of microgels in biomedical imaging is examined, including their roles as contrast agents, signal amplifiers, and carriers for imaging probes. Finally, recent developments in microgel-enabled diagnostics are presented, showcasing their utility in biosensing, biomarker detection, and point-of-care platforms. The literature was selected based on the authors’ expertise, focusing on representative and recent studies, and identified through general academic databases and key references. Collectively, this review provides a comprehensive overview of the multifunctional capabilities of responsive microgels and discusses current challenges and future opportunities toward their clinical translation. Full article
(This article belongs to the Special Issue Smart Polymer Hydrogels for Advanced Biomedical Applications)
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29 pages, 821 KB  
Article
Optimisation of Fuzzy Reverse Logistics Networks for Express Packaging Considering Recycling Rates
by Kun Wang
Mathematics 2026, 14(10), 1764; https://doi.org/10.3390/math14101764 - 20 May 2026
Viewed by 389
Abstract
The recycling and reuse of discarded express delivery cartons can yield environmental, economic, and social benefits. A key factor influencing the volume of express packaging collected is the uncertainty in the total amount of such packaging within the service range of each collection [...] Read more.
The recycling and reuse of discarded express delivery cartons can yield environmental, economic, and social benefits. A key factor influencing the volume of express packaging collected is the uncertainty in the total amount of such packaging within the service range of each collection point. Additional uncertainties include the costs associated with the construction of recycling stations, operational expenses, transportation costs, additional recycling fees, and government subsidies. To address the issue of express packaging recycling, a fuzzy integer programming model for the reverse logistics network of express packaging is constructed. The model aims to minimise the total network cost and maximise the total recycling rate while enabling decisions regarding the location of recycling facilities and the flow between facilities. Then, a memetic algorithm based on dynamic local search is designed. Several alternative solution approaches were considered to evaluate the proposed algorithm, including the precision optimization method (CPLEX) and a hybrid priority-based genetic algorithm. The results confirm the feasibility of the memetic algorithm. Finally, the applicability of this fuzzy programming model is analysed and validated by changing the confidence level. The case study results reveal quantifiable trade-offs: as the confidence level (α) increases from 0.75 to 0.90 under a fixed recycling rate threshold (ε = 80%), the total network cost rises approximately linearly, while the required number of recycling stations increases, with their average facility level upgrading accordingly. Variations in confidence levels and the degree of total recycling rate achievement can significantly influence the increase in target values. Moreover, the magnitude of this influence exhibits irregularity, indicating that changes in confidence levels entail a certain degree of risk. Full article
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15 pages, 488 KB  
Article
Professional Fulfilment in Pharmacy: A Cross-Sectional Survey of Pharmacists in 17 European Countries
by Katarina Fehir Šola, Slaven Falamić, Maja Ortner Hadžiabdić and Piotr Merks
Pharmacy 2026, 14(3), 73; https://doi.org/10.3390/pharmacy14030073 - 14 May 2026
Viewed by 1714
Abstract
Background/Objectives: Pharmacists play an essential role in healthcare delivery across Europe, yet growing professional demands, organisational constraints, and evolving practice models may negatively affect job satisfaction and professional fulfilment. This study aimed to evaluate job satisfaction and professional perception among pharmacists across [...] Read more.
Background/Objectives: Pharmacists play an essential role in healthcare delivery across Europe, yet growing professional demands, organisational constraints, and evolving practice models may negatively affect job satisfaction and professional fulfilment. This study aimed to evaluate job satisfaction and professional perception among pharmacists across multiple European countries and to identify sociodemographic and workplace-related factors associated with these outcomes. Methods: A cross-sectional, web-based survey was conducted between October 2023 and January 2024 among licensed pharmacists from 17 European countries. Eligible participants were pharmacists employed in community pharmacies, hospitals, clinical pharmacy services, or the pharmaceutical industry. The questionnaire, developed and administered in English, collected sociodemographic and professional data and included two composite measures: the Job Satisfaction Scale (12 items) and the Pharmacist Professional Perception Scale (6 items). Responses were recorded using 5-point Likert scales. Descriptive statistics and inferential analyses were performed using SPSS version 27.0. Results: A total of 789 pharmacists participated (median age 40 years; 80.1% female). The mean job satisfaction score was 3.26 (SD 0.88), with the lowest scores related to staffing adequacy and salary, and the highest to collegial relationships. The mean professional perception score was 3.08 (SD 0.81), indicating moderate perceived professional recognition. Significant associations were identified between both scales and workplace setting, income level, employment status, geographical region, education, and professional experience (p < 0.05). Conclusions: In this multi-country convenience sample, pharmacists reported moderate levels of job satisfaction and professional perception, with variation across workplace and sociodemographic factors. These findings should be interpreted cautiously, as the sample is not representative of all European pharmacists; however, they suggest that staffing conditions, remuneration, professional recognition, and career development opportunities may be relevant areas for further investigation and policy attention. Full article
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7 pages, 219 KB  
Case Report
Early-Onset Group B Streptococcal Infection in Bichorionic/Biamniotic Twins Case Study: Is It Time for Changes in Laboratory Diagnosis and Prevention?
by Defkalion Karakalpakis, Sofia Kanatsou, Zoe Siateli, Kalliopi Pappa, Panagiotis Antsaklis, Anastasia Barbouni, Louis Gros and Ekaterina Charvalos
Acta Microbiol. Hell. 2026, 71(2), 10; https://doi.org/10.3390/amh71020010 - 30 Apr 2026
Viewed by 708
Abstract
Early-onset infection caused by Streptococcus agalactiae (Group B Streptococcus, GBS) may occur during gestation or delivery and can lead to severe neonatal sepsis, meningitis, or pneumonia. Discordant GBS infections in twin gestations are rare. We report a fatal case of early-onset GBS infection [...] Read more.
Early-onset infection caused by Streptococcus agalactiae (Group B Streptococcus, GBS) may occur during gestation or delivery and can lead to severe neonatal sepsis, meningitis, or pneumonia. Discordant GBS infections in twin gestations are rare. We report a fatal case of early-onset GBS infection in dichorionic–diamniotic twins conceived via IVF and delivered by caesarean section at 32 weeks’ gestation due to discordant fetal growth and abnormal Doppler indices in Twin A (Umbilical Artery PI = 1.4; Middle Cerebral Artery PI = 1.5). Twin A had Apgar scores of 3, 5, and 5 and rapidly developed tachycardia, respiratory distress, and systemic infection, while Twin B, with Apgar scores of 7, 8, and 9, remained clinically stable. Both infants were admitted to the NICU and underwent routine blood, urine, and cerebrospinal fluid testing. Despite the prompt initiation of parenteral ceftriaxone and respiratory support, Twin A deteriorated rapidly and died within 28 h. GBS was isolated from Twin A’s blood culture, and maternal placental tissue and high vaginal samples collected before antibiotic administration also grew GBS, with all isolates demonstrating identical antimicrobial resistance profiles. Molecular analysis revealed matching rib1 and alp2/3 gene patterns in isolates from the mother and Twin A. Maternal anovaginal immunochromatography at delivery was positive, whereas screening cultures obtained at 29 weeks’ gestation were negative. This case highlights the limitations of culture-based GBS screening in high-risk pregnancies and preterm deliveries and underscores the potential value of molecular assays and point-of-care testing to improve detection of S. agalactiae throughout pregnancy and the peripartum period. Emerging preventive strategies, including modulation of the genital microbiome and maternal vaccination aligned with WHO recommendations, may further reduce the burden of neonatal GBS disease. Full article
27 pages, 827 KB  
Systematic Review
Recent Rural Hospital Closures and Service Disruptions in the United States: A Rapid Systematic Review
by Annabella Bellard, Andrea Otti, Enoc Carbajal, Jaelyn Moore and Cristian Lieneck
Hospitals 2026, 3(2), 11; https://doi.org/10.3390/hospitals3020011 - 22 Apr 2026
Viewed by 3526
Abstract
Rural hospitals are essential access points for healthcare delivery in the United States, yet they continue to experience disproportionate rates of closure and service disruption that threaten community health, economic stability, and equity. This rapid systematic review synthesizes recent peer-reviewed evidence examining rural [...] Read more.
Rural hospitals are essential access points for healthcare delivery in the United States, yet they continue to experience disproportionate rates of closure and service disruption that threaten community health, economic stability, and equity. This rapid systematic review synthesizes recent peer-reviewed evidence examining rural hospital closures and service disruptions, with emphasis on financial, policy, workforce, and performance-related factors and their downstream impacts. Guided by PRISMA methodology, four databases were searched for U.S.-based studies published between January 2024 and June 2025. Following screening and consensus-based review, 59 articles met inclusion criteria. Across studies, financial vulnerability, characterized by revenue instability, low patient volumes, unfavorable payer mix, and reliance on non-operating revenue, emerged as a dominant precursor to closure and service reductions. Policy context, particularly Medicaid expansion status, telehealth and broadband infrastructure, and reimbursement adequacy, strongly shaped hospital sustainability. Closures and service disruptions were consistently associated with increased travel distances, reduced access to maternal, surgical, mental health, and chronic care services, higher prices at surviving hospitals, and increased strain on remaining providers. Workforce shortages further compounded these challenges. Collectively, findings demonstrate that rural hospital closures reflect interconnected structural weaknesses rather than isolated organizational failure. Coordinated policy action, targeted financial stabilization, workforce development, and technology-enabled care models are necessary to mitigate continued erosion of rural healthcare access. Full article
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17 pages, 11390 KB  
Article
Dual Oncogenic Mechanisms of Clonorchis sinensis-Derived Csi-miR-125a in Promoting Cholangiocarcinoma Progression via BAK1 Targeting and ERK Activation
by Aoxun Wu, Anyuan Xu, Linya Huang, Shu Fang, Chunyan Xu, Chenlin Huang, Xiaowen Pan, Meiyu Li, Zifeng Zhong, Yinjuan Wu and Xuerong Li
Parasitologia 2026, 6(2), 22; https://doi.org/10.3390/parasitologia6020022 - 21 Apr 2026
Viewed by 659
Abstract
Cholangiocarcinoma (CCA) is an aggressive malignancy with a poor prognosis that is strongly associated with chronic Clonorchis sinensis (C. sinensis, Cs) infection; however, its underlying molecular mechanisms remain elusive. Recent studies suggest that C. sinensis-derived extracellular vesicles (Cs [...] Read more.
Cholangiocarcinoma (CCA) is an aggressive malignancy with a poor prognosis that is strongly associated with chronic Clonorchis sinensis (C. sinensis, Cs) infection; however, its underlying molecular mechanisms remain elusive. Recent studies suggest that C. sinensis-derived extracellular vesicles (CsEVs) play a crucial role in host–parasite interactions and in shaping the tumor microenvironment during infection. Acting as key delivery vehicles, these CsEVs can transfer specific functional molecules, such as microRNAs (miRNAs), to host cholangiocytes, thereby modulating cellular behaviors—a process that may represent a significant pathway in parasite-induced carcinogenesis. Despite this, the specific miRNAs shuttled by CsEVs and their concrete functions and mechanisms in driving CCA proliferation and metastasis remain largely unexplored. To this end, we investigated Csi-miR-125a, a miRNA abundantly expressed in CsEVs, aiming to systematically elucidate its dual regulatory functions in CCA progression. Our findings offer novel mechanistic insights into host–parasite crosstalk, further the understanding of CCA pathogenesis, and point to potential therapeutic avenues. Using gain-and loss-of-function approaches in RBE and HuCCT1 cell lines, we demonstrated that Csi-miR-125a promotes cell proliferation by accelerating cell-cycle progression and suppressing apoptosis through direct targeting of BAK1. Concurrently, Csi-miR-125a enhances the migratory and invasive capacities of CCA cells via activation of the ERK signaling pathway. In a BALB/c nude mouse lung metastasis model, CsEVs depleted of Csi-miR-125a significantly inhibited pulmonary metastasis. Collectively, This study found that Csi-miR-125a derived from C. sinensis can regulate apoptosis and cell cycle progression by targeting BAK1, thereby promoting the proliferation of cholangiocarcinoma cells; meanwhile, it enhances cell migration and invasion by activating the ERK signaling pathway. These results suggest that Csi-miR-125a participates in and promotes the malignant progression of CCA. However, given its high homology with human endogenous miR-125a, its function may partially overlap with host endogenous miRNAs, rather than representing a completely independent carcinogenic effect. These findings provide mechanistic insights into host–parasite interactions during C. sinensis infection and lay a theoretical foundation for subsequent targeted intervention studies. Full article
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29 pages, 4820 KB  
Review
From Phytotoxin to Cell-Death Probe: Ophiobolin A and Related Sesterterpenoids in Membrane Stress and Non-Apoptotic Cell Death
by David Aebisher, Izabella Wilk and Dorota Bartusik-Aebisher
Molecules 2026, 31(7), 1206; https://doi.org/10.3390/molecules31071206 - 5 Apr 2026
Viewed by 965
Abstract
Ophiobolin A is a fungal sesterterpenoid initially characterised as a phytotoxin but progressively investigated for its biomedical significance due to its potent and mechanistically characteristic cellular activities. In this review, Ophiobolin A is discussed within the wider landscape of natural products as a [...] Read more.
Ophiobolin A is a fungal sesterterpenoid initially characterised as a phytotoxin but progressively investigated for its biomedical significance due to its potent and mechanistically characteristic cellular activities. In this review, Ophiobolin A is discussed within the wider landscape of natural products as a source of bioactive molecular scaffolds, and current knowledge on its structural features, biosynthesis, chemical synthesis, semi-synthetic modification, and in vitro biological applications is summarised. Evidence drawn from chemical, biochemical, and cell biology studies is integrated to describe the distinctive 5-8-5 tricyclic scaffold, the electrophilic dicarbonyl motif, and their roles in covalent modification of cellular components. Collectively, the reviewed evidence underscores that Ophiobolin A and its derivatives trigger both apoptotic and non-apoptotic cell death pathways. These include paraptosis-like death, which is a regulated form of cell death not associated with apoptosis that is defined by major cytoplasmic vacoulisation. This commonly occurs in apoptosis-resistant cancer models via disruption of membrane lipid homeostasis, calmodulin-dependent signalling, mitochondrial function, and proteostasis. Structure–activity relationship studies show that modulation of electrophilicity, oxidation state, and peripheral functionality enables tuning of potency, selectivity, and traceability while retaining key phenotypes. In addition to anticancer effects, antimicrobial and anti-inflammatory activities are also briefly summarised. Taken together, the literature supports Ophiobolin A as a useful molecular probe for considering cell death mechanisms and as a chemically complex yet suitable starting point for derivative development, while reinforcing the need for improved selectivity, delivery strategies, and in vivo validation to further translational potential. Full article
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