Search Results (56,835)

Background and Objectives: Healthcare workers are at heightened risk of SARS-CoV-2 infection. Understanding the duration and protective value of vaccine-induced immunity is critical to inform booster strategies. This study investigates longitudinal dynamics of anti-SARS-CoV-2 receptor-binding domain IgG (anti-RBD IgG) antibodies and their association with infection risk among vaccinated healthcare workers. Materials and Methods: A prospective cohort study was conducted at Vilnius University Hospital Santaros Klinikos, Lithuania. A total of 1778 healthcare workers who completed a primary COVID-19 vaccination series were followed. Blood samples were collected every three months to measure anti-RBD IgG levels. Participants also received up to three booster doses. COVID-19 was identified by PCR, antigen tests, or positive anti-nucleocapsid IgG. For serologically detected cases, infection timing was assigned to the interval between study visits. Antibody dynamics were analyzed across vaccination stages, time, age groups, and circulating SARS-CoV-2 variants. Results: Anti-RBD IgG titers peaked in the first quarter after primary vaccination (mean 7904 AU/mL), declined sharply by quarters 2–3, and rose substantially after booster doses. Following the first booster, titers increased to ~12,598 AU/mL in quarter 1 and continued rising through quarter 3. The highest levels were observed after the second booster (24,456 AU/mL in Q1), followed by gradual decline. A high-titer plateau persisted from quarters 6 to 9 (~21,000 AU/mL), followed by decline in quarters 10–11 and partial rebound in Q12. Approximately 49.6% of participants experienced COVID-19 during follow-up. Antibody response patterns were similar across age groups, with only minor transient differences. Conclusions: COVID-19 booster doses significantly enhance and prolong humoral immunity in healthcare workers compared with the primary vaccination series. However, antibody waning over time emphasizes the need for timely boosters, particularly during periods of variant circulation. These findings support continued booster vaccination and monitoring of long-term immune protection, although anti-RBD IgG should be interpreted as a surrogate marker of humoral rather than overall immunity. Full article

Background/Objectives: Adenomyosis is a common disorder of the uterus in those of reproductive age. Robotic-assisted surgery has been adopted to address the technical challenges of adenomyomectomy. This systematic review evaluated the current evidence regarding the feasibility, safety, and clinical outcomes of robotic-assisted conservative surgery for uterine adenomyosis. Methods: A systematic review of literature was performed on five databases, from the beginning to 21 December 2025, to identify studies reporting robotic-assisted uterus-sparing surgical approaches to adenomyosis. Data were collected on patient characteristics, surgical techniques used, pre- and post-operative pain, fertility outcomes, and complications. Risk of bias was evaluated using the ROBINS-I framework. Results: A total of 514 articles were found; six studies met the inclusion criteria. Most included studies were small and retrospective. The operative time ranged from 279 to 147 min. Mean blood loss ranged between 25 and 296 mL with a low rate of conversion and perioperative complications. Dysmenorrhea improved after surgery as reflected by the post operative visual analog scale pain score and serum CA-125 level. Few reproductive data were collected about successive spontaneous pregnancies. Risk of bias was serious or moderate in all studies included. Conclusions: Robotic-assisted conservative surgery for adenomyosis may represent a feasible and safe option for women with symptomatic adenomyosis who wish preserve the uterus, with a positive impact on patients’ symptoms. Large prospective, multicenter studies with standardized protocols and long-term follow-up are needed to clarify the real impact of robotic surgery in adenomyosis management. Full article

Ventilation air methane (VAM) has an extremely low concentration, making its abatement exceptionally challenging. Catalytic oxidation offers a promising route for VAM treatment, but industrial application requires integrated catalysts with high activity and efficient mass transfer. In this study, a novel straight-channel NiO/CeO₂ ceramic reactor was fabricated via mesh-assisted phase inversion, with NiO content systematically optimized to screen the optimal ratio. The 60 wt% NiO was the optimal composition, exhibiting excellent VAM oxidation performance. Brunauer–Emmett–Teller (BET) analysis confirmed that this optimal ratio yielded the largest specific surface area. Furthermore, H₂-temperature-programmed reduction (H₂-TPR) and X-ray photoelectron spectroscopy (XPS) confirmed that this optimal ratio facilitated the formation of abundant NiO–CeO₂ active interfaces, effectively inducing surface Ce³⁺ species and oxygen vacancies. These merits significantly enhanced the reactor’s oxygen adsorption capacity and redox properties, thus realizing efficient methane activation in catalytic oxidation. Moreover, the optimal reactor successfully passed 10 thermal cycle tests, further verifying the thermal stability of the catalytic structure. In addition, it exhibited outstanding long-term stability during a 100 h test, with no carbon deposition or active phase sintering observed. This work develops an optimized straight-channel NiO/CeO₂ ceramic reactor and offers a practical and scalable design strategy for VAM oxidation. Full article

Concerns regarding the safety, environmental impacts, and long-term sustainability of pesticide-dependent crop protection have intensified interest in biological control, which suppresses pest populations using natural enemies (predators, parasitoids, and pathogens) within integrated pest management (IPM) programs. This bibliometric study maps the development of biological control research from 2000 to 2025 using records retrieved from the Web of Science Core Collection. The publication trends, collaboration structures, leading countries and institutions, core journals, keyword co-occurrence and clustering, citation bursts, and influential cited references were examined using CiteSpace and VOSviewer. The results show a pronounced increase in publication output after 2011, indicating rapid expansion and consolidation of the field in the last decade. Keyword analyses reveal a thematic shift toward ecosystem-based framing, reflected by the growing prominence of terms such as ecosystem services, habitat management, and ecological intensification, which emphasize landscape- and management-oriented approaches to enhancing pest suppression. Cited-reference patterns highlight the persistent influence of the foundational literature on habitat manipulation, landscape complexity, and conservation biological control. Despite the field’s growth, research gaps remain in integrating biological control with emerging bioengineering tools and explicitly accounting for climate-driven variability across regions and production systems. Full article

Kuwait experiences persistently high levels of air pollution driven by industrial emissions, transportation, oil-related activities, and frequent desert dust storms. This study aims to synthesize and critically evaluate the available evidence on the relationship between air pollution, Air Quality Index (AQI), and health outcomes in Kuwait using a guided narrative review approach. A guided literature search identified 26 peer-reviewed studies published between 2014 and 2026 about Kuwait air pollution, which were assessed for methodological characteristics, pollutant types, health outcome categories, and vulnerable populations. The most frequently examined pollutants were particulate matter (PM_2.5: 69%; PM₁₀: 38%), followed by NO₂ (23%), multi-pollutant and AQI-based (19%), O₃ (12%), SO₂ (12%), VOCs and PAHs (8%). Health-related investigations most commonly addressed mortality and respiratory morbidity, while cardiovascular, metabolic, biomarker-based, and cancer-related outcomes were less frequently represented. Among studies reporting direct health outcomes, elevated PM_2.5 exposure was generally associated with increased risks of respiratory hospitalizations, cardiovascular events, and all-cause mortality. Susceptible populations identified across the literature include children, older adults, individuals with pre-existing chronic conditions, and outdoor workers, who may experience higher exposure levels and greater health vulnerability. However, a substantial proportion of the included studies focused primarily on exposure characterization or pollutant modeling without direct assessment of health outcomes. These studies nonetheless indicate consistently elevated pollutant levels and seasonal variability, which may plausibly contribute to population health risks. Overall, while the available Kuwait-specific evidence suggests potential adverse health effects linked to air pollution, the strength of direct epidemiological evidence remains limited. Important gaps persist, including the scarcity of long-term cohort studies, limited multi-pollutant analyses, and insufficient integration of AQI categories with health outcomes. These limitations highlight the need for more robust and longitudinal research to better quantify health risks and inform public health policy in Kuwait. Full article

To investigate the mitigation of high-pressure CO₂-induced degradation of wellbore cement sheath in Carbon Capture, Utilization, and Storage–Enhanced Oil Recovery applications (CCUS-EOR), conventional Class G oil well cement and modified cement systems incorporating graphene, waterborne epoxy resin, and a composite of waterborne epoxy resin with graphene were formulated. This study presents the original comparative investigation on the long-term carbonation resistance of graphene-modified, waterborne-epoxy-modified, and their composite-modified oil well cements under 130 °C and 7 MPa CO₂ partial pressure, filling the research gap of unclear synergistic effects of the two modifiers in high-temperature CCUS environments. The specimens were subjected to simulated downhole conditions, and key properties, including compressive strength and permeability, were evaluated. The underlying mechanisms were elucidated through material characterization techniques such as X-ray diffraction, X-ray computed tomography, and scanning electron microscopy. Results indicated that the waterborne epoxy resin–modified cement system exhibited superior long-term carbonation resistance, achieving a 90 d compressive strength retention rate of 84%. The graphene-modified cement showed a 90 d compressive strength retention rate of 65%, while the waterborne epoxy–graphene composite system only retained 39.7% of its compressive strength at 90 d due to negative synergistic effects. The enhanced durability of the waterborne-epoxy-modified cement is attributed to the formation of a continuous polymeric film, which acts as a protective barrier against CO₂ penetration. This study provides valuable insights for the design of CO₂-resistant cement systems in CCUS-EOR environments. Full article

The recycling of waste clay bricks as raw materials for cement-based materials presents an effective solution to ecological pollution and resource shortages. Previous research has separately examined the effects of recycled brick fine aggregate and recycled brick powder on mortar or concrete, but few studies have investigated their combined use. This study aims to clarify the synergistic effect of recycled brick fine aggregate (RBA) and recycled brick powder (RBP) on mortar performance, quantify the influence of the RBP substitution rate on hydration characteristics and microstructural evolution, and determine the optimal mix proportion and curing system for fully recycled brick mortar. Mortar was prepared using 100% RBA and RBP at substitution rates of 0%, 10%, 20%, and 30%. The physical properties, mechanical performance, and durability of the mortar were evaluated, alongside an analysis of its microstructural morphology, mineral composition, and pore structure. The results indicate that adding an appropriate amount of RBP helped maintain the flowability of the mortar. As the RBP substitution rate increased, the mortar strength generally decreased in the early stages, but long-term curing (≥90 days) effectively mitigated this decline. The inclusion of RBP improved chloride ion permeability, with the 20% substitution rate achieving a favorable balance between compressive strength, fluidity, and durability without significantly affecting carbonation resistance. Microstructural analysis revealed that RBP regulated the morphology of hydration products and optimized the pore structure of the mortar, while the mineral composition of hydration products was similar to that of natural mortar. These findings provide a theoretical basis and technical support for the high-value utilization of construction and demolition waste in cement-based materials. Full article

Oxidative stress and gut microbiota dysbiosis establish a self-perpetuating loop that disrupts epithelial barrier integrity and fuels chronic inflammatory and metabolic disorders, including inflammatory bowel disease (IBD), metabolic syndrome (MS), and chronic kidney disease (CKD). This systematic review synthesizes mechanistic, preclinical, and clinical evidence linking reactive oxygen species (ROS), microbiota-derived metabolites, and host redox homeostasis, with a focus on probiotic-based interventions. Comprehensive searches of PubMed, Scopus, Web of Science, and Google Scholar (2000–March 2026) identified in vitro, animal, and human studies, as well as systematic reviews and meta-analyses, assessing oxidative biomarkers, microbiome profiles, and barrier function outcomes. Probiotic strains, predominantly Lactiplantibacillus, Bifidobacterium, and emerging next-generation taxa, attenuate oxidative stress by inducing antioxidant enzymes [superoxide dismutase (SOD), glutathione peroxidase (GPx)], activating Nrf2 signaling, and restoring short-chain fatty acid (SCFAs) production, thereby lowering malondialdehyde (MDA) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) while enhancing total antioxidant capacity (TAC). At the mucosal interface, probiotics strengthen tight junction proteins, suppress NF-κB-mediated cytokine release, and mitigate dysbiosis, contributing to clinically meaningful improvements in disease activity, insulin sensitivity, and uremic toxin burden along gut–liver, gut–kidney, and other gut–organ axes. Overall, current evidence supports probiotics and synbiotics as promising adjuncts for nutrition-driven redox modulation, while highlighting the need for strain-resolved, multi-omics, multicenter trials with standardized redox and microbiome endpoints to optimize dosing strategies and long-term safety. Full article

The multi-cycle high-rate injection and production operations in Underground Gas Storage (UGS) facilities converted from depleted fracture-pore carbonate gas reservoirs induce complex rock–fluid interactions that threaten long-term integrity and performance. This study experimentally investigates the petrophysical responses of the Xiangguosi (XGS) UGS carbonate reservoirs in China using multi-cycle stress sensitivity tests, fines migration experiments, and water evaporation–salt precipitation analyses. SEM observations distinguish the contributions of crack closure and matrix compression to permeability evolution. Results show a sharp contrast in mechanical damage: high-quality rocks present negligible permanent deformation (<8% Young’s modulus reduction), whereas poor-quality rocks suffer catastrophic deterioration (>60%). Fines migration exhibits a three-stage behavior under cyclic flow, with water saturation significantly aggravating permeability impairment. A critical salinity threshold (220,000 ppm) is identified for the transition between drying-enhanced storage and salt plugging. Permeability declines sharply despite a slight porosity increase due to selective salt clogging of key pore throats, revealing a clear porosity–permeability decoupling. Salt deposition under movable water conditions can reduce UGS capacity by up to 1.45%. Reservoir heterogeneity, microfractures, karst structures, and initial petrophysical properties dominate the storage and flow space evolution. This work provides a predictive framework for optimizing injection–production strategies and improving the performance of complex carbonate UGS. Full article

Background/Objectives: The optimal management of anterior cruciate ligament (ACL) rupture remains debated, especially regarding long-term outcomes after early ACL reconstruction (ACLR) versus rehabilitation-first with optional delayed ACLR. The interpretation of randomized evidence is complicated by frequent treatment crossover. This review synthesized evidence from randomized controlled trial (RCT) cohorts comparing surgical versus rehabilitation-first management strategies across available follow-up durations. Methods: A structured review based on a systematic literature search and narrative synthesis was conducted, with study identification and reporting guided by PRISMA 2020. MEDLINE (via PubMed) and Google Scholar were searched in February 2026 for English-language human RCTs (2000–2026) comparing early ACLR plus rehabilitation with rehabilitation-first management allowing delayed ACLR for persistent instability. A linked-report PubMed search using the KANON trial registration number (ISRCTN84752559) was additionally performed to identify cohort-derived follow-up publications. Reports were grouped by underlying RCT cohort. Data were extracted on crossover, follow-up, and clinical outcomes. Risk of bias for primary RCT reports was assessed with Cochrane RoB 2. Results: Twenty-seven reports representing three RCT cohorts (KANON, COMPARE, ACL SNNAP) were included; six index reports were prioritized for synthesis. In acute ACL rupture (KANON, COMPARE), early ACLR did not show a consistent long-term superiority in patient-reported outcomes versus rehabilitation-first with optional delayed ACLR, although COMPARE reported a statistically significant 2-year subjective functional difference favoring early ACLR; early ACLR more consistently improved mechanical stability and reduced instability episodes. Crossover from rehabilitation to delayed ACLR was common. In non-acute ACL injury with persistent symptomatic instability (ACL SNNAP), surgery-first improved 18-month patient-reported outcomes. Meniscal procedure rates and osteoarthritis-related outcomes did not consistently favor early ACLR. Conclusions: In acute ACL rupture, rehabilitation-first with timely access to delayed ACLR appears to provide long-term patient-reported outcomes comparable to an early ACLR strategy in many patients, while early ACLR more consistently improves knee stability. In non-acute symptomatic ACL deficiency, a surgery-first strategy appears more effective in the mid-term. These randomized trials should be interpreted as comparisons of management strategies rather than of “pure” operative versus nonoperative treatment approaches. Full article

The aim of this study was to evaluate tear cytokine and chemokine profiles in keratoconus (KC) and to assess their association with long-term tomographic outcomes after corneal collagen cross-linking (CXL). In this cross-sectional observational study, 30 KC eyes and nine healthy controls were enrolled. KC severity was graded using the modified Amsler–Krumeich classification. Tear samples were collected and analyzed using multiplex bead-based immunoassays (LEGENDplex™) for cytokines, chemokines, and TGF-β1. Patients were followed for five years after CXL. Treatment response was categorized according to corneal flattening (<1 D, 1–3 D, >3 D). Individual cytokine levels showed no major differences between the KC and controls, although IL-6 and MCP-1 tended to be higher in the KC group. However, IP 10 and IL-17 were higher in controls (p < 0.05). In contrast, multiple pro-/anti-inflammatory ratios (TNF/TGF-β1, IL-17/IL-10, MCP-1/IL-10, IL-6/IL-10, IL-8/TGF-β1, MCP-1/TGF-β1, IL-6/TGF-β1, and IL-8/IL-10) were significantly elevated in the KC group (p < 0.05), indicating immune imbalance. After five years, all treated eyes remained stable or flattened. Lower baseline MCP-1 and IL-8 levels correlated with greater postoperative corneal flattening (p < 0.05). Keratoconus is characterized by disturbed tear immune homeostasis rather than isolated cytokine elevation. Lower preoperative inflammatory activity may predict a more favorable biomechanical response to CXL, supporting the potential role of tear cytokine profiling in patient stratification and prognostication. Full article

Premature ovarian insufficiency (POI) is a clinical condition characterized by loss of ovarian function indicated by amenorrhea or irregular menstrual cycles for at least 4 months and elevated gonadotrophins (FSH > 25 IU/L, measured on one occasion) and low estrogen serum levels in women under the age of 40. Premature ovarian insufficiency can be non-iatrogenic or spontaneous (idiopathic or due to genetic, autoimmune, or metabolic reasons, or infections) and iatrogenic (a consequence of oophorectomy, chemotherapy, radiotherapy, or uterine artery embolization). Women with POI are faced not only with estrogen deficiency but also with infertility and psychological implications. Hormonal replacement therapy is effective in treating the symptoms of premature ovarian insufficiency as well as in lowering the health risk of long-term consequences of premature ovarian insufficiency. Currently, oocyte donation is the standard treatment for patients with POI desiring pregnancy. Recently developed methods for the regeneration of ovarian tissue, such as stem cell therapy, platelet-reach plasma therapy and in vitro activation of ovarian tissue, are still under research and further adequate multicentric clinical studies are needed to develop standardized effective and safe protocols for the infertility treatment of patients with premature ovarian insufficiency. Full article

Background/Objectives: Heart failure (HF) is associated with substantial morbidity, impaired quality of life (QOL), and reduced functional capacity. In selected patients with symptomatic HF despite Optimal Medical Therapy (OMT), Cardiac Contractility Modulation (CCM) may be a therapeutic option. Identifying patients most likely to benefit from CCM remains an unmet need. The Predict-CCM study aims to evaluate long-term clinical and objective outcomes after CCM therapy and to assess the predictive value of pre-implant low-dose dobutamine stress echocardiography (LDDSE). Methods and Results: Predict-CCM is an independent, non-profit, multicenter, observational cohort study conducted in Italy, with both retrospective and prospective enrollment. The primary endpoint is the proportion of subjects with a clinical response to CCM at 12 months, defined as a ≥1-class reduction in NYHA class. Secondary clinical endpoints include reductions in HF-related hospitalizations, changes in QOL assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and changes in NT-proBNP levels from baseline to follow-up. Outcomes will be evaluated in the overall cohort and in two subcohorts stratified by pre-implant LDDSE response: (1) reduction in left ventricular end systolic volume (LVESV) ≥ 15% (DeltaLVESV ≥ 15%); and (2) reduction in LVESV < 15% (DeltaLVESV < 15%). Assuming a 70% clinical response rate at 12 months, the estimated sample size is 120 patients. The study was approved by the Ethics Committee in March 2025. Enrollment will continue for 2 years, with a 12-month follow-up period after implant for each subject. Conclusions: This study may provide new criteria for patient selection and outcome assessment in CCM therapy. Left ventricular contractile reserve assessed by stress echocardiography may be a promising predictor of response. Full article

Allergic asthma is a prevalent chronic inflammatory disease of the airways whose pathogenesis has traditionally been attributed to localized immune dysfunction within the lung. However, accumulating evidence from microbiome research supports a broader system-level perspective in which cross-organ interactions contribute to disease susceptibility and progression. In particular, the gut–lung axis has emerged as a key regulatory pathway linking intestinal microbial ecology, immune development, and respiratory health. This review synthesizes current epidemiological, mechanistic, and experimental evidence supporting the role of gut microbiota dysbiosis in allergic asthma. We examine how early-life environmental and nutritional exposures and gut microbiota establishment during critical developmental windows shape long-term immune tolerance and asthma susceptibility. We then summarize characteristic features of asthma-associated gut dysbiosis and discuss how microbial-derived metabolites, including short-chain fatty acids, tryptophan metabolites, pro-allergic lipid mediators such as 12,13-dihydroxy-9Z-octadecenoic acid, and bacterial-derived histamine, modulate distal airway immune responses through epigenetic, receptor-mediated, and immune trafficking mechanisms. Particular emphasis is placed on the role of diet as a key upstream regulator of gut microbiota composition and metabolic function. Finally, we evaluate experimental and translational studies targeting the gut–lung axis, including dietary modulation, microbiome-targeted interventions such as fecal microbiota transplantation, and emerging postbiotic approaches. Collectively, current evidence indicates that gut microbial composition and metabolic function are critical determinants of respiratory immune homeostasis. Targeting the gut–lung axis through nutrition- and microbiome-based strategies offers a promising avenue for the prevention and precision treatment of allergic asthma. Full article

The optimal design of long-span structures is hindered by the combination of prohibitively high computational costs and the limited physical consistency of purely data-driven surrogates. To address this challenge, this study proposes a multi-stage automated design framework that shifts the workflow from repeated per-task solving to reusable digital asset creation. First, a large-scale surrogate-optimized dataset containing 100,000 design samples is generated by embedding a high-speed MLP emulator into a Genetic Algorithm (GA). The core innovation lies in training a physics-regularized neural design generator. By incorporating a reduced-order total potential energy term derived from the principle of minimum potential energy as a regularization constraint, the network learns the mapping from external design conditions to validated near-optimal internal parameter combinations while suppressing mechanically unfavorable configurations associated with low stiffness. This mechanism improves mechanical admissibility, particularly in data-sparse regions. Validation results show that the generator achieves millisecond-level candidate generation and reduces the prediction error to 31% of that of conventional models under sparse-data conditions. In a like-for-like case study with identical external input parameters, the generated candidate design achieves a 21.1% reduction in total steel consumption. The proposed framework is therefore best understood as a rapid preliminary design tool for producing weight-efficient and mechanically admissible candidate schemes, which can then be subjected to subsequent high-fidelity analysis and code-based verification. Full article