Search Results (1,478)

Background: Traumatic spinal injuries (TSI) are often associated with substantial physical burden and potential psychological consequences. Early detection of depressive symptoms may be important for improving quality of life during recovery. Despite the high prevalence of injury, unique sociocultural factors affecting mental health, and the need to optimize long-term rehabilitation outcomes, there is a lack of longitudinal assessments of depression in TSI patients in this region of the MENA (Middle East and North Africa). This study aimed to examine the occurrence of depressive symptoms following TSI over a 3-month period. Methods: A prospective cohort study was conducted to assess the occurrence of depression in TSI patients admitted between 2019 and 2022 at the Hamad Trauma Center. Conscious patients aged 18–65 years diagnosed with TSI were included. Perceived social support was assessed using the RAND Social Support Survey (Medical Outcomes Study Social Support Survey), a validated instrument measuring multiple dimensions of social support. Patient Health Questionnaire-9 (PHQ-9), a widely validated self-administered screening tool for depressive symptoms, was utilized twice: at 2 weeks and at 3 months post-trauma to evaluate early-onset depressive symptoms and their persistence or resolution over time. Results: A total of 189 TSI were included. The cohort was predominantly young individuals. The most common mechanisms of injury included falls (42.1%) and motor vehicle crashes (31.1%). The mean Injury Severity Score was 16.5 ± 8.2 and the spine Abbreviated Injury Scale score was 2.4 ± 0.7. Injuries involved cervical (32.8%), thoracic (38.1%), and lumbo-sacral (6.9%) regions. A total of 32.6% underwent spinal surgery, and 9.0% experienced neurological deficits. Most patients reported emotional and informational support (69%), and 62% reported caregiving support. At 2 weeks post-trauma, patients demonstrated mild depressive symptoms, with a mean PHQ-9 score of 4.6 ± 5.1, which decreased to 2.5 ± 4.2 at 3 months. The proportion of patients screening positive for depressive symptoms (PHQ-9 ≥ 5) decreased from 39.1% (52/133) at 2 weeks to 19.5% (26/133) at 3 months, corresponding to a 19.6% absolute reduction over the follow-up period. A subset of patients reported increased feelings of depression or hopelessness and sleep disturbances at three months compared with two weeks post-trauma. Conclusions: Patients with TSIs experience psychological distress in the early post-injury period, with a subset screening positive for depressive symptoms. Although depressive symptom scores declined over 3 months, continued psychological screening and follow-up care remain important components of comprehensive TSI management during recovery and rehabilitation. Our results should be considered cautiously because of gender-biased findings, single center data and potential attrition bias. Full article

Background: Recent advancements in heart failure (HF) therapy have significantly enhanced the management of patients across all phenotypes of left ventricular ejection fraction. However, these multidrug regimens frequently induce alterations in renal function by influencing intrarenal hemodynamics, thereby modifying glomerular capillary pressure. This phenomenon could result in a mild to moderate decline in estimated glomerular filtration rate (eGFR), often classified as “worsening kidney function.” This nomenclature stems from consistent observations of eGFR reductions recorded during HF treatment in clinical trials. This narrative review aims to elucidate why the observed eGFR declines in clinical practice may represent either loss of functioning glomeruli or pharmacologically mediated reductions in intraglomerular pressure that ultimately safeguards long-term renal and cardiovascular outcomes. Methods: By a comprehensive re-examination of data from HF clinical trials conducted with various classes of medications, all affecting eGFR, we sought to provide evidence that the decline in eGFR is associated with the activation of specific mechanisms that collectively contribute to a reduction in glomerular filtration pressure, a prominent factor in maladaptive neurohormonal responses. Results: From the investigation of angiotensin-converting enzyme inhibitors to the more recent non-steroidal mineralocorticoid receptor antagonist, the renal effects of these therapeutic regimens correlate with improvements in patient outcomes. The data consistently indicate that an early decline in eGFR, when coupled with an enhancement in HF outcomes, is associated with a more gradual decline in eGFR during long-term follow-up. Conclusions: Clinicians should recognize early declines in eGFR as indicators of favorable intraglomerular hemodynamic adjustments that mitigate maladaptive neurohormonal responses and contribute to improved long-term outcomes in patients with HF. Full article

Background and Objectives: Functional dyspepsia (FD) often overlaps with Pancreatic Exocrine Insufficiency (PEI), leading to diagnostic delays. We aimed to evaluate the prevalence of PEI in patients presenting dyspeptic symptoms using the survey-based PEI test and to assess the clinical response to Pancreatic Enzyme Replacement Therapy (PERT). Methods: This study included 91 patients with PEI and 58 control subjects. PEI was evaluated using the PEI Patient-Reported Outcome (PRO) instrument and classified as mild, moderate, or severe according to the 18-item PEI test. Objective fat malabsorption was assessed by the acid steatocrit method using a gravimetric assay. Patients diagnosed with PEI received PERT, and treatment response was evaluated at follow-up with a repeat PEI test. Results: When the case and control groups were compared in terms of PEI scores, a statistically significant difference was found (p < 0.001). Fecal steatocrit value was found to be statistically significant with the PEI score (p = 0.017). No statistically significant difference was found between amylase, lipase, vitamin D, vitamin B12, and folic acid and the PEI score (p = 0.789, p = 0.299, p = 0.865, p = 0.153, and p = 0.855, respectively). A statistically significant difference was found between the pre-treatment PEI score and the post-treatment PEI score (p < 0.001). The mean pre-treatment PEI score was 1.52 ± 0.50, while the post-treatment PEI score was 0.42 ± 0.48. Approximately 72% reduction in PEI score was observed with treatment. Conclusions: The PEI test may represent a useful, non-invasive tool for identifying suspected pancreatic dysfunction in patients initially diagnosed with functional dyspepsia. Early integration of this tool into clinical practice can improve symptom control and prevent the misclassification of PEI as a purely functional disorder. Full article

Background: Frontal lobe involvement represents an important but heterogeneously expressed feature across neurodegenerative and vascular cognitive disorders. While frontal atrophy has been described in Alzheimer’s disease (AD), detailed volumetric assessment of frontal subregions across Alzheimer’s disease, amnestic mild cognitive impairment (aMCI), and vascular dementia (VaD) remains insufficiently characterized. The aim of this study was to evaluate frontal lobe and frontal subregional volumetric alterations across these diagnostic groups using automated MRI-based volumetry. Methods: This cross-sectional study included 120 participants divided into four groups: AD, VaD, aMCI, and cognitively healthy controls (n = 30 per group). All participants underwent standardized neuropsychological assessment and 3T brain MRI. Automated volumetric analysis of the frontal lobe and its subregions was performed using the Vol2Brain pipeline. Group differences in total intracranial volume–adjusted frontal volumes were assessed using analysis of covariance, controlling for age and sex, followed by Bonferroni-corrected post hoc comparisons. False discovery rate (FDR) correction was applied across subregional comparisons. Results: A significant main effect of diagnostic group was observed for total frontal lobe volume, with lower adjusted volumes in patients with AD compared with aMCI and cognitively healthy controls. After correction for multiple comparisons, only total frontal lobe volume remained statistically significant. At the nominal level, group differences were observed in several frontal subregions, predominantly involving prefrontal and orbitofrontal areas. However, these findings did not survive FDR correction and should be interpreted as exploratory. No consistent frontal volumetric pattern was observed in VaD. Receiver operating characteristic analysis demonstrated moderate discriminatory ability of total frontal lobe volume for distinguishing AD from cognitively healthy controls. Conclusions: Automated MRI-based volumetry revealed global frontal lobe reduction in Alzheimer’s disease, whereas subregional findings were exploratory after correction for multiple testing. Frontal volumetric measures did not demonstrate a characteristic pattern in VaD. Global frontal volume may provide complementary structural information within clinically define cognitive disorders. Full article

Background: For decades, the ketogenic diet has been successfully used for the treatment of obesity, metabolic syndrome, and type 2 diabetes. The mechanisms through which it affects metabolism are not fully understood, but the hormonal changes that occur during ketogenic nutrition are likely to play an important role. Objectives: To investigate the effect of the ketogenic diet on various hormones associated with obesity and the accompanying metabolic disorders in childhood. Methods: One hundred children aged 8–18 years with obesity were enrolled. After baseline anthropometric, biochemical, and hormonal testing, they followed a 4-month “well-formulated ketogenic diet.” Fifty-eight of them successfully completed the study with follow-up assessments. Among them, 8 girls had polycystic ovary syndrome (PCOS) and 7 children had Hashimoto’s autoimmune thyroiditis. Results: At the end of the 4-month period, there was a significant decrease in basal insulinemia (p < 0.0001) and in mean morning cortisol levels (p = 0.04), as well as an increase in adiponectin levels (p = 0.04). All girls with PCOS experienced spontaneous menstrual cycles, accompanied by a reduction in testosterone levels. TSH levels showed no change for the whole group (p = 0.13), but there was a significant decrease in T3 (p < 0.0001) and a mild increase in T4 (p = 0.05). Among patients with Hashimoto’s thyroiditis, TSH levels were significantly higher at the end of the study. Conclusions: A short-term, well-formulated ketogenic diet in children with obesity is associated with hormonal changes that support weight loss and improve insulin sensitivity. The diet shows particularly beneficial effects in girls with PCOS and may be considered as part of a comprehensive therapeutic approach in these patients. Monitoring thyroid function during ketogenic nutrition is advisable in patients with hypothyroidism and thyroid disorders. Full article

Background: Valproic acid (VPA) poisoning has a dynamic clinical course and may require extracorporeal toxin removal (ECTR) in severe cases. Intermittent hemodialysis is the preferred ECTR technique; however, clinical experience with expanded hemodialysis (HDx) using medium cut-off (MCO) membranes in acute VPA intoxication is scarce. We describe a case of severe VPA poisoning managed with intermittent HDx and outline the clinical rationale and kinetic response. Case Report: A 54-year-old woman presented to the emergency department after accidental presumably ingesting approximately 4 g of VPA, with depressed consciousness (Glasgow Coma Scale 7) and metabolic acidosis (pH 7.10, HCO₃⁻ 13 mmol/L, PCO₂ 50 mmHg, lactate 2.8 mmol/L, ionized calcium 0.8 mmol/L, elevated anion gap). Initial plasma VPA was 262.99 µg/mL, ammonia was 14 µmol/L, and cranial computed tomography showed no acute abnormalities. ECTR was initiated in the intensive care unit as intermittent HDx using an MCO dialyzer for 4 h. Serial VPA concentrations were obtained before treatment, at 2 h, and at the end of the session to guide real-time prescription adjustment, with an increase in blood flow from 200 to 230 mL/min. Results: VPA decreased from 262.99 µg/mL pre-HD to 141.48 µg/mL at 2 h (46.2% reduction) and 97.81 µg/mL at 4 h (62.8% reduction), with clear improvement in the level of consciousness. A mild post-dialysis rebound was observed (100.07 µg/mL at 14 h). The patient recovered without additional ECTR and was discharged with normalized VPA levels on follow-up. Conclusions: In this patient, intermittent HDx with an MCO membrane was feasible, well tolerated, and associated with rapid VPA clearance and neurological recovery. Serial drug monitoring enabled bedside optimization of the dialysis prescription and post-treatment evaluation. A single HDx session was sufficient, and VPA therapy was safely reintroduced under close monitoring. Full article

Under conditions of limited irrigation and excessive fertilizer application in the arid regions of Xinjiang, it is essential to adopt well-coordinated strategies to improve yield and crop water productivity (WP). In this study, a comparative experiment was conducted with three irrigation levels, T1 (100% crop evapotranspiration, ET_c), T2 (75% ET_c), and T3 (50% ET_c), combined with three potassium application rates, K1 (540 kg ha⁻¹), K2 (360 kg ha⁻¹), and K3 (180 kg ha⁻¹). The objective was to investigate their effects on the yield, quality, and economic benefits of jujube trees. Limited irrigation amounts significantly affected the photosynthetic characteristics, growth parameters, and ET_c of jujube trees, whereas potassium fertilizer levels primarily regulated fruit development and yield formation. Compared with full irrigation, mild deficit irrigation caused a moderate yield reduction but significantly enhanced economic returns due to the improved water productivity and fruit quality. In contrast, severe water deficit led to substantial decreases in growth parameters and economic benefits by 12.87–45.70% and 81.69%, respectively. Potassium application demonstrated a significant threshold effect, with the K2 treatment showing greater improvements in fruit quality indices, including reducing sugars, vitamin C, and other key quality parameters, compared to the K3 treatment. Based on hierarchical–grey relational analysis, the combination of 75% ET_c and 300 kg K ha⁻¹ was identified as the optimal water–potassium management strategy. The net profit was 29,199 CNY. The benefit–cost ratio increased to 3.63, and the WP improved by 16.17% compared to full irrigation. Thus, this study provides an important theoretical basis and technical support for water-saving and quality-improving cultivation of jujube trees in arid regions. Full article

Background: Acne scars remain a very common complaint in dermatology practices. Even though many treatment options are available, proper treatment remains a challenge. Complex treatment methods that are based on the synergy effect are the ones that result in better effects and patient satisfaction. Methods: Three healthy female patients with a total of 106 atrophic acne scars were recruited to the split-face study with placebo control, where a series of three microneedling procedures in monthly intervals combined with 5% retinyl palmitate-loaded oleogel was compared to the same microneedling protocol with placebo. Patients’ quality of life was measured using the Dermatology Life Quality Index (DLQI) and Skindex-29 questionnaires. Patients’ satisfaction with treatment and intensity of post-procedure symptoms were assessed as well. Results: In clinical evaluation, a modest effect was observed regarding the reduction in atrophic acne scars, whereas moderate-to-marked improvement in acne scar reduction was noted by the patients. Additionally, mild to marked improvement was noted by patients regarding skin quality, moisture level, elasticity, and skin tone. No significant side effects were noted. All the above resulted in good patient satisfaction with the treatment, and willingness to repeat the procedures again. No significant differences regarding acne scar reduction, treatment-related symptoms, and skin quality improvement were noted between active substance and placebo-treated sides of the face. Conclusions: Microneedling remains a key method in the therapeutic arsenal for acne scarring. By combining it with 5% retinyl palmitate-loaded oleogel modest effects can be noted after a series of three procedures, with good overall treatment tolerability and patients’ satisfaction. Full article

Objective: The objective of this study is to evaluate the efficacy and safety of sodium zirconium cyclosilicate in the treatment of hyperkalemia in adult patients based on the available scientific evidence. Methods: A systematic review of randomized controlled trials evaluating SZC in adult patients with hyperkalemia was conducted, including populations with chronic kidney disease and heart failure and patients undergoing hemodialysis. Outcomes assessed included serum potassium reduction, achievement and maintenance of normokalaemia, and adverse events. Results: Seven randomized controlled trials were included. SZC produced a rapid and significant reduction in serum potassium, with reductions of up to 1.28 mmol/L within 48 h and onset of action observed as early as 1–4 h. Across studies, 63–92% of patients achieved normokalaemia within 24–48 h, and maintenance therapy sustained normokalaemia for up to 28 days and longer in selected populations. The most frequently reported adverse events were mild-to-moderate edema and constipation, while hypokalemia was infrequent (<5% in most studies). Conclusions: Sodium zirconium cyclosilicate is an effective and generally well-tolerated option for the management of hyperkalemia, providing rapid potassium reduction and sustained normokalaemia. However, no randomized controlled trial included in this review demonstrated a significant benefit of SZC over comparators in major clinical outcomes—hospitalizations, cardiovascular events, or mortality; the evidence of clinical benefit is therefore absent from the current randomized trial literature. Full article

Terminalia arjuna (Arjun) is a tropical deciduous tree species significantly valued for its pharmaceutical properties for various heart diseases, as well as its economic role in the sericulture industry. However, the growth performance and physiological responses of T. arjuna under water stress conditions remain largely unexplored, particularly in the context of increasing climate variability and the growing challenges posed by climate change. Therefore, this study aimed to examine the morpho-physio-biochemical alterations, nutrient uptake changes, and adaptive strategies under different degrees of water stress with respect to field capacity ($F_{wc}$), maintained at 100% $F_{wc}$ (control), 75% $F_{wc}$ (mild), 50% $F_{wc}$ (moderate), and 25% $F_{wc}$ (severe). Key growth parameters, including shoot and root length, leaf traits and shoot dry biomass, were significantly (p < 0.05) reduced under the given water stresses. Root dry biomass showed a distinct response, increasing under mild to moderate water stress but failing to sustain its levels under severe stress. Increasing drought severity resulted in a substantial reduction in stomatal density (15–37%), while stomatal size increased (18–49%) under mild to moderate stress but decreased under severe stress. These responses were associated with significant reductions in gas exchange traits (45–75%), whereas water use efficiency increased by 59–99%, reflecting a survival-focused adaptive mechanism. Moderate water stress triggered the stress responses in T. arjuna through high proline accumulation and increased oxidative stress markers. The most critical impact was found under the severe stress with a substantial reduction in leaf relative water content and membrane stability index (MSI), although MSI was sustained above the critical threshold, reflecting cellular protection. Increased stress intensity also altered mineral uptake, decreased major nutrients, and increased potassium and calcium content, indicating an adaptive strategy. These findings suggest a threshold effect, where T. arjuna tolerates mild stress well and activates adaptive morpho-physiological mechanisms under moderate stress but shifts to survival-focused strategies under severe stress. The demonstrated tolerance of Terminalia arjuna to mild–moderate drought suggests that climate-resilient forestry policies and conservation programs should prioritize its cultivation and restoration in drought-prone landscapes while ensuring adequate water management to prevent severe stress and sustain its medicinal and economic benefits. Full article

Background: Schizophrenia is a heterogeneous disorder, and treatment-resistant schizophrenia (TRS) affects 20–30% of patients, yet objective biomarkers for its identification remain limited. Routine electroencephalography (EEG) offers a non-invasive window into cortical network dynamics, with previous studies reporting paroxysmal epileptiform activity and background slowing in a subset of patients. However, the biological significance of these findings—whether purely pathological or potentially compensatory—remains unclear. This study aimed to compare EEG abnormalities between TRS patients and those in clinical remission and to propose an integrative neurobiological interpretation. Methods: In a cross-sectional design, 89 patients with schizophrenia (39 TRS, 50 in remission) underwent routine EEG recordings using the international 10–20 system. TRS was defined according to TRRIP consensus criteria, requiring <20% symptom reduction after adequate antipsychotic trials. EEG analysis focused on the prevalence of interictal epileptiform discharges (IEDs) and the severity of background slowing, assessed on a 4-point ordinal scale. Results: IEDs were more than twice as prevalent in TRS patients compared to those in remission. Background slowing was significantly more severe in the TRS group, with the majority showing moderate-to-severe abnormalities versus predominantly normal-to-mild patterns in remission patients. Focal EEG abnormalities also followed this pattern. Multivariate analysis confirmed that both IEDs and background severity were independent predictors of TRS. Conclusions: EEG abnormalities, particularly IEDs and background slowing, are potential neurophysiological signatures associated with treatment resistance. We propose an integrative hypothesis suggesting that IEDs may originate as a failed compensatory mechanism—the brain’s attempt to restore network homeostasis. In chronic TRS these discharges become maladaptive, contributing to excitotoxicity and network dysfunction. This framework opens avenues for EEG-based stratification and novel therapeutic strategies targeting cortical excitability. Full article

Background and Objectives: Genitourinary syndrome of menopause (GSM), previously known as vulvovaginal atrophy, is a chronic, progressive hypoestrogenic condition affecting vulvovaginal, urinary and sexual health in women. Common symptoms include vaginal dryness, itching, dyspareunia, urinary urgency and recurrent urinary tract infections (UTIs). Despite the high prevalence, GSM is underdiagnosed and undertreated, thereby negatively impacting women’s quality of life. To illustrate the practical aspects of GSM diagnosis and provide evidence-based management, we present a case-based narrative review synthesizing recently published, high-quality evidence. Materials and Methods: Evidence was drawn from multiple sources through targeted searches of databases, and included the 2025 AUA/SUFU/AUGS guideline (AUA), the 2024 NICE network meta-analyses (NICE), a 2025 systematic review/meta-analysis in breast-cancer survivors, the 2020 Menopause Society GSM Position Statement, the 2018 NAMS/ISSWSH breast cancer consensus, several primary source citations and other high quality peer-reviewed publications. Results: Five illustrative composite case vignettes of GSM are presented to highlight the evaluation strategy and evidence-supported treatment choices. Nonhormonal options are the first line treatments for mild GSM symptoms, either with or without the addition of vaginal estrogen therapy. For moderate to severe GSM, low-dose vaginal estrogen, vaginal DHEA, and ospemifene are all effective FDA-approved options. In breast cancer survivors, individualized decisions with oncology input are warranted. Maximal caution and a shared decision-making approach is required for women using Aromatase Inhibitors (AIs) for breast cancer risk reduction when choosing treatments for GSM. Conclusions: Treating GSM improves vaginal, sexual and urinary outcomes and quality of life of women. Clinicians need to proactively screen for GSM and offer evidence-based treatment options. The treatment decisions in breast cancer survivors are nuanced, requiring a shared-decision approach. Full article

Background/Objectives: University students are particularly vulnerable to psychological distress and sleep disturbances, which may impair academic performance and overall well-being. Lifestyle changes, increased academic demands, and the COVID-19 pandemic may have further exacerbated these problems. This study aimed to assess the prevalence of insomnia and anxiety among students at the University of Rijeka and to examine their associations with COVID-19 infection, vaccination status, lifestyle habits, and sociodemographic characteristics. Methods: A cross-sectional online survey was conducted between October 2024 and April 2025 among 594 students from 14 faculties of the University of Rijeka. Data were collected using a self-administered questionnaire including sociodemographic variables, the Insomnia Severity Index (ISI), the Generalized Anxiety Disorder-7 (GAD-7), lifestyle behaviors, and COVID-19-related factors. Statistical significance was set at p < 0.05. Results: Insomnia was reported by 50.7% of students (36.9% mild, 12.1% moderate, 1.7% severe), while 49.6% reported elevated anxiety levels. Female sex, smoking, low physical activity, poor subjective sleep quality, and frequent nighttime awakenings were significantly associated with higher ISI and GAD-7 scores (all p < 0.05). COVID-19 infection and vaccination status showed weaker associations with insomnia compared to psychosocial and lifestyle factors. Students living in shared rental accommodation reported higher insomnia severity. In multivariable regression analysis, anxiety severity, sleep fragmentation (frequent nocturnal awakenings), and poor perceived sleep quality emerged as the strongest independent predictors of insomnia severity. Conclusions: Insomnia and anxiety are highly prevalent among University of Rijeka students and are primarily associated with psychosocial and lifestyle factors rather than COVID-19-related variables. University-based interventions focusing on stress reduction, sleep hygiene, and early mental health support are warranted, particularly for high-risk groups. Full article

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by mitochondrial dysfunction, oxidative stress, and apoptosis. Natural products rich in polyphenols have been investigated for their potential to modulate pathways associated with PD-related pathology. The present study evaluated the effects of an acetonic almond skin extract, an agri-food by-product, in a zebrafish (Danio rerio) larval model of PD induced by 6-hydroxydopamine (6-OHDA). Embryos were exposed to 250 µM 6-OHDA alone or in combination with the extract (5 and 25 µg/mL) from 48 to 120 h post-fertilization (hpf). Developmental parameters, locomotor behaviour, oxidative stress biomarkers, apoptosis, mitochondrial membrane potential, and tyrosine hydroxylase (TH) immunoreactivity were assessed at 120 hpf. Exposure to 6-OHDA reduced TH immunofluorescence and impaired locomotor performance, accompanied by increased apoptotic signal and mild alterations in mitochondrial membrane potential. Co-exposure to the almond skin extract attenuated the reduction in TH immunoreactivity and partially modulated behavioural outcomes in a concentration-dependent manner. The extract alone increased glutathione S-transferase (GST) activity and reduced reactive oxygen species (ROS) levels, suggesting modulation of redox-related pathways. Notably, the highest concentration restored the TH signal but did not fully normalize the behavioural endpoints, indicating potential concentration-dependent complexity. Although sustained oxidative stress was not detected at the assessed time point, the observed mitochondrial and apoptotic alterations suggest involvement of multiple cellular processes. However, detailed mechanistic pathways were not directly investigated. Overall, these findings indicate that the almond skin extract modulates dopaminergic and behavioural alterations in a PD-induced zebrafish model, supporting its potential as a source of bioactive compounds, warranting further mechanistic and translational investigation. Full article

This study investigates the conversion of textile wastewater sludge (TWS) and textile cotton waste (TCW) into solid biofuels through pelletization and torrefaction, addressing the growing need for sustainable waste management and alternative fuels in the textile sector. Blended feedstocks were conditioned to ~10% moisture, pelletized into 8 mm cylinders, and thermally upgraded at 200–240 °C for 30–90 min. Proximate and ultimate analyses, calorific value measurements, compressive strength testing, bulk and true density assessment, and TGA–DTG were used to evaluate fuel properties, while response surface methodology (RSM) optimized torrefaction parameters. The TCW-rich 20:80 (TWS:TCW) blend with 5% starch exhibited the most favorable overall performance, achieving a calorific value of 3377 kcal kg⁻¹, ash of 10.3%, bulk density of 554 kg m⁻³, and maximum compressive strength of 14.9 N mm⁻². Torrefaction at 200 °C for 60 min increased the GCV to 4083 kcal kg⁻¹ with a high mass yield of 92%, indicating mild thermal decomposition and good energy retention. Further Torrefaction at 220–240 °C increased GCV to 4362–4565 kcal kg⁻¹, accompanied by expected mass-yield reductions due to increased devolatilization. TGA–DTG confirmed faster and cleaner decomposition for TCW-rich pellets and higher residues for sludge-rich blends. RSM indicated temperature as the dominant factor governing mass and energy yields. These findings demonstrate that optimized co-pelletization and mild-to-moderate torrefaction can effectively transform textile residues into energy-dense, mechanically stable biofuels suitable for industrial heat applications. Full article