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Keywords = optimization of losses

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64 pages, 1429 KiB  
Review
Pharmacist-Driven Chondroprotection in Osteoarthritis: A Multifaceted Approach Using Patient Education, Information Visualization, and Lifestyle Integration
by Eloy del Río
Pharmacy 2025, 13(4), 106; https://doi.org/10.3390/pharmacy13040106 (registering DOI) - 1 Aug 2025
Abstract
Osteoarthritis (OA) remains a major contributor to pain and disability; however, the current management is largely reactive, focusing on symptoms rather than preventing irreversible cartilage loss. This review first examines the mechanistic foundations for pharmacological chondroprotection—illustrating how conventional agents, such as glucosamine sulfate [...] Read more.
Osteoarthritis (OA) remains a major contributor to pain and disability; however, the current management is largely reactive, focusing on symptoms rather than preventing irreversible cartilage loss. This review first examines the mechanistic foundations for pharmacological chondroprotection—illustrating how conventional agents, such as glucosamine sulfate and chondroitin sulfate, can potentially restore extracellular matrix (ECM) components, may attenuate catabolic enzyme activity, and might enhance joint lubrication—and explores the delivery challenges posed by avascular cartilage and synovial diffusion barriers. Subsequently, a practical “What–How–When” framework is introduced to guide community pharmacists in risk screening, DMOAD selection, chronotherapeutic dosing, safety monitoring, and lifestyle integration, as exemplified by the CHONDROMOVING infographic brochure designed for diverse health literacy levels. Building on these strategies, the P4–4P Chondroprotection Framework is proposed, integrating predictive risk profiling (physicians), preventive pharmacokinetic and chronotherapy optimization (pharmacists), personalized biomechanical interventions (physiotherapists), and participatory self-management (patients) into a unified, feedback-driven OA care model. To translate this framework into routine practice, I recommend the development of DMOAD-specific clinical guidelines, incorporation of chondroprotective chronotherapy and interprofessional collaboration into health-professional curricula, and establishment of multidisciplinary OA management pathways—supported by appropriate reimbursement structures, to support preventive, team-based management, and prioritization of large-scale randomized trials and real-world evidence studies to validate the long-term structural, functional, and quality of life benefits of synchronized DMOAD and exercise-timed interventions. This comprehensive, precision-driven paradigm aims to shift OA care from reactive palliation to true disease modification, preserving cartilage integrity and improving the quality of life for millions worldwide. Full article
23 pages, 3817 KiB  
Article
Experimental and Numerical Study on the Restitution Coefficient and the Corresponding Elastic Collision Recovery Mechanism of Rapeseed
by Chuandong Liu, Haoping Zhang, Zebao Li, Zhiheng Zeng, Xuefeng Zhang, Lian Gong and Bin Li
Agronomy 2025, 15(8), 1872; https://doi.org/10.3390/agronomy15081872 (registering DOI) - 1 Aug 2025
Abstract
In this study, we aimed to address the lack of systematic research on key collision dynamics parameters (elastic restitution coefficient) in the full mechanization of rapeseed operations, which hinders the development of precision agriculture. In this present work, the restitution coefficient of rapeseed [...] Read more.
In this study, we aimed to address the lack of systematic research on key collision dynamics parameters (elastic restitution coefficient) in the full mechanization of rapeseed operations, which hinders the development of precision agriculture. In this present work, the restitution coefficient of rapeseed was systematically investigated, and a predictive model (R2 = 0.959) was also established by using Box–Behnken design response surface methodology (BBD-RSM). The results show that the collision restitution coefficient varies in the range of 0.539–0.649, with the key influencing factors ranked as follows: moisture content (Mc) > material layer thickness (L) > drop height (H). The EDEM simulation methodology was adopted to validate the experimental results, and the results show that there is a minimal relative error (−1% < δ < 1%) between the measured and simulated rebound heights, indicating that the established model shows a reliable prediction performance. Moreover, by comprehensively analyzing stress, strain, and energy during the collision process between rapeseed and Q235 steel, it can be concluded that the process can be divided into five stages—free fall, collision compression, collision recovery, rebound oscillation, and rebound stabilization. The maximum stress (1.19 × 10−2 MPa) and strain (6.43 × 10−6 mm) were observed at the beginning of the collision recovery stage, which can provide some theoretical and practical basis for optimizing and designing rapeseed machines, thus achieving the goals of precise control, harvest loss reduction, and increased yields. Full article
(This article belongs to the Section Precision and Digital Agriculture)
44 pages, 941 KiB  
Article
Managing Surcharge Risk in Strategic Fleet Deployment: A Partial Relaxed MIP Model Framework with a Case Study on China-Built Ships
by Yanmeng Tao, Ying Yang and Shuaian Wang
Appl. Sci. 2025, 15(15), 8582; https://doi.org/10.3390/app15158582 (registering DOI) - 1 Aug 2025
Abstract
Container liner shipping companies operate within a complex environment where they must balance profitability and service reliability. Meanwhile, evolving regulatory policies, such as surcharges imposed on ships of a particular origin or type on specific trade lanes, introduce new operational challenges. This study [...] Read more.
Container liner shipping companies operate within a complex environment where they must balance profitability and service reliability. Meanwhile, evolving regulatory policies, such as surcharges imposed on ships of a particular origin or type on specific trade lanes, introduce new operational challenges. This study addresses the heterogeneous ship routing and demand acceptance problem, aiming to maximize two conflicting objectives: weekly profit and total transport volume. We formulate the problem as a bi-objective mixed-integer programming model and prove that the ship chartering constraint matrix is totally unimodular, enabling the reformulation of the model into a partially relaxed MIP that preserves optimality while improving computational efficiency. We further analyze key mathematical properties showing that the Pareto frontier consists of a finite union of continuous, piecewise linear segments but is generally non-convex with discontinuities. A case study based on a realistic liner shipping network confirms the model’s effectiveness in capturing the trade-off between profit and transport volume. Sensitivity analyses show that increasing freight rates enables higher profits without large losses in volume. Notably, this paper provides a practical risk management framework for shipping companies to enhance their adaptability under shifting regulatory landscapes. Full article
(This article belongs to the Special Issue Risk and Safety of Maritime Transportation)
18 pages, 5389 KiB  
Article
Novel Method of Estimating Iron Loss Equivalent Resistance of Laminated Core Winding at Various Frequencies
by Maxime Colin, Thierry Boileau, Noureddine Takorabet and Stéphane Charmoille
Energies 2025, 18(15), 4099; https://doi.org/10.3390/en18154099 (registering DOI) - 1 Aug 2025
Abstract
Electromagnetic and magnetic devices are increasingly prevalent in sectors such as transportation, industry, and renewable energy due to the ongoing electrification trend. These devices exhibit nonlinear behavior, particularly under signals rich in harmonics. They require precise and appropriate modeling for accurate sizing. Identifying [...] Read more.
Electromagnetic and magnetic devices are increasingly prevalent in sectors such as transportation, industry, and renewable energy due to the ongoing electrification trend. These devices exhibit nonlinear behavior, particularly under signals rich in harmonics. They require precise and appropriate modeling for accurate sizing. Identifying model-specific parameters, which depend on frequency, is crucial. This article focuses on a specific frequency range where a circuit model with series resistance and inductance, along with a parallel resistance to account for iron losses (Riron), is applicable. While the determination of series elements is well documented, the determination of Riron remains complex and debated, with traditional methods neglecting operating conditions such as magnetic saturation. To address these limitations, an innovative experimental method is proposed, comprising two main steps: determining the complex impedance of the magnetic device and extracting Riron from the model. This method aims to provide a more precise and representative estimation of Riron, improving the reliability and accuracy of electromagnetic and magnetic device simulations and designs. The obtained values of the iron loss equivalent resistance are different by at least 300% than those obtained by an impedance analyzer. The proposed method is expected to advance the understanding and modeling of losses in electromagnetic and magnetic devices, offering more robust tools for engineers and researchers in optimizing device performance and efficiency. Full article
(This article belongs to the Section F1: Electrical Power System)
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24 pages, 1008 KiB  
Article
Variable Submodule Voltage Control for Enhanced Efficiency in DAB-Integrated Modular Multilevel Converters
by Marzio Barresi, Davide De Simone, Edoardo Ferri and Luigi Piegari
Energies 2025, 18(15), 4096; https://doi.org/10.3390/en18154096 (registering DOI) - 1 Aug 2025
Abstract
Modular multilevel converters (MMCs) are widely used in power-conversion applications, including distributed energy storage integration, because of their scalability, high efficiency, and reduced harmonic distortion. Integrating battery storage systems into MMC submodules using dual active bridge (DAB) converters provides electrical isolation and reduces [...] Read more.
Modular multilevel converters (MMCs) are widely used in power-conversion applications, including distributed energy storage integration, because of their scalability, high efficiency, and reduced harmonic distortion. Integrating battery storage systems into MMC submodules using dual active bridge (DAB) converters provides electrical isolation and reduces voltage stress, harmonics, and common-mode issues. However, voltage fluctuations due to the battery state of charge can compromise the zero-voltage switching (ZVS) operation of a DAB and increase the reactive power circulation, leading to higher losses and reduced system performance. To address these challenges, this study investigated an active control strategy for submodule voltage regulation in an MMC with DAB-based battery integration. Assuming single-phase-shift modulation, two control strategies were evaluated. The first strategy regulated the DAB voltage on one side to match the battery voltage on the other, scaled by the high-frequency transformer turns ratio, which facilitated the ZVS operation and reduced the reactive power. The second strategy optimized this voltage to minimize the total power-conversion losses. The proposed control strategies improved the efficiency, particularly at low power levels, achieving several percentage points of improvement compared to maintaining a constant voltage. Full article
19 pages, 4045 KiB  
Article
Response Surface Optimization Design for High-Speed Ball Bearing Double-Lip Seals Considering Wear Characteristics
by Hengdi Wang, Yulu Yue, Yongcun Cui, Lina Lou and Chang Li
Lubricants 2025, 13(8), 343; https://doi.org/10.3390/lubricants13080343 (registering DOI) - 1 Aug 2025
Abstract
This paper focuses on the sealing failure problem of double-lip seal rings for high-speed ball bearings used in unmanned aerial vehicles. By using ANSYS 2023R1 software, a thermal–stress–wear coupled finite element model was established. Taking the contact pressure and volume loss due to [...] Read more.
This paper focuses on the sealing failure problem of double-lip seal rings for high-speed ball bearings used in unmanned aerial vehicles. By using ANSYS 2023R1 software, a thermal–stress–wear coupled finite element model was established. Taking the contact pressure and volume loss due to wear as indicators to evaluate sealing performance, this study analyzed the influence of lip seal structural parameters on sealing performance, performed response surface optimization of the seal structure parameters and conducted a comparative test on lip seals before and after optimization. The research results show that the contact pressure at the main lip of the lip seal was the greatest, which was 0.79 MPa, and the volume loss due to wear lip seal was 7.94 × 10−7 mm3. Optimal sealing performance is achieved when the seal lip inclination angle is 41.68°, the middle width of the lip seal is 0.153 mm, the main lip height is 0.179 mm, the spring center distance is 0.37 mm and the radial interference is 0.0034 mm. After optimization, the grease leakage rate of the sealing ring decreased by 48% compared to before optimization. Full article
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22 pages, 29737 KiB  
Article
A Comparative Investigation of CFD Approaches for Oil–Air Two-Phase Flow in High-Speed Lubricated Rolling Bearings
by Ruifeng Zhao, Pengfei Zhou, Jianfeng Zhong, Duan Yang and Jie Ling
Machines 2025, 13(8), 678; https://doi.org/10.3390/machines13080678 (registering DOI) - 1 Aug 2025
Abstract
Analyzing the two-phase flow behavior in bearing lubrication is crucial for understanding friction and wear mechanisms, optimizing lubrication design, and improving bearing operational efficiency and reliability. However, the complexity of oil–air two-phase flow in high-speed bearings poses significant research challenges. Currently, there is [...] Read more.
Analyzing the two-phase flow behavior in bearing lubrication is crucial for understanding friction and wear mechanisms, optimizing lubrication design, and improving bearing operational efficiency and reliability. However, the complexity of oil–air two-phase flow in high-speed bearings poses significant research challenges. Currently, there is a lack of comparative studies employing different simulation strategies to address this issue, leaving a gap in evidence-based guidance for selecting appropriate simulation approaches in practical applications. This study begins with a comparative analysis between experimental and simulation results to validate the reliability of the adopted simulation approach. Subsequently, a comparative evaluation of different simulation methods is conducted to provide a scientific basis for relevant decision-making. Evaluated from three dimensions—adaptability to rotational speed conditions, research focuses (oil distribution and power loss), and computational economy—the findings reveal that FVM excels at medium-to-high speeds, accurately predicting continuous oil film distribution and power loss, while MPS, leveraging its meshless Lagrangian characteristics, demonstrates superior capability in describing physical phenomena under extreme conditions, albeit with higher computational costs. Economically, FVM, supported by mature software ecosystems and parallel computing optimization, is more suitable for industrial design applications, whereas MPS, being more reliant on high-performance hardware, is better suited for academic research and customized scenarios. The study further proposes that future research could adopt an FVM-MPS coupled approach to balance efficiency and precision, offering a new paradigm for multi-scale lubrication analysis in bearings. Full article
(This article belongs to the Section Machine Design and Theory)
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22 pages, 1287 KiB  
Article
Comparative Analysis of the Gardner Equation in Plasma Physics Using Analytical and Neural Network Methods
by Zain Majeed, Adil Jhangeer, F. M. Mahomed, Hassan Almusawa and F. D. Zaman
Symmetry 2025, 17(8), 1218; https://doi.org/10.3390/sym17081218 (registering DOI) - 1 Aug 2025
Abstract
In the present paper, a mathematical analysis of the Gardner equation with varying coefficients has been performed to give a more realistic model of physical phenomena, especially in regards to plasma physics. First, a Lie symmetry analysis was carried out, as a result [...] Read more.
In the present paper, a mathematical analysis of the Gardner equation with varying coefficients has been performed to give a more realistic model of physical phenomena, especially in regards to plasma physics. First, a Lie symmetry analysis was carried out, as a result of which a symmetry classification following the different representations of the variable coefficients was systematically derived. The reduced ordinary differential equation obtained is solved using the power-series method and solutions to the equation are represented graphically to give an idea of their dynamical behavior. Moreover, a fully connected neural network has been included as an efficient computation method to deal with the complexity of the reduced equation, by using traveling-wave transformation. The validity and correctness of the solutions provided by the neural networks have been rigorously tested and the solutions provided by the neural networks have been thoroughly compared with those generated by the Runge–Kutta method, which is a conventional and well-recognized numerical method. The impact of a variation in the loss function of different coefficients has also been discussed, and it has also been found that the dispersive coefficient affects the convergence rate of the loss contribution considerably compared to the other coefficients. The results of the current work can be used to improve knowledge on the nonlinear dynamics of waves in plasma physics. They also show how efficient it is to combine the approaches, which consists in the use of analytical and semi-analytical methods and methods based on neural networks, to solve nonlinear differential equations with variable coefficients of a complex nature. Full article
(This article belongs to the Section Physics)
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22 pages, 4480 KiB  
Article
MGMR-Net: Mamba-Guided Multimodal Reconstruction and Fusion Network for Sentiment Analysis with Incomplete Modalities
by Chengcheng Yang, Zhiyao Liang, Tonglai Liu, Zeng Hu and Dashun Yan
Electronics 2025, 14(15), 3088; https://doi.org/10.3390/electronics14153088 (registering DOI) - 1 Aug 2025
Abstract
Multimodal sentiment analysis (MSA) faces key challenges such as incomplete modality inputs, long-range temporal dependencies, and suboptimal fusion strategies. To address these, we propose MGMR-Net, a Mamba-guided multimodal reconstruction and fusion network that integrates modality-aware reconstruction with text-centric fusion within an efficient state-space [...] Read more.
Multimodal sentiment analysis (MSA) faces key challenges such as incomplete modality inputs, long-range temporal dependencies, and suboptimal fusion strategies. To address these, we propose MGMR-Net, a Mamba-guided multimodal reconstruction and fusion network that integrates modality-aware reconstruction with text-centric fusion within an efficient state-space modeling framework. MGMR-Net consists of two core components: the Mamba-collaborative fusion module, which utilizes a two-stage selective state-space mechanism for fine-grained cross-modal alignment and hierarchical temporal integration, and the Mamba-enhanced reconstruction module, which employs continuous-time recurrence and dynamic gating to accurately recover corrupted or missing modality features. The entire network is jointly optimized via a unified multi-task loss, enabling simultaneous learning of discriminative features for sentiment prediction and reconstructive features for modality recovery. Extensive experiments on CMU-MOSI, CMU-MOSEI, and CH-SIMS datasets demonstrate that MGMR-Net consistently outperforms several baseline methods under both complete and missing modality settings, achieving superior accuracy, robustness, and generalization. Full article
(This article belongs to the Special Issue Application of Data Mining in Decision Support Systems (DSSs))
18 pages, 4093 KiB  
Article
Study of Mechanical and Wear Properties of Fabricated Tri-Axial Glass Composites
by Raghu Somanna, Rudresh Bekkalale Madegowda, Rakesh Mahesh Bilwa, Prashanth Malligere Vishveshwaraiah, Prema Nisana Siddegowda, Sandeep Bagrae, Madhukar Beejaganahalli Sangameshwara, Girish Hunaganahalli Nagaraju and Madhusudan Puttaswamy
J. Compos. Sci. 2025, 9(8), 409; https://doi.org/10.3390/jcs9080409 (registering DOI) - 1 Aug 2025
Abstract
This study investigates the mechanical, morphological, and wear properties of SiO2-filled tri-axial warp-knitted (TWK) glass fiber-reinforced vinyl ester matrix composites, with a focus on void fraction, tensile, flexural, hardness, and wear behavior. Adding SiO2 fillers reduced void fractions, enhancing composite [...] Read more.
This study investigates the mechanical, morphological, and wear properties of SiO2-filled tri-axial warp-knitted (TWK) glass fiber-reinforced vinyl ester matrix composites, with a focus on void fraction, tensile, flexural, hardness, and wear behavior. Adding SiO2 fillers reduced void fractions, enhancing composite strength, with values ranging from 1.63% to 5.31%. Tensile tests revealed that composites with 5 wt% SiO2 (GV1) exhibited superior tensile strength, Young’s modulus, and elongation due to enhanced fiber–matrix interaction. Conversely, composites with 10 wt% SiO2 (GV2) showed decreased tensile performance, indicating increased brittleness. Flexural tests demonstrated that GV1 outperformed GV2, showcasing higher flexural strength, elastic modulus, and deflection, reflecting improved load-bearing capacity at optimal filler content. Shore D hardness tests confirmed that GV1 had the highest hardness among the specimens. SEM analysis revealed wear behavior under various loads and sliding distances. GV1 exhibited minimal wear loss at lower loads and distances, while higher loads caused significant matrix detachment and fiber damage. These findings highlight the importance of optimizing SiO2 filler content to enhance epoxy composites’ mechanical and tribological performance. Full article
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14 pages, 21956 KiB  
Article
Evaluating Image Quality Metrics as Loss Functions for Image Dehazing
by Rareș Dobre-Baron, Adrian Savu-Jivanov and Cosmin Ancuți
Sensors 2025, 25(15), 4755; https://doi.org/10.3390/s25154755 (registering DOI) - 1 Aug 2025
Abstract
The difficulty and manual nature of procuring human evaluators for ranking the quality of images affected by various types of degradations, and of those cleaned up by developed algorithms, has lead to the widespread adoption of automated metrics, like the Peak Signal-to-Noise Ratio [...] Read more.
The difficulty and manual nature of procuring human evaluators for ranking the quality of images affected by various types of degradations, and of those cleaned up by developed algorithms, has lead to the widespread adoption of automated metrics, like the Peak Signal-to-Noise Ratio (PSNR) and the Structural Similarity Index Metric (SSIM). However, disparities between rankings given by these metrics and those given by human evaluators have encouraged the development of improved image quality assessment (IQA) metrics that are a better fit for this purpose. These methods have been previously used solely for quality assessments and not as objectives in the training of neural networks for high-level vision tasks, despite the potential improvements that may come about by directly optimizing for desired metrics. This paper examines the adequacy of ten recent IQA metrics, compared with standard loss functions, within two trained dehazing neural networks, with observed broad improvement in their performance. Full article
(This article belongs to the Special Issue Sensing and Imaging in Computer Vision)
23 pages, 3580 KiB  
Article
Distributed Collaborative Data Processing Framework for Unmanned Platforms Based on Federated Edge Intelligence
by Siyang Liu, Nanliang Shan, Xianqiang Bao and Xinghua Xu
Sensors 2025, 25(15), 4752; https://doi.org/10.3390/s25154752 (registering DOI) - 1 Aug 2025
Abstract
Unmanned platforms such as unmanned aerial vehicles, unmanned ground vehicles, and autonomous underwater vehicles often face challenges of data, device, and model heterogeneity when performing collaborative data processing tasks. Existing research does not simultaneously address issues from these three aspects. To address this [...] Read more.
Unmanned platforms such as unmanned aerial vehicles, unmanned ground vehicles, and autonomous underwater vehicles often face challenges of data, device, and model heterogeneity when performing collaborative data processing tasks. Existing research does not simultaneously address issues from these three aspects. To address this issue, this study designs an unmanned platform cluster architecture inspired by the cloud-edge-end model. This architecture integrates federated learning for privacy protection, leverages the advantages of distributed model training, and utilizes edge computing’s near-source data processing capabilities. Additionally, this paper proposes a federated edge intelligence method (DSIA-FEI), which comprises two key components. Based on traditional federated learning, a data sharing mechanism is introduced, in which data is extracted from edge-side platforms and placed into a data sharing platform to form a public dataset. At the beginning of model training, random sampling is conducted from the public dataset and distributed to each unmanned platform, so as to mitigate the impact of data distribution heterogeneity and class imbalance during collaborative data processing in unmanned platforms. Moreover, an intelligent model aggregation strategy based on similarity measurement and loss gradient is developed. This strategy maps heterogeneous model parameters to a unified space via hierarchical parameter alignment, and evaluates the similarity between local and global models of edge devices in real-time, along with the loss gradient, to select the optimal model for global aggregation, reducing the influence of device and model heterogeneity on cooperative learning of unmanned platform swarms. This study carried out extensive validation on multiple datasets, and the experimental results showed that the accuracy of the DSIA-FEI proposed in this paper reaches 0.91, 0.91, 0.88, and 0.87 on the FEMNIST, FEAIR, EuroSAT, and RSSCN7 datasets, respectively, which is more than 10% higher than the baseline method. In addition, the number of communication rounds is reduced by more than 40%, which is better than the existing mainstream methods, and the effectiveness of the proposed method is verified. Full article
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22 pages, 5403 KiB  
Article
Degradation of Synthetic and Natural Textile Materials Using Streptomyces Strains: Model Compost and Genome Exploration for Potential Plastic-Degrading Enzymes
by Vukašin Janković, Brana Pantelic, Marijana Ponjavic, Darka Marković, Maja Radetić, Jasmina Nikodinovic-Runic and Tatjana Ilic-Tomic
Microorganisms 2025, 13(8), 1800; https://doi.org/10.3390/microorganisms13081800 (registering DOI) - 1 Aug 2025
Abstract
Given the environmental significance of the textile industry, especially the accumulation of nondegradable materials, there is extensive development of greener approaches to fabric waste management. Here, we investigated the biodegradation potential of three Streptomyces strains in model compost on polyamide (PA) and polyamide-elastane [...] Read more.
Given the environmental significance of the textile industry, especially the accumulation of nondegradable materials, there is extensive development of greener approaches to fabric waste management. Here, we investigated the biodegradation potential of three Streptomyces strains in model compost on polyamide (PA) and polyamide-elastane (PA-EA) as synthetic, and on cotton (CO) as natural textile materials. Weight change of the materials was followed, while Fourier-Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM) were used to analyze surface changes of the materials upon biodegradation. The bioluminescence-based toxicity test employing Vibrio fischeri confirmed the ecological safety of the tested textiles. After 12 months, the increase of 10 and 16% weight loss, of PA-EA and PA, respectively, was observed in compost augmented with Streptomyces sp. BPS43. Additionally, a 14% increase in cotton degradation was recorded after 2 months in compost augmented with Streptomyces sp. NP10. Genome exploration of the strains was carried out for potential plastic-degrading enzymes. It highlighted BPS43 as the most versatile strain with specific amidases that show sequence identity to UMG-SP-1, UMG-SP-2, and UMG-SP-3 (polyurethane degrading enzymes identified from compost metagenome). Our results showcase the behavior of Streptomyces sp. BPS43 in the degradation of PA and PA-EA textiles in composting conditions, with enzymatic potential that could be further characterized and optimized for increased synthetic textile degradation. Full article
(This article belongs to the Section Environmental Microbiology)
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19 pages, 397 KiB  
Review
Effects of Blood-Glucose Lowering Therapies on Body Composition and Muscle Outcomes in Type 2 Diabetes: A Narrative Review
by Ioana Bujdei-Tebeică, Doina Andrada Mihai, Anca Mihaela Pantea-Stoian, Simona Diana Ștefan, Claudiu Stoicescu and Cristian Serafinceanu
Medicina 2025, 61(8), 1399; https://doi.org/10.3390/medicina61081399 (registering DOI) - 1 Aug 2025
Abstract
Background and Objectives: The management of type 2 diabetes (T2D) extends beyond glycemic control, requiring a more global strategy that includes optimization of body composition, even more so in the context of sarcopenia and visceral adiposity, as they contribute to poor outcomes. [...] Read more.
Background and Objectives: The management of type 2 diabetes (T2D) extends beyond glycemic control, requiring a more global strategy that includes optimization of body composition, even more so in the context of sarcopenia and visceral adiposity, as they contribute to poor outcomes. Past reviews have typically been focused on weight reduction or glycemic effectiveness, with limited inclusion of new therapies’ effects on muscle and fat distribution. In addition, the emergence of incretin-based therapies and dual agonists such as tirzepatide requires an updated synthesis of their impacts on body composition. This review attempts to bridge the gap by taking a systematic approach to how current blood-glucose lowering therapies affect lean body mass, fat mass, and the risk of sarcopenia in T2D patients. Materials and Methods: Between January 2015 and March 2025, we conducted a narrative review by searching the PubMed, Scopus, and Web of Science databases for English-language articles. The keywords were combinations of the following: “type 2 diabetes,” “lean body mass,” “fat mass,” “body composition,” “sarcopenia,” “GLP-1 receptor agonists,” “SGLT2 inhibitors,” “tirzepatide,” and “antidiabetic pharmacotherapy.” Reference lists were searched manually as well. The highest precedence was assigned to studies that aimed at adult type 2 diabetic subjects and reported body composition results. Inclusion criteria for studies were: (1) type 2 diabetic mellitus adult patients and (2) reporting measures of body composition (e.g., lean body mass, fat mass, or muscle function). We prioritized randomized controlled trials and large observational studies and excluded mixed diabetic populations, non-pharmacological interventions only, and poor reporting of body composition. Results: Metformin was widely found to be weight-neutral with minimal effects on muscle mass. Insulin therapy, being an anabolic hormone, often leads to fat mass accumulation and increases the risk of sarcopenic obesity. Incretin-based therapies induced substantial weight loss, mostly from fat mass. Notable results were observed in studies with tirzepatide, demonstrating superior reduction not only in fat mass, but also in visceral fat. Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) promote fat loss but are associated with a small yet significant decrease in lean muscle mass. Conclusions: Blood-glucose lowering therapies demonstrated clinically relevant effects on body composition. Treatment should be personalized, balancing glycemic control, cardiovascular, and renal benefits, together with optimal impact on muscle mass along with glycemic, cardiovascular, and renal benefits. Full article
(This article belongs to the Section Endocrinology)
12 pages, 955 KiB  
Article
Single-Center Preliminary Experience Treating Endometrial Cancer Patients with Fiducial Markers
by Francesca Titone, Eugenia Moretti, Alice Poli, Marika Guernieri, Sarah Bassi, Claudio Foti, Martina Arcieri, Gianluca Vullo, Giuseppe Facondo, Marco Trovò, Pantaleo Greco, Gabriella Macchia, Giuseppe Vizzielli and Stefano Restaino
Life 2025, 15(8), 1218; https://doi.org/10.3390/life15081218 - 1 Aug 2025
Abstract
Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer [...] Read more.
Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer requiring adjuvant radiation with external beams were enrolled. Five patients underwent radiation therapy targeting the pelvic disease and positive lymph nodes, with doses of 50.4 Gy in twenty-eight fractions and a subsequent stereotactic boost on the vaginal vault at a dose of 5 Gy in a single fraction. One patient was administered 30 Gy in five fractions to the vaginal vault. These patients underwent external beam RT following the implantation of three 0.40 × 10 mm gold fiducial markers (FMs). Our IGRT strategy involved real-time 2D kV image-based monitoring of the fiducial markers during the treatment delivery as a surrogate of the vaginal cuff. To explore the potential role of FMs throughout the treatment process, we analyzed cine movies of the 2D kV-triggered images during delivery, as well as the image registration between pre- and post-treatment CBCT scans and the planning CT (pCT). Each CBCT used to trigger fraction delivery was segmented to define the rectum, bladder, and vaginal cuff. We calculated a standard metric to assess the similarity among the images (Dice index). Results: All the patients completed radiotherapy and experienced good tolerance without any reported acute or long-term toxicity. We did not observe any loss of FMs during or before treatment. A total of twenty CBCTs were analyzed across ten fractions. The observed trend showed a relatively emptier bladder compared to the simulation phase, with the bladder filling during the delivery. This resulted in a final median Dice similarity coefficient (DSC) of 0.90, indicating strong performance. The rectum reproducibility revealed greater variability, negatively affecting the quality of the delivery. Only in two patients, FMs showed intrafractional shift > 5 mm, probably associated with considerable rectal volume changes. Target coverage was preserved due to a safe CTV-to-PTV margin (10 mm). Conclusions: In our preliminary study, CBCT in combination with the use of fiducial markers to guide the delivery proved to be a feasible method for IGRT both before and during the treatment of post-operative gynecological cancer. In particular, this approach seems to be promising in selected patients to facilitate the use of SBRT instead of BRT (brachytherapy), thanks to margin reduction and adaptive strategies to optimize dose delivery while minimizing toxicity. A larger sample of patients is needed to confirm our results. Full article
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