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Search Results (1,681)

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Keywords = parallel composition

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29 pages, 2731 KB  
Article
Older Adults’ Perceived Visual Safety in Urban Pocket Parks: Environmental Problems and Design Implications from Four Cases in Nanjing, China
by Yan Li, Yuxin Cheng, Zhen Wu and Hao Zou
Buildings 2026, 16(18), 3733; https://doi.org/10.3390/buildings16183733 (registering DOI) - 19 Sep 2026
Abstract
Urban pocket parks support older adults’ daily activities, yet unclear visual–spatial information can complicate movement. This multiple-case study examined perceived visual safety among older users of four pocket parks in Nanjing, China, using 386 questionnaires, interview notes from 45 participants, and field records. [...] Read more.
Urban pocket parks support older adults’ daily activities, yet unclear visual–spatial information can complicate movement. This multiple-case study examined perceived visual safety among older users of four pocket parks in Nanjing, China, using 386 questionnaires, interview notes from 45 participants, and field records. Predictor-specific de-overlap models, in which overlapping outcome items were removed, served as the primary association analyses. None of the six environmental-problem ratings was significant after Holm correction. In a secondary model using the exploratory 20-item composite, boundary ambiguity and interface conflict were associated with lower values of the exploratory 20-item composite, although the outcome retained conceptually overlapping items. The preliminary questionnaire had a Cronbach’s α of 0.890, but parallel analysis supported four rather than five prespecified domains; visual comfort did not form a distinct factor, and the resulting 20-item composite was treated as exploratory. Mean values of the exploratory 20-item composite were higher in P1 and P2 than in P3 and P4. Interview and field evidence linked reported difficulties to routes, boundaries, level transitions, obstructed sightlines, and movement–activity interfaces. The findings locate perceived visual-safety problems at specific spatial decision points and suggest potential renewal priorities, including clearer route cues, more legible boundaries and level changes, unobstructed sightlines, and clearer organization of walking and activity areas. Full article
(This article belongs to the Section Architectural Design, Urban Science, and Real Estate)
18 pages, 1293 KB  
Article
A Bidirectional C1q/TNF-Related Protein Signature Is Associated with Disease Activity in Behçet’s Disease: A Cross-Sectional Study
by Ahmet Karataş, Ramazan Fazıl Akkoç and Burak Öz
Diagnostics 2026, 16(18), 3035; https://doi.org/10.3390/diagnostics16183035 (registering DOI) - 19 Sep 2026
Abstract
Background/Objectives: Distinguishing active from quiescent Behçet’s disease (BD) is difficult because conventional acute-phase reactants perform inconsistently. C1q/TNF-related proteins (CTRPs) are adiponectin paralogues; several members have been reported to exert opposing immunometabolic actions in experimental systems, although the evidence is uneven across the [...] Read more.
Background/Objectives: Distinguishing active from quiescent Behçet’s disease (BD) is difficult because conventional acute-phase reactants perform inconsistently. C1q/TNF-related proteins (CTRPs) are adiponectin paralogues; several members have been reported to exert opposing immunometabolic actions in experimental systems, although the evidence is uneven across the family and no member has been examined in BD. Methods: In this cross-sectional study, eight CTRPs (CTRP1, CTRP4, CTRP6, CTRP9, CTRP12, CTRP13, CTRP14, CTRP15) were measured in serum using enzyme-linked immunosorbent assay in 30 patients with active BD, 30 with inactive BD and 30 healthy controls. Disease activity was defined by a Behçet’s Disease Current Activity Form (BDCAF) score of ≥2. False discovery rate correction was applied separately to the eight omnibus and eight active-versus-inactive biomarker comparisons. Logistic models were adjusted for age, sex, body mass index and disease duration; a composite index combined the analytes changing in opposite directions. Results: Six analytes differed between active and inactive disease after correction (q = 0.004–0.041): CTRP1, CTRP4, CTRP6 and CTRP14 were higher and CTRP12 and CTRP15 lower in active disease, with five correlating with the BDCAF score in the same directions. Four showed nominally significant associations in the adjusted models (CTRP12, CTRP14, CTRP6 and CTRP15), whereas CTRP1 and CTRP4 did not; adjusted odds ratios per doubling ranged from 0.27 (CTRP12, 95% CI 0.11–0.71) to 2.73 (CTRP14, 1.16–6.44). The composite index achieved an area under the curve of 0.866 (95% CI 0.765–0.944); C-reactive protein alone reached 0.810 (0.682–0.915) and the two combined 0.916 (0.839–0.974). Bootstrap internal validation, in which the selection of components was repeated in each resample, gave an out-of-bag area under the curve of 0.812 (0.649–0.946). The index remained associated with activity after adjustment for C-reactive protein (p = 0.002); adding the index to C-reactive protein did not significantly increase discrimination (ΔAUC +0.106, 95% CI −0.002 to +0.214; DeLong p = 0.055). Conclusions: In this cross-sectional study, active BD was associated with a coordinated bidirectional CTRP pattern that paralleled clinical activity. The composite index remained associated with activity after adjustment for C-reactive protein, but its incremental discrimination over C-reactive protein did not reach statistical significance; longitudinal and external validation are required. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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23 pages, 1307 KB  
Article
Pharmacogenetics-Guided De-Escalation of Dual Antiplatelet Therapy Based on CYP2C19 Testing in Patients After Acute Coronary Syndrome: Clinical Outcomes and Cost–Consequence Analysis
by Firuz Kh. Turaev, Sherzod P. Abdullaev, Kirill I. Matrenin, Furkatjon S. Gafurov, Svetlana N. Tuchkova, David A. Gabrielyan, Karin B. Mirzaev, Dmitry A. Kaprin and Dmitry A. Sychev
J. Clin. Med. 2026, 15(18), 7261; https://doi.org/10.3390/jcm15187261 (registering DOI) - 18 Sep 2026
Abstract
Background/Objectives: De-escalation of dual antiplatelet therapy (DAPT) from ticagrelor to clopidogrel after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) reduces bleeding risk; however, in carriers of loss-of-function CYP2C19 alleles, it may carry a risk of insufficient platelet inhibition. This study [...] Read more.
Background/Objectives: De-escalation of dual antiplatelet therapy (DAPT) from ticagrelor to clopidogrel after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) reduces bleeding risk; however, in carriers of loss-of-function CYP2C19 alleles, it may carry a risk of insufficient platelet inhibition. This study compared the safety and efficacy of CYP2C19 genotype-guided DAPT de-escalation with standard clinical practice in patients after ACS and PCI, and evaluated the cost implications of this approach. Methods: We conducted a prospective, randomized, open-label, parallel group trial (n = 75 genotype-guided group; n = 75 control group) with 12 months of follow-up. In the genotype-guided group, the de-escalation decision was based on the CYP2C19 genotype; in the control group, it followed standard practice at the treating physician’s discretion. The primary safety endpoint was the cumulative incidence of clinically relevant bleeding (BARC ≥2); the secondary efficacy endpoint was a composite of ischemic events. The economic evaluation was performed as a cost–consequence analysis (CCA), reporting drug and testing costs alongside the clinical outcomes described above, including a break-even threshold and one-way sensitivity analysis. Results: In the intention-to-treat population (n = 150), the 12-month cumulative incidence of BARC ≥ 2 bleeding was 10.7% in the genotype-guided group versus 12.0% in the control group (HR 0.88; 95% CI 0.34–2.28; p = 0.79). The cumulative incidence of the ischemic composite was 13.3% versus 14.7% (HR 0.91; 95% CI 0.38–2.13; p = 0.82), and neither difference was statistically significant. A per-protocol sensitivity analysis excluding eight patients who required non-protocol anticoagulant therapy yielded similar results for bleeding (9.7% vs. 11.4%; HR 0.84) and a numerically larger, though still non-significant, effect for the ischemic composite (11.1% vs. 15.7%; HR 0.69). Use of the genotype-guided strategy was associated with savings in drug and pharmacogenetic testing costs of RUB 1,036,340.21 for the cohort (RUB 15,278.16 per patient), a saving that remained positive across the full range of observed drug prices; the drug-and-testing-cost break-even price for testing was RUB 19,748.16 per patient. Conclusions: No statistically significant differences in bleeding or ischemic events were detected between genotype-guided de-escalation of DAPT based on CYP2C19 testing and standard practice in this trial, and the genotype-guided strategy was associated with a reduction in drug and testing costs. Confirmation of the clinical benefit of this approach requires further studies in larger cohorts. Full article
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20 pages, 14864 KB  
Article
Phase Change Material-Coupled Operation Condition Adaptive Liquid-Cooling Strategy for Energy Storage Battery Thermal Management
by Xinyu Wang, Fang Qi, Wei Yue, Lei Gao, Qingfeng Cai, Yan Liu and Gui Lu
Electronics 2026, 15(18), 4261; https://doi.org/10.3390/electronics15184261 (registering DOI) - 18 Sep 2026
Abstract
Thermal management is important for ensuring the safety and reliability of energy storage batteries. Conventional single-mode cooling methods fail to maintain efficiency and temperature uniformity under variable operating conditions. This study presents a phase change material (PCM)-coupled liquid-cooling strategy with an operation condition [...] Read more.
Thermal management is important for ensuring the safety and reliability of energy storage batteries. Conventional single-mode cooling methods fail to maintain efficiency and temperature uniformity under variable operating conditions. This study presents a phase change material (PCM)-coupled liquid-cooling strategy with an operation condition adaptive control scheme for large-capacity energy storage batteries. A battery management system numerical model with paraffin/expanded composite PCM and a parallel-channel liquid cold plate was developed. The thermal management performance of this system was comprehensively validated under different coolant flow rates, inlet temperatures, PCM melting points, and latent heats, followed by a quantitative sensitivity analysis to identify dominant influencing factors. Based on the parametric analysis, an adaptive cooling strategy was proposed: passive PCM cooling is adopted at low charge/discharge rates, while a delayed liquid-cooling activation strategy is implemented at a high rate to fully use PCM latent heat and reduce energy consumption. Results denote that this system reduces the battery surface maximum temperature by 5.1 °C and the maximum temperature difference by 2.62 °C compared with liquid cooling alone. The coolant flow rate exerts the greatest influence on both the temperature difference and the maximum temperature through the sensitivity analysis, followed by the PCM melting point, coolant temperature, and latent heat. Under the delayed cooling strategy, the total liquid-cooling runtime during continuous operation is reduced by 1720 s, with the number of cooling cycles decreasing from eight to three. This work provides an engineering-based, operation-adaptive thermal management solution that significantly enhances the temperature control effectiveness, energy efficiency, and operational safety of energy storage power stations under real-world variable working conditions. Full article
(This article belongs to the Special Issue Optimization Control of Distributed Renewable Energy Systems)
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17 pages, 8317 KB  
Article
Orientation-Dependent Modeling of Recycled Steel Fiber-Reinforced Self-Compacting Concrete
by Kasra Hosseinmostofi, Fatemeh Soltanzadeh and Eduardo N. B. Pereira
Fibers 2026, 14(9), 109; https://doi.org/10.3390/fib14090109 (registering DOI) - 18 Sep 2026
Abstract
Recycled tire steel fibers (RSFs) offer a resource-efficient alternative to manufactured industrial steel fibers (ISFs), but their irregular geometry and casting-induced orientation generate pronounced direction-dependent post-cracking behavior. This study develops and evaluates a three-dimensional orientation-conditioned finite element framework for notched splitting tensile tests [...] Read more.
Recycled tire steel fibers (RSFs) offer a resource-efficient alternative to manufactured industrial steel fibers (ISFs), but their irregular geometry and casting-induced orientation generate pronounced direction-dependent post-cracking behavior. This study develops and evaluates a three-dimensional orientation-conditioned finite element framework for notched splitting tensile tests of self-compacting concrete containing a constant total steel fiber dosage of 90 kg/m3 with ISF:RSF proportions of 90:0, 45:45, 30:60, and 0:90. The experimental mechanical response and independently measured fiber architecture provide the basis for constitutive identification and numerical–experimental assessment. The composite is represented in Abaqus/Standard using the concrete damage plasticity model and eight-node full-integration hexahedral elements. Fiber bridging is introduced through orientation-specific quadrilinear tensile stress-crack-opening laws derived from the measured peak and residual responses, allowing directional fiber effects to be represented without discrete fiber modeling. The simulations reproduce the measured peak, residual, and post-cracking responses for crack planes parallel and perpendicular to the casting flow direction, with deviations below 5% at the evaluated characteristic response points. Progressive RSF replacement reduces peak tensile resistance, whereas hybrid and mono-RSF mixtures retain a smoother post-peak decay. The higher residual capacity observed for the favorable orientation is consistent with the independently measured effective fiber population and orientation factor. The framework provides an efficient continuum strategy for incorporating casting-induced anisotropy into engineering-scale analyses of RSF-reinforced concrete. Full article
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17 pages, 5516 KB  
Article
Improving the Resistance Welding Quality of CF/PA6 Composite by Adjusting the Mesh Size of a Perforated Heating Element
by Shiyuan Wang, Zhanyi Geng, Yiwen Li, Chengyang Yi, Yuanduo Yang, Sansan Ao and Yang Li
Polymers 2026, 18(18), 2275; https://doi.org/10.3390/polym18182275 (registering DOI) - 17 Sep 2026
Abstract
During resistance welding of fiber-reinforced thermoplastic composites (FRTP), lower temperatures are observed at the edge of the welding area that is vertical to the direction of the current (longitudinal edge, L-edge). This paper proposes a perforated heating element (HE) with reduced edge mesh [...] Read more.
During resistance welding of fiber-reinforced thermoplastic composites (FRTP), lower temperatures are observed at the edge of the welding area that is vertical to the direction of the current (longitudinal edge, L-edge). This paper proposes a perforated heating element (HE) with reduced edge mesh size to increase the temperature in the L-edge, thereby mitigating the edge effect during the resistance welding of FRTPs. By reducing the mesh size in the L-edges of the welding area, a temperature gradient can be created during the heating process, thereby increasing heat generation at the L-edges of the HE. Through experimental and numerical investigations, the influence of this HE on temperature evolution and joint performance during FRTP resistance welding was investigated. A resistance model was proposed to analyze the resistance and heat generation of regions with different mesh sizes. The results show that the tailored HE increased the temperature in the L-edge area. Furthermore, the reduced mesh size decreased the resistance of the HE in the welding area, mitigating the excessive temperature in the transverse edge (T-edge) (parallel to the current direction) of the welding area. The joints welded with the tailored HE achieved a lap-shear strength (LSS) of 26.6 ± 0.8 MPa, which is 31% higher than the LSS of joints welded with unmodified HE. The proposed resistance model could predict the changing trends of resistance and heat generation in regions with different mesh sizes at the qualitative level. Further work needs to be carried out to improve its quantitative prediction ability. Full article
(This article belongs to the Section Polymer Composites and Nanocomposites)
36 pages, 8094 KB  
Article
Capturing the Value of Lithological Domain Uncertainty in Geometallurgical Mine–Plant Planning
by Bryan Diaz, Aldo Quelopana and Mohammad Maleki
Minerals 2026, 16(9), 950; https://doi.org/10.3390/min16090950 (registering DOI) - 17 Sep 2026
Abstract
Integrated mine–plant optimization should account for multiple geological uncertainties, yet practice typically considers only grade. Lithological domain uncertainty is a distinct source of geometallurgical variability because rock type governs comminution, recovery, cost, and blending. This paper extends a two-stage stochastic mine–plant planning framework [...] Read more.
Integrated mine–plant optimization should account for multiple geological uncertainties, yet practice typically considers only grade. Lithological domain uncertainty is a distinct source of geometallurgical variability because rock type governs comminution, recovery, cost, and blending. This paper extends a two-stage stochastic mine–plant planning framework to represent this uncertainty in a copper porphyry case study based on geological data from the Río Blanco–Los Bronces deposit in the Central Chilean Andes. Copper grade is fixed by block, while Truncated Gaussian Simulation generates realizations of tourmaline breccia and surrounding lithologies. The first stage optimizes a single long-term extraction schedule; the second evaluates recovery, processing cost at fixed throughput, Bond Work Index, and feed-composition compatibility under two adaptive operational modes. The framework combines parallelized Variable Neighborhood Descent with an embedded matheuristic for mass balance, plant capacity, and blending. Relative to a block-wise modal-domain deterministic benchmark over the same 100 validation scenarios, the stochastic plan increases mean net present value by US$2.38 million (3.28%), yielding an empirical value of the stochastic solution, and raises P10, P50, and P90 by US$2.27, US$2.28, and US$2.53 million, respectively. These results show that lithological domain uncertainty has measurable economic value in mine–plant planning even when copper grades are fixed. Full article
(This article belongs to the Special Issue Geometallurgy Applied to Mine Planning)
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18 pages, 12855 KB  
Article
Vegetation Types and Plant Invasion Shape Pollination Interactions on a Tropical Island
by Laura Gómez-Devia, Christopher N. Kaiser-Bunbury, Anna Traveset and Alba Costa
Plants 2026, 15(18), 2845; https://doi.org/10.3390/plants15182845 - 17 Sep 2026
Abstract
Understanding how habitat transformation and non-native species shape plant–pollinator interactions is important for conserving and restoring oceanic islands, where both disturbances are widespread yet rarely examined together. Here, we investigated pollination networks across six contrasting vegetation types spanning a temporal gradient of invasion [...] Read more.
Understanding how habitat transformation and non-native species shape plant–pollinator interactions is important for conserving and restoring oceanic islands, where both disturbances are widespread yet rarely examined together. Here, we investigated pollination networks across six contrasting vegetation types spanning a temporal gradient of invasion by non-native flowering plants on a tropical island. We recorded 5263 visits involving 327 unique plant–pollinator interactions over a three-month sampling period. We found that vegetation type and plant invasion intensity jointly structure different components of plant–pollinator networks at fine spatial scales. Pollinator assemblage composition differed more substantially across vegetation types than across months, although pollinators did not form distinct vegetation-type-specific assemblages. Plant–pollinator interactions also differed among vegetation types, primarily due to plant species turnover. In parallel, increasing invasion intensity was associated with pollinators visiting fewer native plant species, reducing the proportion of visits received by native plants and their importance to pollinators within the network. Moreover, non-native pollinators became more specialized with increasing invasion intensity. Flower abundance was negatively related to the contribution of both plant and pollinator species to nestedness, a structural network property associated with robustness, possibly reflecting altered pollinator visitation patterns associated with honeybee dominance. Overall, our findings highlight the importance of considering both vegetation heterogeneity and invasion intensity for understanding and conserving island plant–pollinator networks. Full article
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23 pages, 1507 KB  
Systematic Review
From Proof-of-Concept to Production: A Techno-Functional Framework for Generative AI Adoption in Enterprise Settings
by Syed Salman Rabbani, Syeedun Nisa, Mohamed El-Tanani and Syed Arman Rabbani
Information 2026, 17(9), 899; https://doi.org/10.3390/info17090899 - 15 Sep 2026
Viewed by 190
Abstract
Purpose: Enterprise generative artificial intelligence (GenAI) is producing a peculiar adoption pattern: many proofs-of-concept, few production deployments. Existing adoption frameworks, designed for technologies whose outputs are deterministic, struggle with foundation models. This paper develops a four-dimensional framework, the techno-functional framework, to guide enterprise [...] Read more.
Purpose: Enterprise generative artificial intelligence (GenAI) is producing a peculiar adoption pattern: many proofs-of-concept, few production deployments. Existing adoption frameworks, designed for technologies whose outputs are deterministic, struggle with foundation models. This paper develops a four-dimensional framework, the techno-functional framework, to guide enterprise GenAI adoption from initial use case screening through structured post-implementation learning. Its dimensions are relevance, operating model, agility, and retrospective. Design and methodology: The paper is conceptual. Its scaffolding rests on a PRISMA 2020-compliant systematic literature review of 60 high-impact peer-reviewed and adjacent works, combined with structured practitioner reflexivity drawn from the authors’ combined enterprise and higher-education AI implementation experience. Each dimension is anchored in established theory. Relevance sits within the technology–organization–environment tradition and Rogers’s diffusion of innovations; operating model draws on dynamic capabilities; agility on organizational ambidexterity; retrospective on absorptive capacity. Findings: Three asymmetries run through the recent literature. Antecedents of GenAI adoption are well studied, but what organizations do after first deployment is barely theorized. Technology-centric and organization-centric framings sit in separate compartments. Iteration is everywhere assumed but rarely specified as a continuous discipline rather than an implementation phase. The framework proposed here addresses each asymmetry. Twelve testable propositions render the path to empirical validation explicit, and four composite vignettes spanning financial services, industrial manufacturing, global retail, and a higher-education institutional setting illustrate the framework’s dimensions in interaction. Originality and value: To the authors’ knowledge, this is the first GenAI adoption framework to place structured retrospection as a first-class dimension grounded in absorptive capacity, and the first to bridge technology and organizational considerations within a single managerial instrument rather than across parallel streams. The framework is research-generative and managerially actionable. Full article
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26 pages, 1427 KB  
Article
Valorisation of the Halophyte Cakile maritima as a Food Resource for Human Consumption
by Ricardo Mir, María Dolores García-Martínez, Monica Boscaiu, Oscar Vicente, Jaime Prohens and María Dolores Raigón-Jiménez
Foods 2026, 15(18), 3261; https://doi.org/10.3390/foods15183261 - 15 Sep 2026
Viewed by 111
Abstract
Increasing soil salinisation challenges food production, since most crops are highly sensitive to salinity. The identification of wild halophytes adapted to saline environments with nutritional value represents a promising strategy for food production on salt-affected farmlands. Assessing the nutritional potential of such species [...] Read more.
Increasing soil salinisation challenges food production, since most crops are highly sensitive to salinity. The identification of wild halophytes adapted to saline environments with nutritional value represents a promising strategy for food production on salt-affected farmlands. Assessing the nutritional potential of such species requires evaluating their proximate composition, mineral profile, and antioxidant properties. In parallel, citizen-science approaches complement and enhance scientific research by actively engaging potential final consumers in the research process, thereby improving the societal relevance, dissemination, and potential impact of scientific findings. In this study, we characterised the nutritional profile of the facultative halophyte Cakile maritima and found it to be comparable, and in some respects superior, to that of other conventional leafy vegetables, particularly regarding its mineral composition and bioactive compounds. Moreover, similar though not identical nutritional characteristics were observed in two C. maritima leaf morphotypes analysed, since differences in dry matter, ashes, total proteins and carbohydrates were identified. Interestingly, vitamin C accumulation was organ- and morphotype-dependent. Finally, the biochemical characterisation was complemented with an online survey that showed a clear predisposition of consumers towards the incorporation of wild edible plants into their diet, together with a sensory evaluation in which 32 participants assessed the acceptability of up to 11 dishes prepared using C. maritima. Sensory evaluation revealed a prominent bitter flavour amongst dishes containing C. maritima, with weighted scores for negative perceptions slightly exceeding those for positive ones, suggesting that its sensory profile may limit its acceptance by the general public while offering potential for specific consumer segments. Overall, our findings highlight the nutritional potential of C. maritima and support its valorisation as a sustainable species for saline agriculture. Full article
(This article belongs to the Section Plant Foods)
85 pages, 4030 KB  
Review
Antioxidant Interventions on Muscle Function and Mass in Aging-Related Muscle Decline: A Systematic Review of Preclinical and Clinical Evidence
by Xin Li, Ke Zhou, Ronald Man Yeung Wong, Wing Hoi Cheung and Can Cui
Antioxidants 2026, 15(9), 1167; https://doi.org/10.3390/antiox15091167 - 15 Sep 2026
Viewed by 201
Abstract
Oxidative stress contributes to aging-related muscle decline, but antioxidant interventions may affect functional and structural outcomes differently. This systematic review synthesized clinical, animal, and cellular evidence across clinically defined sarcopenia and broader models of aging-related muscle decline. PubMed, Embase, Web of Science, and [...] Read more.
Oxidative stress contributes to aging-related muscle decline, but antioxidant interventions may affect functional and structural outcomes differently. This systematic review synthesized clinical, animal, and cellular evidence across clinically defined sarcopenia and broader models of aging-related muscle decline. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched through 11 July 2026. Eligible studies tested antioxidant interventions in older adults or aging-related preclinical models and were appraised using the Cochrane Risk of Bias 2 (RoB 2) tool, a modified Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) risk-of-bias tool, and a modified in vitro checklist. Forty-four publications were included: eight clinical trials, 26 animal datasets, and 18 cellular datasets, with eight publications contributing both animal and cellular evidence. Comparative clinical benefits were reported primarily for strength or power (7/8 studies), with less support for physical performance (2/6 studies assessing this domain) or body composition-related muscle quantity (2/8 studies). Selected preclinical studies likewise showed functional gains without parallel structural improvement, although effects varied by model and intervention. Preclinical findings implicated antioxidant defense, mitochondrial maintenance, inflammation, and proteostasis, but most pathway evidence was associative and direct experimental validation was limited. Clinical evidence was further constrained by small samples, short interventions, combined nutritional or exercise co-interventions, and heterogeneous outcomes. Current evidence does not support a consistent increase in muscle quantity with antioxidant interventions. The observed pattern appears context dependent and requires confirmation in adequately powered, phenotype-stratified trials assessing muscle strength, physical performance, muscle quantity, and mechanistic endpoints. Full article
(This article belongs to the Section Health Outcomes of Antioxidants and Oxidative Stress)
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54 pages, 1671 KB  
Review
Microbiome-Based Therapeutics in Oncology: Expanding Indications Beyond C. difficile
by Ayham Al-Omari, Abdallah Kheshman, Peter Morkos, Katherine Davanzo and Lea Monday
Onco 2026, 6(3), 47; https://doi.org/10.3390/onco6030047 - 14 Sep 2026
Viewed by 95
Abstract
The intestinal microbiome has emerged as a clinically significant modulator of outcomes across multiple domains of cancer care. In hematopoietic stem cell transplantation (HSCT), loss of microbial diversity and depletion of short-chain fatty acid-producing commensals are independently associated with graft-versus-host disease (GvHD), bloodstream [...] Read more.
The intestinal microbiome has emerged as a clinically significant modulator of outcomes across multiple domains of cancer care. In hematopoietic stem cell transplantation (HSCT), loss of microbial diversity and depletion of short-chain fatty acid-producing commensals are independently associated with graft-versus-host disease (GvHD), bloodstream infections, transplant-related mortality, and overall survival. Mechanistic studies have identified interconnected pathways—including butyrate-mediated epithelial protection, tryptophan-derived aryl hydrocarbon receptor signaling, bile acid metabolism, and Paneth cell–intestinal stem cell interactions—through which microbial communities regulate intestinal barrier integrity and immune homeostasis. These insights have provided the biological rationale for therapeutic strategies aimed at restoring microbial ecology. Fecal microbiota transplantation (FMT) has demonstrated promising clinical activity in steroid-refractory acute GvHD, with one meta-analysis reporting a pooled clinical remission rate of 64% (95% CI, 51–77%) across prospective single-arm studies, and proprietary live biotherapeutic products (LBPs) such as MaaT013 met the primary endpoint of the single-arm phase III ARES trial, achieving a day-28 gastrointestinal overall response rate of 62%; however, the CHMP adopted a negative opinion on its conditional marketing authorization application in June 2026, citing limitations of the single-arm design, and a re-examination is pending. In parallel, gut microbiome composition has been associated with immune checkpoint inhibitor (ICI) response, and early-phase FMT studies suggest that microbiome modulation may restore sensitivity to anti-PD-1 therapy in some patients with refractory melanoma and may enhance treatment responses in first-line ICI settings; however, these findings derive primarily from small, uncontrolled or early-phase studies. Defined single-strain approaches, notably Clostridium butyricum MIYAIRI 588 (CBM588), have shown encouraging secondary clinical efficacy signals in two small, randomized phase I trials in metastatic renal cell carcinoma, including significantly prolonged progression-free survival in one trial and a higher objective response rate in another; however, neither trial met its prespecified primary microbiome endpoint of increased Bifidobacterium spp. abundance. Emerging evidence further links antibiotic-induced dysbiosis to impaired chimeric antigen receptor T-cell (CAR-T) therapy outcomes, while short-chain fatty acids have been identified as direct enhancers of CAR-T cell effector function. This review synthesizes the current evidence for microbiome-based therapeutics across HSCT, GvHD, ICI therapy, CAR-T cell therapy, and infection prevention, and addresses cross-cutting translational challenges including antibiotic stewardship, donor selection, safety in immunocompromised populations, and pharmacomicrobiomics. While randomized controlled trial data remain limited and many approaches are investigational, the convergence of mechanistic, observational, and early interventional evidence positions microbiome restoration as a promising frontier in precision oncology. Full article
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20 pages, 410 KB  
Article
Comparative Efficacy of Rebamipide, Pantoprazole, and Their Combination for Gastroprotection in Patients with Atrial Fibrillation Receiving Direct Oral Anticoagulants: The Randomized REGATA Study
by Natalya M. Vorobyeva, Irina P. Malaya, Vadim D. Zakiev, Antonina A. Masharova, Tatiana P. Pinchuk, Irina V. Kostomarova, Valentina S. Ostapenko, Yulia V. Kotovskaya and Olga N. Tkacheva
Med. Sci. 2026, 14(5), 565; https://doi.org/10.3390/medsci14050565 - 12 Sep 2026
Viewed by 166
Abstract
Background: Patients with atrial fibrillation (AF) receiving direct oral anticoagulants (DOAC) are at an elevated risk of gastrointestinal (GI) mucosal damage and bleeding. Proton pump inhibitors (PPI) are conventional gastroprotectors, but their efficacy in the lower GI tract is limited. This study evaluated [...] Read more.
Background: Patients with atrial fibrillation (AF) receiving direct oral anticoagulants (DOAC) are at an elevated risk of gastrointestinal (GI) mucosal damage and bleeding. Proton pump inhibitors (PPI) are conventional gastroprotectors, but their efficacy in the lower GI tract is limited. This study evaluated the efficacy and safety of rebamipide monotherapy and combination pantoprazole-rebamipide (P + R) therapy compared to pantoprazole monotherapy in this vulnerable population. Methods: In the randomized, parallel-group, open-label, single-center REGATA trial, 210 AF patients receiving DOAC were randomized (1:1:1) to three gastroprotective regimens (n = 70 each) for 24 weeks: pantoprazole monotherapy, rebamipide monotherapy, or their combination. Efficacy analyses were performed in the per-protocol population (n = 118: pantoprazole, n = 36; rebamipide, n = 39; P + R, n = 43). The primary and secondary outcomes included composite clinical GI events (bleeding classified by ISTH/BARC, ulcers/erosions, and severe dyspepsia) and biomarkers of mucosal barrier function (fecal zonulin and calprotectin). Results: The incidence of primary efficacy endpoint events was 13.9% (n = 5; 95% CI: 3.1–25.7) in the pantoprazole group, 10.3% (n = 4; 95% CI: 2.3–21.1) in the rebamipide group, and 9.3% (n = 4; 95% CI: 2.1–18.6) in the P + R group, successfully confirming the non-inferiority hypothesis for both experimental arms within the pre-specified margin of 10% (p < 0.05). Multivariable regression analysis showed that compared with pantoprazole monotherapy, rebamipide monotherapy demonstrated an odds ratio OR of 0.71 (95% CI: 0.18–2.88, p = 0.630), while the P + R therapy was associated with an OR of 0.64 (95% CI: 0.16–2.57, p = 0.525). No major GI bleeding events or fatalities occurred; a single episode of GI bleeding (ISTH minor/BARC Type 2) was recorded in the pantoprazole arm (2.8%). Fecal calprotectin levels significantly decreased in the rebamipide group (by 37.6%, from 139 to 78 µg/g; p < 0.001) and the P + R group (by 50.0%, from 135 to 61 µg/g; p < 0.001), while no significant changes were observed in the pantoprazole group (p = 0.530). Concurrently, fecal zonulin levels, reflecting intestinal epithelial permeability, fell by 45.1% in the rebamipide arm (from 434 to 225 ng/mL; p < 0.001) and by 47.1% in the P + R arm (from 347 to 182 ng/mL; p < 0.001) compared to a minimal 3.0% fluctuation in the pantoprazole group. Conclusions: While demonstrating non-inferiority regarding primary clinical endpoints, both rebamipide monotherapy and combination (P + R) therapy achieved some advantages over pantoprazole monotherapy in decreasing subclinical GI inflammation and restoring intestinal epithelial barrier integrity. Full article
(This article belongs to the Section Hepatic and Gastroenterology Diseases)
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18 pages, 4669 KB  
Review
The Gut–Heart–Kidney Axis in Heart Failure: Trimethylamine N-Oxide and Beyond—A State-of-the-Art Review
by Ismaila Ajayi Yusuf, Solomon Anighoro, Abdullah Sultany, Sheeza Nawaz, Ayush Adhikari, Shubhendu Bajpai, Ashraf Ullah, Arundhati Sharma, Sahil Grover, Naga Sumanth Reddy Gopireddy, Amlish Gondal, Michelle Bernshteyn and Subash Ghimire
Biomedicines 2026, 14(9), 2054; https://doi.org/10.3390/biomedicines14092054 - 12 Sep 2026
Viewed by 405
Abstract
Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite of dietary choline and L-carnitine, has emerged as a leading molecular mediator of the gut–heart–kidney axis in heart failure (HF). This state-of-the-art narrative review synthesizes evidence from 14 observational studies (13 prospective cohorts and one cross-sectional [...] Read more.
Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite of dietary choline and L-carnitine, has emerged as a leading molecular mediator of the gut–heart–kidney axis in heart failure (HF). This state-of-the-art narrative review synthesizes evidence from 14 observational studies (13 prospective cohorts and one cross-sectional analysis), encompassing a heterogeneous range of HF settings, including established chronic HF, acute decompensated HF, incident HF in community cohorts, and subclinical myocardial injury. Across these populations, elevated circulating TMAO has been associated with adverse outcomes, including mortality, rehospitalization, and major adverse cardiovascular events, although the strength and consistency of associations vary by HF phenotype, renal function status, and population ancestry. The prognostic independence of TMAO is attenuated after adjusting for renal function in several cohorts, reflecting both obligatory renal clearance and a potentially bidirectional relationship with kidney injury. TMAO was not reduced during neurohormonal GDMT uptitration in the BIOSTAT-CHF study, suggesting that gut microbiota dysbiosis may represent a pathophysiological axis not reached by current HF treatment. The field has evolved through three thematic stages: TMAO as a single prognostic biomarker, TMAO within cardiorenal pathophysiology, and multimetabolite and multipathway risk profiling. Beyond the TMAO pathway, emerging evidence for phenylacetylglutamine (PAGln), short-chain fatty acids (SCFAs), and protein-bound uremic toxins as parallel gut-derived cardiovascular mediators supports a multidimensional metabolite profiling approach. Several cohorts suggest that selected multimetabolite panels may provide additional prognostic information beyond TMAO alone, although their composition, calibration, and external validity remain uncertain. Population-specific variation in TMAO levels and prognostic thresholds complicates universal clinical application. Without human interventional data demonstrating that lowering TMAO improves cardiovascular outcomes, TMAO remains a prognostic risk marker rather than a validated clinical target. Clinical translation requires resolving the renal confounding problem, validating multimetabolite panels across diverse populations, and conducting intervention trials targeting the gut–heart–kidney axis. Full article
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16 pages, 1061 KB  
Article
Behavioral Domains and Physiological Characteristics in Young Adults: Findings from Integrated Seven-Day Self-Monitoring and Physiological Assessment
by Stanislav Dadelo and Svetlana Danilenko
Life 2026, 16(9), 1520; https://doi.org/10.3390/life16091520 - 12 Sep 2026
Viewed by 208
Abstract
Objectives: This study examined patterns among six selected variables from seven-day self-monitored behavioral records and physiological characteristics and their cross-domain associations in young adults. Methods: The study included 157 university students aged 20–23 years (106 men, 51 women). Six behavioral variables derived from [...] Read more.
Objectives: This study examined patterns among six selected variables from seven-day self-monitored behavioral records and physiological characteristics and their cross-domain associations in young adults. Methods: The study included 157 university students aged 20–23 years (106 men, 51 women). Six behavioral variables derived from seven-day self-monitoring and seven physiological indicators were examined using sex-specific PCA, with component retention determined by parallel analysis. Cross-domain associations between the retained physiological and behavioral components were tested using Pearson correlations with Benjamini–Hochberg FDR correction. Results: Parallel analysis retained two physiological and two behavioral components in each sex. The physiological components represented body composition and cardiorespiratory fitness, while the behavioral components primarily reflected energy intake–expenditure and carbohydrate–protein patterns. Two of the eight cross-domain Pearson associations had raw p-values below 0.05, but neither remained statistically significant after FDR correction. Conclusions: The seven-day behavioral patterns and physiological characteristics showed limited correspondence. Seven-day self-monitoring can complement physiological assessment by documenting recent behavior, but should not be used as a substitute for direct assessment of physiological characteristics. Full article
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