Search Results (5,507)

To address the challenges of coordinated optimization in building integrated energy systems (IES) under the dual-carbon targets—characterized by strong multi-energy coupling, significant uncertainty in renewable generation, and stringent safety constraints—a novel safe deep reinforcement learning algorithm, Safe-DDPG, is proposed. Traditional deep reinforcement learning methods often suffer from high constraint-violation risk and limited policy reliability due to coupled objectives in building IES optimization. To overcome these limitations, a dual-channel critic architecture is designed to independently evaluate and decouple economic and safety objectives. In addition, a dynamic safety–penalty mechanism based on logarithmic barrier functions is introduced, together with an adaptive exploration strategy, enabling dynamic balancing between economic cost and constraint satisfaction according to system states during training. Experimental results demonstrate that, compared with mainstream algorithms, Safe-DDPG achieves substantial improvements across multiple key performance indicators: safety violations are reduced by up to 96.7%, average daily operating costs decrease by 18.5%, and cumulative rewards increase by more than 30%. Ablation studies further confirm the effectiveness and necessity of each core component. Two DRL methods from reference papers are reproduced, and their performance is compared with the proposed method in the existing experimental results, showing that the proposed method has significant advantages in reward value and economic cost. This work provides a safe, reliable, and efficient reinforcement-learning-based approach for optimization and scheduling of building energy systems under complex operational constraints. Full article

On 9–10 December 2025, the Coalition for Epidemic Preparedness Innovations (CEPI) and the International Vaccine Institute (IVI) convened a workshop in Seoul under CEPI’s Disease X Program. The primary objective was to identify existing gaps needing to be filled and streamline vaccine development and preparedness for Severe Fever with Thrombocytopenia Syndrome (SFTS). CEPI’s partners and experts discussed a multifaceted agenda, ranging from understanding the evolving epidemiology to the refinement of animal models and immunological assay harmonization. Key outcomes included the refinement of Target Product Profiles (TPPs) specifying use cases for both peacetime and outbreak contexts, alongside a recommendation for a core immunoassay panel aimed at harmonizing evaluation frameworks and mitigating the challenges posed by low SFTS prevalence. Integration of the One Health approach emerged as a critical strategy for SFTS prevention, complemented by proactive regulatory engagement to compress vaccine development timelines. This report summarizes these key insights from the workshop, delineating a strategic framework for delivering safe, effective, and accessible vaccines for SFTS and broader Disease X threats. Full article

This paper investigates how climate shelter initiatives implemented in European cities interact with National Adaptation Strategies (NAS) and National Adaptation Plans (NAP), assessing the degree of vertical integration between local practices and national climate adaptation frameworks. As urban heat increasingly threatens public health and exacerbates socio-spatial inequalities, climate shelters, conceived as networks of safe, accessible public spaces providing thermal comfort and social support, have emerged as innovative adaptation tools; however, their recognition within national policy architectures remains uneven across the EU. This study adopts a qualitative–comparative design structured in three phases: (i) a systematic review of NAS and NAP in the 27 EU Member States through keyword screening and classification of references as explicit, implicit, or absent; (ii) a mapping of climate shelter initiatives across 244 NUTS-2 capital cities; and (iii) an integrative cross-analysis of national frameworks and local implementation patterns. According to our results, only 4 Member States explicitly refer to climate shelters, 11 include implicit references, and 12 show no recognition, while 88 cities implement 97 initiatives, predominantly based on Nature-based Solutions and schoolyard transformations; 5 recurring governance configurations reveal bottom-up, top-down, and hybrid dynamics, demonstrating that local experimentation can anticipate, complement, and potentially reshape national adaptation policies. Full article

Spontaneous fermentation processes can promote uncontrolled microbial growth and increase the risk of foodborne contamination, making the characterization of artisanal beverages essential for consumer safety. This study investigated the microbial composition of quinoa-based rejuvelac, a homemade fermented drink often perceived as a functional food, with the objective of identifying potential microbiological hazards associated with its preparation. High-throughput sequencing of the 16S rRNA V3–V4 region was combined with shotgun metagenomics to profile bacterial communities and recover metagenome-assembled genomes. The analysis revealed a strong dominance of Pseudomonadales, mainly Pseudomonas, Acinetobacter, Enterobacter and Burkholderiales, while lactic acid bacteria typically responsible for stable and safe fermentations were not detected. Shotgun metagenomics recovered medium- to high-quality genomes from Burkholderiaceae and Clostridiales, supporting the overrepresentation of non-beneficial taxa and indicating deviations from expected fermentation microbiota. These results show that the spontaneous preparation of rejuvelac may favor bacterial groups associated with environmental contamination rather than fermentative pathways, underscoring the importance of hygiene practices, controlled starter cultures and monitoring strategies to mitigate microbiological risk. The study highlights the need for improved safety standards in artisanal fermented foods to prevent unintended microbial contamination and protect consumers. Full article

Background: Ankyloglossia is a congenital anomaly characterized by restricted tongue mobility due to a short, thick, or tight lingual frenulum. Methods: This narrative review synthesizes current concepts on etiology, clinical presentation, diagnostic approaches, functional implications, and management for ankyloglossia in newborns. Results: Ankyloglossia can compromise breastfeeding dynamics, manifesting as suboptimal latch, maternal nipple pain, and inefficient milk transfer, and may influence orofacial function if unrecognized. Because anatomical appearance alone does not reliably predict function, evaluation should prioritize structured functional assessments over purely morphological descriptors. Management should be individualized and stepwise, beginning with lactation support and positioning strategies, and progressing to frenotomy when clear functional limitation persists. In appropriately selected cases, timely intervention can improve feeding efficiency and caregiver comfort while minimizing disruptions to early bonding and nutrition. Post-procedure follow-up is important to confirm functional gains and address residual feeding mechanics. Conclusions: A coordinated, multidisciplinary approach aligns diagnosis and treatment with the infant’s functional needs and family goals, promoting safe, effective, and patient-centered care. Full article

Introduction: Acute gallstone pancreatitis is a potentially severe disease associated with morbidity and mortality. Cholecystectomy is recommended to prevent recurrence. During pregnancy, surgical management is challenging, and in the post-partum period small gallstones may spontaneously disappear. Ursodeoxycholic acid (UDCA) is safe during the last 6 months of pregnancy and effective in dissolving small gallstones, although recurrence after discontinuation is common in the general population. The optimal strategy to prevent recurrent acute pancreatitis during and after pregnancy remains unclear. Methods: Between 2002 and 2017 we prospectively treated women with acute pancreatitis related to small gallstones (≤1 cm in diameter) during the last six months of pregnancy or within the first post-partum year who declined surgery. Patients received UDCA until stone dissolution. A patent cystic duct was confirmed by ultrasonography; after delivery, a non-contrast CT scan was performed to exclude calcified stones. Patients were followed for at least 6 years or until recurrence, with serial clinical and ultrasonographic examinations. Results: UDCA was associated with complete dissolution in 13/14 women within a mean ± SD of 7.77 + 3.1 months. One patient experienced gallstone recurrence 75 months after treatment discontinuation. Two patients developed recurrent pancreatitis (at 1 and 88 months respectively). Twelve women remained free of recurrence over a mean ± SD follow-up of 79.5 + 9.4 months. Discussion: This is an observational study in which we document that UDCA may facilitate the spontaneous dissolution of small gallstones after delivery and can be considered a bridge strategy during pregnancy when surgery is not feasible. However, this study cannot determine the additional benefit of UDCA over the spontaneous disappearance of stones observed after delivery because we had no control group. Cholecystectomy remains the standard of care post-partum. Medical therapy should be reserved for women who refuse surgery and it requires close ultrasonographic surveillance. The main strength of this study is the prospective long-term follow-up of a consecutive cohort with a rare condition. Limitations include the small sample size, missing control group and single-center design. Full article

Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty, typically managed through a two-stage revision protocol involving antibiotic-loaded spacers. This study aimed to evaluate the clinical outcomes and safety of a new multiple high-dose antibiotic-loaded cement (MHDALC) spacer against alternative classical antibiotic combinations for Gram-positive PJI. In this retrospective observational study of 102 patients (30 MHDALC vs. 72 control), the MHDALC cohort received spacers prepared with commercial cement (1 g clindamycin and 1 g gentamicin per 40 g) supplemented with manual additions of 4 g vancomycin and 2 g ceftazidime per 40 g of cement, while the control group received the same commercial cement supplemented with 4 g of vancomycin alone. Treatment failure was significantly lower in the MHDALC group (6.6%) compared to the control group (20.8%; p = 0.005). Furthermore, the time to second-stage reimplantation was drastically reduced in the MHDALC cohort (9.1 vs. 17.8 weeks; p = 0.001). Despite the substantially higher antibiotic load, no significant differences were observed regarding mechanical or surgical complications between the two groups (p = 1.00). In conclusion, the use of MHDALC spacers is an effective and safe strategy for treating Gram-positive PJI, significantly improving eradication rates and accelerating the transition to definitive reconstruction without compromising structural integrity. Full article

To overcome the low thermal conductivity and flow channel clogging inherent in traditional phase change materials (PCMs) for immersion cooling, this study develops a novel oil-based phase change emulsion (PCE) integrating high thermal transport with adaptive rheological behavior. A liquid thermal conductivity enhancer was synthesized by modifying epoxidized soybean oil with LiTFSI and blending it with a synthetic ester to form a dielectric base fluid. A mid-to-low-temperature PCM (Span65) was then incorporated via surfactant-free ultrasonic emulsification. The resulting PCE exhibits a tunable phase-change window (25~40 °C) driven by interfacial confinement effects and a multiscale lamellar network. It achieves significantly enhanced thermal conductivity (15% increase over base oil) while maintaining excellent electrical insulation (<10⁻⁹ S/cm). Rheologically, the emulsion transitions from shear-thinning in the solid state to near-Newtonian in the liquid state, optimizing both suspension stability and pumping efficiency. This work establishes a strategy for designing high-performance, safe, and energy-efficient dielectric coolants, offering a robust solution for next-generation electronic and battery thermal management systems. Full article

The escalating demand for sustainable, nutrient-dense feeds underscores the need to valorize the agro-industrial byproducts utilizing innovative bioconversion strategies. In this context, we have studied the feasibility of incorporating tomato (Solanum lycopersicum) cultivation residues into Black Soldier Fly (BSF) larvae diets to produce high-protein insect meals. These residues are known to contain the naturally occurring toxic steroidal alkaloids tomatidine and α-tomatine, prohibiting their incorporation into human and animal diets. Herein, the tomato cultivation biomass was dried and mill-ground, and its varying volumes were incorporated into standard poultry feed (seven diet levels with 0–100% biomass inclusion) and tested in BSF-larvae-rearing trials to produce insect meals. The optimal results with respect to larvae growth, protein accumulation (highest value = 30.61%), lipid–fiber content, and antioxidant capacity were determined for insect meals obtained from BSF larvae reared with a ration composed of 40% tomato plant biomass. In addition, the toxicity of this insect meal was substantially low, as a consequence of the observed groundbreaking reduction in the contained toxic steroidal alkaloids α-tomatine and its aglycone tomatidine. The results herein reveal the efficacy of the BSF-larvae-rearing process in acting as a biological filter for the bioconversion of the toxic tomato cultivation waste into a functional, safe, and protein-rich livestock feed, supporting the principles of a circular economy. Full article

Objectives: As artificial intelligence (AI) technologies become increasingly integrated into healthcare systems, understanding healthcare professionals’ psychological responses—particularly AI-related anxiety—has become increasingly important for the safe and effective implementation of these technologies in clinical practice. This study aimed to examine the relationships between oncology nurses’ readiness for artificial intelligence, their attitudes toward artificial intelligence, and their levels of AI-related anxiety. Design: A descriptive, cross-sectional study. Setting: An oncology hospital within a state hospital in Istanbul, Turkey. Participants: A total of 207 oncology nurses working full-time in clinical settings. Methods: Data were collected using an online survey consisting of a demographic information form, the Medical Artificial Intelligence Readiness Scale (MAIRS-MS), the Artificial Intelligence Anxiety Scale (AIAS), and the General Attitudes toward Artificial Intelligence Scale (GAAIS). Spearman correlation analysis, general linear modeling, and conditional mediation analysis were performed using JAMOVI (v2.6.17). A p-value of <0.05 was considered statistically significant. Results: AI-related anxiety was significantly and negatively correlated with both readiness and attitudes toward AI. General linear modeling showed that attitudes toward AI significantly predicted anxiety (β = −0.327, p < 0.001), whereas readiness did not have a direct significant effect. Conditional mediation analysis demonstrated that attitudes fully mediated the relationship between readiness and AI anxiety. The indirect effect of readiness on anxiety through attitudes was stronger among nurses who had received prior AI-related education. While the indirect effect remained significant among untrained nurses, its magnitude was considerably smaller. The total effect of readiness on anxiety was significant only in the untrained group, suggesting that structured education redirects the impact of readiness primarily through attitudes. Conclusions: Attitudes toward artificial intelligence represent the key psychological mechanism linking readiness to AI-related anxiety among oncology nurses. Prior AI education appears to strengthen this relationship by enhancing the association between readiness and attitudes and by being associated with lower anxiety levels. Educational and implementation strategies that emphasize ethical awareness and the development of positive, informed attitudes—rather than focusing solely on technical competence—are likely to be more effective in reducing anxiety and promoting the safe and ethical integration of AI into oncology nursing practice. Full article

Aqueous supercapacitors are a class of crucial high-power, long-life, safe and reliable energy storage devices, with their performance fundamentally dependent on electrode materials. Two-dimensional (2D) vanadium-based MXenes, possessing rich multivalent redox activity and tunable layered structures, have emerged as one of highly promising electrode candidates, exhibiting significantly superior specific capacitance and pseudocapacitive properties compared to conventional Ti₃C₂T_z. To overcome inherent limitations in conductivity and structural stability, this review summarizes strategies for regulating composition and microstructure through transition metal solid solution and medium-/high-entropy design. These approaches synergistically optimize electron conduction, expand ion migration pathways, and suppress electrode degradation, thereby comprehensively enhancing rate performance, cycle life, and energy density. This review systematically reveals the composition–structure–performance relationships, providing critical design insights and theoretical foundations for developing next-generation high-performance, long-life aqueous MXene-based supercapacitors. Full article

Background/Objectives: Chronic traumatic spinal cord injury (SCI) causes persistent neurological deficits for which no clinically effective regenerative therapy is currently available. Mesenchymal stromal/stem cells (MSCs), particularly Wharton’s jelly-derived MSCs (WJ-MSCs), demonstrate immunomodulatory and neurotrophic potential. This phase I/II study evaluated the safety and efficacy of intrathecal allogeneic WJ-MSC administration in individuals with chronic incomplete cervical SCI. Methods: In this multicentre, randomised, double-blind, placebo-controlled trial (NCT05054803, EudraCT 2021-000346-18), 18 participants with chronic (1–5 years post-injury) incomplete cervical SCI (AIS B–D) received two intrathecal injections of WJ-MSCs (0.7–1.3 × 10⁶ viable cells/kg) or a placebo at baseline and 3 months. Seventeen participants completed the 12-month follow-up. Primary outcomes assessed safety, and secondary endpoints included International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor and sensory scores, spasticity, neuropathic pain, functional independence, neurophysiological measures, and quality of life. Results: Intrathecal WJ-MSC administration was safe and well tolerated. Eighty adverse events occurred (placebo: 26; WJ-MSC: 54), predominantly mild or moderate; four severe events were unrelated to treatment. Both groups demonstrated significant within-group improvements in total motor scores at 12 months, with no between-group difference. No treatment effects were observed for sensory scores, electrophysiological measures, functional independence, spasticity, pain, or patient-reported outcomes. Conclusions: In this first randomised, placebo-controlled trial evaluating intrathecal WJ-MSCs in chronic incomplete cervical SCI, WJ-MSC administration demonstrated a favourable safety profile; however, no significant between-group differences were detected relative to the placebo. Given the limited sample size and early-phase design, the efficacy findings should be interpreted cautiously. Future research should explore enhanced cell products, intensified dosing schedules, optimised delivery strategies, early intervention, and multimodal therapeutic combinations. Full article

Inherited cardiomyopathies associated with high-risk genotypes, are characterized by a disproportionate risk of malignant ventricular arrhythmias and sudden cardiac death, often independent of left ventricular systolic dysfunction or advanced structural remodeling. Traditional surveillance strategies based on intermittent electrocardiography and phenotype-driven risk assessment are insufficient to capture the dynamic and often silent progression of electrical instability in these populations. This narrative review evaluates the emerging role of artificial intelligence (AI)-enabled sensor technologies in remote arrhythmic monitoring of genetically defined cardiomyopathy cohorts. Wearable ECG devices, implantable cardiac monitors, multisensor cardiac implantable electronic device algorithms, pulmonary artery pressure sensors, and contact-free systems enable continuous acquisition of electrophysiological and hemodynamic data, generating digital biomarkers that may reflect early arrhythmic vulnerability and subclinical decompensation. AI-driven analytics enhance signal processing, automated event detection, and remote data triage, with the potential to reduce clinical workload while preserving diagnostic sensitivity. However, current evidence predominantly derives from heterogeneous heart failure or general arrhythmia populations, and prospective validation in genotype-specific cohorts remains limited. Key challenges include algorithm generalizability, signal quality in ambulatory environments, data governance, interpretability of AI models, and integration into structured remote-care pathways. The convergence of genotype-informed risk stratification and multimodal AI-enabled sensing represents a promising strategy to transition from reactive device-based protection to proactive, precision-guided arrhythmic prevention. Dedicated genotype-focused studies and standardized digital endpoints are required to support safe and effective implementation in inherited cardiomyopathies. Full article

Metabolic diseases, including type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated fatty liver disease (MAFLD), are chronic disorders characterized by dysregulated glucose and lipid homeostasis and represent major contributors to insulin resistance, cardiovascular complications, and liver injury. Despite considerable progress in elucidating their pathogenesis, effective preventive and therapeutic strategies remain limited. N6-methyladenosine (m⁶A) RNA demethylase AlkB homolog 5 (ALKBH5), a nuclear epitranscriptomic “eraser,” broadly regulates post-transcriptional gene expression by modulating RNA splicing, nuclear export, stability, and translation. Dysregulation of ALKBH5 has been implicated in tumorigenesis, immune dysfunction, and stress responses, underscoring its wide-ranging biological significance. Emerging evidence further indicates that ALKBH5 plays a pivotal role in maintaining metabolic homeostasis. However, most existing reviews have focused primarily on its roles in cancer, leaving its functions in metabolic diseases relatively unexplored. In this context, this review summarizes the structural characteristics and molecular mechanisms of ALKBH5 and discusses its emerging roles across a spectrum of metabolic diseases, including MAFLD, metabolic complications such as diabetic retinopathy (DR), diabetes-associated cognitive impairment (DACI), atherosclerosis (AS), and diabetic cardiomyopathy (DCM), as well as metabolism-related inflammatory diseases represented by rheumatoid arthritis (RA). Furthermore, recent pharmacological strategies targeting ALKBH5 are discussed, with attention to the challenges posed by its context-dependent, tissue-specific, and disease stage-specific activities. Overall, ALKBH5 emerges as a key epitranscriptomic regulator in metabolic diseases, and advancing therapeutic strategies that account for molecular context and tissue specificity will be critical for achieving safe and effective clinical interventions. Full article

Edible coatings (ECs) derived from natural biopolymers represent an effective preservation strategy for fruits and vegetables and a promising postharvest approach aligned with the increasing demand for sustainable agricultural practices. These Generally Recognized As Safe (GRAS)-based coatings, which are mainly polysaccharide-, protein-, and lipid-based, can extend shelf-life with minimal impact on texture, flavor, and nutritional value, reducing reliance on synthetic packaging and helping mitigate food loss and waste. Beyond acting as a physical barrier, ECs can significantly influence fruit and vegetable metabolism by modulating biochemical and molecular processes. This review focuses on these effects by summarizing evidence from conventional analytical methods, including targeted metabolite analyses, as well as omics-based approaches, primarily transcriptomics and metabolomics, which remain poorly explored in the current EC research literature. Furthermore, integrated metabolomic and transcriptomic analyses are examined, as they offer a more comprehensive understanding of the molecular mechanisms underlying quality attributes, stress responses, and preservation outcomes. Collectively, this work offers detailed insights into coating-induced changes in metabolite profiles and gene expression in coated fruits and vegetables, including formulations derived from agri-food by-products and coatings enriched with bioactive compounds with antioxidant, antimicrobial, and antifungal properties. Overall, by addressing a current gap in the literature, it provides an integrative and innovative framework for interpreting coating performance at both applied and molecular levels, with potential relevance for the agri-food industry and for future research aimed at developing more sustainable, effective, and commodity-tailored postharvest technologies. Full article