Search Results (452)

Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. Full article

The removal of antibiotics from aqueous media along with their recovery is still an open research topic, due to their practical and economical importance. Adsorption allows these two objectives to be achieved, provided that the adsorbent used is chemically and mechanically stable and has a low preparation cost. In this study, PET (polyethylene terephthalate) fibers, obtained by mechanically processing PET waste, were used for the adsorption of rifampicin (RIF) and rifaximin (RIX) antibiotics from aqueous media. The experimental adsorption capacity of PET fibers for the two antibiotics (RIF and RIX) was determined at different pH values (2.0–6.5), adsorbent dose (0.4–20.0 g/L), contact time (5–1440 min), initial antibiotic concentration (4.0–67.0 mg/L), and temperature (10, 22, and 50 °C); the experimental values of these parameters were analyzed using a neuro-evolutive technique (ANE) combining sequential deep learning (DL) models with a differential evolution algorithm. The obtained optimal ANN-DL algorithm was then used to obtain the optimal models for the adsorption of RIF and RIX on PET fibers, which should adequately describe the adsorption dynamics for both antibiotics. The adsorption processes are spontaneous and endothermic (ΔG < 0, ΔH > 0) and are described by the Langmuir model (R² > 0.97) and the pseudo-second order kinetic model (R² > 0.99). The retention of RIF and RIX on the surface of PET fibers occurs through physicochemical interactions, and the FTIR spectra and microscopic images support this hypothesis. The presence of inorganic anions in the aqueous solution leads to an increase in the adsorption capacities of RIF (max. 7.6 mg/g) and RIX (max. 3.6 mg/g) on PET fibers, which is mainly due to the ordering of water molecules in the solution. The experimental results presented in this study allowed for the development of the adsorption mechanism of RIF and RIX on PET fibers, highlighting the potential practical applications of these adsorption processes. Full article

Excessive phosphate from agriculture and industry has led to widespread eutrophication, posing a serious environmental threat. To address this issue, metal-modified biochars have emerged as promising adsorbents due to their high affinity for phosphate ions. This study investigates the application of two magnesium-modified biochar hydrogels denoted as magnesium–bamboo biochar hydrogel (Mg-BBH) and magnesium–pulp biochar hydrogel (Mg-PBH) for phosphate recovery from aqueous solutions, with an additional aim as slow-release fertilizers. The adsorbents were synthesized by impregnating Mg-modified biochars into sodium-alginate-based hydrogel. The influence of initial phosphate concentration, contact time, and temperature were investigated to determine optimal adsorption conditions. Both adsorbents exhibited excellent adsorption performance, with maximum capacities of 309.96 mg PO₄/g (Mg-BBH) and 234.69 mg PO₄/g (Mg-PBH). Moreover, the adsorption performance of the adsorbents was greatly influenced by the magnesium content. The adsorption process followed the Temkin isotherm and pseudo-second-order kinetics, suggesting that the adsorption energy decreases proportionally with surface coverage and the phosphate uptake was governed by chemisorption. Thermodynamic study confirmed the process was spontaneous and endothermic at 40 °C. A slow-release study further demonstrated a great release of phosphate in soil over time. These findings highlight the dual functionality of Mg-BBH and Mg-PBH as effective materials for both phosphate recovery and controlled nutrient delivery, contributing to sustainable phosphate management. Full article

Aimed at developing an economical and efficient biosorbent for the adsorption and separation of rare earth ions, this study employed Spirulina dry powder biomass as a biosorbent to investigate its removal performance for Pr³⁺ in aqueous solutions. Experimental results demonstrated that under optimized conditions (pH = 5, adsorbent dosage = 2.0 g/L, initial Pr³⁺ concentration = 100 mg/L, and adsorption time = 60 min), the removal efficiency of Pr³⁺ reached 79.0%. FT-IR and XPS characterization confirmed the participation of various functional groups on the Spirulina surface in the adsorption process. When 0.1 mol/L HNO₃ was used as the desorption agent, the desorption rate of Pr³⁺ from Spirulina reached 91.7%, demonstrating excellent regeneration performance. At different temperatures (298–318 K), the adsorption data were fitted using Langmuir, Freundlich, Dubinin–Radushkevich, and Redlich–Peterson models. Among them, the Langmuir model (R² ranged from 0.993 to 0.999) provided the best fit, and the adsorption capacity of Spirulina for Pr³⁺ was in the range of 51.10 to 55.31 mg/g. Kinetic studies revealed that the pseudo-second-order model (R² = 0.999) best described the adsorption process, with a rate constant of 0.054 g/(mg·min) (R² was 0.999) at an initial Pr³⁺ concentration of 300 mg/L, indicating chemisorption-controlled behavior. Thermodynamic parameter analysis showed that within the experimental temperature range, ΔG⁰ < 0 and ΔS⁰ > 0, confirming that the adsorption process was spontaneous and endothermic. This study provides a novel technical approach for the green recovery of rare earth elements and highlights the potential of Spirulina biomass in rare earth resource recycling. Full article

Polymethyl methacrylate nanoparticles functionalized with three different compounds, acrylic acid (AA), curcumin (CUR), and fumaramide (FA), were tested in a two-step solid–liquid extraction process (extraction and stripping) for yttrium recovery. In both stages, the best conditions were determined: pH, solid–liquid ratio and the compound with the highest affinity for yttrium recovery, obtaining 90% of efficiency for both stages in a single work cycle. The results obtained by SEM ruled out the growing of nanoparticles by swelling and confirmed the formation of structural arrangements by the addition of the metal to the system. In addition, there is evidence that the recovery process can be selective considering the mixing of rare earth elements through changes in pH. Using isothermal titration calorimetry (ITC), the thermodynamic properties of the extraction process were calculated, understanding the system as the union of a macromolecule and a ligand. The results showed that the extraction process was spontaneous and highly entropic. Full article

The discharge of synthetic dyes in industrial wastewaters poses a serious environmental threat as they are difficult to degrade naturally and are harmful to aquatic organisms. This study aimed to evaluate the feasibility of using clean untreated rice husk (CRH) as a sustainable and low-cost adsorbent for the removal of methylene blue (MB) from synthetic wastewater. This approach effectively avoids the energy-intensive grinding process by directly using whole unprocessed rice husk, highlighting its potential as a sustainable and cost-effective alternative to activated carbon. A series of batch adsorption experiments were conducted to evaluate the effects of key operating parameters such as initial dye concentration, contact time, pH, ionic strength, and temperature on the adsorption performance. Adsorption kinetics, isotherm models, and thermodynamic analysis were applied to elucidate the adsorption mechanism and behavior. The results showed that the maximum adsorption capacity of CRH for MB was 5.72 mg/g. The adsorption capacity was stable and efficient between pH 4 and 10, and reached the highest value at pH 12. The presence of sodium ions (Na⁺) and calcium ions (Ca²⁺) inhibited the adsorption efficiency, with calcium ions having a more significant effect. Kinetic analysis confirmed that the adsorption process mainly followed a pseudo-second-order model, suggesting the involvement of a chemisorption mechanism; notably, in the presence of ions, the Elovich model provided better predictions of the data. Thermodynamic evaluation showed that the adsorption was endothermic (ΔH° > 0) and spontaneous (ΔG° < 0), accompanied by an increase in the disorder of the solid–liquid interface (ΔS° > 0). The calculated activation energy (Ea) was 17.42 kJ/mol, further supporting the involvement of chemisorption. The equilibrium adsorption data were well matched to the Langmuir model at high concentrations (monolayer adsorption), while they were accurately described by the Freundlich model at lower concentrations (surface heterogeneity). The dimensionless separation factor (RL) confirmed that the adsorption process was favorable at all initial MB concentrations. The results of this study provide insights into the application of agricultural waste in environmental remediation and highlight the potential of untreated whole rice husk as a sustainable and economically viable alternative to activated carbon, which can help promote resource recovery and pollution control. Full article

Encryption and decryption are essential components in signal processing and optical communication systems, providing data confidentiality, integrity, and secure high-speed transmission. We present a novel design and simulation of an all-optical encryption and decryption system operating at 120 Gb/s using carrier reservoir semiconductor optical amplifiers (CR-SOAs) embedded in Mach–Zehnder interferometers (MZIs). The architecture relies on two consecutive exclusive-OR (XOR) logic gates, implemented through phase-sensitive interference in the CR-SOA-MZI structure. The first XOR gate performs encryption by combining the input data signal with a secure optical key, while the second gate decrypts the encoded signal using the same key. The fast gain recovery and efficient carrier dynamics of CR-SOAs enable a high-speed, low-latency operation suitable for modern photonic networks. The system is modeled and simulated using Mathematica Wolfram, and the output quality factors of the encrypted and decrypted signals are found to be 28.57 and 14.48, respectively, confirming excellent signal integrity and logic performance. The influence of key operating parameters, including the impact of amplified spontaneous emission noise, on system behavior is also examined. This work highlights the potential of CR-SOA-MZI-based designs for scalable, ultrafast, and energy-efficient all-optical security applications. Full article

Kallmann syndrome (KS) is a form of hypogonadotropic hypogonadism (HH) characterized by gonadotropin-releasing hormone (GnRH) deficiency and anosmia due to defective neuronal migration. While traditionally considered irreversible, cases of spontaneous improvement of HH have been reported, suggesting residual GnRH neuronal function in some individuals. We present a case of a 29-year-old man with KS who exhibited spontaneous recovery of endogenous testosterone production following the cessation of long-term androgen therapy without the use of alternative hormonal agents. After ceasing testosterone therapy for several months, the patient’s total testosterone levels normalized (407–424 ng/dL), accompanied by increased secondary sexual characteristics, stable gonadotropin levels, and normal testicular volume. Persistent anosmia was noted, suggesting that restoration of reproductive endocrine function can occur independently of olfactory recovery. Genetic testing identified heterozygous mutations in PCSK1 and HS6ST1, genes implicated in GnRH regulation and KS pathogenesis. This case highlights the potential role of genetic variation in spontaneous HH improvement and underscores the need for individualized management strategies, including periodic reassessment of gonadal function and fertility potential. Further research is needed to elucidate the mechanisms driving spontaneous HH improvement, identify predictive biomarkers of reversibility, and explore therapeutic strategies that may promote endogenous GnRH activity in select patients with KS. Full article

The in situ emulsification synergistic self-profile control system has wide application prospects for efficient development on offshore oil reservoirs. During water flooding in Bohai heavy oil reservoirs, random emulsification occurs with superimposed Jamin effects. Effectively utilizing this phenomenon can enhance the efficient development of offshore oilfields. This study addresses the challenges hindering water flooding development in offshore oilfields by investigating the emulsification mechanism and key influencing factors based on oil–water emulsion characteristics, thereby proposing a novel in situ emulsification flooding method. Based on a fundamental analysis of oil–water properties, key factors affecting emulsion stability were examined. Core flooding experiments clarified the impact of spontaneous oil–water emulsification on water flooding recovery. Two-dimensional T1–T2 NMR spectroscopy was employed to detect pure fluid components, innovating the method for distinguishing oil–water distribution during flooding and revealing the characteristics of in situ emulsification interactions. The results indicate that emulsions formed between crude oil and formation water under varying rheometer rotational speeds (500–2500 r/min), water cuts (30–80%), and emulsification temperatures (40–85 °C) are all water-in-oil (W/O) type. Emulsion viscosity exhibits a positive correlation with shear rate, with droplet sizes primarily ranging between 2 and 7 μm and a viscosity amplification factor up to 25.8. Emulsion stability deteriorates with increasing water cut and temperature. Prolonged shearing initially increases viscosity until stabilization. In low-permeability cores, spontaneous oil–water emulsification occurs, yielding a recovery factor of only 30%. For medium- and high-permeability cores (water cuts of 80% and 50%, respectively), recovery factors increased by 9.7% and 12%. The in situ generation of micron-scale emulsions in porous media achieved a recovery factor of approximately 50%, demonstrating significantly enhanced oil recovery (EOR) potential. During emulsification flooding, the system emulsifies oil at pore walls, intensifying water–wall interactions and stripping wall-adhered oil, leading to increased T2 signal intensity and reduced relaxation time. Oil–wall interactions and collision frequencies are lower than those of water, which appears in high-relaxation regions (T1/T2 > 5). The two-dimensional NMR spectrum clearly distinguishes oil and water distributions. Full article

Brachial plexus root avulsion [BPRA] and concomitant spinal cord injury [SCI] represent devastating injuries that come with limited hope for recovery owing to the adult spinal cord’s loss of intrinsic ability to spontaneously regenerate. BPRA/SCI is an enormous public health issue the world over, and its catastrophic impact goes beyond the patient, the family, businesses, and national health budgets, draining billions of dollars annually. The rising population and economic growth have seen the incidence of SCI surging. Genomic, transcriptomic, and proteomic studies have yielded loads of information on the various molecular events that precede, regulate, and support both regenerative and degenerative pathways post-SCI. Metabolomics, on the other hand, comes in as the search for a cure and the objective monitoring of SCI severity and prognosis remains on the horizon. Despite the large number of review articles on metabolomics and its application fields such as in cancer and diabetes research, there is no comprehensive review on metabolite profiling to study disease mechanisms, biomarkers, or neuroprotection in SCI. First, we present a short review on BPRA/SCI. Second, we discuss potential benefits of metabolomics as applied in BPRA/SCI cases. Next, a look at the analytical techniques that are used in metabolomics. Next, we present an overview of the studies that have used metabolomics to reveal SCI metabolic fingerprints and point out areas of further investigation. Finally, we discuss future research directions. Full article

Implementing efficient strategies for the circular recovery and reuse of nutrients from wastewaters is mandatory to meet the Green Deal objectives and Sustainable Development Goals. In this context we investigated the use of zeolitic tuff (containing chabazite and phillipsite) in the selective recovery and reuse of N from various anaerobic liquid digestates in view of their implementation in farm-scale treatment plants. We tested the method on three livestock digestates and two municipal organic solid waste digestates. Adsorption isotherms and kinetics were assessed on each digestate, and a large set of parameters, including (i) contact time, (ii) initial NH₄⁺ concentration, (iii) presence of competing ions, (iv) total solids content, and (vi) separation methods (microfiltration and clarification), were considered in the experimental design. Our results showed that the adsorption mechanism can be explained by the Freundlich model (R² up to 0.97), indicating a multilayer and heterogeneous adsorption, while the kinetic of adsorption can be explained by the pseudo-second-order model, indicating chemical adsorption and ion exchange. The efficiency in the removal of NH₄⁺ was indirectly related to the K⁺ and total solids content of the digestate. Maximum NH₄⁺ removal exceeded 90% in MSW-derived digestates and 80% within 60 min in livestock-derived digestates at a 5% solid/liquid ratio. Thermodynamic parameters confirmed favorable and spontaneous adsorption (ΔG up to −7 kJ⋅mol⁻¹). Farm-scale projections estimate a nitrogen recovery potential of 1.2 to 16 kg N⋅day⁻¹, depending on digestate type and process conditions. These findings support the application of natural zeolitic tuffs as a low-cost, chemical-free solution for ammonium recovery, contributing to sustainable agriculture and circular economy objectives. Full article

Rare earth metals (REMs) are vital for high-tech industries, but their extraction from secondary sources is challenging due to environmental and technical constraints. This study investigates the ion-exchange extraction of light REMs (neodymium, praseodymium, and samarium) from sulfuric and phosphoric acid solutions, modeling industrial leachates from apatite concentrates and phosphogypsum. The study considers the use of anion- and cation-exchange resins with different functional groups for efficient and environmentally safe REM separation. Experimental sorption isotherms were obtained under static conditions at 298 K and analyzed using a thermodynamic model based on the linearization of the mass action equation. Equilibrium constants and Gibbs energy were calculated, which reveals the spontaneity of the processes. Cation-exchange resins demonstrated high selectivity towards individual REMs, while anion-exchange resins were suitable for group extraction. Infrared spectral analysis confirmed the presence of sulfate and phosphate complexes in the resin matrix, clarifying the ion-exchange mechanisms. Thermal effect measurements indicated exothermic sorption on anion-exchange resins with negative entropy and endothermic sorption on cation-exchange resins with positive entropy. The findings highlight the potential of ion-exchange resins for selective and sustainable REM recovery, offering a safer alternative to liquid extraction and enabling the valorization of industrial wastes like phosphogypsum for resource recovery. Full article

Background: Non-cholera Vibrio species are rare waterborne pathogens that can cause severe infections. Among these, few cases of Vibrio metschnikovii infections have been reported, especially in the gastrointestinal tract, with no cardiac tissue involvement as a result. Following the PRISMA checklist, we conducted a literature review, and thirteen articles for twenty-two cases overall were included: seven cases of sepsis (in three cases, the echocardiographic results were negative), seven cases of pneumonia, two skin infections, eleven cases of diarrhoea, and a gastroenteritis outbreak. This report documents the expanding clinical spectrum and the role played by V. metschnikovii in infective endocarditis. Case report: A 28-year-old male patient was referred to the cardiac surgery unit for urgent mitral valve replacement due to suspicion of infective endocarditis. Microbiological tests yielded negative results. Following recovery and discharge with antimicrobial therapy for 6 weeks, the patient experienced prosthesis detachment, necessitating re-hospitalisation for an emergency valve replacement. Vibrio metschnikovii was identified on the prosthesis valve through PCR and successfully treated with ciprofloxacin. However, a spontaneous rupture of the ascending thoracic aorta led to a neurological injury. Discussion: This case represents the first case of valve infection caused by Vibrio metschnikovii, characterised by diagnostic and therapeutic challenges and the involvement of the great vessels. Also considered in this case, for a disease with a median age of 58 years (11–83) and a male-to-female ratio of 2.2, were one male neonate and six cases for whom neither sex nor age was indicated. Excluding gastrointestinal cases, the septic forms are associated with high morbidity, although the single case described involved a young and healthy subject. Risk factors for the pathogen or predisposing/pathological conditions for endocarditis did not emerge. The routes and the time of infection could not be determined, deepening the possibility of occupational exposure via the patient’s position as a boat worker. Poor sensitivity to third-generation cephalosporins has been reported in the literature: the absence of an antibiogram does not allow for a comparison, although resolution was achieved with ciprofloxacin. Conclusion: The rising global incidence of non-cholera Vibrio infections, driven by environmental changes, calls for urgent research into the factors behind their pathogenicity and infection routes. Diagnostic complexities have emerged together with clinical severity. Full article

Background and Clinical Significance: Fulminant pulmonary embolism (PE) leading to an out-of-hospital cardiac arrest (OHCA) is associated with a high mortality rate and cardiopulmonary resuscitation (CPR) frequently failing to achieve return of spontaneous circulation (ROSC). Extracorporeal CPR (eCPR) has emerged as a potential life-saving intervention. Case Presentation: A 66-year-old woman suffered an OHCA due to massive PE, presenting with pulseless electrical activity (PEA). After 90 min of pre- and in-hospital CPR without sustained ROSC, venoarterial extracorporeal membrane oxygenation (va-ECMO) was initiated as eCPR upon arrival at the hospital. Even after implantation of the va-ECMO, there was initially a pronounced acidosis (pH 6.9) with a high elevated lactate level (>30 mmol/L); these factors, together with the prolonged low-flow period, indicated a poor prognosis. Further diagnostic tests revealed intracranial hemorrhage (subdural hematoma), and systemic lysis was not possible. With persistent right heart failure, surgical thrombectomy was performed during hospitalization. Intensive multidisciplinary management finally led to successful therapy and weaning from mechanical ventilation, as well as to complete neurological recovery (CPC-Score 1-2). Conclusions: This case illustrates that eCPR can facilitate survival with good favorable neurological outcomes despite initially poor prognostic predictors. It underscores the importance of refining patient selection criteria and optimizing management strategies for eCPR in refractory cardiac arrest secondary to PE. Full article

Background: Tracheal intubation and mechanical ventilation are facilitated by neuromuscular blocking agents. We investigated the effectiveness of subjective clinical evaluation of neuromuscular function on retroglossal area size, since it determines spontaneous ventilation adequacy following tracheal extubation. Secondarily, we correlated changes in retroglossal area and depth of neuromuscular block assessed during both respiratory phases using quantitative neuromuscular monitoring. Methods: Once mechanical ventilation was no longer needed, antagonists were used to reverse the neuromuscular block in 21 consenting patients; adequacy of reversal was assessed subjectively by delivering a sequence of four rapid (2 Hz) electrical stimuli (train-of-four, TOF) to a peripheral nerve and assessing attainment of four equal muscle contractions (TOF ratio = 1.0), signifying normal neuromuscular function. Retroglossal area during both inhalation and exhalation were measured pharyngoscopically at various phases of neuromuscular recovery, including at baseline after anesthesia induction but before neuromuscular block onset and at recovery before tracheal extubation; area changes were correlated with depth of quantitatively measured neuromuscular block. Results: Clinicians’ subjective evaluation of readiness for tracheal extubation failed to identify significant residual block in most patients who required rescue antagonism. Markedly decreased retroglossal areas (inhalation: 39.5% of baseline; exhalation: 20.1% of baseline) were present at extubation, and 11 out of 21 (52.4%) patients needed rescue antagonism. In contrast, in patients with neuromuscular recovery to the currently recommended threshold determined quantitatively (TOF ratio > 0.90), retroglossal areas were only 80% recovered but returned to near baseline values when the TOF ratio ≥ 0.95. Conclusions: Quantitative monitoring should guide the timing of tracheal extubation. Current definitions of the minimal threshold for adequate neuromuscular recovery (TOF ratio > 0.90) after mechanical ventilation in postoperative patients should be re-evaluated. A TOF ratio > 0.95 better correlates with return to normal (baseline) retroglossal area during both inhalation and exhalation. Full article