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Search Results (1,927)

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25 pages, 4800 KB  
Article
Vegetation Succession Dynamics and Drivers in Accretional Salt Marshes: A 34-Year Case Study in Hangzhou Bay
by Xiao Wang, Yan Bai, Xianqiang He, Bozhong Zhu, Xiaosong Ding, Teng Li, Xuchen Jin and Fang Gong
Remote Sens. 2026, 18(3), 461; https://doi.org/10.3390/rs18030461 (registering DOI) - 1 Feb 2026
Abstract
In naturally accretional salt marshes, pioneer species typically expand seaward and colonize tidal flats. However, this process can be influenced by disturbances such as human activities and species invasions. Understanding the spatiotemporal patterns and driving mechanisms of vegetation succession in salt marshes is [...] Read more.
In naturally accretional salt marshes, pioneer species typically expand seaward and colonize tidal flats. However, this process can be influenced by disturbances such as human activities and species invasions. Understanding the spatiotemporal patterns and driving mechanisms of vegetation succession in salt marshes is critical for wetland conservation, restoration, and management. Using southern Hangzhou Bay as a case study, we developed a remote sensing algorithm to distinguish the dominant species Scirpus mariqueter (S. mariqueter) and Spartina alterniflora (S. alterniflora). Based on long-term time-series remote sensing data (1990–2023) and twelve parameters representing environmental variables, human activity, and interspecific competition, we analyzed the seaward expansion of the dominant salt marsh species and quantified the effects of various drivers on vegetation. The results showed that as a pioneer species, S. mariqueter expanded at a rate of 0.26 km2 yr−1 and was gradually replaced by S. alterniflora, which expanded at a rate of 0.52 km2 yr−1. Over the 34-year period, both species exhibited phased expansion–decline–recovery dynamics. During the relatively stable periods (1990–2003 and 2015–2023), temperature, sea level anomaly, and sea surface salinity were the key drivers of vegetation succession. During the disturbance period (2004–2014), S. mariqueter remained primarily influenced by environmental factors, whereas S. alterniflora was primarily influenced by human activities. This study provides the first satellite-based analysis of salt marsh species dynamics in southern Hangzhou Bay over a 34-year period, revealing nonlinear, staged, and species-specific succession patterns and providing new perspectives for invasive species management and the conservation of dynamic coastal wetlands. Full article
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19 pages, 1530 KB  
Article
Combining Different Yarrowia divulgata Yeast-Based Fermentations into an Integrated Bioprocess for Manufacturing Pigment, Sweetener, Bioemulsifier, and Skin Moisturiser
by Edina Eszterbauer and Áron Németh
Appl. Sci. 2026, 16(3), 1445; https://doi.org/10.3390/app16031445 (registering DOI) - 31 Jan 2026
Abstract
In this study, we examined the enhancement of erythritol production by the Yarrowia divulgata strain 1485. Although erythritol fermentation has been thoroughly investigated in earlier studies, the influence of inoculum ratio has not been comprehensively addressed. Therefore, this parameter was selected as the [...] Read more.
In this study, we examined the enhancement of erythritol production by the Yarrowia divulgata strain 1485. Although erythritol fermentation has been thoroughly investigated in earlier studies, the influence of inoculum ratio has not been comprehensively addressed. Therefore, this parameter was selected as the focus of the present work. Since industrial-scale erythritol production is typically carried out using more efficient fungal strains, further improvements in economic viability are primarily expected through integration with other biotechnological processes, allowing the simultaneous generation of multiple valuable products. To this end, the erythritol fermentation was coupled with microbial pigment production, and the potential recovery of additional compounds—such as biodetergents and cosmetic ingredients—were also explored. Based on the results, the fermentation with a 15% inoculation rate appears to be the most effective, producing 67.9 ± 6.0 g/L of erythritol, and 61.81 ± 0.02 mg/L of pigment was successfully extracted at the end of the pigment fermentation. The cells seem capable of increasing the skin’s moisturizing effect according to our preliminary tests when glass bead cell disruption is used, and the emulsifier has also proven to be effective, maintaining an emulsification index (EI) above 50% even after 24 h. When performing a kinetic model, we found that the measured data matched the model predictions and confirmed optimal inoculation size (15%), providing a solid basis for subsequent techno-economic analysis. The integration of the two basic fermentations (erythritol and pigment) is therefore considered successful, and the Yarrowia divulgata strain appears to have great biotechnological potential. Full article
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24 pages, 2611 KB  
Article
Additive Manufacturing of Shape-Changing Printlets via Powder-Based Extrusion 3D Printing of Natural Cellulose and Polyvinyl Alcohol
by Kasidit Dokhom, Pensak Jantrawut, Pattaraporn Panraksa, Suruk Udomsom, Wirongrong Tongdeesoontorn, Baramee Chanabodeechalermrung, Pornchai Rachtanapun and Tanpong Chaiwarit
Polymers 2026, 18(3), 380; https://doi.org/10.3390/polym18030380 - 30 Jan 2026
Abstract
Powder melt extrusion (PME) represents an alternative approach for personalized oral dosage forms. Furthermore, the utilization of agricultural waste has gained increasing attention because it helps reduce pollution from waste. This study investigated cellulose powders and short fibers from agricultural waste as supporting [...] Read more.
Powder melt extrusion (PME) represents an alternative approach for personalized oral dosage forms. Furthermore, the utilization of agricultural waste has gained increasing attention because it helps reduce pollution from waste. This study investigated cellulose powders and short fibers from agricultural waste as supporting materials for the PME-based production of shape-changing levodopa printlets. Formulations containing cellulose powder (CP), cassava short fiber (CSF), and pineapple short fiber (PSF) demonstrated successful printing. The selected formulations were characterized for morphology, thermal transitions, crystallinity, shape-changing behavior, and drug release. CSF demonstrated superior printability, enhanced shape recovery, and the greatest reduction in crystallinity, supporting amorphous solid dispersion formation. Levodopa-loaded printlets showed uniform and high drug content. The formulation containing 5% CSF and levodopa exhibited the fastest initial release, attributed to its low crystallinity and Super Case II transport mechanism. Overall, this study highlights the feasibility of using natural cellulose as an additive in PME to develop sustainable, shape-changing drug delivery systems and advances PME knowledge by integrating agricultural waste derived cellulose fibers with levodopa processing that provide new insight into the material–process–performance relationship in PME systems. Full article
(This article belongs to the Special Issue Progress in 3D Printing of Polymeric Materials)
17 pages, 6119 KB  
Article
The Influence of Annealing on Microstructure Evolution and Mechanical Properties of 442 Ferritic Stainless Steel
by Yufeng Li, Changbo Wang, Yang Hui, Chen Chen, Xuefeng Lu, Jie Sheng and Xingchang Tang
Metals 2026, 16(2), 167; https://doi.org/10.3390/met16020167 - 30 Jan 2026
Viewed by 51
Abstract
The microstructure evolution law and the changes in mechanical properties of 442 ferritic stainless steel after annealing treatment at different temperatures are systematically investigated. The results show that, as the annealing temperature increases, the cold-rolled 442 ferritic stainless steel successively undergoes the process [...] Read more.
The microstructure evolution law and the changes in mechanical properties of 442 ferritic stainless steel after annealing treatment at different temperatures are systematically investigated. The results show that, as the annealing temperature increases, the cold-rolled 442 ferritic stainless steel successively undergoes the process of recovery, recrystallization and grain growth, with the microstructure gradually changing from a fibrous to recrystallized structure, and the secondary phases, such as the Nb(C, N) phase, σ phase and Laves phase, precipitate. In terms of mechanical properties, the tensile strength, yield strength and Vickers hardness gradually decrease, while the elongation after fracture gradually increases. When the annealing temperature reaches 800 °C, the material exhibits the optimal comprehensive mechanical properties. The yield strength, tensile strength and elongation reach 371 MPa, 534 MPa and 31%, respectively, and the hardness is 175 HV. The fracture mode of the sample is mainly ductile fracture. EBSD analysis indicates that the strong Brass {110}<112> texture existing in the cold-rolled state gradually weakens with the annealing process, and the {111}<110>texture strengthens, thereby reducing the influence of unfavorable textures. The research results provide theoretical basis and data support for microstructure regulation and performance optimization of 442 ferritic stainless steel. Full article
(This article belongs to the Special Issue Advances in High-Strength Low-Alloy Steels (2nd Edition))
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18 pages, 7030 KB  
Article
Soil Properties and Bacterial Community Responses to Herb Vegetation Succession Beneath Sand-Fixation Plantations in a Sandy Grassland, NE China
by Cong Chen, Ying Zhang, Zhenbo Cui and Chengyou Cao
Agronomy 2026, 16(3), 342; https://doi.org/10.3390/agronomy16030342 - 30 Jan 2026
Viewed by 36
Abstract
Establishing shrub plantations on mobile sand dunes is an effective strategy to combat desertification in semi-arid regions. Herbaceous communities developing beneath these plantations enhance ecosystem stability and improve revegetation outcomes. This study investigated the structural responses of soil bacterial communities, key functional genes [...] Read more.
Establishing shrub plantations on mobile sand dunes is an effective strategy to combat desertification in semi-arid regions. Herbaceous communities developing beneath these plantations enhance ecosystem stability and improve revegetation outcomes. This study investigated the structural responses of soil bacterial communities, key functional genes (nifH, amoA, and phoD), and plant–soil–microbe interactions across a herbaceous vegetation succession gradient (initiation, early, middle, and stable stages) under Caragana microphylla sand-fixation plantations in the sandy Horqin Grassland. The results revealed that plant species richness, diversity, and biomass increased progressively with succession. Concurrent improvements in soil nutrients (organic matter, nitrogen, phosphorus, and potassium) and enzymatic activities (urease, protease, phosphatase, glucosidase, polyphenol oxidase, and dehydrogenase) were observed. The abundances of nifH, amoA, and phoD genes rose progressively with vegetation succession, contributing to enhanced soil nutrient levels. All dominant bacterial phyla and genera detected constituted shared taxa across successional stages, but their relative abundances shifted dynamically. Herbaceous succession facilitated rapid restoration of bacterial diversity, though structural recovery lagged, depending on the quantitative fluctuations of the dominant taxa. Soil pH, organic matter, electrical conductivity, total N, total P, available P, and available K all significantly influenced the soil bacterial community, with pH and organic matter being the most influential factors. These findings highlight plant–soil–microbe interactions as intrinsic drivers of vegetation succession in desertified ecosystems. Full article
(This article belongs to the Special Issue Multifunctionality of Grassland Soils: Opportunities and Challenges)
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26 pages, 4762 KB  
Article
Morphology, Heterosis, and Fertility of Novel CMS-Based Solanum melongena × S. aethiopicum Hybrids
by Konstantinos Krommydas, Athanasios Mavromatis, Fotios Bletsos and Demetrios Roupakias
Agronomy 2026, 16(3), 306; https://doi.org/10.3390/agronomy16030306 - 26 Jan 2026
Viewed by 178
Abstract
Although cytoplasmic male sterility (CMS) is well established in eggplant, CMS-based interspecific hybrids with allied species have not yet been reported or studied. In this study, five previously developed CMS-based interspecific F1 hybrids between eggplant and Solanum aethiopicum Group Aculeatum (=S. [...] Read more.
Although cytoplasmic male sterility (CMS) is well established in eggplant, CMS-based interspecific hybrids with allied species have not yet been reported or studied. In this study, five previously developed CMS-based interspecific F1 hybrids between eggplant and Solanum aethiopicum Group Aculeatum (=S. integrifolium) and Group Gilo (=S. gilo), together with their parental lines, were morphologically evaluated for 67 seedling, vegetative, floral, and fruit traits, and their heterosis for vegetative growth was studied. Male fertility was assessed based on anther morphology and pollen viability, while female fertility was evaluated through backcrosses to both parents. The hybrids exhibited predominantly intermediate phenotypes and clustered distinctly from parental lines as confirmed by principal component analysis. Remarkable heterosis was observed for most growth-related traits, indicating favorable nuclear–cytoplasmic interactions despite the use of CMS eggplant lines as maternal parents. All hybrids showed complete male sterility, characterized by non-viable pollen and pronounced anther homeotic alterations, the latter indicating CMS-related effects on male fertility. Female fertility was severely reduced, likely due to meiotic irregularities, as evidenced by the failure of most attempted backcrosses. However, successful recovery of BC1 progeny after backcrossing one CMS-based F1 hybrid to S. gilo demonstrates partial reproductive compatibility and provides a genetic bridge for CMS introgression into S. gilo. These results indicate that CMS systems are suitable for eggplant interspecific crosses aimed at vigorous rootstock production and CMS cytoplasm introgression into allied germplasm. Full article
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15 pages, 556 KB  
Review
Robotic Rectus Muscle Flap Reconstruction After Pelvic Exenteration in Gynecological Oncology: Current and Future Perspectives—A Narrative Review
by Gurhan Guney, Ritchie M. Delara, Johnny Yi, Evrim Erdemoglu and Kristina A. Butler
Cancers 2026, 18(3), 375; https://doi.org/10.3390/cancers18030375 - 25 Jan 2026
Viewed by 166
Abstract
Background/Objectives: Pelvic exenteration is a radical procedure performed for recurrent gynecologic cancers. The goal of exenteration is to prolong survival, but this procedure also results in extensive tissue loss and consequently high morbidity. Reconstruction using vascularized flaps, particularly the VRAM flap, is [...] Read more.
Background/Objectives: Pelvic exenteration is a radical procedure performed for recurrent gynecologic cancers. The goal of exenteration is to prolong survival, but this procedure also results in extensive tissue loss and consequently high morbidity. Reconstruction using vascularized flaps, particularly the VRAM flap, is crucial to restoring pelvic integrity and decreasing complications resulting from extensive tissue loss. With the rise of minimally invasive surgery, the traditionally open abdominal approach to exenteration and reconstruction can now be performed with the assistance of robotic platforms. This review aims to summarize available evidence, describe techniques, and propose future directions for robotic rectus flap reconstruction after pelvic exenteration. Methods: This narrative review was conducted following the SANRA guidelines for narrative synthesis. A comprehensive search of PubMed, Embase, Scopus, and Web of Science was conducted for studies published between January 2000 and November 2025 on pelvic exenteration followed by robotic rectus abdominis flap reconstruction in gynecologic oncology. Eligible studies were retrospective or prospective reports, technical descriptions, case series, or comparative analyses. Non-robotic techniques and animal studies were excluded. Although the primary focus was gynecologic oncology, technically relevant studies from other oncologic disciplines were included when the reconstructive approach was directly applicable to pelvic exenteration. Extracted data included patient demographics, surgical details, and perioperative and oncologic outcomes. Results: The literature search identified primarily case reports and small single-center series describing robot-assisted rectus muscle-based flap reconstruction after pelvic exenteration. Reported cases demonstrated technical feasibility and successful flap harvest using robotic platforms, with adequate pelvic defect coverage. Potential benefits, such as reduced wound morbidity and preservation of a minimally invasive workflow, have been described. However, patient numbers were small, techniques varied, and standardized outcome measures or comparative data with open approaches were lacking. Conclusions: Robotic rectus flap reconstruction represents a promising advancement in pelvic exenteration surgery, potentially reducing morbidity and improving recovery. Further research, including multicenter prospective studies, is needed to validate these findings and establish standardized protocols. Full article
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16 pages, 898 KB  
Review
Extremophile Red Algae for Acid Mine Waste Remediation: A Design-Forward Review Focused on Galdieria sulphuraria
by Shaseevarajan Sivanantharajah, Kirusha Sriram, Mathupreetha Sivanesarajah, Sinthuja Nadesananthan and Thinesh Selvaratnam
Processes 2026, 14(3), 417; https://doi.org/10.3390/pr14030417 - 25 Jan 2026
Viewed by 181
Abstract
Acid mine drainage (AMD) and acid-generating mine wastes exhibit low pH, high sulfate levels, and complex multi-metal loads that strain conventional treatment. Thermoacidophilic red algae of the order Cyanidiales, particularly Galdieria sulphuraria (G. sulphuraria), have attracted interest as a biological option [...] Read more.
Acid mine drainage (AMD) and acid-generating mine wastes exhibit low pH, high sulfate levels, and complex multi-metal loads that strain conventional treatment. Thermoacidophilic red algae of the order Cyanidiales, particularly Galdieria sulphuraria (G. sulphuraria), have attracted interest as a biological option because they tolerate extreme acidity and elevated temperatures, grow under low light in mixotrophic or heterotrophic modes, and display rapid metal binding at the cell surface. This review synthesizes about two decades of peer-reviewed work to clarify how G. sulphuraria can be deployed as a practical module within mine water treatment trains. We examine the mechanisms of biosorption and bioaccumulation and show how they map onto two distinct configurations. Processed freeze-dried biomass functions as a regenerable sorbent for rare earth elements (REEs) and selected transition metals in packed beds with acid elution for recovery. Living cultures serve as polishing units for divalent metals and, when present, nutrients or dissolved organics under low light. We define realistic operating windows centered on pH 2–5 and temperatures of approximately 25–45 °C, and we identify matrix effects that govern success, including competition from ferric iron and aluminum, turbidity and fouling risks, ionic strength from sulfate, and suppression of REE uptake by phosphate in living systems. Building on laboratory studies, industrial leachate tests, and ecosystem observations, we propose placing G. sulphuraria upstream of bulk neutralization and outline reporting practices that enable cross-site comparison. The goal is an actionable framework that reduces reagent use and sludge generation while enabling metal capture and potential recovery of valuable metals from mine-influenced waters. Full article
(This article belongs to the Section Environmental and Green Processes)
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25 pages, 16827 KB  
Review
Development Status and Prospect of Roof-Cutting and Pressure Relief Gob-Side Entry Retaining Technology in China
by Dong Duan, Xin Wang, Jie Li, Baisheng Zhang, Xiaojing Feng, Yongkang Chang, Shibin Tang and Hewen Shi
Appl. Sci. 2026, 16(3), 1182; https://doi.org/10.3390/app16031182 - 23 Jan 2026
Viewed by 137
Abstract
China’s roof-cutting and pressure relief gob-side entry retaining (RCPR-GER) technology provides an efficient non-pillar mining solution that significantly enhances coal recovery. This paper presents a systematic review of the technological progress in Chinese coal mines from 2011 to 2023, based on an analysis [...] Read more.
China’s roof-cutting and pressure relief gob-side entry retaining (RCPR-GER) technology provides an efficient non-pillar mining solution that significantly enhances coal recovery. This paper presents a systematic review of the technological progress in Chinese coal mines from 2011 to 2023, based on an analysis of 1038 publications from CNKI, EI, and Web of Science using VOS viewer and Origin software. Four main technical approaches are examined: gob-side entry retaining without roadside filling, with roadside filling, with roof-cutting and pressure relief, and hybrid methods. Five key roof-cutting techniques are evaluated: dense drilling, high-pressure water-jet slotting, hydraulic fracturing, blasting, presplitting, and roof water injection softening. Successful applications have been documented in coal seams with thicknesses of 1.6–6.15 m and burial depths of 92–1037 m, demonstrating wide adaptability. The roof-cutting short-beam theory underpins the mechanism, which reduces roadway deformation, shortens the cantilever beam length, and alters stress transfer paths. Compared to previous reviews on general gob-side entry retaining, this study offers a dedicated synthesis and comparative analysis of RCPR-GER technologies, establishing a selection framework grounded in geological compatibility and engineering practice. Future research should focus on adaptive parameter design for deep hard composite roofs, quantitative modeling of passive roof-cutting effects, optimization of cutting timing and orientation, and floor-heave control technologies to extend applications under complex geological conditions. Full article
(This article belongs to the Section Energy Science and Technology)
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23 pages, 9954 KB  
Article
Multi-Output Random Forest Model for Spatial Drought Prediction
by Mir Jafar Sadegh Safari
Sustainability 2026, 18(2), 1130; https://doi.org/10.3390/su18021130 - 22 Jan 2026
Viewed by 121
Abstract
In regions with limited meteorological monitoring systems, spatial drought modeling is of importance for efficient water resource management. This study recommends an alternative drought modeling strategy for Standardized Precipitation Evapotranspiration Index (SPEI) prediction at multiple target stations using data from neighboring stations. The [...] Read more.
In regions with limited meteorological monitoring systems, spatial drought modeling is of importance for efficient water resource management. This study recommends an alternative drought modeling strategy for Standardized Precipitation Evapotranspiration Index (SPEI) prediction at multiple target stations using data from neighboring stations. The Multi-Output Random Forest (MORF) model is implemented in this study to consider the spatial correlations among stations for the simultaneous prediction of SPEI for multiple stations instead of training independent models for each station. The efficiency of MORF is further compared to Multi-Output Support Vector Regression (MOSVR) and three baselines; a single-output RF, a monthly climatology model, and a persistence model. In addition to statistical performance criteria, drought characteristics are evaluated using intensity–duration–frequency analysis for three temporal scales (SPEI-3, SPEI-6, and SPEI-12). Results demonstrate that MORF outperformed MOSVR and RF in approximating observed drought intensity, duration, and frequency under moderate, severe, and extreme drought scenarios. Furthermore, spatial analysis reveals that MORF accurately captured the seasonal evolution of drought conditions including onset and recovery phases. The remarkable success of MORF in contrast to MOSVR and three traditional baselines can be explained by its ability to detect nonlinear and complex interactions of drought condition among various neighboring stations. This study emphasizes the promise of multi-output machine learning algorithms for drought monitoring in water resource management and climate adaptation planning in data-scarce regions. Full article
(This article belongs to the Section Sustainable Water Management)
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23 pages, 3417 KB  
Article
The Main Control Factors and Productivity Evaluation Method of Stimulated Well Production Based on an Interpretable Machine Learning Model
by Jin Li, Huiqing Liu, Lin Yan, Zhiping Wang, Hongliang Wang, Shaojun Wang, Xue Qin and Hui Feng
Energies 2026, 19(2), 548; https://doi.org/10.3390/en19020548 - 21 Jan 2026
Viewed by 90
Abstract
Low-permeability waterflooding reservoirs face numerous challenges, including low productivity per well, inadequate formation pressure maintenance, poor waterflood response, and low water injection utilization efficiency. Illustrated by Bai 153 Block in the Changqing Oilfield, the primary concern has shifted in recent years from fracture [...] Read more.
Low-permeability waterflooding reservoirs face numerous challenges, including low productivity per well, inadequate formation pressure maintenance, poor waterflood response, and low water injection utilization efficiency. Illustrated by Bai 153 Block in the Changqing Oilfield, the primary concern has shifted in recent years from fracture water breakthrough to formation blockages. Currently, low-yield wells (≤0.5 t) constitute a significant proportion (27.5%), with a recovery factor of only 0.41%. The effectiveness of stimulation treatments is influenced by reservoir properties, treatment types, process parameters, and production performance. Selecting candidate wells requires collecting and analyzing data such as individual well block characteristics. Evaluating treatment effectiveness involves substantial effort and complexity. Early fracturing treatments exhibited significant variations in effectiveness, and the primary controlling factors influencing fracturing success remained unclear. This paper proposes a big data analysis-based method for evaluating stimulation effectiveness in low-permeability waterflooding reservoirs. Utilizing preprocessed geological, construction, and production data from the target block, an integrated application of the Random Forest algorithm and Recursive Feature Elimination ranks the importance of factors affecting treatments and identifies the block’s main controlling factors. Using these factors as target parameters, a multivariate quantitative evaluation model for fracturing effectiveness is established. This model employs the Pearson correlation coefficient method, Recursive Feature Elimination, and the Random Forest algorithm. Results from the quantitative model indicate that the primary main controlling factors that significantly affect post-fracturing oil increment are production parameters, geological parameters such as vertical thickness, fracture pressure, and oil saturation; engineering parameters such as sand ratio, blowout volume, and fracturing method; and production parameters such as pre-measure cumulative fluid production, production months, and pre-measure cumulative oil production, which are most closely related to post-fracturing oil increment. These parameters show the strongest correlation with incremental oil production. The constructed quantitative model demonstrates a linear correlation rate exceeding 85% between predicted fracturing stimulation and actual well test production, verifying its validity. This approach provides a novel method and theoretical foundation for the post-evaluation of oil increment effectiveness from stimulation treatments in low-permeability waterflooding reservoirs. Full article
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17 pages, 1927 KB  
Perspective
The Interplay Between Neuromodulation and Stem Cell Therapy for Sensory-Motor Neuroplasticity After Spinal Cord Injury: A Perspective View
by Anthony Yousak, Kaci Ann Jose and Ashraf S. Gorgey
J. Clin. Med. 2026, 15(2), 879; https://doi.org/10.3390/jcm15020879 - 21 Jan 2026
Viewed by 240
Abstract
Spinal Cord Injury (SCI) rehabilitation is undergoing a transformative shift with the emergence of new treatment strategies. Historically, treatment options were limited, and few offered meaningful recovery. Recent work in human models has shown that neuromodulation specifically with spinal cord epidural stimulation (SCES) [...] Read more.
Spinal Cord Injury (SCI) rehabilitation is undergoing a transformative shift with the emergence of new treatment strategies. Historically, treatment options were limited, and few offered meaningful recovery. Recent work in human models has shown that neuromodulation specifically with spinal cord epidural stimulation (SCES) paired with task-specific training (TsT) can partially restore motor function such as the ability to stand, step, and perform volitional movements. Despite these advances, the recovery has been shown to plateau even with the combination of therapies. The recovery process typically leads to partial rather than complete restoration of function. This limitation arises because current approaches primarily reactivate existing circuits rather than repair the disrupted pathways. Scar tissue and loss of descending and ascending connections remain major barriers to full recovery, restricting the transmission of neural signals. We argue that the next phase of research should be a synergistic strategy building upon the successes of neuromodulation and TsT while incorporating a regenerative therapy such as stem-cell-based interventions. Whereas neuromodulation and task-specific training increases excitability and reorganizes existing networks, stem cells have the potential to repair structural damage and re-establish communication across injured regions or facilitating the establishment of dormant pathways. The future of SCI recovery relies on multi-modal synergistic interventions that are likely to maximize long-term functional outcomes. In the current perspective, we summarized the basic findings on applications of SCES on restoration of sensory-motor functions. We then projected on current interventions on utilizing stem cell therapy intervention. We highlighted the outcomes of randomized clinical trials, and the major barriers for considering the synergistic approach between SCES and stem cell intervention. We are hopeful that this perspective may lead to roundtable scientific discussion to bridge the gap on how to conduct numerous clinical trials in the field. Full article
(This article belongs to the Section Clinical Neurology)
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9 pages, 218 KB  
Article
Implementation of an ERAS® Programme for Total Hip and Knee Arthroplasty in a High-Volume University Hospital
by Eric Albrecht, Marcio Oliveira, Valérie Addor and Julien Wegrzyn
J. Clin. Med. 2026, 15(2), 836; https://doi.org/10.3390/jcm15020836 - 20 Jan 2026
Viewed by 173
Abstract
Background. Enhanced Recovery After Surgery (ERAS) is a structured, multidisciplinary programme designed to optimise the entire perioperative pathway through evidence-based, patient-centred, standardised care. The objective of this report is to determine whether it is feasible to implement an ERAS® program in [...] Read more.
Background. Enhanced Recovery After Surgery (ERAS) is a structured, multidisciplinary programme designed to optimise the entire perioperative pathway through evidence-based, patient-centred, standardised care. The objective of this report is to determine whether it is feasible to implement an ERAS® program in orthopaedic surgery within our institution for primary THA and TKA. Methods. This single-centre quality-improvement project followed the ERAS® Society certification framework to create and implement an enhanced-recovery pathway for primary total hip and knee arthroplasty. The three-phase roadmap comprised baseline pathway mapping and audit, pilot implementation and refinement, and full roll-out, punctuated by four multidisciplinary seminars. Key aspects of this programme included preoperative education, minimal fasting and early return to feeding, rational choice of regional anaesthesia techniques, administration of multimodal analgesia, reduction in urinary and surgical catheterization, active management of the risk of blood loss and deep vein thrombosis, optimisation of surgical workflow and techniques, and early mobilisation of patients. Global- and element-level compliance was tracked prospectively; ≥70% compliance was required for certification. External ERAS® Society review at month 15 confirmed data integrity, sustainability planning, and successful certification. Continuous feedback loops drove micro-teaching and order-set optimisation throughout deployment phases. Results. Our ERAS programme for primary THA and TKA was introduced in April 2022. The definitive programme contained 24 mandatory elements grouped into three perioperative areas. After the fourth seminar, the rate of compliance was 81%. The certification was obtained in June 2023. Conclusions. Implementing an ERAS® programme for primary total hip and knee arthroplasty is feasible within a high-volume academic institution when supported by multidisciplinary teamwork, robust data collection, and iterative feedback mechanisms. Further high-quality outcome-focused research is required to evaluate the clinical impact of individual ERAS components and to validate a personalised ERAS programme incorporating emerging technologies. Full article
(This article belongs to the Section Anesthesiology)
7 pages, 902 KB  
Case Report
Successful Digital Replantation in a Resource-Limited Kenyan Hospital: A Case Report and Discussion
by Alfio Luca Costa, Luca Folini, Alvise Montanari and Franco Bassetto
Surgeries 2026, 7(1), 13; https://doi.org/10.3390/surgeries7010013 - 20 Jan 2026
Viewed by 127
Abstract
Replantation of an amputated finger is a complex microsurgical procedure that is rarely attempted in low-resource settings due to limited infrastructure and expertise. We report a case of complete amputation of a finger in rural Kenya that was successfully replanted during a humanitarian [...] Read more.
Replantation of an amputated finger is a complex microsurgical procedure that is rarely attempted in low-resource settings due to limited infrastructure and expertise. We report a case of complete amputation of a finger in rural Kenya that was successfully replanted during a humanitarian surgical mission. A 28-year-old man sustained a severe crush avulsion agricultural machine injury resulting in the amputation of all ten digits; only one digit was deemed suitable for replantation. The replantation was performed under loupe and microscope magnification by a visiting specialist team in collaboration with local staff. Intraoperatively, bony fixation with Kirschner wires, extensor and flexor digitorum profundus tendon repair, arterial and venous anastomoses, and neurorrhaphy of the digital nerve were achieved. Postoperatively, the finger survived with adequate perfusion. At one-month follow-up, the replanted finger was viable with progressing wound healing and early joint motion; further rehabilitation was arranged to maximize functional recovery. This case, which is, to our knowledge, one of the first documented digital replantations in East Africa, illustrates that successful microsurgical limb salvage is feasible in a non-specialized hospital setting. Our experience underscores that, with proper planning, training, and teamwork, advanced reconstructive procedures like finger replantation can be safely carried out even in resource-constrained hospitals, offering patients in low-income regions outcomes previously achievable only in high-resource centers. Full article
(This article belongs to the Section Hand Surgery and Research)
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17 pages, 2761 KB  
Article
Plasma miRNA-Metabolite Dysregulation in People with HIV with Cirrhosis Despite Successful HCV Cure
by Ana Virseda-Berdices, Raquel Behar-Lagares, Juan Berenguer, Juan González-García, Belen Requena, Oscar Brochado-Kith, Cristina Díez, Victor Hontañon, Sergio Grande-García, Carolina González-Riano, Coral Barbas, Salvador Resino, Amanda Fernández-Rodríguez, María Ángeles Jiménez-Sousa and the Marathon Study Group
Pharmaceuticals 2026, 19(1), 170; https://doi.org/10.3390/ph19010170 - 19 Jan 2026
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Abstract
Background: Persistent liver pathology despite a sustained virologic response (SVR) to hepatitis C virus (HCV) therapy is a major clinical concern. This is particularly relevant for people with HIV (PWH) with HCV coinfection, a population prone to accelerated liver disease progression. This [...] Read more.
Background: Persistent liver pathology despite a sustained virologic response (SVR) to hepatitis C virus (HCV) therapy is a major clinical concern. This is particularly relevant for people with HIV (PWH) with HCV coinfection, a population prone to accelerated liver disease progression. This study aimed to characterize the plasma miRNA profile in PWH with cirrhosis one year after successful completion of HCV therapy, and to explore their relationship with metabolite alterations. Methods: This cross-sectional study enrolled 47 PWH who achieved HCV clearance with antiviral therapy. Using plasma samples collected approximately one year after completion of HCV therapy, participants were stratified into two groups based on liver stiffness measurement (LSM): compensated cirrhosis (n = 32, LSM ≥ 12.5 kPa) and non-cirrhosis (n = 15, LSM < 12.5 kPa). Plasma miRNAs and metabolites were determined using small RNA sequencing and untargeted capillary electrophoresis-mass spectrometry (CE-MS), respectively. Significantly differentially expressed (SDE) miRNAs were identified using generalized linear models (GLM) with a negative binomial distribution, and their correlation with metabolite levels was quantified using Spearman’s correlation. Results: In the cirrhosis group (n = 32), we identified a distinct signature of 15 SDE miRNAs (9 upregulated, 6 downregulated) compared to the non-cirrhotic group (n = 15), showing hsa-miR-10401-3p, hsa-miR-548ak, hsa-miR-141-3p, and hsa-miR-3940-3p the largest expression changes. miRNA-gene interaction and pathway enrichment analysis suggested that these 15 SDE miRNAs potentially regulate multiple genes involved in immune response and amino acid metabolism. In addition, correlation analyses with our metabolomic data revealed significant associations between specific SDE miRNAs and amino acids and their derivatives. Specifically, the expression of upregulated miRNAs (e.g., hsa-miR-10401-3p and hsa-miR-16-5p) was positively correlated with plasma levels of L-methionine and its derivatives, while downregulated miRNAs (e.g., hsa-miR-625-5p) were inversely correlated with L-tryptophan. Conclusions: In cirrhotic PWH with history of HCV coinfection, a distinct plasma miRNA signature linked to dysregulated amino acid metabolism is found one year after completion of HCV therapy. This underscores that the HCV cure does not equate to complete hepatic recovery, highlighting the critical need for long-term monitoring in this high-risk population. Full article
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