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Radiotherapy serves as a cornerstone of cancer treatment, but its efficacy is often compromised by radioresistance, a process in which cancer-associated fibroblasts (CAFs) play a critical role. Following irradiation, CAFs exhibit inherent radioresistance, not only surviving at higher doses but also undergoing profound functional reprogramming, including senescence, acquisition of a senescence-associated secretory phenotype (SASP), and myofibroblast activation. Importantly, CAFs employ multiple interconnected mechanisms to collectively drive radioresistance: sustained immunosuppression, pro-resistance paracrine signaling, exosome-mediated communication, and stromal remodeling. These reprogrammed CAFs create a microenvironment that paradoxically supports tumor recurrence and limits therapeutic efficacy. Intervention strategies targeting CAFs—including neutralizing soluble factors, blocking key signaling nodes, targeted therapies against fibroblast activation proteins, or disrupting exosome-mediated communication—have shown promise in preclinical studies. A deeper understanding of the complex interactions between radiotherapy and CAFs may ultimately drive a shift in therapeutic strategy from targeting tumor cells alone to leveraging the entire microenvironment to achieve durable antitumor effects. Full article

(This article belongs to the Special Issue Tissue-Specific Organelle Dynamics)

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16 pages, 4172 KB

Open AccessArticle

Sulforaphane Enhances Cytotoxic Effects of Non-Thermal Plasma and Tirapazamine Combination Therapy in Pancreatic Adenocarcinoma Cells

by Ishfar Shaan, Brandon Gulledge, Maksym Poplavskyi, Michelle Eubank, Anastasiia Domukhovska, Anya Weinrieb, Dilbar Alseid, Isabelle Prentice, Samuel Rosen, Gamal Rayan and Shoshanna N. Zucker

Cells 2026, 15(11), 975; https://doi.org/10.3390/cells15110975 (registering DOI) - 26 May 2026

Abstract

Pancreatic adenocarcinoma remains a highly lethal malignancy with limited effective treatment options, largely due to late-stage detection and rapid progression to metastatic disease. Therapeutic strategies capable of targeting both pre-metastatic and metastatic tumors are critically needed. In this study, we evaluated a combination therapy consisting of non-thermal plasma (NTP), a generator of reactive oxygen and nitrogen species, and the hypoxia-activated prodrug tirapazamine (TPZ). We further investigated whether sulforaphane (SF), a bioactive phytochemical, could further enhance therapeutic efficacy. NTP and TPZ produced strong cytotoxic effects as single agents and demonstrated additive to synergistic activity when combined, reducing viability by 87% in pre-metastatic BxPC-3 cells and achieving near-complete elimination of metastatic AsPC-1 cells. The addition of sulforaphane (10 µM) further enhanced cytotoxicity across all treatment conditions, with Bliss independence analysis indicating additive to synergistic interactions depending on cell line and treatment combination. Sulforaphane-mediated enhancement occurred without restoration of connexin 43 expression or coordinated reversal of epithelial-to-mesenchymal transition markers, and treatments did not induce N-cadherin upregulation or suggest acquisition of invasive characteristics. Together, these findings support NTP + TPZ as a potent combinatorial strategy for pancreatic adenocarcinoma and identify sulforaphane as an effective adjunct that enhances cytotoxic efficacy through mechanisms that remain to be fully elucidated. Full article

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6 pages, 525 KB

Open AccessCase Report

Migraine with Focal Cortical Dysplasia: A Case Report

by Michal Fila and Janusz Blasiak

Neurol. Int. 2026, 18(6), 104; https://doi.org/10.3390/neurolint18060104 (registering DOI) - 26 May 2026

Abstract

Background/Objectives: Migraine may be associated with structural changes in the brain, including the cerebellum and brainstem. Some of these changes reflect the brain’s plasticity in adapting to migraine-related alterations, but others may influence the severity of migraines and resistance to treatment. Some studies report changes in cortical thickness among migraine patients, and focal cortical dysplasia (FCD) has been considered a possible cause of these changes. We argued that FCD could contribute to the development of migraine and the severity of its symptoms. To date, there has been no consistent report of FCD occurring in migraine patients. Case: A 29-year-old woman presented with a history of at least 19 years of high-frequency episodic migraine without aura. She experienced motion sickness during childhood and adolescence. Her condition worsened last year, evolving into chronic migraine, which was partially controlled by medications such as amitriptyline and rizatriptan, leading to high-frequency episodic migraines. An MRI conducted in 2024 showed a small area of signal abnormality in the left occipital lobe, believed to represent cortical dysplasia. A follow-up MRI after three months showed no changes in this area. She is currently diagnosed with high-frequency episodic migraine and demonstrated severe migraine-related disability, with a MIDAS score of 25, and a severe impact on daily functioning, with a HIT-6 score of 65. Conclusions: The case involves a worsening migraine that was somewhat alleviated by a pharmacological intervention. FCD may contribute to brain hyperexcitability in this case and her motion-related problems during childhood and adolescence. FCD could also play a role in the increasing severity of her migraines and her partial resistance to medication. Full article

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25 pages, 6597 KB

Open AccessArticle

Photopolymerized Gelatin–PNIPAM as Injectable Hydrogel Drug Delivery Systems

by Olga Luneva, Eugene Sivtsov, Irina Bagriy, Olga Solomakha, Yulia Nashchekina, Alexey Nikiforov, Valeria Ibragimova and Evgenia Korzhikova-Vlakh

Macromol 2026, 6(2), 34; https://doi.org/10.3390/macromol6020034 (registering DOI) - 26 May 2026

Abstract

Injectable hydrogels have attracted substantial and rapidly growing interest due to their ability to be administered into cavities of any shape and provide local therapeutic treatment. This study reports the synthesis and characterization of thermosensitive microgels and hydrogels obtained via photoinitiated copolymerization of methacrylated gelatin (GN-MA) and N-isopropylacrylamide (NIPAM) in the absence and presence of N,N′-methylenebisacrylamide (MBA). The effects of monomer concentration, crosslinker content (MBA), and irradiation time on product yield, grafted chain length, and material properties were systematically investigated. Depending on the polymerization conditions, microgel samples exhibited hydrodynamic diameters in the range of 354–1022 nm at 20 °C, which decreased to 183–308 nm upon heating to 40 °C. Freeze-drying of the microgel dispersions resulted in the formation of a porous sponge-like structure with pore sizes of 50–90 µm. Rheological studies of the hydrogel properties demonstrated evident thermoresponsive behavior, with storage moduli (G′) ranging from 20 to 600 Pa, matching the mechanics of certain soft tissues. The hydrogels showed high equilibrium swelling capacity at 20 °C, which was reduced at 40 °C, as well as temperature-dependent moxifloxacin release (38–88% over 6 days) and excellent biocompatibility (>85% cell viability) with human skin fibroblasts. These findings make them promising for biomedical applications such as postoperative cavity filling and local drug delivery. Full article

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20 pages, 1268 KB

Open AccessReview

Glucagon-like Peptide-1 Receptor Agonists in Rheumatoid Arthritis: A Scoping Review of Metabolic, Anti-Inflammatory, and Cardioprotective Effects

by Simona Buonanno, Carla Gaggiano, Caterina Baldi, Luca Cantarini, Bruno Frediani and Stefano Gentileschi

J. Pers. Med. 2026, 16(6), 284; https://doi.org/10.3390/jpm16060284 (registering DOI) - 26 May 2026

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disorder associated with a substantially increased risk of cardiovascular (CV) disease, driven by both persistent systemic inflammation and a high burden of traditional cardiometabolic risk factors. In recent years, glucagon-like peptide-1 receptor agonists (GLP-1RAs), licensed for type 2 diabetes mellitus and obesity, have attracted attention for their broader metabolic and cardiovascular benefits, raising the question of their potential role in RA. This scoping review summarizes current evidence on the impact of GLP-1RAs on RA disease activity, CV comorbidities, and the underlying immuno-metabolic mechanisms. Experimental studies suggest that GLP-1RAs could modulate key inflammatory pathways in synovial cells, reducing pro-inflammatory cytokine production, oxidative stress, and tissue-degrading enzymes, while improving mitochondrial function. Although clinical data remains limited, observational studies report improvements in disease activity, inflammatory markers, and pain in patients with RA treated with GLP-1RAs in addition to immunosuppressive treatment. Extensive evidence from randomized trials in metabolic populations demonstrates that GLP-1RAs improve glycemic control, induce significant weight loss, and reduce modestly but consistently blood pressure and atherogenic lipids, ultimately lowering major CV events and mortality. Although this evidence cannot be directly translated to RA populations, early real-world data specific to the disease suggest similar favorable trends, including reductions in cardiometabolic risk factors and thromboembolic events. Taken together, these findings suggest that GLP-1RAs may offer dual benefits in RA by addressing both metabolic dysfunction and inflammation. However, the current evidence base is heterogeneous and largely non-randomized, underscoring the need for dedicated trials. Full article

(This article belongs to the Special Issue Rheumatoid Arthritis: New Advances in Personalized Therapies)

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17 pages, 2288 KB

Open AccessArticle

Nb₂O₅/g-C₃N₄ Composite Photocatalysts Supported on Etna-Derived Aluminosilicate for Solar H₂ Production

by Roberto Fiorenza, Roberta Chiarenza, Sebastiano Arcidiacono, Eleonora La Greca, Anna Lucia Pellegrino, Maria Teresa Armeli Iapichino, Giuliana Impellizzeri, Marisa Giuffrida, Marco Viccaro, Cristina Maria Belfiore, Salvatore Scirè and Leonarda Francesca Liotta

Materials 2026, 19(11), 2240; https://doi.org/10.3390/ma19112240 (registering DOI) - 26 May 2026

Abstract

In this work, Etna ash-derived photocatalysts were investigated for the first time for solar H₂ production. Volcanic ash, commonly treated as a special waste in eastern Sicily (Italy), was modified through chemical treatment followed by microwave-assisted crystallization, avoiding the conventional high-temperature thermal route. The obtained material was tested both as a bare photocatalyst and as a support for a Nb₂O₅/graphitic carbon nitride composite prepared by a hydrothermal method. The Etna-derived photocatalyst exhibited a solar H₂ production rate (by TEOA photoreforming) of 920 μmol/g_cat∙h. Upon incorporation of the Nb-based composite, the H₂ evolution rate increased by about 2.5 times, reaching 2370.5 μmol/gcat∙h, demonstrating a strong synergistic effect. Notably, the developed materials largely outperformed commercial TiO₂ P25 (25 μmol/g_cat∙h). The enhanced photocatalytic activity was attributed to the tailored modifications of Etna ash, which increased porosity and promoted aluminosilicate framework reorganization, favoring an optimal distribution of the photocatalytically active TiO₂ and iron oxide phases. The obtained Nb oxide/carbon nitride supported on modified Etna ash also showed a remarkable stability after six consecutive runs of solar photocatalytic H₂ production. This work demonstrates a sustainable strategy for converting volcanic waste into efficient multifunctional photocatalysts while minimizing the use of critical raw materials. Full article

(This article belongs to the Special Issue Innovative Nanostructured and Porous Materials for Advanced Photocatalysis)

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3 pages, 165 KB

Open AccessEditorial

Prosthetic Rehabilitation in Oral Cancer Patients

by Maria Maddalena Marrapodi, Hande Uzunçıbuk and Giuseppe Minervini

Prosthesis 2026, 8(6), 52; https://doi.org/10.3390/prosthesis8060052 (registering DOI) - 26 May 2026

Abstract

Oral cancer is a particularly difficult and morbid malignancy, often resulting in marked functional and aesthetic alterations post-treatment [...] Full article

(This article belongs to the Section Prosthodontics)

16 pages, 1146 KB

Open AccessArticle

Changing Epidemiology, Healthcare-Associated Infections, and Outcomes in Infective Endocarditis: A Five-Year Retrospective Study from a Tertiary Cardiovascular Center

by Adelina Matei, Grigore Tinică, Alberto Bacușcă, Mihail Enache, Andrei Țăruș, Mihaela Cătălina Luca, Gabriela Jugănariu and Doina Azoicăi

Medicina 2026, 62(6), 1028; https://doi.org/10.3390/medicina62061028 (registering DOI) - 26 May 2026

Abstract

Background and Objectives: Infective endocarditis (IE) remains a major clinical challenge. It carries high morbidity and mortality, despite advances in diagnostic and therapeutic methods. This study aimed to evaluate the epidemiological profile, microbiological characteristics, complications, and predictors of adverse outcomes among patients with IE treated at a tertiary cardiovascular center in Romania over 5 years. Materials and Methods: We conducted a retrospective study including 156 patients diagnosed with IE between January 2020 and December 2024. We analyzed demographic data, comorbidities, microbiological findings, treatment strategies, complications, and in-hospital outcomes. Results: The cohort was predominantly male (76.3%), with a mean age of 58.5 years. Native valve endocarditis was the most frequent form (80.1%). Streptococci were the most commonly identified pathogens, followed by enterococci and staphylococci. Complications occurred in 74.4% of patients. Heart failure (70.5%), acute kidney injury (37.2%), and embolic events (32.7%) were most frequent. Healthcare-associated infective endocarditis (HAIE) was seen in 10.3% of patients. Additional healthcare-associated infections (HAIs) occurred in 26.9% of patients and were associated with longer hospital stays (21.7 vs. 13.5 days; p < 0.001). Use of a central venous catheter independently predicted HAI development (adjusted OR, 3.89; 95% CI, 1.08–14.06; p = 0.038). The in-hospital mortality rate was 16.7%. Acute kidney injury and sepsis were the strongest factors associated with in-hospital mortality. Conclusions: IE remains associated with a high burden of complications and in-hospital mortality. HAIs complicate the clinical course and are closely linked to invasive device use. Mortality is mainly driven by systemic disease severity, especially acute kidney injury and sepsis. These findings highlight the importance of infection prevention, prompt risk stratification, and coordinated multidisciplinary care to improve outcomes in patients with IE. Full article

(This article belongs to the Special Issue Emerging Strategies in Infection Control and Antimicrobial Therapy)

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26 pages, 15582 KB

Open AccessArticle

Synthesis and Mechanisms of Scale and Corrosion Inhibition by Ethylenediamine–Benzenesulfonic Acid-Modified Polyaspartic Acid

by Pan Zhang, Yu Han, Xiaogai Lv, Dongyi Li, Linlin Zhao, Shihong Cen and Ying Xu

Polymers 2026, 18(11), 1301; https://doi.org/10.3390/polym18111301 (registering DOI) - 26 May 2026

Abstract

A novel water treatment agent, ethylenediamine–benzenesulfonic acid-modified polyaspartic acid (PASP-S), was controllably synthesized using an amino ring-opening reaction. The controllable synthesis methods, conditions for polymerization degree, and the molecular weight of the new polymer were explored. The structure was characterized using Fourier-transform infrared spectroscopy (FT-IR), ¹H nuclear magnetic resonance (¹H-NMR), and gel permeation chromatography (GPC). The scale inhibition, corrosion inhibition, and fluorescence properties of the new polymer, as well as the corresponding mechanisms, were investigated using static scale inhibition tests, electrochemical measurements, X-ray photoelectron spectroscopy (XPS), density functional theory (DFT), and frontier molecular orbital (FMO) theory. The results indicate that PASP-S exhibits strong Ca²⁺ chelation ability and can effectively inhibit CaCO₃ and CaSO₄ scaling. At 50 mg/L, the scale inhibition efficiency for Ca₃(PO₄)₂ reaches 99.50%. At 30 mg/L, its corrosion inhibition efficiency is 33.19% higher than that of PASP. Unexpectedly, the polymer shows remarkable selective antibacterial activity. At 100 mg/mL, the inhibition rate against Escherichia coli (E. coli) is 71%, while no obvious inhibition is observed for Bacillus cereus. A good linear relationship is found between fluorescence intensity and concentration. Mechanistic studies demonstrate that PASP-S adsorbs on the scale surface, suppressing crystal growth and distorting crystal morphology. Meanwhile, it forms a protective film on the electrode surface, thus reducing the dissolution and corrosion of carbon steel. Full article

(This article belongs to the Section Circular and Green Sustainable Polymer Science)

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21 pages, 6591 KB

Open AccessArticle

Optimization of Heat Treatment Parameters for Austenitic Stainless Steel Cladding Using the Taguchi Method

by Wissal Yangui, Rami Ghorbel, Farid Takali, Wafa Naifar, Ahmed Ktari, Khaled Elleuch and Nader Haddar

Metals 2026, 16(6), 581; https://doi.org/10.3390/met16060581 (registering DOI) - 26 May 2026

Abstract

Hot-rolled A283 Gr C carbon steel/A240 TP 316L stainless steel-clad plates are widely used in structural applications. However, the hot-rolling process introduces residual stresses and microstructural heterogeneities near the interface, which can adversely affect mechanical performance. This study aims to optimize stress-relief annealing parameters for hot-rolled A283 Gr C/A240 TP 316L-clad steel in order to enhance toughness while preserving microstructural integrity. A Taguchi experimental design based on an L9 orthogonal array was employed to evaluate the effects of holding temperature, holding time, and heating/cooling velocity on Charpy impact toughness. Signal-to-noise (S/N) ratio analysis and ANOVA were used to identify the most influential parameters. Microstructural observations, microhardness profiling, and Charpy impact testing were conducted before and after heat treatment. The results indicate that stress-relief annealing does not alter the base microstructures of either the carbon steel substrate or the austenitic stainless steel-clad layer, nor does it induce carbide precipitation or secondary phase formation in the A240 TP 316L stainless steel. A noticeable reduction in the thickness of the decarburized ferrite zone near the interface was observed, suggesting improved interfacial stability. Microhardness measurements revealed a moderate decrease in hardness near the interface, accompanied by a significant increase in Charpy impact toughness under optimized conditions. ANOVA results show that holding temperature is the dominant factor influencing toughness, followed by heating/cooling velocity, while holding time has a minor effect. The optimal stress-relief annealing conditions were identified as 550 °C for 45 min, with a heating/cooling velocity of 100 °C/h. These findings demonstrate that the Taguchi method is an effective approach for optimizing heat treatment parameters and improving the mechanical integrity of hot-rolled stainless steel-clad plates. Full article

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14 pages, 1214 KB

Open AccessArticle

Different Oxidation as a Pre-Treatment for Wastewater from a Coal-Fired Power Plant to Enhance the Sodium Salt Concentrate by RO

by Guang Shi, Liu Yang, Ling Wu, Zheng Ma, Bowen Tan and Ji Li

Separations 2026, 13(6), 160; https://doi.org/10.3390/separations13060160 (registering DOI) - 26 May 2026

Abstract

Carbon dioxide emissions are a major concern for coal-fired power plants. A capture and utilization method is highly demanded. The wastewater generated by a power plant contains a high concentration of Na⁺. Using wastewater salts to absorb carbon dioxide for sodium carbonate production is a promising strategy, as it can achieve carbon capture and utilization and wastewater resource utilization. However, the salt concentration in raw wastewater from coal-fired power plants is generally insufficient to achieve sustainable carbon capture; thus, concentrating the Na⁺ in the wastewater is key. In this study, desulfurization wastewater was investigated as a source of salts. The reverse osmosis (RO) process was selected for salt concentration. As wastewater is significantly complex and unsuitable for direct RO treatment, pre-treatment was conducted. For chemical oxygen demand (COD) removal, Fenton oxidation (49.7%) and electrochemical oxidation (49.3%) achieved better results than microelectrolysis (25.3%). Precipitation showed a strong ability to remove hardness. The removal efficiencies for Mg²⁺ and Ca²⁺ were 99.9% and 99.8%, respectively. It gave 8.6% COD removal as well. Additionally, 89.8% of ammonia was removed by stripping. To further decrease the pollutant concentrations, activated carbon was used for adsorption. RO then concentrated the pre-treated wastewater after nanofiltration. The final level of NaCl was 40.4 g/L after concentration. This was lower than that required to concentrate the water, which contained only NaCl. This is due to the presence of impurities left in the wastewater after pre-treatment. The study reveals that pre-treatment is essential to achieve the desired NaCl concentration in RO with the ultimate goal of CO₂ capture. Full article

(This article belongs to the Topic Advances in Separation Engineering)

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32 pages, 23060 KB

Open AccessArticle

Characterising the Antimicrobial Performance of Engineered Layered Double Hydroxide Surfaces for Biofilm Control

by Federico Delle Fave, Michela Froio, Diego Cisternino, Suguna Jayaraman, Chris Ashley, Pier Gianni Medaglia and Francesco Giorgi

Nanomaterials 2026, 16(11), 666; https://doi.org/10.3390/nano16110666 (registering DOI) - 25 May 2026

Abstract

Antimicrobial resistance (AMR) is a growing global health concern driven by bacterial biofilm formation, which increases tolerance to treatments. Developing surface-based strategies to limit biofilm formation is therefore critical. Layered Double Hydroxides (LDHs) are 2D brucite-like nanomaterials with tuneable physicochemical properties that may reduce bacterial colonisation. Their ease of synthesis, with scalability potential for industrial production, alongside their characteristic and tunable physicochemical properties, makes them a promising nanostructured coating for antimicrobial applications. This study evaluates LDH thin-film coatings as intrinsic antimicrobial surfaces, focusing on the combined effects of chemical composition, nanotopography, and wettability on biofilm formation in Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Four aluminium-based LDHs (ZnAl-NO₃, ZnAl-Cl₂, MgAl-NO₃, MgAl-Cl₂) were synthesised via coprecipitation or in situ growth on aluminium substrates. Materials were characterised by XRD, SEM, EDS, and contact angle measurements. Antimicrobial performance was assessed by quantifying colony-forming units (CFU mL⁻¹) after bacterial exposure. ZnAl-LDH surfaces showed significant antimicrobial activity against E. coli and S. aureus, while MgAl-LDHs showed no effect and occasionally increased bacterial growth. None of the LDH surfaces tested exhibited significant antimicrobial activity against P. aeruginosa strain. The antimicrobial performance of ZnAl-LDH can be attributed to the concurrent effect of the surface chemistry, wettability, and sharp platelet-like nanotopography. The results obtained demonstrate that ZnAl-LDH-based coatings are promising antimicrobial materials with potential relevance for translational research in clinical antimicrobial surface development. Full article

(This article belongs to the Special Issue Advances in Bioactive Materials for Nanomedicine)

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14 pages, 10724 KB

Open AccessArticle

Dietary Supplementation with Zanthoxylum bungeanum Seed Cake and Meal Improves the Productive Performance and Antioxidant Capacity of Laying Hens

by Shanchuan Cao, Hanshu Lin, Xiaocong Li, Xinglai Li, Jianfei Zhao and Jingbo Liu

Animals 2026, 16(11), 1611; https://doi.org/10.3390/ani16111611 (registering DOI) - 25 May 2026

Abstract

The objective of this paper was to examine the effects of differing levels of dietary Zanthoxylum bungeanum seed cake and meal (ZBS) on the productive performance, egg quality, gut microbiota and liver metabolomics of laying hens. In total, 1280 healthy Lohmann Pink laying hens (age, 36 weeks) were randomly assigned to four treatment groups: control (CON), 1% ZBS, 2% ZBS, or 3% ZBS. The trial lasted for eight weeks. The results indicated that compared to the CON group, the 3% ZBS group had a higher egg production during weeks 5–8 and 1–8 (p < 0.05). However, the feed-to-egg ratio and egg breakage rate during weeks 1–8 was lower in the 2% ZBS group and 3% ZBS group compared to the CON group (p < 0.05). Adding different levels of ZBS to the diet significantly increased egg production, reduced the feed-to-egg ratio, and reduced the feed intake of weeks 5–8 in laying hens (p < 0.05) with both effects exhibiting a linear relationship as the addition level increased (p < 0.05). Compared to the CON group, supplementing the diet with 2% or 3% ZBS significantly increased T-AOC levels in the liver and serum, as well as T-SOD enzyme activity, but it significantly decreased the MDA level in the serum (p < 0.05). The addition of ZBS has been demonstrated to induce alterations in the microbial composition of the cecum in laying hens. The key metabolic pathways and key metabolites are glycerophospholipid metabolism and magnoflorine, respectively. In conclusion, the supplementation of diets with ZBS has been demonstrated to significantly enhance the production performance and antioxidant capacity in laying hens. The optimal supplementation level was 3% ZBS. Full article

(This article belongs to the Section Animal Nutrition)

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31 pages, 4076 KB

Open AccessReview

GLP-1 Receptor Agonists in the Rehabilitation of Patients with Heart Failure: Mechanisms, Clinical Evidence, and Future Perspectives

by Luh Oliva Saraswati Suastika, Yasuko K. Bando, Keiji Hoshino, Norimichi Koitabashi, Yukihiro Saito, Shinsuke Yuasa and Kazufumi Nakamura

Nutrients 2026, 18(11), 1688; https://doi.org/10.3390/nu18111688 (registering DOI) - 25 May 2026

Abstract

Heart failure (HF) remains associated with high morbidity and mortality, with heart failure with preserved ejection fraction (HFpEF) becoming increasingly prevalent and therapeutically challenging despite advances in pharmacological and rehabilitative care. Beyond their glucose-lowering effects, glucagon-like peptide-1 receptor agonists (GLP-1RAs) confer cardiometabolic benefits and may serve as effective adjuncts to cardiac rehabilitation (CR), particularly in obese patients with HFpEF. Obesity plays a central role in the pathophysiology of HFpEF, and GLP-1RAs promote weight loss, reduce insulin resistance and leptin signaling, and improve hemodynamic and metabolic abnormalities associated with HFpEF. Accumulating evidence suggests that the benefits of GLP-1RAs are phenotype-specific and more pronounced in patients with HFpEF than in patients with HF with reduced ejection fraction. Current clinical guidelines recommend GLP-1RAs for patients who have type 2 diabetes mellitus and established cardiovascular (CV) disease or are at high CV risk, with recent updates recognizing their potential benefits in patients with HFpEF and obesity. Cardiac rehabilitation, delivered through multidisciplinary programs, remains a cornerstone of HF management. Although caloric restriction and aerobic exercise can be beneficial in patients with HFpEF and obesity, these interventions alone are often insufficient. Sarcopenia is common in older patients with HFpEF and contributes to adverse outcomes, underscoring the importance of incorporating resistance training into CR programs. The most frequent adverse effects of GLP-1RAs are gastrointestinal events, which are generally mild to moderate but may lead to treatment discontinuation in some patients. Future studies should investigate the potential synergistic effects of GLP-1RAs and CR, clarify their long-term safety and efficacy in HF populations, and define their role beyond obese HFpEF phenotypes. Full article

(This article belongs to the Special Issue GLP-1 Receptor Agonists and Nutrition)

30 pages, 2775 KB

Open AccessReview

Liposome-Based Photodynamic Therapy for Breast Cancer: Innovations in Targeted Delivery, Combination Strategies, and Clinical Translation

by Nehla Banu, Elder de la Rosa, Muhammad Azeem Saeed, Pedro Salas and Sandeep Surendra Panikar

Int. J. Mol. Sci. 2026, 27(11), 4763; https://doi.org/10.3390/ijms27114763 (registering DOI) - 25 May 2026

Abstract

Breast cancer remains a leading cause of cancer-related mortality worldwide, with treatment resistance, recurrence, and metastasis significantly limiting the effectiveness of conventional therapies. Photodynamic therapy (PDT) has emerged as a minimally invasive and highly selective approach, utilizing photosensitizer-generated reactive oxygen species (ROS) to achieve precise tumor cytotoxicity while preserving surrounding healthy tissue. However, clinical translation of PDT remains constrained by critical biological barriers within the tumor microenvironment, including tumor hypoxia, limited light penetration, poor photosensitizer stability, and inefficient cellular uptake. Antigen-targeted liposomal nanocarriers offer a compelling solution by enabling targeted drug delivery and tumor-specific photosensitizer accumulation, prolonged systemic circulation, and enhanced cellular internalization. Their multifunctional architecture uniquely supports combinational therapeutic strategies, integrating PDT with chemotherapy, photothermal therapy, gene therapy, X-ray-induced photodynamic therapy (X-PDT) and immune checkpoint blockade, thereby amplifying antitumor efficacy and overcoming drug resistance mechanisms. This review comprehensively summarizes recent advances in liposome-based PDT for breast cancer, highlighting multimodal therapeutic integration. Special emphasis is placed on preclinical and emerging clinical outcomes, pilot-scale manufacturing considerations, and strategies to minimize immune clearance. Full article

(This article belongs to the Special Issue Innovations in Photodynamic Therapy: New Horizons in Breast Cancer Care)

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