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20 pages, 3235 KB  
Article
Short-Term Glucose Release from Ultrasound-Assisted Alkali-Pretreated HH Using Free and Magnetic Nanoparticle-Immobilised Cellulase
by Ziningi Rosebud Myeni, Sani Gumede, Farai Dziike and Nirmala Deenadayalu
Fibers 2026, 14(8), 90; https://doi.org/10.3390/fib14080090 (registering DOI) - 6 Aug 2026
Abstract
The enzymatic conversion of lignocellulosic biomass (LB) into fermentable sugars is important for the development of sustainable biorefineries. This study investigated the immobilisation of Trichoderma reesei (T. reesei) cellulase on amine-functionalised magnetic nanoparticles (MNPs) and evaluated the resulting biocatalyst for the [...] Read more.
The enzymatic conversion of lignocellulosic biomass (LB) into fermentable sugars is important for the development of sustainable biorefineries. This study investigated the immobilisation of Trichoderma reesei (T. reesei) cellulase on amine-functionalised magnetic nanoparticles (MNPs) and evaluated the resulting biocatalyst for the hydrolysis of pretreated hemp hurd (HH) biomass. Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) provided evidence consistent with cellulase association with the nanoparticles, with the estimated dry-state particle diameter increasing from 22.4 ± 0.4 to 27.8 ± 0.3 nm after immobilisation. The selected immobilised catalyst loading produced approximately 89% of the total filter-paper assay response obtained with the selected free-enzyme loading, although this comparison was not normalised to protein content. During 7 h hydrolysis experiments, glucose production increased progressively for both enzyme forms. Across the tested enzyme dilutions, immobilised cellulase generated approximately 88–91% of the glucose produced by free cellulase. The immobilised enzyme also retained approximately 64% of its initial hydrolysis performance after five reuse cycles. These findings demonstrate the potential of magnetic cellulase nanobiocatalysts for recoverable and reusable hydrolysis of lignocellulosic biomass. However, further studies are required to determine protein-normalised activity, immobilisation efficiency, longer-term stability, process economics and industrial scalability. Full article
(This article belongs to the Special Issue Research on Wood and Lignocellulosic Materials)
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24 pages, 5228 KB  
Article
Genome-Wide Characterization of the PLATZ Gene Family in Medicago truncatula and Their Expression Profiles in Response to Abiotic Stress
by Wen Zhou, Shuangjin Fan, Xinyan Zhao, Chenxi Zang, Le Wang and Yongwang Sun
Biology 2026, 15(15), 1318; https://doi.org/10.3390/biology15151318 (registering DOI) - 6 Aug 2026
Abstract
Plant A/T-rich sequence and zinc-binding protein (PLATZ) transcription factors are pivotal regulators of plant growth, development, and abiotic stress responses. Although PLATZ genes have been extensively studied and functionally characterized in various plant species, little information is available regarding these genes in the [...] Read more.
Plant A/T-rich sequence and zinc-binding protein (PLATZ) transcription factors are pivotal regulators of plant growth, development, and abiotic stress responses. Although PLATZ genes have been extensively studied and functionally characterized in various plant species, little information is available regarding these genes in the legume model plant Medicago truncatula. In this study, a total of 16 PLATZ genes (designated MtPLATZ1 to MtPLATZ16) were identified from the M. truncatula genome and distributed across six of the eight chromosomes. Subcellular localization prediction analysis indicated that all MtPLATZ proteins are localized in the nucleus, with eight representative members experimentally validated by transient expression assays. Collinearity analysis indicated that five segmental duplication pairs were the primary driver of MtPLATZ gene expansion. Based on phylogenetic analysis, these genes were classified into four groups, comprising 6, 2, 4, and 4 genes, respectively. Gene structure analysis demonstrated that these genes possess three or four exons. Most MtPLATZ genes were found to contain at least one ABRE cis-element in their promoter regions, and a few also harbored LTR, CAT-box, ARE, and DRE cis-elements. Expression analysis revealed that MtPLATZ genes exhibit distinct expression patterns across different tissues, suggesting that they may be differentially regulated by abiotic stresses in a tissue-specific manner. Under PEG-induced osmotic stress, acute NaCl shock, acute heat shock, and acute cold shock, the expression levels of these eight genes exhibited significant changes, particularly MtPLATZ2, MtPLATZ6, and MtPLATZ9, indicating that MtPLATZ gene family members may play a broad role in abiotic stress responses. In summary, these findings provide valuable insights for future functional exploration of MtPLATZ genes and contribute to a deeper understanding of their roles in stress responses in M. truncatula. Full article
(This article belongs to the Section Plant Science)
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14 pages, 264 KB  
Article
Can Burnout Be Linked to Suicide Among Healthcare Professionals? A Cross-Sectional Study
by Alexandru Ungurianu and Virginia Marina
Nurs. Rep. 2026, 16(8), 276; https://doi.org/10.3390/nursrep16080276 (registering DOI) - 6 Aug 2026
Abstract
Background: Burnout, defined by emotional exhaustion, depersonalization, and reduced personal accomplishment, is a major occupational health concern among healthcare professionals. Burnout has been linked to depression, anxiety, and medical errors, but its association with suicidality in healthcare settings remains insufficiently explored. Objective [...] Read more.
Background: Burnout, defined by emotional exhaustion, depersonalization, and reduced personal accomplishment, is a major occupational health concern among healthcare professionals. Burnout has been linked to depression, anxiety, and medical errors, but its association with suicidality in healthcare settings remains insufficiently explored. Objective: To investigate the association between burnout dimensions and suicidality among healthcare professionals, and to identify occupational and demographic factors influencing this relationship. Methods: A cross-sectional study was conducted among 195 healthcare professionals in Romania, recruited through voluntary participation in an anonymized online survey. Burnout was assessed using an adapted tool inspired by the Maslach Burnout Inventory, while suicidality outcomes included suicidal ideation, self-harm, and suicide attempts. Descriptive statistics were calculated for demographic and professional variables. Pearson correlations and multivariable linear regression analyses, adjusted for age, professional experience, and shift work, were performed to evaluate associations between burnout dimensions and suicidality. Results: Emotional exhaustion (r = 0.42, p < 0.001) and depersonalization (r = 0.37, p < 0.001) were positively correlated with suicidality, while reduced personal accomplishment was negatively correlated (r = −0.29, p = 0.002). In multivariable regression, emotional exhaustion remained the only statistically significant independent predictor of suicidality after adjustment for demographic and occupational characteristics. Younger age and rotating/night-shift work were associated with higher suicidality in unadjusted analyses but were not independent predictors after multivariable adjustment. Strong correlations between burnout dimensions and physical symptoms highlighted the interplay between psychosocial strain and somatic health. Conclusions: Burnout, particularly emotional exhaustion, was independently associated with suicidality among healthcare professionals, while depersonalization demonstrated a significant unadjusted association that did not remain statistically significant after multivariable adjustment. Younger clinicians, shift workers, and those with less experience appear especially vulnerable. These findings emphasize that burnout is a multifactorial construct with both psychological and somatic dimensions, shaped by systemic workplace stressors. These findings support further evaluation of systematic screening, organizational reforms, mentorship programs, and confidential mental health support as potential components of suicide-prevention strategies for healthcare professionals. Full article
21 pages, 23016 KB  
Article
Functional Characterization of GmALA1, a Plasma Membrane-Localized P4-ATPase, and Its Interacting β-Subunit GmALIS2 in Soybean
by Gaoyang Zhang, Muhammad Imran, Jingjing Wei, Mengbo Wang, Zhongke Sun and Chengwei Li
Biology 2026, 15(15), 1319; https://doi.org/10.3390/biology15151319 (registering DOI) - 6 Aug 2026
Abstract
P4-ATPases maintain transbilayer lipid asymmetry, yet their functional roles in legume crops remain poorly understood. In the present study, GmALA1-a plasma membrane-localized P4-ATPase in soybean, was identified and characterized. Its physical interaction with the β-subunit GmALIS2 at the plasma membrane via [...] Read more.
P4-ATPases maintain transbilayer lipid asymmetry, yet their functional roles in legume crops remain poorly understood. In the present study, GmALA1-a plasma membrane-localized P4-ATPase in soybean, was identified and characterized. Its physical interaction with the β-subunit GmALIS2 at the plasma membrane via biomolecular fluorescence complementation was confirmed. Heterologous expression in the P4-ATPase-deficient yeast strain ZHY709 demonstrated that GmALA1 fully complemented the cold-sensitive growth phenotype, while co-expression with GmALIS2 only partially restored growth, suggesting GmALIS2 may modulate rather than simply stimulate GmALA1 activity, though the mechanism remains unresolved. GmALA1 suppresses triacylglycerol accumulation while elevating lysophosphatidylethanolamine and lysophosphatidylcholine content in both wild-type and mutant yeast. These findings were consistent with GmALA1-driven remodeling of membrane lipid flux. In yeast and transgenic soybean hairy roots, GmALA1 alone or in combination with GmALIS2 differentially altered the internalization and tissue-specific distribution of multiple phospholipid classes, with the pattern of NBD-lipid accumulation differing depending on GmALIS2 co-expression and cellular context. GmALA1 expression was also associated with altered yeast sensitivity to divalent cations including Ca2+, Co2+, and Zn2+. Also, cellular cation accumulation in the P4-ATPase-deficient background was enhanced. However, whether this reflects a direct interaction between GmALA1 and cation homeostasis machinery remains to be established. These findings establish GmALA1 as a functionally active phospholipid flippase that coordinates transmembrane lipid redistribution in concert with GmALIS2. These findings advance our understanding of P4-ATPase biology in soybean and legume crops. Full article
(This article belongs to the Section Biochemistry and Molecular Biology)
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16 pages, 4682 KB  
Article
Endothelial Responses to ICS/LABA Combinations Are Determined Primarily by the Corticosteroid Component
by Bassam Redwan, Christian Biancosino, Amir Mehdizadeh-Shrifi, Felix Nikolaus Lennartz, Stefan Fischer, Karsten Wiebe, Marion Schael, Patrick Zardo, Sabina Janciauskiene and Heiko Golpon
Int. J. Mol. Sci. 2026, 27(15), 7045; https://doi.org/10.3390/ijms27157045 (registering DOI) - 6 Aug 2026
Abstract
The pulmonary microvasculature plays an essential role in maintaining alveolar integrity, but the direct effects of inhaled corticosteroids (ICS) on pulmonary endothelial cell function remain poorly understood. We investigated the effects of budesonide, formoterol, and their combination on endothelial network formation, apoptosis, migration, [...] Read more.
The pulmonary microvasculature plays an essential role in maintaining alveolar integrity, but the direct effects of inhaled corticosteroids (ICS) on pulmonary endothelial cell function remain poorly understood. We investigated the effects of budesonide, formoterol, and their combination on endothelial network formation, apoptosis, migration, proliferation, and efferocytosis using human pulmonary microvascular endothelial cells (HPMEC-ST1.6R), A549 alveolar epithelial cells, and phagocytic cell models. Budesonide, alone or combined with formoterol, altered endothelial network formation on Matrigel by reducing total tubule length and the number of junctions while increasing tubule thickness, indicating reduced branching complexity. Budesonide also decreased epithelial secretion of the pro-angiogenic mediators VEGF, IL-8, and MCP-1. An independent set of experiments showed that fluticasone propionate similarly reduced VEGF, IL-8, MCP-1, TNF-α, and IL-6, supporting a class effect of corticosteroids on the epithelial secretome. Despite reducing angiogenic responses, budesonide protected endothelial cells from apoptosis, reduced caspase-3/7 activity, accelerated wound closure without affecting proliferation, preserved endothelial spheroid integrity, and enhanced efferocytosis. Formoterol alone had minimal effects and did not consistently enhance budesonide responses. Together, these in vitro findings suggest that, in the cell models studied, pulmonary endothelial responses to the ICS/LABA combinations tested are determined predominantly by the corticosteroid component, which suppresses pro-angiogenic mediator secretion while preserving endothelial survival and repair. As an exploratory cell-based study, these observations are hypothesis-generating and require confirmation in primary cells and in vivo models before clinical inferences can be drawn. Full article
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29 pages, 14499 KB  
Article
Melatonin and Brassinolide Enhance Cold Tolerance in Osmanthus fragrans: Insights from Integrated Physiological and Multi-Omics Analyses
by Hui Xia, Wenxuan Huang, Jingjing Zou, Hongguo Chen, Xuan Cai, Jie Yang, Zeqing Li, Xiangling Zeng, Yuanhang Wu and Yingting Zhang
Plants 2026, 15(15), 2404; https://doi.org/10.3390/plants15152404 (registering DOI) - 6 Aug 2026
Abstract
Low-temperature stress severely restricts the growth, development, and ornamental value of Osmanthus fragrans Lour. However, the molecular mechanisms by which brassinolide (BR) and melatonin (MT) alleviate low-temperature-induced damage remain unclear. Here, O. fragrans branches were exposed to low-temperature stress (5, 0, −5, −10, [...] Read more.
Low-temperature stress severely restricts the growth, development, and ornamental value of Osmanthus fragrans Lour. However, the molecular mechanisms by which brassinolide (BR) and melatonin (MT) alleviate low-temperature-induced damage remain unclear. Here, O. fragrans branches were exposed to low-temperature stress (5, 0, −5, −10, −15, and −20 °C for 12 h) and treated with exogenous MT (50, 100, and 200 μM) or BR (0.5, 1, and 2 μM). An integrated approach combining phenotypic observation, physiological measurements, transcriptomics, and metabolomics was employed to elucidate the regulatory mechanisms underlying BR- and MT-mediated cold tolerance. The results showed that low-temperature stress significantly increased electrolyte leakage (EL), malondialdehyde (MDA), and hydrogen peroxide (H2O2) accumulation, while reducing superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) activities. Compared with the control, BR and MT treatments alleviated leaf chlorosis and wilting, reduced oxidative damage, and enhanced antioxidant enzyme activities. Integrated transcriptome–metabolome analyses demonstrated that BR and MT commonly activated phenylpropanoid and flavonoid biosynthesis, thereby promoting antioxidant metabolite accumulation, while suppressing α-linolenic acid and linoleic acid metabolism associated with stress-induced lipid remodeling. Network-based transcriptomic analyses identified transcription factors, including ARF, EIL, bHLH, and GRAS, as potential regulators of cold-responsive pathways. Furthermore, BR primarily regulated hormone-responsive networks, whereas MT mainly maintained redox homeostasis and metabolic reprogramming. These findings reveal the coordinated regulatory mechanisms underlying BR- and MT-mediated cold tolerance, providing potential targets for improving cold resilience in O. fragrans. Full article
(This article belongs to the Special Issue Omics in Plant Development and Stress Responses)
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32 pages, 374 KB  
Article
Reconstruction of Quantum Field Equations from Multi-Branch Hamilton–Jacobi Structures
by Cécile Barbachoux
Foundations 2026, 6(3), 30; https://doi.org/10.3390/foundations6030030 (registering DOI) - 6 Aug 2026
Abstract
We develop a framework in which quantum field equations are reconstructed from a multi-branch Hamilton–Jacobi structure supplemented by density functionals on configuration space. Each branch is defined by a solution of a functional Hamilton–Jacobi equation, while the associated density encodes measure-theoretic and dynamical [...] Read more.
We develop a framework in which quantum field equations are reconstructed from a multi-branch Hamilton–Jacobi structure supplemented by density functionals on configuration space. Each branch is defined by a solution of a functional Hamilton–Jacobi equation, while the associated density encodes measure-theoretic and dynamical information. Under suitable analytical assumptions, we show that the superposition of these branchwise contributions yields a wave functional satisfying the functional Schrödinger equation. The construction is established in a mathematically controlled setting, including finite-dimensional regularizations and a continuum limit under appropriate convergence hypotheses. Explicit examples demonstrate the exact reconstruction of both free and interacting scalar quantum field equations. Extensions to fermionic and gauge fields are outlined, highlighting the role of graded structures and constraints. Beyond the reconstruction result, the framework provides a structural reinterpretation of quantum theory. Classical dynamics is encoded in the space of Hamilton–Jacobi solutions, while quantum phenomena arise from the coherent superposition of these classical configurations through density and phase. From a geometric viewpoint, the construction is naturally related to multisymplectic structures and admits a cohomological interpretation. This approach establishes a direct bridge between classical variational principles and quantum field theory, offering a unified perspective on the emergence of quantum behavior from structured ensembles of classical configurations. Full article
(This article belongs to the Section Physical Sciences)
16 pages, 1308 KB  
Article
Potential for Expanding Summertime Timber Harvesting on Drained Peatlands Under Operational Stand Conditions: A Site-Specific Case Study
by Oiva Hiltunen, Ville Hallikainen and Teijo Palander
Forests 2026, 17(8), 925; https://doi.org/10.3390/f17080925 (registering DOI) - 6 Aug 2026
Abstract
The expansion of sustainable timber harvesting on peatland forests is important for forest owners, contractors, and the forest industry. This study investigated the effects of site-specific conditions on summertime harvesting operations and modeled the influence of a light nine-ton forwarder on rut formation. [...] Read more.
The expansion of sustainable timber harvesting on peatland forests is important for forest owners, contractors, and the forest industry. This study investigated the effects of site-specific conditions on summertime harvesting operations and modeled the influence of a light nine-ton forwarder on rut formation. Three logistic mixed-effects models predicted peat surface disturbance (ROC = 0.60, 0.63, and 0.67), while a linear mixed model predicted rut depth when rutting occurred (R2 = 0.35). Rut formation was associated with the number of machine passes, cumulative load, groundwater table depth, peat layer thickness, and interactions between stand and harvesting variables. The results indicate that timber can be successfully forwarded from drained peatlands with limited bearing capacity when operations are adapted to local site conditions. The findings highlight the importance of road-network planning, load management, and operator decision-making in reducing rut formation. This modeling approach also supports operator training, thereby contributing to more sustainable timber harvesting on low-bearing-capacity sites. Full article
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14 pages, 244 KB  
Article
Associations of Oral Functional Impairment, Nutritional Risk, and Functional Dependence with Dementia Among Community-Dwelling Older Koreans
by Sun-Mi Lee, Hye-Min Ku and Mi-Kyoung Jun
Oral 2026, 6(4), 101; https://doi.org/10.3390/oral6040101 (registering DOI) - 6 Aug 2026
Abstract
Background: Dementia is a major geriatric syndrome associated with nutritional vulnerability and functional decline among older adults. This study aimed to compare oral functional impairment, nutritional risk, and functional dependence according to dementia status and to examine their associations with dementia among [...] Read more.
Background: Dementia is a major geriatric syndrome associated with nutritional vulnerability and functional decline among older adults. This study aimed to compare oral functional impairment, nutritional risk, and functional dependence according to dementia status and to examine their associations with dementia among community-dwelling older Koreans. Methods: This cross-sectional study analyzed data from 10,078 adults aged ≥65 years who participated in the 2023 National Survey of Older Koreans. Dementia was defined based on self-reported physician diagnosis. Oral functional impairment, nutritional risk factors, and functional dependence, including activities of daily living (ADL) and instrumental activities of daily living (IADL), were assessed using structured survey questionnaires. Chi-square tests and multivariable logistic regression analyses were performed using four sequentially adjusted models. Results: Older adults with dementia exhibited significantly greater oral functional impairment, nutritional risk, and functional dependence than those without dementia. In the fully adjusted model, denture use remained independently associated with dementia (OR = 1.692, 95% CI: 1.179–2.428). Fewer than two meals per day (OR = 3.156, 95% CI: 1.771–5.623) and difficulty shopping for or preparing meals (OR = 2.408, 95% CI: 1.648–3.520) were significantly associated with dementia. In addition, severe ADL dependence (OR = 5.895, 95% CI: 2.947–11.794) and IADL dependence (OR = 4.598, 95% CI: 3.099–6.822) showed strong associations with dementia. Conclusions: Dementia was significantly associated with oral functional impairment, nutritional risk, and functional dependence, indicating multidimensional geriatric vulnerability and highlighting the need for integrated assessment in dementia care. Full article
24 pages, 33233 KB  
Article
Morphological Divergence Without Genetic Differentiation in Widely Distributed Chinese Cipangopaludina Species
by Yaozong Wang, An Li, Fuguang Luo, Ziyi Wang, Xiao Chen, Zhiqiang Wang and Qianhong Gu
Biology 2026, 15(15), 1317; https://doi.org/10.3390/biology15151317 (registering DOI) - 6 Aug 2026
Abstract
The taxonomic status of Cipangopaludina chinensis and C. cathayensis remains controversial due to morphological overlap. We combined morphometrics (24 landmarks vs. 200 semilandmarks) with multi-locus phylogenetics (COI, 16S rRNA, H3, 28S rRNA) and haplotype networks on sympatric populations [...] Read more.
The taxonomic status of Cipangopaludina chinensis and C. cathayensis remains controversial due to morphological overlap. We combined morphometrics (24 landmarks vs. 200 semilandmarks) with multi-locus phylogenetics (COI, 16S rRNA, H3, 28S rRNA) and haplotype networks on sympatric populations from Liuzhou and GenBank. Morphometrics completely separated C. chinensis_lz from C. cathayensis_lz in shell shape; key diagnostic traits include aperture size, spire height, and body whorl inflation. The high-density semilandmark method outperformed discrete landmarks in dimensionality reduction and fine-scale resolution, capturing subtle apex and lateral whorl variations. No sexual dimorphism occurred in C. cathayensis_lz, with only weak dimorphism in C. chinensis_lz. Molecular data were ambiguous: the species tree and mitochondrial gene tree recovered C. chinensis and C. cathayensis as monophyletic, but the nuclear gene tree showed mixing of C. chinensis_lz/C. cathayensis_lz with C. wisseli, C. chinensis, and C. cathayensis. Haplotype networks revealed haplotypes sharing between C. chinensis_lz and C. cathayensis_lz, yet neither population shared haplotype with GenBank sequences of the two nominal species. Morphology strongly supports C. chinensis_lz and C. cathayensis_lz as distinct species, whereas molecular evidence shows only low-level differentiation and discordant signals between mitochondrial and nuclear markers. We conclude they are likely valid species, yet mitonuclear discordance warrants further genomic investigation. Despite no evidence of microhabitat partitioning, the stable morphological divergence between these sympatric morphospecies supports separate management units to conserve phenotypic diversity and local adaptive potential. This study validates geometric morphometrics as an efficient frontline tool for biodiversity assessment in morphologically diverse yet genetically conserved freshwater snails, and reinforces the need for genome-wide data to resolve species boundaries within the Cipangopaludina complex. Full article
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26 pages, 2030 KB  
Review
Carotid Free-Floating Thrombus: A Case Series, Narrative Review, and Proposal for Biology-Guided Treatment Selection
by Spyros Papadoulas, Kate Tabaku, Chrysanthi Papageorgopoulou, Konstantinos Nikolakopoulos, Zafeiria Papathanassiou, Helen Kourea, Petros Zampakis, Vasilios Panagiotopoulos, John Ellul, Francesk Mulita and Vasileios Leivaditis
Med. Sci. 2026, 14(4), 457; https://doi.org/10.3390/medsci14040457 (registering DOI) - 6 Aug 2026
Abstract
Background: Carotid free-floating thrombus (CFFT) is an uncommon but clinically significant cause of transient ischemic attack and ischemic stroke, carrying a substantial risk of recurrent cerebral embolization. Despite advances in vascular imaging, the optimal management of CFFT remains controversial because available recommendations are [...] Read more.
Background: Carotid free-floating thrombus (CFFT) is an uncommon but clinically significant cause of transient ischemic attack and ischemic stroke, carrying a substantial risk of recurrent cerebral embolization. Despite advances in vascular imaging, the optimal management of CFFT remains controversial because available recommendations are largely based on retrospective studies, case series, and expert opinion. The present study reports a single-center experience with CFFT and provides an updated narrative review of current diagnostic and therapeutic strategies, with particular attention to the timing of intervention. Methods: A retrospective review of patients diagnosed with CFFT and managed at our institution over a 20-year period was performed. Clinical presentation, imaging findings, treatment strategy, and outcomes were analyzed. In parallel, a narrative review of the contemporary literature was conducted to summarize current evidence regarding medical management, carotid endarterectomy, endovascular techniques, hybrid approaches, and emerging concepts related to thrombus composition and maturation. Results: Five patients with symptomatic CFFT were identified. Four patients underwent carotid thromboendarterectomy, whereas one patient was managed medically with anticoagulation and antiplatelet therapy, resulting in complete thrombus resolution. Two patients experienced neurological deterioration while receiving initial anticoagulation and subsequently required urgent surgical intervention. No postoperative strokes occurred after carotid endarterectomy. Review of the literature confirmed that anticoagulation remains the cornerstone of initial therapy and achieves thrombus resolution in a substantial proportion of patients. However, recurrent neurological events continue to occur under medical treatment, while the indications and timing of invasive intervention remain poorly defined. Recent advances in high-resolution magnetic resonance imaging and optical coherence tomography suggest that thrombus age and composition may become important determinants of future treatment selection. Conclusions: CFFT represents a rare but potentially unstable vascular condition for which high-quality evidence is still lacking. Initial anticoagulation remains the most widely accepted treatment strategy, while carotid endarterectomy, endovascular thrombectomy, carotid artery stenting, and hybrid procedures may be appropriate in selected patients. Future management algorithms may ultimately move beyond a one-size-fits-all approach by incorporating thrombus biology, imaging characteristics, and individual patient risk profiles. Although this concept remains preliminary, advances in thrombus characterization may provide the foundation for more personalized treatment strategies as further clinical evidence becomes available. Full article
(This article belongs to the Section Cardiovascular Disease)
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12 pages, 1142 KB  
Article
One-Year Nutritional and Metabolic Changes in Patients on Incremental Peritoneal Dialysis Under Different Protein Diets: A Multicenter Pragmatic Cohort Study
by Silvio Borrelli, Carlo Garofalo, Tino Paolo Ambrosino, Vincenzo Bellizzi, Simona Andriella, Federica Marzano, Roberta Germanò, Chiara Ruotolo, Gianfranca Cabiddu, Roberto Russo, Valerio Vizzardi, Diana Bertoni, Adamasco Cupisti, Loris Neri, Gaetano Alfano, Gennaro Argentino, Silvia D’Alonzo, Paolo Chiodini, Giuseppe Paribello, Francesco Trepiccione, Roberto Minutolo, Luca De Nicola and I-COPE Groupadd Show full author list remove Hide full author list
Nutrients 2026, 18(15), 2565; https://doi.org/10.3390/nu18152565 (registering DOI) - 6 Aug 2026
Abstract
Background: Commencing peritoneal dialysis (PD) with a lower dose (incremental PD) is a common strategy to improve patient acceptance and reduce treatment burden. However, specific dietary protein recommendations for incremental PD are lacking. Methods: An interim analysis of the I-COPE PD [...] Read more.
Background: Commencing peritoneal dialysis (PD) with a lower dose (incremental PD) is a common strategy to improve patient acceptance and reduce treatment burden. However, specific dietary protein recommendations for incremental PD are lacking. Methods: An interim analysis of the I-COPE PD study cohort aimed to assess one-year changes in serum albumin, body mass index (BMI), and metabolic parameters in a cohort of patients on incremental PD. Following local protocols, patients were categorized into two groups according to protein diet prescription: protein diet (PrD) ≤ 0.6 and PrD > 0.6 g/kg/day. Longitudinal changes at baseline, 6 and 12 months were analyzed using mixed-effects models adjusted for age, sex, diabetes, residual kidney function and serum albumin at baseline. Results: We included 205 patients (mean age 63.3 ± 14.2 years; 66% male; 30% diabetes; 92.2% CAPD) and in 45.4% a PrD ≤ 0.6 g/kg/day was prescribed. Baseline demographic, clinical, lab and therapeutic characteristics were well-balanced between the two diet groups. After one year of follow-up, the prevalence of patients persisting in incremental PD was not different between the two dietary groups (59.1% in PrD ≤ 0.6 vs. 63.3% in PrD > 0.6, log-rank test = 0.759), and both groups showed a similar trend in serum albumin, characterized by an initial decline followed by stabilization (p = 0.647), with no significant differences in BMI (p = 0.461). Despite comparable dialysis adequacy, patients on PrD ≤ 0.6 exhibited significantly lower serum urea, phosphate, and potassium levels over time compared to the PrD > 0.6 group. Conclusions: In patients starting incremental PD, the prescription of a lower protein diet could be associated with better control of uremic toxins, while serum albumin levels over time remain comparable to those observed in patients under a higher-protein diet. Full article
(This article belongs to the Special Issue Protein Intake and Kidney Disease)
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17 pages, 803 KB  
Systematic Review
Barriers to Biologic Access in Atopic Dermatitis: Insurance, Cost, and Administrative Challenges
by Calista Persson, Benjamin R. Cooper, Stefano Cena, Taha Rasul and Angelia Stepien
Allergies 2026, 6(3), 29; https://doi.org/10.3390/allergies6030029 (registering DOI) - 6 Aug 2026
Abstract
Biologic therapies have significantly improved outcomes for patients with moderate-to-severe atopic dermatitis (AD), yet access to these treatments remains uneven and frequently limited. This systematic review synthesizes evidence on insurance-related, financial, administrative, prescriber-level, and structural barriers that limit equitable access to biologic therapies [...] Read more.
Biologic therapies have significantly improved outcomes for patients with moderate-to-severe atopic dermatitis (AD), yet access to these treatments remains uneven and frequently limited. This systematic review synthesizes evidence on insurance-related, financial, administrative, prescriber-level, and structural barriers that limit equitable access to biologic therapies for AD. In contrast to prior reviews that primarily focus on biologic efficacy, safety, or general disease management, this review evaluates access itself as the primary outcome. Across diverse study designs and populations, findings consistently demonstrate that high out-of-pocket costs, restrictive insurance policies, and administrative burdens disproportionately impact low-income, minority, and Medicaid-insured patients. However, racial and ethnic disparities should be interpreted cautiously, as factors like insurance type, Medicaid enrollment, socioeconomic status, geographic access, and other structural determinants may influence these associations. Pediatric patients and caregivers also face challenges such as insurance delays, financial burden, and long-term effects of poor disease control. These barriers contribute to delays in treatment initiation, reduced adherence, and poorer clinical outcomes. Persistent racial, socioeconomic, and geographic disparities further exacerbate inequities in care delivery. Variability in prescribing patterns and provider familiarity with biologics also influence treatment access. Collectively, these findings underscore the need for comprehensive policy reform, streamlined authorization processes, and targeted interventions to improve equitable access to biologic therapies in AD. Full article
(This article belongs to the Section Dermatology)
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14 pages, 1547 KB  
Article
Biomass Cooking Fuel Use and Screen-Detected Hypertension Among Peruvian Women Without Known Hypertension: A National Cross-Sectional Study
by Víctor Juan Vera-Ponce, Jhosmer Ballena-Caicedo, Marcos García-Rodríguez, Witre Omar Padilla, José Celso Paredes Carranza and Fiorella E. Zuzunaga-Montoya
Life 2026, 16(8), 1293; https://doi.org/10.3390/life16081293 (registering DOI) - 6 Aug 2026
Abstract
Household biomass combustion remains a source of household air pollution and unequal exposure among women. Its association with hypertension is biologically plausible, but evidence from Latin America remains limited, particularly when the analysis is restricted to women without a prior hypertension diagnosis, which [...] Read more.
Household biomass combustion remains a source of household air pollution and unequal exposure among women. Its association with hypertension is biologically plausible, but evidence from Latin America remains limited, particularly when the analysis is restricted to women without a prior hypertension diagnosis, which represents the population of greatest interest for early screening. This study aimed to estimate the association between biomass cooking fuel use and screen-detected hypertension among Peruvian women aged 15–49 years without known hypertension. We conducted an analytical cross-sectional study using pooled DHS 2014–2024 microdata. Nonpregnant women aged 15–49 years with valid blood pressure measurements, cooking fuel information, complete covariates, and no self-reported diagnosis or current antihypertensive treatment were included. Screen-detected hypertension was defined as mean systolic blood pressure ≥ 140 mmHg or mean diastolic blood pressure ≥ 90 mmHg. Poisson regression with robust variance based on the complex sampling design was used to estimate prevalence ratios (PRs). The main model was adjusted for age, altitude, area of residence, natural region, education, wealth quintile, and survey year. Sensitivity, fuel-specific, effect-modification, positivity, sequential-adjustment, extended-adjustment, and continuous blood-pressure analyses were performed. The analytical sample included 301,575 women, of whom 78,499 used biomass/solid fuel and 18,571 had screen-detected hypertension. The weighted prevalence of screen-detected hypertension was 8.5% among clean-fuel users and 6.4% among biomass/solid-fuel users. The crude association was inverse (crude PR: 0.75; 95% CI: 0.71–0.79), but it reversed after adjustment (adjusted PR: 1.20; 95% CI: 1.10–1.31). Wood was associated with a higher adjusted prevalence (adjusted PR: 1.25; 95% CI: 1.14–1.36). Coal/charcoal showed an imprecise null estimate (adjusted PR: 1.00; 95% CI: 0.76–1.31). The association was stronger in urban than in rural areas (adjusted PR: 1.28 vs. 1.09; interaction p = 0.005). Among Peruvian women without known hypertension, biomass/solid cooking fuel use was associated with a higher adjusted prevalence of screen-detected hypertension, supporting the inclusion of clean-fuel transition within integrated cardiovascular prevention strategies. Full article
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19 pages, 5604 KB  
Article
Phylogenetic Identity, Cyanotoxin Production Potential, and Thermal Performance in Native and Alien Nostocalean Cyanobacteria Under Climate Warming
by Izabelė Šuikaitė, Karina Šmeliova, Jūratė Karosienė, Daiva Burokienė, Dovilė Čepukoit and Judita Koreivienė
Biology 2026, 15(15), 1316; https://doi.org/10.3390/biology15151316 (registering DOI) - 6 Aug 2026
Abstract
Climate-driven warming may enhance the spread of warm-adapted alien cyanobacteria in freshwater ecosystems. This study assessed four nostocalean cyanobacteria from European lakes—native Aphanizomenon gracile and alien Chrysosporum bergii, Raphidiopsis raciborskii, and Sphaerospermopsis aphanizomenoides—to evaluate species identity, toxin production potential, and [...] Read more.
Climate-driven warming may enhance the spread of warm-adapted alien cyanobacteria in freshwater ecosystems. This study assessed four nostocalean cyanobacteria from European lakes—native Aphanizomenon gracile and alien Chrysosporum bergii, Raphidiopsis raciborskii, and Sphaerospermopsis aphanizomenoides—to evaluate species identity, toxin production potential, and thermal responses. A polyphasic approach combining phylogenetic analysis, morphology, and toxin screening confirmed the identifications and revealed a saxitoxin-producing A. gracile strain. No toxin genes were detected in the alien taxa. Experimental testing across 15–35 °C demonstrated broader thermal tolerance in the alien species, which maintained positive growth across 20–35 °C but showed limited performance at 15 °C. In contrast, the native Aphanizomenon gracile maintained positive growth at 15 °C, indicating greater adaptation to cooler conditions. Isolate-specific variation at thermal extremes highlighted the importance of ecotype-level traits. Our findings suggest that rising temperatures, combined with strain-level physiological diversity, may increase the risk of alien cyanobacteria establishing and forming blooms in temperate lakes. This study supports the need for monitoring strategies that integrate taxonomy, ecophysiology, and local adaptation to better assess invasion potential under changing environmental conditions. Full article
(This article belongs to the Special Issue Biological Invasions in Freshwater Ecosystems)
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