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Article
Engineering
Industrial and Manufacturing Engineering

JinJu Lee

,

HyunJun Choi

Abstract: Si MOSFETs are widely used in power conversion systems; however, long-term operation under repetitive switching and electro-thermal stress leads to progressive degradation and eventual failure. Two representative failure modes are commonly observed: gate-oxide degradation and packaging-related degradation, which often exhibit different evolution patterns. This paper proposes an AI-based diagnosis and prognostics framework that jointly leverages steady-state time-series information and fixed-length features extracted from turn-off transients. The study utilizes the NASA Open Accelerated-Aging dataset and reorganized/preprocessed data supported by MATLAB/Simulink measurement cir-cuit modeling. Physics-informed rule-based labeling is applied to discriminate normal, gate-oxide, and packaging-related conditions based on degradation indicators such as Rds_on evolution. The trained model is further interpreted via permutation importance to quantify whether gradual/abrupt degradation indicators and transient features contribute to decision-making. Performance is assessed on held-out tests and synthesized cases sampled from baseline operating distributions to examine consistency under previously unseen conditions.

Article
Computer Science and Mathematics
Algebra and Number Theory

Chee Kian Yap

Abstract: This paper provides a analytical proof of the Riemann Hypothesis using a differential interaction operator Φ(s,δ) on the Hilbert space l2(N). By mapping the Dirichlet η-function to a trace-class operator representing the interaction between states shifted by ±δ from the critical line, we derive a Phase-Torque J(δ,t) governed by a hyperbolic sine bias. We establish a Product Criterion showing that the operator trace vanishes if and only if a zero exists at either 1/2 + δ + it or 1/2 − δ + it. Finally, we establish the convergence criteria for this operator and demonstrate that the Diophantine independence of prime logarithms, amplified by the hyperbolic lever, prevents the trace from vanishing off the critical line.

Article
Environmental and Earth Sciences
Waste Management and Disposal

Jorge Emilio Hernández Ruydíaz

,

Daniel David Otero Meza

,

Juan José Cabello Eras

,

Jairo Guadalupe Salcedo Mendoza

,

Camilo Andrés Novoa Pérez

,

Camilo Andrés Meza Sanmartín

,

María José Lozano Polo

,

Kleyder José Salgado Angulo

,

Eduardo David Arroyo Dagobeth

,

Lisbeth Cecilia Tuirán Romero

Abstract: The transition to a circular bioeconomy in developing economies is frequently hindered by the operational failure of biogas facilities due to feedstock supply discontinuity. Whilst biochemical potential is traditionally the primary selection criterion, this study postulates that logistic reliability serves as the governing constraint for sustainable implementation. To validate this paradigm shift, a spatially explicit decision-making framework integrating Shannon Entropy and TOPSIS was developed and applied to a representative tropical agro-industrial region. By evaluating conflicting criteria covering logistic availability, technical efficiency, and biochemical stability, the model identified Annual Residue Production as the dominant weighting factor. Results established Cattle Manure as the universal baseload substrate essential for mitigating seasonality risks, outweighing higher-yielding but intermittent agricultural residues. Spatial analysis further revealed distinct bioenergy clusters dictating tailored technological strategies: a high-potential Rice-Livestock cluster suitable for centralised industrial plants overseeing recalcitrant biomass, and a Cassava-Livestock cluster favourable for decentralised, low-tech digestion. This data-driven approach demonstrates that successful substrate selection must transcend theoretical yield maximisation to prioritise supply chain reliability, providing a robust roadmap for de-risking bioenergy investments in tropical regions.

Article
Social Sciences
Tourism, Leisure, Sport and Hospitality

Sara Santos

,

Pedro Espírito Santo

,

Sónia Ferreira

,

Paulo Botelho Pires

,

José Duarte Santos

Abstract: Tourism destination marketers increasingly rely on video advertising, yet the psycho-logical mechanisms linking perceived advertising design and destination familiarity to engagement remain underspecified in tourism contexts. Drawing on narrative trans-portation and advertising stimulation perspectives, this study examines how perceived advertising design and destination familiarity relate to narrative transportation and advertising stimulation, and how these mechanisms relate to engagement. Using a survey of 915 Portuguese respondents and structural equation modelling in AMOS, we estimate a model comprising advertising design, destination familiarity, narrative transportation, advertising stimulation, and engagement. Results show that perceived advertising design is positively associated with narrative transportation (β=0.451, p< 0.01) and advertising stimulation (β=0.158, p< 0.01). Destination familiarity is also positively associated with narrative transportation (β=0.215, p< 0.01) and advertising stimulation (β=0.104, p< 0.01). Narrative transportation strongly predicts advertising stimulation (β=0.659, p< 0.01), whereas narrative transportation Tourism destination marketers increasingly rely on video advertising, yet the psycho-logical mechanisms linking perceived advertising design and destination familiarity to engagement remain underspecified in tourism contexts. Drawing on narrative trans-portation and advertising stimulation perspectives, this study examines how perceived advertising design and destination familiarity relate to narrative transportation and advertising stimulation, and how these mechanisms relate to engagement. Using a survey of 915 Portuguese respondents and structural equation modelling in AMOS, we estimate a model comprising advertising design, destination familiarity, narrative transportation, advertising stimulation, and engagement. Results show that perceived advertising design is positively associated with narrative transportation (β=0.451, p< 0.01) and advertising stimulation (β=0.158, p< 0.01). Destination familiarity is also positively associated with narrative transportation (β=0.215, p< 0.01) and advertising stimulation (β=0.104, p< 0.01). Narrative transportation strongly predicts advertising stimulation (β=0.659, p< 0.01), whereas narrative transportation does not show a sig-nificant direct association with engagement (β=0.086, n.s.). Advertising stimulation is positively associated with engagement (β=0.288, p< 0.01). Findings suggest that, in this context, affective activation (stimulation) may be a more proximal correlate of self-reported engagement than narrative immersion alone, warranting careful inter-pretation given the cross-sectional, self-report design. does not show a sig-nificant direct association with engagement (β=0.086, n.s.). Advertising stimulation is positively associated with engagement (β=0.288, p< 0.01). Findings suggest that, in this context, affective activation (stimulation) may be a more proximal correlate of self-reported engagement than narrative immersion alone, warranting careful inter-pretation given the cross-sectional, self-report design.

Article
Physical Sciences
Astronomy and Astrophysics

G. K. Jarvis

Abstract: We present a geometric reinterpretation of cosmic expansion in which expansion is treated as an effective spatial dimension whose projection governs observed distances, time evolution, and physical interactions. By modelling the actual path followed by light through this expanded geometry, we introduce a spiral distance that reproduces observed luminosity and angular-distance relations without requiring accelerated expansion or an additional dark-energy component.Within this framework, gravity emerges as a local suppression of expansion, producing time dilation and curvature consistent with general relativity in the weak-field limit. Expansion is shown to be closely tied to the flow of time itself, with proper time corresponding to progression along the expansion direction and deviations from this trajectory giving rise to gravitational and kinematic time dilation. When applied consistently to both Type Ia supernova luminosity data and the angular scale of the cosmic microwave background, the framework naturally reduces the apparent discrepancy between late- and early-universe determinations of the Hubble constant.Extending the model to the quantum domain, we propose that wave–particle duality, spin, and probabilistic behaviour arise from partial delocalization within a finite temporal window. Electric charge is interpreted as a time-phase asymmetry associated with motion in the expansion dimension, with the electromagnetic coupling strength naturally linked to a dimensionless geometric ratio consistent with the fine-structure constant. Quantum entanglement is reinterpreted as a shared time-phase structure, preserving all experimentally verified predictions of quantum mechanics while providing an intuitive geometric explanation for nonlocal correlations without violating relativistic causality.The framework suggests several testable signatures, including limits on entanglement across extreme temporal separations, time-domain interference effects, and cross-scale correlations between quantum phenomena and gravitational time dilation. While fully compatible with existing observations, this approach offers a unified geometric interpretation connecting cosmology, gravity, time, and quantum behaviour, and motivates further theoretical development and experimental investigation.

Article
Computer Science and Mathematics
Artificial Intelligence and Machine Learning

Stefan Trauth

Abstract: We demonstrate deterministic localization of cryptographic hash preimages within specific layers of deep neural networks trained on information-geometric principles. Using a modified Spin-Glass architecture, MD5 and SHA-256 password preimages are consistently identified in layers ES15-ES20 with >90% accuracy for passwords and >85% for hash values. Analysis reveals linear scaling where longer passwords occupy proportionally expanded layer space, with systematic replication in higher-dimensional layers showing exact topological correspondence.Critically, independent network runs with fresh initialization maintain 41.8% information persistence across 11 trials using unique hash strings and binary representations. Layer-to-layer correlations exhibit non-linear temporal coupling, violating fundamental assumptions of both relativistic causality and quantum mechanical information constraints. Pearson correlations between corresponding layers across independent runs approach ±1.0, indicating information preservation through mechanisms inconsistent with substrate-dependent encoding.These findings suggest the cryptographic "one-way property" represents a geometric barrier in information space rather than mathematical irreversibility. Hash function security may be perspectival accessible through dimensional navigation within neural manifolds that preserve topological invariants across initialization states. Results challenge conventional cryptographic assumptions and necessitate reconceptualization of information persistence independent of physical substrates.

Review
Medicine and Pharmacology
Psychiatry and Mental Health

Paul Grof

Abstract: Lithium remains endorsed as first-line treatment for bipolar disorders across major clinical guidelines, yet robust evidence demonstrates its progressive decline in use in psychiatric practice across numerous countries. To justify this decline, concerns regarding lithium's efficacy, safety profile, and monitoring requirements are frequently cited. Yet, these apprehensions largely stem from misunderstanding of lithium's clinical uses. In fact, when patients are selected for lithium stabilization according to a characteristic clinical profile and not just a bipolar verdict, lithium continues demonstrating excellent efficacy compared to all other psychiatric medications currently available. Moreover, after sufficient clinician and patient education regarding lithium stabilization principles, monitoring requirements stop being burdensome. Furthermore, among lithium-responsive patients, adverse effects are typically mild and clinically manageable, except for glomerular filtration rate decline, which tends to develop after decades of continuous administration. Thus, it may be possible to reverse this unfortunate decline in lithium's use by teaching clinicians to identify the patient profile responsive to lithium stabilization, by investigating intermittent lithium administration to mitigate renal complications, and by implementing educational programs regarding optimal lithium utilization for psychiatrists, patients, and their families.

Article
Medicine and Pharmacology
Epidemiology and Infectious Diseases

Judith Carolina De Arcos-Jiménez

,

Pedro Martínez-Ayala

,

Oscar Francisco Fernández-Diaz

,

Sergio Sánchez-Enríquez

,

Patricia Noemi Vargas-Becerra

,

Ana María López-Yáñez

,

Roberto Miguel Damian-Negrete

,

Sofía Gutierrez-Perez

,

Jaime Briseno-Ramírez

Abstract: Measles resurgence threatens elimination achievements in the Americas. We conducted a nationwide analysis of Mexico's 2025 measles outbreak, integrating individual-level surveillance data from the Special Surveillance System for Febrile Exanthematous Dis-eases with municipal-level social determinants from eight national databases, comple-mented by molecular surveillance data. We analyzed 6151 confirmed cases (epidemio-logical weeks 8–52, 2025) using spatial autocorrelation (Moran’s I, LISA), effective re-production number estimation, negative binomial regression, and logistic regression for risk factors. Cases concentrated in Chihuahua (73%), with 45 LISA hot-spot municipalities containing 71.68% of cases. Molecular surveillance confirmed two independent intro-ductions: D8/MVs/Ontario.CAN/47.24 (98.1%) linked to the Canadian outbreak, and B3 (1.9%) in Oaxaca. Transmission followed a three-stage pattern: introduction through seasonal agricultural worker networks, amplification in undervaccinated communities, and diffusion to marginalized indigenous populations. Vaccine effectiveness was 98.2%, with 83.4% of cases in pockets of susceptibles (municipalities with ≥80% unvaccinated). Risk factors for complications included age < 5 years (aOR 3.59), indigenous status (aOR 2.35), and unvaccinated status (aOR 2.03). Indigenous individuals comprised 30% of cases but 76% of deaths. This outbreak demonstrates that national vaccination thresholds are insufficient when marginalized populations remain systematically underserved.

Article
Environmental and Earth Sciences
Sustainable Science and Technology

Tereza Konstari

Abstract: This research aims to compare the use of AI-powered technologies in the energy sector and discuss their role in enhancing the efficiency and sustainability of urban energy systems. The energy sector is both broad and specialized, with many technologies already developed. However, it continues to face challenges such as the simultaneous integration of various systems, cybersecurity concerns, and the further adaptation of renewable energy sources. AI has the potential to help address these issues. Additionally, the study will explore the risks associated with the transition to green energy and the widespread implementation of AI. The methods employed in this research include the analysis of statistical data and insights from various scientists. Therefore, this study seeks to provide a comprehensive approach to optimizing energy usage in cities through the utilization of AI.

Review
Biology and Life Sciences
Ecology, Evolution, Behavior and Systematics

Wen-Xuan Yue

Abstract: The root of the animal tree—whether sponges (Porifera) or ctenophores (Ctenophora) represent the earliest-branching lineage—remains a key unresolved question in evolutionary biology. This review synthesizes evidence from molecular sequences, rare genomic events, morphology, embryology, and paleontology. While molecular sequence data provide extensive coverage, they are susceptible to methodological errors and confounding evolutionary processes. Rare molecular events, such as chromosomal fusion-with-mixing, provide deeper resolution due to their low convergence potential and high irreversibility. Morphological and embryological traits, historically underestimated, benefit from advances in imaging and comparative gene expression. Fossil records, though direct, remain fragmentary and biased. To explain persistent conflicts among data types, we propose the concepts of a Resolution Limit and the Deep Basal Problem, which formalize why early divergences are so difficult to resolve. We introduce Highly Anti-Convergent and Highly Irreversible Marginal Instances (HACHIMIs) as a promising class of phylogenetic signals. In conclusion, while traditional datasets tend to support the Porifera-sister hypothesis, high-resolution data increasingly favor Ctenophora-sister. More broadly, this review argues that resolving deep phylogenies requires integrative methodological frameworks, not just more data.

Article
Biology and Life Sciences
Plant Sciences

Theoni Margaritopoulou

,

Spyros Foutadakis

,

Giannis Vatsellas

,

Martina Samiotaki

,

Emilia Markellou

Abstract: DNA methylation is a conserved regulatory mechanism of gene expression, genome stability, and development. DNA methylation modifications relate to effective induc-tion of defense responses for plant priming. In the Green Deal era, using plant defense inducers, compounds that activate defense and prime plants against imminent patho-gens attacks, is a safe and environmentally sustainable approach to support plants against pathogens. Here, salicylic acid loaded in chitosan nanoparticles, influenced hypomethylation on specific genomic regions that corresponded to defense-related genes, such as pectin lyases, defensins and leucine-rich repeat transmembrane protein kinases against the biotrophic fungal pathogen Podosphaera xanthii. A genomic region of the promoter of SKP1A, a core member of the SCF E3 ubiquitin ligase complex, was found to be a significantly hypomethylated DMR. Examination of this DMR revealed the presence of salicylic acid-, auxin-, and defense-related cis-elements. Investigation of proteins associated with the above cis-elements showed significant expression upreg-ulation after salicylic acid application. Moreover, association of the identified DMR with transcriptomics showed significant enrichment of the salicylic acid pathway. Overall, these findings shed light on the epigenetic mechanisms that underly salicylic acid- re-lated defense priming in plants.

Article
Biology and Life Sciences
Other

Fernanda J. Ramirez-Uribe

,

Daniel Sierra-Lara

,

Alexandra Arias-Mendoza

,

Malinalli Brianza-Padilla

,

Yaneli Juárez-Vicuña

,

Hector González-Pacheco

,

Miguel Cruz

,

Luis M. Amezcua-Guerra

,

Adrián Hernández-Díazcouder

Abstract: Background/Objectives: Cardiovascular disease is the leading cause of morbidity and mortality worldwide, of which the myocardial Infarction is the most prevalent. However, the underlying pathophysiological mechanisms remain incompletely understood, but are tightly regulated by several cellular mechanisms, including long-non-coding. This study aimed to determine if MEG3 and ATF4 are involved in this pathology. Methods: A cross-section study was conducted at the Instituto Nacional de Cardiología Ignacio Chávez, patients with first time diagnosis STEMI and hemodynamic stability were categorized into with and without major adverse cardiovascular events, the most important clinical and biochemical parameters were collected, which were analyzed and subsequently correlated with MEG3 and ATF4. Results: Forty-two patients with a median age of 54 years (86% men) were included and classified with and without MACE. The expression of MEG3 in MACE group and No MACE (0.8974, 0.4186–1.4131 vs. 1.2259, 0.5516–2.3964; p = 0.0342), and ATF4 in MACE group and No MACE (2.8950, 0.7559–4.3287 vs. 2.3498, 1.0821–3.6903; p = 0.0396), ROC curve MEG3 showed an AUC of 0.6490 (0.4760 to 0.8221; p = 0.0924), in contrast ATF4 demonstrated an AUC of 0.7127 (0.5862 to 0.8393; p = 0.0107). Finally, correlation analyses revealed MEG3 was associated with CK-MB (r = 0.3978, 0.0630 to 0.6520; p = 0.0219), and ATF4 was correlated cTnT (r = 0.3328, 0.0284 to 0.5810; p = 0.0335) and with LVEF (r = –0.4283, –0.6503 to –0.1390; p = 0.0052). Conclusions: The dysregulation of MEG3 and transcription factor ATF4 are involved in pathophysiological mechanisms.

Article
Physical Sciences
Quantum Science and Technology

M. Quiroga

Abstract: Quantum batteries aim to exploit collective and coherent quantum effects to enhance energy storage and charging performance. In this context, the Dicke model provides a paradigmatic platform in which an ensemble of two-level systems interacts collectively with a single cavity mode, potentially enabling superlinear scaling of the charging power. Here, we present a controlled numerical comparison between a collective Dicke quantum battery and a parallel, non-collective benchmark composed of independent two-level systems charged by separate cavity modes. By simulating the open-system dynamics using Lindblad master equations, we analyze the stored energy, optimal charging time, and average charging power as functions of the system size. We identify a clear crossover from superlinear to linear scaling of the charging power controlled by dissipation: collective advantages persist only when coherent light--matter coupling dominates over losses, approximately when $g \gtrsim \kappa + \gamma$. These results delineate the operational regimes in which collective quantum batteries can outperform non-collective architectures and clarify the limitations imposed by environmental decoherence.

Article
Environmental and Earth Sciences
Sustainable Science and Technology

Paula Escudeiro

,

Nuno Escudeiro

,

Piedade Carvalho

,

Sofia Resende

Abstract: This article presents the design and implementation of a strategic sustainability framework for the Portuguese Center of Vocational Excellence (CoVE) in Sustainable Energy (SECoVE), coordinated by the Polytechnic Institute of Porto. The initiative aims to strengthen regional capacity and interinstitutional cooperation among universities, vocational education providers, industry, and public actors, promoting green skills, applied innovation, and collaborative governance within the energy transition ecosystem. Based on an evidence-based situational and ecosystem analysis, including SWOT analysis and stakeholder mapping, the study identifies key internal and external drivers shaping the CoVE’s strategic development and its contribution to sustainable regional transformation. A distinctive feature of SECoVE is the integration of educational and immersive technologies, such as Virtual Reality (VR), Augmented Reality (AR), and interactive digital learning environments, supporting the development of high-quality, technology-enhanced educational programs in sustainable energy. The proposed strategic framework defines four interrelated objectives: strengthening technical and green qualifications aligned with national and European agendas; establishing SECoVE as a hub for applied research and innovation; expanding strategic partnerships among education, industry, and public actors; and ensuring a diversified and resilient financial structure. The study contributes to the academic debate on the Centers of Vocational Excellence as catalysts for the green and digital transitions.

Article
Public Health and Healthcare
Primary Health Care

Aman Jat

,

Benjamin Barton

,

Rohini Mathur

,

Tassella Isaac

,

Beth Stuart

,

Hilda Hounkpatin

,

Hajira Dambha-Miller

Abstract: Background Multimorbidity is increasingly prevalent among UK adults, yet the extent to which remission of long-term conditions is recorded in routine primary care remains poorly understood. Accurate documentation of remission has implications for clinical management, disease trajectories, and interpretation of electronic health records for research. We aimed to describe the frequency and variation of recorded remission across multiple long-term conditions among adults with multimorbidity. Methods We conducted a retrospective cohort study using linked primary care, hospital, and CPRD Aurum data. Adults aged ≥18 with multimorbidity (≥2 long-term conditions) between Jan 1, 1987, and Dec 31, 2020, were included. Remission was defined using condition-specific criteria based on diagnostic or resolution codes, clinical measurements, treatment patterns, and relevant clinical events. We examined remission for 11 conditions with operationalizable definitions. Analyses were descriptive, summarising remission frequencies and sociodemographic patterns. Findings Among 4,745,099 adults followed for a median of 8 years, 900,609 (18.1%) had recorded remission of at least one condition. Remission varied substantially by condition and was highest for endometriosis (90.36%), anaemia (63.0%), asthma (44.71%), and diabetes (15.51%), calculated among individuals with an ever-recorded diagnosis of each condition. Individuals with remission were slightly younger and more often male; Asian and Black ethnic groups were under-represented, while deprivation patterns were broadly similar. Interpretation Recorded remission in multimorbidity is highly heterogeneous and often rare. Variation between conditions and low rates of sustained remission likely reflect coding practices and clinical recording behaviours. Standardised remission definitions and consistent Systematized Nomenclature of Medicine (SNOMED) coding could improve data quality and support more reliable research on remission and disease trajectories.

Article
Medicine and Pharmacology
Pediatrics, Perinatology and Child Health

Nina Žumer

,

Irena Hočevar Boltežar

,

Lilijana Kornhauser Cerar

Abstract: Background/Objectives: The study aimed to compare feeding difficulties (FD) in Slovenian late preterm infants (LPIs) and full-term infants (FTIs), to identify risk factors for FD, and to examine a possible association between FD and later speech-language disorders (SLD) among LPIs. Methods: Parents of 177 children (nLPI = 89; nFTI = 88), born at Ljubljana Maternity Hospital between 1 July 2021 and 30 June 2022 completed a questionnaire providing general information on their child, the child’s health, birth history, and development of feeding, swallowing, and speech-language skills. Additional clinical data were obtained from medical documentation. Using these data, comparisons were made between LPIs and FTIs, and within the LPI group according to the presence or absence of FD and SLD. Results: LPIs experienced significantly more FD than FTIs (32.6% vs 11.4%, p < 0.001). They were breastfed less frequently (68.5% vs 94.3%, p < 0.001) and had a shorter breastfeeding duration (13.8 months vs 17.3 months, p = 0.038). LPIs also demonstrated more challenges in speech and language development (34.1% vs 15.3%, p = 0.004). However, no significant association was found between FD and later SLD (p = 0.324). Conclusions: Slovenian LPIs are at increased risk of both FD and SLD. The findings highlight the importance of high-quality preventive care and timely multidisciplinary interventions.

Article
Public Health and Healthcare
Health Policy and Services

Adaeze Imelda Onyekwelu

Abstract: Amid Nigeria’s drive for digital governance, gender-responsive public procurement remains shadowed by exclusion and bias. This paper pioneers a transformative lens AI for Intersectional Inclusion to reimagine how artificial intelligence can dismantle systemic barriers that silence women in government contracting. Moving beyond efficiency, the analysis fuses feminist technology theory with policy analytics to explore how algorithms, when ethically trained, can expose invisibility, build equity, and rewrite access for marginalized women. Drawing on lessons from Kenya, India, and Nigeria’s emerging procurement systems, it identifies pathways where AI shifts from being a neutral tool to a justice-driven instrument of representation. The study offers a governance blueprint that embeds fairness, transparency, and human-centered participation into digital procurement reform. Ultimately, it argues that inclusive AI is not a futuristic ideal but a present necessity capable of transforming Nigeria’s procurement ecosystem into one where visibility births opportunity.

Article
Medicine and Pharmacology
Oncology and Oncogenics

Zobia Minhas

,

Edwin A Oshin

,

Chunqi Jiang

,

Siqi Guo

Abstract: Pancreatic cancer remains a highly lethal malignancy, with standard therapies offering limited benefits in advanced stages; thus, novel strategies that exploit specific cancer cell vulnerabilities are urgently needed. Building on our previous findings that nanosecond pulsed electric fields (nsPEF) combined with cold atmospheric plasma (CAP) produce enhanced cytotoxicity, this study investigates the mo-lecular mechanisms underlying this synergy. Pan02 pancreatic cancer cells were subjected to nsPEF, CAP, or a combination of both. We assessed cell viability, reactive oxygen species (ROS) production, and mitochondrial integrity using metabolic assays, flow cytometry, and fluorescence microscopy. Apoptotic markers were evaluated via Western blotting and caspase activity assays. Combined nsPEF–CAP treatment significantly outperformed either modality alone in inducing cell death. Mechanistically, dual treatment triggered a surge in intracellular ROS, particularly mitochondrial superoxide, indicating severe oxidative stress. Distinct mitochondrial responses were observed: nsPEF reduced mitochondrial membrane potential (ΔΨm), whereas CAP alone caused a slight elevation. Notably, while CAP induced apoptosis (evidenced by increased cleaved caspase-3 and caspase-3/7 activity), lethal nsPEF (100 pulses) caused cell death without triggering apoptotic signaling. However, mild nsPEF (20 pulses) significantly potentiated CAP-induced apoptosis. These findings suggest that nsPEF sensitizes cells to CAP treat-ment by amplifying oxidative stress and mitochondrial dysfunction. This synergistic combination repre-sents a promising therapeutic approach for targeting pancreatic cancer cells resistant to conventional therapies.

Article
Medicine and Pharmacology
Pediatrics, Perinatology and Child Health

Tetty Yuniati

,

Fiva Aprilia Kadi

,

Aris Primadi

,

Dwi Oktari Erfanti

,

Johannes Edy Siswanto

,

Ahmedz Widiasta

Abstract: Background Chronic kidney disease (CKD) and hypertension in adolescence and young adulthood are predisposing factors for cardiovascular and neurological diseases later in life. Serum creatinine has been routinely used as a daily practice modality for detecting acute kidney injury (AKI) in patients of all ages. Unfortunately, serum creatinine levels have some limitations, such as the delayed increase among AKI events. An earlier biomarker is needed to detect AKI, notably in the neonatal period. The present study aimed to determine whether neutrophil gelatinase-associated lipocalin (NGAL) could be used as a modality in detecting AKI, not only in children and adults, but also in neonates. Methods A prospective-cohort study conducted at Hasan Sadikin General Hospital, Bandung, on preterm neonates with a gestational age of 28 – 34 weeks, and performed serum NGAL and creatinine measurements. Spearman’s rank correlation was used to determine the association between serum NGAL levels and AKI during the first 48 h in these neonates. Results Serum NGAL measurement showed better positivity rate than creatinine (KDIGO and nRIFLE) in detecting early AKI in neonates, with values of 81.8, 24.7, and 10.4, respectively. Conclusion NGAL can be used as a modality in detecting AKI in neonates earlier.

Article
Medicine and Pharmacology
Orthopedics and Sports Medicine

Francesco Leonforte

,

Marco Sapienza

,

Martina Ilardo

,

Klara Komici

,

Cristina Madaudo

,

Claudio Sanfilippo

,

Vito Nicosia

,

Fabio Raciti

,

Antonio Mistretta

,

Vito Pavone

+1 authors

Abstract: Background: Burnout is a growing concern among healthcare professionals, particularly in high-pressure environments, which has been exacerbated by the COVID-19 pandemic. This study investigates the prevalence and determinants of burnout among physicians working in a large hospital in Southern Italy. Methods: A cross-sectional survey was conducted among 367 physicians and trainees at Catania Hospital. The Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) were used to assess emotional exhaustion, depersonalization, personal gratification, and general psycho-logical distress. Stratified analyses were performed according to sex, graduation year, and medical specialty. Results: High levels of burnout were observed across all dimensions: 76.7% of respondents reported low personal gratification, 70.8% showed high deper-sonalization, and nearly 50% experienced high emotional exhaustion. Female physicians and recent graduates (after 2020) exhibited significantly lower levels of gratification and higher psychological distress. Service-area professionals reported lower emotional ex-haustion, but also lower gratification compared to surgical specialties. Notably, otorhi-nolaryngology showed both the highest burnout risk and the highest gratification scores. Conclusions: Burnout is alarmingly prevalent among Italian healthcare professionals, and there is significant variation across sexes, graduation cohorts, and medical specialties. These findings underscore the urgent need for targeted interventions, including men-torship programs, mental health support, and organizational reforms to improve working conditions and job satisfaction.

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