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Anaerobic digestion is one of the technologies that will play a key role in the decarbonization of the economy, due to its capacity to treat organic waste, recover nutrients and simultaneously produce biogas as a renewable biofuel. This feature also makes this technology a relevant partner for approaching a circular economic model. However, the low biogas yield of traditional substrates such as sewage sludge and livestock waste along with high installation costs limit its profitability. Further expansion of this technology encounters several barriers, making it necessary to seek improvements to attain a favorable financial balance. The use of co-substrates benefits the overall digestion performance thanks to the balancing of nutrients, the enhanced conversion of organic matter and stabilization, leading to an increase in biogas production and process economics. This article reviews the main co-substrates used in anaerobic digestion, highlighting their characteristics in terms of methane production, kinetic models commonly used and the synergistic effects described in the literature. The main process parameters and their influence on digestion performance are presented, as well as the current lines of research dedicated to improving biogas yields, focusing on the addition of hydrogen, bioaugmentation, supplementation with carbon compounds and nanoparticles, the introduction of bioelectrodes and adsorbents. These techniques allow a significant increase in waste degradation and reduce inhibitory conditions, thus favoring process outcomes. Future research should focus on global process efficiency, making particular emphasis on the extrapolation of laboratory achievements into large-scale applications, by analyzing logistical issues, global energy demand and economic feasibility.

Anaerobic co-digestion of sheep manure and potato waste was studied under batch and semi-continuous conditions. Biochemical methane potential tests were carried out for the different substrates before evaluating co-digestion at high-solid content. The reactors presented stable performance under mesophilic conditions, at an organic loading rate (OLR) of 3.5–4.0 kg VS/m3 and a hydraulic retention time (HRT) of approximately 20 days. Increasing the OLR of semi-continuous reactors decreased the methane yield and degradation efficiency of the digestion. Methane-specific production was in the range of 196 and 467 mL CH4/g vs. (sheep manure system and co-digestion, respectively). Based on the experimental data obtained, a techno-economic study was performed for wet and solid-state fermentation systems, with the first configuration presenting better results. The economic feasibility of the hypothetical plant was analyzed considering the variability in electricity and compost selling prices. The economic feasibility of the plant was determined with an electricity selling price of EUR 0.25/kWh, and assuming a centralized plant serving several farmers. Still, this price was considered excessive, given the current electricity market values.

Mental health problems are increasingly common among children and adolescents, making schools a key setting for health promotion. Nurses can play a central role in prevention and support, but in Chile, the role of the school nurse has not yet been formally established. Understanding nursing students' experiences in school-based mental health promotion can inform curriculum development and strengthen professional identity. : A qualitative study with a phenomenological approach was conducted with third-year nursing students enrolled in a mental health course (N = 64). Data was collected through six individual interviews and one focus group, transcribed verbatim and analyzed using ATLAS.ti 25.0.1 . To ensure rigor, the study was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ), and trustworthiness was ensured following Lincoln and Guba's criteria. : Five main categories emerged: nursing's role in mental health promotion; perceptions of health promotion as prevention; use of the educational process, with difficulties in formulating objectives; perceived self-efficacy, marked by initial uncertainty in working with children; and experiences in implementing projects, including reflections on the professional role, mixed feelings, facilitators, barriers, and coping strategies. Facilitators included faculty support, teacher collaboration, and group cohesion, while barriers were related to limited experience, challenges in managing children, and external conditions such as noise and unsuitable classroom conditions. : School-based practicums in mental health promotion are valuable opportunities to integrate theory and practice, strengthen professional identity, and develop communication. Strengthening undergraduate curricula with systematic training in these areas is essential for preparing nurses for their role in school and community health. Integrating these experiences into clinical and assistive practice can enhance early detection, interprofessional collaboration, and the promotion of healthier school environments.

Activated carbons from argan nutshells were prepared by chemical activation using phosphoric acid H3PO4. This material was characterized by thermogravimetric analysis, infrared spectrometry, and the Brunauer-Emmett-Teller method. The adsorption of two emerging compounds, a stimulant caffeine and an anti-inflammatory drug diclofenac, from distilled water through batch and dynamic tests was investigated. Batch mode experiments were conducted to assess the capacity of adsorption of caffeine and diclofenac from an aqueous solution using the carbon above. Adsorption tests showed that the equilibrium time is 60 and 90 min for diclofenac and caffeine, respectively. The adsorption of diclofenac and caffeine on activated carbon from argan nutshells is described by a pseudo-second-order kinetic model. The highest adsorption capacity determined by the mathematical model of Langmuir is about 126 mg/g for diclofenac and 210 mg/g for caffeine. The thermodynamic parameters attached to the studied absorbent/adsorbate system indicate that the adsorption process is spontaneous and exothermic for diclofenac and endothermic for caffeine.

Anaerobic digestion is a biological process that transforms high-strength organic effluents into biogas with multiple benefits. However, concurrent with organics’ biological transformation, a liquid phase with a high solid content is also derived from this process. Valorizing this fraction is not an easy task if an agronomic application cannot be considered as a suitable option. The thermal valorization of this fraction allows for energy extraction but also gives rise to additional capital investment and increases the energy demand of the global process. In addition, the thermal treatment of digestate has to deal with a mineralized material. The changes in organic matter due to anaerobic digestion were studied in the present manuscript, by evaluating the thermal behavior of samples, activation energy, and organic transformation using Fourier transform infrared (FTIR) spectroscopy. Digested samples of a mixture composed of manure and glycerin (5% v/v) were studied. The stabilization caused a dramatic decrease in aliphatic compounds, greatly increasing the mineral content of the sample. Results from differential scanning calorimetry (DSC) indicated an energy content of 11 kJ/g for the feed material and a reduction to 9.6 kJ/g for the long-term stabilized sample. The activation energy of the feed was 249.5 kJ/mol, whereas this value was reduced to 70–80 kJ/mol for digested samples. If the valorization route selected for digestates is thermal conversion, the lower energy content and more complex structure of these materials (higher content of lignin and protein-type compounds) must be carefully evaluated.

Background Psoriasis vulgaris is the most common form of psoriasis, yet current treatments often lead to significant side effects, resulting in a high rate of therapy desertion. Here, we explored a novel therapeutic approach using the secretome from Wharton Jelly-derived mesenchymal stem cells, biologically stabilized and enhanced with hyaluronic acid (HA), its presentation is an easy-to-apply topical sponge. This formulation had previously demonstrated efficacy in vitro and in experimental psoriasis mouse models. Methods In vitro characterization studies included dynamic light scattering, nanoparticle tracking analysis, optical/electronic microscopy, microbiological experiments, and angiogenic capacity (HUVEC cells). In vivo studies included angiogenic capacity in chicken embryo chorioallantoic membrane (CAM), safety (hypersensitive and healthy volunteers), and efficacy (double-blinded and randomized patients). Results We demonstrated the presence of spherical exosomes (164 ± 87 nm, PDI of 0.38, and 1.5 × 10⁷ particles/mL) within the selected secretomes, which exhibited significant proangiogenic activity in HUVEC cells and in a CAM assay. The secretome-containing sponges displayed distinct physicochemical properties, such as the absence of nitrogen and reduced carbon and oxygen content, resulting in a more cross-linked material with thinner fibers. These characteristics extended the dispersion time in aqueous media. Microbiological testing confirmed sterility in the packed, ready-to-use secretome-HA sponges after 3 months of storage. To assess safety, we selected doses (based on total protein content) that were applied to three patients with atopic dermatitis (42 µg of protein, patch test, 5 days) and four healthy volunteers (210 µg, 15 days) with no observed adverse topical or systemic effects. In a 30-day efficacy study, 12 patients with bilateral psoriasis exhibited up to a 33% reduction in mPASI scores and a 41% decrease in plaque size. Additionally, transepidermal water loss (TEWL) was reduced by up to 30%, while skin elasticity/flexibility improved by 43%. Conclusions These findings suggest that the topical application of the secretome-HA sponge is a safe and effective therapeutic option for alleviating symptoms of psoriasis vulgaris . Trial registration SSMN, SSMN047/2021. Registered 27 October 2021, https://www.ssmn.cl/comite_etica.php . Graphical abstract

Anaerobic digestion is a biological process with wide application for the treatment of high organic-containing streams. The production of biogas and the lack of oxygen requirements are the main energetic advantages of this process. However, the digested stream may not readily find a final disposal outlet under certain circumstances. The present manuscript analyzed the feasibility of valorizing digestate by the hydrothermal carbonization (HTC) process. A hypothetical plant treating cattle manure and cheese whey as co-substrate (25% v/w, wet weight) was studied. The global performance was evaluated using available data reported in the literature. The best configuration was digestion as a first stage with the subsequent treatment of digestate in an HTC unit. The treatment of manure as sole substrate reported a value of 752 m3/d of biogas which could be increased to 1076 m3/d (43% increase) when coupling an HTC unit for digestate post-treatment and the introduction of the co-substrate. However, the high energy demand of the combined configurations indicated, as the best alternative, the valorization of just a fraction (15%) of digestate to provide the benefits of enhancing biogas production. This configuration presented a much better energy performance than the thermal hydrolysis pre-treatment of manure. The increase in biogas production does not compensate for the high energy demand of the pre-treatment unit. However, several technical factors still need further research to make this alternative a reality, as it is the handling and pumping of high solid slurries that significantly affects the energy demand of the thermal treatment units and the possible toxicity of hydrochar when used in a biological process.

The energy balance of lean-burn turbocharged engines using biogas as fuel is reported. Digestion data were obtained from the wastewater treatment plant (WWTP) of the city of Burgos (Spain), operating with a thermal hydrolysis unit for sludge pre-treatment. Operational performance of the plant was studied by considering the treatment of sludge as a comparative base for analyzing global plant performance if co-digestion is implemented for increasing biogas production. The calculation methodology was based on equations derived from the engine efficiency parameters provided by the manufacturer. Results from real data engine performance when evaluated in isolation as a unique control volume, reported an electrical efficiency of 38.2% and a thermal efficiency of 49.8% leading to a global efficiency of 88% at the operating point. The gross electrical power generated amounted to 1039 kW, which translates into 9102 MWh/year, with an economic value of 837,384 €/year which was completely consumed at the plant. It also represents 55.1% of self-consumption regarding the total electricity demand of the plant. The analysis of the system considering the use of the total installed capacity by adding a co-substrate, such as cheese whey or microalgae, reveals that total electrical self-consumption is attained when the co-substrate is directly fed into the digester (cheese whey case), obtaining 16,517 MWh/year equivalent to 1,519,160 €/year. The application of thermal hydrolysis as pre-treatment to the co-substrate (microalgae case study) leads to lower electricity production, but still attains a better performance than a mono-digestion baseline scenario.

A fully government-funded human papillomavirus (HPV) vaccination program started in 2007 in Spain (only 11–14-year-old girls). The first of those vaccinated cohorts, with the quadrivalent vaccine (Gardasil), turned 25 years old in 2018, the age at which cervical cancer screening begins in Spain. The current study could provide the first evidence about the effectiveness of the quadrivalent vaccine against HPV in Spain and the influence of age of vaccination. The present ambispective cohort study, which was conducted on 790 women aged 25 and 26 years old, compares the rate of HPV prevalence and cytologic anomaly according to the vaccination status. The overall infection rate was 40.09% (vaccinated group) vs. 40.6% (non-vaccinated group). There was a significant reduction in the prevalence of HPV 6 (0% vs. 1.3%) and 16 (2.4% vs. 6.1%), and in the prevalence of cytological abnormalities linked to HPV16: Atypical Squamous Cells of Undetermined Significance (ASCUS) (2.04% vs. 14%), Low-grade Squamous Intraepithelial Lesions (LSIL) (2.94% vs. 18.7%) and High-grade Squamous Intraepithelial Lesion (HSIL) (0% vs. 40%), in the vaccinated group vs. the non-vaccinated group. Only one case of HPV11 and two cases of HPV18 were detected. The vaccine effectively reduces the prevalence of vaccine genotypes and cytological anomalies linked to these genotypes.

Diverticular disease of the small bowel is a rare, generally asymptomatic condition with a challenging diagnostic approach and the potential for life-threatening complications. While diverticular disease can manifest in any part of the gastrointestinal tract, its occurrence in the jejunum is exceptionally uncommon, with an incidence of up to 1%. Although rare, complications from diverticular disease of the small bowel can arise in up to 10% of cases, usually manifesting as signs and symptoms mimicking other etiologies or an acute abdomen. In this case report, we present the management of an elderly male patient with multiple comorbidities who developed an acute abdomen during his intensive care unit stay. The patient required surgical intervention, which revealed numerous complicated diverticula of the small bowel, affecting the jejunum, as the underlying cause of his symptoms.