Search Results (3,331)

Soil sealing and land take are increasingly recognised as critical environmental and land use planning challenges across Europe. Although these issues have received limited attention in Baltic policymaking and the academic literature to date, available data indicate ongoing land consumption despite population decline. This study aims to analyse soil sealing patterns in Estonia, Latvia, and Lithuania between 2018 and 2021 using CLC+ Backbone data, linking them to demographic shifts and local planning frameworks. Results reveal that soil sealing increased in nearly all municipalities across the Baltic states, regardless of population trends. The analysis highlights that shrinking municipalities, constrained by limited resources and declining populations, are structurally disadvantaged in terms of land use efficiency, particularly when measured by sealed area per capita. Moreover, this study discusses emerging policy tensions, including the narrowing conceptual gap between land take and soil sealing in the proposed EU Soil Monitoring and Resilience Directive, as well as the risk of overlooking broader land artificialisation. The findings underscore the need for context-sensitive, multi-scalar approaches to land use monitoring and governance, particularly in sparsely populated and demographically imbalanced regions, such as the Baltic states. Full article

Background/objectives: Polycystic ovary syndrome (PCOS) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common co-morbidities in women of reproductive age. PCOS is highly heterogeneous and is, therefore, divided into four phenotypes. MASLD leads to numerous systemic complications. Studies to date have shown an association between PCOS and MASLD. This study was designed to compare the FIB-4 score (based on age, alanine aminotransferase, aspartate aminotransferase and platelet count) and the results of shear wave elastography in assessing the risk of developing MASLD by patients with PCOS divided by phenotypes. Methods: The study enrolled 242 women age 18–35 years with PCOS diagnosed according to Rotterdam criteria, hospitalized at the Department of Gynaecological Endocrinology of the University Clinical Centre in Katowice. The study subjects were assigned to phenotypes A to D. Clinical and biochemical assessments were performed (including androgens and metabolic parameters), and the FIB-4 index was calculated. Liver fibrosis was evaluated by shear wave elastography. To balance the group sizes of phenotypes, oversampling with replacement was applied (PROC SURVEYSELECT, SAS), increasing the number of observations for phenotypes B, C, and D fivefold. Statistical analyses were performed based on data distribution (Shapiro–Wilk test), using ANOVA or the Kruskal–Wallis test with Dunn’s correction. Statistical significance was set at p < 0.05. Results: The FIB-4 score was the highest in phenotype B patients (0.50 ± 0.15), and the lowest in phenotypes A and C (0.42 ± 0.14). The highest rate of positive elastography findings was recorded in phenotype A patients (34.7%) and the lowest in phenotype C group (13.5%). Significant differences between the phenotypes were also found in terms of androgen levels, insulin, HOMA-IR, and the lipid profile. Among patients with positive elastography, the highest FIB-4 scores were recorded in phenotype C group (0.44 ± 0.06), but the differences between the phenotypes were not statistically significant. Conclusions: The FIB-4 score was the highest in phenotype B patients and differed significantly from phenotypes A, C and D. In the elastography exam, the fibrosis index was statistically significantly higher in phenotype A compared to other phenotypes. No correlation was detected between the FIB-4 index and positive elastography. The findings suggest that the FIB-4 index may be used for MASLD screening, but its usefulness as a predictor of eligibility for elastography requires more research. Full article

In this case study, we used the Delta Simulation Model II (DSM2) to study the salt balance at the land–water interface in the river delta of California’s San Francisco Estuary. Drainage, a source of water and salt for adjacent channels in the study area, is affected by channel salinity. The DSM2 approach has been adopted by several hydrodynamic models of the estuary to enforce water volume balance between diversions, evapotranspiration and drainage at the land–water interface, but does not explicitly enforce salt balance. We found deviations from salt balance to be quite large, albeit variable in magnitude due to the heterogeneity of hydrodynamic and salinity conditions across the study area. We implemented a procedure that approximately enforces salt balance through iterative updates of the baseline drain salinity boundary conditions (termed loose coupling). We found a reasonable comparison with field measurements of drainage salinity. In particular, the adjusted boundary conditions appear to capture the range of observed interannual variability better than the baseline periodic estimates. The effect of the iterative adjustment procedure on channel salinity showed substantial spatial variability: locations dominated by large flows were minimally impacted, and in lower flow channels, deviations between baseline and adjusted channel salinity series were notable, particularly during the irrigation season. This approach, which has the potential to enhance the simulation of extreme salinity intrusion events (when high channel salinity significantly impacts drainage salinity), is essential for robustly modeling hydrodynamic conditions that pre-date contemporary water management infrastructure. We discuss limitations associated with this approach and recommend that—for this case study—further improvements could best be accomplished through code modification rather than coupling of transport and island water balance models. Full article

Racket sports are very popular not only in professional sports but also among recreational players. As a result, their impact on the field of education has grown significantly in recent years. Table tennis (TT) offers significant advantages in terms of skill acquisition and health improvement. Nevertheless, its application within physical education (PE) curricula remains undetermined. The aim of this systematic review was to analyze the use of TT as educational content in the subject of PE in primary school. The PRISMA 2020 methodology was used to conduct the systematic review. Six databases (ERIC, Pubmed, ScienceDirect, Scopus, Sport Discus, and Web of Science) were used during the search process. The search cutoff date was December 31, 2024. After applying the eligibility criteria, 3595 articles were found. Only seven studies were selected for the final analysis and the data included 1526 students from primary school. The results indicate that TT is rarely used in primary education during PE classes. Research indicates interest among teachers and students in playing it during PE. Furthermore, due to the benefits, motivation, and interest this sport generates, educational experiences have been developed, such as roundtable discussions, table top tennis, balloon TT, and TT triathlon. A lack of materials, facilities, and teacher training for teaching this sport is notable. The teaching experiences analyzed in this review confirm that TT is a highly versatile and interesting sport as a subject matter in school PE. The use of TT allows for innovative, comprehensive, and inclusive PE, thanks to the sport’s multiple possibilities. Given its adaptability and low entry barrier, TT could serve as an effective tool for increasing children’s physical activity levels, improving motor skills, and fostering social–emotional development. However further research is needed to quantify its impact on health outcomes such as cardiovascular fitness or obesity prevention. Full article

Healthy food service guidelines (HFSG) comprise food, nutrition, behavioral design, and other standards to guide the purchasing, preparation, and offering of foods and beverages in worksites and institutional food service. To date, there have been few attempts to synthesize evidence for HFSG effectiveness in non-K-12 or early childhood education sectors, particularly at worksites and institutional food services. We conducted a scoping review to achieve the following: (1) characterize the existing literature on the effectiveness of HFSG for improving the institution’s food environment, financial outcomes, and consumers’ diet quality and health, and (2) identify gaps in the literature. The initial search in PubMed and Web of Science retrieved 10,358 articles; after screening and snowball searching, 68 articles were included for analysis. Studies varied in terms of HFSG implementation settings, venues, and outcomes in both U.S. (n = 34) and non-U.S. (n = 34) contexts. The majority of HFSG interventions occurred in venues where food is sold (e.g., worksite cafeterias, vending machines). A diversity of HFSG terminology and measurement tools demonstrates the literature’s breadth. Literature gaps include quasi-experimental study designs, as well as interventions in settings that serve dependent populations (e.g., universities, elderly feeding programs, and prisons). Full article

The Mediterranean region, identified by scientists as a ‘climate hot spot’, is experiencing warmer and drier conditions, along with an increase in the intensity and frequency of extreme weather events. One such extreme phenomena is droughts. The recent wildfires in this region are a concerning consequence of this phenomenon, causing severe environmental damage and transforming natural landscapes. However, droughts involve a two-way interaction: On the one hand, climate change and various human activities, such as urbanization and deforestation, influence the development and severity of droughts. On the other hand, droughts have a significant impact on various sectors, including ecology, agriculture, and the local economy. This study investigates drought dynamics in four Mediterranean countries, Greece, France, Italy, and Spain, each of which has experienced severe wildfire events in recent years. Using satellite-based Earth observation data, we monitored drought conditions across these regions over a five-year period that includes the dates of major wildfires. To support this analysis, we derived and assessed key indices: the Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), and Normalized Difference Drought Index (NDDI). High-resolution satellite imagery processed within the Google Earth Engine (GEE) platform enabled the spatial and temporal analysis of these indicators. Our findings reveal that, in all four study areas, peak drought conditions, as reflected in elevated NDDI values, were observed in the months leading up to wildfire outbreaks. This pattern underscores the potential of satellite-derived indices for identifying regional drought patterns and providing early signals of heightened fire risk. The application of GEE offered significant advantages, as it allows efficient handling of long-term and large-scale datasets and facilitates comprehensive spatial analysis. Our methodological framework contributes to a deeper understanding of regional drought variability and its links to extreme events; thus, it could be a valuable tool for supporting the development of adaptive management strategies. Ultimately, such approaches are vital for enhancing resilience, guiding water resource planning, and implementing early warning systems in fire-prone Mediterranean landscapes. Full article

Hypertrophic cardiomyopathy (HCM) is a prevalent and often underdiagnosed genetic cardiac disorder characterized by left ventricular hypertrophy and, in many cases, dynamic left ventricular outflow tract obstruction (LVOTO). The development of cardiac myosin inhibitors (CMIs) represents an emerging therapeutic approach in the pharmacological management of obstructive HCM (oHCM). This review offers an integrated and up-to-date synthesis of the cardiac myosin inhibitor class, with a focus on mavacamten, aficamten, and the broader landscape of emerging agents. It also highlights recent clinical trial outcomes, pharmacokinetic and pharmacogenetic considerations, and potential future directions in therapy. Furthermore, we incorporate the most recent data up to May 2025, including late-breaking trial results and real-world safety findings, aiming to provide clinicians with a practical and comprehensive perspective on this evolving drug class. A narrative review was conducted by systematically searching PubMed, Scopus, Google Scholar, and ClinicalTrials.gov for English-language articles and trials published between January 2016 and May 2025. Keywords included “cardiac myosin inhibitor”, mavacamten”, “aficamten”, “MYK-224”, and “hypertrophic cardiomyopathy.” Inclusion criteria encompassed clinical trials and comprehensive reviews specifically addressing CMIs in cardiac applications. CMIs such as mavacamten and aficamten have demonstrated significant clinical benefits in reducing LVOT gradients, improving exercise capacity, and alleviating symptoms in patients with oHCM. Mavacamten is currently approved for clinical use, while aficamten is in advanced regulatory review. Comparative data suggest potential advantages of aficamten in the onset of action, pharmacokinetic profile, and tolerability. Emerging evidence supports the exploration of CMIs in pediatric populations, heart failure with preserved ejection fraction (HFpEF), and non-obstructive HCM (nHCM), although results are still preliminary. Cardiac myosin inhibitors offer a novel, pathophysiology-targeted approach to managing oHCM. While mavacamten has established efficacy, next-generation agents like aficamten may offer improved safety and versatility. Further long-term studies are needed to clarify their role across broader patient populations. Full article

Background: Type 2 diabetes (T2D) has been placed among the risk factors for fragility (osteoporotic) fractures, particularly in menopausal women amid modern clinical practice. Objective: We aimed to analyze the bone status in terms of mineral metabolism assays, blood bone turnover markers (BTM), and bone mineral density (DXA-BMD), respectively, to assess the 10-year fracture probability of major osteoporotic fractures (MOF) and hip fracture (HF) upon using conventional FRAX without/with femoral neck BMD (MOF-FN/HF-FN and MOF+FN/HF+FN) and the novel model (FRAXplus) with adjustments for T2D (MOF+T2D/HF+T2D) and lumbar spine BMD (MOF+LS/HF+LS). Methods: This retrospective, cross-sectional, pilot study, from January 2023 until January 2024, in menopausal women (aged: 50–80 years) with/without T2D (group DM/nonDM). Inclusion criteria (group DM): prior T2D under diet ± oral medication or novel T2D (OGTT diagnostic). Exclusion criteria: previous anti-osteoporotic medication, prediabetes, insulin therapy, non-T2D. Results: The cohort (N = 136; mean age: 61.36 ± 8.2y) included T2D (22.06%). Groups DM vs. non-DM were age- and years since menopause (YSM)-matched; they had a similar osteoporosis rate (16.67% vs. 23.58%) and fracture prevalence (6.66% vs. 9.43%). In T2D, body mass index (BMI) was higher (31.80 ± 5.31 vs. 26.54 ± 4.87 kg/m²; p < 0.001), while osteocalcin and CrossLaps were lower (18.09 ± 8.35 vs. 25.62 ± 12.78 ng/mL, p = 0.002; 0.39 ± 0.18 vs. 0.48 ± 0.22 ng/mL, p = 0.048), as well as 25-hydroxyvitamin D (16.96 ± 6.76 vs. 21.29 ± 9.84, p = 0.013). FN-BMD and TH-BMD were increased in T2D (p = 0.007, p = 0.002). MOF+LS/HF+LS were statistically significant lower than MOF-FN/HF-FN, respectively, MOF+FN/HF+FN (N = 136). In T2D: MOF+T2D was higher (p < 0.05) than MOF-FN, respectively, MOF+FN [median(IQR) of 3.7(2.5, 5.6) vs. 3.4(2.1, 5.8), respectively, 3.1(2.3, 4.39)], but MOF+LS was lower [2.75(1.9, 3.25)]. HF+T2D was higher (p < 0.05) than HF-FN, respectively, HF+FN [0.8(0.2, 2.4) vs. 0.5(0.2, 1.5), respectively, 0.35(0.13, 0.8)] but HF+LS was lower [0.2(0.1, 0.45)]. Conclusion: Type 2 diabetic menopausal women when compared to age- and YSM-match controls had a lower 25OHD and BTM (osteocalcin, CrossLaps), increased TH-BMD and FN-BMD (with loss of significance upon BMI adjustment). When applying novel FRAX model, LS-BMD adjustment showed lower MOF and HF as estimated by the conventional FRAX (in either subgroup or entire cohort) or as found by T2D adjustment using FRAXplus (in diabetic subgroup). To date, all four types of 10-year fracture probabilities displayed a strong correlation, but taking into consideration the presence of T2D, statistically significant higher risks than calculated by the traditional FRAX were found, hence, the current model might underestimate the condition-related fracture risk. Addressing the practical aspects of fracture risk assessment in diabetic menopausal women might improve the bone health and further offers a prompt tailored strategy to reduce the fracture risk, thus, reducing the overall disease burden. Full article

Background/Objectives: In the era of treat-to-target strategies in inflammatory bowel disease (IBD), transmural healing (TH) is gaining recognition as a promising therapeutic goal. TH has been associated with significantly better long-term outcomes, including reduced rates of hospitalization, surgery, and the need for therapy escalation. Cross-sectional imaging techniques, such as intestinal ultrasound (IUS), magnetic resonance imaging (MRI), and computed tomography enterography (CTE), offer a comprehensive, non-invasive means to assess this deeper level of healing. This review explores how TH is currently defined across various imaging modalities and evaluates the feasibility and cost-effectiveness of achieving TH with available therapies. Methods: A literature search was conducted across PubMed, Scopus, and Embase using keywords, including “transmural healing”, “intestinal ultrasonography”, “magnetic resonance imaging”, “computed tomography enterography”, “Crohn’s disease”, “ulcerative colitis”, and “inflammatory bowel disease”. Only English-language studies were considered. Results: Despite growing interest, there is no standardized definition of TH across imaging platforms. Among the modalities, IUS emerges as the most feasible and cost-effective tool, owing to its accessibility, accuracy (sensitivity 62–95.2%, specificity 61.5–100%), and real-time capabilities, though it does have limitations. Current advanced therapies induce TH in roughly 20–40% of patients, with no consistent differences observed between biologics and small molecules. However, TH has only been evaluated as a formal endpoint in a single randomized controlled trial to date. Conclusions: A unified and validated definition of transmural healing is critically needed to harmonize research and guide clinical decision-making. While TH holds promise as a meaningful treatment target linked to improved outcomes, existing therapies often fall short of achieving complete transmural resolution. Further studies are essential to clarify its role and optimize strategies for deep healing in IBD. Full article

Alternative proteins denote non-traditional, high-protein foods. These innovative sources aim to compete with conventional animal products by providing protein-rich, sustainable, nutritious, and flavorful options. Currently, five main categories of alternative proteins are being developed: plant-based proteins, cultured meat, single-cell proteins, edible insects, and seaweed. Nonetheless, several chemical and microbiological food safety hazards are associated with these alternatives Incorporating novel protein sources into food products may heighten the prevalence of existing food allergies. This could arise from extracting proteins from their natural matrices and utilizing them at significantly higher concentrations. Additionally, the introduction of new proteins may lead to the development of novel food allergies. Proteins that are currently seldom or never consumed may cause primary sensitisation or trigger cross-reactivity with known allergens. To date, alternative proteins have not been thoroughly studied for their allergenic potential, and there is no standardised method for assessing this risk. This review aims to explore non-traditional protein sources, discussing their nutritional and functional properties, as well as their potential allergenicity based on available research. We conducted a literature search in PubMed and Embase databases. We used specific keywords and MESH terms. A total of 157 studies were included in the review. The studies reviewed in our analysis reveal significant limitations, such as inconsistent methodologies, limited participant numbers, and a lack of long-term data, which hinder the ability to make clear conclusions regarding the safety of these new proteins for individuals with allergies. To address current challenge, future research should integrate food science, regulatory perspectives and advanced technologies. Full article

Skeletal muscle regeneration requires a reliable source of myogenic progenitor cells capable of forming new fibers and creating a self-renewing satellite cell pool. Human induced pluripotent stem cell (hiPSC)-derived teratomas have emerged as a novel in vivo platform for generating skeletal myogenic progenitors, although in vivo studies to date have provided only an early single-time-point snapshot. In this study, we isolated a specific population of CD82⁺ ERBB3⁺ NGFR⁺ cells from human iPSC-derived teratomas and verified their long-term in vivo regenerative capacity following transplantation into NSG-mdx^4Cv mice. Transplanted cells engrafted, expanded, and generated human Dystrophin⁺ muscle fibers that increased in size over time and persisted stably long-term. A dynamic population of PAX7⁺ human satellite cells was established, initially expanding post-transplantation and declining moderately between 4 and 8 months as fibers matured. MyHC isoform analysis revealed a time-based shift from embryonic to neonatal and slow fiber types, indicating a slow progressive maturation of the graft. We further show that these progenitors can be cryopreserved and maintain their engraftment potential. Together, these findings give insight into the evolution of teratoma-derived human myogenic stem cell grafts, and highlight the long-term regenerative potential of teratoma-derived human skeletal myogenic progenitors. Full article

Background: Long-term right ventricular pacing (RVP) can cause electrical and mechanical dyssynchrony, resulting in adverse outcomes. Recently, left bundle branch area pacing (LBBAP) has emerged as a physiological pacing modality and is considered a promising alternative. To date, the long-term outcomes of LBBAP compared with RVP, particularly with respect to sex differences, remain unclear. Methods: Between January 2017 and July 2024, 1211 patients who underwent de novo pacemaker implantation were enrolled and categorized into RVP (n = 789) and LBBAP (n = 422). The primary outcome was a composite of all-cause mortality, heart failure hospitalization (HFH), and pacing-induced cardiomyopathy (PICM). Propensity score matching (PSM) was employed to minimize the selection bias and achieve comparability among the study population. A post hoc power analysis based on the observed effect size and sample size showed a power of 80%, confirming sufficient sensitivity to detect group differences. Results: After PSM, 764 patients were analyzed. The mean age of the patients was 74.6 ± 10.5 years in RVP and 74.5 ± 9.8 years in LBBAP, respectively, and 52.3% patients were male. Patients with LBBAP had a lower incidence of the primary outcome (8.6% vs. 24.6%, p < 0.001), HFH (2.6% vs. 13.6%, p < 0.001), and all-cause mortality (6.5% vs. 13.9%, p < 0.001) compared with RVP. There were no significant differences in the clinical outcomes, including the primary outcome, HFH and all-cause mortality, between the sexes in the group with either RVP or LBBAP. However, during a 2-year follow-up period for survival analysis, male patients with LBBAP had a significant lower incidence of all the endpoints, whereas female patients with LBBAP had a lower incidence of HFH [HR 0.14 (95% CI 0.06–0.32), p = 0.001] compared with those with RVP. Conclusions: Regardless of sex, patients with LBBAP had a lower risk of poor clinical outcomes, including HFH and all-cause mortality, compared to those with RVP. Moreover, compared with RVP, LBBAP decreased the risks of all the major endpoints in male patients and the risk of HFH particularly in female patients. Further research is needed to establish the sex-specific responses to LBBAP. Full article

Photobiomodulation (PBM) has been widely studied for its regenerative and anti-inflammatory properties. Its application, combined with biomaterials, is emerging as a promising strategy for promoting tissue regeneration. Considering the diversity of available evidence, this study conducted an integrative literature review, aiming to critically analyze and synthesize the effects of PBM on bone tissue, particularly its potential role as an adjunct in guided bone regeneration (GBR) procedures. To ensure an integrative approach, studies with different methodological designs were included, encompassing both preclinical and clinical research. The article search was performed in the digital databases PubMed/MEDLINE, Scopus, and Web of Science, using the following search terms: “Photobiomodulation therapy” AND “guided bone regeneration”. The search was conducted from November 2024 to January 2025. A total of 85 articles were found using the presented terms; after checking the results, 11 articles were selected for this study. The remaining articles were excluded because they did not fit the proposed inclusion and exclusion criteria. Studies to date have shown preclinical models that demonstrated increased bone-volume fraction and accelerating healing. Although it has exciting potential in bone regeneration, offering a non-invasive and promising approach to promote healing and repair of damaged bone tissue, the clinical application of PBM faces challenges, such as the lack of consensus on the ideal treatment parameters. Calcium phosphate ceramics were one of the most used biomaterials in the studied associations. Further well-designed studies are necessary to clarify the effectiveness, optimal parameters, and clinical relevance of PBM in bone regeneration, in order to strengthen the current evidence base and guide its potential future use in clinical practice. Full article

The Sierra Minera de Cartagena-La Unión, located in southeast of the Iberian Peninsula, has been significantly impacted by historical mining activities, which resulted in environmental degradation, including acid mine drainage (AMD) and heavy metal contamination. This study evaluates the potential of PRISMA hyperspectral imagery for multi-temporal mapping of AMD-related minerals in two mining-affected drainage basins: Beal and Gorguel. Key minerals indicative of AMD—iron oxides and hydroxides (hematite, jarosite, goethite), gypsum, and aluminium-bearing clays—were identified and mapped using band ratios applied to PRISMA data acquired over five dates between 2020 and 2024. Additionally, Sentinel-2 data were incorporated in the analysis due to their higher temporal resolution to complement iron oxide and hydroxide evolution from PRISMA. Results reveal distinct temporal and spatial patterns in mineral distribution, influenced by seasonal precipitation and climatic factors. Jarosite was predominant after torrential precipitation events, reflecting recent AMD deposition, while gypsum exhibited seasonal variability linked to evaporation cycles. Goethite and hematite increased in drier conditions, indicating transitions in oxidation states. Validation using X-ray diffraction (XRD), laboratory spectral curves, and a larger time-series of Sentinel-2 imagery demonstrated strong correlations, confirming PRISMA’s effectiveness for iron oxides and hydroxides and gypsum identification and monitoring. However, challenges such as noise, striping effects, and limited image availability affected the accuracy of aluminium-bearing clay mapping and limited long-term trend analysis. Full article

In response to the challenges faced by traditional short-term electricity load forecasting models during holiday load predictions, a novel approach based on multifactor analysis and the Backpropagation–Gated Recurrent Unit (BP-GRU) model is proposed. Firstly, the impacts of temperature, humidity, and the type of date on the electricity load curve are examined. The study clarifies the positive and negative effects of temperature at different times on load forecasting and reveals the non-dependence characteristics of historical data on holiday load curves. Secondly, the performance of various model weight parameter optimization algorithms is assessed, leading to the establishment of a combined GRU and BP model. The operational workflow of the BP-GRU model is introduced. Lastly, the effectiveness of the proposed forecasting model is verified using actual load data. Compared to existing models, the proposed approach exhibits a significant advantage in achieving higher accuracy in holiday load predictions. Full article