Search Results (4,784)

Cyanobacterial blooms are an escalating ecological concern driven by eutrophication and climate warming. Bloom-forming cyanobacteria can produce a broad spectrum of bioactive secondary metabolites. Among these, microcystins (MCs) are the most recognised hepatotoxins; however, natural populations of Planktothrix agardhii also synthesise numerous non-ribosomal peptides (NRPs) with poorly understood ecological roles and combined toxic effects. This review demonstrated the role of mixtures of P. agardhii cyanometabolites (oligopeptides and biogenic compounds) in cyanobacterial proliferation, emphasising the rapid evolution of chemotypes. The role of P. agardhii oligopeptides other than MCs in the cyanobacterial toxicity to duckweeds is also discussed. Laboratory experiments indicated that crude extracts containing complex peptide mixtures may inhibit Spirodela polyrhiza growth more strongly than pure MC-LR, suggesting synergistic effects within natural metabolite assemblages. Particular attention is given to variant-specific degradation pathways of MCs within duckweed-associated microbiota. By integrating biochemical, ecological, and microbiological perspectives, this synthesis outlines emerging directions in the study of mixtures of cyanobacterial peptides and other compounds, microbial degraders, and macrophyte-associated bioremediation strategies aimed at mitigating cyanotoxin risks in aquatic environments. Full article

Drug-resistant Klebsiella pneumoniae and related Enterobacterales represent an escalating global public health threat, increasingly limiting therapeutic options in both healthcare- and community-associated infections. This review summarizes how resistance in K. pneumoniae emerges from the synergy of intrinsic barriers and acquired determinants. Key molecular mechanisms include reduced permeability via porin remodeling (notably OmpK35/OmpK36), multidrug efflux (e.g., AcrAB-TolC and OqxAB), and enzymatic drug inactivation driven by extended-spectrum beta-lactamases and carbapenemases (e.g., KPC, OXA-48-like enzymes, and metallo-beta-lactamases). We also highlight clinically meaningful pathways underlying polymyxin/colistin resistance, including mgrB inactivation and PhoPQ/PmrAB-mediated lipid A modification. In addition to stable genetic resistance, adaptive programs can shape transient tolerance and persistence, including stress responses that modulate gene expression under antibiotic and host-imposed pressures. The ability of these organisms to form biofilms, particularly on medical devices, further complicates treatment and eradication. Finally, we discuss therapeutic implications and current options and limitations—including novel beta-lactam/beta-lactamase inhibitor combinations and siderophore cephalosporins—and emphasize the importance of aligning therapy and surveillance with the underlying resistance mechanisms and circulating high-risk lineages. Full article

Cesarean scar pregnancy (CSP) carries a high risk of severe hemorrhage and potential loss of fertility. This narrative review summarizes current evidence on uterine artery embolization (UAE) using absorbable gelatin sponge (GS), focusing on GS preparation, procedural approaches, and reported outcomes. PubMed/MEDLINE, Scopus, and Google Scholar were searched from January 2015 to 31 December 2024 for peer-reviewed studies reporting UAE with GS for CSP (GS alone or combined with intra-arterial methotrexate and/or adjunct particles). Fifty studies (N = 3139) were included. Technical success was 3133/3139 (~99.8%) and clinical success was 2975/3139 (~94.8%), with most cohorts reporting high clinical control. Severe complications were infrequently reported (typically ~2–4% in most series). Menstrual function, when assessed, generally recovered within ~1–2 months. Subsequent pregnancy outcomes were inconsistently reported and follow-up durations were heterogeneous, predominantly in retrospective designs. Overall, UAE with GS appears effective for hemostasis in CSP and may reduce escalation to hysterectomy in appropriately selected patients. Standardized reporting of GS preparation and outcomes, as well as prospective multicenter registries/studies, are needed to refine best practices. Full article

Background/Objectives: Tuberculosis (TB) remains a major global health challenge influenced by social determinants of health (SDHs) such as poverty, overcrowding, malnutrition, and limited healthcare access. Although Central Asia (CA) has achieved progress through vaccination, screening, and treatment, the region continues to face severe disease consequences, unstable incidence patterns, and an escalating challenge of TB resistant to first-line drugs. This study aimed to analyze TB incidence dynamics in Kazakhstan, Tajikistan, the Kyrgyz Republic, Turkmenistan, and Uzbekistan from 2000–2023, forecast trends to 2030, and identify key SDHs shaping the epidemic. Methods: Data on TB incidence were obtained from the World Bank DataBank for 2000–2023. Of 61 socioeconomic, environmental, and health-related indicators, 29 were included in the analysis. Statistical procedures in SPSS (v24.0) involved time-series forecasting through 2030, calculation of average annual percentage change (AAPC), correlation testing, and linear regression, with significance set at p < 0.05. Results: TB incidence generally declined across CA during 2000–2023, though trends varied by country. Forecasts suggest continued decreases in Turkmenistan and Uzbekistan, while Kazakhstan, Tajikistan, and the Kyrgyz Republic display fluctuating or nonsignificant patterns, likely influenced by SDHs. Regression analyses indicated that anemia, undernourishment, and population density showed a positive relationship with TB incidence, while clean fuel access, physician density, and Gross Domestic Product per capita (GDP) were inversely related. Conclusions: The findings highlight the heterogeneous nature of TB dynamics in CA and the possible role of SDHs. Enhanced surveillance, nutritional and social interventions are required to sustain progress toward End TB targets. Full article

This study, set against the backdrop of escalating trade tensions between China and the United States, examines the impact of soybean tariff adjustments on the abnormal asymmetric behavior in the futures market. By employing specialized analytical methods that capture market volatility asymmetry and event study techniques, we focus on the multi-stage soybean tariff adjustments to analyze their effects on market return transmission, volatility asymmetry, and market stability. This study compares the market responses to positive and negative shocks and the distinct performances of the futures markets in China and the United States, with the core aim of verifying whether soybean tariff shocks trigger abnormal asymmetric behavior in the futures market. The results show that tariff shocks significantly lead to asymmetric characteristics in market volatility, with negative shocks having a more pronounced impact on market volatility than positive ones. During the trading days before and after the announcement of tariff policies, the cumulative abnormal return difference, which measures the disparity in market reactions to related assets, also rose significantly. This indicates that tariff adjustments are the core factor causing abnormal asymmetric phenomena in the market, and the commodity futures market needs to pay attention to such asymmetric risks triggered by policies. The value of this study lies in its targeted analysis of the dynamic impact of tariff shocks, combined with volatility analysis and event study methods, to quantify the asymmetric effects in cross-border markets. The research conclusions can help investors avoid risks related to trade policies and provide references for policymakers to stabilize fluctuations in the commodity market, ultimately facilitating the market’s more efficient response to trade policy shocks and reducing information asymmetry in futures market pricing. Full article

The Russo–Ukrainian conflict (RUC) escalated on 24 February 2022 with Russia’s large-scale military operation in Ukraine. Our review aims to present the impact of the RUC on Ukrainian water resources and infrastructure. Its primary objective was to analyze 61 relevant papers, selected and screened according to the PRISMA methodology, concerning changes in inland and marine water quality, employing diverse scientific and analytical methods, and technical tools. Key recurring themes included “Ukraine”, “Russian-Ukrainian War”, and “Ecocide”. Beyond assessing the environmental consequences of destroyed treatment plants, supply systems, and sewerage units, as the secondary objective, the review introduces the concept of “aquacide”—the deliberate or incidental destruction and contamination of water infrastructures and resources during military operations. The most severe cases were documented in southern and eastern Ukraine, with the destruction of the Kakhovka Dam standing out as the most widely reported “aquacide”. Finally, the review highlights the critical role of satellite imagery and remote sensing as the most effective tools in monitoring water quality and infrastructures under wartime conditions, when in situ observations and measurements are often impossible. Full article

The Infectious Diseases Society of America (IDSA) guidelines for community-acquired pneumonia (CAP) recommend pneumococcal urinary antigen testing (UAT) for a subset of inpatients admitted with pneumonia. Despite this, UAT testing is frequently performed on inpatients who do not meet the official IDSA criteria, and current evidence regarding antibiotic de-escalation in UAT-positive cases remains inconclusive. To explore this further, we conducted a retrospective cohort study examining antibiotic de-escalation patterns among hospitalized CAP patients who underwent UAT over a 60-day period during peak respiratory illness season (November and December, 2023). Patients with positive UAT results were compared to those who had negative UAT; the primary outcome was whether a positive UAT impacted antibiotic de-escalation prescribing. A total of 268 patients were analyzed—235 UAT-negative and 33 UAT-positive. Both groups were comparable in terms of disease severity, underlying health conditions, and readmission rates. Empiric therapy targeting Pseudomonas aeruginosa (P. aeruginosa) and methicillin-resistant Staphylococcus aureus (MRSA) was used in 40% of patients (36% in the UAT-positive group and 46% of the UAG-negative group). The use of atypical coverage, MRSA coverage, or anti-pseudomonal β-lactams was frequently de-escalated in both cohorts (p < 0.05); however, the UAT-positive group had significantly shorter durations of anti-pseudomonal therapy (p = 0.03) and anti-MRSA therapy (p = 0.02). Despite this, the UAT-positive group was more commonly given fluoroquinolones, such as levofloxacin or moxifloxacin, over narrow-spectrum β-lactams for final antibiotic coverage (p = 0.021). Overall, positive UAT appeared to support earlier discontinuation of anti-MRSA and anti-pseudomonal antibiotics; however, it did not impact fluoroquinolone use. Future antimicrobial stewardship efforts may benefit from promoting greater use of narrow-spectrum β-lactams in these patients. Full article

The escalating complexity, density, and agility of the modern electromagnetic environment (CME) pose unprecedented challenges to radar signal deinterleaving, a cornerstone of electronic intelligence. While traditional methods face significant performance bottlenecks, the advent of artificial intelligence, particularly deep learning, has catalyzed a paradigm shift. This review provides a systematic, comprehensive, and forward-looking analysis of the radar signal deinterleaving landscape, critically bridging foundational techniques with the cognitive frontiers. Previous reviews often focused on specific technical branches or predated the deep learning revolution. In contrast, our work offers a holistic synthesis. It explicitly links the evolution of algorithms to the persistent challenges of the CME. We first establish a unified mathematical framework and systematically evaluate classical approaches, such as PRI-based search and clustering algorithms, elucidating their contributions and inherent limitations. The core of our review then pivots to the deep learning-driven era, meticulously dissecting the application paradigms, innovations, and performance of mainstream architectures, including Recurrent Neural Networks (RNNs), Transformers, Convolutional Neural Networks (CNNs), and Graph Neural Networks (GNNs). Furthermore, we venture into emerging frontiers, exploring the transformative potential of self-supervised learning, meta-learning, multi-station fusion, and the integration of Large Language Models (LLMs) for enhanced semantic reasoning. A critical assessment of the current dataset landscape is also provided, highlighting the crucial need for standardized benchmarks. Finally, this paper culminates in a comprehensive comparative analysis, identifying key open challenges such as open-set recognition, model interpretability, and real-time deployment. We conclude by offering in-depth insights and a roadmap for future research, aimed at steering the field towards end-to-end intelligent and autonomous deinterleaving systems. This review is intended to serve as a definitive reference and insightful guide for researchers, catalyzing future innovation in intelligent radar signal processing. Full article

Axillary management in early-stage, HER2-negative, hormone receptor-positive breast cancer has undergone major changes in recent years. While axillary lymph node dissection (ALND) was once considered essential for staging and regional control, increasing evidence supports the safety of surgical de-escalation in selected patients. At the same time, systemic therapies such as CDK4/6 and PARP inhibitors rely on nodal burden to define eligibility, raising new challenges in balancing oncologic benefit with treatment-related morbidity. This narrative review summarizes current strategies in axillary management for patients undergoing upfront surgery for HR-positive, HER2-negative early breast cancer. It explores the role of sentinel lymph node biopsy (SLNB), the indications for ALND, the integration of adjuvant systemic therapy, and the emerging role of radiotherapy and predictive tools in guiding individualized treatment decisions. Key randomized trials including Z0011, AMAROS, SENOMAC, SOUND, and INSEMA have demonstrated that omission of ALND is safe in patients with limited nodal involvement, especially when combined with whole-breast or regional nodal radiotherapy. However, trials such as MonarchE and OlympiA have introduced systemic therapies whose indications are closely tied to nodal status, prompting reconsideration of the extent of axillary staging. Advances in imaging and risk stratification tools offer new avenues for safely limiting surgical intervention while preserving access to systemic options. In conclusion, modern axillary management in HR-positive, HER2-negative breast cancer involves navigating the intersection between de-escalated surgery and risk-adapted systemic therapy. Future strategies should prioritize individualized care, incorporating tumor biology, imaging findings, and patient preferences, with multidisciplinary collaboration playing a central role in optimizing outcomes. Full article

Advancing rapidly in modern bridge engineering technology, through concrete-filled steel tubular (CFST) arch bridges have achieved widespread application in transportation infrastructure development. Nevertheless, vehicle fires occurring in complicated operational settings may rapidly escalate into major disasters. Fires in oil tankers are particularly dangerous for the safety of bridges. This study examines the fire resistance of through concrete-filled steel tubular (CFST) arch bridges exposed to tanker truck fires. The study formulates a detailed model utilizing Fire Dynamics Simulator (FDS) to simulate fire scenarios, elucidating the spatial temperature distribution characteristics within arch bridge structures. A three-dimensional finite element model established in ABAQUS (Abaqus 2024, Dassault Systèmes Simulia Corp, Providence, RI, USA) is employed to simulate structural responses by analyzing the mechanical behavior of key components under different fire conditions. Practical fire resistance design recommendations for extreme tanker truck fire scenarios are ultimately proposed. Numerical results demonstrate that structural components near the fire source (such as transverse bracings, hangers, and fire-exposed arch surfaces) experience significantly higher temperatures than other regions. Notable temperature gradients developing along hangers and arch ribs in fire-affected zones are observed, while substantial cross-sectional temperature gradients occurring in these components under tanker truck fires reveal their damage evolution mechanisms. The fire exposure scenario at the quarter-point of the midspan is identified as the most critical fire exposure scenario for through CFST arch bridges under tanker truck fires. Under this extreme scenario, the deflection on the fire-exposed side of the global structure exhibits a significant three-stage distribution characteristic: an initial ascending phase around 0–800 s, followed by a sharp descending phase during 800–1100 s, and then a stabilization trend. A fire resistance limit criterion based on component failure (t_f3 = 853.43 s) is established, and a global fire resistance limit assessment methodology for through CFST arch bridges under extreme tanker truck scenarios is proposed. Full article

Aquaculture systems face escalating ecological risks due to the widespread use and persistence of antibiotics, which disrupt microbial-mediated nitrogen cycling and exacerbate greenhouse gas (GHG) emissions. This review synthesizes the recent research on how common antibiotics, such as sulfonamides, quinolones, tetracyclines, and macrolides, with the concentration ranging from μg/L to mg/L, alter microbial community structure, functional gene expression (e.g., amoA, nirK, and nosZ), and key nitrogen transformation processes. These disruptions inhibit nitrogen-removal efficiency by 25–55%, promote the accumulation of toxic intermediates (e.g., NH₄⁺ and NO₂⁻), and enhance emissions of potent GHGs of nitrous oxide (N₂O) and methane (CH₄). The effects are influenced by antibiotic type; concentration; environmental conditions; and interactions with co-contaminants such as heavy metals (Cu²⁺ and Pb²⁺ at 50–200 μg/L) and microplastics (0.1–10 mg/L), which can synergistically amplify ecological risks by 20–40%. The research in this field has largely focused on the toxicity of individual antibiotics, so significant gaps remain regarding combined pollution effects, long-term microbial adaptation, and molecular-scale mechanisms. This review synthesizes research on the impacts of aquaculture antibiotics on microbial nitrogen cycling and GHG emissions, identifying key mechanisms and research gaps. Its significance lies in laying a scientific foundation for integrated antibiotics pollution control strategies and bridging basic research with practical aquaculture management to advance the sustainability of aquaculture ecosystems. Full article

Escalating energy prices have positioned households as pivotal agents in advancing demand-side energy efficiency. This study examines three complementary energy-saving strategies among Polish households: (1) habitual, low-cost actions such as switching off unnecessary lighting; (2) capital-intensive investments, including LED lighting and energy-efficient appliances; and (3) time-based and prosumptive strategies linked to dynamic tariffs and photovoltaic systems. The empirical analysis is based on a nationwide survey conducted using the Computer-Assisted Web Interviewing method, involving 401 respondents. The study’s contribution lies in integrating these strategies within a single analytical model and providing the first empirical evidence on their socio-demographic determinants in Central and Eastern Europe, with Poland as a representative case. The results show that older individuals more often adopt everyday habitual practices, whereas higher income and education levels are associated with investment-oriented behaviours. Urban households tend to favour technological solutions, while rural households more frequently adopt time-of-use tariffs and PV systems. Two complementary pathways are identified: a behavioural–habitual path and an investment–technological path. The findings offer guidance for public policy by showing that energy savings increase when financial incentives are combined with clear communication and low-effort decision tools that help households optimise energy use regardless of demographic profile. Full article

Bacteriophages, viruses that target bacteria, offer a promising alternative to antibiotics in the face of escalating bacterial resistance. Despite their discovery over a century ago, their widespread adoption has been impeded by regulatory challenges, limited funding, and the dominance of antibiotics. This review evaluates the current status of phage therapy by examining a comprehensive literature search, applying predefined inclusion and exclusion criteria. The review assesses selected scientific reports and clinical studies for their safety and efficacy profiles. Our findings indicate that advancements in phage therapy involve critical steps such as rapid bacterial detection, effective isolation, production, purification of phage preparations, and understanding their interactions with the host. Clinical studies generally show promising safety profiles with fewer adverse events compared to controls, and some trials suggest efficacy even at lower phage titers. Case reports further highlight phage therapy’s potential, demonstrating high success rates and minimal adverse events, although caution is advised due to potential biases. Despite promising results, significant research gaps remain, primarily due to the limited number of large-scale, well-designed clinical trials. Full article

Coastal cities face escalating flood risk under sea-level rise, yet landscape-based adaptation strategies often remain speculative and weakly connected to the accessibility and economic constraints that shape sustainable urban development. This study developed a modeling-to-design framework that translates coupled climate and land-use projections into implementable landscape interventions, through planning-level spatial allocation, using Dalian, China as a case study under “middle of the road” (SSP2-4.5) climate conditions. The framework integrates the Land-use Evolution and Assessment Model (LEAM) with connected-bathtub flood modeling to evaluate whether strategic landscape design can redirect development away from flood-prone zones while accommodating projected growth and maintaining accessibility to employment and services. Interventions—protective wetland restoration (810 km²) and blue–green corridors (8 km²)—derived from a meta-synthesis of implemented coastal projects were operationalized as LEAM spatial constraints. Our results show that residential development can be redirected away from coastal risk with 100% demand satisfaction and elimination of moderate-risk allocations. Cropland demand was fully accommodated. In contrast, commercial development experienced 99.8% reduction under strict coastal protection, reflecting locational dependence on port-adjacent sites. This modeling-to-design framework offers a transferable approach to quantifying where landscape interventions succeed, where they face barriers, and where complementary measures are required, supporting decision-making that balances environmental protection, economic function, and social accessibility in sustainable coastal development. Full article