Search Results (3,691)

Background and Objectives: We aimed to determine whether gynecologic cancer–related factors are associated with postoperative clinically significant cognitive decline (CCD) after accounting for age and comorbidity using competing-risk models. Materials and Methods: We performed a retrospective cohort study of adult women undergoing index surgery for gynecologic cancer at a tertiary university hospital. CCD was defined as new clinician-documented cognitive impairment, neurology/psychiatry consultation, or initiation of cognition-targeted pharmacotherapy ≥30 days postoperatively. Competing events were all-cause death and major neurologic events/hospice. We fit Fine–Gray subdistribution hazard models adjusted for age, Charlson Comorbidity Index (CCI), cancer stage, and treatment intensity, and evaluated a prespecified age × stage interaction. Results: Among 1023 eligible patients (mean age 62.4 ± 11.8 years; 41.3% International Federation of Gynecology and Obstetrics [FIGO] stage III–IV; median CCI 3 [IQR 2–5]), CCD occurred in 98 (9.6%). The 12-month cumulative incidence of CCD was 11.2% accounting for competing risks. Advanced stage was independently associated with higher CCD risk (sHR 1.85, 95% CI 1.27–2.69; p = 0.001). A significant age × stage interaction was observed (p < 0.001), with the strongest association in patients ≥70 years (sHR 2.48, 95% CI 1.61–3.81). Perioperative factors associated with CCD included open surgery (sHR 1.54) and postoperative delirium (sHR 2.76); these findings should be interpreted as associative signals rather than validated causal treatment targets. A stratified blinded chart review of 160 patients (80 flagged-positive and 80 unflagged controls) supported the CCD definition (PPV 88.8%; sensitivity 72.1%; specificity 94.3%; NPV 91.5%). Visit-frequency adjustment confirmed robustness (advanced stage sHR 1.78; p = 0.003). Conclusions: Gynecologic cancer–related factors, particularly advanced stage, are independently associated with CCD after accounting for competing risks, and high-risk phenotypes (age ≥70, FIGO III–IV) may benefit from perioperative pathways integrating cognitive screening, delirium prevention, and neurocognitive follow-up. Full article

South Africa is highly susceptible to climate variability and long-term climatic shifts, necessitating a comprehensive understanding of changing extreme precipitation patterns to guide effective mitigation and adaptation responses. This study examined variations in extreme precipitation indices from 1981 to 2023 across the eastern Free State Province using daily rainfall records derived from the Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS). Ten extreme precipitation indices were evaluated, with trend detection conducted through the Innovative Trend Analysis (ITA) technique. Findings indicate that the majority of municipalities exhibited statistically significant declining trends (p < 0.05) in total wet-day precipitation (PRCPTOT), R99P, R95P, the Simple Daily Intensity Index (SDII), CDD, RX5day, R20mm, and R10mm, suggesting an overall reduction in both heavy and moderate rainfall occurrences. In contrast, significant upward trends (p < 0.05) were identified in CWD, and RX1day, reflecting a shift toward prolonged wet periods and more intense short-duration rainfall events. Taken together, these divergent patterns point to the simultaneous emergence of heightened drought vulnerability driven by reduced cumulative rainfall and increased flood risk linked to intensified precipitation extremes. These results underscore the importance of forward-looking, climate-resilient water resource management and context-specific adaptation strategies suited to the eastern Free State’s complex mountainous terrain. Full article

Background: Immunotherapy has become an integral part of systemic treatment for cervical cancer (CC). This study assessed the safety profile of cemiplimab and the association between immune-related adverse events (irAEs) and treatment outcomes in patients with persistent, recurrent or metastatic CC. Methods: This ambispective, multicenter, real-world cohort study included 101 patients treated in 13 reference oncology centers as part of the PCCIG-01 study. We evaluated the frequency and severity of irAEs and their association with progression-free survival (PFS) and overall survival (OS). Survival outcomes were analyzed using the Kaplan–Meier method and Cox proportional hazards models, with p < 0.05 considered statistically significant. Results: After a median follow-up of 7.5 months, adverse events occurred in 45 patients (44.6%) and were mostly grade (G) 1–2. IrAEs were observed in 34 patients (33.7%). Endocrine toxicities predominated (n = 24, 58.5% of irAEs), followed by hepatic (n = 5, 12.2%) and gastrointestinal events (n = 4, 9.8%). G3 irAEs occurred in 8 patients (7.9%). Median PFS was 3.9 months (95% CI 2.9–5.6) in patients without irAEs and 10.9 months (95% CI 5.7–16.3) in those with irAEs (p = 0.03). Median OS was 15.3 months (95% CI 8.6–25.9) in patients without irAEs and was not reached in those with irAEs (95% CI 11.6-NR; p = 0.11). The development of irAEs was associated with a 54% reduction in the risk of progression (HR 0.46, 95% CI 0.27–0.80), with no statistically significant impact on OS. Conclusions: In exploratory analyses, the occurrence of irAEs was associated with improved PFS in cemiplimab-treated patients with persistent, recurrent or metastatic CC. Cemiplimab showed a manageable safety profile, with most toxicities being G1–G2. Full article

Operational shutdowns following hazardous liquid pipeline incidents are critical but poorly understood events that impact the U.S. energy supply. Although prior research has investigated the causes and outcomes of pipeline failures, limited work has explained what drives both the likelihood of a shutdown and the duration once it begins. The goal of this study is to address this gap by developing a hurdle regression model to examine the two-stage shutdown mechanism in pipeline incidents, using the Pipeline and Hazardous Materials Safety Administration (PHMSA) incident dataset from 2010 to 2025. The hurdle model consists of a logistic regression restricted to pre-decision predictors to model the probability of shutdown, and a lognormal regression to model the duration of those leading to shutdown. The results revealed that distinct factors are associated with each outcome. Shutdown probability is associated with pre-decision operational and contextual indicators, including operating pressure at the time of incident, accident type, location, monitoring presence, and response delay. In contrast, shutdown duration is associated with logistical complexity and post-incident severity, including incidents at pipeline crossings, pressures exceeding 110% of the maximum operating pressure, and reported property damage. These findings, while exploratory in nature given the use of public incident data, offer practical reference points for operators and regulators who aim to shorten recovery time and strengthen the resilience of energy infrastructure. Full article

Real-time crash risk assessment is a key component of proactive road safety management, enabling the identification of hazardous conditions within short temporal intervals before crashes occur. Traditional crash-based models are unsuitable for such applications due to the rarity, reporting delay, and stochastic nature of crash data. Traffic conflicts, capturing near-miss interactions between road users, provide a practical alternative for real-time safety analysis. Over the past decade, numerous modelling approaches have been developed to translate conflict information into crash risk estimates; however, the literature remains fragmented and lacks a unified analytical synthesis. This review presents a state-of-the-art, model-centric analysis of conflict-based approaches, classifying them into five paradigms: statistical/regression-based, Bayesian, extreme value theory (EVT), machine learning (ML), and hybrid models. Beyond classification, the study conducts a structured cross-paradigm comparison across key dimensions, including conflict representation, data characteristics, temporal modelling, uncertainty treatment, validation strategies, computational complexity, and operational readiness. The paradigms are further interpreted through the complementary lenses of conflict frequency and severity. The review identifies key research gaps, including fragmented conflict definitions, challenges in modelling rare and extreme events, incomplete treatment of uncertainty and spatiotemporal dynamics, and limitations in validation, transferability, and deployment. Emerging research directions include standardized and adaptive conflict indicators, EVT–machine learning integration, integrated uncertainty-aware frameworks, advanced spatiotemporal modelling, transferable models, and scalable real-time implementation. By combining structured evidence mapping and cross-paradigm synthesis, this study supports model selection, development, and deployment for dynamic crash risk assessment. Full article

Background: Peripheral artery disease (PAD) impacts more than 200 million individuals globally. Despite its prevalence, management remains suboptimal, partly due to the lack of reliable blood-based biomarkers. The ankle–brachial index (ABI), the current gold-standard test for PAD, is limited by inter-operator variability, misinterpretation, and reduced accuracy in patients with diabetes. Fatty acid binding protein 3 (FABP3) has emerged as a potential biomarker for PAD; however, its prognostic performance relative to ABI remains unclear. This study compared FABP3 and ABI for predicting PAD outcomes using statistical and machine learning approaches. Methods: A total of 1001 participants were prospectively recruited, including 644 patients with PAD and 357 without PAD. The primary outcome was 2-year major adverse limb event (MALE), defined as a composite of vascular intervention, major amputation, or acute limb ischemia. At enrollment, plasma FABP3 was quantified using a validated multiplex immunoassay. Kaplan–Meier analysis of MALE-free survival was performed across pre-specified FABP3 tertiles (high [>3.55 ng/mL], moderate [1.55–3.55 ng/mL], and low [<1.55 ng/mL]) and ABI tertiles (severe [<0.40], moderate [0.40–<0.70], and mild [0.70–0.90]), with curve separation assessed using log-rank tests. Multivariable Cox proportional hazards modelling was used to evaluate the independent relationships of FABP3 and ABI with 2-year MALE after adjustment for baseline demographic and clinical covariates. To assess predictive performance for 2-year MALE, an extreme gradient boosting (XGBoost) classification model incorporating 10-fold cross-validation was trained using a combination of clinical covariates, plasma FABP3 levels, and ABI. Discriminatory performance was assessed using the area under the receiver operating characteristic curve (AUC). Results: The average participant age was 68 years (SD 12), and 34% (n = 340) were women. Mean ABI was 0.75 ± 0.25 and mean FABP3 concentration was 2.97 ± 2.06 ng/mL. Among the 644 participants with PAD, 558 (86.6%) had complete time-to-event data for MALE status, FABP3, and ABI. Over the median follow-up period of 2 years, 140 (25.1%) participants with PAD experienced MALE. Kaplan–Meier analyses demonstrated significant separation in MALE-free survival across FABP3 tertiles (log-rank p < 0.001). At 24 months, MALE-free survival was 100.0% in the FABP3 < 1.55 group, compared with 71.1% in the FABP3 1.55–3.55 group and 67.7% in the FABP3 > 3.55 group. In contrast, ABI severity groups showed less pronounced separation, with 24-month MALE-free survival rates of 80.3% for mild ABI, 73.2% for moderate ABI, and 71.3% for severe ABI, without a statistically significant overall difference (p = 0.170). In adjusted Cox proportional hazards models, FABP3 demonstrated strong prognostic performance for 2-year MALE. A 1 SD increase in log-transformed FABP3 was independently associated with a higher risk of 2-year MALE (HR 1.90, 95% CI 1.60–2.25; p < 0.001), with minimal change after additional adjustment for ABI (HR 1.90, 95% CI 1.60–2.24; p < 0.001). Machine learning analyses similarly favored FABP3 over ABI, with the FABP3-based model achieving an AUC of 0.773 compared to 0.686 for the ABI-based model. Adding ABI to the FABP3 model did not improve discrimination. Conclusions: Circulating plasma levels of FABP3 are strongly associated with PAD outcomes. Specifically, FABP3 demonstrated a stronger and more robust association with 2-year MALE compared to ABI. This study validates the prognostic value of FABP3 for PAD outcomes in comparison to ABI. Full article

In recent decades, intensified temperature variability has increased the likelihood of abrupt transitions between anomalously cold and warm conditions, exerting substantial ecological and societal impacts. This study identifies rapid temperature flip events (RTFEs), including cold-to-warm transition events (C2Ws) and warm-to-cold transition events (W2Cs), across China using the CN05.1 gridded daily mean temperature data for 1961–2022, and further reveals their regional heterogeneity and long-term changes. Eastern China represents a hotspot of RTFEs, exhibiting higher frequencies and stronger intensities compared with western China. RTFEs are most frequent in spring, followed by summer. Over the period 1961–2022, both C2W and W2C became more frequent and more intense, with W2C showing a larger increase in frequency of 0.54 events century⁻¹ and a larger increase in intensity of 0.29 s.d. century⁻¹, compared with increases of 0.01 events century⁻¹ and 0.11 s.d. century⁻¹, respectively, for C2W. In addition, significant decadal changes in both types of events were observed across large areas of China during the 1990s–2000s and 2010s, following a high–low–high pattern. Analysis across the seven natural sub-regions reveals distinct high-hazard areas where RTFE hotspots coincide with increasing frequency and intensity: the eastern monsoonal regions of China for W2Cs and Inner Mongolia for both event types. These findings contribute to addressing climate change and mitigating the risk of RTFEs. Full article

Uncontrolled scrap tire fires represent high-intensity episodic emission events that pose severe toxicological threats to urban environments. This study employs atmospheric dispersion modelling to quantify the impact of a tire stockpile fire on a distal educational receptor, evaluating two distinct dynamic stages of the event: an initial high-intensity open flame scenario (E1, 4 h) and a prolonged smouldering/suppression scenario (E2, 6 h), induced by firefighting interventions. Results reveal extreme pollutant loading at the receptor site during E1, with PM₁₀ and SO₂ concentrations peaking at 23,766 ${\displaystyle \frac{\mathsf{\mu }\mathrm{g}}{{\mathrm{m}}^3}}$ and 7821 ${\displaystyle \frac{\mathsf{\mu }\mathrm{g}}{{\mathrm{m}}^3}}$ respectively, indicating an immediate risk of acute respiratory distress. The organic fraction was dominated by volatile organic compounds (VOCs) (8691 ${\displaystyle \frac{\mathsf{\mu }\mathrm{g}}{{\mathrm{m}}^3}}$) and a ∑16 PAHs flux of 313.9 ${\displaystyle \frac{\mathsf{\mu }\mathrm{g}}{{\mathrm{m}}^3}}$. Toxicological assessment identified Benzo[a]pyrene (BaP) as the primary driver of health hazards, contributing approximately 70% to the carcinogenic risk profile. A critical disparity was observed between Mutagenic Equivalency (MEQ) of 18.32 and Toxic Equivalency (TEQ) of 15.37, suggesting that standard monitoring significantly underestimates the biological threat to sensitive paediatric populations. These findings demonstrate that acute, oxygen-limited tire combustion creates a concentrated toxic slug of high-molecular-weight PAHs. The study underscores the necessity of integrating mutagenicity-based models into emergency response protocols to accurately safeguard vulnerable communities against the long-term toxicological legacy of elastomer thermolysis. Full article

Background and Objectives: Major burn injury causes profound hypermetabolism and altered thermoregulation. While perioperative hypothermia is linked to adverse outcomes, the prognostic significance of preoperative core temperature in major burn patients remains poorly defined. Therefore, we investigated the association between preoperative core temperature and postoperative mortality in patients with major burns. Materials and Methods: This retrospective study included 635 adult patients with major burns who underwent surgery. Preoperative core temperature was measured in the intensive care unit before surgery. The primary outcome was 90-day postoperative mortality. Secondary outcomes were 30-day postoperative complications, including major adverse cardiovascular events (MACE), bloodstream infection, and continuous renal replacement therapy (CRRT) requirement. Cox proportional hazards regression, receiver operating characteristic (ROC) curve, Kaplan–Meier survival, and restricted cubic spline analyses were performed. Results: The 90-day postoperative mortality rate was 35.6%. Mortality increased in a graded manner as preoperative core temperature decreased. In multivariable Cox regression analysis, preoperative core temperature remained independently associated with 90-day mortality. Restricted cubic spline analysis showed an inverse linear association between preoperative core temperature and mortality risk. ROC curve analysis identified 37.0 °C as an exploratory and hypothesis-generating cohort-specific threshold for risk stratification. Regarding secondary outcomes, the core temperature ≤37.0 °C group had higher rates of MACE, bloodstream infections, and CRRT requirement (all p < 0.05). Conclusions: Lower preoperative core temperature was associated with increased 90-day postoperative mortality in adults with major burns undergoing surgery. Preoperative temperature may serve as a clinically relevant marker of physiologic vulnerability and postoperative risk. Full article

Drought–flood abrupt alternation (DFAA) is a typical compound hydroclimatic extreme process and has important implications for regional water resources regulation, agricultural production, and ecological stability. However, existing studies have mainly focused on event identification and frequency variation, while lacking a systematic investigation of the directional differences between drought-to-flood (DF) and flood-to-drought (FD) events in terms of process structure, cumulative effects, and spatial hazard patterns. Based on daily precipitation data from 1960 to 2024, this study identified DFAA events in the Yellow River Basin by combining the standardized weighted average precipitation (SWAP) index with run theory, and analyzed the asymmetric characteristics of DF and FD events from the perspectives of event frequency, phase duration, abrupt-transition characteristics, cumulative severity, and integrated hazard. The results show that: (1) the frequency of DFAA events in the Yellow River Basin exhibited pronounced spatial heterogeneity, with an overall pattern of being higher in the middle reaches and lower in the upper and lower reaches. The frequency of DF events was generally higher than that of FD events, and their spatial distribution was also more continuous. No significant long-term trend was detected in the annual frequency, although clear interdecadal variability was observed, characterized by a transition from relatively low-frequency periods to medium- and high-frequency periods. (2) DF and FD events exhibited stable asymmetry in process structure. The abrupt-transition duration of DF events was mainly concentrated within 1–2 days, whereas that of FD events was mainly concentrated within 3–5 days. The two event types had comparable pre-transition durations, but DF events tended to shift more rapidly and were followed by a longer-lasting flood phase. (3) The differences between the two event types in terms of instantaneous intensity were relatively limited, whereas clearer divergence was observed in cumulative severity, with DF events showing greater overall severity than FD events. This indicates that the directional difference is manifested primarily in cumulative process effects rather than in the magnitude at a single moment. (4) The comprehensive hazard index (CHI) revealed that the northern and central-eastern parts of the middle reaches of the Yellow River Basin were the main hotspots of DFAA hazard. Among them, high-hazard areas of DF events were more extensive, whereas FD hazards were characterized more by localized intensification. These findings indicate that within the identification framework adopted here, DFAA in the Yellow River Basin is characterized not only by rapid dry–wet transitions, but also by clear directional differences between DF and FD in process structure and hazard pattern. This study can provide a scientific reference for the monitoring, early warning, and zonal hazard prevention of DFAA in the basin. Full article

Great Britain has a temperate climate, but like other countries, its weather patterns have already been profoundly affected by climate change, and the changes are very likely to continue for decades. It also has an older building stock than most other countries, which may mean it is more difficult to adapt the built environment to reduce vulnerability to climate hazards. However, Great Britain has excellent mapping and buildings data. The built environment is better described than most other countries, and the authors’ work on the National Buildings Database for Great Britain, which draws together the most reliable sources of data covering non-domestic buildings in England, Scotland and Wales, provides an unparalleled opportunity to evaluate how many people will be affected by climate hazards. There has been considerable research effort assessing how housing will be affected by climate change, but so far much less systematic assessment of impacts on non-domestic buildings. Here, the authors examine three aspects of climate hazard affecting people in non-domestic buildings in Great Britain: (1) Overheating—How many and what types of non-domestic buildings are vulnerable to overheating risks in a heat wave? What total floor area is affected, and how many people typically occupy these buildings? (2) Flooding—How many and what types of non-domestic buildings are threatened by flooding now and in 2080? How much floorspace is threatened, and how many people typically occupy these buildings? (3) Safe space—How much air-conditioned ‘safe space’ is available where people vulnerable to overheating risks could retreat to in an emergency overheating event (e.g., schools or hospitals)? How many people could be accommodated, and what fraction of the total GB working population does this represent? We propose five new metrics to assess two of the immediate hazards posed by climate change (overheating and flooding) and to begin to assess to what extent Great Britain could find temporary accommodation for people displaced by these hazards. Full article

Due to climate change and its increased variability, as well as the extreme weather events, flooding is becoming a major natural threat causing profound economic, social, and ecological impact. This paper systematically reviews 89 peer-reviewed articles published between 2010 and 2024 on flood risk assessment approaches, including geospatial techniques and methods for flooding, using the PRISMA framework and the ScienceDirect and Web of Science databases. GIS and remote sensing are the most popular tools for flood hazard mapping, and hydrodynamic models such as HEC-RAS and MIKE FLOOD dominate flood simulation. Machine learning algorithms, multi-criteria decision analysis (MCDA), and climate scenario analysis have also emerged as increasingly prominent methodological contributions to flood risk frameworks. This review makes a novel contribution by providing the first systematic synthesis of geospatial flood risk assessment methods, explicitly quantifying both the urban–rural research imbalance and the degree of hazard, vulnerability, and exposure integration across the literature. Specifically, only 13 (2.7%) of all eligible articles addressed rural flooding, despite the profound socioeconomic impacts that disproportionately affect these communities, and only 16% of included studies integrated any combination of hazard, vulnerability, and exposure components within current assessment approaches. This review highlights the importance of interdisciplinary collaboration and sensitivity to rural contexts in cultivating resilience and fostering equitable flood risk management. Full article

The widespread adoption of photovoltaic systems in residential electrical installations has increased the importance of Automatic Transfer Switches (ATSs) for ensuring power continuity during grid outages. However, many low-cost ATS solutions available on the market prioritize economic efficiency over operational safety, leading to significant risks under fault conditions. This paper investigates a real overvoltage incident in a residential three-phase installation equipped with a photovoltaic inverter and an ATS, which resulted in the failure of multiple electronic loads. The study reconstructs the event and demonstrates that the loss of the neutral conductor during backup operation caused severe phase voltage imbalance, generating overvoltage conditions across lightly loaded phases. A simplified electrical model is used to explain current paths and voltage redistribution under asymmetric loads, highlighting the critical role of correct neutral switching in ATS design. Two commercially available ATS architectures, one based on a changeover-contact mechanism and one employing four-pole miniature circuit breakers, are experimentally evaluated. The evaluation reveals major design deficiencies, including the absence of protective elements for control circuits, reliance on mechanical end-position limiters, and the use of switching devices not intended for frequent source transfer. These shortcomings introduce risks such as uncontrolled actuator operation, overheating, mechanical damage, and potential fire hazards. To overcome these limitations, a new ATS architecture was developed using a phase-monitoring relay, interlocked ABB contactors, and dedicated fuse protection for all control circuits. Detailed laboratory measurements were conducted to characterize contactor switching times and internal relay command delays. By optimizing the command sequence, the proposed ATS achieves predictable, fault-tolerant operation with competitive transfer times, representing a meaningful safety improvement over the evaluated commercial alternatives. The proposed solution is scoped to three-phase residential installations equipped with a hybrid photovoltaic inverter providing a dedicated backup output, operating within TN-S or TN-C-S earthing systems with a maximum grid connection capacity of 21 kW. Full article

Weather-related hazards cause significant societal impacts, yet systematic long-term analyses linking these events to all levels of impact severity remain limited. This study investigates weather-related events and their associated impacts in Greece (2000–2025) using the High-Impact Weather Events Database (HIWE-DB). The HIWE-DB records 626 events, corresponding to 1871 localized records and includes 269 confirmed fatalities. Flood-related hazards are dominant, followed by windstorms, while one-third of all events involve multiple hazardous phenomena. A multilevel analysis, independently assessing weather intensity (W) and impact severity (I), reveals a statistically significant annual increase in the total number of events, driven mainly by low- to moderate-impact events (I1-I2), alongside an increase in high-intensity events (W3). While the most severe events (I3) show high annual variability, they exhibit a 38% increase in the second half of the study period compared to the first. Spatially, societal impacts are predominantly concentrated in major metropolitan areas, whereas the highest per capita fatality rates occur in specific regions, such as West Attica. The findings demonstrate how the independent indicators of intensity and severity contribute to understanding the link between weather hazards and societal exposure, providing an empirical basis for evidence-based risk assessment and impact-based early warnings. Full article

Transmission lines in Southwestern China are highly exposed to compound hazards induced by extreme winds and ice and snow conditions. This study assesses future changes in extreme wind hazards and their spatial overlap with baseline ice susceptibility under the SSP2-4.5 emission scenario, using high-resolution dynamically downscaled climate projections. Compared to the historical period (1995–2014), the results indicate a marked intensification of extreme spring wind events over northwestern Southwestern China and the transitional zone between the Sichuan Basin and the Hengduan Mountains during 2041–2060. The occurrence frequency of wind speeds exceeding historical 50-year return levels is projected to increase by 5–10 times in complex terrain, particularly along the Golmud–Qaidam belt. The Comprehensive Extreme Wind Index (CEWI) identifies the Golmud–Wulanwusu–Qaidam river basin belt as the region of highest wind hazard amplification. Meanwhile, analysis of historical observations reveals that icing-prone conditions occur on more than 25 days each spring in the Nyenchentanglha Mountains and southeastern Tibetan Plateau valleys, establishing a baseline map of ice susceptibility. Due to methodological limitations in projecting future icing, this susceptibility map is used as a static indicator of ice-prone areas. By superimposing projected wind intensification onto the baseline ice susceptibility map, four relative hazard exposure categories are delineated. Regions of highest potential exposure are concentrated in the Bayan Har Mountains and portions of the western Hengduan Mountains, whereas northwestern basins are dominated by high wind risk alone. These results reveal pronounced spatial heterogeneity in the relative amplification of compound hazards under future warming and provide a scenario-informed scientific basis for prioritizing regions in disaster risk reduction and resilient planning of transmission infrastructure in mountainous regions. Full article