Search Results (947)

With the acceleration of urbanization in China, water resources have become a key factor restricting regional sustainable development. Current research primarily examines the temporal or spatial variations in the water resources ecological footprint (WREF), with limited emphasis on the integration of both spatial and temporal scales. In this study, we collected the data and information from the 2005–2022 Statistical Yearbook and Water Resources Bulletin of the Yangtze River Delta Urban Agglomeration (YRDUA), and calculated evaluation indicators: WREF, water resources ecological carrying capacity (WRECC), water resources ecological pressure (WREP), and water resources ecological surplus and deficit (WRESD). We primarily analyzed the temporal and spatial variation in the per capita WREF and used the method of Geodetector to explore factors driving its temporal and spatial variation in the YRDUA. The results showed that: (1) From 2005 to 2022, the per capita WREF (total water, agricultural water, and industrial water) of the YRDUA generally showed fluctuating declining trends, while the per capita WREF of domestic water and ecological water showed obvious growth. (2) The per capita WREF and the per capita WRECC were in the order of Jiangsu Province > Anhui Province > Shanghai City > Zhejiang Province. The spatial distribution of the per capita WREF was similar to those of the per capita WRECC, and most areas effectively consume water resources. (3) The explanatory power of the interaction between factors was greater than that of a single factor, indicating that the spatiotemporal variation in the per capita WREF of the YRDUA was affected by the combination of multiple factors and that there were regional differences in the major factors in the case of secondary metropolitan areas. (4) The per capita WREF of YRDUA was affected by natural resources, and the impact of the ecological condition on the per capita WREF increased gradually over time. The impact factors of secondary metropolitan areas also clearly changed over time. Our results showed that the ecological situation of per capita water resources in the YRDUA is generally good, with obvious spatial and temporal differences. Full article

This research examines the compounding risks of global environmental change, including climate change, environmental law, biodiversity loss, and pollution, which threaten the stability of economic systems worldwide. While digital technology and global governance regulation are increasingly being proposed as solutions, their synergistic potential in advancing economic sustainability has been less explored. How can these technologies mitigate environmental risks while promoting sustainable and equitable development, aligning with the Sustainable Development Goals? We analyze policy global environmental data from the World Bank and the United Nations, as well as literature reviews on digital interventions, artificial intelligence, and smart databases. Global environmental change presents economic stability and rule of law threats, and innovative governance responses are needed. This study evaluates the potential for digital technology to be leveraged to enhance climate resilience and regulatory systems and address key implementation, equity, and policy coherence deficits. Policy recommendations for aligning economic development trajectories with planetary boundaries emphasize that proactive digital governance integration is indispensable for decoupling growth from environmental degradation. However, fragmented governance and unequal access to technologies undermine scalability. Successful experiences demonstrate that integrated policies, combining incentives, data transparency, and multilateral coordination, deliver maximum economic and environmental co-benefits, matching digital innovation with good governance. We provide policymakers with an action plan to leverage technology as a multiplier of sustainability, prioritizing inclusive governance structures to address implementation gaps and inform legislation. Full article

Background/Objectives: Pituitary tumors account for over 90% of all sellar region masses. However, a spectrum of rare neoplastic, inflammatory, infectious, and vascular lesions—benign and malignant—can arise in the intra- and parasellar compartments and clinically and radiologically mimic PitNETs. We report a cohort of 47 such rare and cystic midline intracranial lesions, emphasizing their distinctive morphological, clinical, and imaging features and the personalized treatment strategies applied. Methods: In this retrospective single-center study, we reviewed all patients treated for suspected PitNETs via transsphenoidal approach between 2015 and 2024. Of 529 surgical cases, we excluded confirmed PitNETs, meningiomas, and classical intradural craniopharyngiomas. Collected data encompassed patient demographics, tumor characteristics, presenting symptoms, extent of resection or medical therapy, endocrine outcomes, and follow-up information. Results: Among all 529 patients who underwent surgical treatment for sellar lesions from 2015 to 2024, 47 cases (8.9%) were identified as rare or cystic masses. Forty-six underwent transsphenoidal resection; one patient with hypophysitis received corticosteroid therapy alone. Presenting symptoms included headache (n = 16), dizziness (n = 5), oculomotor disturbances (n = 2), and visual impairment (n = 17). Endocrine dysfunction was found in 30 patients, 27 of whom required hydrocortisone replacement. Histopathological diagnoses were led by colloid cysts (n = 14) and Rathke’s cleft cysts (n = 11). The remaining 22 cases comprised plasmacytoma, germinoma, lymphoma, pituicytoma, inverted papilloma, metastatic carcinoma, chordoma, nasopharyngeal carcinoma, chloroma, and other rare entities. Preoperative imaging diagnosis proved incorrect in 38% (18/47) of cases, with several lesions initially misidentified as PitNETs. Conclusions: Nearly 9% of presumed PitNETs were rare, often benign or inflammatory lesions requiring distinct management. Most could be safely resected and demonstrated excellent long-term outcomes. Yet, despite advanced imaging techniques, accurate preoperative differentiation remains challenging, with over one-third misdiagnosed. Clinical red flags—such as early hormone deficits, rapid progression or atypical imaging findings—should prompt early interdisciplinary evaluation and, when indicated, image-guided biopsy to avoid unnecessary surgery and ensure tailored therapy. Full article

Individuals with autism spectrum disorder (ASD) have deficits in social–emotional competence. Most people with ASD have difficulties in emotion recognition, emotion understanding, emotion expression, and emotion regulation, which seriously affects their normal social communication and interaction. The information technology (IT) era has given more possibilities for intervention training for people with ASD, and research has proven that technological interventions have a significant effect on the socio-emotional competence of people with ASD. This study employed a meta-analytic approach using 32 independent effect sizes from 25 studies to investigate the effects of IT interventions on socio-emotional competence in individuals with ASD, using emotion recognition, understanding, expression, and regulation as dependent variables and examining key moderating factors. The results found that information technology has an excellent effect on social–emotional competence in ASD (Hedges’ g = 0.897, CI = 0.676, 1.117, z = 7.967, p < 0.001) and is significantly moderated by the intervention technique (Q = 7.392, p = 0.025) and the intervener (Q = 4.933, p = 0.026). The findings provide insights into further deepening information technology intervention research as well as practical applications. Full article

In early May 2025, extreme wildfires swept across Manitoba, Canada, fueled by unseasonably warm temperatures, prolonged drought, and stressed vegetation. We explore how multi-source satellite indicators—such as anomalies in snow cover, precipitation, temperature, vegetation indices, and soil moisture in April–May—jointly signal landscape preconditioning for fire, highlighting the potential of these compound anomalies to inform fire risk awareness in boreal regions. Results indicate that rainfall deficits and diminished snowpack significantly reduced soil moisture, which subsequently decreased vegetative greenness and created a flammable environment prior to ignition. This concept captures how multiple moderate anomalies, when occurring simultaneously, can converge to create high-impact fire conditions that would not be flagged by individual thresholds alone. These findings underscore the importance of integrating climate and biosphere anomalies into wildfire risk monitoring to enhance preparedness in boreal regions under accelerating climate change. Full article

Background: Autism spectrum disorder (ASD) is characterised by atypical behavioural and cognitive diversity, yet the neural underpinnings linking brain activity and individual presentations remain poorly understood. In this study, we investigated the relationship between resting-state functional magnetic resonance imaging (fMRI) signal complexity and intelligence (full-scale intelligence quotient (FIQ); verbal intelligence quotient (VIQ); and performance intelligence quotient (PIQ)) in male adults with ASD (n = 14) and matched neurotypical controls (n = 15). Methods: We used three complexity-based metrics: Hurst exponent (H), fuzzy approximate entropy (fApEn), and fuzzy sample entropy (fSampEn) to characterise resting-state fMRI signal dynamics, and correlated these measures with standardised intelligence scores. Results: Using a whole-brain measure, ASD participants showed significant negative correlations between PIQ and both fApEn and fSampEn, suggesting that increased neural irregularity may relate to reduced cognitive–perceptual performance in autistic individuals. No significant associations between entropy (fApEn and fSampEn) and PIQ were found in the control group. Group differences in brain–behaviour associations were confirmed through formal interaction testing using Fisher’s r-to-z transformation, which showed significantly stronger correlations in the ASD group. Complementary regression analyses with interaction terms further demonstrated that the entropy (fApEn and fSampEn) and PIQ relationship was significantly moderated by group, reinforcing evidence for autism-specific neural mechanisms underlying cognitive function. Conclusions: These findings provide insight into how cognitive functions in autism may not only reflect deficits but also an alternative neural strategy, suggesting that distinct temporal patterns may be associated with intelligence in ASD. These preliminary findings could inform clinical practice and influence health and social care policies, particularly in autism diagnosis and personalised support planning. Full article

The insular cortex has emerged as a key region implicated in a wide array of cognitive, emotional, and sensory processes. The anterior part of the insula (AIC) is central to emotional awareness, decision-making, and interoception, while the posterior insula (PIC) is more associated with somatosensory processing. The insula acts as a functional hub within the salience network and integrates homeostatic, affective, and cognitive information; thus, its role in different mental disorders seems to be prominent. Altered structure and connectivity of the insular cortex are evident in several psychiatric conditions. In schizophrenia, reductions in insular volume—especially on the left—correlate with hallucinations, emotional dysregulation, and cognitive deficits. Bipolar and major depressive disorders exhibit AIC volume loss and aberrant connectivity patterns linked to impaired affect regulation and interoceptive awareness. Anxiety disorders show functional hyperactivity of the insula, especially in response to fear-inducing stimuli, though findings on structural changes are mixed. Overall, growing evidence underscores the insular cortex’s central role in psychiatric pathophysiology and highlights its potential as a target for future diagnostic and therapeutic strategies. Full article

Alexithymia is a trait-like deficit in the cognitive processing of emotions, characterized by difficulty identifying and describing feelings, externally oriented thinking, and limited imaginal capacity. It reflects a deficit in emotional intelligence, specifically in the intrapersonal ability to understand and manage one’s own emotional states and to similarly recognize how others might view them. Emotional intelligence has been conceptualized as a distinct form of intelligence that involves emotion-related mental abilities and meets standard psychometric criteria for inclusion within the broader taxonomy of human intelligences. Increasingly, alexithymia is also understood as a failure of affect-focused mentalization, or the ability to perceive emotions in oneself and others as intentional states. This study examined alexithymia using a multi-informant approach to assess intrapersonal and interpersonal emotional awareness. A sample of 211 university students and their informants completed the Toronto Alexithymia Scale (TAS-20), an informant version (TAS-20-IF), and a novel meta-perception version (TAS-20-Meta). Two hypotheses were tested and supported: (1) participants underestimated their alexithymia traits relative to informant ratings and (2) self- and meta-perception ratings were more strongly correlated than either was with informant ratings. These findings support the view that alexithymia reflects deficits in both affective mentalization and a specific domain of human intelligence. Full article

Earthen flood protection structures are planned and constructed with an expected service life of several decades while being exposed to environmental impacts that may lead to structural or hydraulic failure. Current maintenance procedures involve only repairing external damage, leaving internal processes contributing to structural damage often undetected. Through structural health monitoring (SHM), structural deficits can be detected before visible damage occurs. To improve maintenance workflows and support predictive maintenance of dikes, this paper reports on the integration of digital twin concepts with SHM strategies, referred to as “digital-twin-based SHM”. A digital twin concept, including a standard-compliant building information model, is proposed and implemented in terms of a digital twin environment. For integrating monitoring and sensor data into the digital twin environment, a customized webform is designed. A communication protocol links preprocessed sensor data stored on a server with the digital twin environment, enabling model-based visualization and contextualization of the sensor data. As will be shown in this paper, a digital twin environment is set up and managed in the context of SHM in compliance with technical standards and using well-established software tools. In conclusion, digital-twin-based SHM, as proposed in this paper, has proven to advance predictive maintenance of dikes, contributing to the resilience of critical infrastructure against environmental impacts. Full article

Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains—including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life—among hemodialysis patients. Materials and Methods: A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman’s or Pearson’s correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Results: Age showed moderate positive correlations with fatigue (ρ = 0.44–0.53), cognitive deficits (ρ = 0.37–0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant (p < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). Conclusions: While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies. Full article

Background/Objectives: The co-existence of multiple compression sites on the same nerve can pose a clinical and diagnostic challenge, warranting a different treatment strategy. This so-called double crush syndrome (DCS) has mainly been investigated in the upper limb. Only a few studies have investigated DCS for the lower limb. In this article, a single-center illustrative clinical case series is presented, and current literature on L5 nerve root (NR) and concomitant common peroneal nerve (CPN) is reviewed. Methods: All patients presenting between 2019 and 2022 with L5 nerve root (NR) compression and, along their clinical courses, concomitant compression of the common peroneal nerve (CPN) at the fibular head were included. Information on clinical features, diagnostics and surgeries was obtained. The outcome was assessed at the last outpatient follow-up appointment. In addition, an extensive literature review has been conducted. Results: Fourteen patients were included with a mean follow-up of 6.8 months. The majority had pain (71%) or motor deficits (71%). Seven patients were referred for clinical and radiological L5 NR compression but were also found to have CPN compression; the other seven patients had persisting or recurrent symptoms after surgically or conservatively treated L5 NR compression, suggestive of additional peroneal neuropathy. All patients had CPN decompression at the fibular head, with successful results obtained in 93% of the patients. Pain of the lower leg improved in all patients, and dorsiflexion function improved in 78%. Conclusions: Concomitant L5 NR and CPN appear to occur more frequently than expected. Peroneal neuropathy can present simultaneously with L5 nerve radiculopathy or after surgically or conservatively treated L5 NR compression. Overlapping symptoms and variation in clinical presentations make it difficult to diagnose and, therefore, underrecognized. More awareness among treating physicians of this specific double crush syndrome is important to prevent any delay in treatment, in this case, a less invasive common peroneal nerve release at the fibular head, and to avoid unnecessary (additional) spinal surgery. Full article

Over the past three turbulent decades, research has profoundly reshaped our understanding of chronic Toxoplasma gondii infection—traditionally regarded as harmless in immunocompetent individuals—unveiling its surprising impact on human health, performance, and behavior. This review emphasizes the effects of chronic Toxoplasma infection on physical and mental health, cognitive performance, and behavioral changes, highlighting key findings from studies investigating these domains, with a particular focus on both ultimate and proximate mechanisms underlying the observed effects. To this end, the primary focus will be on human studies; however, animal model studies will also be thoroughly considered when necessary and appropriate, to provide context and additional important information. Research demonstrates that chronic Toxoplasma infection may contribute to a broad spectrum of physical health issues. Ecological studies have revealed correlations between toxoplasmosis prevalence and increased morbidity and mortality from various conditions, including cardiovascular diseases, neurological disorders, and certain cancers. Large-scale cross-sectional studies have further shown that infected individuals report a higher incidence of numerous health complaints and diagnosed diseases, suggesting a significant impact on overall physical well-being. In addition to physical health, lifelong Toxoplasma infection (subclinical toxoplasmosis) has been implicated in cognitive impairments and behavioral changes. Studies have reported associations between infection and poorer performance in areas such as reaction time, processing speed, working memory, and executive function. Many of these behavioral changes likely relate to worsened health and a shift towards a “fast life history strategy.” These cognitive deficits can have significant implications for daily functioning and performance. Furthermore, the role of Toxoplasma infection in the development or exacerbation of mental health disorders has been extensively investigated. Meta-analyses, ecological studies, and large-scale observational studies have demonstrated associations between Toxoplasma infection and an increased risk of disorders such as schizophrenia and obsessive–compulsive disorder. While the precise mechanisms underlying these associations remain under investigation, research suggests that neuroinflammation and alterations in neurotransmitter systems are likely to play a role. Far from being harmless, subclinical toxoplasmosis is increasingly recognized as a hidden factor influencing human health, behavior, and cognitive performance—with implications that extend well beyond the individual to public health at large. Further research is warranted to elucidate the complex interplay between Toxoplasma infection, host physiology, and the development of various physical, cognitive, behavioral, and mental health conditions. Full article

Background: Borderline personality disorder (BPD) is a severe psychiatric condition characterised by emotional instability, impulsivity, interpersonal dysfunction, and self-injurious behaviours. Despite growing clinical interest, the neuropsychological mechanisms underlying these symptoms are still not fully understood. This review aims to summarise findings from neuroimaging, psychophysiological, and neurodevelopmental studies in order to clarify the neurobiological and physiological basis of BPD, with a particular focus on emotional dysregulation and implications for the treatment of adolescents. Methods: A narrative review was conducted, integrating results from longitudinal neurodevelopmental studies, functional and structural neuroimaging research (e.g. FMRI and PET), and psychophysiological assessments (e.g., heart rate variability and cortisol reactivity). Studies were selected based on their contribution to understanding the neural correlates of BPD symptom dimensions, particularly emotion dysregulation, impulsivity, interpersonal dysfunction, and self-harm. Results: Findings suggest that early reductions in amygdala volume, as early as age 13 predict later BPD symptoms. Hyperactivity of the amygdala, combined with hypoactivity in the prefrontal cortex, underlies deficits in emotion regulation. Orbitofrontal abnormalities correlate with impulsivity, while disruptions in the default mode network and oxytocin signaling are related to interpersonal dysfunction. Self-injurious behaviour appears to serve a neuropsychological function in regulating emotional pain and trauma-related arousal. This is linked to disruption of the hypothalamic-pituitary-adrenal (HPA) axis and structural brain alterations. The Unified Protocol for Adolescents (UP-A) was more effective to Mentalization-Based Therapy for Adolescents (MBT-A) at reducing emotional dysregulation compared, though challenges in treating identity disturbance and relational difficulties remain. Discussion: The reviewed evidence suggests that BPD has its in early neurodevelopmental vulnerability and is sustained by maladaptive neurophysiological processes. Emotional dysregulation emerges as a central transdiagnostic mechanism. Self-harm may serve as a strategy for regulating emotions in response to trauma-related neural dysregulation. These findings advocate for the integration of neuroscience into psychotherapeutic practice, including the application of neuromodulation techniques and psychophysiological monitoring. Conclusions: A comprehensive understanding of BPD requires a neuropsychologically informed framework. Personalised treatment approaches combining pharmacotherapy, brain-based interventions, and developmentally adapted psychotherapies—particularly DBT, psychodynamic therapy, and trauma-informed care—are essential. Future research should prioritise interdisciplinary, longitudinal studies to further bridge the gap between neurobiological findings and clinical innovation. Full article

The growing influence of technology in the healthcare industry has led to the creation of innovative applications that improve convenience, accessibility, and diagnostic accuracy. However, health applications face significant challenges concerning user privacy and data security, as they handle extremely sensitive personal and medical information. Privacy-Enhancing Technologies (PETs), such as Privacy-Attribute-based Credentials, Differential Privacy, and Federated Learning, have emerged as crucial tools to tackle these challenges. Despite their potential, PETs are not widely utilized due to technical and implementation obstacles. This research introduces a comprehensive framework for protecting health applications from privacy and security threats, with a specific emphasis on gamified mental health apps designed to manage Attention Deficit Hyperactivity Disorder (ADHD) in children. Acknowledging the heightened sensitivity of mental health data, especially in applications for children, our framework prioritizes user-centered design and strong privacy measures. We suggest an identity management system based on blockchain technology to ensure secure and transparent credential management and incorporate Federated Learning to enable privacy-preserving AI-driven predictions. These advancements ensure compliance with data protection regulations, like GDPR, while meeting the needs of various stakeholders, including children, parents, educators, and healthcare professionals. Full article

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex neurodevelopmental condition typically requiring information from multiple informants for accurate diagnosis. However, the consistency and diagnostic value of reports from teachers, parents, primary care providers (PCPs), and other professionals remain debated. This study aimed to examine the role and diagnostic accuracy of different informants in the referral and diagnostic process for ADHD in children aged 3–11. Methods: This retrospective study analyzed data from 120 children referred for suspected ADHD. Initial reports were obtained from teachers, parents, PCPs, and other professionals, and final diagnoses were determined through comprehensive neuropsychiatric evaluations. Diagnostic concordance and informant-specific contributions were assessed. Results: Of the 120 children, 64 (53.3%) received an ADHD diagnosis. Teachers were the most frequent informants, followed by parents, with fewer referrals from PCPs and other professionals. No significant differences in diagnostic accuracy were found among informants, aligning with previous studies suggesting that no single informant is superior in identifying ADHD. Notably, over 93% of referred children were diagnosed with a neuropsychiatric disorder, though not necessarily ADHD. Conclusions: The findings underscore the importance of combining reports from parents and teachers to capture symptom expression across different environments, which is essential for accurate ADHD diagnosis. Enhanced training for informants and a multidisciplinary approach is recommended to improve diagnostic accuracy and support early identification and intervention efforts. These results support nuanced evaluation strategies that account for informant variability and help mitigate potential misinterpretations of ADHD symptoms. Full article