Search Results (836)

Groundwater in arid and semi-arid regions is increasingly stressed by low rainfall, high evaporation, population growth, agricultural expansion, and climate change. A critical question is whether non-renewable aquifers can sustain rising water demand without irreversible decline. This study addresses that question for the Al Kufrah Basin in southeastern Libya, part of the Nubian Sandstone Aquifer System, the world’s largest fossil aquifer. A three-dimensional groundwater flow model (MODFLOW-2000) was calibrated using data from more than 1000 production wells and 32 piezometers spanning 1968–2022. The model was applied to simulate groundwater behavior under five scenarios extending to 2050, including the planned development of 150 new wells. The results indicate that over 85% of withdrawals are derived from aquifer storage rather than boundary inflows. While regional water levels remain relatively stable over the 25-year horizon, localized drawdowns of up to 11 m are expected near new well fields. These findings highlight short-term resilience but point to long-term vulnerability, as continued reliance on non-renewable reserves without recharge will ultimately lead to depletion. The study underscores the need for adaptive management, climate-resilient water strategies, and regional cooperation to ensure the sustainable use of this transboundary aquifer under increasing environmental and socio-economic pressures. Full article

Lake Erhai is an important plateau freshwater lake in China. It serves not only as a crucial drinking water source for the local region but also as the core area of the Cangshan Erhai National Nature Reserve. Consequently, Lake Erhai plays an extremely significant role in the local economy, society, and ecology. Since 2000, the water quality of Lake Erhai has continuously deteriorated, showing a eutrophic trend. To identify the primary driving forces behind these water quality changes, this study employed stepwise regression analysis. Climate conditions, socio-economic development within the basin, and implementation of environmental protection measures (IEPMs) were considered influencing factors for a comprehensive and systematic analysis of Lake Erhai’s water quality. The results indicate that rising air temperature may increase total phosphorus (TP) concentration, while rainfall may elevate both TP and total nitrogen (TN) levels. In contrast, higher wind speed may reduce chemical oxygen demand (COD_Mn), TP, and TN concentrations. Socio-economic development, meanwhile, may contribute to increased COD_Mn concentration. Based on these findings, this paper proposes recommendations focusing on formulating more effective non-point source pollution control measures and strengthening water quality monitoring in Lake Erhai during summer. By identifying the key natural and anthropogenic drivers of water quality changes in Lake Erhai, this study provides a scientific basis for the development of targeted pollution control strategies and directly contributes to the protection of clean water sources. Moreover, its revelation of the coupled impacts of climate change and socio-economic activities enhances understanding of plateau lake ecosystem resilience. This insight is critical for ensuring regional ecological security and serves as a model for advancing sustainable development goals in similar lake systems worldwide. Full article

Carbapenems comprise a class of β-lactam antibiotics with broad-spectrum hydrolytic activity and are often reserved as last-line agents for the treatment of serious multidrug-resistant (MDR) bacterial infections. Clinically important nosocomial MDR Gram-negative bacteria (GNB) include Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Carbapenem resistance among these organisms is predominantly mediated by the production of β-lactamases called carbapenemases, such as K. pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), and selected oxacillinase (OXA)-type carbapenemases. These enzymes degrade carbapenems, significantly compromising their clinical efficacy. To address escalating antimicrobial resistance, novel next-generation β-lactamase inhibitors (BLIs), partnered with established β-lactams (BLs), have been approved or are currently under development to inhibit carbapenemase activity. The present narrative review aims to synthesize the most current information on the major carbapenemases and discusses recently approved and investigational BL/BLI combination therapies in terms of their mechanisms of action, spectrum of activity, gaps in coverage, and available clinical and in vitro evidence. Development of resistance to novel BL/BLI combinations is also examined. Comparative analysis of inhibitory spectra and microbiological coverage indicates a continued need for metallo-β-lactamase inhibitors with direct pan-inhibitory activity, pathogen-specific BL/BLI regimens for carbapenem-resistant A. baumannii, and carbapenemase-targeted agents effective in the context of non-enzymatic resistance mechanisms. Treatment-emergent resistance to novel BL/BLIs and limitations in activity profiles underscore the critical need for continued innovation in pipeline development, vigilant global and local surveillance of carbapenemase epidemiology, and robust antimicrobial stewardship strategies to aid in preserving the efficacy of the antibacterial drug armamentarium. Full article

The structural integrity of bogie frames is a critical factor in the safety and reliability of railway rolling stock, requiring advanced assessment methods to handle complex, multi-axial stress states. This research presents a robust numerical framework for the preliminary fatigue evaluation of a metro bogie frame, integrating high-fidelity Finite Element Analysis (FEA) with the Findley multi-axial fatigue criterion. The methodology overcomes the limitations of traditional uniaxial verification methods by employing a localized critical plane approach, implemented through a proprietary computational code. The investigation simulates a realistic operational scenario by superimposing a static vertical load of 15 tons per side with dynamic components derived from on-track accelerometric data. This integrated loading condition enables a precise reproduction of the “rotating” stress states typically encountered in service. Global structural analysis identified critical transverse welded joints as high-stress concentration zones, which were then subjected to a detailed multi-axial investigation. By correlating the extracted stress tensors with the resistance category included in the reference standard, over a regulatory life of 10 million cycles, a maximum cumulative damage index of 0.4602 was recorded. The results demonstrate that while the frame possesses adequate structural reserves, nearly half of its fatigue life is consumed in localized nodes. This methodology provides a reliable and computationally efficient tool for the structural health monitoring and development of innovative railway geometries, offering a superior predictive capability that remains scarcely utilized by major rolling stock manufacturers. Full article

High-penetration renewable energy significantly increases uncertainty, dynamic network coupling, and the need for secure and coordinated smart-grid dispatch. To address the limitations of conventional forecasting-based and static graph-based methods, this paper proposes a unified dispatch framework that integrates topology-informed dynamic graph learning, privacy-aware multi-agent symbiotic reinforcement learning, and structural causal intervention analysis. The dispatch problem is formulated as a constrained partially observable stochastic game, in which multiple agents coordinate generation adjustment, reserve allocation, and congestion-aware corrective actions under engineering constraints. A physics-informed dynamic graph convolutional module captures both fixed physical topology and stress-dependent operational couplings, while a KL-regularized multi-agent reinforcement learning scheme improves cooperative task allocation under renewable fluctuations. Federated optimization with Rényi differential privacy is introduced to protect sensitive local operational information during training. In addition, a structural causal module provides intervention-based interpretation of how wind variation, load escalation, and line stress affect dispatch cost, congestion risk, and renewable curtailment. Experiments on a public-trace-driven benchmark based on a modified IEEE 30-bus system show that the proposed method achieves the best overall performance among the compared baselines, reducing dispatch-cost RMSE to 3.82, locational-price MAE to 2.95, renewable curtailment to 4.8%, and the constraint-violation rate to 0.30%. Overall, the framework shows favorable performance on the test benchmark, provides post hoc intervention-based interpretation of dispatch outcomes, and is evaluated under a reproducible benchmark construction and assessment protocol. Full article

Background: Care for knee osteoarthritis (KOA) is frequently fragmented, and pathway-level decisions within Physical Medicine and Rehabilitation (PM&R) are influenced by local organizations. The objective of this study was to identify areas of agreement and disagreement among PM&R experts and to translate these into a clinically interpretable, function-oriented care pathway for knee osteoarthritis (KOA) within rehabilitation services. Methods: A two-round Real-Time Delphi study was conducted using the SmartDelphi web platform. A steering committee of five PM&R physicians developed a 37-item questionnaire covering referral/access, functional and outcome assessment, conservative management, escalation/referral thresholds, and follow-up/discharge. Round 1 was online (SERMEF osteoarthritis working group; 46 invited, 40 completed; 87.0%) with responses collected until 30 April 2025. Round 2 was an in-person, facilitated validation round on 30 May 2025 at the SERMEF Congress (A Coruña; 85 invited, 70 completed; 82.4%). Items were rated on a 6-point Likert scale; consensus strength was defined by interquartile range (IQR): strong (0–1) vs. weak (≥2). No patient-level data were collected; participant characteristics were comparable across rounds, suggesting consensus refinement reflected deliberation rather than panel shifts over time. Results: Consensus supported a longitudinal, function-first pathway that was structured into five phases: entry/referral to PM&R; comprehensive functional assessment using a minimum outcomes dataset (pain VAS/NRS, WOMAC function, quality-of-life scale); multimodal conservative rehabilitation combining exercise/physiotherapy, education/self-management support, and indicated oral/topical therapies; reassessment-guided escalation in non-responders, reserving interventional PM&R techniques, multidisciplinary musculoskeletal pain-unit management, or orthopedic evaluation for persistent pain and/or functional limitation; and longitudinal monitoring with defined discharge criteria. Conclusions: SERMEF PM&R experts converged on an implementation-oriented, outcomes-driven KOA itinerary centred on functioning, conservative multimodal care, structured reassessment, and explicit discharge planning. Full article

Background/Objectives: The corneal endothelium maintains corneal transparency through its barrier function and active pumping mechanism that regulates stromal hydration. Limited regenerative capacity makes these cells vulnerable to progressive cell loss. Although local ocular factors are well known, recent data suggest that numerous systemic diseases may contribute to endothelial dysfunction and reduce endothelial reserve before the onset of clinically apparent corneal pathology. The purpose of this narrative review is to synthesize current evidence on the impact of systemic diseases on corneal endothelial health and to highlight the underlying mechanisms and clinical implications. Methods: A narrative literature review was conducted using the PubMed, MEDLINE, and Google Scholar databases for articles published between January 2000 and December 2025. Observational studies, case series, and review articles that evaluated structural or functional changes in the corneal endothelium in association with systemic diseases were included. Results: Reviewed literature shows that several categories of systemic diseases are associated with signs of corneal endothelial stress. These changes include decreased endothelial cell density, increased cell size variability, reduced hexagonality, and, in some cases, increased central corneal thickness. Metabolic, cardiovascular, renal, autoimmune, and hypoxic conditions, as well as extracellular matrix disorders and aging, show consistent associations with these changes. Conclusions: Systemic diseases can compromise corneal endothelial integrity and reduce functional reserve even in the absence of clinically evident corneal pathology. Recognition of these associations underscores the importance of evaluating the patient’s systemic context, including a detailed medical history and corneal endothelial analysis, particularly before intraocular surgery. Full article

This study investigates plant species diversity, regeneration patterns, and the ecological drivers influencing endangered plant species in the Than Sa–Phuong Hoang Nature Reserve, Thai Nguyen Province, Vietnam. Although tropical forest ecosystems in Southeast Asia are known for their high biodiversity, there is still a lack of site-specific studies that integrate species diversity, regeneration dynamics, and environmental drivers at the reserve scale. A total of 15 standard plots (20 × 50 m) were established across three main forest types (limestone forests, soil mountain forests, and transitional forests) to assess species composition, community structure, and regeneration patterns. Multivariate analyses, including principal component analysis (PCA) and cluster analysis, were applied to identify key ecological factors shaping species distribution and regeneration. The results recorded 1234 plant species belonging to 171 families, confirming the high biodiversity of the study area. Regeneration capacity differed significantly among forest types and was strongly influenced by environmental variables such as canopy cover, soil moisture, topography, and human disturbance. Multivariate results revealed clear ecological differentiation among forest types, highlighting the role of environmental filtering in structuring plant communities. The three target species (Curculigo orchioides Gaertn, Parashorea chinensis, and Paphiopedilum hirsutissimum Stein) exhibited strong dependence on stable microhabitat conditions and showed limited regeneration under disturbed environments, indicating high sensitivity to ecological changes and anthropogenic pressure. This study provides new insights into species–environment relationships at a local scale and highlights key ecological drivers of endangered plant distribution and regeneration, contributing to more effective conservation planning and biodiversity management in tropical forest ecosystems. Full article

With the exponential growth of natural gas reserves and utilization scale in China, underground gas storage (UGS) facilities—critical infrastructure within the natural gas production-supply-storage-sales system—have entered a phase of rapid expansion. As the core component connecting subsurface reservoirs with surface systems, wellbore integrity directly influences operational safety and service lifespan of UGS facilities. However, current leakage detection and integrity analysis methodologies for gas storage wellbores remain deficient in effective real-time monitoring capabilities. Traditional methods, however, are constrained by limited spatial coverage and insufficient precision, rendering them inadequate for comprehensive, continuous safety monitoring requirements. To address this industry challenge, this study proposes a real-time wellbore integrity monitoring framework based on distributed fiber optic sensing technology, integrating distributed temperature sensing (DTS) and distributed acoustic sensing (DAS) devices into a synergistic monitoring system. The DTS component enables preliminary localization of potential leakage points through detection of minute temperature anomalies along the wellbore, while the DAS unit accurately identifies acoustic signatures caused by gas leakage within casings via monitoring of acoustic vibration signals propagating along the optical fiber. Through joint analysis of DTS and DAS data streams, real-time diagnosis of wellbore leakage events and integrity status can be achieved. Field trials demonstrated that this hybrid monitoring system achieved leakage localization accuracy within 1.0 m, effectively distinguishing normal operational signals from abnormal leakage characteristics. During actual monitoring operations, no indications of wellbore integrity compromise were detected; only minor noise and interference signals originating from surface construction activities were observed. Full article

Radiation pneumonitis (RP), one of the most common and severe complications in locally advanced non-small cell lung cancer (LA-NSCLC) patients following thoracic radiotherapy, presents significant challenges in prediction due to the complexity of clinical risk factors, incomplete multimodal data, and unavailable slice-level annotations in pre-radiotherapy CT images. To address these challenges, we propose a multimodal fusion framework based on Dual-Layer Attention-Based Adaptive Bag Embedding Multiple-Instance Learning (DAAE-MIL) for accurate RP prediction. This study retrospectively collected data from 995 LA-NSCLC patients who received thoracic radiotherapy between November 2018 and April 2025. After screening, Subject datasets (n = 670) were allocated for training (n = 535), and the remaining samples (n = 135) were reserved for an independent test set. The proposed framework first extracts pre-radiotherapy CT image features using a fine-tuned C3D network, followed by the DAAE-MIL module to screen critical instances and generate bag-level representations, thereby enhancing the accuracy of deep feature extraction. Subsequently, clinical data, radiomics features, and CT-derived deep features are integrated to construct a multimodal prediction model. The proposed model demonstrates promising RP prediction performance across multiple evaluation metrics, outperforming both state-of-the-art and unimodal RP prediction approaches. On the test set, it achieves an accuracy (ACC) of 0.93 and an area under the curve (AUC) of 0.97. This study validates that the proposed method effectively addresses the limitations of single-modal prediction and the unknown key features in pre-radiotherapy CT images while providing significant clinical value for RP risk assessment. Full article

The geomorphological characterization of coastal–marine environments is essential for environmental management and biodiversity conservation. The objective of this study was to model the geomorphological diversity of the Punta de Coles National Reserve, located in Puerto de Ilo, Moquegua, Peru, using GNSS geodetic receivers, integrating topographic and bathymetric data to continuously represent both the emerged and submerged relief. The methodology involved establishing two “C”-order geodetic control points, implementing a closed polygon with 13 vertices, conducting a topographic survey, and recording bathymetric data along coastal transects extending 1 km offshore using an echo sounder and GNSS positioning. The data were processed in a GIS environment to generate a Coastal–Marine Digital Terrain Model (CM-DTM) with metric resolution. The results showed a total area of 171.451 ha, with elevation variations ranging from sea level to 71.617 m above sea level. Distinct geomorphological units were identified, such as coastal plains (0–5% slope), hills (15–35%), and cliffs (>45%), in addition to 16 rocky islets covering 1.537 ha. In the underwater environment, the model made it possible to identify submerged terraces, slopes, and local depressions down to a depth of −115 m, revealing a continuous transition between the land and sea topography; additionally, areas with a higher susceptibility to erosion and areas of high ecological importance were identified. This study’s contribution lies in the integration of GNSS geodetic data with topobathymetric surveys, which enabled the generation of a high-precision continuous model in an area with limited prior information, establishing a scientific baseline for coastal and marine management and conservation. Full article

Since the start of the U.S. Conservation Reserve Program (CRP) in 1985, producers have enrolled environmentally sensitive land in exchange for annual rental payments, supporting multiple dimensions of sustainability through reduced soil loss, improved water quality, enhanced habitat provision, and strengthened climate resilience through land stewardship. Recent declines in enrollment raise concerns about whether participation remains spatially aligned with local environmental need and economic incentives. This study examines regional variation in CRP participation and its sustainability implications by identifying spatial patterns in participation and key drivers using exploratory spatial data analysis (ESDA). We analyze county-level CRP participation rates alongside three key drivers (CRP rental rates, soil erosion risk on cultivated cropland, and farm income) and assess spatial dependence using Global Moran’s I, univariate Local Indicators of Spatial Association (LISA), and bivariate LISA (BiLISA). Framed as an assessment of agri-environmental policy effectiveness for sustainable land management, the framework is applied to counties in the U.S. Midwest, a region with historically substantial CRP enrollment. Global Moran’s I statistics indicate significant positive spatial autocorrelation for CRP participation (I = 0.491), CRP rental rates (I = 0.892), and soil erosion (I = 0.503), confirming pronounced regional clustering across Midwestern counties. LISA results further show that more than 60% of counties fall into high–high (HH) or low–low (LL) clusters for CRP rental rates, while BiLISA results indicate that 22.9% of counties form HH clusters between CRP participation and soil erosion, suggesting only partial alignment between CRP participation and the environmental need. These findings indicate that the environmental benefits of CRP may vary across the region depending on where participation occurs. Overall, the findings support a shift toward a data-driven, spatially explicit CRP strategy that integrates environmental risk, economic incentives, and regional context to strengthen sustainability outcomes and enhance environmental effectiveness, economic efficiency, and the spatial equity of conservation benefits in the United States. Full article

Spatio-temporal analysis of land cover (LC) dynamics is essential for understanding landscape transformation in semi-arid woodland ecosystems. This study assessed historical and projected land cover changes in the Elnour Natural Forest Reserve (ENFR), Sudan, from 1995 to 2060. Historical maps for 1995, 2008, and 2021 were generated using a Random Forest classifier, while future scenarios for 2034, 2047, and 2060 were simulated using a Cellular Automata–Artificial Neural Network (CA–ANN) model. The results show that semi-bare land expanded from 23.1% in 1995 to 40.0% in 2021, while dense woodland declined from 26.7% to 15.7%, indicating substantial structural transformation of the landscape. Open woodland exhibited partial recovery, increasing to 39.9% in 2021. Future projections indicate a moderate increase in dense woodland to 23.8% by 2060; however, semi-bare land remains the dominant class, reflecting persistent landscape instability. These findings demonstrate the coexistence of degradation and localized regeneration processes in ENFR and highlight the importance of long-term monitoring of land cover dynamics in dryland environments. The study further shows that integrating machine learning classification with spatially explicit CA–ANN modeling provides an effective framework for analyzing historical trends and exploring potential future trajectories of land cover change in data-limited semi-arid regions. Full article

Early fault vibration signals from rolling bearings are typically nonlinear, non-stationary, and heavily obscured by background noise, which severely impedes the accurate extraction of fault features. To overcome the limitations of traditional stochastic resonance (SR)—specifically the small-parameter restriction for high-frequency signals and the subjectivity in parameter selection—this paper proposes an adaptive SR envelope spectroscopy method based on particle swarm optimization (PSO) and local mean decomposition (LMD). First, a variable-scale transformation is introduced to compress the high-frequency fault signals into the effective frequency band required by the adiabatic approximation theory. Second, utilizing the global search capability of PSO, the potential well parameters of the bistable system are adaptively optimized by maximizing the output signal-to-noise ratio (SNR), thereby achieving optimal matching between the nonlinear system and the input signal. Finally, the enhanced signal is decomposed by LMD, and the sensitive components are selected for envelope spectrum analysis to identify fault characteristics. Experimental validation using the Case Western Reserve University bearing dataset demonstrates that the proposed method effectively amplifies weak fault signals under strong noise conditions, exhibiting superior feature extraction accuracy and noise robustness compared to traditional methods. Full article

With the introduction of total neoadjuvant therapy (TNT) in locally advanced rectal cancer treatment, multidisciplinary treatment options have become more diverse than before, and many challenges remain unresolved. A randomized clinical study in intermediate-risk locally advanced rectal cancer showed that neoadjuvant full-dose systemic chemotherapy with response-adapted omission of radiation therapy is non-inferior to concurrent chemoradiotherapy. Given that preoperative systemic chemotherapy provides an additional layer of local disease control, the traditional role and extent of neoadjuvant radiation therapy could be strategically re-evaluated within the TNT framework. In this context, a risk-adapted approach featuring selective reduction in elective nodal irradiation volume, particularly of the lateral pelvic lymph nodes, may offer a promising middle ground for treatment personalization. Drawing parallels from surgical practice—where total mesorectal excision is standard but lateral pelvic lymph node dissection is reserved for selected cases—this perspective advocates for similar selectivity in radiation therapy targeting, focusing on mesorectal and presacral regions while judiciously omitting lateral nodes in appropriately selected patients. This approach could maintain oncologic safety by focusing radiation therapy on limited but essential volumes. With modern intensity-modulated radiation therapy, reducing the target volume translates directly to enhanced organs-at-risk sparing, thereby mitigating radiation-induced toxicity. When combined with induction chemotherapy response assessment to refine patient selection, this approach can offer a biologically informed, personalized treatment paradigm that balances disease control with quality of life. Full article