Search Results (5,570)

Climate-driven hydrological extremes and anthropogenic interventions are increasingly altering streamflow regimes worldwide. While prior studies have explored climate or regulation effects separately, few have integrated multiple teleconnection indices and reservoir chronologies within a cross-basin comparative framework. This study addresses this gap by assessing long-term streamflow nonstationarity and its drivers at two key stations—Khabarovsk on the Amur River and Datong on the Yangtze River—representing distinct hydroclimatic settings. We utilized monthly discharge records, meteorological data, and large-scale climate indices to apply trend analysis, wavelet transform, percentile-based extreme diagnostics, lagged random forest regression, and slope-based attribution. The results show that Khabarovsk experienced an increase in winter baseflow from 513 to 1335 m³/s and a notable reduction in seasonal discharge contrast, primarily driven by temperature and cold-region reservoir regulation. In contrast, Datong displayed increased discharge extremes, with flood discharges increasing by +71.9 m³/s/year, equivalent to approximately 0.12% of the mean flood discharge annually, and low discharges by +24.2 m³/s/year in recent decades, shaped by both climate variability and large-scale hydropower infrastructure. Random forest models identified temperature and precipitation as short-term drivers, with ENSO-related indices showing lagged impacts on streamflow variability. Attribution analysis indicated that Khabarovsk is primarily shaped by cold-region reservoir operations in conjunction with temperature-driven snowmelt dynamics, while Datong reflects a combined influence of both climate variability and regulation. These insights may provide guidance for climate-responsive reservoir scheduling and basin-specific regulation strategies, supporting the development of integrated frameworks for adaptive water management under climate change. Full article

Background/Objectives: Mumps remains a relevant vaccine-preventable disease globally, especially in settings where immunization coverage fluctuates or vaccine-induced immunity wanes. This study aimed to assess long-term trends in mumps incidence, vaccination coverage, clinical outcomes, and demographic characteristics in the Autonomous Province of Vojvodina (AP Vojvodina), Serbia, over a 47-year period. Methods: We conducted a retrospective observational study using surveillance data from the Institute of Public Health of Vojvodina. Analyses included annual mumps incidence rates (1978–2024), coverage with mumps-containing vaccines (MuCVs; 1986–2024), monthly case counts, and individual-level case data for the 1997–2024 period. Variables analyzed included age, month of notification, gender, vaccination status, presence of clinical complications, and the method used for case confirmation. Results: Following the introduction of MuCV in 1986, the mumps incidence markedly declined, with limited resurgences in 2000, 2009, and 2012. Between 1997 and 2024, a total of 1358 cases were reported, with 62.7% occurring in males. Over time, the age distribution shifted, with adolescents and young adults being increasingly affected during the later (2011–2024) observed period. In 2012, the highest age-specific incidence was observed among individuals aged 10–19 and 20–39 years (49.1 and 45.5 per 100,000, respectively). Vaccination coverage for both MuCV doses was suboptimal in several years. The proportion of unvaccinated cases decreased over time, while the proportion with unknown vaccination status increased. Mumps-related complications—such as orchitis, pancreatitis, and meningitis—were rare and predominantly affected unvaccinated individuals: 84.2% of orchitis, 40.0% of pancreatitis, and all meningitis cases. Only two pancreatitis cases (40.0%) were reported after one MMR dose, while fully vaccinated individuals (two doses) had one orchitis case (5.3%) and no other complications. Laboratory confirmation was applied more consistently from 2009 onward, with 49.6% of cases confirmed that year (58 out of 117), and, in several years after 2020, only laboratory-confirmed cases were reported, indicating improved diagnostic capacity. Conclusions: Despite substantial progress in controlling mumps, gaps in vaccine coverage, waning immunity, and incomplete vaccination records continue to pose a risk for mumps transmission. Strengthening routine immunization, ensuring high two-dose MuCV coverage, improving vaccination record keeping, and enhancing laboratory-based case confirmation are critical. Consideration should be given to booster doses in high-risk populations and to conducting a seroepidemiological study to estimate the susceptible population for mumps in AP Vojvodina. Full article

Wildfire and drought are key drivers of shrubland expansion in southwestern US landscapes. Stand-replacing fires in conifer forests induce shrub-dominated stages, and changing climatic patterns may cause a long-term shift to deciduous shrubland. We assessed change in deciduous fractional shrub cover (DFSC) in the eastern Jemez Mountains from 2019 to 2023 using topographic and Sentinel-2 satellite data and evaluated the impact of spatial scale on model performance. First, we built a 10 m and a 20 m random forest model. The 20 m model outperformed the 10 m model, achieving an R-squared value of 0.82 and an RMSE of 7.85, compared to the 10 m model (0.76 and 9.99, respectively). We projected the 20 m model to the other years of the study using imagery from the respective years, yielding yearly DFSC predictions. DFSC decreased from 2019 to 2022, coinciding with severe drought and a 2022 fire, followed by an increase in 2023, particularly within the 2022 fire footprint. Overall, DFSC trends showed an increase, with elevation being a key variable influencing these trends. This framework revealed vegetation dynamics in a semi-arid system and provided a close look at post-fire regeneration in deciduous resprouting shrubs and could be applied to similar systems. Full article

The cement industry is a significant contributor to global carbon dioxide emissions, primarily due to the energy demands of its production process and its reliance on clinker, a material formed through the high-temperature calcination of limestone. Strategies to reduce emissions include the adoption of low-carbon fuels, the use of carbon capture and storage (CCS) technologies, and the integration of supplementary cementitious materials (SCMs) to reduce the clinker content. The effectiveness of these measures depends on a complex set of interactions involving technological feasibility, market dynamics, and regulatory frameworks. This study presents a system dynamics model designed to assess how various decarbonization approaches influence long-term emission trends within the cement industry. The model accounts for supply chains, production technologies, market adoption rates, and changes in cement production costs. This study then analyzes a number of scenarios where there is large-scale sustained investment in each of three carbon mitigation strategies. The results show that CCS by itself allows the cement industry to achieve carbon neutrality, but the high capital investment results in a large cost increase for cement. A combined approach using alternative fuels and SCMs was found to achieve a large carbon reduction without a sustained increase in cement prices, highlighting the trade-offs between cost, effectiveness, and system-wide interactions. Full article

Background: Papillary thyroid microcarcinoma (PTMC) is associated with certain features that carry an increased risk of local recurrence, underscoring the importance of preoperative risk assessment. This study investigated the clinicopathological factors associated with high-risk lymph node metastasis (HRLNM) and patient outcomes. HRLNM is defined as ≥5 metastatic lymph nodes and/or lateral neck metastasis. Methods: We conducted a retrospective review of 985 patients with PTMC who underwent thyroidectomy at the Kaohsiung Chang Gung Memorial Hospital from 2013 to 2022. Results: Among the 985 patients, 100 (10.2%) had lymph node metastasis (LNM), and 27% of these were classified as having HRLNM. Male sex (OR 3.61, p = 0.04) and extranodal extension (OR 3.76, p = 0.043) were independent predictors of HRLNM. Patients with LNM exhibited lower rates of excellent treatment response (75% vs. 87%, p = 0.001), higher recurrence rates (9.0% vs. 0.6%, p = 0.001), and an increased risk of distant metastasis (2.0% vs. 0%). Recurrence-free survival (RFS) was significantly shorter in patients with LNM (120.9 vs. 198.6 months, p < 0.001). Although HRLNM showed a trend toward reduced RFS (113.5 vs. 124.6 months, p = 0.177), its impact on long-term survival remains uncertain. Conclusions: Male sex and extranodal extension were significant risk factors for HRLNM in patients with PTMC. These findings highlight the need for individualized risk stratification to guide treatment strategies and improve patient outcomes. Full article

This study investigates long-term land surface temperature (LST) trends along the shoreline of Lake Drūkšiai, a transboundary lake in eastern Lithuania that formerly served as a cooling reservoir for the Ignalina Nuclear Power Plant (INPP). Although the INPP was decommissioned in 2009, its legacy continues to influence the lake’s thermal regime. Using Landsat 8 thermal infrared imagery and NDVI-based methods, we analysed spatial and temporal LST variations from 2013 to 2024. The results indicate persistent temperature anomalies and elevated LST values, particularly in zones previously affected by thermal discharges. The years 2020 and 2024 exhibited the highest average LST values; some years (e.g., 2018) showed lower readings due to localised environmental factors such as river inflow and seasonal variability. Despite a slight stabilisation observed in 2024, temperatures remain higher than those recorded in 2013, suggesting that pre-industrial thermal conditions have not yet been restored. These findings underscore the long-term environmental impacts of industrial activity and highlight the importance of satellite-based monitoring for the sustainable management of land, water resources, and coastal zones. Full article

This study evaluates the relationship between preoperative cartilage quality, measured by T2 mapping, and patient-reported outcomes following labral tear treatment. We retrospectively reviewed patients aged 14–50 who underwent primary hip arthroscopy with either labral repair or reconstruction. Preoperative T2 values of femoral, acetabular, and labral tissue were assessed from MRI by blinded reviewers. International Hip Outcome Tool (iHOT-12) scores were collected preoperatively and up to two years postoperatively. Associations between T2 values and iHOT-12 scores were analyzed using univariate mixed linear models. Twenty-nine patients were included (mean age of 32.5 years, BMI 24 kg/m², 48.3% female, and 22 repairs). Across all patients, higher T2 values were associated with higher iHOT-12 scores at baseline and early postoperative timepoints (three months for cartilage and six months for labrum; p < 0.05). Lower T2 values were associated with higher 12- and 24-month iHOT-12 scores across all structures (p < 0.001). Similar trends were observed within the repair and reconstruction subgroups, with delayed negative associations correlating with worse tissue quality. T2 mapping showed time-dependent correlations with iHOT-12 scores, indicating that worse cartilage or labral quality predicts poorer long-term outcomes. These findings support the utility of T2 mapping as a preoperative tool for prognosis in hip preservation surgery. Full article

Background/Objectives: This study examines how seasonality, pollution, and sample type (water and sediment) influence the presence and distribution of antibiotic resistance genes (ARGs), with a focus on antibiotic resistance genes (ARGs) located on plasmids (the complete set of plasmid-derived sequences, including ARGs) in a tropical urban river. Methods: Samples were collected from three sites along a pollution gradient in the Virilla River, Costa Rica, during three seasonal campaigns (wet 2021, dry 2022, and wet 2022). ARGs in water and sediment were quantified by qPCR, and metagenomic sequencing was applied to analyze chromosomal and plasmid-associated resistance profiles in sediments. Tobit and linear regression models, along with multivariate ordination, were used to assess spatial and seasonal trends. Results: During the wet season of 2021, the abundance of antibiotic resistance genes (ARGs) such as sul-1, intI-1, and tetA in water samples decreased significantly, likely due to dilution, while intI-1 and tetQ increased in sediments, suggesting particle-bound accumulation. In the wet season 2022, intI-1 remained low in water, qnrS increased, and sediments showed significant increases in tetQ, tetA, and qnrS, along with decreases in sul-1 and sul-2. Metagenomic analysis revealed spatial differences in plasmid-associated ARGs, with the highest abundance at the most polluted site (Site 3). Bacterial taxa also showed spatial differences, with greater plasmidome diversity and a higher representation of potential pathogens in the most contaminated site. Conclusions: Seasonality and pollution gradients jointly shape ARG dynamics in this tropical river. Plasmid-mediated resistance responds rapidly to environmental change and is enriched at polluted sites, while sediments serve as long-term reservoirs. These findings support the use of plasmid-based monitoring for antimicrobial resistance surveillance in aquatic systems. Full article

The taxonomic composition and structure of invertebrate assemblages in five lakes from the Kulunda steppe, located in an arid region of southwestern Siberia (Russia), were studied. The lakes varied greatly in their total salinity (5 to 304 g L⁻¹) and carbonate alkalinity (0.03 to 4.03 mol-eq L⁻¹). The invertebrate fauna was characterized by low diversity. Only five taxa of macrozoobenthos and two taxa of planktonic invertebrates were identified. As water salinity increased, the taxonomic diversity of the studied lakes decreased, and at salinities > 276 g L⁻¹, monodominant assemblages were formed. The high numbers and biomass of aquatic organism provide a rich food supply for native and migratory waterfowl. The low taxonomic diversity of the invertebrate assemblages of the lakes makes them vulnerable to any negative external impact. The climate in the Kulunda steppe demonstrates a long-term aridization trend. If this continues in the future, then over time, this may lead to the gradual salinization of lakes and a further decrease in the taxonomic diversity of hydrobiological assemblages. This emphasizes the ecological importance of the studied territory and the necessity for its inclusion in the list of sites protected by the Ramsar Convention. Full article

This study analyzes spatiotemporal aridity dynamics in Central Kazakhstan (1960–2022) using a monthly Aridity Index (AI = P/PET), where P is precipitation and PET is potential evapotranspiration, Mann–Kendall trend analysis, and climate zone classification. Results reveal a northeast–southwest aridity gradient, with Aridity Index ranging from 0.11 to 0.14 in southern deserts to 0.43 in the Kazakh Uplands. Between 1960–1990 and 1991–2022, southern regions experienced intensified aridity, with Aridity Index declining from 0.12–0.15 to 0.10–0.14, while northern mountainous areas became more humid, where Aridity Index increased from 0.40–0.44 to 0.41–0.46. Seasonal analysis reveals divergent patterns, with winter showing improved moisture conditions (52.4% reduction in arid lands), contrasting sharply with aridification in spring and summer. Summer emerges as the most extreme season, with hyper-arid zones (8%) along with expanding arid territories (69%), while autumn shows intermediate conditions with notable dry sub-humid areas (5%) in northwestern regions. Statistical analysis confirms these observations, with northern areas showing positive Aridity Index trends (+0.007/10 years) against southwestern declines (−0.003/10 years). Key drivers include rising temperatures (with recent degradation) and variable precipitation (long-term drying followed by winter and spring), and PET fluctuations linked to temperature. Since 1991, arid zones have expanded from 40% to 47% of the region, with semi-arid lands transitioning to arid, with a northward shift of the boundary. These changes are strongly seasonal, highlighting the vulnerability of Central Kazakhstan to climate-driven aridification. Full article

In the past three decades, localized research has highlighted shifts in rainfall patterns and temperature trends in central Ethiopia, a region vital for agriculture and economic activities and heavily dependent on climate conditions to sustain livelihoods and ensure food security. However, comprehensive analyses of long-term climate data remain limited for this area. Understanding local climate trends is essential for enhancing agricultural resilience in the study area, a region heavily dependent on rainfall for crop production. This study analyzes historical rainfall and temperature patterns over the past 30 years and projects future climate conditions using downscaled CMIP6 models under SSP4.5 and SSP8.5 scenarios. Results indicate spatial variability in rainfall trends, with certain areas showing increasing rainfall while others experience declines. Temperature has shown a consistent upward trend across all seasons, with more pronounced warming during the short rainy season (Belg). Climate projections suggest continued warming and moderate increases in annual rainfall, particularly under SSP8.5 by the end of the 21st century. It is concluded that both temperature and rainfall are projected to increase in magnitude by 2080, with higher Sen’s slope values compared to earlier periods, indicating a continued upward trend. These findings highlight potential breaks in agricultural calendars, such as shifts in rainfall onset and cessation, shortened or extended growing seasons, and increased risk of temperature-induced stress. This study highlights the need for localized adaptation strategies to safeguard agriculture production and enhance resilience in the face of future climate variability. Full article

Background: Bipolar disorder (BD) is a chronic and disabling psychiatric condition characterized by recurring episodes of mania, hypomania, and depression. Despite the availability of mood stabilizers, antipsychotics, and antidepressants, long-term management remains challenging due to incomplete symptom control, adverse effects, and high relapse rates. Methods: This paper is a narrative review aimed at synthesizing emerging trends and future directions in the pharmacological treatment of BD. Results: Future pharmacotherapy for BD is likely to shift toward precision medicine, leveraging advances in genetics, biomarkers, and neuroimaging to guide personalized treatment strategies. Novel drug development will also target previously underexplored mechanisms, such as inflammation, mitochondrial dysfunction, circadian rhythm disturbances, and glutamatergic dysregulation. Physiological endophenotypes, such as immune-metabolic profiles, circadian rhythms, and stress reactivity, are emerging as promising translational tools for tailoring treatment and reducing associated somatic comorbidity and mortality. Recognition of the heterogeneous longitudinal trajectories of BD, including chronic mixed states, long depressive episodes, or intermittent manic phases, has underscored the value of clinical staging models to inform both pharmacological strategies and biomarker research. Disrupted circadian rhythms and associated chronotypes further support the development of individualized chronotherapeutic interventions. Emerging chronotherapeutic approaches based on individual biological rhythms, along with innovative monitoring strategies such as saliva-based lithium sensors, are reshaping the future landscape. Anti-inflammatory agents, neurosteroids, and compounds modulating oxidative stress are emerging as promising candidates. Additionally, medications targeting specific biological pathways implicated in bipolar pathophysiology, such as N-methyl-D-aspartate (NMDA) receptor modulators, phosphodiesterase inhibitors, and neuropeptides, are under investigation. Conclusions: Advances in pharmacogenomics will enable clinicians to predict individual responses and tolerability, minimizing trial-and-error prescribing. The future landscape may also incorporate digital therapeutics, combining pharmacotherapy with remote monitoring and data-driven adjustments. Ultimately, integrating innovative drug therapies with personalized approaches has the potential to enhance efficacy, reduce adverse effects, and improve long-term outcomes for individuals with bipolar disorder, ushering in a new era of precision psychiatry. Full article

Background/Objectives: Pulmonary typical carcinoid (TC) is a rare type of primary neuroendocrine neoplasm of the lung with indolent behavior and a good prognosis. The main treatment strategy is surgery, the extent of which is controversial given the nature of the disease. The aim of this study is to assess whether the extent of resection influences survival and recurrence in patients undergoing lung resection and lymphadenectomy for TC and to investigate negative prognostic factors for OS. Methods: A single-centre retrospective study of 15 years’ experience was conducted. Data from all patients who underwent lung resection and lymphadenectomy for TC were collected. Patients were divided into two groups: anatomical and non-anatomical resections. Perioperative and long-term oncological results were analyzed. Results: In total, 115 patients were surgically treated for TC, of whom 83 (72%) underwent anatomical resection and 32 (28%) non-anatomical resection. Univariate analyses showed that age, left lower lobe, and many comorbidities had a detrimental effect on OS, whereas on multivariate analysis, only left lower lobe location and a high Charlson–Deyo comorbidity index (CCI) were confirmed as negative prognostic factors for OS. At a median follow-up of 93 months (IQR 57-129), the OS survival curves show a slightly lower trend for non-anatomical resections (p 0.152), while no differences were found for DFS. Conclusions: The results of this study confirm that in selected patients at risk for major resections, non-anatomical resection can be used to treat TC when R0 is achievable. These data, together with evidence from the literature, highlight the importance of patient-centred care in this rare disease. Full article

Willow stands (Salix spp.) are an essential part of riparian ecosystems, as they sustain biodiversity and provide bioenergy solutions. The present review synthesizes the global scientific literature about the management of willow stands. In order to achieve this goal, we used a dual approach combining bibliometric analysis with traditional literature review. As such, we consulted 416 publications published between 1978 and 2024. This allowed us to identify key species, ecosystem services, conservation strategies, and management issues. The results we have obtained show a diversity of approaches, with an increase in short-rotation coppice (SRC) systems and the multiple roles covered by willow stands (carbon sequestration, biomass production, riparian restoration, and habitat provision). The key trends we have identified show a shift toward topics such as climate resilience, ecological restoration, and precision forestry. This trend has become especially pronounced over the past decade (2014–2024), as reflected in the increasing use of these keywords in the literature. However, as willow systems expand in scale and function—from biomass production to ecological restoration—they also raise complex challenges, including invasive tendencies in non-native regions and uncertainties surrounding biodiversity impacts and soil carbon dynamics over the long term. The present review is a guide for forest policies and, more specifically, for future research, linking the need to integrate and use adaptive strategies in order to maintain the willow stands. Full article

Population aging poses significant challenges to the sustainability of pension systems. This study presents an integrated methodological approach that uniquely combines actuarial life-cycle modeling with agent-based simulation to assess the potential of Reverse Mortgage Loans (RMLs) as a dual lever for enhancing retiree welfare and supporting pension system resilience under demographic and financial uncertainty. We explore Reverse Mortgage Loans (RMLs) as a potential financial instrument to support retirees while alleviating pressure on public pensions. Unlike prior research that treats individual decisions or policy outcomes in isolation, our hybrid model explicitly captures feedback loops between household-level behavior and system-wide financial stability. To test our hypothesis that RMLs can improve individual consumption outcomes and bolster systemic solvency, we develop a hybrid model combining actuarial techniques and agent-based simulations, incorporating stochastic housing prices, longevity risk, regulatory capital requirements, and demographic shifts. This dual-framework enables a structured investigation of how micro-level financial decisions propagate through market dynamics, influencing solvency, pricing, and adoption trends. Our central hypothesis is that reverse mortgages, when actuarially calibrated and macroprudentially regulated, enhance individual financial well-being while preserving long-run solvency at the system level. Simulation results indicate that RMLs can improve consumption smoothing, raise expected utility for retirees, and contribute to long-term fiscal sustainability. Moreover, we introduce a dynamic regulatory mechanism that adjusts capital buffers based on evolving market and demographic conditions, enhancing system resilience. Our simulation design supports multi-scenario testing of financial robustness and policy outcomes, providing a transparent tool for stress-testing RML adoption at scale. These findings suggest that, when well-regulated, RMLs can serve as a viable supplement to traditional retirement financing. Rather than offering prescriptive guidance, this framework provides insights to policymakers, financial institutions, and regulators seeking to integrate RMLs into broader pension strategies. Full article