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Keywords = long-term change trend

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28 pages, 19171 KiB  
Article
Spatiotemporal Evolution of Precipitation Concentration in the Yangtze River Basin (1960–2019): Associations with Extreme Heavy Precipitation and Validation Using GPM IMERG
by Tao Jin, Yuliang Zhou, Ping Zhou, Ziling Zheng, Rongxing Zhou, Yanqi Wei, Yuliang Zhang and Juliang Jin
Remote Sens. 2025, 17(15), 2732; https://doi.org/10.3390/rs17152732 - 7 Aug 2025
Abstract
Precipitation concentration reflects the uneven temporal distribution of rainfall. It plays a critical role in water resource management and flood–drought risk under climate change. However, its long-term trends, associations with atmospheric teleconnections as potential drivers, and links to extreme heavy precipitation events remain [...] Read more.
Precipitation concentration reflects the uneven temporal distribution of rainfall. It plays a critical role in water resource management and flood–drought risk under climate change. However, its long-term trends, associations with atmospheric teleconnections as potential drivers, and links to extreme heavy precipitation events remain poorly understood in complex basins like the Yangtze River Basin. This study analyzes these aspects using ground station data from 1960 to 2019 and conducts a comparison using the Global Precipitation Measurement Integrated Multi-satellitE Retrievals for GPM (GPM IMERG) satellite product. We calculated three indices—Daily Precipitation Concentration Index (PCID), Monthly Precipitation Concentration Index (PCIM), and Seasonal Precipitation Concentration Index (SPCI)—to quantify rainfall unevenness, selected for their ability to capture multi-scale variability and associations with extremes. Key methods include Mann–Kendall trend tests for detecting changes, Hurst exponents for persistence, Pettitt detection for abrupt shifts, random forest modeling to assess atmospheric teleconnections, and hot spot analysis for spatial clustering. Results show a significant basin-wide decrease in PCID, driven by increased frequency of small-to-moderate rainfall events, with strong spatial synchrony to extreme heavy precipitation indices. PCIM is most strongly associated with El Niño-Southern Oscillation (ENSO) and Pacific Decadal Oscillation (PDO). GPM IMERG captures PCIM patterns well but underestimates PCID trends and magnitudes, highlighting limitations in daily-scale resolution. These findings provide a benchmark for satellite product improvement and support adaptive strategies for extreme precipitation risks in changing climates. Full article
(This article belongs to the Special Issue Remote Sensing in Hydrometeorology and Natural Hazards)
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22 pages, 3135 KiB  
Article
Nonstationary Streamflow Variability and Climate Drivers in the Amur and Yangtze River Basins: A Comparative Perspective Under Climate Change
by Qinye Ma, Jue Wang, Nuo Lei, Zhengzheng Zhou, Shuguang Liu, Aleksei N. Makhinov and Aleksandra F. Makhinova
Water 2025, 17(15), 2339; https://doi.org/10.3390/w17152339 - 6 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Risks of Hydrometeorological Extremes)
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23 pages, 4515 KiB  
Article
Monitoring Post-Fire Deciduous Shrub Cover Using Machine Learning and Multiscale Remote Sensing
by Hannah Trommer and Timothy Assal
Land 2025, 14(8), 1603; https://doi.org/10.3390/land14081603 - 6 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Section Land – Observation and Monitoring)
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21 pages, 1827 KiB  
Article
System Dynamics Modeling of Cement Industry Decarbonization Pathways: An Analysis of Carbon Reduction Strategies
by Vikram Mittal and Logan Dosan
Sustainability 2025, 17(15), 7128; https://doi.org/10.3390/su17157128 - 6 Aug 2025
Abstract
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 [...] Read more.
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
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14 pages, 1870 KiB  
Article
Analysis of Risk Factors for High-Risk Lymph Node Metastasis in Papillary Thyroid Microcarcinoma
by Yi-Hsiang Chiu, Shu-Ting Wu, Yung-Nien Chen, Wen-Chieh Chen, Lay-San Lim, Yvonne Ee Wern Chiew, Ping-Chen Kuo, Ya-Chen Yang, Shun-Yu Chi and Chen-Kai Chou
Cancers 2025, 17(15), 2585; https://doi.org/10.3390/cancers17152585 - 6 Aug 2025
Abstract
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 [...] Read more.
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
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24 pages, 3176 KiB  
Article
Influence of Seasonality and Pollution on the Presence of Antibiotic Resistance Genes and Potentially Pathogenic Bacteria in a Tropical Urban River
by Kenia Barrantes-Jiménez, Bradd Mendoza-Guido, Eric Morales-Mora, Luis Rivera-Montero, José Montiel-Mora, Luz Chacón-Jiménez, Keilor Rojas-Jiménez and María Arias-Andrés
Antibiotics 2025, 14(8), 798; https://doi.org/10.3390/antibiotics14080798 - 5 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Origins and Evolution of Antibiotic Resistance in the Environment)
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17 pages, 8464 KiB  
Article
Spatiotemporal Dynamics of the Aridity Index in Central Kazakhstan
by Sanim Bissenbayeva, Dana Shokparova, Jilili Abuduwaili, Alim Samat, Long Ma and Yongxiao Ge
Sustainability 2025, 17(15), 7089; https://doi.org/10.3390/su17157089 - 5 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Section Air, Climate Change and Sustainability)
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18 pages, 914 KiB  
Article
Microvascular, Biochemical, and Clinical Impact of Hyperbaric Oxygen Therapy in Recalcitrant Diabetic Foot Ulcers
by Daniela Martins-Mendes, Raquel Costa, Ilda Rodrigues, Óscar Camacho, Pedro Barata Coelho, Vítor Paixão-Dias, Carla Luís, Ana Cláudia Pereira, Rúben Fernandes, Jorge Lima and Raquel Soares
Cells 2025, 14(15), 1196; https://doi.org/10.3390/cells14151196 - 4 Aug 2025
Viewed by 181
Abstract
Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes and are often difficult to treat. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment to promote healing, but its long-term clinical and biological effects remain insufficiently characterized. This study [...] Read more.
Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes and are often difficult to treat. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment to promote healing, but its long-term clinical and biological effects remain insufficiently characterized. This study aimed to evaluate the impact of HBOT on systemic biomarkers, local microvasculature, and clinical outcomes in patients with DFUs. Methods: In this non-randomized prospective study, 20 patients with ischemic DFUs were followed over a 36-month period. Fourteen received HBOT in addition to standard care, while six received standard care alone. Clinical outcomes—including DFU resolution, recurrence, lower extremity amputation (LEA), and mortality—were assessed alongside systemic inflammatory and angiogenic biomarkers and wound characteristics at baseline and at 3, 6, 12, and 36 months. CD31 immunostaining was performed on available tissue samples. Results: The two groups were comparable at baseline (mean age 62 ± 12 years; diabetes duration 18 ± 9 years). At 3 months, the HBOT group showed significant reductions in erythrocyte sedimentation rate and DFU size (p < 0.05), with downward trends observed in C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and placental growth factor (PlGF), and an increase in stromal-derived factor-1 alpha (SDF1-α). No significant changes were observed in the control group. CD31+ microvessel density appeared to increase in HBOT-treated DFU tissue after one month, although the sample size was limited. Patients receiving HBOT had lower rates of LEA and mortality, improved wound healing, and sustained outcomes over three years. DFU recurrence rates were similar between groups. Conclusions: HBOT was associated with improved wound healing and favorable biomarker profiles in patients with treatment-resistant ischemic DFUs. While these findings are encouraging, the small sample size and non-randomized design limit their generalizability, highlighting the need for larger, controlled studies. Full article
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20 pages, 16139 KiB  
Article
XCH4 Spatiotemporal Variations in a Natural-Gas-Exploiting Basin with Intensive Agriculture Activities Using Multiple Remote Sensing Datasets: Case from Sichuan Basin, China
by Tengnan Wang and Yunpeng Wang
Remote Sens. 2025, 17(15), 2695; https://doi.org/10.3390/rs17152695 - 4 Aug 2025
Viewed by 167
Abstract
The Sichuan Basin is a natural-gas-exploiting area with intensive agriculture activities. However, the spatial and temporal distribution of atmospheric methane concentration and the relationships with intensive agriculture and natural gas extraction activities are not well investigated. In this study, a long-term (2003–2021) dataset [...] Read more.
The Sichuan Basin is a natural-gas-exploiting area with intensive agriculture activities. However, the spatial and temporal distribution of atmospheric methane concentration and the relationships with intensive agriculture and natural gas extraction activities are not well investigated. In this study, a long-term (2003–2021) dataset of column-averaged dry-air mole fraction of methane (XCH4) over the Sichuan Basin and adjacent regions was built by integrating multi-satellite remote sensing data (SCIAMACHY, GOSAT, Sentinel-5P), which was calibrated using ground station data. The results show a strong correlation and consistency (R = 0.88) between the ground station and satellite observations. The atmospheric CH4 concentration of the Sichuan Basin showed an overall higher level (around 20 ppb) than that of the whole of China and an increasing trend in the rates, from around 2.27 ppb to 10.44 ppb per year between 2003 and 2021. The atmospheric CH4 concentration of the Sichuan Basin also exhibits clear seasonal changes (higher in the summer and autumn and lower in the winter and spring) with a clustered geographical distribution. Agricultural activities and natural gas extraction contribute significantly to atmospheric methane concentrations in the study area, which should be considered in carbon emission management. This study provides an effective way to investigate the spatiotemporal distribution of atmospheric CH4 concentration and related factors at a regional scale with natural and human influences using multi-source satellite remote sensing data. Full article
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15 pages, 967 KiB  
Article
Biomarker Correlations in PTSD: IL-18, IRE1, pERK, and ATF6 via Courtauld Emotional Control Scale (CECS)
by Izabela Woźny-Rasała and Ewa Alicja Ogłodek
Int. J. Mol. Sci. 2025, 26(15), 7506; https://doi.org/10.3390/ijms26157506 - 3 Aug 2025
Viewed by 203
Abstract
Post-traumatic stress disorder (PTSD) is a chronic mental health condition resulting from exposure to traumatic events. It is associated with long-term neurobiological changes and disturbances in emotional regulation. Understanding the sociodemographic profiles, biomarkers, and emotional control in patients with PTSD helps to better [...] Read more.
Post-traumatic stress disorder (PTSD) is a chronic mental health condition resulting from exposure to traumatic events. It is associated with long-term neurobiological changes and disturbances in emotional regulation. Understanding the sociodemographic profiles, biomarkers, and emotional control in patients with PTSD helps to better comprehend the impact of the disorder on the body and its clinical course. An analysis of biomarkers such as Interleukin-18 (IL-18), Inositol-Requiring Enzyme 1 (IRE1), Phosphorylated Extracellular Signal-Regulated Kinase (pERK), and Activating Transcription Factor–6 (ATF-6) in PTSD patients with varying durations of illness (≤5 years and >5 years) and a control group without PTSD revealed significant differences. Patients with recently diagnosed PTSD (≤5 years) showed markedly elevated levels of inflammatory and cellular stress markers, indicating an intense neuroinflammatory response during the acute phase of the disorder. In the chronic PTSD group (>5 years), the levels of these biomarkers were lower than in the recently diagnosed group, but still significantly higher than in the control group. An opposite trend was observed regarding the suppression of negative emotions, as measured by the Courtauld Emotional Control Scale (CECS): individuals with chronic PTSD exhibited a significantly greater suppression of anger, depression, and anxiety than those with recent PTSD or healthy controls. Correlations between biomarkers were strongest in individuals with chronic PTSD, suggesting a persistent neuroinflammatory dysfunction. However, the relationships between biomarkers and emotional suppression varied depending on the stage of PTSD. These findings highlight the critical role of PTSD duration in shaping the neurobiological and emotional mechanisms of the disorder, which may have important implications for therapeutic strategies and patient monitoring. Full article
(This article belongs to the Section Molecular Genetics and Genomics)
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19 pages, 1376 KiB  
Article
The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial
by Melissa Hui Juan Tay, Qai Ven Yap, Su Lin Lim, Yuki Wei Yi Ong, Victoria Chantel Hui Ting Wee and Chin Meng Khoo
Nutrients 2025, 17(15), 2541; https://doi.org/10.3390/nu17152541 - 1 Aug 2025
Viewed by 331
Abstract
Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net [...] Read more.
Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m2 were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥ 5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. Full article
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13 pages, 239 KiB  
Article
Haglund’s Deformity with Preoperative Achilles Tendon Rupture: A Retrospective Comparative Study
by Kevin A. Wu, Alexandra N. Krez, Katherine M. Kutzer, Albert T. Anastasio, Zoe W. Hinton, Kali J. Morrissette, Andrew E. Hanselman, Karl M. Schweitzer, Samuel B. Adams, Mark E. Easley, James A. Nunley and Annunziato Amendola
Complications 2025, 2(3), 19; https://doi.org/10.3390/complications2030019 - 1 Aug 2025
Viewed by 116
Abstract
Introduction: Haglund’s deformity, characterized by bony enlargement at the back of the heel, often coincides with Achilles tendon pathology due to impingement on the retrocalcaneal bursa and tendon insertion. Surgical management of Haglund’s deformity with a preexisting Achilles tendon rupture is complex, and [...] Read more.
Introduction: Haglund’s deformity, characterized by bony enlargement at the back of the heel, often coincides with Achilles tendon pathology due to impingement on the retrocalcaneal bursa and tendon insertion. Surgical management of Haglund’s deformity with a preexisting Achilles tendon rupture is complex, and understanding the outcomes of this subset of patients is essential for optimizing treatment strategies. Methods: This retrospective study reviewed patients undergoing open surgical management for Haglund’s syndrome between January 2015 and December 2023. Patients with chronic degenerative changes secondary to Haglund’s deformity and a preoperative Achilles tendon rupture were compared to those without. Data on demographics, surgical techniques, weightbearing protocols, and complications were collected. Univariate analysis was performed using χ2 or Fisher’s exact test for categorical variables, and the T-test or Wilcoxon rank-sum test for continuous and ordinal variables, with normality assessed via the Shapiro–Wilk test. Results: Four hundred and three patients were included, with 13 having a preoperative Achilles tendon rupture. There was a higher incidence of preoperative ruptures among males. Surgical repair techniques and postoperative weightbearing protocols varied, though were not randomized. Complications included persistent pain, wound breakdown, infection, plantar flexion weakness, and revision surgery. While patients with Haglund’s deformity and a preoperative Achilles tendon rupture demonstrated a trend toward higher complication rates, including postoperative rupture and wound breakdown, these differences were not statistically significant in our analysis. Conclusions: A cautious approach is warranted in managing these patients, with careful consideration of surgical planning and postoperative rehabilitation. While our findings provide valuable insights into managing patients with Haglund’s deformity and preoperative Achilles tendon rupture, the retrospective design, limited sample size of the rupture group, and short duration of follow-up restrict generalizability and the strength of the conclusions by limiting the power of the analysis and underestimating the incidence of long-term complications. Therefore, the results of this study should be interpreted with caution. Further studies with larger patient cohorts, validated functional outcome measures, and comparable follow-up durations between groups are needed to confirm these results and optimize treatment approaches. Full article
15 pages, 1071 KiB  
Article
A Synthetic Difference-in-Differences Approach to Assess the Impact of Shanghai’s 2022 Lockdown on Ozone Levels
by Yumin Li, Jun Wang, Yuntong Fan, Chuchu Chen, Jaime Campos Gutiérrez, Ling Huang, Zhenxing Lin, Siyuan Li and Yu Lei
Sustainability 2025, 17(15), 6997; https://doi.org/10.3390/su17156997 - 1 Aug 2025
Viewed by 242
Abstract
Promoting sustainable development requires a clear understanding of how short-term fluctuations in anthropogenic emissions affect urban environmental quality. This is especially relevant for cities experiencing rapid industrial changes or emergency policy interventions. Among key environmental concerns, variations in ambient pollutants like ozone (O [...] Read more.
Promoting sustainable development requires a clear understanding of how short-term fluctuations in anthropogenic emissions affect urban environmental quality. This is especially relevant for cities experiencing rapid industrial changes or emergency policy interventions. Among key environmental concerns, variations in ambient pollutants like ozone (O3) are closely tied to both public health and long-term sustainability goals. However, traditional chemical transport models often face challenges in accurately estimating emission changes and providing timely assessments. In contrast, statistical approaches such as the difference-in-differences (DID) model utilize observational data to improve evaluation accuracy and efficiency. This study leverages the synthetic difference-in-differences (SDID) approach, which integrates the strengths of both DID and the synthetic control method (SCM), to provide a more reliable and accurate analysis of the impacts of interventions on city-level air quality. Using Shanghai’s 2022 lockdown as a case study, we compare the deweathered ozone (O3) concentration in Shanghai to a counterfactual constructed from a weighted average of cities in the Yangtze River Delta (YRD) that did not undergo lockdown. The quasi-natural experiment reveals an average increase of 4.4 μg/m3 (95% CI: 0.24–8.56) in Shanghai’s maximum daily 8 h O3 concentration attributable to the lockdown. The SDID method reduces reliance on the parallel trends assumption and improves the estimate stability through unit- and time-specific weights. Multiple robustness checks confirm the reliability of these findings, underscoring the efficacy of the SDID approach in quantitatively evaluating the causal impact of emission perturbations on air quality. This study provides credible causal evidence of the environmental impact of short-term policy interventions, highlighting the utility of SDID in informing adaptive air quality management. The findings support the development of timely, evidence-based strategies for sustainable urban governance and environmental policy design. Full article
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12 pages, 955 KiB  
Article
Single-Center Preliminary Experience Treating Endometrial Cancer Patients with Fiducial Markers
by Francesca Titone, Eugenia Moretti, Alice Poli, Marika Guernieri, Sarah Bassi, Claudio Foti, Martina Arcieri, Gianluca Vullo, Giuseppe Facondo, Marco Trovò, Pantaleo Greco, Gabriella Macchia, Giuseppe Vizzielli and Stefano Restaino
Life 2025, 15(8), 1218; https://doi.org/10.3390/life15081218 - 1 Aug 2025
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Abstract
Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer [...] Read more.
Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer requiring adjuvant radiation with external beams were enrolled. Five patients underwent radiation therapy targeting the pelvic disease and positive lymph nodes, with doses of 50.4 Gy in twenty-eight fractions and a subsequent stereotactic boost on the vaginal vault at a dose of 5 Gy in a single fraction. One patient was administered 30 Gy in five fractions to the vaginal vault. These patients underwent external beam RT following the implantation of three 0.40 × 10 mm gold fiducial markers (FMs). Our IGRT strategy involved real-time 2D kV image-based monitoring of the fiducial markers during the treatment delivery as a surrogate of the vaginal cuff. To explore the potential role of FMs throughout the treatment process, we analyzed cine movies of the 2D kV-triggered images during delivery, as well as the image registration between pre- and post-treatment CBCT scans and the planning CT (pCT). Each CBCT used to trigger fraction delivery was segmented to define the rectum, bladder, and vaginal cuff. We calculated a standard metric to assess the similarity among the images (Dice index). Results: All the patients completed radiotherapy and experienced good tolerance without any reported acute or long-term toxicity. We did not observe any loss of FMs during or before treatment. A total of twenty CBCTs were analyzed across ten fractions. The observed trend showed a relatively emptier bladder compared to the simulation phase, with the bladder filling during the delivery. This resulted in a final median Dice similarity coefficient (DSC) of 0.90, indicating strong performance. The rectum reproducibility revealed greater variability, negatively affecting the quality of the delivery. Only in two patients, FMs showed intrafractional shift > 5 mm, probably associated with considerable rectal volume changes. Target coverage was preserved due to a safe CTV-to-PTV margin (10 mm). Conclusions: In our preliminary study, CBCT in combination with the use of fiducial markers to guide the delivery proved to be a feasible method for IGRT both before and during the treatment of post-operative gynecological cancer. In particular, this approach seems to be promising in selected patients to facilitate the use of SBRT instead of BRT (brachytherapy), thanks to margin reduction and adaptive strategies to optimize dose delivery while minimizing toxicity. A larger sample of patients is needed to confirm our results. Full article
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20 pages, 4901 KiB  
Article
Study on the Adaptability of FBG Sensors Encapsulated in CNT-Modified Gel Material for Asphalt Pavement
by Tengteng Guo, Xu Guo, Yuanzhao Chen, Chenze Fang, Jingyu Yang, Zhenxia Li, Jiajie Feng, Jiahua Kong, Haijun Chen, Chaohui Wang, Qian Chen and Jiachen Wang
Gels 2025, 11(8), 590; https://doi.org/10.3390/gels11080590 - 31 Jul 2025
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Abstract
To prolong the service life of asphalt pavement and reduce its maintenance cost, a fiber Bragg grating (FBG) sensor encapsulated in carboxylated carbon nanotube (CNT-COOH)-modified gel material suitable for strain monitoring of asphalt pavement was developed. Through tensile and bending tests, the effects [...] Read more.
To prolong the service life of asphalt pavement and reduce its maintenance cost, a fiber Bragg grating (FBG) sensor encapsulated in carboxylated carbon nanotube (CNT-COOH)-modified gel material suitable for strain monitoring of asphalt pavement was developed. Through tensile and bending tests, the effects of carboxylated carbon nanotubes on the mechanical properties of gel materials under different dosages were evaluated and the optimal dosage of carbon nanotubes was determined. Infrared spectrometer and scanning electron microscopy were used to compare and analyze the infrared spectra and microstructure of carbon nanotubes before and after carboxyl functionalization and modified gel materials. The results show that the incorporation of CNTs-COOH increased the tensile strength, elongation at break, and tensile modulus of the gel material by 36.2%, 47%, and 17.2%, respectively, and increased the flexural strength, flexural modulus, and flexural strain by 89.7%, 7.5%, and 63.8%, respectively. Through infrared spectrum analysis, it was determined that carboxyl (COOH) and hydroxyl (OH) were successfully introduced on the surface of carbon nanotubes. By analyzing the microstructure, it can be seen that the carboxyl functionalization of CNTs improved the agglomeration of carbon nanotubes. The tensile section of the modified gel material is rougher than that of the pure epoxy resin, showing obvious plastic deformation, and the toughness is improved. According to the data from the calibration experiment, the strain and temperature sensitivity coefficients of the packaged sensor are 1.9864 pm/μm and 0.0383 nm/°C, respectively, which are 1.63 times and 3.61 times higher than those of the bare fiber grating. The results of an applicability study show that the internal structure strain of asphalt rutting specimen changed linearly with the external static load, and the fitting sensitivity is 0.0286 με/N. Combined with ANSYS finite element analysis, it is verified that the simulation analysis results are close to the measured data, which verifies the effectiveness and monitoring accuracy of the sensor. The dynamic load test results reflect the internal strain change trend of asphalt mixture under external rutting load, confirming that the encapsulated FBG sensor is suitable for the long-term monitoring of asphalt pavement strain. Full article
(This article belongs to the Special Issue Synthesis, Properties, and Applications of Novel Polymer-Based Gels)
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