Search Results (2,448)

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

Effective management of cascade reservoir systems is essential for balancing hydropower generation, flood control, and ecological sustainability, especially under increasingly uncertain runoff conditions driven by climate change. Traditional optimization methods, while widely used, often struggle with high dimensionality and fail to adequately address inflow variability. This study introduces a novel deep reinforcement learning (DRL) framework that tightly couples probabilistic runoff forecasting with adaptive reservoir scheduling. We integrate a Long Short-Term Memory (LSTM) neural network to model runoff uncertainty and generate probabilistic inflow forecasts, which are then embedded into a Proximal Policy Optimization (PPO) algorithm via Monte Carlo sampling. This unified forecast–optimize architecture allows for dynamic policy adjustment in response to stochastic hydrological conditions. A case study on China’s Xiluodu–Xiangjiaba cascade system demonstrates that the proposed LSTM-PPO framework achieves superior performance compared to traditional baselines, notably improving power output, storage utilization, and spillage reduction. The results highlight the method’s robustness and scalability, suggesting strong potential for supporting resilient water–energy nexus management under complex environmental uncertainty. 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

This study presents the scientific and methodological foundation of Spain’s first national framework for the ethical management of community cat populations: the Action Plan for the Management of Community Cat Colonies (PACF), launched in 2025 under the mandate of Law 7/2023. This pioneering legislation introduces a standardized, nationwide obligation for trap–neuter–return (TNR)-based management of free-roaming cats, defined as animals living freely, territorially attached, and with limited socialization toward humans. The PACF aims to support municipalities in implementing this mandate through evidence-based strategies that integrate animal welfare, biodiversity protection, and public health objectives. Using standardized data submitted by 1128 municipalities (13.9% of Spain’s total), we estimated a baseline population of 1.81 million community cats distributed across 125,000 colonies. These data were stratified by municipal population size and applied to national census figures to generate a model-ready demographic structure. We then implemented a stochastic simulation using Vortex software to project long-term population dynamics over a 25-year horizon. The model integrated eight demographic–environmental scenarios defined by a combination of urban–rural classification and ecological reproductive potential based on photoperiod and winter temperature. Parameters included reproductive output, mortality, sterilization coverage, abandonment and adoption rates, stochastic catastrophic events, and territorial carrying capacity. Under current sterilization rates (~20%), our projections indicate that Spain’s community cat population could surpass 5 million individuals by 2050, saturating ecological and social thresholds within a decade. In contrast, a differentiated sterilization strategy aligned with territorial reproductive intensity (50% in most areas, 60–70% in high-pressure zones) achieves population stabilization by 2030 at approximately 1.5 million cats, followed by a gradual long-term decline. This scenario prioritizes feasibility while substantially reducing reproductive output, particularly in rural and high-intensity contexts. The PACF combines stratified demographic modeling with spatial sensitivity, offering a flexible framework adaptable to local conditions. It incorporates One Health principles and introduces tools for adaptive management, including digital monitoring platforms and standardized welfare protocols. While ecological impacts were not directly assessed, the proposed demographic stabilization is designed to mitigate population-driven risks to biodiversity and public health without relying on lethal control. By integrating legal mandates, stratified modeling, and realistic intervention goals, this study outlines a replicable and scalable framework for coordinated action across administrative levels. It exemplifies how national policy can be operationalized through data-driven, territorially sensitive planning tools. The findings support the strategic deployment of TNR-based programs across diverse municipal contexts, providing a model for other countries seeking to align animal welfare policy with ecological planning under a multi-level governance perspective. Full article

Insulin resistance (IR) plays a pivotal role in the pathogenesis of several dermatological diseases, including psoriasis, acne, acanthosis nigricans, and hidradenitis suppurativa (HS). These conditions are characterized by chronic inflammation, oxidative stress, and metabolic dysfunction, which are exacerbated by IR. This narrative review examines the emerging role of nutraceutical insulin-sensitizing agents (ISAs), including myo-inositol, alpha-lipoic acid, vitamin D, vitamin C, and folic acid, in managing IR-related dermatological disorders. A comprehensive literature search was conducted across Cochrane Library and MEDLINE (1965–May 2025), focusing on clinical trials involving nutraceutical ISAs in dermatological conditions associated with IR. Only human studies published in English were included. Evidence from randomized controlled trials (RCTs) and observational studies suggests that ISAs improve glycemic control, reduce oxidative stress, and modulate inflammatory pathways in IR-related dermatoses. Notably, myo-inositol combined with magnesium and folic acid has demonstrated significant reductions in acne severity, hirsutism, and quality-of-life impairments in women with polycystic ovary syndrome. Similar benefits have been observed in psoriasis and HS, though data remain limited. Nutraceutical ISAs offer a promising adjunctive approach for the management of IR-associated dermatological diseases, potentially addressing both metabolic dysfunction and skin inflammation. However, robust RCTs with long-term follow-up are needed to confirm these preliminary findings and to establish optimal treatment regimens. Full article

Acacia mearnsii De Wild. has been introduced to over 150 countries for its economic value. However, it easily escapes from plantations and establishes monospecific stands across plains, hills, valleys, and riparian habitats, including protected areas such as national parks and forest reserves. Due to its negative ecological impact, A. mearnsii has been listed among the world’s 100 worst invasive alien species. This species exhibits rapid stem growth in its sapling stage and reaches reproductive maturity early. It produces a large quantity of long-lived seeds, establishing a substantial seed bank. A. mearnsii can grow in different environmental conditions and tolerates various adverse conditions, such as low temperatures and drought. Its invasive populations are unlikely to be seriously damaged by herbivores and pathogens. Additionally, A. mearnsii exhibits allelopathic activity, though its ecological significance remains unclear. These characteristics of A. mearnsii may contribute to its expansion in introduced ranges. The presence of A. mearnsii affects abiotic processes in ecosystems by reducing water availability, increasing the risk of soil erosion and flooding, altering soil chemical composition, and obstructing solar light irradiation. The invasion negatively affects biotic processes as well, reducing the diversity and abundance of native plants and arthropods, including protective species. Eradicating invasive populations of A. mearnsii requires an integrated, long-term management approach based on an understanding of its invasive mechanisms. Early detection of invasive populations and the promotion of public awareness about their impact are also important. More attention must be given to its invasive traits because it easily escapes from cultivation. Full article

Introduction: Cystic fibrosis (CF) is a genetic condition affecting several organs and systems, including the pancreas, colon, respiratory system, and reproductive system. The detection of a growing number of CFTR variants and genotypes has contributed to an increase in the CF population which, in turn, has had an impact on the overall statistics regarding the prognosis and outcome of the condition. Given the increase in life expectancy, it is critical to better predict outcomes and prognosticate in CF. Thus, each person’s choice to aggressively treat specific disease components can be more appropriate and tailored, further increasing survival. The objective of our narrative review is to summarize the most recent information concerning the value and significance of clinical parameters in predicting outcomes, such as gender, diabetes, liver and pancreatic status, lung function, radiography, bacteriology, and blood and sputum biomarkers of inflammation and disease, and how variations in these parameters affect prognosis from the prenatal stage to maturity. Materials and methods: A methodological search of the available data was performed with regard to prognostic factors in the evolution of CF in children and young adults. We evaluated articles from the PubMed academic search engine using the following search terms: prognostic factors AND children AND cystic fibrosis OR mucoviscidosis. Results: We found that it is crucial to customize CF patients’ care based on their unique clinical and biological parameters, genetics, and related comorbidities. Conclusions: The predictive significance of more dynamic clinical condition markers provides more realistic future objectives to center treatment and targets for each patient. Over the past ten years, improvements in care, diagnostics, and treatment have impacted the prognosis for CF. Although genotyping offers a way to categorize CF to direct research and treatment, it is crucial to understand that a variety of other factors, such as epigenetics, genetic modifiers, environmental factors, and socioeconomic status, can affect CF outcomes. The long-term management of this complicated multisystem condition has been made easier for patients, their families, and physicians by earlier and more accurate identification techniques, evidence-based research, and centralized expert multidisciplinary care. Full article

A shallow quaternary sedimentary aquifer within the river alluvial deposits of eastern Uzbekistan is increasingly vulnerable to the impacts of climate change and anthropogenic activities. Despite its essential role in supplying water for domestic, agricultural, and industrial purposes, the aquifer system remains poorly understood. This study employed a three-dimensional MODFLOW-based groundwater flow model to assess climate change impacts on water budget components under the SSP5-8.5 scenario for 2020–2099. Model calibration yielded RMSE values between 0.25 and 0.51 m, indicating satisfactory performance. Simulations revealed that lateral inflows from upstream and side-valley alluvial deposits contribute over 84% of total inflow, while direct recharge from precipitation (averaging 120 mm/year, 24.7% of annual rainfall) and riverbed leakage together account for only 11.4%. Recharge occurs predominantly from November to April, with no recharge from June to August. Under future scenarios, winter recharge may increase by up to 22.7%, while summer recharge could decline by up to 100%. Groundwater storage is projected to decrease by 7.3% to 58.3% compared to 2010–2020, indicating the aquifer’s vulnerability to prolonged dry periods. These findings emphasize the urgent need for adaptive water management strategies and long-term monitoring to ensure sustainable groundwater use under changing climate conditions. Full article

The COVID-19 pandemic catalyzed the rapid adoption of remote patient monitoring (RPM) technologies such as telemedicine and wearable devices (WDs), significantly transforming healthcare delivery. Telemedicine made virtual consultations possible, reducing in-person visits and infection risks, particularly for the management of chronic diseases. Wearable devices enabled the real-time continuous monitoring of health that assisted in condition prediction and management, such as for COVID-19. This narrative review addresses these transformations by uniquely synthesizing findings from 13 diverse studies (sourced from PubMed and Google Scholar, 2020–2024) to analyze the parallel evolution of telemedicine and WDs as interconnected RPM components. It highlights the pandemic’s dual impact, as follows: accelerating RPM innovation and adoption while simultaneously unmasking systemic challenges such as inequities in access and a need for robust integration approaches; while telemedicine usage soared during the pandemic, consumption post-pandemic, as indicated by the reviewed studies, suggests continued barriers to adoption among older adults. Likewise, wearable devices demonstrated significant potential in early disease detection and long-term health management, with promising applications extending beyond COVID-19, including long COVID conditions. Addressing the identified challenges is crucial for healthcare providers and systems to fully embrace these technologies and this would improve efficiency and patient outcomes. Full article

Tillage is a major factor influencing soil biological communities, particularly earthworms, which play a key role in soil structure and nutrient cycling. To address soil degradation, less-intensive tillage practices are increasingly being adopted globally and have shown positive effects on earthworm populations when applied consistently over extended periods. However, understanding of the earthworm population dynamics in the period following the implementation of changes in tillage practices remains limited. This three-year field study (2021–2023) investigates earthworm populations during the early transition phase (4–6 years) following the conversion from conventional ploughing to conservation (<8 cm depth, with residue retention) and no-tillage systems in a temperate arable system in central Slovenia. Earthworms were sampled annually in early October from three adjacent fields, each following the same three-year crop rotation (maize—winter cereal + cover crop—soybeans), using a combination of hand-sorting and allyl isothiocyanate (AITC) extraction. Results showed that reduced tillage practices significantly increased both earthworm biomass and abundance compared to conventional ploughing. However, a significant interaction between tillage and year was observed, with a sharp decline in earthworm abundance and mass in 2022, likely driven by a combination of 2022 summer tillage prior to cover crop sowing and extreme drought conditions. Juvenile earthworms were especially affected, with their proportion decreasing from 62% to 34% in ploughed plots and from 63% to 26% in conservation tillage plots. Despite interannual fluctuations, no-till showed the lowest variability in earthworm population. Long-term monitoring is essential to disentangle management and environmental effects and to inform resilient soil management strategies. Full article

Aquatic vegetation plays a crucial role in freshwater ecosystems by providing habitats, regulating water quality, and supporting biodiversity. This study aims to monitor and analyze the dynamics of aquatic vegetation in Chimaditida Shallow Lake, Greece, using Sentinel-2 satellite imagery, with validation from field measurements. Data processing was performed using Google Earth Engine and QGIS. The study focuses on discriminating and mapping two classes of aquatic surface conditions: areas covered with Floating and Emergent Aquatic Vegetation and open water, covering all seasons from 1 March 2024, to 28 February 2025. Spectral bands such as B04 (red), B08 (near infrared), B03 (green), and B11 (shortwave infrared) were used, along with indices like the Modified Normalized Difference Water Index and Normalized Difference Vegetation Index. The classification was enhanced using Otsu’s thresholding technique to distinguish accurately between Floating and Emergent Aquatic Vegetation and open water. Seasonal fluctuations were observed, with significant peaks in vegetation growth during the summer and autumn months, including a peak coverage of 2.08 km² on 9 September 2024 and a low of 0.00068 km² on 28 December 2024. These variations correspond to the seasonal growth patterns of Floating and Emergent Aquatic Vegetation, driven by temperature and nutrient availability. The study achieved a high overall classification accuracy of 89.31%, with producer accuracy for Floating and Emergent Aquatic Vegetation at 97.42% and user accuracy at 95.38%. Validation with Unmanned Aerial Vehicle-based aerial surveys showed a strong correlation (R² = 0.88) between satellite-derived and field data, underscoring the reliability of Sentinel-2 for aquatic vegetation monitoring. Findings highlight the potential of satellite-based remote sensing to monitor vegetation health and dynamics, offering valuable insights for the management and conservation of freshwater ecosystems. The results are particularly useful for governmental authorities and natural park administrations, enabling near-real-time monitoring to mitigate the impacts of overgrowth on water quality, biodiversity, and ecosystem services. This methodology provides a cost-effective alternative for long-term environmental monitoring, especially in regions where traditional methods are impractical or costly. Full article

Aims/Background: Polypharmacy, or the concurrent intake of five or more medications, is a significant issue in clinical practice, particularly in multimorbid elderly individuals. Despite its importance for patient safety, medical education often lacks systematic training in recognising and managing polypharmacy within the framework of patient-centred care. We investigated the impact of a structured learning intervention introducing polypharmacy as a chronic condition, assessing whether it enhances medical students’ diagnostic competence, confidence, and interprofessional collaboration. Methods: A prospective cohort study was conducted with 50 final-year medical students who received a three-phase educational intervention. Phase 1 was interactive workshops on the principles of polypharmacy, its dangers, and diagnostic tools. Phase 2 involved simulated patient consultations and medication review exercises with pharmacists. Phase 3 involved reflection through debriefing sessions, reflective diaries, and standardised patient feedback. Student knowledge, confidence, and attitudes towards polypharmacy management were assessed using pre- and post-intervention questionnaires. Quantitative data were analysed through paired t-tests, and qualitative data were analysed thematically from reflective diaries. Results: Students demonstrated considerable improvement after the intervention in identifying symptoms of polypharmacy, suggesting deprescribing strategies, and working in multidisciplinary teams. Confidence in prioritising polypharmacy as a primary diagnostic problem increased from 32% to 86% (p < 0.01), and knowledge of diagnostic tools increased from 3.1 ± 0.6 to 4.7 ± 0.3 (p < 0.01). Standardised patients felt communication and patient-centredness had improved, with satisfaction scores increasing from 3.5 ± 0.8 to 4.8 ± 0.4 (p < 0.01). Reflective diaries indicated a shift towards more holistic thinking regarding medication burden. The small sample size limits the generalisability of the results. Conclusions: Teaching polypharmacy as a chronic condition in medical school enhances diagnostic competence, interprofessional teamwork, and patient safety. Education is a structured way of integrating the management of polypharmacy into routine clinical practice. This model provides valuable insights for designing medical curricula. Future research must assess the impact of such training on patient outcomes and clinical decision-making in the long term. Full article

Autonomous underwater vehicles (AUVs) have obtained extensive application in the exploitation of marine resources. Terrain-aided navigation (TAN), as an accurate and reliable autonomous navigation method, is commonly used for AUV navigation. However, its accuracy degrades significantly in self-similar terrain features or measurement uncertainties. To overcome these challenges, we propose a novel terrain-aided navigation framework integrating an Improved Marine Predators Algorithm with Depth-First Search optimization (DFS-IMPA-TAN). This framework maintains positioning precision in partially self-similar terrains through two synergistic mechanisms: (1) IMPA-driven optimization based on the hunger-inspired adaptive exploitation to determine optimal trajectory transformations, cascaded with Kalman filtering for navigation state correction; (2) a Robust Tree (RT) hypothesis manager that maintains potential trajectory candidates in graph-structured memory, employing Depth-First Search for ambiguity resolution in feature matching. Experimental validation through simulations and in-vehicle testing demonstrates the framework’s distinctive advantages: (1) consistent terrain association in partially self-similar topographies; (2) inherent error resilience against ambiguous feature measurements; and (3) long-term navigation stability. In all experimental groups, the root mean squared error of the framework remained around 60 m. Under adverse conditions, its navigation accuracy improved by over 30% compared to other traditional batch processing TAN methods. Comparative analysis confirms superior performance over conventional methods under challenging conditions, establishing DFS-IMPA-TAN as a robust navigation solution for AUVs in complex underwater environments. Full article

Recently, deep learning algorithms have been increasingly applied in construction for activity recognition, particularly for excavators, to automate processes and enhance safety and productivity through continuous monitoring of earthmoving activities. These deep learning algorithms analyze construction videos to classify excavator activities for earthmoving purposes. However, previous studies have solely focused on single-source external videos, which limits the activity recognition capabilities of the deep learning algorithm. This paper introduces a novel multi-modal deep learning-based methodology for recognizing excavator activities, utilizing multi-stream input data. It processes point clouds and RGB images using the two-stream long short-term memory convolutional neural network (CNN-LSTM) method to extract spatiotemporal features, enabling the recognition of excavator activities. A comprehensive dataset comprising 495,000 video frames of synchronized RGB and point cloud data was collected across multiple construction sites under varying conditions. The dataset encompasses five key excavator activities: Approach, Digging, Dumping, Idle, and Leveling. To assess the effectiveness of the proposed method, the performance of the two-stream CNN-LSTM architecture is compared with that of single-stream CNN-LSTM models on the same RGB and point cloud datasets, separately. The results demonstrate that the proposed multi-stream approach achieved an accuracy of 94.67%, outperforming existing state-of-the-art single-stream models, which achieved 90.67% accuracy for the RGB-based model and 92.00% for the point cloud-based model. These findings underscore the potential of the proposed activity recognition method, making it highly effective for automatic real-time monitoring of excavator activities, thereby laying the groundwork for future integration into digital twin systems for proactive maintenance and intelligent equipment management. Full article

Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. Methods: We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. Results: Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. Conclusions: The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders. Full article