Search Results (14,092)

Background: Sarcopenia is associated with adverse surgical outcomes. Recent literature suggested that pre-surgery prehabilitation, nutrition and β-Hydroxy β-methylbutyric acid (HMB) supplementation improve myological and functional outcomes. However, long-term outcomes remain uncertain. Thus, we aimed to analyse findings from the long-term follow-up of surgical patients undergoing oral supplementation and prehabilitation. Methods: A prospective single-centre pilot cohort study was conducted to evaluate the effects of multimodal prehabilitation using high-protein oral nutritional supplementation (HP-ONS) with HMB. Sarcopenic patients between 40 and 90 years old and undergoing gastrointestinal surgery were included from June 2022 to January 2024. Patients were followed up from two to four weeks pre-operatively to six months post-operatively. Paired Wilcoxon signed-rank tests were conducted to evaluate outcomes between time points. Results: 36 patients were included with a median age of 71.5 years (IQR: 55–90), and 50% were male. 12 (33.3%) patients were sarcopenic, while 24 (66.7%) were severely sarcopenic. No significant difference in IMAT% was observed at post-operative six months. Number of chair rise repetitions (Median:15 vs. 11, p < 0.001) and six-min walk test (Median: 387 m vs. 349 m, p = 0.020), mid-arm muscle circumference (Median: 23.7 cm vs. 22.5 cm, p = 0.013), mid-arm muscle area (Median: 44.8 cm² vs. 39.3 cm², p = 0.005), weight (Median: 51.6 kg vs. 50.8 kg, p = 0.023) and BMI (Median: 23.2 kg/m² vs. 21.8 kg/m², p = 0.025) increased significantly at six-months post-operatively from surgery. Conclusions: Our findings suggest that improvements in anthropometric and functional outcomes from prehabilitation may persist beyond the acute recovery period. If supported by future works, multimodal prehabilitation has the potential to optimise postoperative recovery amongst sarcopenic older adult surgical patients. Full article

Global climate change and spatiotemporal heterogeneity in water resources exacerbate supply-demand imbalances. Accurate outflow simulation for joint reservoir group operations thus becomes critical for scientific water resources management. Existing data-driven models like the Long Short-Term Memory (LSTM) lack the robust integration of physical constraints. Traditional mechanistic methods, by contrast, lack generality and stability under complex hydrological conditions. To address this limitation, we propose MDUPLEX-KG-LSTM—a physically constrained data-driven model for reservoir outflow simulation. The model incorporates multi-round DUPLEX (MDUPLEX) data partitioning, which ensures statistical homogeneity across training, validation, and test datasets. It also features a Knowledge-Guided (KG) loss function that embeds core physical constraints: water balance, dead water level, flood season restricted water level, and inter-reservoir re-regulation mechanisms. Additionally, it adopts an LSTM network optimized via Particle Swarm Optimization (PSO) for enhanced predictive performance. We validate the model using daily hydrological data from 2010 to 2025 for three reservoirs in the Wujiaqu Irrigation District of Xinjiang, China. The model exhibits exceptional stability and predictive accuracy across key evaluation metrics: Nash–Sutcliffe Efficiency (NSE) ≥ 0.82, Pearson correlation coefficient (r) > 0.94, Root Mean Square Error (RMSE) ≤ 1.50 m³/s, and Water Balance Index (WBI) ≤ 0.016. It outperforms conventional data-driven and mechanistic models in extreme flow simulation scenarios. It also eliminates unphysical negative outflow values in all predictive results. The model achieves 100% compliance with flood control standards and an irrigation guarantee rate of no less than 86%. This study advances the development of physically constrained data-driven modeling for water resources engineering. It provides reliable methodological support for the intelligent operation of reservoir groups in smart water conservancy systems. The model also balances training cost and inference efficiency effectively. It demonstrates verified scalability for reservoir groups of varying scales, fully meeting the operational deployment requirements of smart water systems. Full article

Background/Objectives: Osseointegration is essential for the long-term success of dental implants, and radiographic assessment may support the evaluation of peri-implant bone healing. This retrospective study evaluated peri-implant radiographic bone density (PIBD) as a potential indicator of osseointegration in patients who underwent successful implant-prosthetic rehabilitation. Methods: Patients with at least one endosseous dental implant and a minimum of two standardized periapical radiographs—one at placement (T0) and one during follow-up—were included. Digital radiographs were obtained using the paralleling technique and analyzed with ImageJ^®. Normalized bone density values were calculated for predefined areas of interest (AOIs). Marginal Bone Level (MBL) changes were also assessed. Statistical analyses included the Shapiro–Wilk test, Kruskal–Wallis test, and Dunn’s post hoc test with Bonferroni correction. Results: 88 implants in 64 patients were analyzed (198 radiographs; 1299 AOIs measurements). Normalized bone density showed significant temporal changes in several AOIs, mainly from 3 to 12 months, across coronal/middle/apical regions. PIBD decreased by approximately 8% between T0 and 3 months, followed by a significant increase at one year. MBL values were minimal and well below physiologic thresholds throughout follow-up. No significant correlation was found between MBL and normalized bone density. Conclusions: PIBD assessment may be a reliable, non-invasive tool for monitoring osseointegration during follow-up and supporting clinical decision-making in postoperative controls. The temporal pattern observed confirms three radiographic healing phases after implant placement: an initial decrease in PIBD during early remodeling, a subsequent increase reflecting osseointegration, and a final stabilization phase corresponding to tertiary implant stability. Full article

Background: Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies and is associated with both short- and long-term risks for the mother and child. Twin pregnancies are inherently high risk, and the coexistence of GDM may amplify these risks. While the effects of GDM in singleton pregnancies have been widely studied, data on its impact in twin gestations remain limited. The aim of this study was to determine differences regarding metabolic characteristics, treatment requirements, and maternal as well as fetal outcomes between twin and singleton pregnancies with GDM to contribute to improved perinatal care. Methods: This retrospective study included obstetric data from 73 twin pregnancies (146 neonates) and 1664 singleton pregnancies with a GDM diagnosis at a tertiary perinatal center in Berlin, Germany, between 2015 and 2022. Baseline characteristics and perinatal outcomes were assessed. Adjusted multiple linear and logistic regression analyses were used for group comparisons. Results: Women with GDM in twin and singleton pregnancies exhibited comparable glucose values in the 75 g oral glucose tolerance test (OGTT) (median fasting: 95 vs. 96 mg/dL; 1 h: 183 vs. 183 mg/dL; 2 h: 144 vs. 139 mg/dL). Despite this, insulin therapy was required significantly less often in twin (5.5%) compared to singleton pregnancies (22.3%) (OR = 0.86; 95% CI: 0.78–0.96). Among insulin-treated women, combined insulin therapy was most common in twins (75%), while singleton mothers most frequently received long-acting insulin alone (61.7%), followed by combined therapy (31.3%) and short-acting insulin alone (7%). Birthweight was significantly lower in twins (β = –0.83 kg; 95% CI: –0.98 to –0.69), and when evaluated using twin-based growth standards, twins were more likely to be classified as having intrauterine growth restriction (IUGR, <3rd percentile) (OR = 3.37; 95% CI: 0.96–9.11), being small for gestational age (SGA, <10th percentile) (OR = 2.50; 95% CI: 1.23–4.76), or having a birthweight below the 30th percentile (OR = 6.11; 95% CI: 3.49–11.12). No large-for-gestational-age (LGA, >90th percentile) neonates were observed in the twin group. Conclusions: GDM manifests differently in twin and singleton pregnancies. Despite similar OGTT values, twin mothers require insulin less frequently. Growth-related complications such as IUGR and SGA are significantly more frequent in twins, likely reflecting the physiological constraints of multiple gestations rather than GDM itself. Conversely, LGA is predominantly a concern in singleton pregnancies. These findings underscore the need for individualized diagnostic criteria and management strategies for GDM in twin pregnancies. Full article

Composting chicken manure is a source of significant ammonia (NH₃) emissions, which, because of propagation, contributes to the eutrophication of the environment and decreases in air quality. Therefore, it is reasonable to use methods to limit its emission into the atmosphere. Biofiltration, using the metabolic activity of nitrifying and heterotrophic microorganisms capable of oxidizing ammonia, is an effective method to reduce ammonia emissions. In addition, the performance of the biofiltration process depends on operational parameters such as the humidity of the medium, the temperature, the contact time of the gas with the biofiltering medium, and the chemical composition and structure of the filter material. The aim of the study was to evaluate the effectiveness of biofilter fillings in reducing ammonia emissions from composting chicken manure along with the identification of factors allowing us to determine the proposed design solution as the most advantageous in terms of efficiency. Experiments on reducing odour emissions with biofiltration were carried out in two compact composting reactors, in which a compost mixture with a C:N ratio of 10:1 was used. The mixture was prepared in a ratio of 5:1 of chicken manure to the structuring material, with wheat straw used as the structuring material. Based on the results of the research on the course of the composting process, high values of ammonia concentration were recorded. Ammonia concentrations of 886 ppm (composter 1) and 811 ppm (composter 2) were recorded, which confirms the intensive nature of this gas emissions during the process of stabilizing the chicken manure. As part of the conducted research, the effectiveness of biofiltration in reducing ammonia emissions was evaluated by analysing the influence of the aeration intensity of the biofilter (20 dm³/h and 50 dm³/h), directly determining the time of contact of the gas with the bed (EBCT—Empty Bed Contact Time). Coconut-activated carbon was used as a filter bed, which was an effective carrier for the development of microorganisms responsible for the biological removal of ammonia from waste gases generated during composting. In addition, this material showed the ability to physically adsorb ammonia, thus supporting the process of its elimination. Each of the test stations has been equipped with a biofiltration installation. To determine the effectiveness of biological removal of ammonia and to assess the legitimacy of the use of selected strains of microorganisms in the process of biological removal of ammonia, the bed of one of the biofilters (biofilter 2) was inoculated with a strain of nitrifying bacteria. During the study, the high efficiency of ammonia removal because of biofiltration was noted in each of the configurations. In the case of an aeration intensity of 20 dm³/h, a reduction in emissions of 99% was achieved; with a higher aeration value, i.e., 50 dm³/h, the efficiency was 89%. These results indicate that the intensity of aeration has a significant impact on the efficiency of the biofiltration process. The analysis of a biofilter enriched with a strain of nitrifying bacteria requires long-term testing. This is important to reliably determine the effect of inoculation on the efficiency of the biological removal of ammonia in biofilters. It has been shown that optimizing these factors allows us to achieve a reduction in ammonia emissions of up to 90%, while minimizing the formation of unpleasant odours. The use of biofiltration in composting systems for organic waste of animal origin is an effective, sustainable solution that fits into the idea of sustainable development, combining the efficiency of air purification technology with environmental protection and the responsible management of resources. This study demonstrates that biofiltration using coconut-shell-activated carbon is an effective and economical method for reducing ammonia and odour emissions from composting chicken manure. The results provide valuable theoretical and practical information on emissions management in organic waste composting processes. Data from this study could be useful in developing strategies to minimize odour emissions, including from the agricultural sector. Full article

Closed-basin lakes are highly sensitive to climatic variability, yet for the Lake Van Basin (Türkiye), the dynamic and spatially heterogeneous linkages among atmospheric drivers and lake-level changes (particularly their lag structure and predictive directionality) remain insufficiently quantified in a unified multivariate setting. This study examines how temperature and precipitation jointly influence hydrological behavior in the Lake Van Basin using a multi-station Vector Autoregression (VAR) framework. By integrating long-term observations from multiple meteorological stations, the analysis explicitly captures the spatial heterogeneity that characterizes this complex endorheic system and provides a consistent basis for comparing station-specific dynamics. The results show strong persistence in lake-level dynamics across specifications, with lagged lake-level coefficients of 0.2595 to 0.3685 (p < 0.01), indicating a buffered endorheic response. Temperature exhibits a highly consistent seasonal dependence across stations, reflected by a uniformly negative and significant four-month temperature lag in the temperature equations (−0.34 to −0.42, p < 0.01). Granger-causality tests further indicate robust bidirectional coupling between temperature and precipitation in all station specifications (p < 0.01 and typically p ≤ 0.05), while climate-to-lake-level linkages remain spatially heterogeneous but are statistically supported across both Tatvan-based and Gevas-based specifications (Tatvan-Tatvan: p < 0.01 for both climate variables; Tatvan-Ahlat: temperature p = 0.000; Gevas-Van, Gevas-Ercis, and Gevas-Muradiye: temperature p = 0.000 and precipitation p = 0.013, 0.008, and 0.015, respectively). Distinct station-level patterns further demonstrate that topographical differences modulate the strength and direction of climate–hydrology linkages across the basin. By providing a coherent, causally consistent understanding of these interactions and explicitly incorporating season-specific VAR and Granger-causality evidence, this study offers a transferable methodological framework for analyzing climate-sensitive lake systems and highlights the need to incorporate temperature-driven processes into water-management and climate-adaptation strategies in endorheic basins. Full article

Direct-acting antiviral therapies can cure most people with hepatitis C virus (HCV) infection with little need for testing or monitoring. A major challenge to eliminating HCV is ensuring patients complete all steps of care, including confirmation of cure. We assessed the concordance of sustained virologic response (SVR) at 4 weeks (SVR4) and 12 weeks (SVR12) post-treatment to evaluate the viability of SVR4 as a predictor of cure in patients treated with sofosbuvir (SOF)/velpatasvir (VEL). We conducted a retrospective analysis of patients from the Phase 3 ASTRAL-1, -2, and -3 programs and a historical cohort from the Louisiana Department of Health Sexually Transmitted Infection (STI)/HIV/Hepatitis Program claims database. Concordance analyses were performed for patients with both SVR4 and SVR12 data. The concordance analysis in the ASTRAL studies included 1015 patients; 1005 and 1002 achieved SVR4 and SVR12, respectively. Among SVR4 achievers, 3 failed to maintain SVR12, while all (10/10) patients who did not achieve SVR4 also failed SVR12. In the real-world cohort, 479/509 (94%) patients achieved SVR4 and 485/509 (95%) achieved SVR12. Of those with SVR4, 7 failed SVR12; 17 of 30 patients who did not achieve SVR4 also failed SVR12. High concordance between SVR4 and SVR12 was observed in both ASTRAL and the real-world dataset, supporting the use of SVR4 as a predictor of long-term SVR in patients with HCV infection treated with SOF/VEL. Streamlining cure confirmation by shifting SVR determination from week 12 to week 4 post-treatment may reduce patient loss to follow-up. Full article

The Cairo Monorail System presents significant geotechnical challenges due to its integrated structural configuration and its alignment across heterogeneous soil conditions, including collapsible and swelling soils. This study investigates the foundation performance of the monorail through a combination of advanced site investigations, full-scale pile load testing under dry and wetted conditions, and finite-element modeling incorporating soil–structure interaction. Field load tests on large-diameter bored piles founded in collapsible soils demonstrated a pronounced increase in settlement and a reduction in stiffness following wetting, confirming the sensitivity of pile behavior to moisture variations. Three-dimensional numerical analyses of the integrated monorail system showed that differential settlements between adjacent columns are generally limited to less than 9 mm under serviceability loading conditions, satisfying passenger comfort requirements. Long-term coupled seepage–deformation analyses conducted using PLAXIS indicated that surface water infiltration into swelling soils may induce time-dependent monopile heave of approximately 10 mm over a 50-year design life, which remains within acceptable serviceability limits. The results demonstrate that detailed geotechnical characterization, combined with appropriate numerical modeling strategies, can effectively control differential deformation and long-term heave in continuous monorail systems, ensuring their operational safety and long-term performance. Full article

Artificial intelligence (AI) is reshaping healthcare by supporting faster and more informed clinical decisions. However, the complexity of human health makes accurate predictive modeling challenging. In this study, we introduce a methodological framework for constructing intelligent digital twins of disease progression by combining patients’ sequential medical images with temporally aligned electronic health records (EHRs). EHRs in this context include structured clinical parameters such as laboratory test results, demographic characteristics, and medication information. The existing literature provides limited approaches that jointly forecast future medical images and clinical status using long-term historical data. Our framework integrates aligned temporal image sequences with these EHR features and employs either ConvLSTM or ViViT-based spatio-temporal encoders, optionally coupled with a generative module for future image synthesis. While awaiting access to patient datasets, we conducted an initial evaluation using a single-cell time-lapse microscopy dataset whose temporal dynamics resemble patient data. Both systems generate time-ordered image sequences that evolve under changing conditions, and the shifting nutrient environment in microfluidic channels parallels the temporal variations observed in patients’ EHR records. This preliminary study demonstrates the broader applicability of our model to datasets containing long-term sequential images and associated parameters, supporting its potential for future patient-specific digital twin development. Full article

Residual β-cell secretory function plays a central role in diabetes pathophysiology; however, long-term comparative data describing β-cell trajectories from diagnosis across diabetes phenotypes remain limited. In this prospective observational study, 393 adults with newly diagnosed diabetes underwent assessment of fasting and glucagon-stimulated C-peptide at diagnosis. The cohort included individuals with type 1 diabetes mellitus (T1DM), encompassing both classical adult-onset autoimmune diabetes and latent autoimmune diabetes in adults (LADA), as well as individuals with type 2 diabetes mellitus (T2DM). A subgroup of 89 participants underwent follow-up visit after a mean of seven years. Glucagon stimulation testing was not repeated at follow-up in patients with T1DM and LADA for clinical and safety reasons; therefore, longitudinal analyses in these groups are based on fasting C-peptide measurements. At diagnosis, fasting and glucagon-stimulated C-peptide concentrations differed markedly between phenotypes (median fasting C-peptide: 0.87 ng/mL in T1DM, 1.53 ng/mL in LADA, and 2.64 ng/mL in T2DM; stimulated C-peptide: 1.35, 1.86, and 4.60 ng/mL, respectively; all p < 0.001). During follow-up, patients with T1DM exhibited a pronounced decline in fasting C-peptide (from 0.95 to 0.10 ng/mL), whereas individuals with T2DM showed preserved or increased stimulated responses (from 4.37 to 5.46 ng/mL). Participants with LADA displayed intermediate baseline values and a gradual decline in fasting C-peptide (from 1.41 to 0.31 ng/mL). Higher baseline C-peptide concentrations were associated with more favourable long-term metabolic profiles, including lower insulin resistance and better glycaemic control. These findings demonstrate that the early dynamic assessment of β-cell reserve using the glucagon stimulation test complements fasting C-peptide by revealing biologically meaningful heterogeneity in disease trajectories, thereby refining phenotypic classification and prognostic stratification at the time of diabetes diagnosis. Full article

Background: Despite advances in the management of acute coronary syndrome (ACS), women continue to experience higher long-term mortality and lower access to secondary prevention compared with men. Objective: This study aimed to assess whether a universally inclusive, nurse-led secondary prevention program implemented at a University Hospital improved post-ACS outcomes and reduced gender disparities in risk factor control and mortality. Methods: This retrospective, observational study compared two cohorts of ACS survivors discharged from Bellvitge University Hospital: a pre-intervention cohort (2018) and a post-intervention cohort (2022). The nurse-led program included universal enrollment of all ACS patients, early follow-up, pharmacological optimization, therapeutic exercise, lifestyle counseling, and coordination with primary care. Outcomes included lipid and glycemic control and 18-month mortality, stratified by sex. Results: A total of 409 patients were included (2018: n = 200; 2022: n = 209), of whom 130 were women. Women were older and had more comorbidities. Post-program implementation, the proportion of patients without post-discharge blood testing dropped from >50% to <17% in both sexes. Lipid and glycemic control improved significantly at both early (1–4 months) and late (9–18 months) follow-up. Early differences favoring men disappeared by 18 months. Mortality decreased by 27.5% in men and 47.6% in women, representing a significantly greater relative reduction among women (p = 0.0001). Conclusions: A structured, nurse-led secondary prevention program with systematic inclusion improved clinical outcomes and significantly narrowed the gender gap in cardiovascular mortality. These findings demonstrate that equitable, protocolized care led by advanced practice nurses can reduce systemic inequities in cardiovascular health. Full article

Background: This study assessed the long-term stability of dental arch changes achieved through clear aligner treatment in growing patients during the early mixed dentition stage. Methods: This retrospective study included 20 patients (mean age 8.3 ± 0.4 years) treated with clear aligners according to a standardized sequential expansion protocol. No additional auxiliaries, interproximal reductions, or retentions were used. Dental casts were collected at baseline (T0), end of treatment (T1), and two years post-treatment without retention (T2). Linear and angular measurements (arch width, molar and incisor torque, Henry’s angle, overjet, overbite, and Little’s index) were assessed on digital models. Friedman ANOVA and Wilcoxon signed-rank tests were applied (α = 0.05). Results: At T1-T0, significant transversal expansion was achieved in both arches (U6–6 mesial +2.1 mm; L6–6 mesial +2.4 mm; p < 0.05), with favorable torque changes and a reduction in overjet (−1.5 mm). From T1 to T2, only minimal, non-significant relapse was detected, except for a slight reduction in lower left molar torque (−1.1°). The T2-T0 comparison confirmed stable improvements in mesial intermolar widths (upper +2.0 mm; lower +1.6 mm), molar derotations, and overjets (−1.9 mm), with no significant loss of expansion or sagittal correction. Conclusions: Clear aligners in early mixed dentition achieved significant and stable dental arch modifications over a 2-year follow-up without the use of retention appliances. This therapeutic approach may represent a reliable interceptive option in growing patients. Full article

Rapid energy planning in cities needs decision-support tools that can change based on the supply of renewable resources and the needs of stakeholders. This paper introduces an innovative adaptive decision-support framework that integrates Long Short-Term Memory (LSTM)-based short-term renewable energy forecasting with an interval-valued Pythagorean fuzzy Best-Worst Method–TOPSIS (IVPF-BWM–TOPSIS). This enables forecast-driven and temporally adaptive prioritisation of urban energy technologies, as opposed to static expert-based evaluation. Using criteria based on forecasted technical feasibility and scalability, the five green energy options that are looked at are rooftop solar, wind energy, smart grids, solar-integrated electric vehicle infrastructure, and battery energy storage. The best score is for rooftop solar (RDC = 0.65), followed by solar-integrated EV infrastructure (RDC = 0.566), and finally smart grids (RDC = 0.55). Wind energy gets the lowest score because it will not be very useful in cities. Sensitivity analysis (±20% weight change) and 15 scenario-based stress tests show that the framework is strong and does not change the order of the ranks. The results show that the proposed mixed AI and fuzzy method can be used to make plans for renewable energy in smart cities that are both based on data and can be used by many people. Full article

Introduction/Purpose: Congenital cryptorchidism and retractile testis represent the most commonly presented abnormalities of the male genitourinary system. Orchiopexy is the surgical treatment for both conditions and can be performed either via the conventional two-incision surgical approach or via a singular scrotal incision. The present study firstly investigated the complications associated with each orchiopexy approach in a single-center pediatric surgical department and secondly compared the surgical outcomes in children with congenital cryptorchidism or retractile testes. Methodology: A retrospective analysis was conducted in pediatric patients with either congenital cryptorchidism or retractile testes who underwent orchiopexy from 2015 to 2019. Data collected during the study included diagnosis, surgical technique and both short- and long-term complications. Patient stratification was performed in accordance with the type of orchiopexy and the diagnosis UDT vs. RT and inguinal orchidopexy vs. scrotal orchidopexy. Results: A total of 362 children underwent 443 orchiopexies of which 227 were inguinal and 216 were scrotal. Complications were reported in 16 (3.6%) surgeries and from which 14 (3.16%) were presented in for postoperative complications. Short-term complications were presented in four (0.9%) cases and consisted of wound dehiscence. Long-term complications were recorded in 12 (2.7%) cases, including recurrence in six (1.3%) testes, testicular atrophy in three (0.6%) cases and presentation of hydrocele or inguinal hernia in two (0.4%) and one (0.2%) patient, respectively. Notably, 13 orchidopexies with preoperative diagnosis of congenital cryptorchidism, were linked with complications (p = 0.01), 12 of which underwent with two-incision technique (p = 0.07). Conclusions: The findings of the study suggest that a preoperative diagnosis of congenital cryptorchidism is a possible risk factor for postoperative complications. With regard to the surgical technique performed, the single-incision scrotal orchiopexy appears to be a much safer and more effective approach palpable undescended testes, compared to the two-incision approach. For the high-lying testes, although the single-scrotal technique provides good results, more prospective studies with selected impalpable undescended testes are needed to strengthen the existing literature. Full article

This study assesses the diversity, distribution, and ecological interactions of freshwater gastropod communities across eight sites in southern Iraq, spanning marshes, rivers, and canal systems within the Tigris-Euphrates basin. Diversity indices (Shannon–Wiener H′ and Pielou’s evenness J) were calculated to evaluate community structure, and a revised stacked bar chart of relative abundances revealed widespread dominance by species such as Melanoides tuberculata and Physella acuta, which frequently exceeded 50% of local assemblages. While P. acuta is an established invasive species, M. tuberculata is now considered native or long-established in the region. Species interactions were examined using Pianka’s niche overlap index, and null model testing (999 permutations) revealed only a few statistically significant overlaps (p < 0.05), suggesting that species co-occurrence is shaped more by environmental filtering than direct competition. To directly examine the influence of environmental drivers on species composition, Multiple Factor Analysis (MFA) was performed. MFA revealed patterns of association between dissolved oxygen, salinity, and species assemblages, suggesting these abiotic factors may influence community structure. To our knowledge, this study is the first in Iraq to use null models, constrained ordination, and MFA to investigate community assembly of freshwater gastropods, ultimately producing novel insights regarding the interactions between environmental stressors and aquatic biodiversity patterns. The results of this study highlight the need for long-term ecological monitoring and conservation in marshland habitats important for the resiliency of native species. Full article