Search Results (2,377)

Hydrogen (H₂) is regarded as a promising option for sustainable energy systems; however, its large-scale use in electricity supply remains limited. This study develops a stochastic network optimization model to examine the applicability of H₂-based electricity generation. The proposed Hydrogen Supply Chain (HSC) model evaluates cost and emission performance under uncertainty by considering disaster conditions, transmission losses, depreciation, and the time value of money. The Marmara Region of Türkiye is divided into 24 grid nodes, and a single-period model for 2023 is solved using Mixed-Integer Linear Programming (MILP). The HSC is allowed to meet 10–40% of electricity demand and to replace collapsed grid lines by supplying critical public centers (CPCs) during disasters. The results show that the HSC can meet 24.82% of demand, although at costs approximately 3.9 times higher than power grid (PG) electricity, while producing 3.44 MtCO₂/year compared to 65.96 MtCO₂/year from the PG. The model is then extended to a multi-period structure (2023–2053) and solved by Variable Neighborhood Search (VNS). Over time, H₂ costs decline, and their share rises from 19% to 35%, while electricity costs decrease from 408 USD/MWh to 170 USD/MWh. These findings suggest that H₂-based electricity supply can support long-term sustainability and resilience objectives in regional energy planning. Full article

This paper presents a comprehensive evaluation of control strategies for a highly energy-efficient plus-energy terraced housing complex equipped with photovoltaic generation, modulating ground-source heat pumps, electrical and thermal energy storage systems, and activation of building thermal mass. The study combines long-term monitoring data, annual simulations, and hardware-in-the-loop (HiL) experiments to assess modulating heat-controlled operation (HC), PV-controlled (PVC), and predictive control strategies, including simple predictive control (SPC) and model predictive control (MPC). The simulation results show that the baseline HC operation already achieves a high load cover factor (LCF), defined as the fraction of total electrical demand covered by local PV generation (direct use + battery discharge) of 65.6% and a seasonal performance factor (SPF) of the central heat pumps of 5.8. PVC increases LCF (71.0%) by shifting heat pump operation toward PV-rich periods but leads to elevated storage temperatures up to 5 K and a reduced SPF of 4.8. MPC further enhances LCF by 4–7 percentage points in simulated and HiL environments. However, its real-world performance is strongly influenced by forecast quality and the limited controllability of the heat pump system. In addition, building thermal mass activation is investigated as a complementary flexibility option. Simulation and monitoring results demonstrate that moderate room temperature set-point (2 K) increases during PV availability significantly improve LCF from 20% to 55% while maintaining thermal comfort. Overall, the findings indicate that in highly efficient plus-energy buildings, robust rule-based strategies combined with thermal mass activation can achieve a large share of the attainable benefits, while the added complexity of MPC must be carefully weighed against practical limitations. Full article

Bronchopleural fistula is a rare but severe complication of lung resection, associated with significant morbidity and mortality, especially when an open-window thoracostomy is required. The clinical and surgical management is complex and becomes even more challenging in the presence of underlying conditions such as recurrent infections or malignancy. Postoperative management is equally demanding, as local compression may help prevent fistula recurrence but can compromise flap perfusion. A 65-year-old male with a history of right upper lobectomy and subsequent sublobar resection for lung adenocarcinoma presented with an 8 × 4 cm open-window thoracostomy complicated by chronic bronchopleural fistula and empyema. Extensive fibrosis of the surrounding tissues, including the ipsilateral latissimus dorsi muscle, limited the available reconstructive locoregional options. Reconstruction was performed using primary fistula closure reinforced with a contralateral free latissimus dorsi musculocutaneous flap and a fascia patch graft secured with cyanoacrylate-based bioadhesive. Postoperatively, continuous near-infrared spectroscopy monitoring enabled safe application of compressive bandage while minimizing the risk of flap perfusion compromise. Complete fistula closure was achieved. Apart from a surgical site abscess requiring debridement on postoperative day 7, no further complications occurred. At the 2-year follow-up, the patient remains free of fistula recurrence, wound dehiscence, or oncological relapse. We describe a novel approach for open-window thoracostomy closure combining a free musculocutaneous flap with a fascia patch graft reinforced by bioadhesive, together with postoperative perfusion monitoring using near-infrared spectroscopy. This strategy may help address both the reconstructive and postoperative challenges associated with complex bronchopleural fistulas. Full article

To meet practical needs such as anti-icing for wind turbine blades, carbon nanotube coatings (CNTCs)—known for their excellent mechanical properties, high strength, and high thermal conductivity—have emerged as a research hotspot in the field of coating materials and represent a promising option for such applications. Outlines the key properties and mainstream preparation processes of CNT coatings, and provides an objective evaluation of research on their primary properties based on existing findings. Furthermore, to satisfy the comprehensive performance requirements of coatings in practical application scenarios, this paper proposes a property-balancing method for CNTCs specifically tailored to the anti-icing field of wind turbine blades. This method enables the coatings to fully satisfy the practical performance requirements in terms of strength and hydrophobicity, and avoids cost waste caused by excessive single performance beyond actual demands. It is expected to provide a reference for the application of CNTCs in related fields. Full article

Demand-side management is increasingly important for low-carbon transport governance. However, many studies assume relatively stable travel preferences and pay limited attention to behavioural changes under sudden external shocks. This study proposes an Event–Behaviour–Resilience framework and applies Natural Language Processing to Sina Weibo data to examine travel responses to extreme heat and refined oil price adjustments. The results show asymmetric response patterns. Oil price increases were associated with cost-based low-carbon substitution, with new-energy vehicle intentions accounting for 64.4% of the share. In contrast, extreme heat was associated with both trip reduction and motorised travel. Travel reduction reached 52.4%, while ride-hailing or taxi responses accounted for 24.6%. A quadratic fitting analysis identified 38.0–39.0 °C as an observed transition interval, within which high-carbon motorised willingness began to exceed low-carbon slow mobility willingness. Group-level analysis showed unequal behavioural flexibility. While 80.0% of the general population reduced travel under extreme heat, the forced mobility group showed limited travel reduction and maintained a high level of low-carbon willingness at 86.87%. XGBoost-SHAP results indicated that temperature, emotional valence, and behavioural constraints contributed to low-carbon mobility intention. These findings suggest that behavioural responses can help identify spatial interventions for low-carbon transport, especially in relation to heat exposure, mobility flexibility, and access to adaptive travel options. Full article

Background: Dietary interventions in heart failure (HF) remain limited, with current guidance focused largely on sodium restriction. Ketone metabolism has emerged as a potential therapeutic target in HF, with ketone supplementation shown to improve cardiac function. However, there are currently no studies investigating factors affecting adherence to a ketogenic diet (KD) in HF. Aim: To explore the factors influencing adherence to a KD in patients with HF to inform future dietary interventions. Method: This qualitative study was embedded within the KETO-HF pilot randomised controlled trial, in which participants with HF with reduced ejection fraction undertook a 4-month KD. Consenting participants were invited to complete semi-structured interviews. Interviews were audio-recorded, deidentified and transcribed verbatim. Data were analysed using thematic analysis with a mixed inductive–deductive strategy. Results: Fifteen participants were interviewed. Facilitators of adherence were: (1) personal motivation and self-regulation; (2) improved well-being; (3) interpersonal support and; (4) adaptive strategies and improved nutritional literacy. Barriers included: (1) early-phase physiological and psychological challenges; (2) social and cultural friction; (3) competing family and work demands and; (4) limited availability of suitable foods, particularly difficulty managing social situations and dining out. Conclusions: Adherence to a KD in people with HF is shaped by a combination of individual and social factors. These findings highlight the need for improved education, support, and increased food options to optimise implementation of dietary ketosis in HF. Full article

Land-use change is a major driver of ecosystem service reconfiguration, yet the character and intensity of resulting trade-offs remain highly variable across studies. This review synthesizes English-language research retrieved primarily from the Web of Science Core Collection and supplemented by Scopus and Google Scholar, with particular attention to the multi-scale characteristics of trade-offs, the analytical consequences of different assessment approaches, and their relevance for sustainability governance. The reviewed literature reveals several recurrent patterns. Intensive land conversion commonly produces short-term gains in provisioning or construction-related benefits while reducing regulating and supporting services. Trade-offs are strongly scale dependent, reflecting differences in ecological processes, land-use decisions, and governance units rather than analytical sensitivity alone. The landscape configuration further shapes ecosystem service interactions in ways that cannot be inferred from land-use area alone. However, evidence on restoration co-benefits, spatial-optimization gains, and governance claims based on scenario results remains context-dependent. These findings should be interpreted as conditional support for comparing land-use options, identifying potential trade-off displacement, and clarifying planning constraints, rather than as proof that restoration or optimization will automatically improve governance outcomes. The current evidence base is geographically uneven and strongly concentrated in Chinese case studies, which enriches planning-oriented research but limits straightforward generalization across institutional and environmental settings. Further progress may depend on stronger cross-scale and dynamic analysis, closer integration of the ecosystem service supply, demand, and flow, and more explicit treatment of uncertainty. More importantly, the value of future research will lie not simply in producing additional maps or indicators, but in establishing a clearer correspondence between the type of evidence generated and the governance decisions it is expected to inform. Full article

Accurate design and performance assessment of solar thermal domestic hot water systems coupled with a heat pump auxiliary typically requires transient simulation, as the system’s behavior depends on multiple interactions among collector characteristics, storage stratification, control logic, weather, and draw-off timing. Monthly methods such as the f-chart are useful for first-pass estimates, but they do not resolve stratification, thermostat operation, or demand timing, and they may become inaccurate for stratified thermostat-controlled systems. Direct comparisons of locally inspectable symbolic and black-box surrogate families for this system class remain limited. A 10,982-case development dataset was generated from minute-resolved annual MATLAB simulations, parameterized by collector area, optical efficiency, and first- and second-order loss coefficients. Three surrogate families were benchmarked under a unified protocol, random forest-assisted shape-constrained symbolic regression (SR), feed-forward artificial neural network (ANN) models, and Automatic Learning of Algebraic Models for Optimization (ALAMO), with the f-chart used as a monthly reference method. The targets were the 12 monthly solar fractions under the direct solar heat definition and the corresponding annual mean solar fraction, evaluated on the same independent 991-case test set. SR achieved the lowest average error (mean absolute percentage error, MAPE = 0.82%; root mean square error, RMSE = 0.006), followed by the ANN (MAPE = 2.07%, RMSE = 0.028) and ALAMO (MAPE = 3.67%, RMSE = 0.060), with Nash–Sutcliffe efficiency (NSE) values above 0.98 for all models. Evaluation times were 0.0026–0.124 s per target, compared with about 1000 s for one full-year simulation. These results define the study as a common protocol benchmark within the studied simulator-defined envelope. SR gives the strongest accuracy with local symbolic inspectability, the ANN remains the flexible retrainable option, and ALAMO provides compact algebraic evaluation with the shortest learned model runtime. Full article

Background/Objectives: Aztreonam/avibactam is a promising treatment option for serious infections caused by metallo-β-lactamase-producing carbapenem-resistant Enterobacterales (MBL-CRE). However, the labeled regimen is operationally demanding because it requires frequent, prolonged infusions, and the recommended loading dose does not match the commercially available vial strength. This population pharmacokinetic (PopPK)-based Monte Carlo simulation study aimed to optimize aztreonam/avibactam dosing across renal function strata while maintaining pharmacokinetic/pharmacodynamic (PK/PD) target attainment. Methods: Published PopPK models for aztreonam and avibactam were reconstructed and applied in Monte Carlo simulations. Virtual adult patients (body weight 70 kg) were stratified into five renal function groups according to creatinine clearance (CrCL): 101–120, 81–100, 51–80, 31–50, and 15–30 mL/min. Simulated scenarios varied infusion duration, dosing interval, maintenance dose, and loading strategy. Prespecified PK/PD targets were 60% fT > MIC (the percentage of dosing interval that free drug concentration remains above the minimum inhibitory concentration) for aztreonam (MIC 8 mg/L) and 50% fT > CT (the percentage of dosing interval that free drug concentration remains above the critical threshold concentration) for avibactam (CT 2.5 mg/L). A joint probability of target attainment (PTA) ≥ 90% was considered acceptable. Results: Regimen performance differed across renal function strata. For patients with CrCL > 80 mL/min, the labeled q6h regimen infused over 3 h remained the most robust option, whereas shortening the infusion to 1 h or 2 h reduced target attainment. In the CrCL 51–80 and 31–50 mL/min subgroups, both q6h/3 h and q6h/2 h regimens generally achieved acceptable PTA. However, in the CrCL 31–50 mL/min subgroup receiving q6h/2 h administration, omitting a loading dose was associated with reduced early avibactam exposure. In the CrCL 15–30 mL/min subgroup, a simplified half-vial regimen (0.75/0.25 g q8h/2 h) provided PTA comparable to that of the complex labeled reduced-dose regimen. Across loading dose scenarios, omission of the loading dose was best supported in the CrCL 51–80 mL/min subgroup, whereas retaining the labeled loading dose remained the more prudent approach in the CrCL 31–50 mL/min subgroup when a 2 h infusion was used. Conclusions: PopPK-guided, renal function-stratified simplification of aztreonam/avibactam dosing may improve clinical practicality without materially compromising PK/PD target attainment in selected patient subgroups. A 2 h infusion appears a reasonable alternative for patients with CrCL 31–80 mL/min, and a 0.75/0.25 g q8h/2 h half-vial regimen may be considered a plausible exploratory option for patients with CrCL 15–30 mL/min. These findings support more feasible administration strategies, but prospective clinical validation remains necessary. Full article

Background and Clinical Significance: Localized amyloidoma rarely affects the tongue base, a site far less commonly involved than the larynx. When it does occur at this location, the clinical and radiological presentation can closely mimic oropharyngeal malignancy, making it a genuine diagnostic pitfall for head and neck surgeons. Establishing the diagnosis demands histological proof, and ruling out systemic amyloidosis is an essential prerequisite. Case Presentation: An 80-year-old nonsmoking woman was evaluated for progressive dysphagia and globus sensation that had worsened over several years. Endoscopy revealed a firm, lobulated mass at the tongue base, centered on the glossotonsillar sulcus. Incisional biopsy under local anesthesia showed amyloid deposits. MRI demonstrated an avidly enhancing, well-circumscribed lesion without invasion of the deep neck spaces. A comprehensive systemic evaluation—including serum and urine protein electrophoresis with immunofixation, serum free light chains (κ/λ ratio 1.05), echocardiography, and bone marrow biopsy—yielded no evidence of systemic AL amyloidosis or plasma-cell dyscrasia. The mass was excised through transoral robotic surgery (TORS). Histopathology confirmed Congo red-positive, apple-green birefringent amyloid with lambda light-chain restriction; staining for AA amyloid and transthyretin was negative. The patient was diagnosed with primary localized lingual amyloidoma of the AL lambda type and remained symptom-free, with no endoscopic evidence of recurrence, at 12-month follow-up. Discussion: Amyloidoma deserves a place in the differential diagnosis of tongue base masses, particularly when the clinical picture does not fit squamous cell carcinoma. Congo red staining under polarized light, immunohistochemical light-chain typing, and a rigorous systemic workup are the cornerstones of diagnosis. Robotic-assisted transoral excision provides excellent access to the tongue base with low morbidity. Conclusions: This case underscores the need to consider amyloidoma when evaluating tongue base lesions, the central role of Congo red staining and light-chain typing, and the utility of TORS as an effective treatment option for selected symptomatic cases. Full article

This study outlines the design and assessment of a hybrid renewable energy system aimed at powering rural electrification for five villages in the Butha-Buthe district of Lesotho, which has an overall daily energy consumption of 1342 kWh and a peak demand of 112 kW. Utilizing HOMER Pro (version 3.18.4), various configurations were analyzed. The most cost-effective system, comprising PV, wind, hydro, batteries, and a diesel generator, resulted in an LCOE of USD 0.3194, alongside a renewable share of 73%. An entirely renewable setup was also explored, achieving a 100% renewable share but with a higher LCOE of USD 0.6615. Sensitivity analysis regarding diesel pricing and hydro flow rates revealed significant effects on Net Present Cost and fuel consumption. The results highlight feasible options for economically efficient, renewable-centric rural electrification in isolated areas. Full article

Electricity purchase price variation can influence the economic feasibility of residential distributed generation, particularly in regulated markets where grid electricity prices and export compensation conditions affect investment decisions. This study evaluates the impact of flat electricity purchase price scenarios on the techno-economic viability of residential grid-connected energy systems in Santo Domingo Tehuantepec, Oaxaca, Mexico, using HOMER Pro. The analysis considers PV, wind generation, diesel generation, converter, and grid connection as candidate components, while evaluating three residential demand profiles of 11.26, 30.00, and 83.30 kWh/day and 10 electricity purchase price scenarios ranging from 3.45 to 5.00 MXN/kWh. The objective is to identify the electricity purchase price values at which the optimal architecture changes from conventional grid-only supply to PV/converter/grid adoption under the evaluated case study assumptions. The results show that grid-only supply remains the least-cost option from 3.45 to 4.20 MXN/kWh for all demand profiles. At 4.25 MXN/kWh, HOMER Pro selects PV/converter/grid configurations for the medium- and high-demand profiles, while the low-demand profile remains grid-only. At 4.30 MXN/kWh, PV/converter/grid also becomes optimal for the low-demand profile. At 5.00 MXN/kWh, ROI reaches 11.0% for the three residential demand profiles, while payback decreases to 6.5 years for the low- and medium-demand profiles and 6.4 years for the high-demand profile. The wind turbine and diesel generator were not selected in the optimal configurations, despite being included as candidate technologies. These findings provide a practical case study indicator of the electricity purchase price levels at which residential PV-grid adoption becomes economically competitive under flat purchase price scenarios and zero export compensation. Full article

Arid and semi-arid shelterbelts must provide long-term ecological protection under chronic water scarcity, high evaporative demand, and rising salinization risk, yet management still lacks an integrated framework linking irrigation, root-zone salt dynamics, and woody plant performance. Here, we synthesize evidence on water–salt–root linkages in drip-irrigated shelterbelts and related dryland woody systems from a structured Web of Science Core Collection search (1 January 2000–1 January 2026). The evidence shows that shelterbelt performance is governed not by water or salinity alone, but by a coupled root-zone system: localized irrigation creates moisture–salt heterogeneity, salts accumulate near evaporative fronts and emitter margins, and roots redistribute depth, density, and uptake zones. In hyper-arid saline-drip systems, precipitation may be only ~24.6 to <50 mm yr⁻¹, evaporation > 3000–3639 mm yr⁻¹, groundwater salinity 2.8–29.7 g L⁻¹, active roots 20–80 cm, and salt mainly in the 0–20 cm surface layer. Irrigation thus acts as both the basis of establishment and a source of long-term vulnerability, particularly where saline groundwater or other non-conventional water sources are used. Management options can improve root-zone habitability, but shelterbelt-specific thresholds and integrated indicators remain limited. This review proposes a root-zone-centered framework supporting predictive regulation. Full article

Antimicrobial resistance (AMR) is a leading global cause of death, with recent World Health Organization (WHO) data revealing that one in six laboratory-confirmed bacterial infections shows resistance to at least one antibiotic treatment. This review comprehensively analyzes the AMR landscape in 2026, detailing its evolution, mechanisms, and the innovative strategies being deployed to combat it. Driven by Darwinian selection and accelerated by factors like antibiotic overuse during the Coronavirus Disease 2019 (COVID-19) pandemic (predominantly in hospitalized patients with suspected bacterial co-infection), AMR is propelled by a diverse molecular arsenal in bacteria. Key mechanisms include enzymatic drug inactivation (e.g., the diversifying β-lactamase superfamily), target site modification (e.g., mcr genes conferring colistin resistance), efflux pumps, and biofilm formation. The rapid global spread of these traits is facilitated by a dynamic “mobilome”, a network of plasmids and transposons that shuttle resistance genes between species. This crisis has sparked a major scientific mobilization. Advances include the discovery of novel antibiotic scaffolds like lariocidin and the regulatory approval of critical new antibiotic/inhibitor combinations such as sulbactam/durlobactam and aztreonam/avibactam, which target highly resistant Gram-negative bacteria. Moreover, the first-in-class antibiotic gepotidacin offers a new option for urinary tract infections. Beyond traditional drugs, the pipeline is diversifying to include phage therapy, antivirulence strategies, and artificial intelligence-guided drug discovery. This diversification is critical as it helps preserve the effectiveness of existing Medically Important Antimicrobials (MIAs), those deemed essential for human medicine, by providing alternative or adjunctive treatment options. However, scientific innovation alone is insufficient. This review argues that lasting success requires parallel progress in global policy and infrastructure. Strategic priorities beyond 2026 must include finalizing and funding updated global action plans, strengthening real-time surveillance and diagnostic capacity, especially in low-resource settings, and implementing new economic models to de-risk antibiotic development. Embedding effective antimicrobial stewardship within universal health coverage and pandemic preparedness plans is crucial. Ultimately, defeating AMR demands an unprecedented, coordinated global effort that outpaces the relentless adaptability of bacterial pathogens. Full article

Industrial heat demand is a major source of CO₂ emissions, making the decarbonization of this sector essential for achieving sustainability. This study explores and compares different methods for supplying useful heat to the industrial sector through a multi-criteria approach that considers technical performance, economic viability, and environmental impact. Both conventional and alternative systems are examined, aiming to develop sustainable designs. These include solar-based systems using parabolic trough collectors, supported by either electric heaters or natural gas boilers. In addition, a high-temperature heat pump (HTHP) utilizing waste heat is analyzed, also combined with either electric heaters or gas boilers as backup. For reference, a conventional natural gas boiler system is included as a baseline case. In total, five scenarios are evaluated for applications in the chemical industry. Each scenario is assessed in terms of energy and exergy efficiency, cost, and CO₂ emissions. A multi-criteria analysis is then applied to determine the most sustainable option under varying electricity and waste heat price conditions. The results indicate that the configuration combining a high-temperature heat pump with electric heaters (Scenario 3) achieves the highest performance, with energy and exergy efficiencies of 0.952 and 0.666, respectively. The lowest CO₂ emissions are observed in the case of using solar collectors with electric heaters (Scenario 1), reaching 4154 tons per year. From an economic perspective, Scenario 3 emerges as the most favorable option at lower electricity prices (0.10 €/kWh), with a levelized cost of heating (LCOH) of 0.0555 €/kWh. At higher electricity prices, the optimal design shifts to Scenario 2, which combines solar collectors with a natural gas boiler, resulting in an LCOH of 0.0603 €/kWh. Full article