Search Results (1,758)

Addressing the need to optimize human settlement quality in arid and semi-arid regions under rapid urbanization, this study innovatively constructs an evaluation framework integrating greenness, thermal conditions, impervious surfaces, water bodies, and air transparency. Focusing on 12 prefecture-level cities in Inner Mongolia, Northern China, it systematically reveals the spatial differentiation characteristics and driving mechanisms of human settlement quality. Findings indicate the following: (1) Regional human settlement quality exhibits a spindle-shaped structure dominated by the medium grade (Excellent: 18.13%, High: 23.34%, Medium: 46.48%, Low: 12.04%), with Ulanqab City having the highest proportion of Excellent areas (25.26%) and Ordos City the lowest proportion of Low-grade areas (6.20%), reflecting a critical transition period for regional quality enhancement. (2) Spatial patterns show pronounced east-west gradients and functional differentiation: western arid zones display significant blue-green space advantages but face high-temperature stress and rigid water constraints, eastern humid zones benefit from superior ecological foundations with weaker heat island effects, the core Hetao Plain experiences strong heat island effects due to high impervious surface density, while industrial cities confront prominent air pollution pressures. Consequently, implementing differentiated strategies—strengthening ecological protection/restoration in High/Low-grade zones and optimizing regulation to drive upgrades in Medium-grade zones—is essential for achieving three sustainable pathways: compact development, blue-green space optimization, and industrial upgrading, providing vital decision-making support for enhancing human settlement quality and promoting sustainable development in ecologically fragile cities across northern China. Full article

Background and Objectives: Deep venous thrombosis (DVT) is associated with pulmonary embolism and long-term complications such as post-thrombotic syndrome (PTS). Anticoagulation prevents thrombus extension but does not actively remove clot. Interventional techniques, including catheter-directed thrombolysis, mechanical and pharmacomechanical thrombectomy, and venous stenting, have been introduced to restore venous patency and reduce complications. This systematic review summarizes current evidence on outcomes, safety, and patient selection for these procedures. Materials and Methods: A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was conducted for studies published between January 2000 and February 2024. Eligible studies included randomized controlled trials, systematic reviews, meta-analyses, and observational studies with ≥20 patients. Extracted outcomes were technical success, thrombus clearance, venous patency, PTS, quality of life, and complications. Risk of bias was assessed using the Cochrane Risk of Bias Tool, Newcastle–Ottawa Scale, and AMSTAR-2. Results: Of 456 records screened, 35 studies were included. Randomized trials (CaVenT, ATTRACT, CAVA) showed that catheter-directed and pharmacomechanical approaches improved venous patency and reduced moderate-to-severe PTS in selected patients with iliofemoral DVT, though overall benefit was variable. Mechanical thrombectomy devices (e.g., AngioJet, ClotTriever, FlowTriever) achieved high thrombus clearance and shorter procedural times, with device-specific complication profiles. Observational data demonstrated venous stenting patency rates of 74–89% at 12 months. Study heterogeneity limited direct comparisons. Conclusions: Interventional procedures can reduce PTS and improve outcomes in carefully selected patients, particularly those with acute iliofemoral DVT. Modern mechanical and pharmacomechanical techniques enhance efficiency and safety, while venous stenting addresses underlying obstructions. Further high-quality trials with long-term follow-up are needed to define optimal patient selection and comparative effectiveness. Full article

Background: Cervicogenic headache (CGH) is a prevalent secondary headache disorder associated with upper cervical spine dysfunction, often involving nociceptive convergence at the trigeminocervical complex. While manual therapy and exercise have demonstrated benefit, autonomic dysregulation may contribute to persistent symptoms. This case report explores the integration of external vagus nerve stimulation (eVNS) into a multimodal physical therapy approach targeting both mechanical and neurophysiological contributors to CGH. Case Description: A 63-year-old female presented with chronic CGH characterized by right-sided suboccipital and supraorbital pain, impaired sleep, and postural dysfunction. Examination revealed a right rotational atlas positional fault, restricted left atlantoaxial (AA) mobility, suboccipital hypertonicity, and reduced deep neck flexor endurance. Initial treatment emphasized manual therapy to restore AA mobility and atlas symmetry, combined with postural correction and neuromuscular training. Intervention: After initial symptom improvement plateaued, eVNS targeting the auricular branch of the vagus nerve was introduced to modulate autonomic tone. The patient used a handheld eVNS device nightly over three weeks. Outcomes: Substantial improvements were observed in the Neck Disability Index (↓77%), Headache Disability Inventory (↓72%), and pain scores (↓100%). Cervical mobility, atlas symmetry, and deep neck flexor endurance improved markedly. The patient reported reduced anxiety, improved sleep, and sustained headache relief at one-month follow-up. Conclusions: This case highlights the potential synergistic benefits of integrating eVNS within a physiotherapy-led CGH management plan. Further research is warranted to explore its role in targeting autonomic imbalance and enhancing conservative treatment outcomes. Full article

In this study, the objective is to assess the impacts of NH₃ emissions from mink farming on human health and nature, which are sensitive to atmospheric nitrogen deposition. The impact-pathway approach is applied to follow the emissions from source to impact on human health in Europe (including Denmark) and from source to critical nitrogen load exceedances for NH₃-sensitive nature in Denmark. The Danish Eulerian Hemispheric Model (DEHM) is used for modelling the air pollution concentrations in Europe and nitrogen depositions on land and water surfaces in Denmark arising from NH₃ emissions from mink farming in Denmark. The Economic Valuation of Air (EVA) pollution model system is applied for deriving the health effects and corresponding socio-economic costs in Denmark and Europe arising from the emissions from mink farming. On a local scale in Denmark, the deposition resulting from the NH₃ emissions from mink farming is modelled using the results from the OML-DEP model at a high resolution to derive the critical nitrogen load exceedances for Danish nature areas sensitive to NH₃. From the analysis of the impacts through human exposure to the air pollutants PM_2.5, NO₂, and O₃, it is concluded that in total, ~60 premature deaths annually in Europe, including Denmark, can be attributed to the emissions of NH₃ to the atmosphere from the mink farming sector in Denmark. This corresponds to annual socio-economic costs on the order of EUR 142 million. From the analysis of critical load exceedances, it is concluded that an exceedance of the critical load of nitrogen deposition of ~14,600 hectares (ha) of NH₃-sensitive nature areas in Denmark can be attributed to NH₃ emissions from mink farming. The cost for restoring nature areas of this size, damaged by eutrophication from excess nitrogen deposition, is estimated to be ~EUR 110 million. In 2020, the mink sector in Denmark was shut down in connection with the COVID-19 pandemic. All mink were culled by order of the Danish Government, and now in 2025, the process of determining the level of financial compensation to the farmers is still ongoing. The socio-economic costs following the impacts on human health in Europe and nitrogen-sensitive nature in Denmark of NH₃ emissions from the now non-existing mink sector can therefore be viewed as socio-economic benefits. In this study, these benefits are compared with the expected level of compensation from the Danish Government to the mink farmers, and the conclusion is that the compensation to the mink farmers breaks even with the benefits from reduced NH₃ emissions over a timescale of ~20 years. Full article

Background: Living donor liver transplantation (LDLT) poses significant physiological challenges, especially during early postoperative recovery. While the long-term benefits of structured rehabilitation are well documented, data on short-term effects—particularly during the critical early inpatient phase—remain limited. This study aimed to evaluate the short-term impact of a structured exercise program on cardiopulmonary function, respiratory muscle strength, physical performance, oxidative stress markers, and quality of life in LDLT recipients. Methods: Four LDLT recipients (2 males, 2 females; mean age 48.00 ± 18.35 years) underwent a 4-week inpatient rehabilitation protocol. Weeks 1–2 involved conventional care, while weeks 3–4 included structured exercise consisting of early mobilization and inspiratory muscle training. Outcome measures included cardiopulmonary exercise testing (CPET), spirometry, maximal inspiratory and expiratory pressures (PImax, PEmax), 6 min walk distance (6MWD), lower limb muscle strength, Chronic Liver Disease Questionnaire (CLDQ), and serum oxidative stress markers (total antioxidant capacity [TAC] and malondialdehyde [MDA]). Results: All patients demonstrated postoperative declines in VO₂ peak, PImax, PEmax, and TAC. Structured exercise yielded clinically meaningful improvements in respiratory muscle strength, notably in female and younger participants. Two younger patients showed increased 6MWD; however, no patient regained preoperative VO₂ peak. TAC levels decreased following the intervention, and MDA levels remained stable in most cases. Conclusions: A two-week structured exercise program during early postoperative recovery may provide partial benefits in respiratory muscle strength and physical performance but is insufficient to restore full cardiopulmonary function in LDLT recipients. Longer rehabilitation periods may be necessary to achieve preoperative recovery levels. Full article

The growing global demand for bioplastics highlights the need for sustainable starch sources, and Indonesia has considerable potential for cultivating such feedstock. While cassava has been widely promoted, there is limited scientific justification for prioritizing it over alternatives such as sago. An important distinction is that cassava is grown on mineral soils, where many alternative crops are viable, whereas sago is cultivated on peatlands, where relatively few crops can be grown sustainably. This study compares the socio-economic benefits of cassava and sago, considering their competitiveness against their main competing crops (i.e., corn on mineral soils and oil palm on peatlands). For new plantations, sago generated lower farm-level benefits than cassava, with net present values of 1534 EUR/ha and 5719 EUR/ha, respectively. However, when integrating starch processing and environmental impacts, sago provided greater benefits than cassava (4166 EUR/ha vs. 3555 EUR/ha). In the long term, sago may become more profitable than cassava due to its low maintenance and lack of replanting needs. Additionally, sago offers broader societal and environmental advantages, as it thrives on undrained peatlands, for which few alternatives exist. This study concludes that sago, as a paludiculture crop, is a sustainable option for bioplastic feedstock and can support peatland restoration. Full article

This study presents a methodological framework for prioritizing areas for forest restoration with the primary objective of enhancing water provision. A multi-scale approach was employed, starting with macro-scale criteria at the river basin level, followed by more localized landscape and hydro-ecological assessments. This two-stage process facilitated strategic planning for interventions aimed at restoring forest cover in permanent preservation areas (PPAs) along watercourses and springs. The methodology was applied to the Joanes and Jacuípe Rivers Permanent Protection Areas Forest Rehabilitation Project in the Salvador Metropolitan Region, Bahia. The project’s primary goal is to improve water security by restoring native vegetation across 100 springs and 100 hectares of riparian zones, which are critical to the water supply system for the Salvador Metropolitan Region. The prioritization process integrated hydrological, ecological, and socio-environmental criteria, ensuring that restoration efforts not only enhance water production but also provide long-term ecological and social benefits. Full article

Due to rapid urbanization over the past five decades, there has been growing interest in the role of biodiversity in supporting human well-being. While previous research highlights the role of landscape biodiversity in psychological restoration, the pathway linking visual and auditory cues to perceived biodiversity—and subsequently to restorative outcomes—remains poorly understood. This study explores how visual and auditory stimuli influence human perception, including perceived biodiversity, preference, and restorative effects, within environments that maintain a consistent level of ecological biodiversity. This study constructed 16 hypothetical environments by combining three visual factors (species evenness, vegetation height, and plant color) with one auditory factor (presence or absence of natural sound), holding actual biodiversity constant. By comparing results from ANOVA and mixed-effect modeling, our analysis revealed important contrasts between the direct and indirect effects of visual and auditory features on perceived biodiversity and restoration. Plant height and natural sound consistently demonstrated direct positive effects on restorative outcomes. In contrast, plant color and species evenness influenced restoration indirectly, mediated through perceived biodiversity. The mixed-effect model indicated a partial mediation pathway between landscape features and restorative effects—an effect not observed in the ANOVA analysis. Surprisingly, species evenness was not directly associated with restorative outcomes, but was indirectly linked via perceived biodiversity. Similarly, while color enhanced biodiversity perception, it did not directly improve mental restoration and, under some conditions, may even contribute to overstimulation. These findings suggest that the restorative benefits of nature arise not only from the ecological composition of landscapes but also from how biodiversity is perceived. Designers and planners should consider not only biodiversity itself, but also how it is presented and perceived through multisensory experiences. Full article

This paper investigates whether carbon payments are sufficient to entice private landholders to invest in the rehabilitation and protection of coastal wetlands as a nature-based climate solution. Ecologically intact coastal wetlands, such as mangroves and saltmarshes, are capable of sequestering and storing large amounts of carbon. Reinstating ecological functionality of degraded coastal wetlands may be achieved by installing conservation fences that exclude hard-hoofed domestic and feral animals. This research integrates ecological, technical and economic data to ascertain whether conservation fencing could represent a financially viable investment for coastal landholders in the Australian context, if restored wetlands attracted carbon payments. Data gleaned through literature review and expert interviews about technical fencing requirements, contemporary costs and potential blue carbon income are consolidated into scenarios and tested using cost–benefit analysis. Payback periods are calculated using deterministic parameters. Risk-based cost–benefit analysis accounts for uncertainty of ecological and price parameters; it provides probability distributions of benefit–cost ratios assuming an expert-agreed economic lifespan of conservation fences. The results demonstrate that the payback period and benefit–cost ratio are highly sensitive to wetlands’ carbon sequestration capacity, fencing costs and the carbon price going forward. In general, carbon payments on their own are likely insufficient to entice private landholders to protect coastal wetlands through conservation fencing, except in circumstances where restored wetlands achieve high additional carbon sequestration rates. Policy measures that reduce up-front costs and risk and remuneration of multiple ecosystem services provided by restored wetlands are required to upscale blue carbon solutions using conservation fencing. The research findings bear relevance for other conservation and land-use contexts that use fencing to achieve sustainability goals and generate payments for ecosystem services. Full article

Obesity and related metabolic disorders are major global health challenges. Postbiotics, such as heat-inactivated probiotics, have attracted attention for their improved safety, stability, and potential metabolic benefits compared to live probiotics. However, the comparative anti-obesity effects and mechanisms of live versus heat-inactivated Lactiplantibacillus plantarum FRT4 remain unclear, so this study systematically evaluated their effects and mechanisms in high-fat-diet-induced obese mice. Mice received oral administration of live or heat-inactivated FRT4 (prepared by heating in a water bath at 80 °C for 5 min) for 16 weeks. Comprehensive analyses included metabolic profiling, histological evaluation, serum and liver biomarkers, gut microbiota composition, liver metabolomics, and transcriptomics. Both live and inactivated FRT4 significantly reduced body weight gain, adiposity, hepatic steatosis, and dyslipidemia, with inactivated FRT4 exhibiting comparable or superior efficacy. Notably, inactivated FRT4 restored gut microbiota composition, increased short-chain fatty acid production, and regulated hepatic metabolic pathways. Multi-omics analyses revealed modulation of lipid biosynthesis, amino acid metabolism, and energy utilization pathways. Specifically, the “biosynthesis of unsaturated fatty acids” pathway was downregulated in metabolomics and significantly enriched in transcriptomics, highlighting its central role in FRT4M-mediated metabolic reprogramming. These findings demonstrate that heat-inactivated Lp. plantarum FRT4 exerts systemic anti-obesity effects via gut–liver axis modulation, supporting its potential as a promising postbiotic intervention for obesity and metabolic dysfunction. Full article

Background: Subacromial impingement or pain syndrome (SAPS) is the most common diagnosis for chronic shoulder pain. Current surgeries do not reduce long-term pain, suggesting they miss the root etiology. Previously, we described the Human Disharmony Loop (HDL), where the unique lower trunk innervation to the pectoralis minor (PM) causes scapular dyskinesis and deforms its connections, including tugging the acromion down and impinging the subacromial structures. We hypothesize that SAPS patients who meet HDL criteria would benefit significantly from PM tenotomy with infraclavicular brachial plexus neurolysis (PM + ICN) alone. Methods: SAPS patients who met HDL diagnostic criteria were treated with PM + ICN, with secondary distal neurolysis if needed. Outcomes included pain and shoulder abduction ROM. Six-month follow-up minimum was required. Results: N = 140 patients were included. Median age was 49. Prior surgeries included 27% subacromial decompression/acromioplasty, 21% rotator cuff repair, 16% biceps tenodesis, 4% SLAP repair, 2% labral repair, 7% distal clavicle resection, 10% reverse total shoulder arthroplasty (rTSA), 1% rib resection with scalenectomy, 16% cervical spine fusion, 28% distal neurolysis. Median pain decreased from 8 to 2 and median shoulder ROM increased from 90 to 180 degrees. Positive impingement signs on exam decreased from 100% to 11%. (p < 0.01) Conclusions: In a large series of SAPS patients, evaluation and treatment for the HDL significantly reduced pain and restored motion. These findings suggest that in many patients SAPS may be a subset of the HDL: the ventral PM disturbing the scapula constitutes the anatomic basis and optimal surgical target behind SAPS. Full article

Conventional reports on wildfire damage focus on damage to built structures and life loss without capturing the long-term loss of many environmental benefits provided by natural capital. The assessment of the full cost of a wildfire event can be very challenging and time-consuming due to its broad range of impacts traversing decades. Two major wildfires, the 2021 Caldor Fire and 2022 Mosquito Fire, impacted rural communities and burned nearly 30 percent of the approximately 1 million acres of forests and private timber lands in the Upper American River Watershed (UARW) in California’s Sierra Nevada headwaters. The UARW provides a stock of natural capital that provides a flow of environmental benefits, or ecosystem goods and services, including California statewide water supply that was not recognized in the conventional reporting to properly inform decisions and investments for mitigation and recovery. Leveraging new tools available through the recent valuation of the UARW’s ecosystem goods and services, this study provides a first look at the magnitude of damage to the headwaters’ ecosystem from wildfires and, thus, informs proactive, adaptive management actions and post-disaster recovery and restoration. Using burn severity data and per-acre estimates of ecosystem goods and services, we estimate natural capital damage of over USD 14.8 billion across an optimistically estimated period of 20 years. Several recovery time horizons are used to evaluate the sensitivity of the analysis. These findings provide important benchmarks and a viable approach for all levels of government and private entities responsible for allocating resources, mitigating wildfire risks, and improving watershed health. Full article

Background and aim of this review: The ongoing opioid epidemic underscores the urgent need for innovative pharmacological and behavioral interventions to mitigate the impact of opioid use disorder (OUD). This review aims to explore theoretical overlaps between the neurobiological mechanisms underlying OUD development and the pharmacodynamic profile of methylphenidate (MPH). Particular attention is given to the potential shared molecular targets, safety considerations, and therapeutic implications of MPH use in this clinical context. Main finding: In the development of opioid dependence, the negative reinforcement of the dopaminergic transmission of the mesocorticolimbic pathway induced by the supraspinal action of opioid receptor agonists plays a major role. The induced state of hypodopaminergic and hyperadrenergic modulates the underlying disease process by affecting cognitive control, affective regulation, and motivational drive. MPH, acting as a dopamine reuptake inhibitor and modulator of vesicular monoamine transporter 2 (VMAT-2), increases extracellular dopamine availability and enhances dopaminergic signaling, suggesting potential utility in restoring dopaminergic tone in OUD. Additionally, MPH has shown efficacy in hypoactive delirium in patients with terminal cancer, improving both cognitive function and psychomotor drive. Conclusions and future perspectives: There appear to be converging neurobiological mechanisms between the action of MPH and the pathophysiology of OUD, particularly within the dopaminergic system. However, well-designed clinical trials are essential to identify the patient subgroups that may benefit from adjunctive MPH treatment, to evaluate its efficacy in this setting, and to assess the long-term safety and risk profile of stimulant use in individuals with OUD. Full article

To improve the reliability of glass-fiber/epoxy-reinforced polymer (GFRP) composites, four laminates were manufactured by vacuum bagging: (i) a virgin baseline, (ii) an epoxy system modified with 15 wt% high-density polyethylene (PE) powder, (iii) a laminate interleaved with electrospun polyacrylonitrile (PAN)-based nanofiber mats, and (iv) a hybrid combining both modifiers. The specimens were subjected to low-velocity impacts; half were then heated at 150 °C for 30 min and re-impacted. PE caused peak-load loss up to 30% compared to virgin specimens but recovered 25% after heating by filling cracks. PAN interleaves limited the loss to 5%, and the hybrid laminate merged the benefits: it showed the highest first-impact load, retained 96% on re-impact, and gained a further 10% after heating while keeping the smallest permanent indentation. SEM confirmed molten PE migrating along the nanofiber mat to repair delamination fronts, explaining the laminate’s bell-shaped, oscillation-free force response and demonstrating a practical, synergistic self-healing mechanism. Collectively, the results demonstrate a clear structure–property connection: PAN nanofibers capture crack growth, while PE provides temperature-triggered self-healing, and their synergy offers a practical pathway to lightweight GFRP structures with enhanced impact resilience and restoration of mechanical integrity. Full article

The treatment of shoulder dysplasia resulting from brachial plexus birth injury (BPBI) remains a matter of debate within pediatric orthopedic and neurosurgical communities. Various approaches have been proposed to address the muscular imbalance and joint incongruity that develop in affected children, with special attention paid to the roles of humeral head reduction and tendon transfers. Background/Objectives: These procedures aim to correct the disproportionate strength between internal and external rotators of the shoulder. However, the specific contribution of skeletal procedures such as glenoid osteotomy to restoring shoulder mechanics remains controversial. Glenoid osteotomy, a technique that involves surgically reorienting the glenoid cavity, is hypothesized to promote better containment of the humeral head and allow more physiological joint development. On one hand, altering the glenoid axis could enhance joint congruency and facilitate remodeling during growth. On the other hand, there is limited evidence supporting its efficacy and safety. Methods: This review aims to assess the available literature to determine whether glenoid osteotomy represents a safe and effective procedure for patients with BPBI-associated shoulder dysplasia. A comprehensive literature search yielded 1380 titles. After excluding studies focused on adults and those failing to meet inclusion criteria, only three studies were selected for final analysis. Due to the limited data and variability in study design, no statistical meta-analysis could be performed. Results: Findings suggest that glenoid osteotomy, particularly when combined with tendon transfers, may lead to improvements in shoulder abduction and external rotation. However, outcomes are often difficult to interpret in isolation, and the specific benefits attributable to the osteotomy remain unclear. The lack of standardized imaging, follow-up, and scoring systems limits the strength of current conclusions. Conclusions: Further multicenter, prospective studies are needed to evaluate the long-term efficacy of glenoid osteotomy, its role in skeletal remodeling, and its contribution to overall shoulder stability and function. Such studies would help clarify the true potential of this surgical technique in the broader context of BPBI treatment. Full article