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22 pages, 16162 KB  
Article
Regional Development Assessment at Grid Scale: A Multisource Remote Sensing Approach in Chongqing, China
by Ting Hu, Peilin Yang, Shimin Ji and Jinran Gao
Sustainability 2026, 18(15), 7671; https://doi.org/10.3390/su18157671 - 28 Jul 2026
Abstract
Regional development disparities remain a persistent global challenge, yet existing assessment approaches often face a trade-off between spatial detail and temporal coverage. Conventional socioeconomic statistics provide relatively reliable information but are typically limited by coarse spatial representation and low update frequency, whereas high-resolution [...] Read more.
Regional development disparities remain a persistent global challenge, yet existing assessment approaches often face a trade-off between spatial detail and temporal coverage. Conventional socioeconomic statistics provide relatively reliable information but are typically limited by coarse spatial representation and low update frequency, whereas high-resolution remote sensing-based studies often focus on individual time points, making it difficult to capture the temporal evolution of regional development. Remote sensing observations provide valuable opportunities for regional development assessment by offering extensive spatial coverage and repeated observations over time. To address this gap, this study proposes a multisource remote sensing framework for characterizing the spatiotemporal dynamics of regional development in Chongqing Municipality across four temporal nodes (2014, 2016, 2018, and 2020). We first construct a county-level Development Intensity Index (DII) using socioeconomic indicators derived from statistical data. Subsequently, we integrate nighttime light, DEM, NDVI, and POI data to generate a 500 m gridded Comprehensive Spatial Development Index (CSDI), which captures spatial heterogeneity at a fine spatial scale. The CSDI exhibits strong correspondence with the DII, and its spatial validity is further corroborated through visual interpretation of Google Earth imagery. Results indicate that areas with higher development levels are predominantly concentrated in Chongqing’s central urban core, while less-developed counties are concentrated in the northeastern and southeastern peripheries. Although a general upward trend in development is observed across the study period, notable spatial disparities persist. Overall, the proposed CSDI-based framework offers an effective and replicable approach for gridded regional development assessment, with implications for targeted regional planning and differentiated policy design. Full article
(This article belongs to the Section Development Goals towards Sustainability)
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17 pages, 572 KB  
Article
Disparities in Pediatric Concussion Outcomes and Family Burden by Neighborhood Opportunity
by Karen Nakhla, Dana Waltzman, Lindsay D. Nelson, Anthony P. Kontos and Danny G. Thomas
Behav. Sci. 2026, 16(8), 1287; https://doi.org/10.3390/bs16081287 - 28 Jul 2026
Abstract
Mild traumatic brain injury (mTBI) is a common cause for pediatric emergency department visits and can impose substantial burdens on families, including missed work and childcare needs. Socioeconomic context may influence both healthcare use and these downstream impacts. This study examined the association [...] Read more.
Mild traumatic brain injury (mTBI) is a common cause for pediatric emergency department visits and can impose substantial burdens on families, including missed work and childcare needs. Socioeconomic context may influence both healthcare use and these downstream impacts. This study examined the association between Child Opportunity Index (COI), a neighborhood-level measure of socioeconomic status, and healthcare utilization and indirect costs following pediatric concussion. In a secondary analysis of a multisite randomized controlled trial of patients with acute (<72 h) concussion, participants were categorized into high, middle, and low COI groups. Outcomes included follow-up care, caregiver missed workdays, childcare needs, and indirect costs, analyzed using multivariable regression models. Participants from lower COI neighborhoods were more likely to present to the emergency department, with 93.02% compared to 71.43% in higher COI groups (p = 0.005); had higher symptom scores at 14 days, 28.69 versus 16.64 (p = 0.03); and were less likely to be seen by concussion specialists, 6.98% versus 28.57% (p = 0.005). They also had lower odds of attending follow-up within 14 days (OR = 0.36, p = 0.015) and higher caregiver burden, including more missed workdays and childcare needs. Although total indirect costs did not differ significantly for low COI groups after adjustment, middle COI participants had lower costs than high COI ones. Overall, disparities were observed in care patterns and caregiver burden despite similar recovery outcomes. These findings suggest that expanding access to affordable concussion follow-up through school-based programs, telehealth services, transportation assistance, and flexible scheduling may help reduce caregiver burden and improve continuity of care for children from lower COI neighborhoods following pediatric mTBI. Full article
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29 pages, 85528 KB  
Article
Spatial Equity of Green-Space Provision in Chinese Megacities: Nonlinear Associations with Urban Morphology Across Three Temporal Snapshots (2015–2025)
by Jun Wu, Shuo Liu, Xiaojin Huang, Yuqiao Zhang, Xiaokuo Qin, Wenzhe Zhu and Ran Cheng
Forests 2026, 17(8), 874; https://doi.org/10.3390/f17080874 - 27 Jul 2026
Abstract
Against the backdrop of stock-space urban renewal, green-space governance in megacity cores increasingly requires a shift from expansion-oriented supply to the optimisation of existing spatial resources. This study examines the spatial equity of green-space provision in the central districts of seven Chinese megacities [...] Read more.
Against the backdrop of stock-space urban renewal, green-space governance in megacity cores increasingly requires a shift from expansion-oriented supply to the optimisation of existing spatial resources. This study examines the spatial equity of green-space provision in the central districts of seven Chinese megacities using high-resolution remote-sensing data from 2015, 2020, and 2025. We combined semantic segmentation, nested-buffer measurement, the Gini coefficient, Extreme Gradient Boosting (XGBoost), and Shapley Additive Explanations (SHAP) to evaluate the relationships between urban morphology and green-space provision. We first derived a pixel-level cumulative green-space provision index from nested-buffer measurements and calculated city-year Gini coefficients to quantify distributional inequality. XGBoost models were then used to predict the cumulative green-space provision index from urban morphology, and SHAP was applied to interpret the resulting nonlinear, model-derived associations. The results show that changes in the green-space provision index and its distributional inequality were not synchronous across cities. Beijing showed the largest increase in inequality, whereas Chengdu showed the strongest improvement; Tianjin recorded the fastest increase in the green-space provision index, while Beijing experienced a marked decline. Urban form showed nonlinear associations with the unit-level green-space provision index, helping to explain the spatial differentiation underlying the city-year Gini coefficients. Building density was the primary contributor in most city-year models, whereas compactness showed threshold-like associations, with positive effects at lower levels and inhibitory effects at higher levels. Statistical testing and clustering further indicated substantial heterogeneity among cities, which were categorised into three spatial patterns: centripetal agglomeration, peripheral expansion, and clustering/ring-shaped fluctuation. These findings provide morphology-based evidence for differentiated green-space governance in high-density megacity cores, though they should not be interpreted as a complete socioeconomic assessment of green-space equity. Full article
(This article belongs to the Section Urban Forestry)
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21 pages, 7902 KB  
Article
An Integrated Spatial Prioritization Framework for Sustainable Watershed Management Using Hydrological, Economic, and Social Indicators: A Case Study of the Taleghan Watershed, Iran
by Vahid Beiranvandi, Roghayeh Jahdi and Saeid Beiranvandi
Sustainability 2026, 18(15), 7594; https://doi.org/10.3390/su18157594 - 26 Jul 2026
Abstract
Effective watershed management requires spatial prioritization frameworks that simultaneously account for hydrological effectiveness, economic feasibility, and social readiness to support sustainable decision-making. However, most existing prioritization approaches rely primarily on biophysical indicators and rarely integrate socio-economic dimensions within a unified decision-making framework. This [...] Read more.
Effective watershed management requires spatial prioritization frameworks that simultaneously account for hydrological effectiveness, economic feasibility, and social readiness to support sustainable decision-making. However, most existing prioritization approaches rely primarily on biophysical indicators and rarely integrate socio-economic dimensions within a unified decision-making framework. This study proposes an integrated spatial prioritization framework for sustainable watershed management and applies it to the Taleghan watershed (341.4 km2) in the central Alborz Mountains, Iran. Hydrological responses were simulated using a calibrated HEC-HMS model, whereas soil erosion was estimated using a locally calibrated RUSLE model. Technical effectiveness was quantified based on reductions in peak discharge and soil erosion. At the same time, economic feasibility was evaluated through probabilistic cost–benefit analysis using Monte Carlo simulation to account for economic uncertainty. Social readiness was assessed using a validated Social Readiness Index (SRI) developed through Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). The Technical Effectiveness Index (TEI), Economic Feasibility Index (EFI), and Social Readiness Index (SRI) were integrated using a hybrid Fuzzy AHP–TOPSIS approach to derive a Composite Priority Index (CPI) for 29 Hydrological Response Units (HRUs). The calibrated HEC-HMS model demonstrated satisfactory performance (NSE = 0.79–0.91), while the calibrated RUSLE model accurately reproduced observed soil erosion (R2 = 0.76; RMSE = 4.2 t ha−1 yr−1). TEI, EFI, and SRI values ranged from 0.09–0.94, 0.05–0.91, and 0.28–0.84, respectively, indicating substantial spatial heterogeneity across the watershed. The integrated prioritization classified 7.8% of the watershed as very high priority for intervention, whereas sensitivity analysis showed that approximately 65% of HRUs maintained stable priority rankings under ±20% variations in criterion weights. The findings demonstrate that integrating hydrological, economic, and social dimensions provides a more robust and implementation-oriented basis for watershed planning than conventional single-criterion approaches. Overall, the proposed framework provides a decision-support approach that may be adapted to other semi-arid mountainous watersheds following appropriate local calibration. Full article
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25 pages, 6108 KB  
Article
Spatiotemporal Evolution and Fragmentation of Paddy Landscapes Under Non-Grain Production Risk: A Case Study of Northern Jiangxi, China
by Hyun-Sil Shin and Xiongzhi Hu
Earth 2026, 7(4), 124; https://doi.org/10.3390/earth7040124 - 26 Jul 2026
Abstract
Non-grain production of cultivated land has increasingly affected regional food security and the stability of agricultural ecosystems. In traditional rice-producing regions, changes associated with non-rice cultivation, fallow land, rice-fishery integrated farming, and intensive agricultural management are reshaping the spatial structure of paddy landscapes. [...] Read more.
Non-grain production of cultivated land has increasingly affected regional food security and the stability of agricultural ecosystems. In traditional rice-producing regions, changes associated with non-rice cultivation, fallow land, rice-fishery integrated farming, and intensive agricultural management are reshaping the spatial structure of paddy landscapes. To identify the long-term spatiotemporal evolution of paddy systems, this study investigated Northern Jiangxi, China, using Landsat surface reflectance imagery from 2000, 2005, 2010, 2015, and 2020 on the Google Earth Engine (GEE) platform. The Enhanced Vegetation Index (EVI) and Land Surface Water Index (LSWI) were used to construct a phenology-based Flooding Frequency (FF) indicator. Based on the annual frequency with which pixels satisfied the condition LSWI > EVI, cultivated land was classified into three categories: non-flooded cropland, standard rice paddy, and high-frequency flooded cropland. In this study, non-flooded cropland was used as an indicator of potential non-rice cultivation rather than as direct evidence of confirmed non-grain production. Landscape metrics, transition matrices, gravity center migration, standard deviation ellipses, and geographically weighted regression (GWR) were then used to examine paddy landscape dynamics, fragmentation patterns, and county-level spatial associations with socioeconomic factors. The results suggest that the paddy system in Northern Jiangxi experienced marked stage-based fluctuations between 2000 and 2020. Standard rice paddy recovered during 2005–2010, whereas non-flooded cropland expanded considerably during 2010–2015, accompanied by intensified paddy landscape fragmentation. Non-flooded cropland was mainly distributed around urban fringes, transport corridors, and some hilly margins. Standard rice paddy was concentrated in traditional grain-producing areas, including the Poyang Lake Plain and the Gan-Fu Plain. High-frequency flooded cropland was primarily located in low-lying lake areas, where its dynamics were likely associated with rice-fishery integrated farming, continuous irrigation, and hydrological fluctuations. Landscape metrics showed that the largest patch index and mean patch size of standard rice paddy declined after 2010, indicating reduced spatial continuity of core paddy fields. The GWR analysis provided auxiliary evidence that total population, per capita gross domestic product (GDP), and urbanization rate were spatially associated with changes in non-flooded cropland at the county level; however, the results should be interpreted as exploratory associations rather than causal mechanisms. Overall, paddy landscape change in Northern Jiangxi was expressed not only through changes in cultivated land area, but also through the reorganization of paddy function, spatial continuity, and land-use intensity. Future cropland protection should therefore move beyond area-based control toward integrated management of quantity, quality, function, and spatial configuration. Future research should further verify these findings using dynamic cropland boundaries, higher-resolution imagery, and more detailed socioeconomic data. Full article
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22 pages, 3848 KB  
Article
Remote Sensing Dynamic Monitoring and Driving Mechanism of Lake Area in Ebinur Lake, 1992–2024
by Xingyu Wang, Decao Niu, Xiaoming Cao, Yongxin Li, Jie Han, Xiaochang Jiang, Zhengwei Han, Changle Yang and Yuanxin Zhang
Water 2026, 18(15), 1810; https://doi.org/10.3390/w18151810 - 25 Jul 2026
Viewed by 96
Abstract
Arid inland saline lakes are key components of basin ecosystems. As the largest saline lake in Xinjiang and a critical ecological barrier in northwest China, Ebinur Lake’s area dynamics are vital to regional sustainable development. This study integrates Landsat imagery (1992–2024) with meteorological [...] Read more.
Arid inland saline lakes are key components of basin ecosystems. As the largest saline lake in Xinjiang and a critical ecological barrier in northwest China, Ebinur Lake’s area dynamics are vital to regional sustainable development. This study integrates Landsat imagery (1992–2024) with meteorological and socio-economic data to investigate optimal water extraction methods, spatio-temporal lake area variations, and driving mechanisms. Multiple methods were employed, including water index comparison, Mann–Kendall test, Pearson correlation, and ridge regression. Results show that: (1) the Normalized Difference Water Index (NDWI) maintains high, stable classification accuracy across years and months, making it suitable for long-term monitoring; (2) from 1992 to 2024, lake area demonstrates a significant fluctuating downward trend without abrupt change points, indicating continuous degradation. During the growing season (April–October), it first decreases and then increases, with larger early-season areas, minima in August and September, coinciding with peak agricultural irrigation demand; (3) regarding driving mechanisms, socio-economic factors dominate (approximately 70%), while meteorological factors play a weakly regulatory role (about 30%). Population growth and increased water consumption are the primary drivers, with obvious seasonal differences. Meteorological changes, socio-economic development, and ecological measures jointly influence lake area. Although extreme events (e.g., anomalous precipitation) induce short-term fluctuations, they do not alter the long-term degradation trend dominated by human activities. This study provides methodological support for long-term monitoring of arid saline lakes and scientific evidence for ecological conservation and water resource management in the Ebinur Lake Basin. Full article
(This article belongs to the Special Issue Application of Remote Sensing in Inland and Coastal Water Monitoring)
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21 pages, 21169 KB  
Article
Spatial Imbalance Between Flood Disaster Risk and Socioeconomic Development Across Cities in China’s Pearl River Basin
by Zehui Zhou, Weidong Huang, Tingting Wang, Linlin Gong, Dianchen Sun and Lei Yu
Land 2026, 15(8), 1339; https://doi.org/10.3390/land15081339 - 25 Jul 2026
Viewed by 138
Abstract
Climate change and rapid urbanization are reshaping the spatial relationship between flood risk and socioeconomic development, yet basin-scale evidence on where risk pressure and development capacity diverge remains limited. Taking 54 cities in China’s Pearl River Basin as the study area, this study [...] Read more.
Climate change and rapid urbanization are reshaping the spatial relationship between flood risk and socioeconomic development, yet basin-scale evidence on where risk pressure and development capacity diverge remains limited. Taking 54 cities in China’s Pearl River Basin as the study area, this study adopts a dual-system evaluation framework integrating game-theory weighting, coupling coordination analysis, and spatial autocorrelation. Flood risk is characterized through hazard, exposure, vulnerability, and Resilience, while socioeconomic development is represented by economic scale, urban construction, and population agglomeration. This design extends previous Pearl River Delta-centered analyses to the entire basin and enables city-scale identification of risk–development imbalance. The results reveal a pronounced downstream–upstream gradient. The Pearl River Delta has the highest flood exposure (mean exposure index = 0.2603, 117% higher than the basin average of 0.1208), but strong Resilience and socioeconomic capacity prevent high exposure from translating into the highest overall risk. By contrast, east-central Guangxi emerges as a critical hotspot where moderate to high hazard overlaps with high vulnerability and weak Resilience. Coupling coordination remains generally low, shifting from basic coordination in parts of the Pearl River Delta to severe imbalance in upstream Guizhou, Guangxi, and Yunnan. The global Moran’s I is 0.4261 and significant at the 1% level, indicating marked spatial clustering, with high-high clusters concentrated in core Pearl River Delta cities and low–low clusters in eastern Yunnan and southwestern Guizhou. By distinguishing high exposure cities from high priority intervention areas, this study provides a potentially transferable framework for differentiated flood governance, infrastructure investment, and Resilience enhancement across large river basins. Full article
(This article belongs to the Special Issue Building Resilient and Sustainable Urban Futures)
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26 pages, 6764 KB  
Article
Does New-Type Urbanization Correct the Imbalance Between Urbanization and Environmental Quality? Evidence from Satellite-Derived Data in China
by Pengfan Shi and Bo Yang
Sustainability 2026, 18(15), 7575; https://doi.org/10.3390/su18157575 - 24 Jul 2026
Viewed by 180
Abstract
Rapid urbanization has generated substantial economic growth but has also intensified pressure on the environment. China’s New-Type Urbanization Policy (NTU) was designed to promote people-centered, smart governance, and green development. However, whether the NTU policy has improved the coordination between urbanization and environmental [...] Read more.
Rapid urbanization has generated substantial economic growth but has also intensified pressure on the environment. China’s New-Type Urbanization Policy (NTU) was designed to promote people-centered, smart governance, and green development. However, whether the NTU policy has improved the coordination between urbanization and environmental quality remains insufficiently examined. Using panel data in China from 2010 to 2021, this study constructs an urbanization–environment coupling coordination degree index based on satellite-derived China’s High-resolution Eco-Environmental Quality dataset and applies a continuous difference-in-differences model to evaluate the impact of NTU policy intensity. The results show that greater NTU policy intensity is associated with significant improvements in urbanization–environment coordination after controlling for pre-existing socioeconomic, ecological, and geographical differences across cities. This finding is consistent with a corrective effect: rather than simply expanding urban scale, NTU appears to help offset the misalignment between urban development and environmental quality. Conditional analyses further suggest that the estimated policy effect is more readily observed where industrial structures are more advanced and local attention to ecological governance is stronger, indicating that these conditions shape the extent to which NTU can be translated into coordination gains. Heterogeneity analyses show that the estimates are statistically more robust in eastern, coastal, and non-resource-based cities, while the comparison across green-coverage groups remains inconclusive because the low-coverage group has a larger but less precisely estimated coefficient. Overall, the findings suggest that NTU has corrective potential, but that its effect is conditional rather than uniform across cities and depends on local governance, industrial, and ecological circumstances. Full article
(This article belongs to the Section Sustainable Urban and Rural Development)
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25 pages, 1752 KB  
Article
Does the County-Level Business Environment Improve the Quality of Agriculture-Related Market Entry? Evidence from China
by Xingyuan Yao, Jingyi Huang, Yufen Zhong, Qingfan Lin and Weiming Lin
Agriculture 2026, 16(15), 1575; https://doi.org/10.3390/agriculture16151575 - 23 Jul 2026
Viewed by 236
Abstract
Improving the quality of agriculture-related market entry is central to rural industrial upgrading, yet existing studies mainly measure entry quantity. The primary objective of this study is to assess whether the county-level business environment is associated with the structural quality of new agriculture-related [...] Read more.
Improving the quality of agriculture-related market entry is central to rural industrial upgrading, yet existing studies mainly measure entry quantity. The primary objective of this study is to assess whether the county-level business environment is associated with the structural quality of new agriculture-related entrants. Specifically, the study asks three questions: whether the association is positive; whether financial services, market connectivity, and human capital supply are consistent transmission channels; and whether the association varies with agricultural foundations, initial factor market conditions, and access to urban spillovers. Using Chinese business registration records and county-level socioeconomic data for 2010–2023, we construct a county–year panel and measure entry quality through capital quality, organizational quality, and value chain extension. Two-way fixed effects, double machine learning, fractional response models, robustness tests, and a supplementary instrumental variable diagnostic are applied. The preferred fixed effects estimate indicates that a 0.1 increase in the business environment index is associated with a 4.16 percentage point increase in the high-quality entry ratio; a one-standard-deviation increase corresponds to approximately 3.77 percentage points. The association remains positive under nonlinear and bounded-outcome specifications. Channel tests are consistent with financial, market connectivity, and human capital pathways, and the association is stronger in central and western counties, non-municipal districts, counties with stronger agricultural foundations, and counties with weaker initial financial and market conditions. Because the estimate becomes statistically insignificant after prefecture-by-year fixed effects are included, the findings are interpreted as robust conditional associations rather than definitive county-level causal effects. Full article
(This article belongs to the Section Agricultural Economics, Policies and Rural Management)
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23 pages, 2801 KB  
Article
Sleep Quality in Spanish Adult Women: Associations with Sociodemographic Variables and Pre-Sleep Habits
by Andrés Vicente Marín Ferrandis, Valentina Micheluzzi, Michela Capoferri, Michela Piredda and Elena Sandri
Healthcare 2026, 14(14), 2234; https://doi.org/10.3390/healthcare14142234 - 22 Jul 2026
Viewed by 175
Abstract
Background/Objectives: Sleep health is a key determinant of physical and psychological well-being, yet poor sleep quality remains common, particularly among women. Sociodemographic inequalities and culturally patterned pre-sleep behaviours may contribute to sleep disturbances, but their combined role in Mediterranean populations is still insufficiently [...] Read more.
Background/Objectives: Sleep health is a key determinant of physical and psychological well-being, yet poor sleep quality remains common, particularly among women. Sociodemographic inequalities and culturally patterned pre-sleep behaviours may contribute to sleep disturbances, but their combined role in Mediterranean populations is still insufficiently understood. This study aimed to examine sleep quality and its associations with sociodemographic characteristics and pre-sleep habits among adult women living in Spain. Methods: A cross-sectional online survey was conducted among 785 Spanish adult women aged 18–64 years. Sleep quality was assessed using the Spanish version of the Pittsburgh Sleep Quality Index (PSQI). Additional questionnaire items collected information on sociodemographic variables and pre-sleep habits, including meal timing, stimulant consumption, physical activity, bedtime routines, screen exposure, and sleeping alone or with company. Data were analysed using chi-square tests, Mann–Whitney U tests, Kruskal–Wallis tests, Spearman’s correlations, and principal component analysis. Results: The mean global PSQI score was 7.5 (SD = 3.01), indicating mildly impaired sleep quality overall. Age showed the largest association with global PSQI score (ε2 = 0.052, p < 0.001), followed by income (ε2 = 0.010, p = 0.016). Frequent nocturnal awakenings were the most common sleep disturbance, whereas sleep medication use was uncommon. Older age and lower income were associated with poorer sleep outcomes, including shorter sleep duration, lower sleep efficiency, and higher global PSQI scores. Higher education and health-related training were generally associated with more favourable sleep profiles. Pre-sleep habits such as late dinners, stimulant use, and evening screen exposure were highly prevalent but showed weak and non-significant associations with global PSQI scores. Conclusions: In this cross-sectional sample, poorer sleep quality was associated with selected sociodemographic characteristics, whereas isolated pre-sleep behaviours showed weak or non-significant associations with global PSQI scores. Given the study design and non-probability sampling, these findings should be interpreted as associations and generalized with caution. They may inform future studies and support the development of gender-sensitive, non-pharmacological sleep-health strategies that consider socioeconomic and cultural context. Full article
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18 pages, 514 KB  
Article
Oral Health Status, Oral Hygiene, and Behavioural Factors Among Disadvantaged Children: A Cross-Sectional Comparison Between the Peruvian Amazon and Valencia, Spain
by Lucía Miralles-Jordá, Julián Espinosa-Giménez, Anna Paradowska-Stolarz, Mónica Fernández-Mafé, María Dolores Gómez-Adrián, María Teresa Murillo-Llorente, Marcelino Pérez-Bermejo and María Ester Legidos-García
Dent. J. 2026, 14(7), 459; https://doi.org/10.3390/dj14070459 - 21 Jul 2026
Viewed by 181
Abstract
Background/Objectives: Dental caries remains a major public health problem in childhood and disproportionately affects socioeconomically disadvantaged populations. Although toothbrushing and oral hygiene are commonly promoted as key preventive behaviours, their protective effect may be limited by structural factors such as access to [...] Read more.
Background/Objectives: Dental caries remains a major public health problem in childhood and disproportionately affects socioeconomically disadvantaged populations. Although toothbrushing and oral hygiene are commonly promoted as key preventive behaviours, their protective effect may be limited by structural factors such as access to dental care, fluoride exposure, and preventive services. This study aimed to compare dental caries experience, oral hygiene status, toothbrushing frequency, and sugar consumption among disadvantaged children from the Peruvian Amazon and Valencia, Spain, and to explore whether differences in hygiene behaviours were reflected in caries outcomes. Methods: An exploratory cross-sectional school-based study was conducted among 291 children aged 5–12 years attending three purposively selected schools serving socioeconomically disadvantaged communities: one rural school in the Peruvian Amazon (n = 162) and two urban schools in Valencia, Spain (n = 129). Dental caries experience was assessed using a combined global caries score derived from the dmft and DMFT (CAOD/cod) indices according to dentition type, and oral hygiene status was evaluated using the Simplified Oral Hygiene Index (OHI-S). Toothbrushing frequency and sugar consumption were collected through structured questionnaires. Group comparisons, Spearman correlation analyses, and exploratory multiple linear regression models were performed. Results: Mean global caries scores did not differ significantly between Peruvian and Spanish children (3.71 ± 2.86 vs. 4.07 ± 3.44; p = 0.596). However, severe caries experience (score ≥ 8) was more frequent among Valencian children (21.7% vs. 10.5%; p = 0.014). Peruvian children showed significantly better oral hygiene status (OHI-S-derived score: 1.25 ± 0.79 vs. 1.49 ± 0.84; p = 0.014) and higher toothbrushing frequency (p < 0.001). Frequent sugar consumption was similarly high in both groups. Within each population, poorer oral hygiene and lower toothbrushing frequency were associated with higher caries experience in bivariate analyses, although the exploratory multivariable models showed a more limited pattern of association. Conclusions: Among the participating schools, children from the Peruvian Amazon showed better oral hygiene indicators and more frequent toothbrushing than Spanish children, while no statistically significant difference in caries experience was detected. Because structural variables such as fluoride exposure, dental attendance, and access to restorative care were not directly measured, explanations involving healthcare infrastructure should be considered as candidate hypotheses to be tested in future, adequately powered and adjusted studies, rather than as confirmed mechanisms. Findings should not be generalised beyond the participating schools. Full article
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29 pages, 4841 KB  
Article
Spatiotemporal Evolution and Driving Mechanisms of Rural Green Development in the Ecological Green Heart of the Chang-Zhu-Tan Urban Agglomeration, China
by Keliang Chen, Yan Wang, Xi Yang, Yueling Chen and Feixiang Yin
Sustainability 2026, 18(14), 7449; https://doi.org/10.3390/su18147449 - 21 Jul 2026
Viewed by 321
Abstract
Rural green development is essential for coordinating ecological protection, rural revitalisation and spatial governance in ecological spaces within urban agglomerations. Taking the Chang-Zhu-Tan Ecological Green Heart region in China as a case study, this study evaluates rural green development in 10 counties, county-level [...] Read more.
Rural green development is essential for coordinating ecological protection, rural revitalisation and spatial governance in ecological spaces within urban agglomerations. Taking the Chang-Zhu-Tan Ecological Green Heart region in China as a case study, this study evaluates rural green development in 10 counties, county-level cities and districts from 2013 to 2022. A combined weighting–TOPSIS model is used to measure development levels, while Global Moran’s I, the Theil index and XGBoost–SHAP are applied to examine spatial patterns, regional disparities and key associated factors. The results show that rural green development improved overall, with the regional average index increasing from 0.315 in 2013 to 0.378 in 2022. High-value areas gradually expanded, and the Changsha group formed the main high-value core, but no statistically significant global spatial clustering was identified. Regional disparities narrowed during the study period, although intra-group disparities, especially within the Zhuzhou group, remained the main source of imbalance. Human capital, medical resources, income level, urbanisation level, PM2.5 concentration and pesticide use intensity were closely associated with rural green development, with socioeconomic factors generally contributing positively and environmental pressures acting as constraints. These findings suggest that rural green development in ecological green heart regions is a spatially differentiated and multi-factor process, providing empirical evidence for differentiated county-level governance, coordinated ecological protection and rural green transformation in urban agglomerations. Full article
(This article belongs to the Section Environmental Sustainability and Applications)
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19 pages, 2217 KB  
Article
Cold Extremities and Underweight as a Combined Risk Profile for Open-Angle Glaucoma: A Population-Based Cross-Sectional Study in Korea
by Kwang-Ho Bae, Youngseop Lee, Man Young Park, Ho-Yeon Go, Ilkoo Ahn and Yong-Sik Park
Medicina 2026, 62(7), 1411; https://doi.org/10.3390/medicina62071411 - 21 Jul 2026
Viewed by 174
Abstract
Background/Objectives: Glaucoma is one of the leading causes of irreversible blindness worldwide. Open-angle glaucoma (OAG) predominates in East Asian populations, with normal-tension glaucoma accounting for the majority of cases. Although intraocular pressure remains the most established risk factor, non-pressure-dependent mechanisms, including ocular [...] Read more.
Background/Objectives: Glaucoma is one of the leading causes of irreversible blindness worldwide. Open-angle glaucoma (OAG) predominates in East Asian populations, with normal-tension glaucoma accounting for the majority of cases. Although intraocular pressure remains the most established risk factor, non-pressure-dependent mechanisms, including ocular vascular dysregulation, warrant further investigation. Cold extremities, a hallmark of Flammer syndrome reflecting primary vascular dysregulation, and underweight (body mass index [BMI] < 18.5 kg/m2) are each independently associated with OAG; however, their combined effect has not been examined at the population level. Materials and Methods: Using nationally representative data from the Korea National Health and Nutrition Examination Survey 2008–2012 (n = 8135; controls 7418, OAG 717), participants aged ≥ 50 years with measured intraocular pressure within the normal range (5–21 mmHg) at the time of examination were classified into four groups: non-underweight without cold extremities (N-N, reference), cold extremities only (CEO), underweight only (UWO), and underweight with cold extremities (UW+CE). Complex sample logistic regression was adjusted for sex, age, diabetes mellitus, mean arterial pressure, intraocular pressure, and spherical equivalent. Results: UW+CE was associated with significantly higher odds of OAG than N-N (adjusted odds ratio [OR] = 2.10, 95% confidence interval: 1.14–3.88, p = 0.018), whereas neither CEO (OR = 1.10, p = 0.431) nor UWO (OR = 1.54, p = 0.170) was significantly associated individually. This association with UW+CE remained robust across alternative BMI thresholds and after further adjustment for socioeconomic, lifestyle, and cardiometabolic variables. Conclusions: Co-occurring cold extremities and underweight status were associated with a combined hemodynamic risk profile for OAG, suggesting their potential utility as clinically accessible noninvasive markers for the early identification of highly vulnerable individuals and informing proactive glaucoma screening strategies. Full article
(This article belongs to the Section Ophthalmology)
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10 pages, 232 KB  
Article
Impact of Dementia on Outcomes in Patients Hospitalized with Urinary Tract Infections
by Sanobar Jaka, Anushareddy Muddasani, Subhendu Rath, Aditee Dash, Ninad Desai, Simarpreet Kaur, Phani V. Akella and Anudeep Surendranath
J. Dement. Alzheimer's Dis. 2026, 3(3), 36; https://doi.org/10.3390/jdad3030036 - 21 Jul 2026
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Abstract
Background: People living with dementia (PLWD) are at increased risk for medical complications, including urinary tract infections (UTIs), which are often presented atypically with delirium or behavioral changes. These atypical presentations frequently prompt psychiatric consultation and complicated medical management. As the aging population [...] Read more.
Background: People living with dementia (PLWD) are at increased risk for medical complications, including urinary tract infections (UTIs), which are often presented atypically with delirium or behavioral changes. These atypical presentations frequently prompt psychiatric consultation and complicated medical management. As the aging population grows, understanding how dementia influences UTI-related outcomes is critical for C-L psychiatrists working at the interface of medicine and psychiatry. Methods: This retrospective cohort study used the 2021 National Inpatient Sample (NIS) to identify adult inpatients with a principal diagnosis of UTI. Patients were stratified by the presence of a comorbid dementia diagnosis. Multivariate logistic and linear regression models adjusted for demographic, clinical, and hospital-level covariates were used to examine associations between dementia and outcomes: in-hospital mortality (primary), length of stay (LOS), hospital charges, and discharge disposition (secondary). Adjusted models included available demographic, socioeconomic, comorbidity, and hospital-level covariates, including age, sex, race/ethnicity, median household income quartile by patient ZIP code, insurance type, Charlson Comorbidity Index, hospital region, urban hospital location, and hospital teaching status. Results: Among 295,494 hospitalizations for UTI, 78,990 (26.7%) involved patients with dementia. Compared to those without dementia, PLWD were significantly older (mean age 82.5 vs. 69.5 years), more likely to be female, and had greater comorbidity burden. Adjusted analyses revealed that dementia was linked to higher odds of in-hospital mortality (aOR: 1.28, 95% CI: 1.03–1.58), longer LOS (+0.93 days, p < 0.01), and increased hospital charges (+$3243.50, p < 0.01). Additionally, PLWD had lower odds of discharge to home (aOR: 0.53) and higher odds of discharge to skilled nursing facilities (aOR: 1.94). Conclusions: Among patients hospitalized with a principal diagnosis of UTI, comorbid dementia was linked with higher in-hospital mortality, longer length of stay, higher hospital charges, and lower likelihood of discharge home. These findings should be interpreted in the context of important limitations of administrative data, including residual confounding and inability to distinguish symptomatic UTI from asymptomatic bacteriuria. Full article
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17 pages, 3182 KB  
Article
Projected Impacts of Climate Change on the Habitat of Handeliodendron bodinieri: An Ensemble Species Distribution Modeling Approach
by Zexu Long, Xue Sun and Sikan Chen
Sustainability 2026, 18(14), 7425; https://doi.org/10.3390/su18147425 - 20 Jul 2026
Viewed by 282
Abstract
Handeliodendron bodinieri is a rare tree species endemic to the karst mountains of southwestern China and is listed as a national Class II key protected wild plant. Due to its highly specialized habitat requirements and limited reproductive dispersal ability, the species is exceptionally [...] Read more.
Handeliodendron bodinieri is a rare tree species endemic to the karst mountains of southwestern China and is listed as a national Class II key protected wild plant. Due to its highly specialized habitat requirements and limited reproductive dispersal ability, the species is exceptionally vulnerable to environmental changes. To predict the impacts of future climate change on its habitat suitability while minimizing predictive uncertainties, this study compiled multi-source occurrence data alongside bioclimatic, topographic, and edaphic variables. We deployed an ensemble species distribution modeling framework to project the current and future (2100) distribution patterns and dynamic shifts in suitable habitat for H. bodinieri under three Shared Socioeconomic Pathways (SSP126, SSP370, and SSP585). Three independent evaluation metrics (AUCprg, TSS, and the Boyce index) consistently demonstrated that the ensemble model significantly outperformed individual algorithmic models (GLM, MARS, MAXENT, and RFd). Under current conditions, the weighted-average ensemble model estimated the suitable habitat area for H. bodinieri to be 70,582 km2. By 2100, the suitable habitat area is projected to contract under all three SSP scenarios, with reduction rates ranging from 27.38% to 80.43%. Concurrently, the centroid of the suitable habitat is expected to shift southeastward or southward by 13–40 km, accompanied by varying degrees of shifts in mean elevation. Furthermore, we identified climate-insensitive regions across the scenarios, which are primarily clustered along the border between Guangxi and Guizhou provinces. Our study provides a robust scientific foundation for formulating effective conservation and management strategies for H. bodinieri amidst ongoing climate change, ultimately maintaining the sustainable survival of the species. Full article
(This article belongs to the Special Issue Sustainable Forest Ecosystems, Climate Change and Biodiversity)
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