Search Results (1,033)

The compound effects of extreme climate change and intensive urban development have led to more frequent urban inundation, highlighting the urgent need for the fine-scale evaluation of stormwater drainage system performance in high-density urban built-up areas. A typical basin, located in Shenzhen, was selected, and a pipe–river coupled SWMM was developed and calibrated via a genetic algorithm to simulate the storm drainage system. Design storm scenario analyses revealed that regional inundation occurred in the central area of the basin and the enclosed culvert sections of the midstream river, even under a 0.5-year recurrence period, while the downstream open river channels maintained a substantial drainage capacity under a 200-year rainfall event. To systematically identify bottleneck zones, two novel metrics, namely, the node cumulative inundation volume and the conduit cumulative inundation length, were proposed to quantify the local inundation severity and spatial interactions across the drainage network. Two critical bottleneck zones were selected, and strategic improvement via the cross-sectional expansion of pipes and river culverts significantly enhanced the drainage efficiency. This study provides a practical case study and transferable technical framework for integrating hydraulic modeling, spatial analytics, and targeted infrastructure upgrades to enhance the resilience of drainage systems in high-density urban environments, offering an actionable framework for sustainable urban stormwater drainage system management. Full article

The city of Acapulco was impacted by two near-consecutive hurricanes. On 25 October 2023, Hurricane Otis made landfall, reaching the highest Category 5 storm on the Saffir–Simpson scale, causing extensive coastal destruction due to extreme winds and waves. Nearly one year later (23 September 2024), Hurricane John—a Category 2 storm—caused severe flooding despite its lower intensity, primarily due to its unusual trajectory and prolonged rainfall. Digital shoreline analysis of PlanetScope images (captured one month before and after Hurricane Otis) revealed that the southern coast of Acapulco, specifically Zona Diamante—where the major seafront hotels are located—experienced substantial shoreline erosion (94 ha) and damage. In the northwestern section of the study area, the Coyuca Bar experienced the most dramatic geomorphological change in surface area. This was primarily due to the complete disappearance of the bar on October 26, which resulted in a shoreline retreat of 85 m immediately after the passage of Hurricane Otis. Sentinel-1 Synthetic Aperture Radar (SAR) showed that Hurricane John inundated 2385 ha, four times greater than Hurricane Otis’s flooding (567 ha). The retrofitted QGIS methodology demonstrated high reliability when compared to limited in situ local reports. Given the increased frequency of intense hurricanes, these methods and findings will be relevant in other coastal areas for monitoring and managing local communities affected by severe climate events. Full article

Lung transplantation remains the standard of care for end-stage lung disease, yet a persistent gap exists between donor lung availability and growing clinical demand. Expanding the donor pool and optimising donor lung management are therefore critical priorities. However, no universally accepted management protocols are currently in place. This narrative review examines evidence-based strategies to improve lung utilisation across three donor categories: donors after brain death (DBD), controlled donors after circulatory death (cDCD), and uncontrolled donors after circulatory death (uDCD). A systematic literature search was conducted to identify interventions targeting lung preservation and function, including protective ventilation, recruitment manoeuvres, fluid and hormonal management, and ex vivo lung perfusion (EVLP). Distinct pathophysiological mechanisms—sympathetic storm and systemic inflammation in DBD, ischaemia–reperfusion injury in cDCD, and prolonged warm ischaemia in uDCD—necessitate tailored approaches to lung preservation. In DBD donors, early application of protective ventilation, bronchoscopy, and infection surveillance is essential. cDCD donors benefit from optimised pre- and post-withdrawal management to mitigate lung injury. uDCD donor lungs, uniquely vulnerable to ischaemia, require meticulous post-mortem evaluation and preservation using EVLP. Implementing structured, evidence-based lung management strategies can significantly enhance donor lung utilisation and expand the transplantable organ pool. The integration of such practices into clinical protocols is vital to addressing the global shortage of suitable lungs for transplantation. Full article

The electrical ventricular storm (VES) is defined as multiple sustained ventricular arrhythmias arising in a short time, often refractory to standard antiarrhythmic treatment. The three pillars of the physiopathogenesis of the VES are autonomic dysfunction, triggers, and an altered ventricular substrate. Incessant or highly recurrent ventricular arrhythmia impacts the hemodynamic status by worsening heart failure and increasing mortality. A stepwise, team-based, and tailored therapeutic approach is required to stop ventricular arrhythmia and regain the hemodynamic and electric stability of the patient. The authors focused on describing all currently available therapeutic approaches for VES, intending to establish the best VES therapeutic approaches. This process involves considering the patient’s specific condition, responses to previous treatments, and the potential risks and benefits of each approach. The options range from adjusting antiarrhythmic therapy to reprogramming of the ICD, sedation, epidural anaesthesia, stellate ganglia anaesthetic block, and the use of ECMO or left ventricular assist devices and radiofrequency catheter ablation. Particular attention is paid to the detailed management of genetic primary arrhythmia syndromes like long-QT syndrome, catecholaminergic polymorphic ventricular tachycardia, Brugada syndrome and Wolff–Parkinson–White syndrome, early repolarisation syndrome, right ventricular arrhythmogenic dysplasia, and idiopathic ventricular fibrillation. After overcoming the acute events of VES and obtaining hemodynamic stability, the treatment should shift toward an optimal balance of heart failure therapy, controlling the substrate by revascularisation procedures and resolving other pathology-generating ventricular arrhythmias. This article provides a comprehensive overview of ESV’s current management options using the most efficient strategies known to date. Full article

Currently, most studies evaluating storm surges are conducted at the provincial level, and there is a lack of detailed research focusing on cities. This paper focuses on the urban scale, using some fine-scale data of coastal areas obtained through remote sensing images. This research is based on the Hazard–Exposure–Vulnerability (H-E-V) framework and PPRR (Prevention, Preparedness, Response, and Recovery) crisis management theory. It focuses on 52 Chinese coastal cities as the research subject. The evaluation system for the disaster response capabilities of Chinese coastal cities was constructed based on three aspects: the stability of the disaster-incubating environment (S), the risk of disaster-causing factors (R), and the vulnerability of disaster-bearing bodies (V). The significance of this study is that the storm surge capability of China’s coastal cities can be analyzed based on the results of the evaluation, and the evaluation model can be used to identify its deficiencies. In this paper, these storm surge disaster response capabilities of coastal cities were scored using the entropy weighted TOPSIS method and the weight rank sum ratio (WRSR), and the results were also analyzed. The results indicate that Wenzhou has the best comprehensive disaster response capability, while Yancheng has the worst. Moreover, Tianjin, Ningde, and Shenzhen performed well in the three aspects of vulnerability of disaster-bearing bodies, risk of disaster-causing factors, and stability of disaster-incubating environment separately. On the contrary, Dandong (tied with Qinzhou), Jiaxing, and Chaozhou performed poorly in the above three areas. Full article

Quantifying future changes in extreme events and associated flooding is challenging yet fundamental for stormwater managers. Along the U.S. Atlantic Coast, Eastern North Carolina (ENC) is frequently exposed to catastrophic floods from extreme rainfall that is typically associated with tropical cyclones. This study presents a novel approach that uses rainfall data from five dynamically and statistically downscaled (DD and SD) global climate models under two scenarios to visualize a potential future extent of flooding in ENC. Here, we use DD data (at 36-km grid spacing) to compute future changes in precipitation intensity–duration–frequency (PIDF) curves at the end of the 21st century. These PIDF curves are further applied to observed rainfall from Hurricane Matthew—a landfalling storm that created widespread flooding across ENC in 2016—to project versions of “Matthew 2100” that reflect changes in extreme precipitation under those scenarios. Each Matthew-2100 rainfall distribution was then used in hydrologic models (HEC-HMS and HEC-RAS) to simulate “2100” discharges and flooding extents in the Neuse River Basin (4686 km²) in ENC. The results show that DD datasets better represented historical changes in extreme rainfall than SD datasets. The projected changes in ENC rainfall (up to 112%) exceed values published for the U.S. but do not exceed historical values. The peak discharges for Matthew-2100 could increase by 23–69%, with 0.4–3 m increases in water surface elevation and 8–57% increases in flooded area. The projected increases in flooding would threaten people, ecosystems, agriculture, infrastructure, and the economy throughout ENC. Full article

This study examines urban expansion, coastal erosion, and extreme wave events in Licantén, Maule Region, following the 2010 earthquake and tsunami. Using multi-source data—Landsat and Sentinel-2 imagery, ERA5 reanalysis, high-resolution Maxar images, UAV surveys, and the CoastSat algorithm—we detected significant urban growth in tsunami-prone areas: Iloca (36.88%), La Pesca (33.34%), and Pichibudi (20.78%). A 39-year shoreline reconstruction (1985–2024) revealed notable changes in erosion rates and shoreline dynamics using DSAS v6.0, influenced by tides, storm surges, and wave action modeled in R to quantify storm surge events over time. Results underscore the lack of urban planning in hazard-exposed areas and the urgent need for resilient coastal management under climate change. Full article

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing lung disease characterized by chronic inflammation, vascular remodeling, and immune dysregulation. COVID-19, caused by SARS-CoV-2, shares several systemic immunohematologic disturbances with IPF, including cytokine storms, endothelial injury, and prothrombotic states. Unlike general comparisons of viral infections and chronic lung disease, this review offers a focused analysis of the shared hematologic and immunologic mechanisms between COVID-19 and IPF. Our aim is to better understand how SARS-CoV-2 infection may worsen disease progression in IPF and identify converging pathophysiological pathways that may inform clinical management. We conducted a narrative synthesis of the peer-reviewed literature from PubMed, Scopus, and Web of Science, focusing on clinical, experimental, and pathological studies addressing immune and coagulation abnormalities in both COVID-19 and IPF. Both diseases exhibit significant overlap in inflammatory and fibrotic signaling, particularly via the TGF-β, IL-6, and TNF-α pathways. COVID-19 amplifies coagulation disturbances and endothelial dysfunction already present in IPF, promoting microvascular thrombosis and acute exacerbations. Myeloid cell overactivation, impaired lymphocyte responses, and fibroblast proliferation are central to this shared pathophysiology. These synergistic mechanisms may accelerate fibrosis and increase mortality risk in IPF patients infected with SARS-CoV-2. This review proposes an integrative framework for understanding the hematologic and immunologic convergence of COVID-19 and IPF. Such insights are essential for refining therapeutic targets, improving prognostic stratification, and guiding early interventions in this high-risk population. Full article

Under accelerating global warming, the northern slope of the Middle Kunlun Mountains in Xinjiang, China, has seen a marked rise in extreme rainfall, posing increasing challenges for flood risk management and water resources. To improve our predictive capabilities and deepen our understanding of the driving mechanisms, we combine the European Centre for Medium-Range Weather Forecasts Reanalysis-5 (ERA5) reanalysis, regional observations, and high-resolution Weather Research and Forecasting model (WRF) simulations to dissect the 14–17 June 2021, extreme rainfall event. A deep Siberia–Central Asia trough and nascent Central Asian vortex established a coupled upper- and low-level jet configuration that amplified large-scale ascent. Embedded shortwaves funnelled abundant moisture into the orographic basin, where strong low-level moisture convergence and vigorous warm-sector updrafts triggered and sustained deep convection. WRF reasonably replicated observed wind shear and radar echoes, revealing the descent of a mid-level jet into an ultra-low-level jet that provided a mesoscale engine for storm intensification. Momentum–budget diagnostics underscore the role of meridional momentum transport along sloping terrain in reinforcing low-level convergence and shear. Together, these synoptic-to-mesoscale interactions and moisture dynamics led to this landmark extreme-precipitation event. Full article

The preservation and protection of historic urban centers in climate-sensitive coastal areas contributes to the promotion of culture as a driver and enabler of achieving temporal and spatial sustainability, as it is recognized that urban heritage is an integral part of the urban landscape, culture, and economy. The aim of this study was to enhance the resilience and protection of cultural heritage and historic urban centers (HUCs) in the coastal area of Kaštela, Croatia, by providing recommendations and action guidelines in response to climate change impacts, including rising temperatures, sea levels, storms, droughts, and flooding. Preserving HUCs is essential to maintain their cultural values, original structures, and appearance. Many ancient coastal Roman HUCs lie partially or entirely below mean sea level, while low-lying medieval castles, urban areas, and modern developments are increasingly at risk. Based on vulnerability assessments, targeted mitigation and adaptation measures were proposed to address HUC vulnerability sources. The Historical Urban Landscape Approach tool was used to transition and manage HUCs, linking past, present, and future hazard contexts to enable rational, comprehensive, and sustainable solutions. The effective protection of HUCs requires a deeper understanding of the evolution of urban development, climate dynamics, and the natural environments, including both tangible and intangible urban heritage elements. The “hazard-specific” vulnerability assessment framework, which incorporates hazard-relevant indicators of sensitivity and adaptive capacity, was a practical tool for risk reduction. This method relies on analyzing the historical performance and physical characteristics of the system, without necessitating additional simulations of transformation processes. Full article

Hydrotechnical structures reshape sandy coasts by altering hydrodynamics and sediment transport, yet their long-term effects on sediment texture remain underexplored, particularly in the Baltic Sea. This study investigates the spatial and temporal variations in sediment grain size near two ports (Šventoji and Klaipėda) on the sandy Baltic Sea coast, considering the influence of jetties, nourishment, and geological framework. A total of 246 surface sand samples were collected from beach and foredune zones between 1993 and 2018. These samples were analyzed in relation to shoreline changes, hydrodynamic data, and geological context. The results show that sediment texture is most affected within 1–2 km downdrift and up to 4–5 km updrift of port structures. Downdrift areas tend to contain coarser, poorly sorted sediments because of erosion and the exposure of deeper strata, while updrift zones accumulate finer, well-sorted sands via longshore transport. In the long term, the geological framework controls sediment characteristics. In the medium term, introduced material that differs in grain size from natural beach sediments may alter the texture of the sediment, either coarsening or refining it. The latter slowly returns to its natural texture. Short-term changes are driven by storm events. These findings highlight the importance of integrating structural interventions, nourishment practices, and geological understanding for sustainable coastal management. Full article

Coastal climate processes that affect landscape hydrology and beach dynamics are studied using local and remote data sets near Cape Vidal (28.12° S, 32.55° E). The sporadic intra-seasonal pulsing of coastal runoff, vegetation, and winds is analyzed to understand sediment inputs and transport by near-shore wind-waves and currents. River-borne sediments, eroded coral substrates, and reworked beach sand are mobilized by frequent storms. Surf-zone currents ~0.4 m/s instill the northward transport of ~6 10⁵ kg/yr/m. An analysis of the mean annual cycle over the period of 1997–2024 indicates a crest of rainfall over the Umfolozi catchment during summer (Oct–Mar), whereas coastal suspended sediment, based on satellite red-band reflectivity, rises in winter (Apr–Sep) due to a deeper mixed layer and larger northward wave heights. Sediment input to the beaches near Cape Vidal exhibit a 3–6-year cycle of southeasterly waves and rainy weather associated with cool La Nina tropical sea temperatures. Beachfront sand dunes are wind-swept and release sediment at ~10³ m³/yr/m, which builds tall back-dunes and helps replenish the shoreline, especially during anticyclonic dry spells. A wind event in Nov 2018 is analyzed to quantify aeolian transport, and a flood in Jan–Feb 2025 is studied for river plumes that meet with stormy seas. Management efforts to limit development and recreational access have contributed to a sustainable coastal environment despite rising tides and inland temperatures. Full article

Today, coastal storms represent one of the most formidable environmental challenges, causing significant impacts on coastal communities. This situation underscores both the importance and urgency of studying storms and their characterization. This study proposes an innovative approach combining Principal Component Analysis (PCA) and machine learning (Classification and Regression Trees, CART) to characterize and distinguish damaging storms from non-damaging ones along the coast of Dakar, Senegal. The analysis revealed that among several hydrometeorological variables studied (wave height, period, direction, runup, wave energy, sea level anomaly, tide, etc.), the variables SLA and tide play a central role in the occurrence of damage, although they are weakly correlated with the others. By cross-analyzing these variables, critical thresholds were established, such as Tide > 0.53 m combined with SLA ≥ 0.061 m, Tide > 0.53 m and ECWL ≥ 1.3 m, as well as Runup ≤ 0.64 m associated with a high wave period (Tp), allowing accurate differentiation of potentially damaging storms. The CART method validated these results and identified three key combinations: (1) Tide–SLA, where no damage is observed if Tide < 0.53 m, and damage occurs beyond this threshold when SLA ≥ 0.061 m; (2) Tide–ECWL, where storms are damaging if Tide > 0.53 m and ECWL ≥ 1.3 m; (3) Runup–Tp, where storms are damaging if Runup ≤ 0.64 m or if Runup > 0.82 m with Tp ≥ 16 s. These results constitute the first application of machine learning for storm classification on the Senegalese coast, providing a novel quantitative foundation for better understanding the hydrodynamic conditions associated with damaging storms. The findings of this study could be valuable for risk management and the development of early warning systems Full article

Background: Sepsis and septic shock are major contributors to global morbidity and mortality. The “cytokine storm,” a hyper-inflammatory response, plays a central role in sepsis pathophysiology, leading to multi-organ failure. Extracorporeal cytokine adsorption therapies, such as CytoSorb, Toraymyxin, Oxiris, HA330/380, and Seraph 100 Microbind, aim to mitigate the inflammatory response by removing circulating cytokines and other mediators. Methods: A comprehensive search of Scopus and PubMed was conducted for studies published from January 2020 to May 2025. The search terms included “sepsis,” “septic shock,” and “extracorporeal cytokine adsorption.” Relevant studies, including clinical trials and meta-analyses, were included to assess the efficacy and safety of these therapies. Results: Extracorporeal cytokine adsorption has shown promising results in reducing cytokine levels, improving organ function, and decreasing vasopressor requirements. However, evidence regarding mortality reduction remains inconsistent. Studies have demonstrated benefits in sepsis, ARDS, and cardiogenic shock, improving organ recovery and inflammatory markers. Conclusions: Extracorporeal cytokine adsorption is a potential adjunctive therapy in sepsis management, offering improvements in organ function and inflammatory control. While the mortality benefit remains uncertain, ongoing research and large-scale clinical trials are essential to define its clinical role and optimize its application. Full article

Low-impact development (LID) offers environmental, economic, and social benefits, yet research on optimizing facility combinations remains limited. This study evaluates four representative LID types—green roofs, sunken green spaces, permeable pavement, and rain gardens—using an integrated framework combining the Storm Water Management Model (SWMM), NSGA-II genetic algorithm, and Analytic Hierarchy Process (AHP) at Taiyuan University of Technology in Shanxi Province, China. Based on site constraints, each LID type was pre-assigned to suitable subareas, and optimization focused on determining proportional allocations within these areas. SWMM simulations revealed that permeable paving achieved the highest runoff reduction (up to 19.4% at 65% coverage) and strong cost-effectiveness (0.013 USD per % reduction). NSGA-II was used to generate a set of optimal solutions by minimizing construction costs and maximizing runoff and pollutant reductions. AHP then ranked these solutions according to their environmental, economic, and social benefits. In this case, the ideal mix—subject to site-specific constraints and model assumptions—includes 28.58% green roofs, 19.37% sunken green spaces, 48.68% permeable paving, and 3.37% rain gardens. The study proposes a sponge campus renewal strategy, offering theoretical and practical insights for sustainable urban development and precise environmental management. Full article