Search Results (251)

Background: Preoperative clear fluid fasting is intended to reduce aspiration risk, but prolonged abstinence may impair hydration, comfort, and cardiovascular stability. Arterial hypotension during anesthesia induction is a common perioperative complication, and its association with fasting duration has become an important concern. The objective of this review was to evaluate the relationship between the duration of preoperative clear fluid fasting and the risk of arterial hypotension during anesthesia induction in both adult and pediatric populations. Methods: A structured PubMed search identified 17 studies, including randomized controlled trials, prospective cohorts, registry-based analyses, and interventional imaging investigations. Data were extracted on patient age, fasting duration, hypotension definitions, and monitoring modalities. Subgroups included adults, pediatric patients, and studies employing echocardiography or ultrasound to evaluate preload. Results: A total of 96,017 patients were included (77,978 adults; 17,685 children). In adults, fasting beyond two hours was associated with hypovolemia and a greater incidence of post-induction hypotension, while fasting of ≤2 h improved hemodynamic stability without increasing aspiration risk. Pediatric studies demonstrated fasting durations often exceeding 6–10 h, correlating with higher odds of hypotension and metabolic derangements. Liberalized regimens, including carbohydrate-containing fluids, were consistently safe. Ultrasound-based studies revealed increased inferior vena cava collapsibility and reduced ventricular filling after prolonged fasting, providing a mechanistic explanation for blood pressure instability. Conclusions: Prolonged preoperative fasting was not consistently an independent predictor of peri-induction hypotension in all populations; however, data from large adult and pediatric studies demonstrate that extended fasting increases hypotension risk through volume and metabolic depletion. These findings support the importance of liberalized fasting policies and proactive fluid optimization to reduce early hemodynamic instability during anesthesia induction. Full article

Background and Objectives: Laryngeal cancer imposes a disproportionate burden on speech, airway protection and long-term quality of life. Contemporary population-based data for Central and Eastern Europe remain scarce, and the post-pandemic trajectory is uncertain. Materials and Methods: We performed a nationwide, retrospective ecological time-series study using Romanian mortality registers and hospital-discharge files for 2017–2023. Crude and age-standardised mortality rates (ASMRs) were calculated, county-level indirect standardisation and spatial autocorrelation assessed and joinpoint regression quantified temporal trends. Forecasts to 2040 combined Holt–Winters/ARIMA models with Elliott-wave heuristics anchored to Fibonacci retracements. Results: In 2023, 798 laryngeal cancer deaths yielded a crude mortality of 3.65/100,000 (95% CI 3.41–3.91). Male mortality (7.07/100,000) exceeded female mortality 18-fold. Rural residents experienced a higher rate than urban counterparts (4.26 vs. 3.04/100,000), a difference unchanged after indirect age standardisation. National ASMR fell by 3.7% annually (p < 0.01), yet five counties formed a high-risk corridor (standardised mortality ratios 1.59–1.82); Moran’s I = 0.27 (p < 0.01) indicated significant spatial clustering. Pandemic-era surgical throughput collapsed by 48%, generating a backlog projected to persist beyond 2030. Ensemble forecasting anticipates a doubling of discharges and mortality between 2034 and 2037 unless smoking prevalence falls by ≥30% and radon exposure is curtailed. Conclusions: Although overall laryngeal cancer mortality in Romania is declining, the pace lags behind Western Europe and is threatened by geographic inequities and pandemic-related care delays. Aggressive tobacco control, radon-remediation policies and expansion of surgical and radiotherapeutic capacity are required to avert a forecasted surge in the next decade. Full article

This work is framed as an application of static and small exponential random graph models for complex networks in multiple layers. This document revisits the small network and exhibits its potential. Examining the bibliography reveals considerable interest in large and dynamic complex networks. This research examines the application of small networks (50,000 population) for analyzing global commerce, conducting a comparative graph structure of the tariffs, and importing multilayer networks. The authors created and described the scenario where the readers can compare the graph models visually, at a glance. The proposed methodology represents a significant contribution, providing detailed descriptions and instructions, thereby ensuring the operational effectiveness of the application. The method is organized into five distinct blocks (Bn) and an accompanying appendix containing reproduction notes. Each block encompasses a primary task and associated sub-tasks, articulated through a hierarchical series of steps. The most challenging mathematical aspects of a small network analysis pertain to modeling and sample selection (sel_p). This document describes several modeling tasks that confirm that sel_p = 10 is the best option, including modeling the edges and the convergence and covariance model parameters, modeling the node factor by vertex names, Pearson residual distributions, goodness of fit, and more. This method establishes a foundation for addressing the intricate questions derived from the established hypotheses. It provides eight model specifications and a detailed description. Given the scope of this investigation, a historical examination of the relationships between different network actors is deemed essential, providing context for the study of actors engaged in global trade. Various analytical perspectives (six), encompassing degree analyses, diameter and edges, hubs and authority, co-citation and cliques in mutual and collapse approaches, k-core, and clustering, facilitate the identification of the specific roles played by actors within the importation network in comparison to the tariff network. This study focuses on the Latin American and Caribbean region. Full article

Nieuwerkerk Volcano, located in the Banda Sea, Indonesia, is a submarine volcano whose entire edifice lies beneath sea level. Its proximity to several inhabited islands raises significant concerns regarding potential impacts from future volcanic hazards. Despite historical unrest recorded in 1925 and 1927, a comprehensive geological and geophysical understanding of Nieuwerkerk remains notably limited, with the last research expedition being in 1930. This study seeks to advance our understanding of the geomorphological structure and subsurface characteristics of the region, contributing to a preliminary hazard assessment and delineating key directions for future geoscientific investigation. The data were obtained during our most recent expedition conducted in 2022. High-resolution multibeam bathymetry data were analyzed to delineate the volcano’s morphology, while marine magnetic survey data were processed to interpret magnetic anomalies associated with its structure beneath volcano. Our updated morphological analysis reveals the following: (1) Nieuwerkerk Volcano is among the largest submarine volcanic edifices in the Banda Sea (length = 80 km, width = 30 km, height = 3460 m); (2) there is the presence of twin peaks (depth~300m); (3) there are indications of sector collapse (diameter = 10–12 km); (4) there are significant fault lineaments; and (5) there are landslide deposits, suggesting a complex volcanic edifice shaped by various constructive and destructive processes. The magnetic data show a low magnetic anomaly beneath the surface, where one of the indications is the presence of active magma. These findings significantly enhance our understanding of Nieuwerkerk’s current condition and volcanic evolution for an initial assessment of potential hazards, including future eruptions, edifice collapse, and landslides, which could subsequently trigger tsunamis. Further investigation, including comprehensive geophysical surveys covering the entire Nieuwerkerk area, rock sample analysis, visual seafloor observation, and seawater characterization, is crucial for a comprehensive understanding of its magmatic system and a more robust hazard assessment. This research highlights the critical need for detailed investigations of active submarine volcanoes, particularly those with sparse historical records and close proximity to populated areas, within tectonically complex settings such as the Banda Sea. Full article

The survival status of Lumnitzera littorea is near threatened globally and critically endangered in China. Clarifying its global distribution pattern and its changing trends under different future climate models is of great significance for the protection and restoration of its endangered status. To build a model for this purpose, this study selected 73 actual distribution points of Lumnitzera littorea worldwide, combined with 12 environmental factors, and simulated its potential suitable habitats in six periods: the Last Interglacial (130,000–115,000 years ago), the Last Glacial Maximum (27,000–19,000 years ago), the Mid-Holocene (6000 years ago), the present (1970–2000), and the future 2050s (2041–2060) and 2070s (2061–2080). The results show that the optimal model parameter combination is the regularization multiplier RM = 4.0 and the feature combination FC (Feature class) = L (Linear) + Q (Quadratic) + P (Product). The MaxEnt model has a low omission rate and a more concise model structure. The AUC values in each period are between 0.981 and 0.985, indicating relatively high prediction accuracy. Min temperature of the coldest month, mean diurnal range, clay content, precipitation of the warmest quarter, and elevation are the dominant environmental factors affecting its distribution. The environmental conditions for min temperature of the coldest month at ≥19.6 °C, mean diurnal range at <7.66 °C, clay content at 34.14%, precipitation of the warmest quarter at ≥570.04 mm, and elevation at >1.39 m are conducive to Lumnitzera littorea’s survival and distribution. The global potential distribution areas are located along coasts. Starting from the paleoclimate, the plant’s distribution has gradually expanded, and its adaptability has gradually improved. In China, the range of potential highly suitable habitats is relatively narrow. Hainan Island is the core potential habitat, but there are fragmented areas in regions such as Guangdong, Guangxi, and Taiwan. The modern centroid of Lumnitzera littorea is located at (109.81° E, 2.56° N), and it will shift to (108.44° E, 3.22° N) in the later stage of the high-emission scenario (2070s (SSP585)). Under global warming trends, it has a tendency to migrate to higher latitudes. The development of the aquaculture industry and human deforestation has damaged the habitats of Lumnitzera littorea, and its population size has been sharply and continuously decreasing. The breeding and renewal system has collapsed, seed abortion and seedling establishment failure are common, and genetic variation is too scarce. This may indicate why Lumnitzera littorea is near threatened globally and critically endangered in China. Therefore, the protection and restoration strategies we propose are as follows: strengthen the legislative guarantee and law enforcement supervision of the native distribution areas of Lumnitzera littorea, expanding its population size outside the native environment, and explore measures to improve its seed germination rate, systematically collecting and introducing foreign germplasm resources to increase its genetic diversity. Full article

This article examines the potential role of the Antonine Plague (165–180 CE) and climate change in the mid-2nd-century collapse of the Afro-Eurasian world-system. Following the model proposed by Gills and Frank, the world-system cycles between phases of integration (A) and disintegration (B). Integrative phases are marked by increasingly complex exchanges of goods, services, information, and populations, which enhance connectivity and intensify the circulation of matter and energy. Yet, this very complexity, while driving growth and expansion, also generates systemic vulnerabilities. The plague and climate change are examined here as critical shocks that triggered the shift from an A phase to a B phase, destabilizing interconnected regions such as the Roman Empire in the West and the Han Dynasty in China. The demographic losses and logistical strains of the pandemic eroded the integrative structures underpinning Afro-Eurasian connectivity, creating conditions for prolonged disintegration. These developments are further situated within the broader history of the Silk Roads, whose role in fostering transcontinental connections had reached a peak in the centuries preceding the crisis. The analysis underscores how pandemics like the Antonine Plague, together with episodes of abrupt climate change, can act as decisive agents in the disintegration phases of world-systems, reshaping the trajectories of complex societies and accelerating the collapse of established networks. Full article

This paper proposes a novel intelligent optimization algorithm, ICPMSHOA, that effectively balances population diversity and convergence performance by integrating an iterative chaotic map with infinite collapses (ICMIC), centroid opposition-based learning, and periodic mutation strategy. To verify its performance, we adopted benchmark functions from the IEEE CEC 2017 and 2022 standard test suites and compared it with six algorithms, including OOA and BWO. The results show that ICPMSHOA has significant improvements in convergence speed, global search capability, and stability, with statistically significant advantages. Furthermore, the algorithm performs outstandingly in three practical engineering constrained optimization problems: Haverly’s pooling problem, hybrid pooling–preparation problem, and optimization design of industrial refrigeration systems. This study confirms that ICPMSHOA provides efficient and reliable solutions for complex optimization tasks and has strong practical value in engineering scenarios. Full article

The tomato leafminer (Tuta absoluta) is a globally invasive pest that causes severe yield losses in tomato crops. Nanotechnology-based strategies offer promising alternatives to conventional insecticides. This study examines the physiological, biochemical, and demographic responses of T. absoluta following exposure to mesoporous silica nanoparticles (MSNs) applied to tomato leaves at concentrations of 0, 3, 30, and 300 mg L⁻¹. Comprehensive assessments were conducted, including digestive and detoxifying enzyme activities in the insect, neurotoxicity indicators, life table parameters, and antioxidant responses in the host plant. At 30 mg L⁻¹, MSNs significantly impaired larval development, fecundity, and survival of T. absoluta without inducing phytotoxicity. Tomato plants treated at this concentration exhibited enhanced antioxidant enzyme activity (SOD, CAT, POD) and a reduced malondialdehyde (MDA) content, indicating an active oxidative defense. These plant responses were significantly correlated with changes in insect fitness traits, suggesting a plant-mediated effect on pest physiology. Digestive enzyme disruption, decreased acetylcholinesterase activity, and extended developmental periods contributed to suppressed population growth, as evidenced by reductions in the intrinsic rate of increase (r), net reproductive rate (R₀), and fecundity. At 300 mg L⁻¹, however, severe phytotoxicity and enzymatic collapse were observed in both plant and insect systems. These findings highlight moderate concentration of MSNs (30 mg L⁻¹) as a promising dose for sustainable and host-safe pest management, offering multi-targeted suppression of T. absoluta through combined plant and insect biochemical pathways. Full article

Honeybees (Apis mellifera) are indispensable pollinators vital to global biodiversity, ecosystem stability, and agricultural productivity, and they promote over 35% of food crops and 75% of flowering plants. Yet, they are in unprecedented decline, partly as a result of neonicotinoid pesticide use elsewhere. These effects on honey bee health are synthesized in this paper through molecular, physiological, and behavioral data showing that sublethal effects of neonicotinoids impair honey bee health. As neurotoxic insecticides that target nicotinic acetylcholine receptors (nAChRs), these insecticides interfere with neurotransmission and underlie cognitive impairment, immune suppression, and oxidative stress. Developmental toxicity is manifested in larvae as retarded growth, reduced feeding, and increased death; queen and drone reproduction are impaired, lowering colony viability. As a result, adult bees have shortened lives and erratic foraging, are further disoriented, and experience impaired navigation, communication, and resource collection. Together, these effects cascade to reduced brood care, thermoregulatory failure, and heretofore unrecognized increased susceptibility to pathogens, increasing the probability of colony collapse at the colony level. Contaminants such as pesticides may cause pollinator exposure and, in turn, may cause their population to be undermined if they are not mitigated; therefore, urgent mitigation strategies, including integrated pest management (IPM), regulatory reforms, and adoption of biopesticides, are needed to mitigate pollinator exposure. The focus of this review lies in the ecological necessity of restructuring how agriculture is managed to simultaneously meet food security and the conservation of honeybee health, the linchpin of global ecosystems. Full article

Peripheral rural coastal areas in Europe face persistent structural challenges, including demographic decline, aging populations, and the collapse of traditional sectors like fishing. These are further aggravated by environmental disasters, which weaken local economies. Public sector intervention is therefore essential, not only to provide an immediate response, but also to guarantee long-term solutions. This study explores the contribution of state-led tourism infrastructures to rural development and post-disaster recovery, taking the Parador Costa da Morte in Galicia as a case study. Based on data from a survey of parador guests, it identifies tourist profiles through factor and cluster motivation analysis. The parador’s impacts on the surrounding region are assessed by examining tourists’ travel patterns and spending behavior, as well as the analysis of secondary data on regional changes in tourism supply and demand. The results show widely differing motivations and, despite varying visitor profiles, the predominance of a tourism typology that generates significant local spillovers. These findings support the potential of high-quality, publicly driven tourism initiatives to stimulate the economy of structurally disadvantaged rural areas. The article ends with recommendations for tourism strategies aligned with local recovery and development goals. Full article

Relict fern species, confined to microhabitats with stable historical conditions, are especially vulnerable to climate change. The Alboran Arc hosts a unique relict fern flora, including Culcita macrocarpa, Diplazium caudatum, and Pteris incompleta, and functions as a major Pleistocene refuge. This study assesses the population trends and climate sensitivity of these species in Los Alcornocales Natural Park using annual abundance time series for a decade, empirical survival projections, and principal component analysis to identify key climatic drivers. Results reveal distinct climate response clusters among populations, though intra-specific variation highlights the importance of local conditions. Climate change is already impacting population viability, especially for P. incompleta, which shows high sensitivity to rising maximum temperatures and prolonged heatwaves. Climate-driven models forecast more severe declines than empirical ones, particularly for C. macrocarpa and P. incompleta, with the latter showing a projected collapse by the mid-century. In contrast, D. caudatum exhibits moderate vulnerability. Crucially, the divergence between models underscores the impact of conservation efforts: without reinforcement and reintroduction actions, projected declines would likely be more severe. These results project a decline in the populations of the studied ferns, highlighting the urgent need to continue implementing both in situ and ex situ conservation measures. Full article

This study examines the impact of reproductive inequality on the long-term survival of Homo sapiens by comparing two reproductive models: the Pareto (power-law) distribution of unequal reproduction and the Gaussian (normal) distribution of equal reproduction. We conducted simulations to explore how genetic diversity, measured by heterozygosity, evolves over time. The results predict population crashes due to genetic bottlenecks under both models, but with large differences in timing. We refer to Pareto reproductive inequality as the Genghis Khan effect. This effect accelerates the loss of genetic diversity, increasing the species’ vulnerability to environmental stressors, resource depletion, and genetic drift, and thereby raising the risk of an earlier population collapse. Our findings showcase the importance of reproductive balance for the prolonged presence of Homo sapiens on this planet. Full article

The Millard’s rat (Dacnomys millardi), a threatened murid endemic to Southeast Asian montane rainforests and the sole member of its monotypic genus, faces escalating endangered risks as a Near Threatened species in China’s Biodiversity Red List. This ecologically specialized rodent exhibits diagnostic morphological adaptations—hypertrophied upper molars and cryptic pelage—that underpin niche differentiation in undisturbed tropical/subtropical forests. Despite its evolutionary distinctiveness, the conservation prioritization given to Dacnomys is hindered due to a deficiency of data and unresolved phylogenetic relationships. Here, we integrated morphological analyses with the first complete mitogenome (16,289 bp in size; no structural rearrangements) of D. millardi to validate its phylogenetic placement within the subfamily Murinae and provide novel insights into genetic diversity erosion. Bayesian and maximum likelihood phylogenies robustly supported Dacnomys as sister to Leopoldamys (PP = 1.0; BS = 100%), with an early Pliocene divergence (~4.8 Mya, 95% HPD: 3.65–5.47 Mya). Additionally, based on its basal phylogenetic position within Murinae, we propose reclassifying Micromys from Rattini to the tribe Micromyini. Codon usage bias analyses revealed pervasive purifying selection (Ka/Ks < 1), constraining mitogenome evolution. Genetic diversity analyses showed low genetic variation (CYTB: π = 0.0135 ± 0.0023; COX1: π = 0.0101 ± 0.0025) in fragmented populations. We propose three new insights into this genetic diversity erosion. (1) Evolutionary constraints: genome-wide evolutionary conservation and shallow evolutionary history (~4.8 Mya) limited mutation accumulation. (2) Anthropogenic pressures: deforestation-driven fragmentation of habitats (>20,000 km²/year loss since 2000) has reduced effective population size, exacerbating genetic drift. (3) Ecological specialization: long-term adaptation to stable niches favored genomic optimization over adaptive flexibility. These findings necessitate suitable conservation action by enforcing protection of core habitats to prevent deforestation-driven population collapses and advocating IUCN reclassification of D. millardi from Data Deficient to Near Threatened. Full article

Background: Pes planus is a condition where the arch of the foot collapses, resulting in the entire sole contacting the ground. The biomechanical implications of pes planus on gait have been widely studied; however, research specific to Black African populations, particularly recreational runners, is scarce. Aim: This study aimed to describe the forefoot centre of pressure (CoP) trajectory during the barefoot gait cycle among Black African recreational runners with pes planus. Methods: A prospective explorative and quantitative study design was employed. Participants included Black African male recreational runners aged 18 to 45 years diagnosed with pes planus. A Freemed™ 6050 force plate was used to collect gait data. Statistical analysis included cross-tabulations to identify patterns. Results: This study included 104 male participants across seven weight categories, with the majority in the 70-to-79 kg range (34.6%, n = 36). Most participants with pes planus showed a neutral foot posture (74.0%, n = 77) on the foot posture index 6 (FPI-6) scale. Flexible pes planus (94.2%, n = 98) was much more common than rigid pes planus (5.8%, n = 6). Lateral displacement of the CoP was observed in the right forefoot (90.4%, n = 94) and left forefoot (57.7%, n = 60). Load distribution patterns differed between feet, with the right foot favouring the medial heel, arch, and metatarsal heads, while the left foot favoured the lateral heel, medial heel, and lateral arch. No statistical significance was found in the cross-tabulations, but notable lateral CoP displacement in the forefoot was observed. Conclusions: The findings challenge the traditional view of pes planus causing overpronation and highlight the need for clinicians to reconsider standard diagnostic and management approaches. Further research is needed to explore the implications of these findings for injury prevention and management in this population. Full article

Prolonged conflicts in Iraq over the past four decades have profoundly disrupted environmental systems, not only through immediate post-conflict emissions—such as residues from munitions and explosives—but also via long-term infrastructural collapse, population displacement, and unsustainable resource practices. Despite growing concern over air quality in conflict-affected regions, comprehensive assessments integrating long-term data and localized measurements remain scarce. This study addresses this gap by analyzing the environmental consequences of sustained instability in Mosul, focusing on air pollution trends using both remote sensing data (1983–2023) and in situ monitoring of key pollutants—including PM_2.5, PM₁₀, TVOCs, NO₂, SO₂, and formaldehyde—at six urban sites during 2022–2023. The results indicate marked seasonal variations, with winter peaks in combustion-related pollutants (NO₂, SO₂) and elevated particulate concentrations in summer driven by sandstorm activity. Annual average concentrations of all six pollutants increased by 14–51%, frequently exceeding WHO air quality guidelines. These patterns coincide with worsening meteorological conditions, including higher temperatures, reduced rainfall, and more frequent storms, suggesting synergistic effects between climate stress and pollution. The findings highlight severe public health risks and emphasize the urgent need for integrated urban recovery strategies that promote sustainable infrastructure, environmental restoration, and resilience to climate change. Full article