Search Results (192)

Coastal societies face increasing health risks from climate change, such as weather-related extreme conditions, environmental destruction, and the occurrence of epidemics, posing significant challenges to sustainable development. There is a need to accurately measure the risks in place through integrating the climate variability with socio-economic exposure and health components to support long-term resilience and sustainable adaptation. This study conceptualized and validated a composite index-based method to assess climate–health risks across three Indonesian coastal cities: Banda Aceh, Mataram, and Ambon. This validation process was conducted by checking for face validity and consistency between sub-indices, as well as conformity to existing frameworks in the literature. Using satellite-derived climate data, national socio-economic statistics, and public health records, we identified the key parameters (hazard, sensitivity, exposure, and adaptive capacity) and quantified the risk levels for 190 villages. The results show that over 92% of villages fall into the high or very high risk categories, with universal high sensitivity and low adaptive capacity (78.95%). This points towards structural inequalities that hinder sustainable development. Spatial and quadrant analyses revealed region-specific vulnerabilities where Ambon showed higher hazard exposure (56% high and 42% very high). The findings provide policymakers and stakeholders with priority areas for targeted interventions and actionable suggestions to support public health planning, equitable resource allocation, and long-term sustainable coastal development. Full article

Objective: The association between vitamin D status and paediatric fracture risk remains controversial, with inconsistent findings across existing studies. This study aimed to evaluate the relationship between serum 25(OH)D concentrations, vitamin D sufficiency, insufficiency and deficiency, vitamin D supplementation and fracture risk in a large Southeast Asian paediatric cohort. Methods: This retrospective cross-sectional study included children under 18 years whose serum 25(OH)D concentrations were measured between 2014 and 2022. One-way ANOVA determined statistical significance between 25(OH)D concentrations in fracture and non-fracture groups. Prevalence of vitamin D insufficiency, deficiency and supplementation was compared between the two groups. Chi-square tests evaluated the association between 25(OH)D concentrations and supplementation against fracture risk. Results: A total of 4530 children were included (157 fracture cases, 4373 controls). Mean serum 25(OH)D concentration was lower in the fracture group than in the controls (27.44 ± 12.26 vs. 30.75 ± 15.21 ng/mL; p = 0.007). Sub-sufficient vitamin D status (<30 ng/mL) was more prevalent among fracture patients (p = 0.001), and suboptimal (p = 0.001), insufficient (p = 0.001), and deficient (p = 0.014) categories were each significantly associated with fractures. An association between vitamin D supplementation and fracture risk was observed. However, the dataset did not permit the determination of causality and a protective effect cannot be inferred. Conclusions: Higher serum 25(OH)D concentrations were associated with lower fracture risk, suggesting that optimisation of vitamin D status may represent a modifiable factor in paediatric bone health. Healthcare institutions should aim to maintain adequate 25(OH)D concentrations (>30 ng/mL). An association between vitamin D supplementation and fracture risk was observed; however, causality cannot be inferred from this retrospective dataset. Full article

Reservoir fluid identification is a critical aspect of oil and gas geophysical exploration. Accurate fluid identification directly impacts the interpretation of subsurface geological conditions, reduces exploration risks, and provides essential guidance for formulating oil and gas development strategies. Therefore, reliable and precise fluid identification is indispensable across different stages of oil and gas exploration and production. This study proposes a hierarchical classification method based on conditional Variational Autoencoder (cVAE) and time series forest (TSF) algorithms to address reservoir fluid identification under complex geological conditions. The main contributions of this work are as follows: (i) the cVAE is used to pre-process the logging data to suppress local high-frequency disturbances and isolated anomalies that may exist in the logging curves, thereby improving the quality of the input data; and (ii) hierarchical classification strategy is utilized to perform the fluid identification task in two steps. The first step involves a top-level classification to distinguish the gas bearing layer from the non-gas layer. The second step refines this classification into subcategories, including the gas layer (GL), gas–water layer (GW), gas-bearing water layer (GBW), water layer (WL), and non-reservoir layer (DW). This can fully address the challenges of imbalanced datasets and improve the recognition accuracy of minority classes. Additionally, integrating the TSF algorithm within the hierarchical classification framework effectively captures the sequential characteristics of well logging data, improving the model’s ability to recognize complex geological patterns. A real-world application in a block of the Yinggehai Basin in the South China Sea demonstrated the superior performance of the proposed model. Experimental results show that the method achieves an accuracy of over 84% in all four wells, enabling accurate and reliable reservoir fluid classification. Full article

Background/Objectives: The foetal alcohol syndrome spectrum is linked with neurodevelopmental delay and cognitive and educational problems. Direct consequences of prenatal alcohol exposure include impaired processes of neural migration and brain development. Among the important features present in affected children are impaired communicational skills and intelligence. Methods: Here we presented the case–control comparison of 124 children with foetal alcohol syndrome spectrum disorder (FAS: 62 (50%), pFAS: 34 (27.42%) and ARND: 28 (22.58%)) and 53 healthy controls regarding intelligence quotient and a verbal fluency task. The verbal and non-verbal intelligence was measured using the WISC-R scale, and the verbal fluency task encompassed phonemic, semantic and categorial assessment in 15 and 60 s; we used the authors’ parental/caregiver survey to determine risk factors. In statistical analysis both methods of classical parametric/non-parametric tests and machine learning algorithms were used. Results: Foetal alcohol syndrome spectrum patients were clearly distinguished from healthy controls regarding total verbal and non-verbal intelligence, as well as all three categories of verbal fluency (p < 0.01). ML methods distinguished an FAS group with 0.49 precision and 80% recall and for pFAS and ARND diagnoses we obtained: 0.50/0.33 precision and 3%/7% recall. None of the parameters analysed in our study differentiated foetal alcohol syndrome, partial foetal alcohol syndrome and alcohol-related neurodevelopmental disorders. Conclusions: Children with foetal alcohol syndrome spectrum disorder markedly differ from healthy control subjects in intelligence and verbal fluency. The diagnostic sub-types of foetal alcohol spectrum are not clearly defined in obtained neuropsychological and clinical data. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity, mortality, and healthcare utilization. Lung volume reduction surgery improves outcomes in a select cohort but portends high morbidity. Bronchoscopic lung volume reduction (BLVR) is a less invasive, reversible manner of lung volume reduction, using one-way valves to improve lung function, quality of life, and exercise capacity. Nevertheless, knowledge gaps persist regarding factors that predict procedural success. Methods: We retrospectively reviewed 142 patients who underwent BLVR at the University of Chicago between December 2018 and July 2024 to assess the relationship between comorbidities and procedural outcomes. Using logistic and multinomial regression, we determined odds ratios (ORs) for a binary outcome of success and failure and relative risk ratios (RRRs) for failure sub-categories relative to procedural success. Results: We observed a procedural success rate of 48.1% and pneumothorax prevalence of 21.8%. After adjusting for age, sex, race, and body mass index (BMI), comorbidities associated with procedural failure included chronic kidney disease (CKD), congestive heart failure (CHF), anemia, and a BMI, Obstruction, Dyspnea and Exercise (BODE) Index of 5 or greater. Obstructive sleep apnea (OSA) was associated with procedural success. Conclusions: Comorbidities associated with dyspnea appear to have a significant effect on procedural success in BLVR. Full article

The construction sector is central to achieving the objectives of the European Green Deal (EGD). While existing research on transition risks predominantly focuses on project- or firm-level challenges, less is known about the transition risks implied by high-level EU policy documents. This study addresses this gap by systematically analysing 101 EGD-related policy and guidance documents published between 2019 and February 2025. A mixed human–AI content analysis approach was applied, combining human expert manual coding with automated validation using large language models (Kimi K2 and GLM 4.6). The final dataset contains 2752 coded risk references organised into eight main categories and twenty-six subcategories. Results show that transition risks are most frequently associated with environmental, economic, and legislative domains, with Climate Change Impact, Cost of Transition, Pollution, Investment Risks, and Implementation Variability emerging as the most prominent risks across the corpus. Technological and social risks appear less frequently but highlight important systemic and contextual vulnerabilities. Overall, analysis of the EGD policy texts reveals the green transition as being constrained not only by environmental pressures but also by financial feasibility and execution capacity. The study provides a structured, policy-level risk profile of the EGD and demonstrates the value of hybrid human–LLM analysis for large-scale policy content analysis and interpretation. These insights support policymakers and industry stakeholders to anticipate structural uncertainties that may affect the construction sector’s transition toward a low-carbon, circular economy. Full article

Background/Objectives: Breast cancer is the most common malignancy among women, and early detection is critical for improving outcomes. The Breast Imaging Reporting and Data System (BI-RADS) standardizes reporting, but the BI-RADS 4 category presents a major challenge, with malignancy risk ranging from 2% to 95%. Consequently, most women in this category undergo biopsies that ultimately prove unnecessary. This study evaluated whether exhaled breath analysis could distinguish malignant from benign findings in BI-RADS 4 patients. Methods: Participants referred to the McGill University Health Centre Breast Center with BI-RADS 3–5 findings provided multiple breath specimens. Breathprints were captured using an electronic nose (eNose) powered breathalyzer, and diagnoses were confirmed by imaging and pathology. An autoencoder-based model fused the breath data with BI-RADS scores to predict malignancy. Model performance was assessed using repeated cross-validation with ensemble voting, prioritizing sensitivity to minimize false negatives. Results: The breath specimens of eighty-five participants, including sixty-eight patients with biopsy-confirmed benign lesions and seventeen patients with biopsy-confirmed breast cancer within the BI-RADS 4 cohort were analyzed. The model achieved a mean sensitivity of 88%, specificity of 75%, and a negative predictive value (NPV) of 97%. Results were consistent across BI-RADS 4 subcategories, with particularly strong sensitivity in higher-risk groups. Conclusions: This proof-of-concept study shows that exhaled breath analysis can reliably differentiate malignant from benign findings in BI-RADS 4 patients. With its high negative predictive value, this approach may serve as a non-invasive rule-out tool to reduce unnecessary biopsies, lessen patient burden, and improve diagnostic decision-making. Larger, multi-center studies are warranted. Full article

Background. Glucocorticoid-induced osteoporosis represents a well-known type of secondary osteoporosis (SOp). While the most prevalent sub-category includes corticotherapy, another important contributor is represented by Cushing’s syndrome. In this traditional landscape, adrenal incidentalomas do not involve a standard cause of SOp, since most of them are non-functioning adrenal tumours (NFATs). Yet, 30–40% of them are not entirely “non-functioning”, due to mild autonomous cortisol secretion (MACS). Despite not being a guideline-based diagnosis, a lower ACTH might point to various NFATs/MACS complications. Objective. This study aimed to determine the relationship between the bone health status of post-menopausal women with NFATs/MACS and their baseline morning ACTH level. The bone health indicators were DXA, FRAX, and bone remodelling markers. Methods. This was a retrospective, real-life, transversal study in adult females who were hospitalized in a single tertiary centre of endocrinology. They were all anti-osteoporotic drug-naïve. The subjects underwent CT and DXA scanning and a 1 mg dexamethasone suppression test (DST). Results. The cohort (sample size of N = 84 patients, 61.49 ± 7.86 years) had a type 2 diabetes rate of 18%, arterial hypertension rate of 75%, and a dyslipidemia rate of 78%. Median ACTH was 11.89 pg/mL. The prevalence of MACS was 30.95%. The mean largest tumour diameter (LTD) was 2.25 ± 0.99 cm. ACTH correlated with second-day cortisol after the 1 mg DST (r = −0.301, p = 0.024), and LTD (r = −0.434, p < 0.001). ROC analysis for the bone resorption marker CrossLaps showed an AUC of 0.647 (p = 0.05), with the highest Youden index for the cut-off at 0.32 ng/mL (sensitivity 87.50%, specificity 39.50%). Bone impairment (osteoporosis + osteopenia) was found in 65% of patients, with an osteoporotic fracture prevalence of 4.76%. The lowest mean T-score (−1.12 ± 1.00) showed osteopenia, and the median trabecular bone score pointed a partially degraded microarchitecture [median (interquartile interval): 1.320 (1.230, 1.392)]. FRAX and FRAXplus estimations correlated with bone mineral density (BMD) at all three central DXA sites, regardless of the ACTH cut-off. Patients with a low ACTH (<10 pg/mL) displayed similar bone/adrenal features when compared to those with normal ACTH, except forbut they had a higher MACS rate (45.45% versus 21.57%, p = 0.021) and a larger LTD (2.67 ± 0.98 versus 1.98 ± 0.92 cm, p = 0.003). Fracture estimation showed that only in patients with a low ACTH, the 10-year fracture risk for major osteoporotic fractures (MOF) adjusted for lumbar BMD was lower than the risk for MOF adjusted for diabetes (p = 0.036), and the 10-year hip fracture risk was lower when adjusted for lumbar BMD (p = 0.007). ACTH correlated with lumbar BMD (r = 0.591, p = 0.002) only in the group with an ACTH < 10 pg/mL, suggesting its potential usefulness as a bone biomarker in these cases. On the other hand, MACS-negative subjects with a low ACTH versus those with a normal ACTH showed higher CrossLaps (0.60 ± 0.27 versus 0.42 ± 0.21 ng/mL, p = 0.022), indicating an elevated bone resorption even in patients with tumours that are regarded as true non-secretors. Conclusions. A subgroup of patients diagnosed with NFATs/MACS might be prone to skeletal damage, and biomarkers such as ACTH (specifically, suppressed ACTH) might serve as a surrogate pointer to help refine this higher risk in daily practice. Further research to address other ACTH cut-offs will place ACTH assays in the overall bone status evaluation in these patients, most probably not as a single biomarker, but in addition to other assays. Full article

Background and Objectives: Preterm birth is a common obstetric problem. Attention-deficit hyperactivity disorder (ADHD) affects an increasing number of children. There is evidence that all subcategories of preterm birth are related to the occurrence of ADHD. The present article reviews the findings of the last two years regarding this association. Materials and Methods: PubMed was screened for relevant articles published in English between January 2024 and November 2025. Keyword combinations of the words “preterm birth”, “prematurity”, “attention deficit disorder”, “attention disorders”, “ADHD”, “preterm” and “attention deficit hyperactivity disorder” were used. A total of 28 articles were retrieved, reviewed and selected. Results: Preterm birth results in higher risk of ADHD, while early preterm births are characterized by an even higher risk of ADHD. Additionally, postnatal complications commonly experienced by preterm infants are associated with the presence of ADHD. It seems that the maternal use of ADHD medications during pregnancy is associated with a high risk of preterm birth, although there is a concern about the role of other psychotropic medications during pregnancy. Various neurodevelopmental disorders are also associated with preterm birth. Maternal use of glucocorticoids combined with preterm birth leads to higher risk of ADHD. However, the outcome of ADHD is shaped by a wide range of social, familiar and biological factors. Conclusions: Prematurity is a significant risk factor for the development of ADHD symptoms in children. However, many biological, environmental, and psychosocial factors, such as neurodevelopmental vulnerability, perinatal complications, maternal health and adverse psychosocial factors, act as regulators in this relationship. Researching and understanding these associations will help in implementing preventive measures in children who are at increased risk of developing ADHD. Full article

Internet of Things deployments face escalating security threats, yet systematic methods for auditing the defensive posture of IoT device networks remain underdeveloped. Current intrusion detection evaluations focus on algorithmic accuracy while neglecting operational requirements—computational efficiency, reproducibility, and interpretable risk assessment—that security audits demand. This paper introduces a reproducible security audit framework for IoT device networks, demonstrated through systematic evaluation of four machine learning models (Random Forest, LightGBM, XGBoost, Logistic Regression) on the TON_IoT dataset containing nine attack categories targeting smart environments. Our audit methodology enforces strict feature hygiene by excluding identity-revealing attributes, benchmarks both threat detection capability and computational cost, and provides complete reproducibility artifacts including preprocessing pipelines and trained models. The framework evaluates security posture through dual lenses: binary classification (distinguishing compromised from legitimate traffic) and multiclass classification (attributing threats to specific attack types). Binary audit results show ensemble models achieve 99.8–99.9% accuracy with perfect ROC-AUC (100%) and sub-15 ms inference latency per 1000 flows, confirming reliable attack detection. Multiclass auditing reveals more nuanced findings: while overall accuracy reaches 99.0% with macro-F1 near 97%, rare attack types expose critical blind spots—man-in-the-middle threats achieve only 78% F1 despite representing serious security risks. LightGBM provides optimal audit performance, balancing 99.93% detection accuracy with 2.76 MB deployment footprint. We translate audit findings into actionable security recommendations (network segmentation, rate-limiting, TLS metadata collection) and compare against twenty published studies, demonstrating that our framework achieves competitive detection rates while uniquely delivering the transparency, efficiency metrics, and reproducibility required for credible security assessment of production IoT networks. Full article

Typhoon-induced hazards in South Korea exhibit strong spatial heterogeneity, requiring localized assessments to support impact-based early warning. This study develops a district-level typhoon hazard framework by integrating high-resolution meteorological fields with structural and hydrological vulnerability indicators. Two impact-oriented indices were formulated: the Strong Wind Risk Index (SWI), based on 3 s gust wind intensity and building-age fragility, and the Heavy Rainfall Risk Index (HRI), combining probable maximum precipitation with permeability and river-network density. Hazard levels were classified into four categories, Attention, Caution, Warning, and Danger, using district-specific percentile thresholds consistent with the THIRA methodology. Nationwide analysis across 250 districts revealed a pronounced coastal–inland gradient: mean SWI and HRI values in Busan were approximately 1.9 and 6.3 times higher than those in Seoul, respectively. Sub-district mapping further identified localized hotspots driven by topographic exposure and structural vulnerability. By establishing statistically derived, region-specific thresholds, this framework provides an operational foundation for integrating localized hazard interpretation into Korea’s Typhoon Ready System (TRS). The results strengthen the scientific basis for adaptive, evidence-based early warning and climate-resilient disaster-risk governance. Full article

Even though primary Sjögren disease (pSjD) is mainly associated with sicca symptoms, there are extraglandular manifestations of the disease which affect the quality of life of patients the most and may even be life-threatening. Among the most severe, polyneuropathy and myopathy are worth mentioning. Additionally, clinical observations suggest a higher prevalence of fibromyalgia (FM) in this group of patients, clouding physicians’ assessment and potentially leading to unsuccessful therapeutic decisions. The aim of our study was to evaluate the frequency of pSjD and FM co-occurrence as well as to find the most effective screening tools and markers of such overlap. A total of 97 consecutive patients with diagnosed pSjD were incorporated in the study after obtaining their informed consent. Participants completed a set of broadly available questionnaires, including Fibromyalgia Survey Questionnaire, SF-36 and EULAR Sjögren’s Syndrome Patient-Reported Index (ESSPRI). Data on their laboratory results was collected in the dedicated database. Moreover, patients underwent electroneurographic (ENG) and electromyographic (EMG) testing. Central nervous system (CNS) abnormalities were detected using MRI. Objective disease activity was evaluated based on EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI). The mean age was 55.3 (range 19.0–78.0 years, SD = 13.9). The disease duration ranged from 2 to 42 years (M = 9.03 years, SD = 7.1 years). Nearly half of the participants (n = 44, 45%) met diagnostic criteria of FM. Interestingly, the diagnosis of FM correlated with CNS involvement. There was no significant correlation between FM and either polyneuropathy/myopathy nor laboratory findings (however, C3c and folic acid concentrations were near the level of significance—mean 1.2 vs. 1.29; p = 0.075 and mean 11.35 vs. 9.21; p = 0.071, respectively). Within the subcategories of SF-36 and ESSPRI scales, significant positive correlation was noted with ESSPRI total score and ESSPRI pain score (neuropathic subcategory), while a negative correlation was found with SF-36 vitality score, physical functioning score, and the SF-36 total score. FM is common among pSjD patients and should be considered rather a comorbidity requiring different therapeutic approaches. At the fast-paced clinical environment, a concise ESSPRI assessment may be helpful in the initial screening of patients at risk of FM. Even though the origin of this phenomenon is unknown, the concepts of central sensitization and microglia polarization may be potential explanations and more molecular research in this direction could benefit the pSjD patients. Full article

Background/Objectives: Residual symptoms—such as persistent negative or cognitive symptoms—and relapse remain common in schizophrenia (SCZ) despite the proven efficacy of antipsychotics. As a result, add-on medications are frequently prescribed in real-world clinical practice. Although these agents are often used chronically, most evidence supporting their benefits comes from short-term trials. This systematic review aimed to assess the effect of adjunctive medication on long-term clinical outcomes and relapse prevention. Methods: Following PRISMA guidelines, we searched PubMed and Scopus (2000–2025) for trials of add-on agents administered for ≥24 weeks in SCZ spectrum disorders. Eligible studies compared antipsychotic treatment as usual with and without an add-on pharmacological agent (or with an added placebo). The primary outcome was long-term symptom change evaluated via established clinical scales, while relapse was the secondary outcome. Risk of bias was assessed with the Cochrane RoB 2 tool (PROSPERO registration: CRD420251075647). Results: The 22 of 4101 selected studies were classified into a group of frequently used add-on agents in clinical practice (antidepressants, mood stabilizers) and a group of less common agents, encompassing cognitive enhancers, antibiotics and antioxidants/anti-inflammatory agents. Results regarding clinical efficacy were mixed for both groups and respective subcategories. Overall, no drug class produced robust benefits. Relapse was systematically reported in only one study, with low overall relapse rates (2.5%). Risk-of-bias assessment did not reveal significant methodological concerns, apart from high attrition (average 29.5%). Conclusions: Evidence for the long-term efficacy of add-on pharmacological treatments in SCZ is inconsistent, with no agent demonstrating reliable benefits. These findings raise concerns regarding long-term polypharmacy and also highlight the need for further investigations. Future studies should prioritize longer follow-up, relapse outcomes and realistic treatment patterns. Full article

Background/Objectives: Hyponatremia has been associated with mortality and hospital readmissions. Although multimorbid older patients are particularly affected, specific data on this group are lacking. Methods: A prospective cohort was used based on the OPERAM (OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly) trial, a European multicenter, cluster-randomized trial among hospitalized patients aged ≥70 years with ≥3 chronic medical conditions taking ≥5 long-term medications, with documented sodium values at admission, excluding participants with hypernatremia (>145 mmol/L). The primary outcome was all-cause 1-year mortality, and secondary outcomes were 30-day mortality and readmission at 1 year and at 30 days. We examined the association between hyponatremia and mortality in comparison to normonatremia using a mixed-effects survival model, with adjustment for age, sex, comorbidities, study intervention arm, study site and cluster; and the association between hyponatremia and readmission using competing risk models with death as the competing risk. Subgroup analyses were performed across sodium hyponatremia categories (mild 134–130 mmol/L, moderate 129–125 mmol/L, severe < 125 mmol/L). Results: Of 2008 OPERAM participants, 1968 had a sodium value at admission, and 33 were excluded due to hypernatremia. In the 1935 participants, the mean age was 79.4 years (standard deviation 6.3), 866 (44.8%) were female, the median number of comorbidities was 11 (IQR 8–16), the median number of drugs was 10 (IQR 7–13), and 401 (20.7%) had hyponatremia at admission. The multivariate-adjusted hazard ratio (HR) for 1-year mortality with hyponatremia was 1.41 (95% confidence interval [CI] 1.11–1.78, 364 deaths) and for 30-day mortality was 1.20 (95%CI 0.74–1.94, 89 deaths). The adjusted sub-HR for 1-year readmission was 0.94 (95%CI 0.79–1.11), and that for 30-day readmission was 1.1 (95%CI 0.78–1.59). There was a linear increase in 1-year mortality across hyponatremia categories (HR from 1.31 to 2.64, p for trend = 0.001). Conclusions: Hyponatremia at admission is associated with increased 1-year mortality in multimorbid older adults, with increasing risk for lower sodium values. These findings support sodium as a useful prognostic marker in this setting, while its potential independent impact on survival remains to be clarified in prospective studies. Full article

Soil erosion is a key factor in land degradation across Mediterranean mountain regions, yet comprehensive assessments at the national scale are still uncommon. In this study, the Erosion Potential Method (EPM, Gavrilović method) was applied to 1127 mountainous watersheds of Greece in order to classify their erosion severity through the erosion coefficient (Z). Information on relief, geology and vegetation was combined so that each watershed could be assigned to one of five erosion severity classes. The classification revealed that 53.2% of the watersheds fall into the slight category, while 26.0% are moderate and 16.3% are very slight. Severe cases account for 3.9%, and only 0.5% are classified as excessive, though these few basins are locally very important. The distribution is far from uniform: severe watersheds occur more often in North Peloponnese (EL02), Thessaly (EL08), and the Western Sterea Ellada (EL04). By contrast, Crete (EL13) and the Aegean Islands (EL14) include a relatively greater proportion of watersheds in the moderate category. This variation indicates that erosion risk should not be considered a uniform condition across the country. Even watersheds with low overall Z may contain steep or degraded slopes that act as local hotspots. Consequently, effective management should move beyond country-wide averages and instead focus on the sub-areas that are most exposed and susceptible to erosion. Full article