Glacier retreat transforms landscapes in polar and mountainous regions. Yet, the topography of the emerging terrain remains poorly known. Here, we present a physically consistent, global map of the ice-covered topography beneath all glaciers on Earth distinct from the ice sheets, derived from the three-dimensional higher-order Instructed Glacier Model, and constrained by extensive observational datasets. The map allows us to identify  > 50,000 possible future lakes in the presently ice-covered landscape, with a maximum total volume of 3,138 km3-enough to store 7 mm sea-level equivalent (SLE). Additionally, we estimate the total global glacier volume at 149.41 ± 29.28 × 103 km3 (308 ± 60 mm SLE). Large overdeepenings near glacier fronts in High Mountain Asia suggest an increased risk for glacier lake outburst floods under glacier retreat. The subglacial topography and ice thickness data offer new opportunities for diverse cryospheric and Earth system studies, including refined projections of glacier changes and landscape evolution of deglaciated terrain.
It is widely accepted that match venue influences technical, tactical, fitness, nutrition, the importance of the match, sleep, and psychological factors. This study investigates the impact of match venue (i.e., home vs. away) and match outcome (i.e., win, draw, or loss) on performance metrics among Turkish Super League teams. Utilizing a Generalized Linear Model (GLM) approach, we analyze performance indicators such as total distance covered, distance covered at different speed intervals, and number of sprint efforts (> 7 m·s⁻¹). Considering the total distance covered, the GLM showed no significant effects of match venue [Wald (1,625) = 0.398; p = 0.528], match outcome [Wald (2,624) = 3.413; p = 0.181], and interaction between the factors [Wald (2,624) = 0.477; p = 0.788]. Significant effects were observed in the distance covered at speeds over 7 m·s⁻¹. In conclusion, the match venue does not impact physical performance. At the same time, winning teams display higher distances covered at higher speeds and perform more sprint efforts (> 7 m·s⁻¹), indicating that physically outperforming opponents is relevant for winning in elite soccer.
Insurance status is known to influence access to spine surgery, but its role in cervical spondylotic myelopathy (CSM) remains underexplored. The authors hypothesized that government insurance payor status would be associated with delayed care access, evidenced by prolonged symptom duration and greater baseline symptom severity relative to those with private insurance. This was a prospective observational cohort study of 1085 patients enrolled in the Quality Outcomes Database CSM module of the 14-site Spine CORe™ study group. Patients were included if they had complete data for insurance, symptom duration, and baseline patient-reported outcomes (PROs). Insurance status was categorized as private, Medicare, Medicaid, or Veterans Affairs (VA)/federal. Primary outcomes included surrogates of access to care, assessed by symptom duration (> 12 months) and baseline PROs, i.e., the Neck Disability Index (NDI) and EQ-5D. Associations were evaluated using multivariable logistic regression analysis. A total of 1085 patients with CSM who underwent surgery were enrolled, with more than 80% completing 5-year follow-up. Patients were excluded if they were uninsured or did not report baseline symptom duration, EQ-5D score, or NDI score, leaving a cohort of 977 patients for analysis. The proportion of patients reporting symptom duration > 12 months differed by insurance status (p < 0.001): highest in VA/federal (18/24, 75%), followed by Medicaid (45/70, 64%), Medicare (206/375, 55%), and private insurance (228/508, 45%). Compared to those who had private insurance, patients covered by VA/federal insurance (OR 3.85, 95% CI 1.56-10.89), Medicaid (OR 2.05, 95% CI 1.18-3.61), and Medicare (OR 1.98, 95% CI 1.39-2.82) had symptom duration > 12 months. Of patients with government insurance payors, Medicaid insurance status was independently associated with worse baseline disability (NDI: β = 7.35, 95% CI 2.35-12.35; p = 0.004) and lower quality of life (EQ-5D: β = -0.12, 95% CI -0.18 to -0.07; p < 0.001). Compared to patients with private insurance, patients covered by government insurance payors (VA/federal insurance, Medicare, and Medicaid) had significantly longer symptom duration before undergoing surgery. Patients with VA/federal insurance coverage had the longest symptom duration of the government payors. Of the government insurance payor types, Medicaid was the only one independently associated with significantly worse baseline disability (NDI) and quality of life (EQ-5D). After controlling for other factors, patients with government insurance coverage, and more specifically Medicaid, have difficulty accessing surgical care in a timely fashion to treat CSM compared to patients with private insurance.
To conduct an overview of existing systematic reviews and meta-analyses on magnesium sulfate for acute asthma in children and adults, and to develop evidence-based, age-specific nursing interventions. We searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM from inception to August 10, 2025, for systematic reviews and meta-analyses on magnesium sulfate for acute asthma in children and adults. Primary study overlap was assessed using citation matrices and the corrected covered area. Quality was evaluated with ROBIS, AMSTAR-2, PRISMA 2020, and GRADE tools. Primary outcomes were then analyzed quantitatively and qualitatively to interpret the evidence. Eighteen systematic reviews/meta-analyses were included. Primary study overlap was mild (corrected covered area = 5.090%). ROBIS indicated low risk of bias for all studies. AMSTAR-2 ratings: 4 high, 1 moderate, 12 low, 1 critically low. PRISMA 2020 scores (22-41) corresponded to 5 high, 12 moderate, and 1 low reporting quality. GRADE outcomes were high (n = 4), moderate (n = 31), low (n = 30), or extremely low (n = 27) quality. Magnesium sulfate demonstrates a clearer benefit in children, reducing hospitalizations and improving physiological outcomes. In adults, it primarily lowers hospitalization risk without consistently improving lung function. Safety appears acceptable in both groups. For pediatric acute asthma, magnesium sulfate may be used as second- or third-line adjunctive therapy. For critically ill adults, it should be an individualized option, not routine. Guidelines and nursing protocols should incorporate these age-stratified recommendations.
Medical graduates must integrate new scientific findings into clinical practice requiring strong scientific training. In Germany, scientific education in medical curricula is often undervalued, necessitating curricular changes. This study evaluates medical students' current scientific training, perceived and objective knowledge, and their preferences for curricular organisation. A nationwide cross-sectional study was conducted using an online survey distributed to medical students across 45 German medical schools. The survey, conducted from March to May 2023, covered scientific education aspects including self-assessment of scientific skills and an optional 25-item knowledge competency test. Data were collected from 3005 students, with 1319 completing the full competency test. Only 53.8% of students were aware of their scientific curriculum, and over 60% reported no evaluation of their scientific skills at their universities. In their final year, 52.7% felt competent in literature search, and 44.1% in scientific writing. However, only 19.9% felt competent in study design, 25.7% in developing research projects, and 19.8% in applying findings to patient care. The average competency test score for final-year students was 16 out of 25, with notable deficiencies in empirics and practical applications. At least 62.2% of students expressed a desire for more scientific training, and 71.3% favoured mandatory scientific courses. German medical students are dissatisfied with their current scientific education with 75% expressing dissatisfaction. They feel unprepared to apply scientific knowledge in clinical settings. The study highlights the need for urgent curricular reforms to enhance practical scientific training and better prepare future physicians for modern medical practice and research.
Healthcare-seeking behavior is a key factor in how well a health system performs and how fair it is. In Saudi Arabia, public healthcare services are free, yet many people still choose private healthcare, especially in cities like Riyadh. It is important to understand why people seek care from private clinics to help shape health policies, distribute resources better, and improve services across the healthcare system. This study aimed to examine the frequency of private healthcare use, defined as the reported usual or concurrent use of private healthcare services, and to identify sociodemographic, behavioral, and health-related factors associated with this choice among adults in Riyadh, Saudi Arabia. A cross-sectional study was carried out in Riyadh from March to July 2023 using a multistage cluster sampling method. We randomly selected 48 government primary healthcare centers and invited adults aged 18 and older who visited these centers to participate. We collected data electronically with a validated questionnaire that covered sociodemographic details, patterns of healthcare use, reasons for choosing private healthcare, behavioral risk factors, and existing health conditions. We used multivariate logistic regression analysis to find independent predictors of private healthcare use, reporting adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Of 14,239 participants, 72.4% reported using private healthcare services either as a usual source of care or alongside public services. The multivariable analysis revealed several factors to be positively related to private healthcare utilization. Those who were married were more likely to use private healthcare services (AOR 1.23, 95% CI 1.11-1.36). Those with insurance coverage were threefold higher odds of private healthcare use (AOR 3.51, 95% CI 3.13-3.94). Smokers were more likely to seek private healthcare (AOR 1.60, 95% CI 1.45-1.77) than non-smokers, and those who exercised reported increased utilization (AOR 1.83, 95% CI 1.67-2.00). Obesity was also positively related to private healthcare utilization (AOR 1.38, 95% CI 1.12-1.71), and those with heart disease had substantially higher odds of using private healthcare services (AOR 2.09, 95% CI 1.59-2.76). Private healthcare use in Riyadh is common and associated with insurance coverage, marital status, behavioral factors, and certain chronic conditions. These findings provide descriptive insights into factors related to private healthcare utilization among public PHC attendees in Riyadh, without implying causal effects or policy recommendations beyond the scope of the data.
Lymphedema is a chronic, progressive condition characterized by impaired lymphatic drainage and fluid accumulation. Conventional diagnostic and monitoring tools remain operator-dependent or insensitive to early disease. Artificial intelligence (AI) offers opportunities to address these limitations through multimodal data integration and automated, reproducible analysis. This systematic review followed the PRISMA guidelines and was registered in PROSPERO (CRD420251133232). PubMed and Google Scholar were searched for clinical studies published between January 2015 and July 2025 by applying AI to lymphedema diagnosis, risk prediction, monitoring, or surgical planning. Data extraction included study design, population, methodology, predictors, and performance metrics. Risk of bias was assessed using PROBAST and QUADAS-2. Eighteen studies involving 8720 patients were included. Applications covered risk prediction, imaging-based diagnosis, volumetric assessment, and clinical decision support. Reported performance ranged as follows: AUC, 0.80-0.99 and accuracy, 77-98%. Machine learning models integrating demographic and clinical data achieved AUCs up to 0.89, whereas deep learning models applied to ultrasound, CT, MRI, and clinical photographs achieved diagnostic accuracies up to 98%. Volumetric tools using dual-camera or 3D imaging correlated strongly with gold-standard water displacement (R = 0.99). External validation was absent and methodological heterogeneity was substantial. AI in lymphedema shows promise for early detection, risk stratification, and longitudinal monitoring; however, current evidence remains preliminary. Larger, multi-institutional validation studies are essential to confirm generalizability and demonstrate clinical utility.
Research using the multidimensional sleep health (MDSH) framework has increased globally, often relying on self-report measures. The Ru-SATED scale and Sleep Health Index (SHI) are common self-report measures of MDSH, but comparative data on their measurement properties and contextual characteristics remain limited. Seven electronic databases were searched for measurement properties and uses of the two scales over the past twelve years. This review identified 19 psychometric validation studies concerning two original and 17 cross-cultural, and summarized contextual comparison of MDSH measures and frameworks. Measurement properties of both measures were assessed with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline, and contextual comparisons were conducted narratively. Both measures exhibited acceptable psychometric properties across diverse cultural settings, with the SHI findings showing greater consistency than those of the Ru-SATED scale. Aggregating the Ru-SATED and SHI frameworks fully covered the sleep characteristics assessed by five instruments grounded in the World Sleep Society initiative, encompassing regularity, satisfaction, alertness, timing, efficiency, duration, and disorder. Notably, the SHI framework incorporates targeted sleep disorder assessment while the Ru-SATED framework specifically excludes such assessment, highlighting the distinct focus and scope of each tool. Instrument selection depends primarily on research purpose, study sample, and intended use. We recommend characterizing both sleep health and sleep disorders to fully capture the complex relationships between sleep and health outcomes.
Virtual, augmented, mixed, and other immersive technologies, collectively referred to as extended reality (XR), are increasingly used to enhance experiential learning in health education. By creating interactive 3-dimensional or 360° environments, these technologies allow expectant parents to engage in realistic prenatal and childbirth scenarios, promoting emotional preparedness, knowledge acquisition, and confidence. Although XR has been widely studied in clinical training, its application in prenatal and childbirth education for parents remains less systematically explored. This scoping review aims to map and synthesize the current evidence on the use of virtual, augmented, mixed, and immersive technologies in prenatal and childbirth education, highlighting their educational benefits, methodological approaches, and implementation challenges. A comprehensive search was conducted across Scopus, Web of Science, PubMed, CINAHL, IEEE Xplore, APA PsycINFO, and APA PsycArticles from inception to October 16, 2025. Search terms included "virtual reality," "augmented reality," "mixed reality," "extended reality," and "immersive technology," combined with prenatal and childbirth education descriptors. Studies were included if they applied immersive or XR technologies to deliver prenatal or childbirth education for expectant parents. Screening and data extraction were performed independently by 2 reviewers following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The review was registered on Open Science Framework (OSF). From 1861 records, 11 studies from 8 countries were included, spanning randomized controlled, quasi-experimental, feasibility, and qualitative designs. Interventions comprised head-mounted display-based virtual reality, 360° video, and mixed reality simulations. Outcomes covered psychological, physiological, educational, and experiential domains. Most studies reported feasibility and high engagement, with encouraging signals for reduced anxiety and improved birth preparedness and, in some cases, reductions in pain and intrapartum indicators. No serious adverse events were reported; nausea and discomfort were infrequent and transient. Thematic analysis identified 5 recurring themes: enhanced birth preparedness, realism and presence as a key mechanism, usability barriers and the need for guided facilitation, motivational and educational potential, and limited partner inclusion. Methodological quality was heterogeneous, with small samples, nonstandardized measures, and short follow-up. Evidence for XR in prenatal education is promising yet preliminary. Rigorous multicenter studies with standardized outcomes, longer follow-up, and greater partner involvement, alongside attention to equitable access and digital literacy, are needed to support integration into maternity care pathways.
As the food packaging industry advances towards green and low-carbon solutions, developing sustainable, high-performance materials is essential to mitigate white pollution and enhance food safety monitoring. This review systematically summarizes the preparation strategies for transparent cellulose films, covering physical methods, chemical modification, and green dissolution-regeneration systems. It focuses on analyzing the regulatory mechanisms of different preparation routes with respect to transparency, mechanical properties, and functional characteristics. Building on this basis, this paper proposes the research concept of physicochemical structural regulation of cellulose, which emphasizes the precise optimization of cellulose's aggregated-state structure, surface chemistry, and interfacial properties. This approach aims to enhance the comprehensive performance of film materials, constructing a new generation of "efficient, stable, and multi-scenario adaptable" intelligent packaging. Furthermore, functionalization strategies such as in situ growth, composite loading, electrospinning, and layer-by-layer self-assembly are elaborated, and their mechanisms for endowing films with antibacterial, antioxidant, UV-shielding, and intelligent response properties are discussed. Despite their advantages, challenges regarding wet stability, the trade-off between transparency and functionalization, and large-scale production bottlenecks remain. Finally, the review outlines future directions-including green processing, multifunctional integration, and industrial scalability-to accelerate the transition of cellulose-based intelligent packaging from laboratory research to commercial application.
Gastrodia elata (GE) serves both edible and medicinal purposes. This study employed fourier transform near-infrared (FT-NIR) technology to preliminarily analyze the chemical components of GE from 9 different geographical origins. The results showed that the spectral profiles of samples from Yunnan were distinctly different from those of Hubei and Guizhou. Phenotypic analysis based on L*, a*, and b* parameters further revealed differences in appearance traits, with results similar to the spectral characteristics obtained through principal component analysis (PCA), indicating a certain correlation between external traits and internal chemical components. To further uncover chemical compositional differences, non-targeted metabolomics using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) identified 810 polyphenol metabolites, including 257 differential metabolites (P < 0.05, VIP > 1), covering phenolic acids, flavonoids, lignans and coumarins, and tannins. Correlation analysis between traits and metabolites showed that a* and b* were significantly negatively correlated with phenolic acids and flavonoids (P < 0.05 or P < 0.01), while L* was significantly positively correlated with flavonoids (P < 0.05 or P < 0.01). Additionally, the study indicated that temperature and humidity are key environmental factors affecting the synthesis and accumulation of metabolites in GE.
Landfill gas (LFG) harms human health and worsens the greenhouse effect. Long-term monitoring enables scientific assessment of environmental impacts. This paper presents a year-long observation of methane and volatile organic compounds (VOCs) concentrations and fluxes on the surface cover of a large-scale landfill in Hangzhou. Based on monitoring data, the LFG migration model was established to evaluate the gas containment effectiveness of different cover layers. It indicates that landfill cover systems effectively reduce methane and VOC emissions. Compared to the Phase II landfill, VOC fluxes on the surface of the Phase I landfill have decreased by over 50%, with the number of VOCs reducing from 19 to 11. Besides, the concentration and flux of LFG exhibit significant spatio-temporal heterogeneity. The permeation coefficient of GMB was determined by inverting the analytical model, and it was found to increase with rising temperature. This is due to increased gas molecule activity and heightened polymer segmental motion in GMBs at elevated temperatures. Additionally, it has been found that planting camphor trees on the cover layer can effectively reduce methane emissions, followed by Pyracantha fortuneana 'Harlequin' and Nerium. This is because camphor trees possess the deepest root systems and exhibit the strongest capacity for methane oxidation. Moreover, Pearson correlation analysis indicates a significant negative correlation between methane and VOC emissions. This is because methane oxidation consumes oxygen, thereby inhibiting VOC degradation. This study elucidates the migration and emission patterns of LFG, providing theoretical and data-driven support for the design and management of landfill cover systems.
Protecting and improving surface water quality is contingent upon understanding the trends and spatial patterns in physical, biological, and chemical conditions and their underlying drivers. This requires observational data, spanning a diverse range of water quality constituents, coupled with contextual environmental data. Here we present the first global-scale integration of stream water quality into large-sample hydrology (named Caravan-Qual), combining ~96 million observations of 100 constituents with streamflow measurements, meteorological forcing and catchment attributes covering the period 1980-2025. We envisage that the dataset can facilitate a diverse range of empirical analyses (e.g. spatio-temporal analysis across diverse regions, quantification of pollutant loadings and exports, concentration-discharge analysis), in addition to supporting development and evaluation of process-based and data-driven models for water quality prediction and management.
The aim of this study was to conduct a randomized, double-blind, split-mouth comparative clinical trial to clinically assess and compare different bi-layer biomimetic strategies of composite resin in large class I cavities over an 18-month period. A total of 160 posterior composite restorations in 40 participants of age 35-45 years old were enrolled in the study based on inclusion criteria. Each patient received four different bilayer biomimetic bases in four equal groups (n = 40) as follows: Group I: short-fiber reinforced composite (everX Posterior, GC Corporation, Tokyo, Japan); Group II: long-fiber reinforced composite (polyethylene fibers, Ribbond Inc., USA); Group III: Resin-Modified Glass Ionomer Cement (RMGIC) (Riva SDI, Bayswater, VIC, Australia); and Group IV: flowable composite (G-aenial universal Flo, GC Corp., Tokyo, Japan). A 2 mm surface layer of nanohybrid composite resin (Tetric Evo Ceram, Ivoclar Vivadent) was applied to cover the biomimetic base in all groups. Occlusal Class I cavities were prepared according to caries extension with a cavity depth of 4-5 mm. No bevels were prepared. Clinical assessment was carried out according to the World Dental Federation (FDI) by two calibrated evaluators at baseline and at 6, 12, and 18 months for aesthetic properties (surface and marginal staining), functional properties (fracture and retention, marginal adaptation), and biological properties (postoperative sensitivity, secondary caries). Statistical analysis employed Friedman and Kruskal-Wallis tests. The level of significance was established at α = 0.05 across all tests. Forty patients with a total of 160 restorations were evaluated in line with FDI at the end of the study with 100% recall rates. No fracture or secondary caries was reported over an 18-month evaluation period. The intragroup (Friedman test) and intergroup (Kruskal-Wallis test) comparisons revealed no statistically significant differences among short fiber reinforced composite, long fiber reinforced composite, resin-modified glass ionomer cement, and flowable composite for the assessed criteria over time (p > 0.05). All tested bilayer biomimetic composite resins have comparable excellent short-term clinical performance by the end of the study period. The protocol of the current study was approved by the Research Ethics Committee of the Faculty of Dentistry, Tanta University, Egypt, with approval number #R-RD-03-25-3194. This study was registered at www. gov with the identification number NCT07285772 on 15/12/2025-'retrospectively registered.'
As eusocial insects enter the post-genomic era, the availability of reference genomes and genomic datasets have facilitated Genome-wide Association Studies (GWAS) for traits measured on whole colonies. Several GWAS have been completed for traits like foraging and colony nesting behavior. However, no studies have addressed the specific challenges of applying GWAS to eusocial species. Eusocial species, such as honey bees, present several hurdles for traditional GWAS designs: they have high recombination rates, their social traits are generally polygenic, and the existence of multiple castes introduces additional layers of complexity in identifying genotype-phenotype associations. Moreover, many eusocial species are haplodiploid and polyandrous. To address these challenges, we used the honey bee (Apis mellifera) as a model to simulate GWAS scenarios for honey yield. We explored the influence of factors such as the number of quantitative trait loci (QTL), heritability level, number of SNP markers covering the genome, and sample size on QTL discovery. We also examined the impact of genotyping queens versus workers. Our results suggest that a p-value threshold of 1 × 10- 6 and sample sizes of at least 1,000 are effective for identifying QTL for key traits. Including both queen and worker genotypes improved QTL discovery power, emphasizing the need to optimize GWAS methods for eusocial species. Our results should improve future GWAS in honey bees and highlights the need for additional simulations and standard-setting work in other eusocial species.
Ag-In-Ga-S (AIGS) quantum dots (QDs) are eco-friendly alternatives to Pb/Cd-based QDs, offering tunable emission, high photoluminescence quantum yield (PLQY), and solution-based processing. However, their practical performance is constrained by the reactivity mismatch among Ag, In, and Ga precursors, which can be rationalized by Hard and Soft Acids and Bases (HSAB) considerations, hindering Ga/In incorporation and causing defect-related broadening, along with poor thermal-humidity stability that degrades color purity and device lifetimes in WLEDs. We present a ligand-mediated compositional engineering strategy where tuning oleylamine (OLA) content during synthesis regulates precursor reactivity and Ga/In incorporation, enabling fine control of emission wavelength, line width, and PLQY. Growing a heteroepitaxial AgGaS2 (AGS) shell on the AIGS QDs provides effective passivation, yielding AIGS/AGS core-shell QDs with significantly enhanced PLQY and narrowed emission. Furthermore, polymer encapsulation significantly enhances thermal-humidity stability, maintaining color purity and extending the operational lifetime. Combining blue LEDs with AIGS QDs and red QDs produces WLEDs with broad emission covering 106% of the NTSC color gamut and achieving 99.9% coverage, along with excellent operational stability (T50 = 1060 min at 600 cd m-2).
Per- and polyfluoroalkyl substances (PFAS) are persistent contaminants widely detected in landfill leachates, yet infrastructure materials themselves have not been comprehensively evaluated as potential intrinsic sources of PFAS. This study provides the first integrated fluorine mass-balance assessment of geosynthetics used in landfill liner and cover systems. Twenty-two targeted PFAS were quantified across 26 materials, including polyester and polypropylene geotextiles and a polyethylene coating, alongside total oxidisable precursor (TOP) assays and total fluorine (TF) analysis. Ultra-short-chain PFAS, particularly pentafluoropropionic acid (PFPrA) and trifluoroacetic acid (TFA), were frequently detected. Across material types, the summed targeted PFAS concentrations varied considerably, reaching up to 33.51 μg/g in nonwoven polypropylene geotextiles, compared to a maximum of 2.21 μg/g in nonwoven polyester geotextiles, up to 2.18 μg/g in woven polypropylene geotextiles, and 3.69 μg/g in the polyethylene coating. The polyethylene coating showed the largest response to precursor oxidation among all materials tested, with PFAS concentrations rising nearly tenfold and perfluorobutanesulfonic acid (PFBS) as the dominant post-oxidation compound. Across materials with detectable total fluorine, targeted PFAS accounted for less than 16% of the measured total fluorine, indicating that the majority of fluorinated content is present in non-target or polymeric fluorinated forms not captured by conventional monitoring. These findings demonstrate that certain geosynthetics used in landfill systems contain embedded PFAS and precursor inventories that may influence facility-scale fluorine mass balances, emphasising the importance of material-level PFAS characterisation in regulatory frameworks for waste containment. While the results are specific to the materials analysed herein, they highlight the need for a broader evaluation of infrastructure materials used in waste containment systems.
Aging is a major risk factor for chronic diseases. Unlike the general population, members of long-lived families maintain exceptional health as they age, with over 10 years delayed onset of their first chronic disease. We therefore hypothesize that one of the key features explaining healthy survival up to high ages (longevity) is the absence of chronic disease risk alleles. We investigated this hypothesis in the Leiden Longevity Study, a cohort with data from more than 420 long-lived families in three generations and the Leiden 85-plus study. To analyze our data, we constructed a set of polygenic scores (PGS) covering the top diseases causing most deaths in the Netherlands. We showed that having an increasing number of long-lived ancestors is additively associated with lower genetic risk for coronary artery disease (CAD). Using accelerated failure time modelling, we further showed that a lower PGS for CAD explains up to 20% of the delay in cardiovascular disease incidence in descendants of long-lived families. Finally, we constructed a novel cholesterol-metabolism-PGS, based on gene-annotation enrichment analysis, that predicted time to all-cause mortality in two independent 90 + study populations. Our findings demonstrate that the absence of chronic disease risk alleles is one key feature linked to longevity and that alleles linked to cholesterol metabolism are a key component in healthy aging trajectories.
Chronic kidney disease (CKD) attributable to type 2 diabetes mellitus (T2DM) represents a growing global health concern. However, comprehensive long-term epidemiological trends and projections, stratified by sociodemographic and geographic variables, remain inadequately delineated. To evaluate the global, regional, and national burden of CKD due to T2DM from 1990 to 2021, and to forecast its trends through 2035 using Bayesian age-period-cohort (BAPC) modeling. This population-based observational study used data from the Global Burden of Disease Study 2021 (GBD 2021), which includes 204 countries and territories across five sociodemographic index (SDI) quintiles and 21 GBD regions. The study covers the period 1990-2021 with projections to 2035. Diagnosis of T2DM mellitus as an underlying cause for CKD. Incident and prevalent cases, mortality, and disability-adjusted life-years (DALYs) attributable to T2DM-related CKD. Age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASDR), and DALY (ASR) rates were computed, alongside estimated annual percentage changes (EAPC). From 1990 to 2021, the global number of incident CKD cases due to T2DM increased by 167.2%, while the ASIR rose by 21.0% (EAPC: 0.61). Prevalent cases nearly doubled (+85.1%), although ASPR declined slightly (-5.1%, EAPC: -0.17). Deaths surged by 222.6%, and ASDR increased by 37.8% (EAPC: 1.17). DALYs rose by 173.6%, with a 24.0% increase in ASR (EAPC: 0.81). Males and older adults consistently exhibited higher burden across all indicators. Low- and middle-SDI nations experienced the most pronounced burden growth, yet high-SDI regions also registered substantial increases in mortality and DALYs. Projections to 2035 suggest a continued escalation, with incident cases exceeding 2.6 million and deaths surpassing 700,000 annually by mid-century. These findings highlight the importance of targeted prevention, early detection, and improved management strategies, particularly in high-growth regions and vulnerable populations.
ClimActor 2.0 is an open, spatialized database that compiles climate targets, action plans, and self-reported emission inventories from subnational governments, including cities, municipalities, states and regions, worldwide. The dataset provides standardized administrative boundaries for each entity, enabling direct linkage to geospatial data such as population, GDP, land cover, and other globally-gridded datasets. Each record is anchored to a unique identifier that connects decision-making authorities to their corresponding geometries. The database integrates information from 14 major climate disclosure platforms and reporting initiatives, complemented with a few national-level datasets. In total, ClimActor includes over 15,000 entities that participate in a national or transnational climate initiative, of which more than 10,000 of these entities have adopted either a climate mitigation target or plan. In addition to the harmonized spatial boundaries, ClimActor 2.0 provides four harmonized core datasets: aggregated emissions, sectoral emissions, climate targets, and climate plans, in addition to network participation data. Users can utilize the data as a standalone dataset or as an open-source R statistical computing software package, which includes a set of cleaning and matching functions that allow users to easily combine other datasets with ClimActor 2.0 for a wide range of subnational climate action analyses.