Health Systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

Evaluation of the effects of health education interventions for hypertensive patients based on the health belief model

BACKGROUND Hypertension is a major risk factor for cardiovascular disease and stroke,and its prevalence is increasing worldwide.Health education interventions based on the health belief model(HBM)can improve the knowledge,attitudes,and behaviors of patients with hypertension and help them control their blood pressure.AIM To evaluate the effects of health education interventions based on the HBM in patients with hypertension in China.METHODS Between 2021 and 2023,140 patients with hypertension were randomly assigned to either the intervention or control group.The intervention group received health education based on the HBM,including lectures,brochures,videos,and counseling sessions,whereas the control group received routine care.Outcomes were measured at baseline,three months,and six months after the intervention and included blood pressure,medication adherence,self-efficacy,and perceived benefits,barriers,susceptibility,and severity.RESULTS The intervention group had significantly lower systolic blood pressure[mean difference(MD):-8.2 mmHg,P<0.001]and diastolic blood pressure(MD:-5.1 mmHg,P=0.002)compared to the control group at six months.The intervention group also had higher medication adherence(MD:1.8,P<0.001),self-efficacy(MD:12.4,P<0.001),perceived benefits(MD:3.2,P<0.001),lower perceived barriers(MD:-2.6,P=0.001),higher perceived susceptibility(MD:2.8,P=0.002),and higher perceived severity(MD:3.1,P<0.001)than the control group at six months.CONCLUSION Health education interventions based on the HBM effectively improve blood pressure control and health beliefs in patients with hypertension and should be implemented in clinical practice and community settings.

Planetary health risks in urban agriculture

Urban agriculture is gaining recognition for its potential contributions to environmental resilience and climate change adaptation,providing advantages such as urban greening,reduced heat island effects,and decreased air pollution.Moreover,it indirectly supports communities during weather events and natural disasters,ensuring food security and fostering community cohesion.However,concerns about planetary health risks persist in highly urbanized and climate-affected areas.Employing electronic databases such as Web of Science and PubMed and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,we identified 55 relevant papers to comprehend the planetary health risks associated with urban agriculture,The literature review identified five distinct health risks related to urban agriculture:(1)trace metal risks in urban farms;(2)health risks associated with wastewater irrigation;(3)zoonotic risks;(4)other health risks;and(5)social and economic risks.The study highlights that urban agriculture,while emphasizing environmental benefits,particularly raises concerns about trace metal bioaccumulation in soil and vegetables,posing health risks for populations.Other well studied risks included wastewater irrigation and backyard livestock farming.The main limitations in the available literature were in studying infectious diseases and antibiotic resistance associated with urban agriculture.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

How University Athletics Can Impact Mental Health among Student Athletes at the University of Evansville

In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Observation on the Effect of Health Education in Health Management of Chronic Disease Patients

Objective: By the end of 2021, the aging rate of China’s population is 18.9%, and the prevalence rate of chronic diseases in the elderly population is increasing year by year, and chronic diseases have become the main causes of death and health threats of Chinese residents. Therefore, how to manage this huge group well is crucial. This paper analyzes the value of health education in the process of health management for patients with chronic diseases. Methods: 102 patients with chronic diseases treated from January 2021 to December 2021 were divided into control group and experimental group by random number table method. The control group was given routine health management while the experimental group was given health education based on the control group, and the implementation effect was analyzed. Results: After management, the scores of chronic disease knowledge in the experimental group were significantly higher than those in the control group, and the dimensions of ESCA were higher than those in the control group, and P < 0.05;Conclusion: The implementation of health education in the process of chronic disease health management is helpful to improve patients’ self-care ability and better control disease progression.

ERAD: Enhanced Ransomware Attack Defense System for Healthcare Organizations

Digital integration within healthcare systems exacerbates their vulnerability to sophisticated ransomware threats, leading to severe operational disruptions and data breaches. Current defenses are typically categorized into active and passive measures that struggle to achieve comprehensive threat mitigation and often lack real-time response effectiveness. This paper presents an innovative ransomware defense system, ERAD, designed for healthcare environments that apply the MITRE ATT&CK Matrix to coordinate dynamic, stage-specific countermeasures throughout the ransomware attack lifecycle. By systematically identifying and addressing threats based on indicators of compromise (IOCs), the proposed system proactively disrupts the attack chain before serious damage occurs. Validation is provided through a detailed analysis of a system deployment against LockBit 3.0 ransomware, illustrating significant enhancements in mitigating the impact of the attack, reducing the cost of recovery, and strengthening the cybersecurity framework of healthcare organizations, but also applicable to other non-health sectors of the business world.

Personalized Health Monitoring Systems: Integrating Wearable and AI

The integration of wearable technologies and artificial intelligence (AI) has revolutionized healthcare, enabling advanced personal health monitoring systems. This article explores the transformative impact of wearable technologies and AI on healthcare, highlighting the development and theoretical application of the Integrated Personal Health Monitoring System (IPHMS). By integrating data from various wearable devices, such as smartphones, Apple Watches, and Oura Rings, the IPHMS framework aims to revolutionize personal health monitoring through real-time alerts, comprehensive tracking, and personalized insights. Despite its potential, the practical implementation faces challenges, including data privacy, system interoperability, and scalability. The evolution of healthcare technology from traditional methods to AI-enhanced wearables underscores a significant advancement towards personalized care, necessitating further research and innovation to address existing limitations and fully realize the benefits of such integrated health monitoring systems.

The Nigeria Government Engagement with the Private Health Sector

In Nigeria, the healthcare sector is divided into primary health which is under the local government’s authority that oversees the Primary Health centers, secondary health which is under the supervision of the State Ministry of Health in charge of the State General Hospitals that cater to primary and secondary healthcare. Tertiary health is supervised by the Federal Ministry of Health that oversees the Federal Medical Centres, the Teaching Hospitals, and Specialist Training Centres. Not to be excluded from Nigeria’s healthcare system are the private clinics and the public-private partnership. The funding for healthcare systems is mainly budgetary allocations from the government. This systemic review was done using secondary literature, policy documents, peer-reviewed literature, and national newspapers, collected using search engines such as Google Scholar, PubMed, and Medline. The review was done over 2-month period from February-April 2024. The literature was arranged in order of relevance and the literature not used was kept aside. The World Health Organization (WHO) has recommended that 11% of a country’s budget be allocated to health. African countries that make up the African Union (AU) recommended that 15% of each member African country’s yearly budget should be committed to providing healthcare services to her citizens. Unfortunately, Nigeria has yet to attain either the WHO target or the AU target while committing an average, of 6% of her budgetary allocation to health. On the other hand, her neighbouring West African country Ghana, has met the average of 15% recommended by AU. The improved National Health Insurance Authority and the government’s partnership with the private health sector in Public-Private Partnership (PPP) is hoped and would improve access to affordable healthcare in general and oral healthcare in particular.

全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

Challenges and opportunities for battery health estimation:Bridging laboratory research and real-world applications

Addressing climate change demands a significant shift away from fossil fuels,with sectors like electricity and transportation relying heavily on renewable energy.Integral to this transition are energy storage systems,notably lithium-ion batteries.Over time,these batteries degrade,affecting their efficiency and posing safety risks.Monitoring and predicting battery aging is essential,especially estimating its state of health(SOH).Various SOH estimation methods exist,from traditional model-based approaches to machine learning approaches.

Alexa,let's train now!——A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

Background:There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging.Consequently,the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions.In this context,digital and home-based physical training interventions might be a promising alternative to center-based intervention programs.Thus,this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.Methods:In this pre-registered systematic review(PROSPERO;ID:CRD42022320031),5 electronic databases(PubMed,Web of Science,Psyclnfo,SPORTDiscus,and Cochrane Library)were searched by 2 independent researchers(FH and PT)to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults.The systematic literature search yielded 8258 records(extra17 records from other sources),of which 27 controlled trials were considered relevant.Two reviewers(FH and PT)independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale).Results:Of the 27 reviewed studies,15 reported positive effects on cognitive and motor-cognitive outcomes(i.e.,performance improvements in measures of executive functions,working memory,and choice stepping reaction test),and a considerable heterogeneity concerning study-related,population-related,and intervention-related characteristics was noticed.A more detailed analysis suggests that,in particular,interventions using online classes and technology-based exercise devices(i.e.,step-based exergames)can improve cognitive performance in healthy older adults.Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence(≤85%)and monitoring of the level of regular physical activity in the control group.Conclusion:The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall,though there is limited evidence that specific types of digital and home-based physical training interventions(e.g.,online classes and step-based exergames)can be an effective strategy for improving cognitive performance in older adults.However,due to the limited number of available studies,future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

世界动物卫生组织One Health总体框架及最新关注方向

近年来,人兽共患病在全球越来越多的地方影响人类和动物的健康。在此背景下,由联合国粮食及农业组织(FAO)、世界卫生组织(WHO)和世界动物卫生组织(WOAH)三方国际组织提出了“One Health”的概念。2021年底,FAO、WOAH、WHO和联合国环境规划署(UNEP)共同成立了One Health高级别委员会(One Health High Level Expert Panel,OHHLEP),并将“One Health”重新定义。论文就“One Health”的概念、提出的背景、重要发展进程、总体框架和协调机制以及未来应用展望进行了全面的介绍和阐述,为我国进一步深入了解“One Health”理念,实践并更好地应用“One Health”方法,从而解决我国人兽共患病、抗生素耐药等对人类、动物和环境危害严重的问题提供思路和参考。

Probiotic cocktails accelerate baicalin metabolism in the ileum to modulate intestinal health in broiler chickens

Background Baicalin and probiotic cocktails are promising feed additives with broad application prospects.While probiotic cocktails are known to enhance intestinal health,the potential synergistic impact of combining baicalin with probiotic cocktails on the gut health of broiler chickens remains largely unexplored.Therefore,this study aims to investigate the influence of the combined administration of baicalin and probiotic cocktails on the composition of ileal and cecal microbiota in broiler chickens to elucidate the underlying mechanisms responsible for the healthpromoting effects.Results A total of 3201-day-old male Arbor Acres broilers were divided into 4 groups,each with 8 replicates of 10 chicks per replicate.Over a period of 42 d,the birds were fed a basal diet or the same diet supplemented with 37.5 g/t baicalin(BC),1,000 g/t probiotic cocktails(PC),or a combination of both BC(37.5 g/t)and PC(1,000 g/t).The results demonstrated that BC+PC exhibited positive synergistic effects,enhancing intestinal morphology,immune function,and barrier function.This was evidenced by increased VH/CD ratio,sIgA levels,and upregulated expression of occludin and claudin-1(P<0.05).16S rRNA analysis indicated that PC potentiated the effects of BC,particularly in the ileum,where BC+PC significantly increased theα-diversity of the ileal microbiota,altered itsβ-diversity,and increased the relative abundance of Flavonifractor(P<0.05),a flavonoid-metabolizing bacterium.Furthermore,Flavonifractor positively correlated with chicken ileum crypt depth(P<0.05).While BC+PC had a limited effect on cecal microbiota structure,the PC group had a very similar microbial composition to BC+PC,suggesting that the effect of PC at the distal end of the gut overshadowed those of BC.Conclusions We demonstrated the synergistic enhancement of gut health regulation in broiler chickens by combining baicalin and probiotic cocktails.Probiotic cocktails enhanced the effects of baicalin and accelerated its metabolism in the ileum,thereby influencing the ileal microbiota structure.This study elucidates the interaction mechanism between probiotic cocktails and plant extract additives within the host microbiota.These findings provide compelling evidence for the future development of feed additive combinations.

Clinical Analysis and Mental Health Survey of Hemophilia Carriers:a Cross-sectional Study

Objective:Hemophilia carriers(HCs),who are heterozygous for mutations in the clotting factor VIII/clotting factor IX gene(F8 or F9),may have a wide range of clotting factor levels,from very low,similar to afflicted males,to the upper limit of normal,and may experience mental health issues.The purpose of this study was to provide genetic information on mothers of hemophilia patients and to understand the clotting factor activity and phenotype of HCs.Additionally,we aimed to investigate the mental health status of HCs in China.Methods:A total of 127 hemophilia mothers,including 93 hemophilia A(HA)mothers and 34 hemophilia B(HB)mothers,were enrolled in this study.Long distance PCR,multiplex PCR,and Sanger sequencing were used to analyze mutations in F8 or F9.Coagulation factor activity was detected by a one-stage clotting assay.The Symptom Checklist 90(SCL-90,China/Mandarin version)was given to HCs at the same time to assess their mental health.Results:A total of 90.6%of hemophilia mothers were diagnosed genetically as carriers,with inversion in intron 22 and missense mutations being the most common mutation types in HA and HB carriers,respectively.The median clotting factor level in carriers was 0.74 IU/mL(ranging from 0.09 to 1.74 IU/mL)compared with 1.49 IU/mL(ranging from 0.93 to 1.89 IU/mL)in noncarriers,of which 14.3%of HCs had clotting factor levels of 0.40 IU/mL or below.A total of 53.8%(7/13)of HA carriers with low clotting factor levels(less than 0.50 IU/mL)had a history of bleeding,while none of the HB carriers displayed a bleeding phenotype.The total mean score and the global severity index of the SCL-90 for surveyed HCs were 171.00(±60.37)and 1.78(±0.59),respectively.A total of 67.7%of the respondents had psychological symptoms,with obsessive-compulsive disorder being the most prevalent and severe.The pooled estimates of all nine factors were significantly higher than those in the general population(P<0.05).Conclusions:The detection rate of gene mutations in hemophilia mothers was 90.6%,with a median clotting factor level of 0.74 IU/mL,and 14.3%of HCs had a clotting factor level of 0.40 IU/mL or below.A history of bleeding was present in 41.2%of HCs with low clotting factor levels(less than 0.50 IU/mL).Additionally,given the fragile mental health status of HCs in China,it is critical to develop efficient strategies to improve psychological well-being.

Social Media-Based Surveillance Systems for Health Informatics Using Machine and Deep Learning Techniques:A Comprehensive Review and Open Challenges

Social media(SM)based surveillance systems,combined with machine learning(ML)and deep learning(DL)techniques,have shown potential for early detection of epidemic outbreaks.This review discusses the current state of SM-based surveillance methods for early epidemic outbreaks and the role of ML and DL in enhancing their performance.Since,every year,a large amount of data related to epidemic outbreaks,particularly Twitter data is generated by SM.This paper outlines the theme of SM analysis for tracking health-related issues and detecting epidemic outbreaks in SM,along with the ML and DL techniques that have been configured for the detection of epidemic outbreaks.DL has emerged as a promising ML technique that adaptsmultiple layers of representations or features of the data and yields state-of-the-art extrapolation results.In recent years,along with the success of ML and DL in many other application domains,both ML and DL are also popularly used in SM analysis.This paper aims to provide an overview of epidemic outbreaks in SM and then outlines a comprehensive analysis of ML and DL approaches and their existing applications in SM analysis.Finally,this review serves the purpose of offering suggestions,ideas,and proposals,along with highlighting the ongoing challenges in the field of early outbreak detection that still need to be addressed.

Identifying the Hydrochemical Characteristics,Genetic Mechanisms and Potential Human Health Risks of Fluoride and Nitrate Enriched Groundwater in the Tongzhou District,Beijing,North China

Fluoride and nitrate enriched groundwater are potential threats to the safety of the groundwater supply that may cause significant effects on human health and public safety,especially in aggregated population areas and economic hubs.This study focuses on the high F^(−)and NO_(3)^(−)concentration groundwater in Tongzhou District,Beijing,North China.A total of 36 groundwater samples were collected to analyze the hydrochemical characteristics,elucidate genetic mechanisms and evaluate the potential human health risks.The results of the analysis indicate:Firstly,most of the groundwater samples are characterized by Mg-HCO_(3) and Na-HCO_(3) with the pH ranging from 7.19 to 8.28 and TDS with a large variation across the range 471-2337 mg/L.The NO_(3)^(−)concentration in 38.89%groundwater samples and the F^(−)concentration in 66.67%groundwater samples exceed the permissible limited value.Secondly,F^(−)in groundwater originates predominantly from water-rock interactions and the fluorite dissolution,which is also regulated by cation exchange,competitive adsorption of HCO_(3)−and an alkaline environment.Thirdly,the effect of sewage disposal and agricultural activities have a significant effect on high NO3-concentration,while the high F^(−)concentration is less influenced by anthropogenic activity.The alkaline environment favors nitrification,thus being conducive to the production of NO_(3)^(−).Finally,the health risk assessment is evaluated for different population groups.The results indicate that high NO_(3)^(−)and F^(−)concentration in groundwater would have the largest threat to children’s health.The findings of this study could contribute to the provision of a scientific basis for groundwater supply policy formulation relating to public health in Tongzhou District.

A Blockchain and CP-ABE Based Access Control Scheme with Fine-Grained Revocation of Attributes in Cloud Health

The Access control scheme is an effective method to protect user data privacy.The access control scheme based on blockchain and ciphertext policy attribute encryption(CP–ABE)can solve the problems of single—point of failure and lack of trust in the centralized system.However,it also brings new problems to the health information in the cloud storage environment,such as attribute leakage,low consensus efficiency,complex permission updates,and so on.This paper proposes an access control scheme with fine-grained attribute revocation,keyword search,and traceability of the attribute private key distribution process.Blockchain technology tracks the authorization of attribute private keys.The credit scoring method improves the Raft protocol in consensus efficiency.Besides,the interplanetary file system(IPFS)addresses the capacity deficit of blockchain.Under the premise of hiding policy,the research proposes a fine-grained access control method based on users,user attributes,and file structure.It optimizes the data-sharing mode.At the same time,Proxy Re-Encryption(PRE)technology is used to update the access rights.The proposed scheme proved to be secure.Comparative analysis and experimental results show that the proposed scheme has higher efficiency and more functions.It can meet the needs of medical institutions.

Assessment of groundwater quantity, quality, and associated health risk of the Tano river basin, Ghana

In the Tano River Basin,groundwater serves as a crucial resource;however,its quantity and quality with regard to trace elements and microbiological loadings remain poorly understood due to the lack of groundwater logs and limited water research.This study presents a comprehensive analysis of the Tano River Basin,focusing on three key objectives.First,it investigated the aquifer hydraulic parameters and the results showed significant spatial variations in borehole depths,yields,transmissivity,hydraulic conductivity,and specific capacity.Deeper boreholes were concentrated in the northeastern and southeastern zones,while geological formations,particu-larly the Apollonian Formation,exhibit a strong influence on borehole yields.The study identified areas with high transmissivity and hydraulic conductivity in the southern and eastern regions,suggesting good groundwater avail-ability and suitability for sustainable water supply.Sec-ondly,the research investigated the groundwater quality and observed that the majority of borehole samples fall within WHO(Guidelines for Drinking-water Quality,Environmental Health Criteria,Geneva,2011,2017.http://www.who.int)limit.However,some samples have pH levels below the standards,although the groundwater generally qualifies as freshwater.The study further explores hydrochemical facies and health risk assessment,highlighting the dominance of Ca–HCO3 water type.Trace element analysis reveals minimal health risks from most elements,with chromium(Cr)as the primary contributor to chronic health risk.Overall,this study has provided a key insights into the Tano River Basin’s hydrogeology and associated health risks.The outcome of this research has contributed to the broader understanding of hydrogeologi-cal dynamics and the importance of managing groundwater resources sustainably in complex geological environments.