Climate change projection using statistical downscaling model over southern coastal Iran.

Iran is highly vulnerable to climate change, particularly evident in shifting precipitation and temperature patterns, especially in its southern coastal region. With these changing climate conditions, there is an urgent need for practical and adaptive management of water resources and energy supply to address the challenges posed by future climate change. Over the next two to three decades, the effects of climate change, such as precipitation and temperature, are expected to worsen, posing greater risks to water resources, agriculture, and infrastructure stability. Therefore, this study aims to evaluate the alterations in mean daily temperature (Tmean) and total daily rainfall (rrr24) utilizing climate change scenarios from both phases 5 and 6 of the Coupled Model Inter-comparison Project (CMIP5 and CMIP6, respectively) in the southern coastal regions of Iran (Hormozgan province), specifically north of the Strait of Hormuz. The predictions were generated using the Statistical Downscaling Model (SDSM) and National Centre for Environmental Prediction (NCEP) predictors, incorporating climate change scenarios from CMIP5 with Representative Concentration Pathways (RCPs) 2.6, 4.5, and 8.5 and CMIP6 with Shared Socioeconomic Pathways (SSPs) 1, 2, and 5. The analysis was conducted for three distinct time periods: the early 21st century (2021-2045), middle 21st century (2046-2071), and late 21st century (2071-2095). The results indicated that the CMIP5 model outperformed the CMIP6 model in simulating and predicting Tmean and rrr24. In addition, a significant increase in Tmean was observed across all the scenarios and time periods, with the most pronounced trend occurring in the middle and late 21st century future periods. This increase was already evident during the base period of 2021-2045 across all scenarios. Moreover, the fluctuations in precipitation throughout the region and across all scenarios were significant in the three examined future periods. The results indicated that among CMIP5 scenarios, RCP8.5 had highest changes of Tmean (+1.22 °C) in Bandar Lengeh station in 2071-2095 period. The lowest change magnitude of Tmean among CMIP5 scenarios was found in RCP4.5 (-1.94 °C) in Ch station in 2046-2070 period. The results indicated that among CMIP5 scenarios, RCP8.5 had highest changes of rrr24 (+150.2 mm) in Chabahar station in 2071-2095 period. The lowest change magnitude of rrr24 among CMIP5 scenarios was found in RCP8.5 (-25.8 mm) in Bandar Abbas station in 2046-2070 period. In conclusion, the study reveals that the coastal area of Hormozgan province will experience rising temperatures and changing rainfall patterns in the future. These changes may lead to challenges such as increased water and energy consumption, heightened risks of droughts or floods, and potential damage to agriculture and infrastructure. These findings offer valuable insights for implementing local mitigation policies and strategies and adapting to emerging climate changes in Hormozgan's coastal areas. For example, utilizing water harvesting technologies, implementing watershed management practices, and adopting new irrigation systems can address challenges like water consumption, agricultural impacts, and infrastructure vulnerability. Future research should accurately assess the effect of these changes in precipitation and temperature on water resources, forest ecosystems, agriculture, and other infrastructures in the study area to implement effective management measures.

Soil moisture change analysis under watershed management practice using in situ and remote sensing data in a paired watershed.

Soil moisture, vegetation cover, and land surface temperature are vital variables in water-energy balance, eco-hydrological processes, and water resources management, which can be influenced by watershed management activities. This research focused on the spatial and temporal variability of soil moisture, vegetation cover, land surface temperature, and Temperature-Vegetation Dryness Index (TVDI) under a biological watershed management practice in the Taleghan paired watershed, namely, treated (TW) and control watersheds (CW), in Alborz province, Iran. In this research, along with the remote sensing techniques, the soil moisture and vegetation cover data were measured and statistically analyzed in the three aspects of both TW and CW during a growth period from May to October 2017. The results indicated that soil moisture, vegetation cover, and land surface temperature values in the paired watershed were significantly different at the 0.01 level during the study period. The increased vegetation cover in the TW had an inverse effect on the land surface temperature and TVDI, while directly impacted the soil moisture content. The average TVDI in the CW was 0.83, while this index was found to be 0.69 in the TW. Unlike the vegetation cover and soil moisture, the results revealed that the southern aspects had the highest TVDI and land surface temperature compared to the northern and eastern aspects of both watersheds. However, the increased vegetation cover as a biological watershed management activity in the steep terrain and mountainous areas of TW led to an increased soil moisture and a decreased land surface temperature and soil dryness. As a result, decreasing soil dryness in the TW can exert vital controls on the water resources and increasing water availability. In the arid and semiarid countries such as Iran, a proper watershed management activity can effectively increase soil moisture and water availability in the watersheds. In particular, the vegetation cover protection and biological practices can be considered as practical solutions in the rehabilitation of exhausted watersheds in arid and semiarid environments.

Natural and anthropogenic forcings lead to contrasting vegetation response in long-term vs. short-term timeframes.

Understanding vegetation response to natural and anthropogenic forcings is vital for managing watersheds as natural ecosystems. We used a novel integrated framework to separate the impacts of natural factors (e.g. drought, precipitation and temperature) from those of anthropogenic factors (e.g. human activity) on vegetation cover change at the watershed scale. We also integrated several datasets including satellite remote sensing and in-situ measurements for a twenty-year time period (2000-2019). Our results show that despite no significant trend being observed in temperature and precipitation, vegetation indices expressed an increasing trend at both the control and treated watersheds. The vegetation cover was not significantly affected by the natural factors whereas the watershed management practice (as a human activity) had significant impacts on vegetation change in the long-term. Further, the vegetation cover long-term response to watershed management practice was mainly linear. We also found that the vegetation indices values in the 2011-2019 period (as the treated period in treated watershed) were significantly higher than those in the 2000-2010 period. In the short-term, however, the drought condition and decreased precipitation (as natural factors) explained the majority of the change in vegetation cover. For example, the majority of the breakpoints occurred in 2008, and it was related to a widespread extreme drought in the area. The watershed management practice as a human activity along with extreme climatic events could explain a large part of the vegetation changes observed in the treated and control watersheds.

Complete supine PCNL: ultrasound vs. fluoroscopic guided: a randomized clinical trial.

INTRODUCTION AND HYPOTHESIS: To compare complications and outcomes of complete supine percutaneous nephrolithotomy (csPCNL) with ultrasound guided and fluoroscopically guided procedure. MATERIALS AND METHODS: In this randomized clinical trial study from January 2009 to September 2010, 26 of 51 patients with renal stones underwent csPCNL with ultrasonographic guidance in all steps of the procedure (group A), and the other 25 patients underwent standard fluoroscopically guided csPCNL (group B). All of the patients underwent PCNL in the complete supine position. Statistical analysis was performed with SPSS16 software. RESULTS: Mean BMI was 28.14 in group A and 26.31 in group B (p=0.30). The mean stone burden was 26.48 and 30.44 in groups A and B, respectively (p=0.20). The stone free rate was 88.5% in group A and 75.5% in group B, that was no significant (p=0.16). Overall 2 patients (7.7%) in group A and 6 patients (24%) in group B had complications (p=0.11). Mean operative time in group A was 88.46 minutes, and in group B it was 79.58 minutes (p=0.39). Mean hospital stay was 69.70 and 61.79 hours in group A and B, respectively (p=0.22). There was no visceral injury in groups. CONCLUSIONS: This randomized study showed that totally ultrasonic had the same outcomes of fluoroscopically csPCNL. Ultrasonography can be an alternative rather than fluoroscopy in PCNL. We believe that more randomized studies are needed to allow endourologists to use sonography rather than fluoroscopy in order to avoid exposition to radiation.

Complete supine PCNL: ultrasound vs. fluoroscopic guided: a randomized clinical trial

ABSTRACT Introduction and Hypothesis: To compare complications and outcomes of complete supine percutaneous nephrolithotomy (csPCNL) with ultrasound guided and fluoroscopically guided procedure. Materials and Methods: In this randomized clinical trial study from January 2009 to September 2010, 26 of 51 patients with renal stones underwent csPCNL with ultrasonographic guidance in all steps of the procedure (group A), and the other 25 patients underwent standard fluoroscopically guided csPCNL (group B). All of the patients underwent PCNL in the complete supine position. Statistical analysis was performed with SPSS16 software. Results: Mean BMI was 28.14 in group A and 26.31 in group B (p=0.30). The mean stone burden was 26.48 and 30.44 in groups A and B, respectively (p=0.20). The stone free rate was 88.5% in group A and 75.5% in group B, that was no significant (p=0.16). Overall 2 patients (7.7%) in group A and 6 patients (24%) in group B had complications (p=0.11). Mean operative time in group A was 88.46 minutes, and in group B it was 79.58 minutes (p=0.39). Mean hospital stay was 69.70 and 61.79 hours in group A and B, respectively (p=0.22). There was no visceral injury in groups. Conclusions: This randomized study showed that totally ultrasonic had the same outcomes of fluoroscopically csPCNL. Ultrasonography can be an alternative rather than fluoroscopy in PCNL. We believe that more randomized studies are needed to allow endourologists to use sonography rather than fluoroscopy in order to avoid exposition to radiation.

Middle calyx access in complete supine percutaneous nephrolithotomy.

BACKGROUND: Middle calyx access has been underused in percutaneous nephrolithotomy (PCNL), especially in the supine position. We compared the safety and efficacy outcomes between middle calyx and lower calyx accesses in the complete supine PCNL in a non-randomized single-surgeon clinical study. METHODS: Between February 2008 and October 2011, 170 patients underwent posterior subcostal single tract complete supine PCNL with one-shot dilation and middle calyx (n = 48) and lower calyx (n = 122) accesses. Stone location and surgeon decision determined target calyx for access. Inclusion criteria were pelvis stones, staghorn stones and multiple location stones. Exclusion criteria were renal anomalies, only upper calyx stones, only middle calyx stones and only lower calyx stones. Important parameters were compared between the two groups. A p value of <0.05 was considered significant. RESULTS: Two groups were similar in important patient- and stone-related parameters. Mean operative time (60.7 minutes), mean postoperative hospital stay (1.84 days) and mean hemoglobin drop (0.67 g/dL) in the middle calyx group were significantly lesser than in the lower calyx group (80.1 minutes, 2.19 days, 1.36 g/dL). The middle calyx group (89.6%; 79.6%) had a higher stone-free rate (p = 0.054) and efficiency quotient than the lower calyx group (76.2%; 61.6%). In the middle calyx group (10.4%; 2.1%), complication and transfusion rates were lesser (p > 0.05) than lower calyx group (14.8%; 7.4%). No significant difference (p = 0.40) was seen between two groups using the modified Clavien classification of complications. INTERPRETATION: Middle calyx can be an optimal access in PCNL with the complete supine position for many of upper urinary tract stones due to its superior outcomes.

Randomized controlled trial of the efficacy of isosorbide-SR addition to current treatment in medical expulsive therapy for ureteral calculi.

It has been suggested that nitrates are potent smooth muscle relaxants that may reduce pain and facilitate ureteral stone passage; therefore it may be an option for medical expulsive therapy in ureteral stones. In a prospective randomized controlled clinical trial, we evaluated the efficacy of medical expulsive therapy with isosorbide-SR 40 mg in patients with ureteral stones (≤10 mm). The patients with ureteral stones in KUB or urinary tract ultrasonography were randomized to receive methylprednisolone plus celecoxib without (control group), and with isosorbide-SR 40 mg (treatment group) for 21 days. 66 patients [33(50%) in control, 33(50%) in treatment group] were entered randomly to our study. The stone expulsion rate was not significantly different between two groups (54.5 vs. 45.5%) (P = 0.497). The need for surgical procedures were more common in control group within 21 days (9.4 vs. 6.1%) and more common in treatment group after 21 days (33.3 vs. 21.9%) (P = 0.756).Patients in the treatment group experienced more intractable pain (27.3 vs. 6.1%), intractable vomiting (3 vs. 0%) (P = 0.046) and hospitalization (3 vs. 0%) (P = 0.314). Drug side effects including headache and dizziness were more common in treatment group (39.4 vs. 9.1%) (P = 0.004). In our study, the use of isosorbide-SR in treatment group did not improve the stone expulsion rate in patients with ureteral stones (≤10 mm) but developed more side effects. Then it may not an appropriate alternative for medical expulsive therapy. Of course, further trials are recommended.

Totally ultrasound versus fluoroscopically guided complete supine percutaneous nephrolithotripsy: a first report.

PURPOSE: As endourologists are highly exposed to X-ray irradiation during endourologic surgeries, the use of alternative methods for entrance into the collective system and dilatation of tract could be safe and less expensive. MATERIALS AND METHODS: Percutaneous access was created under ultrasonographic guidance in the complete supine position without flank elevation in 14 patients (group A) and under fluoroscopic guidance in the complete supine position without flank elevation in 14 patients (group B). We performed all steps of the complete supine percutaneous nephrolithotripsy (PCNL) with ultrasonographic guidance in group A. RESULTS: In group A, mean age of patients was 46.5 ± 15.54 years and in group B 45.21 ± 10.72 years. The mean stone burden was 51.07 and 41.92 mm in groups A and B, respectively (p = 0.54). Mean operative time in group A was 88.93 ± 33.29 minutes and in group B it was 79.29 ± 16.74 minutes (p = 0.34). Stone-free rate was 78.6% in group A and 71.4% in group B (p = 0.66). Hospital stay was 85.88 ± 17.25 and 80.20 ± 17.71 hours in groups A and B, respectively (p = 0.12). Transfusion was done in 1 (7.14%) patient in group A and in 3 (21.43%) patients in group B (p = 0.28). Fever was detected in 2 (14.28%) patients in group A and in 1 (7.14%) patient in group B (p = 0.54). In our study, there were no pleural effusion, postoperative hematoma, renal pelvis perforation, and visceral organ trauma in any groups. CONCLUSION: We showed that totally ultrasound-guided complete supine PCNL is safe and feasible even in reoperative patients. It has certain advantages such as elimination of X-ray exposure to the surgeon and staff of the operating room, avoidance of contrast material administration, identification of all the tissue between the skin and kidney, and the energy expenditure of the surgeon and other staff of the operating room is decreased as it is not necessary to wear a lead shield.