We simulated Austrian forests under different sustainable management scenarios. A reference scenario was compared to scenarios focusing on the provision of bioenergy, enhancing the delivery of wood products, and reduced harvesting rates. The standing stock of the stem biomass, carbon in stems, and the soil carbon pool were calculated for the period 2010–2100. We used the forest growth model Câldis and the soil carbon model Yasso07. The wood demand of all scenarios could be satisfied within the simulation period. The reference scenario led to a small decrease of the stem biomass. Scenarios aiming at a supply of more timber decreased the standing stock to a greater extent. Emphasizing the production of bioenergy was successful for several decades but ultimately exhausted the available resources for fuel wood. Lower harvesting rates reduced the standing stock of coniferous and increased the standing stock of deciduous forests. The soil carbon pool was marginally changed by different management strategies. We conclude that the production of long-living wood products is the preferred implementation of climate-smart forestry. The accumulation of carbon in the standing biomass is risky in the case of disturbances. The production of bioenergy is suitable as a byproduct of high value forest products.

Nutrition can play an important role in the treatment of chronic wounds such as diabetic foot ulcers (DFUs); however, diet therapy is not currently part of the standard care for DFUs. There are numerous controversies about dietary recommendations, especially regarding calories and macronutrients, for overweight and obese patients with DFUs. This study examined the effects of nutrition education and supplementation on body composition in overweight and obese patients with DFUs. Twenty-nine patients with DFUs between the ages of 30 and 70 years were randomly assigned to either the treatment group (nutritional supplements, diet education, and standard care) or the control group (standard care). At baseline, the mean body mass index (BMI) was 33.5 kg/m² for the treatment group and 34.1 kg/m² for the control group. HbA1c decreased in both groups, with no significant difference between the groups. On average, patients in the treatment group lost less lean body mass and gained less fat than the control group ((3.8 kg vs. 4.9 kg) and (0.9 kg vs. 3.6 kg), respectively). While the interaction between group and time did not reach statistical significance for any of the study variables after adjustments for confounding variables, the observed changes are clinically relevant.

Diabetic foot ulcers (DFUs) are classified as chronic wounds and are one of the most common complications of diabetes. In chronic wounds, management of inflammation is a key step in treatment. Nutrition plays an important role in managing and controlling inflammation. This study evaluated the effects of nutrition supplementation and education on inflammatory biomarkers in patients with DFUs. Eligible patients with foot ulcers were randomly assigned to either a treatment (n = 15) or control group (n = 14). Both groups received standard care for wound treatment from the clinic; however, the treatment group was also provided with nutritional supplementation and education. Plasma concentrations of inflammatory biomarkers, namely C-reactive protein (CRP), interleukin 6 (IL6), interleukin 10 (IL10), and tristetraprolin (TTP), were evaluated at baseline and every four weeks, until complete wound closure had occurred or up to 12 weeks. The mean plasma concentration of IL6 significantly decreased in the treatment group (p = 0.001). The interaction between time and group was not statistically significant for the mean plasma concentrations of CRP, IL10, and TTP during the 12 weeks of the study. The results of this study showed the positive effects of nutritional intervention on controlling inflammation in DFU patients. More clinical trials with a larger population and longer duration of time are needed to confirm our results.

Trials on nutritional supplements for the treatment of diabetic foot ulcer (DFU) have only evaluated the effects of supplementation with specific nutrients. Additionally, nutrition education has not been a systematic part of these studies. The aim of this study was to evaluate the effects of a nutrient-dense formula combined with nutrition education on wound healing in DFU patients. Twenty-nine patients were randomly assigned to the treatment group (n = 15) receiving two servings of supplements daily plus nutrition education or control group (n = 14) that received the standard of care but no additional nutritional or educational intervention. Both groups were followed for a maximum of 12 weeks. Wound healing, as measured by planimetry, was examined at baseline and every four weeks until complete wound closure or up to 12 weeks. There were no significant differences between groups for BMI, age, duration of diabetes, wound age estimation, or wound area at baseline. The treatment group experienced a faster wound healing rate (6.43 mm²/week more reduction in the wound area) than the control group. The mean reduction in the wound area during the first four weeks of the study was almost 13-fold greater in the treatment group compared to the control group (18.0 mm²/week vs. 1.4 mm²/week, respectively). Our findings showed that nutrition supplementation plus nutrition education significantly accelerated wound healing in DFU patients compared to those who just received a standard-of-care regimen.

Theoretical models involving one or multiple intervening variables often posit whether a cause influences an outcome both directly and indirectly or only indirectly. In testing mediation, this distinction of partial and full mediation has become a subject of debate because of statistical issues. We extend the critique on this notion and provide insights into what a statistically significant direct effect between a cause and an outcome in a mediation model can mean. We also evaluate different effect size measures for direct and indirect effects and offer practical recommendations for assessing mediation mechanisms, which we illustrate using different examples. The broader relevance of these recommendations beyond mediation analysis is discussed.