Search Results (116)

Background: Delta large-channel endoscopic decompression is an emerging, minimally invasive approach for lumbar degenerative disease, but its comparative effectiveness and perioperative performance have not been comprehensively synthesized. We performed a systematic review and meta-analysis to evaluate clinical, functional, and safety outcomes of Delta large-channel endoscopy relative to established decompression techniques. Methods: PubMed, Embase, and Scopus were searched from database inception through July 2025 (PROSPERO #CRD420251107750). Peer-reviewed English-language studies reporting extractable outcomes after Delta large-channel endoscopic surgery in adults were included. Random-effects meta-analyses were used for pooled comparisons. Results: Nine studies met the inclusion criteria, comprising 737 patients overall, including 379 treated with Delta large-channel endoscopy and 358 treated with comparator procedures. Reported outcome assessment generally ranged from 1 week to 12 months postoperatively, or variable latest follow-up timepoints, and mean follow-up was inconsistently reported. All studies originated in China and included five retrospective cohorts, two randomized controlled trials, one prospective cohort, and one case series. The pooled mean operative time for Delta procedures was 88.28 min (95% CI, 79.24–97.31), pooled mean intraoperative blood loss was 24.58 mL (95% CI, 11.14–38.02), and pooled mean hospital stay was 4.59 days (95% CI, 2.87–6.31). Compared with microscopic, endoscopic, and open techniques, Delta large-channel endoscopy showed no statistically significant differences in operative time (MD = 6.95 min, 95% CI: −11.51–25.40 min; p = 0.4037), intraoperative blood loss (MD, −40.62 mL; 95% CI, −83.68–2.44; p = 0.0598), 3-month ODI change from baseline (MD, 1.26; 95% CI, −2.17–4.69; p = 0.3661), or complication rates (OR, 0.67; 95% CI, 0.40–1.12; p = 0.1094). Delta procedures were associated with shorter hospital stay (MD, −1.69 days; 95% CI, −2.83 to −0.56; p = 0.0122) and marginally greater improvement in six-month VAS low back pain change from baseline (MD, 0.28; 95% CI, 0.26–0.29; p = 0.0002), though clinically insignificant. The pooled complication rate for Delta procedures was 6.0% (95% CI, 4–10%) and reported rates of excellent or good MacNab outcomes ranged from 80 to 93% across Delta cohorts. Conclusions: Delta large-channel endoscopy may provide clinical and functional outcomes comparable to established decompression techniques, with similar safety and potential perioperative benefits, including shorter hospitalization. However, these findings are based on limited, low-certainty evidence with high heterogeneity and should be interpreted as exploratory rather than definitive. Additional multicenter studies with longer follow-up, broader geographic representation, and higher methodological quality are necessary before definitive conclusions regarding comparative effectiveness can be established. Full article

French coastal systems are characterized by strong environmental gradients and increasing anthropogenic pressures, resulting in rapid land cover transformations across coastal landscapes. This study investigates land cover dynamics along the northern, western, and southern French coasts using Sentinel-2 summer image time series acquired between 2015 and 2025. The research aims to identify the most dynamic coastal regions and determine where land cover transitions are most pronounced. A harmonized workflow was developed in GRASS GIS for preprocessing Sentinel imagery, generating seasonal composites, classifying land cover using a Random Forest (RF) supervised algorithm, and detecting changes through time. All imagery was processed using CORINE Land Cover (Level 1) classification nomenclature and projected to Lambert-93 (EPSG:2154). Comparative analyses were performed among the three coastal regions using statistical indicators of change intensity, persistence, and transition rates. The results reveal substantial regional differences in coastal dynamics, with the southern Mediterranean coast exhibiting the highest transformation rate (22.9% of total area changed, at 2.29% ${\mathrm{yr}}^{-1}$), followed by the northern English Channel coast (18.6%; 1.86% ${\mathrm{yr}}^{-1}$) and the western Atlantic coast (14.2%; 1.42% ${\mathrm{yr}}^{-1}$). Urbanization and natural vegetation loss were identified as dominant transition types across all regions. The study demonstrates the effectiveness of Sentinel-2 time series and open-source GRASS GIS methods for long-term coastal monitoring and provides a reproducible framework for large-scale assessments of coastal land cover dynamics in Europe. Full article

Aedes aegypti (Ae. aegypti) is the primary vector for dengue, Zika and chikungunya, which represent major global public health concerns. The use of Wolbachia as a biological control agent in Ae. aegypti has gained significant international attention following the successful establishment of field-released mosquitoes in Australia, Malaysia, Brazil, Indonesia and Singapore. This study presents a comprehensive scientometric analysis of the research landscape of Wolbachia and Ae. aegypti. Data comprising 662 English-language publications from 2000 to 2025 were extracted from the Scopus database. Analytic tools, including VOSviewer and R-based Biblioshiny, were employed to quantify author productivity, transcontinental collaboration networks, thematic evolution, research gaps and future directions, while Bradford’s Law of Scattering was used to identify core dissemination channels. Publications have shown a steady upward trajectory since 2000, with an overall relative growth rate of 0.3%, while annual citations peaked in 2009 and 2011 (3337 and 3460 citations, respectively). The dataset strictly conformed to Bradford’s distribution (0.16% error), identifying PLOS Neglected Tropical Diseases (11.9%) and Parasites and Vectors (5.6%) as the core journals. Global research networks are predominantly led by Australia and the United States, supported primarily by the National Institutes of Health (14.8%) and the National Health and Medical Research Council (14.2%). Crucially, thematic analysis using a methodological triangulation approach demonstrates a progressive maturation in the field, shifting from foundational laboratory mechanisms toward large-scale deployment logistics and microbiome dynamics. Overall, this study highlights the intellectual landscape, underscores the vital role of global collaboration, and provides strategic insights to guide future evidence-based policies in Wolbachia–Aedes aegypti research. Full article

Climate-driven changes in oceanographic conditions are increasingly affecting the distribution of marine species, particularly vulnerable elasmobranchs. The undulate ray, Raja undulata, is a Near Threatened batoid species distributed throughout the northeastern Atlantic Ocean and parts of the Mediterranean Sea, yet its potential response to future climate change remains poorly understood. This study assessed current and future habitat suitability using species distribution modelling approaches and CMIP6 climate projections under the SSP245 scenario. Species occurrence records were compiled from biodiversity databases and published sources, and environmental predictors were selected following multicollinearity screening. Among twelve evaluated modelling algorithms, MaxEnt showed the highest predictive performance (AUC = 0.99; TSS = 0.95) and was selected for subsequent analyses. Current habitat suitability was concentrated along the Iberian Peninsula, the Bay of Biscay, the English Channel, and parts of the western Mediterranean Sea. Future projections indicated substantial habitat contraction, with habitat loss (57.3%) greatly exceeding habitat gain (2.2%), resulting in a southward redistribution of suitable habitats. Minimum phytoplankton concentration, sea surface temperature, and silicate concentration were identified as the most influential environmental predictors. Areas predicted to remain suitable under both current and future conditions may represent important climate refugia for the species. Overall, the results indicate that R. undulata is highly vulnerable to future environmental change and highlight the need to incorporate climate-driven habitat shifts into conservation planning, fisheries management, and long-term monitoring strategies. Full article

Subtitles often attract visual attention even when they are not necessary for comprehension. In the present eye-tracking experiment, we examined whether attention to subtitles in instructional videos varies as a function of audio–subtitle language–script pairing in Hindi–English bilinguals with an English-medium instruction (EMI) background. Native Hindi participants viewed videos in three conditions: English audio with English subtitles (L2–L2), Hindi audio with Hindi subtitles (L1–L1), and English audio with Hindi subtitles (L2–L1). In the L2–L2 condition, gaze was distributed similarly across speakers’ faces and subtitles. In contrast, in both Hindi-subtitle formats, viewers allocated more dwell time to the speakers’ faces than to the subtitles. Comprehension scores did not differ significantly across conditions. These findings suggest that subtitle engagement among EMI bilinguals is not solely determined by the presence of subtitles but is also modulated by the properties and perceived utility of the written channel. More generally, our results caution against the view that subtitle engagement is uniformly automatic across multilingual instructional settings. Full article

Disaster-related social media posts often report casualties, rescue needs, infrastructure damage, shelter demand, and local situation changes earlier than formal channels, yet their brevity and noise make operational classification difficult. This study examines whether a practical and reproducible classification pipeline can support fine-grained, emergency-oriented semantic recognition under a deliberately conservative evaluation setting. We convert 14,392 English tweets from CrisisSense-LLM into six actionable semantic categories, partition the data by proxy event groups, and compare a TF-IDF logistic-regression baseline, supervised BERT-base fine-tuning, and zero-shot natural language inference. The evaluation is further extended to mapped HumAID data, a manually reviewed 177-post Chinese boundary-test set, a Chinese-to-English translation bridge, and a fixed-budget selective adjudication simulation. BERT-base achieves the best held-out main-test performance (Macro-F1 = 0.8824), outperforming TF-IDF (0.6133) and zero-shot inference (0.3581), and reaches 0.8132 Macro-F1 on HumAID without retraining. Direct English-to-Chinese transfer is ineffective, whereas multilingual BERT and translation bridging improve Chinese Macro-F1 to 0.2684 and 0.3603, respectively. With 600 reviewed posts, selective adjudication reaches 0.7792 Macro-F1 on the main test set and 0.7153 on HumAID. These findings indicate that the central contribution is not a new model architecture, but an empirically validated workflow that combines supervised fine-tuning, leakage-aware evaluation, external validation, cross-lingual stress testing, and information-driven human review. The novelty therefore lies in the reproducible integration of data mapping, group-aware evaluation, external and cross-lingual stress testing, and selective human review into a single emergency-oriented assessment workflow. Full article

Background/Objectives: Guidelines for obstructive hypertrophic cardiomyopathy (HCM) recommend treatment with disopyramide as an add-on to beta-blockers or calcium-channel blockers when symptoms persist. Data pertaining to effective disopyramide use in practice beyond single-center experience are very limited. This study aimed to quantify disopyramide use in patients with obstructive HCM in England, France and Germany, before the availability of cardiac myosin inhibitors. Methods: This retrospective study used nationally representative databases from England (Clinical Practice Research Datalink and Hospital Episode Statistics, 2010–2019), France (National Healthcare Data System, 2012–2019) and Germany (German statutory health insurance, 2011–2019). Adults (18+) with obstructive HCM were included, based on diagnostic codes for obstructive HCM or any HCM with septal reduction therapy. Disopyramide usage was defined as ≥1 prescription for a patient in a calendar year. Results: Overall, 3730, 6823 and 1141 patients diagnosed with obstructive HCM were identified in the English, French and German databases, respectively. In England, disopyramide use ranged from 4.7% to 5.6% per year with use generally stable over time. The equivalent usage for France was 1.7% to 2.6% per year. As expected, no recorded reimbursed use was reported in Germany during the study period. Conclusions: Disopyramide use is very low in patients with obstructive HCM, possibly due to treatment-related issues, availability or lack of reimbursement. These barriers may drive the uptake of alternative guideline recommended therapies for obstructive HCM treatment. Full article

This study provides a systematic review of research hotspots and trends in the field of parent–child reading, covering the period from 2005 to 2024, based on data retrieved from the China National Knowledge Infrastructure (CNKI) and the Web of Science (WOS). The results indicate that both Chinese- and English-context research on parent–child reading focus on the family literacy environment, the impact of parent–child reading on child development, social support systems, and educational equity. Chinese research places greater emphasis on family reading, family–kindergarten collaboration, and father involvement. This research mainly examines parental guidance strategies and pays particular attention to current practices, especially in rural areas. It highlights the role of fathers in reading, with picture books being the most commonly used reading materials. In contrast, English-context research focuses more on language development and early literacy, with particular emphasis on the development of children’s literacy skills and school readiness. Greater attention is also given to multicultural and minority groups, the role of mothers in reading is more frequently emphasized, and the reading materials are predominantly storybooks and wordless books. Research in both Chinese and English contexts reveals that parent–child reading interactions serve as a channel for the transmission of cultural values, leading to distinct developmental priorities for children. These differences profoundly reflect the systematic influence of sociocultural logics on parental reading behaviors and related research. This analysis provides an empirical foundation for future international collaboration in cross-cultural research. Full article

Organizations communicate across many channels, yet official websites remain a controlled, authoritative space where firms articulate identity and strategy. This study examines how Croatia’s top enterprises (n = 100) describe themselves on their websites and which emotional tones they use to signal strategic intent. Our goal is to identify recurring strategic signifiers and map distinct sentiment profiles in corporate narratives. We compiled company descriptions from official sites; texts were originally in Croatian and machine-translated into English, and all analysis was conducted on the English corpus. Using lexicon-based sentiment methods (AFINN, Bing, NRC), we quantified polarity and discrete emotions, aggregated scores at the firm level, and applied k-means clustering to normalized emotion vectors. Results show a consistent emphasis on mission–vision–values language and a dominance of positive emotions—especially trust and anticipation. We interpret, based on cluster exemplars, that higher trust/anticipation tones can function as soft governance cues, while transparency about negatives characterizes an issue-addressing regime without eroding overall positivity. Cluster analysis reveals three stable profiles: optimistic consumer-oriented narratives, transparent issue-addressing messaging, and low-affect technical descriptions. We conclude that sentiment profiling offers a practical audit tool for aligning website copy with stakeholder expectations and governance communication, supporting benchmarking, and future tests linking narrative tone to investor behavior and firm performance. Full article

Like most of the North Atlantic marine coastal area, the seawater temperature in the English Channel (EC) is showing an increase that began in the middle of the 1980s. Similarly, during the same period, there has been an increase in human activities (extraction of aggregates, harbour sediment dredging and spoil disposal, Offshore Wind Farms). This point of view examines and analyses the changes in biodiversity of benthic species and communities from the EC under climatic and anthropogenic pressures during the four last decades. Four main changes have been recorded: (1) additions to the checklist of benthic species, due to new prospections; (2) changes in the structure of benthic communities, due to human activities; (3) an increase in diversity due to the arrival of non-indigenous species, some of which have effects on the structure of benthic communities; and (4) eastward progression of temperate species, while some boreal species tend to disappear. Situated in temperate mid-latitudes bordering the North-eastern Atlantic, the EC is an excellent open laboratory to observe and understand the impact of climatic change and human activities on marine coastal ecosystems. Today, the increase in seawater temperature and the introduction of non-native species appear to be the main factors that explain the changes in benthic diversity in the EC. Full article

Background and Objectives: Because of its consistently high stone-free rates (SFRs), percutaneous nephrolithotomy (PCNL) continues to be the first-line treatment for renal stones larger than 20 mm. Standard 24 to 30 Fr access tracts, however, are linked to access-related morbidity, such as bleeding, pain, and extended hospital stays. These restrictions have led to progressive tract miniaturization and the development of mini-PCNL, ultra-mini PCNL, and micro-PCN techniques. Materials and Methods: We performed a narrative review of studies published through January 2026 using PubMed and Google Scholar. Search terms included percutaneous nephrolithotomy, mini-PCNL, ultra-mini PCNL, micro-PCNL, and vacuum-assisted PCNL. Original studies, systematic reviews, and meta-analyses reporting clinical outcomes, complications, and advancements were selected, whereas conference abstracts, non-English papers, and articles without accessible full text were excluded. Results: Across randomized trials, miniaturized PCNL generally preserves efficacy when patients are selected appropriately. Across randomized trials and meta-analyses, miniaturized PCNL achieved stone-free rates comparable to standard PCNL (typically ~80–90% for stones ≤20 mm and similar rates in selected stones >2 cm), while demonstrating lower hemoglobin decrease (mean difference approximately −0.6 to −1.0 g/dL), reduced transfusion rates, and shorter hospital stays, at the cost of longer operative time (mean difference ~8–12 min). On the other hand, operative time may increase, and smaller working channels can make visualization and fragment evacuation more demanding as stone burden rises. Raised intrarenal pressure is a recurring safety issue because it may increase infectious risk unless drainage is actively managed. Recent innovations aim to address these limitations, including vacuum-assisted access sheaths, pressure-controlled irrigation, improved laser and lithotripsy platforms, image-fusion guidance, navigation systems, and robotic assistance. Conclusions: PCNL now spans a spectrum of tract sizes rather than a single standard approach. When chosen appropriately and performed with attention to pressure control and fragment evacuation, miniaturized PCNL can reduce morbidity without sacrificing stone clearance. Future advancements in percutaneous stone surgery are more likely to rely on integrated technological solutions that improve accuracy, safety, and repeatability than on additional tract size reduction. Full article

Chemotherapy-induced neuropathic pain (CINP) can be caused by several chemotherapeutic drugs, including paclitaxel, oxaliplatin, and vincristine, which is difficult to treat with several drugs, including antidepressants and anticonvulsants. The patho-mechanisms of CINP are not completely understood. However, they showed oxidative stress, mitochondrial damage, ion channel damage, and immunological dysfunction. Acting as a key regulator of antioxidant responses, nuclear factor erythroid 2-related factor 2 (Nrf2) decreased oxidative stress and mitochondrial damage. In addition, it plays a role in inhibiting nuclear factor kappa B (NF-κB). A systematic, English-only search of MEDLINE (PubMed) was performed for studies on Nrf2, chemotherapy, and neuropathic pain from database inception through 1 December 2024. Several Nrf2 activators, including tempol, oltipraz, rosiglitazone, pristimerin, cannabidiol, daidzein, bardoxolone methyl, curcumin, resveratrol, and mitoquinone, demonstrated analgesic effects in CINP animal models. Furthermore, in clinical studies, curcumin demonstrated significant efficacy in reducing vincristine-induced neuropathy in pediatric leukemia patients, while the combined administration of alpha-lipoic acid with ipidacrin hydrochloride prevented paclitaxel-induced motor neuropathy and improved axonal function in breast cancer patients. Thus, the purposes of our review article were to summarize the analgesic effects of Nrf2 activators and the patho-mechanisms of Nrf2 in CINP animal, and then the consequences for clinical trials were presented. Full article

Background: This equity audit assessed enrolment and completion of a state-funded cardiometabolic risk-reduction programme for women with prior gestational diabetes in Victoria, Australia. The analyses compared completion rates between the standard prevention programme Life! with one specifically adapted for women with prior gestational diabetes (Life! GDM) using the PROGRESS equity framework. Methods: Women with a history of GDM in the Life! GDM or the mainstream Life! programme in 2022–2025 were included. Multinomial logistic regression was used to impute categorical variables, logistic regression for binary variables, and linear regression for continuous variables. Estimates were combined across imputed datasets using Rubin’s rules. Results: A total of 2261 women were included: 370 in Life! GDM, and 1891 in Life! from 2022 to 2025, with completion rates of 36.7% and 52.2%, respectively. Compared with women in Life!, women in Life! GDM were more likely to come from non-English-speaking backgrounds, particularly South and Central Asian (30.5% vs. 17.0%) and South-East Asian backgrounds (13.0% vs. 4.3%). After multiple imputation, multivariable logistic regression showed that none of the examined participant characteristics were significantly associated with programme completion in Life! GDM. In the Life! cohort, completion was significantly associated with marital status, with single participants having lower odds of completion (OR = 0.59, 95% CI: 0.41–0.85), and with referral channel, with self-referral associated with higher odds of completion (OR = 1.71, 95% CI: 1.39–2.12). Conclusions: The adapted programme appeared to have reached more culturally and linguistically diverse women; however, lower completion among those experiencing disadvantage highlights the need for enhanced support and retention strategies to ensure equitable postpartum diabetes prevention. Full article

Background/Objectives: Trigeminal Neuralgia (TN) is a chronic neuropathic condition characterized by sudden, severe facial pain. Anticonvulsants are the cornerstone of pharmacological management, yet comparative evidence based on pharmacological class remains scarce. This systematic review aimed to evaluate the efficacy and safety of anticonvulsants in TN, stratified by their mechanism of action. Methods: A systematic search in PubMed, Scopus and Web of Science was conducted following PRISMA 2020 guidelines. Studies employing a pharmacological approach including human patients with TN, published in English since 2000, were included. Risk of bias was assessed using the Cochrane RoB 2, the ROBINS-I and the ROBINS-E tools, according to the study design. Results: Out of 922 initial records, 12 studies met the eligibility criteria. Sodium channel inhibitors showed high efficacy but frequent adverse effects, particularly hyponatremia and central nervous system symptoms. Calcium channel modulators offered a more favorable safety profile. Combination therapies showed benefits, levetiracetam and topiramate were moderately effective and well tolerated. Although the evidence has limitations, anticonvulsants continue to be the primary treatment for TN. Sodium-channel blockers demonstrate strong efficacy, whereas alternative agents generally provide superior tolerability. Conclusions: These findings support selecting drugs according to their underlying mechanisms of action. Equally important is tailoring therapy to pain phenotype and patient characteristics, balancing mechanism with tolerability and efficacy. Full article

Understanding how moral and emotional language operates in paid social advertising is essential for evaluating persuasion and its ethical contours. We provide a descriptive map of Moral Foundations Theory (MFT) language in Meta ad copy (Facebook/Instagram) drawn from seven global beverage brands across eight English-speaking markets. Using the moralstrength toolkit, we implement a two-channel pipeline that combines an unsupervised semantic estimator (SIMON) with supervised classifiers, enforces a strict cross-channel consensus rule, and adds a non-overriding purity diagnostic to reduce attribute-based false positives. The corpus comprises 758 text units, of which only 25 ads (3.3%) exhibit strong consensus, indicating that much of the copy is either non-moral or linguistically ambiguous. Within this high-consensus subset, the distribution of moral cues varies systematically by brand and category, with loyalty, fairness, and purity emerging as the most prominent frames. A valence pass (VADER) indicates that moralized copy tends toward negative valence, yet it may still yield a constructive overall tone when advertisers follow a crisis–resolution structure in which high-intensity moral cues set the stakes while surrounding copy positions the brand as the solution. We caution that text-only models undercapture multimodal signaling and that platform policies and algorithmic recombination shape which moral cues appear in copy. Overall, the study demonstrates both the promise and the limits of current text-based MFT estimators for advertising: they support transparent, reproducible mapping of moral rhetoric, but future progress requires multimodal, domain-sensitive pipelines, policy-aware sampling, and (where available) impression/spend weighting to contextualize descriptive labels. Full article