Search Results (25)

Purpose: To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating digital orthoptic interventions, including virtual reality (VR)–based approaches, for convergence insufficiency and intermittent exotropia. Methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines and AMSTAR-2 standards and was prospectively registered in PROSPERO. PubMed, Web of Science, and Scopus were searched up to December 2025. Eligible studies were RCTs comparing VR-based or digital orthoptic interventions with conventional therapy, placebo VR, or control conditions. Primary outcomes included near point of convergence, ocular deviation, fusional reserves, and stereopsis. Risk of bias was assessed using RoB 2 and certainty of evidence with GRADE. Results: Four RCTs (184 participants) were included. In convergence insufficiency, digital orthoptic interventions, including VR-based approaches, significantly reduced near heterophoria (mean difference [MD] −1.64 prism diopters; 95% CI −3.17 to −0.12), with no significant effects on near point of convergence or positive fusional reserves. In intermittent exotropia, VR-based interventions significantly improved near point of convergence (MD −1.60 cm; 95% CI −2.64 to −0.55), although this change did not reach the ≥4 cm threshold considered clinically meaningful according to the Convergence Insufficiency Treatment Trial. Improvements were also observed in stereopsis (MD −0.19 log units; 95% CI −0.33 to −0.04), while changes in near deviation were not significant. Evidence certainty ranged from low to moderate. Conclusions: VR-based and digital orthoptic interventions may offer modest, outcome-specific benefits as adjunctive treatments for selected binocular vision disorders. Larger, well-designed RCTs with standardized outcomes are needed. Full article

Business failure is an increasingly relevant topic in the field of business management due to its impact on entrepreneurial ecosystems, strategic decision-making, and policy development. Although academic interest in this area has intensified in recent years, significant gaps remain that hinder a comprehensive understanding of its underlying causes and evolving patterns. This study aims to explore the main research trends related to business failure by identifying key thematic developments, influential contributors, and conceptual gaps in the existing academic literature. A systematic literature review was conducted using the PRISMA 2020 protocol, analyzing documents indexed in the Scopus and Web of Science databases. The analysis considered publication trends, most cited authors and journals, contributing countries, and keyword co-occurrence networks to examine the thematic evolution and structure of the field. The findings highlight the need for future research agendas focused on emerging areas such as machine learning, financial distress, entrepreneurial failure, and business failure prediction. Additionally, the study suggests the adoption of interdisciplinary approaches and longitudinal analyses to address the dynamic and multifaceted nature of business failure. By integrating bibliometric and thematic perspectives, this review provides an updated and comprehensive overview of the literature, revealing under-explored topics and research opportunities, and offering valuable insights to guide future scholarly work in this critical area of business research. Full article

Background/Objectives: Oral and oropharyngeal cancers are highly prevalent and associated with a high mortality. The primary treatment modality is surgery with free flap reconstruction becoming the gold standard. Our study aimed to assess the anthropometric and metabolic predictors of the occurrence of postoperative complications after free flap reconstruction, and to present a PRISM (Predictive Reconstructive Index for Soft-tissue Microflaps) scoring system. Methods: This retrospective cohort study included 92 patients with advanced oral and oropharyngeal squamous cell carcinoma who underwent primary surgical treatment with microvascular free flap reconstruction between 2020 and 2024. Clinical, surgical, and biochemical parameters (operative and flap ischemia time, BMI; serum albumin, total protein, and calcium) were analyzed in relation to postoperative complications. Associations were assessed using correlation analyses and binary logistic regression. Based on the key predictive variables, the PRISM scoring system was developed to estimate perioperative risk. Results: Underweight or overweight patients showed higher complication rates (Kruskal–Wallis, p = 0.019). Longer surgeries were associated with a higher incidence of SIRS, which in turn correlated with increased flap ischemia (Man-Whitney, p = 0.032 and 0.039). Lower albumin and total protein levels on the second postoperative day were linked to more complications (Kruskal–Wallis, p = 0.001 and 0.010), as were lower calcium levels on the first postoperative day (p = 0.033). Additionally, longer hospitalization was significantly associated with complication severity (p = 0.031). The PRISM score stratified patients into low-, moderate-, and high-risk groups. Conclusions: Free flap outcomes in oral and oropharyngeal cancer are influenced by SIRS, nutritional status, and surgical factors. Longer surgeries, flap ischemia, low albumin, protein, calcium, and abnormal BMI increased the complication risk. Careful preoperative assessment, optimization of patient condition, and strategies to minimize operative time and ischemia are essential. The PRISM score may help stratify patients and guide clinical decisions. Full article

Background: Antimicrobial resistance (AMR) is a global threat that extends beyond clinical settings, impacting animals, food, and the environment. To the best of our knowledge, this review presents the first systematic evaluation of AMR and antimicrobial resistance genes (ARGs) in non-human sources in Qatar, using a One Health framework. Methods: Following PRISMA 2020 guidelines, we searched five major databases: PubMed, Scopus, Web of Science, Embase, Google Scholar (only 3 pages) and QRDI, without date restrictions for studies on AMR and ARGs in animals, food, and environmental sources in Qatar. Only primary studies from Qatar reporting phenotypic or genotypic AMR/ARG data in animals, food, or the environment were included; all human-focused, non-Qatar, or non-primary research were excluded. Eligible studies were screened and analyzed using GraphPad Prism 10.4 and StatsDirect, applying random- or fixed-effects models based on heterogeneity and assessed for quality using the JBI checklist for prevalence. Results: Fifteen eligible studies published up to 2025 were included. Escherichia coli was the most frequently reported organism. High resistance rates were observed in the Access group antibiotics, such as ampicillin (0.50; 95% CI: 0.47–0.53) and tetracycline (0.50; 95% CI: 0.45–0.55), as well as in the Watch group antibiotics, including ciprofloxacin (0.40; 95% CI: 0.36–0.44) and fosfomycin (0.26; 95% CI: 0.20–0.32). Resistance to Reserve group antibiotics was comparatively lower, with pooled estimates of 0.14 (95% CI: 0.08–0.20) for colistin and 0.11 (95% CI: 0.05–0.25) for carbapenems, though lower, remains concerning. The overall pooled estimate for multidrug resistance (MDR) was 0.56 (95% CI: 0.36–0.72), and poultry was identified as the main reservoir, particularly to Critically Important Antimicrobials (CIAs). ARGs, including bla_CTX-M, bla_TEM, mcr-1, and qnr, were detected across all sectors, with wastewater showing a notable ARG burden. Data on other livestock species remain limited. Limitations include a few studies, variable quality, and inconsistent methods affecting comparability and precision. Conclusions: This review highlights significant AMR and ARG prevalence in non-human sources in Qatar and underscores the urgent need for a national One Health surveillance strategy incorporating WHO AWaRe and CIA frameworks to address this escalating public health threat. Full article

Background: A cytokine storm can lead to organ dysfunction and death in critically ill children. Extracorporeal hemoperfusion aims to reduce hyperinflammation by filtering out mid-range cytokines (e.g., IL-6), but pediatric data remain limited. Methods: We conducted a narrative review with PRISMA-guided screening of PubMed, Scopus, and Google Scholar for pediatric reports of HA330/HA380 from January 2020 to June 2025. Due to heterogeneity in populations, circuits, and outcome timing, the results were synthesized descriptively. Three studies met the inclusion criteria: a prospective series of 12 patients with septic shock using HA330, a single case of a pediatric heart transplant with HA380 during cardiopulmonary bypass, and a retrospective comparative cohort study of Pediatric Intensive Care Unit (PICU) oncology patients on continuous renal replacement therapy (CRRT) comparing HA330 (n = 11) versus CytoSorb (n = 10). Results: Three studies involving 23 pediatric patients were analyzed. The median age was 8 years, and 56.5% of patients were male. Most patients underwent hemoadsorption with HA330 via continuous renal replacement therapy (CRRT) or continuous venovenous hemodiafiltration (CVVHDF). Post-treatment reductions were noted in interleukin-6 (IL-6) (mean −69.6%), C-reactive protein (CRP) (−59.0%), and procalcitonin (PCT) (−70.4%). Severity scores (Pediatric Logistic Organ Dysfunction-2 (PELOD-2), Pediatric Risk of Mortality-3 (PRISM-3), and Pediatric Sequential Organ Failure Assessment (pSOFA) improved significantly (p = 0.002). The mean PICU stay was 15.6 days. The survival rate was 87%, and no hemoadsorption-related adverse events were reported. Conclusions: HA330/380 hemoadsorption is a safe and potentially effective treatment for pediatric cytokine storms, reducing inflammation and improving clinical status. However, larger, standardized studies are needed to confirm these findings and guide clinical use. Full article

Background/Objectives: Breast cancer is the most commonly diagnosed cancer worldwide, with high rates of distant metastasis. While circulating tumor cells (CTCs) are the disseminatory units of metastasis and are indicative of a poor prognosis, CTC heterogeneity within individual patients, among breast cancer subtypes, and between primary and metastatic tumors within a patient obscures the relationship between CTCs and disease progression. EpCAM, its homolog Trop2, and a pan-Cytokeratin marker were evaluated to determine their contributions to CTC presence and clustering over the study period. We conducted a systematic longitudinal analysis of 51 breast cancer patients during the course of their treatment to deepen our understanding of CTC contributions to breast cancer progression. Methods: 272 total blood samples from 51 metastatic breast cancer (mBC) patients were included in the study. Patients received diverse treatment schedules based on discretion of the practicing oncologist. Patients were monitored from July 2020 to March 2023, with blood samples collected at scheduled care appointments. Nucleated cells were isolated, imaged, and analyzed using Rarecyte^® technology, and statistical analysis was performed in R using the lmerTest and lme4 packages, as well as in Graphpad Prism version 10.4.1. Results: Both classical CTCs (DAPI+, EpCAM+, CK+, CD45– cells) and Trop2+ CTCs were detected in the blood of breast cancer patients. A high degree of correlation was found between CTC biomarkers, and CTC expression of EpCAM, Trop2, and the presence of CD45+ cells, all predicted cluster size, while Pan-CK did not. Furthermore, while analyses of biomarkers by receptor status revealed no significant differences among HR+, HER2+, and TNBC patients, longitudinal analysis found evidence for discrete trajectories of EpCAM, Trop2, and clustering between HR+ and HER2+ cancers after diagnosis of metastasis. Conclusions: Correlation and longitudinal analysis revealed that EpCAM+, Trop2+, and CD45+ cells were predictive of CTC cluster presence and size, and highlighted distinct trajectories of biomarker change over time between HR+ and HER2+ cancers following metastatic diagnosis. Full article

Widespread use of pesticides in agriculture causes adverse impacts on non-target organisms and environmental pollution. Efficient and sustainable pesticide removal alternatives must be developed to reduce pesticide environmental impacts. Recently, bioremediation based on immobilized microorganisms has been proposed as an environmentally friendly and cost-effective approach for pesticide degradation in water. Agro-industrial wastes are produced in large quantities in crop fields; their high availability, low cost, and potential for reuse make them ideal support materials for microbial immobilization. This systematic review, conducted through the PRISM 2020 methodology, compiles recent research on using agro-industrial waste to immobilize microorganisms for pesticide degradation. The identified studies highlight corn straw as the most studied agro-industrial waste, while the organophosphorus insecticides, chlorpyrifos, and methyl parathion were the most representative pesticides; in the identified studies, pesticide degradation was conducted mainly by bacteria of the Acinetobacter, Bacillus, and Pseudomonas genera. Overall, microbial immobilization significantly enhanced pesticide degradation, rendering it a viable bioremediation strategy for pesticide-contaminated water. Full article

This article discusses the conversion of Hagia Sophia to a mosque in 2020. Examining this act through the prism of the neo-Ottoman political platform and with consideration of the meaning and importance of this historic cultural monument, it is inferred that the reconversion constitutes a political decision par excellence, intended to symbolically mark the beginning of a new era for Turkey while closing the chapter of Kemalism. In doing so, the current political establishment seeks to communicate its resolution to invert the process of secularisation, as a form of revanche for the Westernisation of the country and the identity erosion that it caused. Further, the reconversion symbolically connotes the conquest of Constantinople and the triumph of Islam over Christianity anew, harking back to past glories and upholding them as guidelines for the future, thus hinting to a revisionist political agenda, applicable both domestically and abroad, intended, according to rhetoric at least, to consolidate Turkey as a regional power and a worthy successor of the Ottoman Empire. Full article

Given the critical role of media in times of crisis, particularly for relaying scientific knowledge and political decisions, we evaluated to what extent the first COVID-19 pandemic wave affected the treatment by traditional media of important societal topics. We searched a database of 650 French-speaking Swiss media outlets using specific keywords and reported the number of publications per month containing these items, associated or not with SARS-CoV-2. The number of publications related to viruses increased 12-fold during the first semester 2020, while the media coverage of topics about bacteria, parasites, and fungi remained stable. During the first pandemic wave, media generated a larger number of publications treating of political and medical subjects than before the pandemic, whereas the coverage of other topics was unchanged. All topics were viewed through the prism of the pandemic, up to 82% of the publications being associated with COVID-19. The media largely covered all medical aspects related to SARS-CoV-2 infection and offered scientists multiple opportunities to communicate with the public. However, their influence was strongly challenged by the capacity of social networks to disseminate rumors and misinformation. We also assessed the articles published in traditional media during the five subsequent epidemic waves, showing that the largest media peaks occurred during the first infection wave studied extensively in the present work, and during the huge fifth infection wave due to Omicron variant BA1. Undoubtedly, the COVID-19 pandemic highlighted how important it is for science communication to harness the tremendous power of social media. Full article

Coastal development such as sea reclamation, port terminals, and breakwater construction has significantly altered the southwestern coastline of Laizhou Bay, changing the regional hydrodynamic environment. To explore how tidal range and tidal prism respond to these 20-year coastline changes, this paper selected the southwestern coastline data of Laizhou Bay in 2000 and 2020, established a 2-D tidal model, and studied the impact of the 20-year coastline changes on tidal range and tidal prism in this sea area. The results show that during the 20 years from 2000 to 2020, most of the bay area’s coastline was in a growth trend of advancing toward the sea, 85.3% of the cross-sections were growth areas, 11.9% were dynamic stable areas, and there was almost no erosion area. Affected by reclamation activities, the area of the southwestern part of Laizhou Bay decreased by 11.66%, the coastline increased by 63.27%, and the center of mass moved 2.22 km to the northeast. The reclamation of tidal flats caused the potential energy of tidal waves in the bay to increase, the maximum possible tidal wave in the southwestern part of the bay showed an increasing trend, and the bay top between Weifang Port and Guangli Port increased particularly significantly, with a maximum increase of 22 cm. The spring tide period, neap tide period and average tidal prism in the southwestern bay decreased by 4.79%, 3.29%, and 4.24%, respectively. The reclamation of tidal flats is the main reason for the decrease in tidal prism in the southwestern part of the bay. Full article

Extreme flood events present a significant challenge for operators and managers of large drinking water reservoirs. Detailed flood response analysis can predict the hydrology response of a reservoir to changing climate conditions and can aid in managing the reservoir in anticipation of extreme events. Herein, the Soil and Water Assessment Tool (SWAT), a watershed model, was used in conjunction with a reservoir management model, the Operational Analysis and Simulation of Integrated Systems (OASIS) model, to evaluate extreme flood events across a set of initial reservoir storage capacities across various CMIP6 climate scenarios. The SWAT model was calibrated and validated with PRISM climate data in conjunction with land and soil cover data and multi-site gauged stream discharges. The validated model demonstrated satisfactory performance (NSE = 0.55 and R² = 0.56) for total reservoir inflow. The resulting inflow values from SWAT were utilized to set up a calibrated/validated OASIS model (NSE = 0.55 and R² = 0.68). OASIS was then used to assess alternative operating rules for the reservoir under varying climate scenarios (RCP4.5 and RCP8.5) and extreme events (synthetic hurricanes). Focusing on a major reservoir in the Northeastern United States, the analysis of the reservoir response was based on (1) reservoir volume–elevation curve, (2) daily reservoir inflow, (3) daily precipitation, (4) spillway flow, and (5) reservoir evaporation. Projected future scenarios indicate a >20% increase in precipitation in April compared to historical records, coupled with likely reduced runoff from November to March. With extreme conditions most likely in the month of April, RCP4.5 and RCP8.5 projections suggest that most scenarios result in a 10–15% increase in the mean of 3D30Y runoff volumes, and a 150% increase under the most extreme conditions. For 7D30Y runoff volumes in April, the RCP4.5 and RCP8.5 analyses reveal an increased likelihood of the reservoir elevation reaching overspill flow levels during the latter half of the simulation period (2020 to 2080). Our findings indicate that simulations with SWAT coupled with OASIS can assist reservoir managers in regulating water levels in anticipation of extreme precipitation events. Full article

This study addresses the critical global challenge of climate adaptation by assessing the inadequacies in current methodologies for estimating adaptation costs. Broad assessments reveal a significant investment shortfall in adaptation strategies, highlighting the necessity for precise cost analysis to guide effective policy-making. By employing the PRISMA 2020 protocol and enhancing it with the prismAId tool, this review systematically analyzes the recent evolution of cost assessment methodologies using state-of-the-art generative AI. The AI-enhanced approach facilitates rapid and replicable research extensions. The analysis reveals a significant geographical and sectoral disparity in research on climate adaptation costs, with notable underrepresentation of crucial areas and sectors that are most vulnerable to climate impacts. The study also highlights a predominant reliance on secondary data and a lack of comprehensive uncertainty quantification in economic assessments, suggesting an urgent need for methodological enhancements. It concludes that extending analyses beyond merely verifying that benefits exceed costs is crucial for supporting effective climate adaptation. By assessing the profitability of adaptation investments, it becomes possible to prioritize these investments not only against similar interventions but also across the broader spectrum of public spending. Full article

This article reviews the literature covering the period from 1965 to 2020 dedicated to the issue of artificial beach nourishment along the Polish coast, with a particular focus on the Hel Peninsula. The primary sources used in this work include 34 reports from unpublished case studies and projects implemented by the Department of Maritime Hydrotechnics, Maritime Institute in Gdańsk, between 1971 and 2020. This paper also presents detailed information about the total fill volume in cubic meters of dredged material deposited along the Polish coast and lagoon shores in 1980–2020. During these 40 years, approximately 40.5 million m³ of sediment was deposited along the Polish coast and lagoon shores. Particular consideration was given to beach fills along the Hel Peninsula, which was at actual risk of breaking in its basal and central sections after intense storms at the turn of 1988 and 1989. The survey materials collected enabled the assessment of the coastal morphodynamics of the peninsula under the Coastal Protection Program through the prism of changes in the fill volume along the coastal sections, which were replenished with material coming from submarine deposits. The peninsula’s stability was also assessed, taking into account the ongoing climate change. Moreover, this article discusses the proposed rules and terms for protecting the Polish coast by way of artificial nourishment. Full article

Efficient water management strategies are of utmost importance in drought-prone regions, given the fundamental role irrigation plays in avoiding yield losses and food shortages. Traditional methodologies for estimating irrigation amounts face limitations in terms of overall precision and operational scalability. This study proposes to estimate irrigation amounts from soil moisture (SM) data by adapting the PrISM (Precipitation Inferred from Soil Moisture) methodology. The PrISM assimilates SM into a simple Antecedent Precipitation Index (API) model using a particle filter approach, which allows the creation and estimation of irrigation events. The methodology is applied in a semi-arid region in the Ebro basin, located in the north-east of Spain (Catalonia), from 2016 to 2023. Multi-year drought, which started in 2020, particularly affected the region starting from the spring of 2023, which led to significant reductions in irrigation district water allocations in some of the areas of the region. This study demonstrates that the PrISM approach can correctly identify areas where water restrictions were adopted in 2023, and monitor the water usage with good performances and reliable results. When compared with in situ data for 8 consecutive years, PrISM showed a significant person’s correlation between $0.58$ and $0.76$ and a cumulative weekly root mean squared error (rmse) between 7 and 11 mm. Additionally, PrISM was applied to three irrigation districts with different levels of modernization, due to the different predominant irrigation systems: flood, sprinkler, and drip. This analysis underlined the strengths and limitations of PrISM depending on the irrigation techniques monitored. PrISM has good performances in areas irrigated by sprinkler and flood systems, while difficulties are present over drip irrigated areas, where the very localized and limited irrigation amounts could not be detected from $SM$ observations. Full article

The transition towards the circular economy (CE) is one of the major priorities of the European Union (EU). By observing its benefits through the prism of sustainable development, this study aims to reveal the intricate relationships between the CE and the economy–society–environment nexus across 27 EU countries during the period from 2012 to 2020. Utilizing an extensive dataset comprising 243 observations drawn from the EUROSTAT database, we employed a panel data analysis. In this research, we quantified the impact of CE indicators on key dependent variables: GDP per capita (economic dimension), mortality, morbidity, and the welfare cost associated with exposure to environment-related risks (social dimension) and greenhouse gas (GHG) emissions in the environmental realm. The findings of our study illuminate the multifaceted connections between circular economy practices and the broader goals of sustainable development within the EU-27 context. The CE indicators aggregated at the EU level not only have a beneficial impact on the economy but also on society and the environment. The analysis reveals that each of the six explanatory variables incorporated into the models exhibits the anticipated relationship with at least one of the outcome variables. This research contributes valuable insights for policymakers, public authorities, and other stakeholders seeking to enhance the circular economy landscape in respective countries. Full article