Search Results (5,058)

Nepal is highly susceptible to natural hazards, including earthquakes, flooding, and landslides, all of which may occur independently or in combination. Climate change is projected to increase the frequency and intensity of these natural hazards, posing growing risks to Nepal’s infrastructure and development. To the authors’ knowledge, the majority of existing geohazard research in Nepal is typically limited to single hazards or localised areas. To address this gap, MiMapper was developed as a cloud-based, open-access multi-hazard mapping tool covering the full national extent. Built on Google Earth Engine and using only open-source spatial datasets, MiMapper applies an Analytical Hierarchy Process (AHP) to generate hazard indices for earthquakes, floods, and landslides. These indices are combined into an aggregated hazard layer and presented in an interactive, user-friendly web map that requires no prior GIS expertise. MiMapper uses a standardised hazard categorisation system for all layers, providing pixel-based scores for each layer between 0 (Very Low) and 1 (Very High). The modal and mean hazard categories for aggregated hazard in Nepal were Low (47.66% of pixels) and Medium (45.61% of pixels), respectively, but there was high spatial variability in hazard categories depending on hazard type. The validation of MiMapper’s flooding and landslide layers showed an accuracy of 0.412 and 0.668, sensitivity of 0.637 and 0.898, and precision of 0.116 and 0.627, respectively. These validation results show strong overall performance for landslide prediction, whilst broad-scale exposure patterns are predicted for flooding but may lack the resolution or sensitivity to fully represent real-world flood events. Consequently, MiMapper is a useful tool to support initial hazard screening by professionals in urban planning, infrastructure development, disaster management, and research. It can contribute to a Level 1 Integrated Geohazard Assessment as part of the evaluation for improving the resilience of hydropower schemes to the impacts of climate change. MiMapper also offers potential as a teaching tool for exploring hazard processes in data-limited, high-relief environments such as Nepal. Full article

Impulsive purchasing behavior among university students has gained increased attention in the context of digital consumption settings; however, much of the existing research is product-specific and quantitative, leaving the subjective nuances of this phenomenon underexplored. This study investigates how college students perceive and explain their impulsive purchase behavior across various product categories and platforms, using qualitative data from focus groups (n = 72). By revealing the prevalence of key patterns—interest-aligned, emotional relief, hedonistic lifestyle, social influence, inquisitive reviewer, presentation appeal, and controlled purchase—this research uncovers the underlying identity-affirming practices, internal emotional negotiations, and external sociotechnical cues that shape such behavior. Ultimately, it reframes impulsive buying as a socially embedded, identity-driven act rather than an act of irrationality. These findings advance our understanding of consumer psychology by emphasizing the lived experiences and self-construction processes of young consumers navigating media-saturated, algorithmically curated purchasing environments. Full article

Early and accurate detection of lemon disease is necessary for effective citrus crop management. Traditional approaches often lack refined diagnosis, necessitating more powerful solutions. The article introduces adaptive PSO-LemonNetX, a novel framework integrating a novel deep learning model, adaptive Particle Swarm Optimization (PSO)-based feature selection, and explainable AI (XAI) using LIME. The approach improves the accuracy of classification while also enhancing the explainability of the model. Our end-to-end model obtained 97.01% testing and 98.55% validation accuracy. Performance was enhanced further with adaptive PSO and conventional classifiers—100% validation accuracy using Naive Bayes and 98.8% testing accuracy using Naive Bayes and an SVM. The suggested PSO-based feature selection performed better than ReliefF, Kruskal–Wallis, and Chi-squared approaches. Due to its lightweight design and good performance, this approach can be adapted for edge devices in IoT-enabled smart farms, contributing to sustainable and automated disease detection systems. These results show the potential of integrating deep learning, PSO, grid search, and XAI into smart agriculture workflows for enhancing agricultural disease detection and decision-making. Full article

Background/Objectives: Aortic stenosis (AS) leads to progressive left ventricular (LV) pressure overload, adverse myocardial remodeling, and eventual functional decline. While traditional parameters such as left ventricular ejection fraction (LVEF) may remain preserved until advanced stages, they are insufficiently sensitive to early dysfunction. Global longitudinal strain (GLS) offers improved detection but remains load-dependent. In contrast, non-invasive myocardial work (MW)—derived from pressure-strain loops—offers a more load-independent assessment of myocardial function. This systematic review and meta-analysis aimed to evaluate the effects of transcatheter aortic valve implantation (TAVI) on MW indices in patients with severe AS. Methods: We performed a systematic review and meta-analysis of studies reporting non-invasive myocardial work parameters before and after TAVI (PROSPERO ID: CRD420250517138). Databases were searched through 31 March 2025. Pooled mean differences in global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were calculated using random-effects models. Sensitivity analyses and meta-regression were conducted to explore heterogeneity and the influence of baseline characteristics. Results: Eleven studies encompassing 1493 patients were included. TAVI was associated with a significant reduction in GWI (−236.67 mmHg% [95% CI: −373.82 to −99.52]; I² = 97.0%; p = 0.002) and GCW (−243.71 mmHg% [95% CI: −407.38 to −80.03]; I² = 97.4%; p = 0.006). No significant changes were observed in GWW or GWE. Meta-regression showed age and baseline LVEF significantly influenced GWE changes, but not other parameters. Conclusions: TAVI leads to a significant reduction in GWI and GCW, reflecting decreased myocardial workload and afterload relief. These findings support the utility of MW indices as valuable tools for assessing myocardial adaptation post-TAVI and potentially guiding clinical decision-making. Full article

Wetland mapping plays a crucial role in monitoring wetland ecosystems, water resource management, and habitat suitability assessment. Wetland classification remains significantly challenging due to the diverse types, intricate spatial patterns, and highly dynamic nature. This study proposed a dynamic hybrid method that integrated feature selection and object-oriented ensemble model construction to improve wetland mapping using Sentinel-1 and Sentinel-2 data. The proposed feature selection approach integrates the ReliefF and recursive feature elimination (RFE) algorithms with a feature evaluation criterion based on Shapley additive explanations (SHAP) values, aiming to optimize the feature set composed of various variables. During the construction of ensemble models (i.e., RF, XGBoost, and LightGBM) with features selected by RFE, hyperparameter tuning is subsequently conducted using Bayesian optimization (BO), ensuring that the selected optimal features and hyperparameters significantly enhance the accuracy and performance of the classifiers. The accuracy assessment demonstrates that the BO-LightGBM model with ReliefF-RFE-SHAP-selected features achieves superior performance to the RF and XGBoost models, achieving the highest overall accuracy of 89.4% and a kappa coefficient of 0.875. The object-oriented classification maps accurately depict the spatial distribution patterns of different wetland types. Furthermore, SHAP values offer global and local interpretations of the model to better understand the contribution of various features to wetland classification. The proposed dynamic hybrid method offers an effective tool for wetland mapping and contributes to wetland environmental monitoring and management. Full article

The consumption of dietary supplements is increasing worldwide, yet national data from Saudi Arabia remain limited. This study examined the prevalence, patterns, and predictors of dietary supplement use, with emphasis on vitamin intake. A cross-sectional survey was conducted among 477 adults meeting inclusion criteria. Self-reported data included demographics, supplement use in the past 12 months, types and forms consumed, frequency, motivations, and information sources. Descriptive statistics and logistic regression were applied. Overall, 58% reported using at least one supplement in the past year, with vitamins comprising 81% of use. Pills and capsules were preferred, and daily intake was most common (58%). Female gender (AOR = 2.04; 95% CI: 1.26–3.31) and higher education (AOR = 4.04; 95% CI: 1.88–8.64) significantly predicted vitamin use. Common motivations included health promotion (19%), symptom relief (24%), and physical appearance (10%), with gender differences in reasons related to general health and immunity. Nearly three-quarters of participants relied on informal sources for supplement intake. Dietary supplement use is prevalent, particularly among women and the highly educated. Targeted education and regulatory measures are needed to promote safe, informed use, aligning with the national health strategies under Saudi Vision 2030. Full article

Optical transmission gratings with quasi-sinusoidal surface-relief profiles were inscribed in IOG and Pyrex glasses and in Bi₁₂GeO₂₀, Er: LiNbO_3, and Er: Fe: LiNbO₃ crystals by microbeams of carbon, nitrogen, and oxygen ions at ion energies of 5, 6, and 10.5 MeV. Grating constants were 4, 8, and 16 μm. Amplitudes of the surface-relief gratings were in the 10–2000 nm range. The diffraction efficiency of the gratings was measured at a wavelength of 640 nm. Maximum diffraction efficiencies were close to the theoretical maximum of 33% for thin gratings. Grating profiles were measured by optical microscopic profilometry. Measurement of the diffraction efficiencies at higher orders and Fourier analysis of the grating profiles revealed the dependence of the residual nonlinearity of the grating profiles on the implanted ion fluence. The ion microbeam-written gratings can be used as light coupling elements in integrated optics for sensors and telecommunication. Full article

Objective: Chronic non-cervical-origin interscapular pain remains challenging to treat when refractory to conservative management and ultrasound-guided injections. This retrospective feasibility study aimed to assess the feasibility, procedural practicality, safety, and preliminary clinical outcomes of transarterial embolization (TAE) as a salvage therapy in this patient population. Methods: This single-center retrospective study included 20 patients with chronic interscapular pain (Numeric Rating Scale [NRS] score ≥5 for >3 months) who initially underwent ultrasound-guided injection therapy. Patients who experienced inadequate pain relief after 3 months (n = 10) proceeded to TAE, while the remaining 10 patients with sufficient relief formed the comparison group. TAE primarily targeted the transverse cervical artery using imipenem/cilastatin sodium as the embolic agent. Pain outcomes were assessed using NRS scores at 1, 3, and 6 months post-procedure. The primary outcome was pain reduction (≥50% decrease in NRS score), with secondary outcomes including technical success, medication use, and safety assessment. Results: The mean baseline NRS score for all patients was 6.5 ± 1.4, which decreased to 3.4 ± 2.0 at 1 month and 3.9 ± 2.5 at 3 months post-injection (p < 0.001). In the TAE group, the NRS score decreased from 7.4 ± 1.4 to 5.1 ± 1.1 at 1 month and 6.0 ± 1.4 at 3 months, indicating inadequate pain relief. In contrast, the injection-only group showed significant improvement, with NRS scores decreasing from 5.6 ± 0.5 to 1.6 ± 0.5 at 1 month and 1.7 ± 0.7 at 3 months (p < 0.001). The reduction in NRS scores was significantly less in the TAE group compared with the injection-only group (−2.2 vs. −4.0 and −28.7% vs. −71.4% at 1 month; −1.4 vs. −3.9 and −18.2% vs. −69.7% at 3 months; all p ≤ 0.001). Following TAE, the mean NRS score further decreased to 2.1 ± 0.7, 2.0 ± 1.1, and 1.9 ± 1.2 at 1, 3, and 6 months, respectively (p < 0.001), with clinical success rates of 90%, 100%, and 90% at these respective time points. At the final follow-up, the percentage of NRS score reduction was comparable between the TAE and injection-only groups (−74.8% vs. −69.7%, p = 0.397). No severe or life-threatening adverse events were observed; only self-limited adverse events were reported. Conclusions: In this retrospective feasibility study, TAE appeared safe and effective as a salvage therapy for patients with refractory non-cervical-origin interscapular pain unresponsive to injection therapy. Further prospective, randomized studies are needed to validate these findings, refine patient selection criteria, and optimize treatment outcomes. Full article

Background/Objectives: Diabetic neuropathy (DN) is a prevalent complication of diabetes mellitus, affecting up to 50% of long-term patients and causing significant pain, reduced quality of life, and healthcare burden. Conventional treatments, including anticonvulsants, antidepressants, and opioids, offer limited efficacy and are associated with adverse effects. Emerging evidence suggests that cannabis, acting via the endocannabinoid system, may provide analgesic and neuroprotective benefits. This study evaluates the long-term effects of inhaled cannabis as adjunctive therapy for refractory painful DN. Inhaled cannabis exhibits rapid onset pharmacokinetics (within minutes, lasting 2–4 h) due to pulmonary absorption, targeting CB1 and CB2 receptors to modulate pain and inflammation. Methods: In this prospective, observational study, 52 patients with confirmed painful DN, unresponsive to at least three prior analgesics plus non-pharmacological interventions, were recruited from a single clinic. Following a 1-month washout, patients initiated inhaled medical-grade cannabis (20% THC, <1% CBD), titrated individually. Assessments occurred at baseline and annually for 5 years, including the Brief Pain Inventory (BPI) for pain severity and interference; the degree of pain relief; Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) score; HbA1c; and medication usage. Statistical analyses used repeated-measures ANOVA, Kruskal–Wallis tests, Welch’s t-tests, and Pearson’s correlations via Analyze-it for Excel. Results: Of 52 patients (mean age 45.3 ± 17.8 years; 71.2% male; diabetes duration 23.3 ± 17.8 years), 50 completed follow-up visits. Significant reductions occurred in BPI pain severity (9.0 ± 0.8 to 2.0 ± 0.7, p < 0.001), interference (7.5 ± 1.7 to 2.2 ± 0.9, p < 0.001), LANSS score (19.4 ± 3.8 to 10.2 ± 6.4, p < 0.001), and HbA1c (9.77% ± 1.50 to 7.79% ± 1.51, p < 0.001). Analgesic use decreased markedly (e.g., morphine equivalents: 66.8 ± 49.2 mg to 4.5 ± 9.6 mg). Cannabis dose correlated positively with pain relief (r = 0.74, p < 0.001) and negatively with narcotic use (r = −0.43, p < 0.001) and pain interference (r = −0.43, p < 0.001). No serious adverse events were reported; mild side effects (e.g., dry mouth or euphoria) occurred in 15.4% of patients. Conclusions: Inhaled cannabis showed sustained pain relief, improved glycemic control, and opioid-sparing effects in refractory DN over 5 years, with a favorable safety profile. These findings are associative due to the observational design, and randomized controlled trials (RCTs) are needed to confirm efficacy and determine optimal usage, addressing limitations such as single-center bias and small sample size (n = 52). Future studies incorporating biomarker analysis (e.g., endocannabinoid levels) could elucidate mechanisms and enhance precision in cannabis therapy. Full article

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by amyloid-β (Aβ) accumulation, synaptic dysfunction, and cognitive decline. Current pharmacological treatments provide only symptomatic relief without altering disease progression. Photobiomodulation therapy (PBMT), a light-based intervention, has shown neuroprotective potential, although its exact neurobiological mechanisms in AD pathogenesis remain obscure. In this study, we investigated the effects of PBMT using a 660 nm wavelength light-emitting diode (LED) in 5xFAD transgenic mouse, a well-established model of early-onset AD. Mice were subjected to once daily PBMT sessions over a defined treatment period and outcomes were assessed through immunohistochemical analysis of hippocampal regions (CA1, CA2, CA3, and dentate gyrus) alongside behavioral testing using the Y-maze spontaneous alternation task. PBMT significantly reduced Aβ plaque load across hippocampal regions, accompanied by improved preservation of neuronal morphology. Furthermore, PBMT significantly upregulated SIRT1 expression, a critical regulator of synaptic plasticity and memory processes. Behaviorally, PBMT-treated mice displayed enhanced spatial working memory compared with controls, indicating a functional benefit linked to the observed molecular and structural changes. These findings suggest that 660 nm PBMT attenuates hallmark AD pathology, promotes neuroprotective pathways, and improves cognition, highlighting its potential as a disease-modifying therapy that warrants further preclinical and clinical investigation. Full article

As global climate change intensifies the frequency of extreme weather events, urban flood control and disaster reduction efforts face unprecedented challenges. With the limitations of traditional, top-down emergency management becoming increasingly apparent, many countries are actively incorporating community-based participation into flood risk governance. While research in this area is expanding, the specific impact of urban flood inundation severity on residents’ participation in relief efforts remains significantly underexplored. To address this research gap, this study employs the Community Capitals Framework (CCF) and a Gradient Boosting Decision Tree (GBDT) model to empirically analyze 1322 survey responses from Zhengzhou, China, exploring the non-linear relationship between flood severity and public participation. Our findings are threefold: (1) As the most direct source of residents’ risk perception, flood inundation severity has a significant association with their participation level. (2) This relationship is distinctly non-linear. For instance, inundation severity within a 200 m radius of a resident’s home shows a predominantly negative relation with participation level, with the negative effect lessening at extreme levels of inundation. The distance from inundated areas, conversely, exhibits an “S-shaped” curve. (3) Flood severity exhibits a significant reinforcement interaction with both communication technology levels and government organizational mobilization. This indicates that, during public crises like flash floods, robust information channels and effective organizational support are positively related to residents’ transition from passive to active participation. This study reveals the complex, non-linear associations between flood severity and civic engagement, providing theoretical support and practical insights for optimizing disaster policies and enhancing community resilience within the broader context of urban land management and sustainable development. Full article

Background: Shoulder subluxation and pain are common complications of stroke that impair upper limb function. Objectives: This study conducted a systematic review and network meta-analysis to compare multiple therapeutic interventions for post-stroke shoulder subluxation, establishing an evidence-based hierarchy of treatment efficacy to optimize rehabilitation strategies and guide clinical practice. Methods: A comprehensive search was conducted using the MEDLINE, EMBASE, Cochrane, Scopus, and Web of Science databases until 8 August 2025. Randomized controlled trials evaluating treatments for shoulder subluxation, including neuromuscular electrical stimulation (NMES), Kinesio taping, corticosteroid injections, slings, repetitive peripheral magnetic stimulation, and electroacupuncture, were included. The follow-up duration in the included trials ranged from 1 to 12 weeks. Effect sizes were calculated using standardized mean differences with a random-effects model, and treatment rankings were determined using surface under the cumulative ranking curve (SUCRA). Results: Thirteen studies including 402 patients were analyzed. NMES was the most effective intervention for reducing subluxation distance (SUCRA: 84.9), while corticosteroid injections provided the greatest pain relief at rest (SUCRA: 73.6). Kinesio taping was most effective for functional recovery, as measured by the Fugl–Meyer Assessment (SUCRA: 98.5), and for pain relief during activity (SUCRA: 87.7). Conclusions: Our network meta-analysis suggests that different interventions are optimal for specific aspects of post-stroke shoulder impairment. NMES most effectively reduces subluxation distance, whereas corticosteroid injections are most effective for alleviating pain at rest. Kinesio taping appears superior for enhancing functional recovery and reducing pain during movement. These findings, based on short-term follow-up durations (1–12 weeks), provide an evidence-based ranking of interventions to support multimodal rehabilitation and inform clinical decision-making. The observed heterogeneity across studies underscores the need for standardized treatment protocols and rigorous long-term investigations. Full article

High-resolution pushbroom satellites routinely acquire multi-tenskilometer-scale strips whose vendors’ rational polynomial coefficients (RPCs) exhibit systematic, direction-dependent biases that accumulate downstream when ground control is sparse. This study presents a physically interpretable stripwise extrapolation framework that predicts along- and across-track RPC correlation coefficients for inaccessible segments from an upstream calibration subset. Terrain-independent RPCs were regenerated and residual image-space errors were modeled with weighted least squares using elapsed time, off-nadir evolution, and morphometric descriptors of the target terrain. Gaussian kernel weights favor calibration scenes with a Jarque–Bera-indexed relief similar to the target. When applied to three KOMPSAT-3A panchromatic strips, the approach preserves native scene geometry while transporting calibrated coefficients downstream, reducing positional errors in two strips to <2.8 pixels (~2.0 m at 0.710 m Ground Sample Distance, GSD). The first strip with a stronger attitude drift retains 4.589 pixel along-track errors, indicating the need for wider predictor coverage under aggressive maneuvers. The results clarify the directional error structure with a near-constant across-track bias and low-frequency along-track drift and show that a compact predictor set can stabilize extrapolation without full-block adjustment or dense tie networks. This provides a GCP-efficient alternative to full-block adjustment and enables accurate georeferencing in controlled environments. Full article

Biliary tract cancers include cholangiocarcinoma, gallbladder cancer, and ampullary cancer. Although overall rare, the incidence is increasing globally, particularly the subset of intrahepatic cholangiocarcinoma. Surgery is currently considered to be the only curative treatment approach; however, survival outcomes after surgery remain poor. Moreover, many patients already have advanced-stage, unresectable disease at the time of diagnosis. Herein, we will review the role of adjuvant radiotherapy to improve local control after surgery, the role of neoadjuvant radiotherapy to increase the proportion of patients able to undergo surgery, and the use of definitive/palliative radiotherapy to provide local control/symptom relief for patients who have inoperable disease. Most studies observed a survival benefit associated with radiotherapy, with the strongest evidence for those with high-risk disease features (e.g., positive surgical margins, lymph node involvement). However, due to the low incidence of biliary tract cancers, most existing studies are retrospective; there is very limited randomized data and prospective studies tend to have small sample sizes, underscoring the need for more high-quality research on radiotherapy for biliary tract cancers. As some studies show evidence of a dose-dependent response, further investigation into the delivery of dose-escalated radiotherapy with modern techniques such as proton therapy is warranted. Full article

Background: Deficient mismatch repair rectal cancer represents approximately 10% of rectal malignancies and demonstrates exceptional responsiveness to immune checkpoint inhibitors, achieving unprecedented complete response rates approaching 100%. This creates a novel clinical dilemma: should patients achieving complete response undergo standard surgical resection or pursue organ preservation through watch-and-wait management? Methods: We conducted a comprehensive literature review of clinical trials and retrospective studies published through 2025, focusing on response assessment strategies, decision-making frameworks, oncological outcomes, and quality of life assessments. Results: Landmark studies demonstrated remarkable efficacy with dostarlimab achieving 100% clinical complete response, while surgical cohorts achieved 68–92% pathological complete response rates. Response assessment challenges included pseudoprogression and pseudoresidue phenomena that complicated conventional imaging interpretation and required specialised multimodal evaluation protocols. Comparative analyses suggest equivalent oncological outcomes between surgical and non-surgical approaches in complete responders, achieving 100% disease-free survival at 2–3 years across multiple studies. The watch-and-wait approach offered significant advantages by preserving organ integrity and avoiding surgical morbidity, including permanent colostomy (15.4%) and perioperative complications (19.3%). Conversely, surgical management provided distinct benefits through definitive tissue confirmation and anxiety relief from intensive surveillance requirements and potential recurrence concerns. Conclusions: The surgery versus watch-and-wait dilemma represents a choice between equally effective oncological approaches with different quality of life implications. Evidence supports individualised decision-making weighing functional preservation benefits against patient preferences and institutional capabilities in this evolving therapeutic landscape. Full article