Modeling policy decisions to mitigate the risk of emerging arboviral diseases under ecological changes in Uganda: Proposing a one Health in all policies approach.

Low back pain is a common pathology in the general population. In people over 60 years of age, it is associated with degenerative changes that cause narrowing of the vertebral canal. Its treatment includes conservative measures and even surgery with decompression and fusion. In those patients with moderate symptoms, the use of interspinous spacers emerged as a minimally invasive therapeutic option. This scoping review seeks to map the existing literature on the use of interspinous spacers and identify knowledge gaps to clarify their real position in the stepwise approach to low back pain. This study as a scoping review, conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR guidelines. The type of synthesis chosen was descriptive and mapping-based, allowing for the inclusion of diverse study designs (randomized controlled trials, observational studies, case series, clinical guidelines, and relevant reviews) to capture a comprehensive overview of the field. This approach was selected because the existing literature is heterogeneous in terms of intervention protocols, clinical outcomes, and follow-up duration, and the effectiveness and indications for interspinous spacers (ISD) remain controversial. The search was extended from the inception of the databases until November 2025. The program "Rayyan" was used to collect the information and facilitate the analysis process. Each of the authors independently reviewed the summary of all the articles found and applied the following inclusion criteria: systematic review, clinical trials, observational studies, and case series. articles in cadavers or made in the laboratory. A total of 522 articles were found in the databases consulted, of which 95 duplicate articles were eliminated. The criteria (Inclusion/Exclusion) were applied to the 427 identified articles based on the independent reading of the abstracts by each of the authors in the Rayyan platform, and 110 articles were excluded. The 317 selected articles were reviewed completely by each of the authors to finally obtain 101 articles included in the review. The use of ISD in the treatment of moderate LSS may be controversial. Although the clinical results seem conclusive about the usefulness in controlling symptoms, more studies are needed to compare these technologies with new surgical procedures and especially new biomechanical concepts. The efforts made to treat patients with moderate LSS appropriately should continue to be channeled into optimizing techniques.

Tracking important site safeguard through different approaches to measuring the indicator of protected area coverage of Key Biodiversity Areas

Policy blind spots in forest conservation implementation: The overlooked value of primary forests

The effect of soil conservation measures on the sorting characteristics and transport mechanism of eroded sediment on spoil tips

Elucidating the spatial-temporal characteristics and influencing factors of migration activities is the basis for understanding the life cycle of migratory birds and for making conservation measures. Short-distance migratory birds experience less timing pressure during migration; they tend to migrate under suitable environmental conditions and thus the migration decision might be strongly influenced by external environmental conditions. To test this hypothesis, we deployed GPS tags on Far Eastern Oystercatchers ( Haematopus ostralegus osculans ) in the northern Yellow Sea and tracked their annual migration. The tagged oystercatchers, including five adults and seven immatures (second/third-year birds), mainly wintered along the west coast of the Yellow Sea and bred inland in northeastern China. The migration distance between breeding and wintering sites was 1640.7 ± 260.4 km in spring and 1668.7 ± 306.1 km in autumn. Compared with adults, immatures departed from the wintering sites and arrived at the breeding sites later, while there were no significant differences between adults and immatures in the dates of departure from breeding sites and arrival at wintering sites. Migration initiation generally occurred around sunset. Wind conditions consistently provided tailwinds on departure days from wintering, breeding, and stopover sites during both seasons, with wind assistance exceeding the 5- or 10-day pre-departure average. During autumn migration, the temperature on departure days at stopover sites was lower than the mean temperature over the preceding 5 or 10 days. The Yalu Jiang estuary was the main stopover site during both spring and autumn migrations. The stopover duration in autumn (adults: 118.3 ± 8.4 days; immatures: 130.4 ± 5.1 days) was the longest among the studied shorebirds, likely due to moulting of flight feathers at the stopover site. Our results indicate that the migratory decisions of oystercatchers are strongly influenced by wind conditions during the whole annual cycle, whereas they are also affected by temperature when departing from stopover sites in autumn. The extended stopover at the Yalu Jiang estuary in autumn highlights its importance for the species.

Energy management and optimal control of a multifarious water heating systems with waste heat recovery and a solar-assisted heat pump: A case of large-capacity healthcare building

Soil erosion and sediment export under rainfed agriculture dominated landscapes: Model-based evidence from the Didessa watershed, southwestern Ethiopia

The expansion and intensification of agriculture are widely recognized as major drivers of biodiversity loss. While research has primarily focused on deforestation frontiers, few studies have linked spatial-temporal land-cover dynamics to the organizational arrangements of agro-industrial supply chains. This study addresses this gap by analyzing land-use systems in the Upper Parana Atlantic Forest in Argentina, a priority biodiversity hotspot. We identify trends and patterns of agricultural and forest land-use change over the past two decades. We interpret these patterns in relation to the territorial integration of agro-industrial supply chains, using secondary data sources. We divided the study area into hexagonal cells of approximately 100 km². Interannual trends in native forest cover and dominant land uses were analyzed from 2000 to 2019. Trends were estimated by regressing the proportional area of land-cover classes derived from the MapBiomas Trinational Atlantic Forest against calendar year. To explore landscape homogenization, we regressed Shannon land-cover diversity indices over time. Our results reveal two contrasting spatial configurations. Some landscapes are dominated by a single land use, showing increasing homogenization. Others maintain a diversity of land uses and remain heterogeneous. These configurations seem closely associated with transaction modalities between primary producers and agro-industrial actors. In turn, these arrangements influence their impacts on native forest cover and habitat conservation outside protected areas. Understanding how agro-industrial supply chains are territorially embedded is critical for identifying incentives to foster more sustainable land-use trajectories and support biodiversity conservation, like the design of effective governance systems for Other Effective Area-Based Conservation Measures (OECMs).

Adaptive genomic divergence parallels migratory behavior in Atlantic bluefin tuna.

Acute kidney injury (AKI) affects up to 50% of critically ill patients, with mortality rates exceeding 40% in severe cases. Kidney replacement therapy (KRT) is a cornerstone in the management of severe AKI, yet the optimal timing for initiation and discontinuation remains uncertain. The debate between "early" initiation-guided by kidney injury biomarkers, trends in creatinine or urine output, and positive fluid balance-and "delayed" initiation-triggered by life-threatening complications-has been shaped by recent randomized controlled trials and meta-analyses, yet still lacks clearly defined parameters to guide clinical decision-making. Current evidence favors an individualized strategy that integrates AKI etiology and trajectory, comorbidities, clinical status, and response to conservative measures, aiming to prevent complications while maximizing renal recovery. Criteria for stopping KRT are less standardized and mostly derived from observational studies. Predictors of successful discontinuation include urine output >400 mL/day without diuretics or >2000mL/day with diuretics, creatinine clearance ≥15 mL/min and low biomarker levels. Combining at least two of these parameters, alongside clinical stability, increases the likelihood of sustained renal recovery. Determining the optimal timing for KRT initiation and discontinuation in AKI is a dynamic process requiring integration of clinical, biochemical, and functional data, and close multidisciplinary collaboration. This review synthesizes the best available evidence and proposes a practical, evidence-informed algorithm combining functional tests, biomarkers, and clinical criteria to guide nephrologists in optimizing KRT timing, with potential to improve outcomes and resource utilization.

Red lists provide critical knowledge regarding biodiversity decline, especially in Finland, where broad assessments have been made regularly since the 1980s. They deliver information on the threat status of species and ecosystems, propose actions to guide conservation policy, and have the potential to spur transformative change. We examined whether the transformative potential of the proposals has changed over time. We analyzed the contents qualitatively and quantitatively of seven Finnish Red Lists of Species or Ecosystems from 1986 to 2019. We used a prior analysis of transformative potential of conservation actions in the Conservation Measures Partnership classification (such as outreach or conservation designation and planning), which identified Meadows' sustainability leverage points (i.e., in complex systems, a point at which a small change can lead to large changes) associated with each action category. We also determined the number of proposals that overlapped with sectors beyond conservation. We used a nonparametric Mann-Kendall trend test and linear models to analyze temporal trends in the data. Cross-sectoral proposals increased over time, but there was only a small shift toward actions that influenced the root causes of biodiversity loss (i.e., deep leverage actions). In the qualitative assessment of how the actions were proposed to be implemented, actions became more complex and effectiveness of implementation increased, demonstrating a change within conservation action categories toward deeper leverage points. This increasing transformative potential can be a catalyst and a consequence of broader societal change driven by ongoing biodiversity loss. Red lists could play a role in transformative change, but the engagement of actors across society in devising action proposals must be inclusive and cover expertise from the social sciences and humanities. Our results emphasize the importance of considering complementary dimensions of transformative change simultaneously to achieve a comprehensive understanding of viable paths to societal change.

This paper presents new regional chorological data for eighteen plant taxa, derived from our own collections and personal field observations during the vegetation seasons from 2015 to 2025. One of the recorded species - Viola hymettia, is new to the Bulgarian flora. The remaining records document new occurrences of these taxa within different floristic regions of the country. Four of the listed taxa are protected under Bulgaria’s Biological Diversity Act and are categorised as threatened in the national Red List: Geranium palustre (VU), Gagea amblyopetala (VU), Romulea linaresii subsp. graeca (VU), and Parvotrisetum myrianthum (CR). Populations of Dipsacus gmelinii consist of critically low numbers of individuals and require urgent conservation measures. Additional information is provided on the habitats at the recorded sites, the state of the populations, the floristic composition, and relevant herbarium records.

Editorial Commentary: Refractory Osteitis Pubis Appears to Respond Favorably to Endoscopic Pubic Symphysectomy.

Abstract Spasticity is a common manifestation of upper motor neuron syndrome due to central nervous system dysfunction and occurs in conditions such as traumatic brain injury, spinal cord injury, cerebral palsy and stroke. Excessive spasticity can interfere with posture, mobility and activities of daily living, requiring intervention. The first-line management typically includes physiotherapy, oral antispastic medications and botulinum toxin injections; however, surgical neurotomy remains a valuable option for localised spasticity unresponsive to conservative measures. We report the case of a 40-year-old male with post-traumatic paraplegia following a D12 compression fracture who developed equinus deformity due to poor adherence to home rehabilitation. Despite tendo-Achilles Z-plasty, he developed intractable right ankle clonus. He underwent selective tibial neurotomy combined with bilateral Baker’s procedure, resulting in the resolution of clonus and improved ankle mobility. Post-operative follow-up at 3 and 6 months demonstrated sustained functional improvement, enabling independent ambulation with walker support and no recurrence of clonus. Selective neurotomy should be considered in patients with refractory focal spasticity after failure of conservative therapies, providing durable functional improvement and enhancing the quality of life.

Abstract. Soil erosion is a major problem, which has had adverse effects on the productivity of agriculture, the quality of water, and the sustainability of land in the long term, especially in semi-arid states of southern India. This paper examines the spatial and intensity of soil erosion in the Chitar River Basin, Tamil Nadu, through the usage of the Revised Universal Soil Loss Equation (RUSLE), the Geographic Information System (GIS) techniques and remote-sensing techniques. RUSLE components, such as rainfall erosivity (R), soil erodibility (K), slope length and steepness (LS), cover management (C), and support practices (P), were calculated based on the Indian Meteorological Department rainfall data, FAO soil data, a digital elevation model and Landsat-based land-use/land-cover data. Annual soil loss deposition ranges from negligible to over 100 t/ha/yr, confirming the basin's high spatial variability. Findings indicate that most of the basin is very low to minimal erosion (0–10 t ha⁻¹ yr⁻¹), and moderate erosion (10–25 t ha⁻¹ yr⁻¹) occurs sporadically. Spatial areas are limited to high and very severe erosion zones (25-100 t ha⁻¹ yr⁻¹) and extreme erosion areas (100 t ha⁻¹ yr⁻¹), which are mainly found in steep slopes, upper catchments and drainage networks, where high values of R, LS and C are also accompanied by relative high values of P-factor. These focal areas of erosion are a disproportionate contributor to sediment yield and thus require immediate Erosion conservation measures, including contour bunding, terraces, afforestation, and check dams. The study revealed that the RUSLE and GIS method is a highly effective instrument of defining erosion susceptible areas and the basis of managing the watersheds on a sustainable and targeted basis in the Chitar River Basin.

This article presents the first published results on the spatial ecology of Golden Eagles (Aquila chrysaetos) in Central Asia, using GPS/GSM telemetry. Movements of three juvenile Golden Eagles were followed. The eaglets were tagged in the nest, two in Russia (2018, 2023), and one in Kazakhstan (2024). The duration of the post-fledging dependence period (PFDP) varies from 89 to 124 days, averaging 109±18 days. The home range sizes of eagles during the PFDP, calculated as 100% MCP, varied from 2.67 to 1177.56 km² (averaging 642.16±594.32 km²). Daily flight activity averaged 1.64±1.17 h (based on the most detailed track), corresponding to 13.4±10.34% of the total daylight hours. The average flight altitude of the birds varied from 79.19±44.33 m to 217.41±102.55 m, depending on the season and landscape, and was highest during migration. The natal dispersal process and transition to a territorial lifestyle in the tracked female culminated in a nesting attempt at age three. The data obtained are important for understanding the ontogenesis of eagle behavior and developing scientifically based conservation measures for the species, particularly in the context of wind energy development and other anthropogenic threats.

Postburn facial scars represent a major reconstructive challenge due to the functional and aesthetic importance of the face. The preexpanded occipitocervicopectoral (OCP) flap provides thin, color-matched tissue suitable for facial resurfacing. This study aimed to evaluate the versatility and outcomes of unilateral and bilateral preexpanded OCP flaps in postburn facial reconstruction. A prospective study was conducted between May 2021 and May 2023, including 26 patients with postburn facial scars who underwent resurfacing using unilateral or bilateral preexpanded OCP flaps. Tissue expanders were placed beneath the planned flap and progressively inflated before the flap was transferred. A novel flap design, termed the "COVID" or "bat" flap, was developed and derived from bilateral expanded OCP flaps, enabling simultaneous bilateral facial reconstruction after division along the midline. Demographic, clinical, and surgical data were collected, and patient-reported outcomes were assessed using the FACE-Q questionnaire before and after surgery. Twenty-nine preexpanded OCP flaps were transferred in 26 patients (17 males, 9 females; mean age, 14years). The mean expander volume was 393mL, and the mean flap dimensions were 12×8cm. No total flap loss occurred. Distal necrosis developed in 5 flaps (17%), all located at or above the zygomatic arch, and was managed successfully with conservative measures or skin grafting. FACE-Q analysis demonstrated significant postoperative improvement across all domains ( P <0.001), except for "appraisal of neck." Subgroup analysis revealed no significant difference in FACE-Q improvement between patients with and without distal flap necrosis. The preexpanded OCP flap provides a reliable and aesthetically favorable option for postburn facial resurfacing, offering color-matched, thin tissue coverage with minimal donor-site morbidity. The bilaterally preexpanded "COVID" modification further enhances its versatility for simultaneous reconstruction of both cheeks and the upper neck.

Outcomes following arthroscopic rotator cuff repair adversely affected by underlying diagnosis of glenohumeral osteoarthritis: a matched cohort analysis.

Upper extremity lymphedema occurs in 40% of patients following breast cancer treatments. In contrast, truncal lymphedema, a common complication of breast cancer treatment, is less understood and underreported. This study has 2 aims: (1) map lymphatic patterns of patients with truncal lymphedema and (2) describe our approach for the application of lymphovenous anastomosis (LVA) for truncal lymphedema and demonstrate the technical feasibility and potential clinical benefit. We retrospectively reviewed 95 patients (173 hemitrunks) following breast cancer treatment who underwent truncal ICG lymphography over 9 years. In 2 cases where conservative measures failed to provide relief, patients were treated with LVA placed inferior to the inframammary fold, directed by lymphographic findings. Dermal backflow was significantly worse in the superior trunk, above the inframammary fold (P < 0.001). Diffuse or absent superficial lymphatic channels were observed in 84% of mastectomy skin flaps. Lymphatic drainage was visualized to the ipsilateral axilla (40%), ipsilateral groin (66%), and contralateral trunk (26%). LVA can be used for surgical treatment of truncal lymphedema when conservative measures are insufficient. Patients treated in our practice had complete relief of symptoms by 12 months with reduced conservative management use, Lymphedema Life Impact Score, and number of infections per year. This work demonstrate that detailed lymphatic mapping enables targeted LVA planning and may offer an effective surgical option for managing breast cancer-related truncal lymphedema.