Exploring pathway scenarios for future urban water resilience using systems approach coupled with an agent-based model operated on synthetic social-policy networks.

Revision total hip arthroplasty (THA) in the presence of severe acetabular bone loss remains technically demanding. Oversized, highly porous acetabular components ("Mega Cups") have been introduced to maximize host bone contact, enhance biological fixation, and restore the anatomical hip center. A retrospective study was conducted between 2014 and 2022, including 34 hips reconstructed with highly porous Mega Cups for Paprosky type II and selected type III defects. Clinical outcomes (Harris Hip Score [HHS], WOMAC, pain VAS), radiographic stability, complications, and implant survivorship were analyzed at mid-term follow-up. At a mean follow-up of 5.3 years, Mega Cups demonstrated 95.5% survivorship. Radiographic stability was achieved in 90.9% of hips, with graft incorporation observed in 88.9%. Functional recovery was substantial: HHS improved by +34.4 points, WOMAC decreased by -37.8, and pain VAS declined by -4.8 (all p < 0.001 vs.baseline). Subgroup analysis confirmed excellent outcomes in Paprosky II defects and in patients aged 40-65 years. Complication rates were low, with dislocation (2.9%), mechanical failure (2.9%), superficial infection (8.6%), and thromboembolism (2.9%) within published benchmarks. Highly porous oversized acetabular cups provide reliable fixation, durable mid term survivorship, and superior functional improvement in revision THA for Paprosky II and selected III defects. Their ability to maximize host bone contact and reduce reliance on grafts makes them a dependable option in complex acetabular reconstructions. Longer multicenter studies are warranted to validate durability beyond 10 years and to benchmark outcomes against alternative strategies.

To describe the outcomes of patellar ligament (PL) reconstruction with an ultra-high-molecular-weight polyethylene (UHMWPE) implant secured with an interference screw in dogs. Medical records from 7 referral centers were reviewed for dogs treated for PL rupture between 2021 and 2025. Cases treated exclusively with UHMWPE implants with a minimum follow-up of 6 months were included. Dogs presented with lameness and examination findings consistent with PL rupture, confirmed by radiography in all cases. The data collected included diagnostic test findings, surgical technique, complications, follow-up, and outcomes. Canine Brief Pain Inventory scores were obtained at the final follow-up. Radiographic measurements were used to assess the patellar ligament length-to-patellar length ratio in operated and contralateral limbs over time. 10 stifles from 9 dogs met the inclusion criteria. Median follow-up was 18 months (range, 1.5 to 3.8 years). No major complications were recorded. The patellar ligament length-to-patellar length ratio decreased after surgery. Return to activity was reported between 2 and 6 months postoperatively. Full function was recovered in 7 dogs; 2 dogs showed mild lameness beyond mid term. Canine Brief Pain Inventory scores in 8 dogs had a median of 4/100 (range, 0 to 26). The UHMWPE implant provided effective repair without major complications in all 10 cases and resulted in acceptable to full functional outcomes in 9 dogs. The observed outcomes suggested that this technique could minimize the need for postoperative immobilization and may be associated with a low complication rate.

Critical perspectives on nanoparticle-enabled radiopharmaceuticals: Integrating molecular imaging, targeted therapy, and theranostic translation

A0028 SUSTeR study: Sub-Urethral Sling Treatment Removal, a retrospective multicentric cohort about mid and long term mid-urethral sling complications between 2010-2024: Symptomatic recovery is it possible?

The increasing complexity and variability of electricity consumption in modern power systems have highlighted the need for intelligent, real-time forecasting solutions to ensure reliable, cost-efficient, and sustainable grid oper ations. This research presents Smart Cast, an AI-driven load forecasting frame work that integrates Long Short-Term Memory (LSTM) networks with Gradient Boosting models to capture both nonlinear temporal patterns and external influ encing factors such as weather dynamics. The system leverages historical smart meter data along with real-time sensor inputs to generate accurate short- and mid term demand predictions. In addition, Smart Cast incorporates anomaly detection techniques to proactively identify irregular consumption behaviors that may in dicate faults, energy theft, or operational inefficiencies. Outputs are delivered through an interactive web dashboard, enabling utility operators and industrial consumers to visualize demand behavior and receive cost-aware recommenda tions for optimized energy usage. By enhancing grid planning, reducing opera tional risks, and increasing renewable integration potential, Smart Cast presents a scalable and practical solution to advancing smart-grid intelligence and overall energy sustainability.

ABSTRACT Climate change has a significant impact on global hydrological processes and water resource availability. Compared to global challenges, the Olifants Basin (ORB) also faces pronounced effects of climate change on its water resources. This study aims to investigate the impact of climate change on the hydrological water balance components under RCP and SSP scenarios using the SWAT+ model. The model's sensitive parameters were identified, and its calibration (NSE, R2, and PBIAS = 0.76, 0.78, and 5.76, respectively) and validation (0.77, 0.82, and 12.22, respectively) were conducted and showed satisfactory performance. 6Moreover, under the SSP245, water yield and surface runoff are projected to decline by 44.02%, 44.16%, 51.2%, and 51.35% in mid‐term (2030–2060) and long‐term (2070–2100), respectively. Similar decreasing water yield and surface runoff patterns were observed in the mid and long term under SSP585, with reductions of 60.8%, 61.75%, 59.03%, and 58.98%, respectively. Declining water yield and runoff patterns were observed in the mid and long term under SSP and RCP scenarios. Specifically, under RCP4.5 and RCP8.5, surface runoff is projected to decrease by 50.89% and 47.52%, respectively, and by 46.94% and 68.28% in the long term. In general, projections under RCP scenarios indicate a decline in water yields across all future periods, with a more pronounced decline under high‐emission scenarios, reaching 66.94% in the far future. Therefore, climate adaptation strategies, climate‐resilient agricultural practices, integrated watershed management, and enhanced water use efficiency are necessary to safeguard sustainable water resource availability.

High quality comparative studies on treatments of the small saphenous vein (SSV) are lacking. Therefore, the primary aim of this study was to evaluate anatomic success across different SSV treatment modalities at short, mid, and long term follow up using a network meta-analysis (NMA) and pooled results from a meta-analysis. MEDLINE and Embase. Cohort studies (prospective and retrospective) and randomised controlled trials (RCTs) were included. Studies reported on the primary outcome of anatomic success (occlusion, absence of reflux) for all thermal, non-thermal, and surgical SSV treatment modalities. Secondary outcomes included complications, peri-procedural pain, time to return to daily activities or work, Venous Clinical Severity Score, and quality of life. Anatomic success was assessed at short term (up to and including three months), midterm (three months to one year), and long term (more than one year) follow up. A risk of bias and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evaluation were done. Sixty eight articles were included (28 retrospective studies, 26 prospective studies, four RCTs, and nine studies of unknown design), comprising a total of 6 793 limbs at baseline. The NMA ranked endovenous laser ablation (EVLA) as superior treatment at short term follow up, and radiofrequency ablation (RFA) at midterm follow up. Data were insufficient to perform a NMA for long term outcomes. The meta-analysis reported the highest anatomic success rates for RFA at short term follow up (98.4%) and for EVLA at both mid and long term follow up (96.1% and 94.3%, respectively). Of the secondary outcomes, only major complications could be pooled. Deep venous thrombosis was found in 0.2% of all patients and nerve injury in 3.0%. Although risk of bias in the NMA was low, most network estimates were of low or very low GRADE quality. The limited number of high quality comparative studies on the SSV complicates ranking treatments based on anatomic success. However, RFA and EVLA showed the highest anatomic success.

Preliminary results of arthroscopic shelf acetabuloplasty in the treatment of mild and borderline dysplasia combined with cam-type femoroacetabular impingement in hips with microinstability.

In this multicentre observational retrospective study, bimekizumab demonstrated high effectiveness, together with a good safety profile, over a period of 78 weeks. The presence of psoriatic arthritis, obesity and longer disease duration seemed to influence response to treatment negatively in the mid term (24 weeks), while previous biologic exposure affected clinical outcomes in the long term (52 weeks).

Patella dislocation is among the most common knee pathologies in the young population. The anatomical structure getting injured in these cases is the medial patellofemoral ligament (MPFL), leading to patella instability. This study aims to evaluate the medium to long-term clinical results of our double-bundle technique for isolated MPFL reconstruction with hamstring autograft, mainly focusing on the incidence of subsequent patellofemoral arthritis. A retrospective analysis of 35 patients (39 patellae) with patella instability treated with isolated MPFL reconstruction surgery by the same orthopaedic surgeon between 2010 and 2020 was conducted. Patients were assessed using the following PROMs: IKDC, Lysholm, Kujala and Modified Cincinnati, both pre and postoperatively. Additionally, the development of posttraumatic patellofemoral arthritis based on the Iwano classification was assessed by evaluating X-rays performed before surgery and at the final follow-up. The mean patients' age at the time of the first dislocation was 16.1 years (range, 10-21 years), and the mean age at the time of surgery was 20.3 years (range, 18-26). Females were 56,2% of the patients, and 43.8% were males; 75% of the injuries occurred during sport activities, while the rest after a direct hit. The mean follow-up was 7.3 years (5-13). All scores demonstrated significant melioration postoperatively. At the final follow-up, the IKDC score increased from 49.2 to 84.5, Lysholm from 53 to 88.2, Kujala from 61 to 88.5, and modified Cincinnati from 49.2 to 83.6. No immediate postoperative complication was reported, and no redislocation was recorded. Radiological evaluation indicated only mild signs of patellofemoral arthritis in eight patients (20%). The double-bundle technique for MPFL reconstruction with hamstring autograft is a safe and reliable option for treating patella dislocation in patients with low-grade trochlear dysplasia. It provides satisfactory outcomes without remarkable arthritic changes at a mid term follow-up. Level III.

BackgroundImprovements in medical standards have allowed critically ill patients to benefit from liver transplantation, but defining futility arbitrarily according to one single-stage outcome could deprive patients of the potential benefits of transplantation. This study aimed to redefine futile liver transplantation by multiterm outcomes and develop a novel scoring system to predict futile liver transplantation.MethodsThis retrospective study in China enrolled patients who had liver transplantation from 3 centres between January 2015 and April 2021. Independent risk factors were identified by logistic regression analysis and used to establish risk prediction models. Kaplan–Meier survival curves were calculated to explore the association between futile score and overall survival.ResultsOf 1408 patients undergoing liver transplantation, patients at persistent high risk for mortality in the short term (3 months), mid term (1 year), and long term (3 years) were defined as the truly futile liver transplantation group. Higher donor and recipient age, hepatorenal syndrome, intensive care unit stay, need for mechanical ventilator, ABO blood group incompatibility, prolonged cold ischaemia time, increased alanine aminotransferase levels, and decreased albumin levels were independent risk factors for futility, and were used to construct a futile scoring system. The scoring system had good predictive capability, with an area under the receiver operating characteristic curve of 0.921, better than that of a previously established scoring system. Survival analysis showed that the group with a high futile risk had decreased survival.ConclusionThis study has redefined futile liver transplantation and established a novel futile scoring system. This can be used to optimize the allocation of medical resources, especially with regard to recipient selection for liver transplantation, and increase survival prediction for selected patients.

Background Venous-Origin Chronic Pelvic Pain (VO-CPP), a subgroup of Pelvic Venous Disorders (PeVD) can significantly affect Quality of Life (QoL). Previous papers have highlighted the lack of evaluations measuring QoL of patients before and after embolization. The aim of this study was to evaluate the effectiveness of embolization in reducing a variety of symptoms and improving QoL in patients with VO-CPP. Methods A prospective analysis of 40 female patients (mean 36.9 years) diagnosed with VO-CPP, undergoing venous embolization between June 2020 and May 2023 was conducted. Patients with extrinsic compressions, other pelvic conditions, and S3V3 without S2 in SVP Classification were excluded. Patients were evaluated before and after treatment at mid-term (MT) (9.4 ± 5.1 months) and long-term (LT) (29.6 ± 6.94 months). The severity of 12 different symptoms were assessed using VAS scale (pelvic, postcoital, standing, back, hip, leg and abdominal pain; nausea frequency, urinary discomfort, sleep disturbance and dysmenorrhoea), while QoL was measured using the SF-36 questionnaire. Patient satisfaction was assessed using the Likert scale. Results Significant reductions in all measured symptoms were observed between pre-treatment and MT and LT follow-ups (p < 0.0001). No statistically significant differences were found between MT and LT scores, indicating a sustained relief. The greatest benefits were observed in reducing daytime pelvic pain (6.25 ± 1.93 to 2.49 ± 2.47), standing (7.43 ± 1.65 to 3.41 ± 2.43) and postcoital pain (6.40 ± 2.63 to 2.54 ± 2.22). QoL scores in both physical and mental health showed statistically significant and sustained improvement after the procedure. Most patients were satisfied with the procedure (81%), with 86% willing to undergo it again and 89% to recommend it. Conclusion Embolization provides significant, sustained improvements in symptom relief while enhancing QoL in VO-CPP patients. Randomized controlled trials are needed to confirm these effects and exclude a placebo response.

IntroductionThe Epidemiological Study of Cognitive Impairment in Schizophrenia (EPICOG-SCH) is a brief battery to screen for cognitive impact of schizophrenia in outpatient settings. The EPICOG-SCH includes well-known subtests available worldwide that cover key cognitive domains demonstrated to be related to a variety of functional outcomes. Novel composite scores are modelled to predict patient’s functionality in daily life at short, mid and long term.ObjectivesWe want to progress in the elaboration of specific algorithms first episodes of schizophrenia at different follow up periods by modelling cognitive performance to predict short, mid and long term functionality.MethodsData for the present investigation were obtained from an the epidemiological and three-year longitudinal intervention program of first-episode psychosis (PAFIP) conducted at the outpatient clinic and the inpatient unit at the University Hospital Marques de Valdecilla, Spain. The cohort is composed by 167 patients with a diagnose of Schizophrenia and 160 healthy controls recruited between February 2001 to February 2014. For all analyses, a subset of measures was selected corresponding to the EPICOG-SCH domains with the Rey Auditory Verbal Learning Test (RAVLT) task ifor Logical Memory. Functional outcomes were measured by the Disability Assessment Scale (DAS) and the General Assessment for Function (GAF) scales. Functional measurements were conducted regarding premorbid, baseline set at clinical stabilization and 1, 3 year follow-up, and cognitive assessments where conducted at baseline and 1, 3 years of follow up.ResultsA cohort of 122 patients and 114 Controls completed the study with a 3-year follow up were included in the analysis. Changes across evaluations is tested in patients and controls. A regression analysis including the different EPICOG-SCH subtests at baseline as predictors of functionality at the different time points to explore the best predictive algorithms at 1 and 3 years of patient’s functionality in daily life following a first-episode.ConclusionsThe EPICOG-SCH brief battery is modelled to be a useful first to screen for the cognitive impact of schizophrenia in daily functionality daily life. This research work will validate the composite scores for a context of use of first-episodes schizophrenia and follow up. To date it has not been described an efficient and straightforward way for clinicians working with schizophrenia to transfer quantitative information about patient cognitive profile into real life. The EPICOG-SCH global composite score provides valuable information to clinicians which can facilitate disease management, drawing a roadmap for cognitive rehabilitation, and planning of supportive resources from the community and health care system.Disclosure of InterestNone Declared

IntroductionCyclin-dependent kinase 4/6 (CDK4/6) inhibitors, such as Palbociclib and Ribociclib, have significantly improved outcomes for patients with hormone receptor-positive, HER2-negative (HR+/HER2-) advanced breast cancer. Although clinical trials have established the efficacy of these agents globally, real-world data from India is limited. This study compares the clinical effectiveness and safety profiles of Palbociclib and Ribociclib in a cohort of Indian patients.Materials and methodsThis prospective study included 60 patients with metastatic HR+/HER2- breast cancer treated at Army hospitals and research centers in India between 2020 and 2023. Progression-free survival (PFS), overall survival (OS), and safety profiles were analyzed to assess the real-world performance of Palbociclib and Ribociclib. Patients were treated with either Palbociclib or Ribociclib in combination with standard endocrine therapy.ResultsAmong the 60 patients, the median PFS was 39.40 months for the Palbociclib group and 42.93 months for the Ribociclib group (p = 0.26), indicating no statistically significant difference. The median OS was 41.98 months in the Palbociclib group and 45.51 months in the Ribociclib group (p = 0.15), with Ribociclib showing a slight but non-significant survival advantage. The most common adverse event was neutropenia, which occurred in 26% of patients receiving Palbociclib and 23% of patients on Ribociclib. Deranged liver function tests (LFTs) and fatigue were also reported in both groups.ConclusionsPalbociclib and Ribociclib demonstrated comparable efficacy and safety profiles in this Indian cohort. While no statistically significant differences in PFS or OS were observed, the data suggest a marginal survival benefit with Ribociclib. These findings underscore the importance of individualized treatment plans in HR+/HER2- breast cancer, taking into consideration patient-specific factors. Larger studies with longer follow-up are needed to further clarify the nuances between these two agents.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12885-025-14270-1.

Adapting social and financial education for adolescents in Zimbabwe: A qualitative study of the Aflateen+ program.

ABSTRACT This study investigated future precipitation changes over West Africa (WA) using the latest art of climate models sourced from NEX‐GDDP CMIP6 and based on five machine learning (ML) algorithms. Changes in precipitation are important for policy makers and researchers to better understand the effects and impacts of climate change. Precipitation variations in the future were evaluated under two scenarios (SSP2‐4.5 and SSP5‐8.5) of the Shared Socioeconomic Pathways, with 2040–2070 being short term and 2070–2100 being long term, using a 30‐year baseline period. The results of the statistical analysis of the five machine learning algorithms showed that the gradient boosting regressor algorithm, which was trained and validated using the NEX‐GDDP models' historical precipitation data set, was superior to the other four ML algorithms in simulating the observed precipitation during the validation period. Further, the results demonstrated that the SVR algorithm was the least performing among its pairs. With an annual precipitation range of 10% to nearly 25%, the projected precipitation trended upward under SSP5‐8.5. This shows that there will be a significant increase in precipitation over WA in the future. This precipitation increase was observed by the projection done by the choosing ML algorithm. The increase is observed both in the mid term and long term of both scenarios. Our findings in this study are strongly recommended to policy makers in the region and researchers interested in studying the WA climate system.

Purpose Manufacturing companies face many hurdles to adapt their production tools and processes to Industry 4.0. Cost reduction and profit increase are expected in the mid or long term, but the plan to reach the expected level of maturity is not easy to draw. To converge toward higher maturity levels, we need first to assess the readiness level of the company and define the tools required for reaching the next level of maturity. Design/methodology/approach We propose in this article a methodology to help manufacturing companies establish a road map toward Industry 4.0 maturity. In addition to the standard analysis of the maturity level, we propose a scoring methodology that positions the studied maturity items according to the overall business strategy and the cost required to move toward upper grades of maturity. We use principal components analysis (PCA) on this data to automate the ranking of items according to company objectives and feasibility at an acceptable cost. Findings There is no one-size-fits-all path to maturity. In our case study of a French cable manufacturing company, our analysis highlights the high priority to put on the need for proper data analysis tools. Originality/value The scoring methodology presented in the current paper differs from others due to the multidimensional analysis which is performed by Principal Components Analysis. Therefore, items of high priority can be selected by the company regarding a combination of criteria related to company priorities, effort required, company strategy or expected revenue at once. The previous articles addressing this issue cope with other approaches based on the skills of company experts and or other techniques of data analysis.

P0P85BM808 Safety and mid term follow up, vía phone call, in Laparoscopic Conversion of Sleeve Gastrectomy to One Anastomosis Gastric Bypass in a Medical Tourism Center

In the contemporary era, plastic pollution is regarded as a significant environmental issue, given its deleterious effects on the ecosystem and, consequently, on human health. The proposed roadmap delineates the steps and measures to address marine plastic pollution, and strongly urges the participation of various key stakeholders, including policymakers, scientists, community members, non-governmental organisations, and other organisations that are impacted or can help to enforce policies. This is to be done with consideration for the specificities and challenges faced by Small Island Developing States. To develop this roadmap, several key elements are essential, including conducting plastic audits, implementing circular economies, formulating strategies and actions, establishing regulatory frameworks, and monitoring progress. The implementation plan comprises a series of actions which have been categorised into three distinct timeframes: short, mid and long term. In conclusion, it is imperative that Small Island Developing States pursue international collaboration for the effective implementation of the roadmap, given that marine debris is being deposited on their shores despite its genesis in distant locations.