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While many have extolled the potential impacts of digital advisory services for smallholder agriculture, the evidence for sustained uptake of such tools remains limited. This paper utilizes a survey of tool developers and researchers, as well as a systematic -analysis of prior studies, to assess the extent and challenges of scaling decision support tools for site-specific soil nutrient management (SSNM-DST) across smallholder farming systems, where "scaling" is defined as a significant increase in tool usage beyond pilot levels. Our evaluation draws on relevant literature, expert opinion and apps available in different repositories. Despite their acclaimed yield benefits, we find that SSNM-DST have struggled to reach scale over the last few decades and, with strong heterogeneity in adoption among intended stakeholders and tools. For example, the log odds of a SSNM-DST reaching 5-10 % of the target farmers compared with reaching none, decreases by ∼200% when a technical problem is stated as a reason for the tools' failure to be used at scale. We find a similar decrease in odds ratios when technical, socioeconomic, policy, and R&D constraints were identified as barriers to scaling by national extension and private systems. Meta-regression analysis indicates that the response ratio of using SSNM-DST over Farmer Fertilizer Practice (FFP) varies by non-tool related covariates, such as initial crop yield potential under FFP, current and past crop types, acidity class of the soil, temperature and rainfall regimes, and the amount of input under FFP. In general, the SSNM-DST have moved one step forward compared with the traditional 'blanket' fertilizer recommendation by accounting for in-field heterogeneities in soil and crop characteristics, while remaining undifferentiated in terms of demographic and socioeconomic heterogeneities among users, which potentially constrains adoption at scale. The SSNM-DSTs possess reasonable applicability and can be labeled 'ready' from purely scientific viewpoints, although their readiness for system-level uptake at scale remains limited, especially where socio-technical and institutional constraints are prevalent.
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http://dx.doi.org/10.1016/j.compag.2023.108060 | DOI Listing |
JMIR Form Res
September 2025
Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong Provincial Geriatrics Institute, No. 106, Zhongshaner Rd, Guangzhou, 510080, China, 86 15920151904.
Background: Point-of-care ultrasonography has become a valuable tool for assessing diaphragmatic function in critically ill patients receiving invasive mechanical ventilation. However, conventional diaphragm ultrasound assessment remains highly operator-dependent and subjective. Previous research introduced automatic measurement of diaphragmatic excursion and velocity using 2D speckle-tracking technology.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
Clinique du sport, Paris, France.
Purpose: To compare the outcomes of isolated anterior cruciate ligament reconstruction (ACLR) versus ACLR + lateral extra-articular procedures (LEAPs) at mid-term follow-up in a low activity population based on the Tegner activity scale (TAS ≤ 4).
Methods: This was a retrospective analysis comparing patients with a pre-injury TAS ≤ 4 who underwent primary isolated ACLR versus ACLR + LEAPs between 2012 and 2022. Propensity score matching based on age, sex, and presence of meniscal injury was used to establish two groups: ACLR alone and ACLR with LEAP.
Cureus
August 2025
Internal Medicine, Jaber Al-Ahmad Hospital, Al Jahra, KWT.
Heart failure (HF) remains a global health challenge with high morbidity and mortality, necessitating reliable biomarkers for risk stratification. The platelet-to-lymphocyte ratio (PLR), an emerging inflammatory marker, has shown prognostic potential in cardiovascular diseases, but its utility in HF remains inconsistently reported. This systematic review synthesizes evidence on PLR's prognostic value in HF, focusing on mortality, hospitalization, and its role in multimarker models.
View Article and Find Full Text PDFACS Appl Mater Interfaces
September 2025
School of Materials Science and Engineering, Beihang University, Beijing 100191, P. R. China.
Nanostructured cubic boron nitride (NS-cBN) has attracted significant attention due to its high hardness and excellent thermal stability, yet a systematic strategy to balance strength and toughness through atomically structural design remains elusive. Here, we integrate plasticity theory with large-scale atomistic simulations to elucidate the size-dependent roles of internal defects, i.e.
View Article and Find Full Text PDFAm J Prev Cardiol
September 2025
Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA.
Background: Data on outcomes associated with various modes of delivery in pregnant patients with heart failure (HF) or pulmonary hypertension (pHTN) are limited.
Objective: We aim to investigate the association between mode of delivery on maternal and fetal outcomes in pregnant patients with HF or pHTN by conducting a multicenter, large scale and nationwide retrospective cohort study.
Methods: This retrospective population-based cohort study used the Nationwide Readmission Database to identify all hospitalized pregnant patients who were primarily admitted for vaginal or cesarean delivery from 2011 to 2019.