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28 pages, 4437 KiB  
Review
Development and Core Technologies of Long-Range Underwater Gliders: A Review
by Xu Wang, Changyu Wang, Ke Zhang, Kai Ren and Jiancheng Yu
J. Mar. Sci. Eng. 2025, 13(8), 1509; https://doi.org/10.3390/jmse13081509 - 5 Aug 2025
Abstract
Long-range underwater gliders (LRUGs) have emerged as essential platforms for sustained and autonomous observation in deep and remote marine environments. This paper provides a comprehensive review of their developmental status, performance characteristics, and application progress. Emphasis is placed on two critical enabling technologies [...] Read more.
Long-range underwater gliders (LRUGs) have emerged as essential platforms for sustained and autonomous observation in deep and remote marine environments. This paper provides a comprehensive review of their developmental status, performance characteristics, and application progress. Emphasis is placed on two critical enabling technologies that fundamentally determine endurance: lightweight, pressure-resistant hull structures and high-efficiency buoyancy-driven propulsion systems. First, the role of carbon fiber composite pressure hulls in enhancing energy capacity and structural integrity is examined, with attention to material selection, fabrication methods, compressibility compatibility, and antifouling resistance. Second, the evolution of buoyancy control systems is analyzed, covering the transition to hybrid active–passive architectures, rapid-response actuators based on smart materials, thermohaline energy harvesting, and energy recovery mechanisms. Based on this analysis, the paper identifies four key technical challenges and proposes strategic research directions, including the development of ultralight, high-strength structural materials; integrated multi-mechanism antifouling technologies; energy-optimized coordinated buoyancy systems; and thermally adaptive glider platforms. Achieving a system architecture with ultra-long endurance, enhanced energy efficiency, and robust environmental adaptability is anticipated to be a foundational enabler for future long-duration missions and globally distributed underwater glider networks. Full article
(This article belongs to the Section Ocean Engineering)
15 pages, 2015 KiB  
Article
Optimization of Dust Spray Parameters for Simulated LiDAR Sensor Contamination in Autonomous Vehicles Using a Face-Centered Composite Design
by Sungho Son, Hyunmi Lee, Jiwoong Yang, Jungki Lee, Jeongah Jang, Charyung Kim, Joonho Jun, Hyungwon Park, Sunyoung Park and Woongsu Lee
Appl. Sci. 2025, 15(15), 8651; https://doi.org/10.3390/app15158651 (registering DOI) - 5 Aug 2025
Abstract
Light detection and ranging (LiDAR) provides three-dimensional environmental information that is critical for maintaining the safety and reliability of autonomous driving systems. However, dust accumulation on the LiDAR window can cause detection errors and degrade performance. This study determined the optimal spray conditions [...] Read more.
Light detection and ranging (LiDAR) provides three-dimensional environmental information that is critical for maintaining the safety and reliability of autonomous driving systems. However, dust accumulation on the LiDAR window can cause detection errors and degrade performance. This study determined the optimal spray conditions for accumulating dust to evaluate LiDAR sensor cleaning performance. A primary optimization experiment using spray pressure, spray speed, spray distance, and the number of sprays as variables showed that spray pressure and number of sprays had the most significant influence on the kinetic energy and distribution of dust particles. Notably, the interaction between spray distance and number of sprays—related to curvature effects—was identified as a key variable increasing process sensitivity. A supplementary experiment, which added spray angle as a variable, indicated that while spray pressure remained the most significant factor, spray angle and number of sprays had an indirect influence through interaction terms. Both experiments used the same response variable (point cloud data) interactions to stepwise analyze particle transfer and spatial diffusion. The resulting optimal conditions offer a standard basis for evaluating LiDAR cleaning performance and may help improve cleaning efficiency and maintenance strategies. Full article
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16 pages, 5104 KiB  
Article
Integrating OpenPose for Proactive Human–Robot Interaction Through Upper-Body Pose Recognition
by Shih-Huan Tseng, Jhih-Ciang Chiang, Cheng-En Shiue and Hsiu-Ping Yueh
Electronics 2025, 14(15), 3112; https://doi.org/10.3390/electronics14153112 - 5 Aug 2025
Abstract
This paper introduces a novel system that utilizes OpenPose for skeleton estimation to enable a tabletop robot to interact with humans proactively. By accurately recognizing upper-body poses based on the skeleton information, the robot autonomously approaches individuals and initiates conversations. The contributions of [...] Read more.
This paper introduces a novel system that utilizes OpenPose for skeleton estimation to enable a tabletop robot to interact with humans proactively. By accurately recognizing upper-body poses based on the skeleton information, the robot autonomously approaches individuals and initiates conversations. The contributions of this paper can be summarized into three main features. Firstly, we conducted a comprehensive data collection process, capturing five different table-front poses: looking down, looking at the screen, looking at the robot, resting the head on hands, and stretching both hands. These poses were selected to represent common interaction scenarios. Secondly, we designed the robot’s dialog content and movement patterns to correspond with the identified table-front poses. By aligning the robot’s responses with the specific pose, we aimed to create a more engaging and intuitive interaction experience for users. Finally, we performed an extensive evaluation by exploring the performance of three classification models—non-linear Support Vector Machine (SVM), Artificial Neural Network (ANN), and convolutional neural network (CNN)—for accurately recognizing table-front poses. We used an Asus Zenbo Junior robot to acquire images and leveraged OpenPose to extract 12 upper-body skeleton points as input for training the classification models. The experimental results indicate that the ANN model outperformed the other models, demonstrating its effectiveness in pose recognition. Overall, the proposed system not only showcases the potential of utilizing OpenPose for proactive human–robot interaction but also demonstrates its real-world applicability. By combining advanced pose recognition techniques with carefully designed dialog and movement patterns, the tabletop robot successfully engages with humans in a proactive manner. Full article
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24 pages, 4519 KiB  
Article
Aerial Autonomy Under Adversity: Advances in Obstacle and Aircraft Detection Techniques for Unmanned Aerial Vehicles
by Cristian Randieri, Sai Venkata Ganesh, Rayappa David Amar Raj, Rama Muni Reddy Yanamala, Archana Pallakonda and Christian Napoli
Drones 2025, 9(8), 549; https://doi.org/10.3390/drones9080549 - 4 Aug 2025
Abstract
Unmanned Aerial Vehicles (UAVs) have rapidly grown into different essential applications, including surveillance, disaster response, agriculture, and urban monitoring. However, for UAVS to steer safely and autonomously, the ability to detect obstacles and nearby aircraft remains crucial, especially under hard environmental conditions. This [...] Read more.
Unmanned Aerial Vehicles (UAVs) have rapidly grown into different essential applications, including surveillance, disaster response, agriculture, and urban monitoring. However, for UAVS to steer safely and autonomously, the ability to detect obstacles and nearby aircraft remains crucial, especially under hard environmental conditions. This study comprehensively analyzes the recent landscape of obstacle and aircraft detection techniques tailored for UAVs acting in difficult scenarios such as fog, rain, smoke, low light, motion blur, and disorderly environments. It starts with a detailed discussion of key detection challenges and continues with an evaluation of different sensor types, from RGB and infrared cameras to LiDAR, radar, sonar, and event-based vision sensors. Both classical computer vision methods and deep learning-based detection techniques are examined in particular, highlighting their performance strengths and limitations under degraded sensing conditions. The paper additionally offers an overview of suitable UAV-specific datasets and the evaluation metrics generally used to evaluate detection systems. Finally, the paper examines open problems and coming research directions, emphasising the demand for lightweight, adaptive, and weather-resilient detection systems appropriate for real-time onboard processing. This study aims to guide students and engineers towards developing stronger and intelligent detection systems for next-generation UAV operations. Full article
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27 pages, 2361 KiB  
Review
Review of Thrust Regulation and System Control Methods of Variable-Thrust Liquid Rocket Engines in Space Drones
by Meng Sun, Xiangzhou Long, Bowen Xu, Haixia Ding, Xianyu Wu, Weiqi Yang, Wei Zhao and Shuangxi Liu
Actuators 2025, 14(8), 385; https://doi.org/10.3390/act14080385 - 4 Aug 2025
Abstract
Variable-thrust liquid rocket engines are essential for precision landing in deep-space exploration, reusable launch vehicle recovery, high-accuracy orbital maneuvers, and emergency obstacle evasions of space drones. However, with the increasingly complex space missions, challenges remain with the development of different technical schemes. In [...] Read more.
Variable-thrust liquid rocket engines are essential for precision landing in deep-space exploration, reusable launch vehicle recovery, high-accuracy orbital maneuvers, and emergency obstacle evasions of space drones. However, with the increasingly complex space missions, challenges remain with the development of different technical schemes. In view of these issues, this paper systematically reviews the technology’s evolution through mechanical throttling, electromechanical precision regulation, and commercial space-driven deep throttling. Then, the development of key variable thrust technologies for liquid rocket engines is summarized from the perspective of thrust regulation and control strategy. For instance, thrust regulation requires synergistic flow control devices and adjustable pintle injectors to dynamically match flow rates with injection pressure drops, ensuring combustion stability across wide thrust ranges—particularly under extreme conditions during space drones’ high-maneuver orbital adjustments—though pintle injector optimization for such scenarios remains challenging. System control must address strong multivariable coupling, response delays, and high-disturbance environments, as well as bottlenecks in sensor reliability and nonlinear modeling. Furthermore, prospects are made in response to the research progress, and breakthroughs are required in cryogenic wide-range flow regulation for liquid oxygen-methane propellants, combustion stability during deep throttling, and AI-based intelligent control to support space drones’ autonomous orbital transfer, rapid reusability, and on-demand trajectory correction in complex deep-space missions. Full article
(This article belongs to the Section Aerospace Actuators)
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33 pages, 1945 KiB  
Article
A Novel Distributed Hybrid Cognitive Strategy for Odor Source Location in Turbulent and Sparse Environment
by Yingmiao Jia, Shurui Fan, Weijia Cui, Chengliang Di and Yafeng Hao
Entropy 2025, 27(8), 826; https://doi.org/10.3390/e27080826 (registering DOI) - 4 Aug 2025
Abstract
Precise odor source localization in turbulent and sparse environments plays a vital role in enabling robotic systems for hazardous chemical monitoring and effective disaster response. To address this, we propose Cooperative Gravitational-Rényi Infotaxis (CGRInfotaxis), a distributed decision-optimization framework that combines multi-agent collaboration with [...] Read more.
Precise odor source localization in turbulent and sparse environments plays a vital role in enabling robotic systems for hazardous chemical monitoring and effective disaster response. To address this, we propose Cooperative Gravitational-Rényi Infotaxis (CGRInfotaxis), a distributed decision-optimization framework that combines multi-agent collaboration with hybrid cognitive strategy to improve search efficiency and robustness. The method integrates a gravitational potential field for rapid source convergence and Rényi divergence-based probabilistic exploration to handle sparse detections, dynamically balanced via a regulation factor. Particle filtering optimizes posterior probability estimation to autonomously refine search areas while preserving computational efficiency, alongside a distributed interactive-optimization mechanism for real-time decision updates through agent cooperation. The algorithm’s performance is evaluated in scenarios with fixed and randomized odor source locations, as well as with varying numbers of agents. Results demonstrate that CGRInfotaxis achieves a near-100% success rate with high consistency across diverse conditions, outperforming existing methods in stability and adaptability. Increasing the number of agents further enhances search efficiency without compromising reliability. These findings suggest that CGRInfotaxis significantly advances multi-agent odor source localization in turbulent, sparse environments, offering practical utility for real-world applications. Full article
(This article belongs to the Section Multidisciplinary Applications)
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31 pages, 1737 KiB  
Article
Trajectory Optimization for Autonomous Highway Driving Using Quintic Splines
by Wael A. Farag and Morsi M. Mahmoud
World Electr. Veh. J. 2025, 16(8), 434; https://doi.org/10.3390/wevj16080434 - 3 Aug 2025
Viewed by 39
Abstract
This paper introduces a robust and efficient Localized Spline-based Path-Planning (LSPP) algorithm designed to enhance autonomous vehicle navigation on highways. The LSPP approach prioritizes smooth maneuvering, obstacle avoidance, passenger comfort, and adherence to road constraints, including lane boundaries, through optimized trajectory generation using [...] Read more.
This paper introduces a robust and efficient Localized Spline-based Path-Planning (LSPP) algorithm designed to enhance autonomous vehicle navigation on highways. The LSPP approach prioritizes smooth maneuvering, obstacle avoidance, passenger comfort, and adherence to road constraints, including lane boundaries, through optimized trajectory generation using quintic spline functions and a dynamic speed profile. Leveraging real-time data from the vehicle’s sensor fusion module, the LSPP algorithm accurately interprets the positions of surrounding vehicles and obstacles, creating a safe, dynamically feasible path that is relayed to the Model Predictive Control (MPC) track-following module for precise execution. The theoretical distinction of LSPP lies in its modular integration of: (1) a finite state machine (FSM)-based decision-making layer that selects maneuver-specific goal states (e.g., keep lane, change lane left/right); (2) quintic spline optimization to generate smooth, jerk-minimized, and kinematically consistent trajectories; (3) a multi-objective cost evaluation framework that ranks competing paths according to safety, comfort, and efficiency; and (4) a closed-loop MPC controller to ensure real-time trajectory execution with robustness. Extensive simulations conducted in diverse highway scenarios and traffic conditions demonstrate LSPP’s effectiveness in delivering smooth, safe, and computationally efficient trajectories. Results show consistent improvements in lane-keeping accuracy, collision avoidance, enhanced materials wear performance, and planning responsiveness compared to traditional path-planning methods. These findings confirm LSPP’s potential as a practical and high-performance solution for autonomous highway driving. Full article
(This article belongs to the Special Issue Motion Planning and Control of Autonomous Vehicles)
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34 pages, 1227 KiB  
Review
Beyond Cutting: CRISPR-Driven Synthetic Biology Toolkit for Next-Generation Microalgal Metabolic Engineering
by Limin Yang and Qian Lu
Int. J. Mol. Sci. 2025, 26(15), 7470; https://doi.org/10.3390/ijms26157470 - 2 Aug 2025
Viewed by 206
Abstract
Microalgae, with their unparalleled capabilities for sunlight-driven growth, CO2 fixation, and synthesis of diverse high-value compounds, represent sustainable cell factories for a circular bioeconomy. However, industrial deployment has been hindered by biological constraints and the inadequacy of conventional genetic tools. The advent [...] Read more.
Microalgae, with their unparalleled capabilities for sunlight-driven growth, CO2 fixation, and synthesis of diverse high-value compounds, represent sustainable cell factories for a circular bioeconomy. However, industrial deployment has been hindered by biological constraints and the inadequacy of conventional genetic tools. The advent of CRISPR-Cas systems initially provided precise gene editing via targeted DNA cleavage. This review argues that the true transformative potential lies in moving decisively beyond cutting to harness CRISPR as a versatile synthetic biology “Swiss Army Knife”. We synthesize the rapid evolution of CRISPR-derived tools—including transcriptional modulators (CRISPRa/i), epigenome editors, base/prime editors, multiplexed systems, and biosensor-integrated logic gates—and their revolutionary applications in microalgal engineering. These tools enable tunable gene expression, stable epigenetic reprogramming, DSB-free nucleotide-level precision editing, coordinated rewiring of complex metabolic networks, and dynamic, autonomous control in response to environmental cues. We critically evaluate their deployment to enhance photosynthesis, boost lipid/biofuel production, engineer high-value compound pathways (carotenoids, PUFAs, proteins), improve stress resilience, and optimize carbon utilization. Persistent challenges—species-specific tool optimization, delivery efficiency, genetic stability, scalability, and biosafety—are analyzed, alongside emerging solutions and future directions integrating AI, automation, and multi-omics. The strategic integration of this CRISPR toolkit unlocks the potential to engineer robust, high-productivity microalgal cell factories, finally realizing their promise as sustainable platforms for next-generation biomanufacturing. Full article
(This article belongs to the Special Issue Developing Methods and Molecular Basis in Plant Biotechnology)
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26 pages, 2843 KiB  
Article
A CDC–ANFIS-Based Model for Assessing Ship Collision Risk in Autonomous Navigation
by Hee-Jin Lee and Ho Namgung
J. Mar. Sci. Eng. 2025, 13(8), 1492; https://doi.org/10.3390/jmse13081492 (registering DOI) - 1 Aug 2025
Viewed by 141
Abstract
To improve collision risk prediction in high-traffic coastal waters and support real-time decision-making in maritime navigation, this study proposes a regional collision risk prediction system integrating the Computed Distance at Collision (CDC) method with an Adaptive Neuro-Fuzzy Inference System (ANFIS). Unlike Distance at [...] Read more.
To improve collision risk prediction in high-traffic coastal waters and support real-time decision-making in maritime navigation, this study proposes a regional collision risk prediction system integrating the Computed Distance at Collision (CDC) method with an Adaptive Neuro-Fuzzy Inference System (ANFIS). Unlike Distance at Closest Point of Approach (DCPA), which depends on the position of Global Positioning System (GPS) antennas, Computed Distance at Collision (CDC) directly reflects the actual hull shape and potential collision point. This enables a more realistic assessment of collision risk by accounting for the hull geometry and boundary conditions specific to different ship types. The system was designed and validated using ship motion simulations involving bulk and container ships across varying speeds and crossing angles. The CDC method was used to define collision, almost-collision, and near-collision situations based on geometric and hydrodynamic criteria. Subsequently, the FIS–CDC model was constructed using the ANFIS by learning patterns in collision time and distance under each condition. A total of four input variables—ship speed, crossing angle, remaining time, and remaining distance—were used to infer the collision risk index (CRI), allowing for a more nuanced and vessel-specific assessment than traditional CPA-based indicators. Simulation results show that the time to collision decreases with higher speeds and increases with wider crossing angles. The bulk carrier exhibited a wider collision-prone angle range and a greater sensitivity to speed changes than the container ship, highlighting differences in maneuverability and risk response. The proposed system demonstrated real-time applicability and accurate risk differentiation across scenarios. This research contributes to enhancing situational awareness and proactive risk mitigation in Maritime Autonomous Surface Ship (MASS) and Vessel Traffic System (VTS) environments. Future work will focus on real-time CDC optimization and extending the model to accommodate diverse ship types and encounter geometries. Full article
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36 pages, 5053 KiB  
Systematic Review
Prescriptive Maintenance: A Systematic Literature Review and Exploratory Meta-Synthesis
by Marko Orošnjak, Felix Saretzky and Slawomir Kedziora
Appl. Sci. 2025, 15(15), 8507; https://doi.org/10.3390/app15158507 (registering DOI) - 31 Jul 2025
Viewed by 175
Abstract
Prescriptive Maintenance (PsM) transforms industrial asset management by enabling autonomous decisions through simultaneous failure anticipation and optimal maintenance recommendations. Yet, despite increasing research interest, the conceptual clarity, technological maturity, and practical deployment of PsM remains fragmented. Here, we conduct a comprehensive and application-oriented [...] Read more.
Prescriptive Maintenance (PsM) transforms industrial asset management by enabling autonomous decisions through simultaneous failure anticipation and optimal maintenance recommendations. Yet, despite increasing research interest, the conceptual clarity, technological maturity, and practical deployment of PsM remains fragmented. Here, we conduct a comprehensive and application-oriented Systematic Literature Review of studies published between 2013–2024. We identify key enablers—artificial intelligence and machine learning, horizontal and vertical integration, and deep reinforcement learning—that map the functional space of PsM across industrial sectors. The results from our multivariate meta-synthesis uncover three main thematic research clusters, ranging from decision-automation of technical (multi)component-level systems to strategic and organisational-support strategies. Notably, while predictive models are widely adopted, the translation of these capabilities to PsM remains limited. Primary reasons include semantic interoperability, real-time optimisation, and deployment scalability. As a response, a structured research agenda is proposed to emphasise hybrid architectures, context-aware prescription mechanisms, and alignment with Industry 5.0 principles of human-centricity, resilience, and sustainability. The review establishes a critical foundation for future advances in intelligent, explainable, and action-oriented maintenance systems. Full article
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40 pages, 18923 KiB  
Article
Twin-AI: Intelligent Barrier Eddy Current Separator with Digital Twin and AI Integration
by Shohreh Kia, Johannes B. Mayer, Erik Westphal and Benjamin Leiding
Sensors 2025, 25(15), 4731; https://doi.org/10.3390/s25154731 - 31 Jul 2025
Viewed by 112
Abstract
The current paper presents a comprehensive intelligent system designed to optimize the performance of a barrier eddy current separator (BECS), comprising a conveyor belt, a vibration feeder, and a magnetic drum. This system was trained and validated on real-world industrial data gathered directly [...] Read more.
The current paper presents a comprehensive intelligent system designed to optimize the performance of a barrier eddy current separator (BECS), comprising a conveyor belt, a vibration feeder, and a magnetic drum. This system was trained and validated on real-world industrial data gathered directly from the working separator under 81 different operational scenarios. The intelligent models were used to recommend optimal settings for drum speed, belt speed, vibration intensity, and drum angle, thereby maximizing separation quality and minimizing energy consumption. the smart separation module utilizes YOLOv11n-seg and achieves a mean average precision (mAP) of 0.838 across 7163 industrial instances from aluminum, copper, and plastic materials. For shape classification (sharp vs. smooth), the model reached 91.8% accuracy across 1105 annotated samples. Furthermore, the thermal monitoring unit can detect iron contamination by analyzing temperature anomalies. Scenarios with iron showed a maximum temperature increase of over 20 °C compared to clean materials, with a detection response time of under 2.5 s. The architecture integrates a Digital Twin using Azure Digital Twins to virtually mirror the system, enabling real-time tracking, behavior simulation, and remote updates. A full connection with the PLC has been implemented, allowing the AI-driven system to adjust physical parameters autonomously. This combination of AI, IoT, and digital twin technologies delivers a reliable and scalable solution for enhanced separation quality, improved operational safety, and predictive maintenance in industrial recycling environments. Full article
(This article belongs to the Special Issue Sensors and IoT Technologies for the Smart Industry)
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24 pages, 2854 KiB  
Article
Autonomous Trajectory Control for Quadrotor eVTOL in Hover and Low-Speed Flight via the Integration of Model Predictive and Following Control
by Yeping Wang, Honglei Ji, Qingyu Kang, Haotian Qi and Jinghan Wen
Drones 2025, 9(8), 537; https://doi.org/10.3390/drones9080537 - 30 Jul 2025
Viewed by 231
Abstract
This paper proposes a novel hierarchical control architecture that combines Model Predictive Control (MPC) with Explicit Model-Following Control (EMFC) to enable accurate and efficient trajectory tracking for quadrotor electric Vertical Takeoff and Landing (eVTOL) aircraft operating in urban environments. The approach addresses the [...] Read more.
This paper proposes a novel hierarchical control architecture that combines Model Predictive Control (MPC) with Explicit Model-Following Control (EMFC) to enable accurate and efficient trajectory tracking for quadrotor electric Vertical Takeoff and Landing (eVTOL) aircraft operating in urban environments. The approach addresses the challenges of strong nonlinear dynamics, multi-axis coupling, and stringent safety constraints by separating the planning task from the fast-response control task. The MPC layer generates constrained velocity and yaw rate commands based on a simplified inertial prediction model, effectively reducing computational complexity while accounting for physical and operational limits. The EMFC layer then compensates for dynamic couplings and ensures the rapid execution of commands. A high-fidelity simulation model, incorporating rotor flapping dynamics, differential collective pitch control, and enhanced aerodynamic interference effects, is developed to validate the controller. Four representative ADS-33E-PRF tasks—Hover, Hovering Turn, Pirouette, and Vertical Maneuver—are simulated. Results demonstrate that the proposed controller achieves accurate trajectory tracking, stable flight performance, and full compliance with ADS-33E-PRF criteria, highlighting its potential for autonomous urban air mobility applications. Full article
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23 pages, 2248 KiB  
Article
Autonomic and Neuroendocrine Reactivity to VR Game Exposure in Children and Adolescents with Obesity: A Factor Analytic Approach to Physiological Reactivity and Eating Behavior
by Cristiana Amalia Onita, Daniela-Viorelia Matei, Laura-Mihaela Trandafir, Diana Petrescu-Miron, Calin Corciova, Robert Fuior, Lorena-Mihaela Manole, Bogdan-Mircea Mihai, Cristina-Gena Dascalu, Monica Tarcea, Stéphane Bouchard and Veronica Mocanu
Nutrients 2025, 17(15), 2492; https://doi.org/10.3390/nu17152492 - 30 Jul 2025
Viewed by 268
Abstract
Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with [...] Read more.
Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. Full article
(This article belongs to the Special Issue A Path Towards Personalized Smart Nutrition)
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39 pages, 514 KiB  
Review
A Comprehensive Review of a Mechanism-Based Ventricular Electrical Storm Management
by Alina Gabriela Negru, Diana Carina Iovanovici, Ana Lascu, Alexandru Silviu Pescariu, Gabriel Cismaru, Simina Crișan, Ștefan Ailoaei, Diana Luiza Bebec, Caius Glad Streian, Mariela Romina Bîrza, Andrei Raul Manzur, Silvia Ana Luca, Dana David, Svetlana Moșteoru, Dan Gaiță and Constantin Tudor Luca
J. Clin. Med. 2025, 14(15), 5351; https://doi.org/10.3390/jcm14155351 - 29 Jul 2025
Viewed by 363
Abstract
The electrical ventricular storm (VES) is defined as multiple sustained ventricular arrhythmias arising in a short time, often refractory to standard antiarrhythmic treatment. The three pillars of the physiopathogenesis of the VES are autonomic dysfunction, triggers, and an altered ventricular substrate. Incessant or [...] Read more.
The electrical ventricular storm (VES) is defined as multiple sustained ventricular arrhythmias arising in a short time, often refractory to standard antiarrhythmic treatment. The three pillars of the physiopathogenesis of the VES are autonomic dysfunction, triggers, and an altered ventricular substrate. Incessant or highly recurrent ventricular arrhythmia impacts the hemodynamic status by worsening heart failure and increasing mortality. A stepwise, team-based, and tailored therapeutic approach is required to stop ventricular arrhythmia and regain the hemodynamic and electric stability of the patient. The authors focused on describing all currently available therapeutic approaches for VES, intending to establish the best VES therapeutic approaches. This process involves considering the patient’s specific condition, responses to previous treatments, and the potential risks and benefits of each approach. The options range from adjusting antiarrhythmic therapy to reprogramming of the ICD, sedation, epidural anaesthesia, stellate ganglia anaesthetic block, and the use of ECMO or left ventricular assist devices and radiofrequency catheter ablation. Particular attention is paid to the detailed management of genetic primary arrhythmia syndromes like long-QT syndrome, catecholaminergic polymorphic ventricular tachycardia, Brugada syndrome and Wolff–Parkinson–White syndrome, early repolarisation syndrome, right ventricular arrhythmogenic dysplasia, and idiopathic ventricular fibrillation. After overcoming the acute events of VES and obtaining hemodynamic stability, the treatment should shift toward an optimal balance of heart failure therapy, controlling the substrate by revascularisation procedures and resolving other pathology-generating ventricular arrhythmias. This article provides a comprehensive overview of ESV’s current management options using the most efficient strategies known to date. Full article
(This article belongs to the Section Cardiology)
17 pages, 1540 KiB  
Article
Evaluating a Nationally Localized AI Chatbot for Personalized Primary Care Guidance: Insights from the HomeDOCtor Deployment in Slovenia
by Matjaž Gams, Tadej Horvat, Žiga Kolar, Primož Kocuvan, Kostadin Mishev and Monika Simjanoska Misheva
Healthcare 2025, 13(15), 1843; https://doi.org/10.3390/healthcare13151843 - 29 Jul 2025
Viewed by 324
Abstract
Background/Objectives: The demand for accessible and reliable digital health services has increased significantly in recent years, particularly in regions facing physician shortages. HomeDOCtor, a conversational AI platform developed in Slovenia, addresses this need with a nationally adapted architecture that combines retrieval-augmented generation [...] Read more.
Background/Objectives: The demand for accessible and reliable digital health services has increased significantly in recent years, particularly in regions facing physician shortages. HomeDOCtor, a conversational AI platform developed in Slovenia, addresses this need with a nationally adapted architecture that combines retrieval-augmented generation (RAG) and a Redis-based vector database of curated medical guidelines. The objective of this study was to assess the performance and impact of HomeDOCtor in providing AI-powered healthcare assistance. Methods: HomeDOCtor is designed for human-centered communication and clinical relevance, supporting multilingual and multimedia citizen inputs while being available 24/7. It was tested using a set of 100 international clinical vignettes and 150 internal medicine exam questions from the University of Ljubljana to validate its clinical performance. Results: During its six-month nationwide deployment, HomeDOCtor received overwhelmingly positive user feedback with minimal criticism, and exceeded initial expectations, especially in light of widespread media narratives warning about the risks of AI. HomeDOCtor autonomously delivered localized, evidence-based guidance, including self-care instructions and referral suggestions, with average response times under three seconds. On international benchmarks, the system achieved ≥95% Top-1 diagnostic accuracy, comparable to leading medical AI platforms, and significantly outperformed stand-alone ChatGPT-4o in the national context (90.7% vs. 80.7%, p = 0.0135). Conclusions: Practically, HomeDOCtor eases the burden on healthcare professionals by providing citizens with 24/7 autonomous, personalized triage and self-care guidance for less complex medical issues, ensuring that these cases are self-managed efficiently. The system also identifies more serious cases that might otherwise be neglected, directing them to professionals for appropriate care. Theoretically, HomeDOCtor demonstrates that domain-specific, nationally adapted large language models can outperform general-purpose models. Methodologically, it offers a framework for integrating GDPR-compliant AI solutions in healthcare. These findings emphasize the value of localization in conversational AI and telemedicine solutions across diverse national contexts. Full article
(This article belongs to the Special Issue Application of Digital Services to Improve Patient-Centered Care)
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