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23 pages, 6117 KB  
Article
Post-Fire Assessment in a Precast Concrete Industrial Building: Case Study
by Mehmet Gesoglu, Yavuz Yardim and Marco Corradi
Buildings 2026, 16(7), 1306; https://doi.org/10.3390/buildings16071306 (registering DOI) - 25 Mar 2026
Abstract
An investigation employing multiple diagnostic techniques was conducted to evaluate the post-fire condition and residual structural safety of a fire-damaged precast concrete industrial building. The evaluation included a detailed visual inspection, mechanical testing of extracted concrete cores, and mineralogical and microstructural analysis through [...] Read more.
An investigation employing multiple diagnostic techniques was conducted to evaluate the post-fire condition and residual structural safety of a fire-damaged precast concrete industrial building. The evaluation included a detailed visual inspection, mechanical testing of extracted concrete cores, and mineralogical and microstructural analysis through thermo-chemical methods, namely X-ray Diffraction, Scanning Electron Microscopy, and Energy-Dispersive X-ray Spectroscopy, alongside tensile strength tests of reinforcement bars sampled from the affected structure. The building was divided into five sections according to the severity and extent of observed fire damage. Results indicated that the highest in situ temperatures were attained in the most heavily damaged section, whereas the remaining sections experienced progressively lower temperatures, remained below approximately 600 °C. Despite the severe fire exposure in localized areas, all assessed structural elements maintained adequate residual integrity. The reinforcing steel exhibited satisfactory residual mechanical properties, exhibiting yield strengths ranging from 550 to 600 MPa. The integration of visual, mechanical, and microstructural assessments provides a reliable framework for estimating fire temperatures and supporting structural rehabilitation decisions. Full article
22 pages, 4621 KB  
Article
Comparative Assessment of Supervised Machine Learning Models for Predicting Water Uptake in Sorption-Based Thermal Energy Storage
by Milad Tajik Jamalabad, Elham Abohamzeh, Daud Mustafa Minhas, Seongbhin Kim, Dohyun Kim, Aejung Yoon and Georg Frey
Energies 2026, 19(7), 1619; https://doi.org/10.3390/en19071619 - 25 Mar 2026
Abstract
In this study, supervised machine learning (ML) regression models are employed to predict water uptake during the sorption process in a sorption reactor for thermal energy storage applications. Two main methods are used to study sorption storage systems: experimental studies and numerical simulations. [...] Read more.
In this study, supervised machine learning (ML) regression models are employed to predict water uptake during the sorption process in a sorption reactor for thermal energy storage applications. Two main methods are used to study sorption storage systems: experimental studies and numerical simulations. Experimental studies involve physical testing and measurements but are often costly and time-consuming. Numerical simulations are more flexible and cost-effective, though they can require significant computational resources for large or complex systems. To address these challenges, researchers are increasingly employing various machine learning techniques, which offer strong potential for data analysis and predictive modeling. In this study, CFD-based sorption simulations are integrated with machine learning models to predict the spatiotemporal evolution of water uptake. Several ML techniques including support vector regression (SVR), Random Forest, XGBoost, CatBoost (gradient boosting decision trees), and multilayer perceptron neural networks (MLPs) are evaluated and compared. A fixed-bed reactor equipped with fins and tubes is considered within a closed adsorption thermal storage system. Numerical simulations are conducted for three different fin lengths (10 mm, 25 mm, and 35 mm) to generate a comprehensive dataset for training the ML models and capturing the complex temporal evolution of water uptake, thereby enabling predictions for unseen fin geometries. The results indicate that neural network-based models achieve superior predictive performance compared to the other methods. For water uptake training, the mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R2) are approximately 2.83, 4.37, and 0.91, respectively. The predicted water uptake shows close agreement with the numerical simulation results. For the prediction cases, the MAE, MSE, and R2 values are approximately 1.13, 1.2, and 0.8, respectively. Overall, the study demonstrates that machine learning models can accurately predict water uptake beyond the training dataset, indicating strong generalization capability and significant potential for improving thermal management system design. Additionally, the proposed approach reduces simulation time and computational cost while providing an efficient and reliable framework for modeling complex sorption processes in thermal energy storage systems. Full article
50 pages, 3024 KB  
Review
Convergence of Multidimensional Sensing: A Review of AI-Enhanced Space-Division Multiplexing in Optical Fiber Sensors
by Rabiu Imam Sabitu and Amin Malekmohammadi
Sensors 2026, 26(7), 2044; https://doi.org/10.3390/s26072044 - 25 Mar 2026
Abstract
The growing demand for high-fidelity, multi-parameter, distributed sensing in critical domains such as structural health monitoring, oil and gas exploration, and secure perimeter surveillance is pushing traditional optical fiber sensors (OFS) to their performance limits. Although conventional multiplexing techniques such as time-division and [...] Read more.
The growing demand for high-fidelity, multi-parameter, distributed sensing in critical domains such as structural health monitoring, oil and gas exploration, and secure perimeter surveillance is pushing traditional optical fiber sensors (OFS) to their performance limits. Although conventional multiplexing techniques such as time-division and wavelength-division multiplexing (TDM, WDM) have been commercially successful, they are rapidly approaching fundamental bottlenecks in sensor density, spatial resolution, and data capacity. This review argues that the synergistic convergence of space-division multiplexing (SDM) and artificial intelligence (AI) represents a paradigm shift, enabling a new generation of intelligent, high-dimensional sensing networks. We comprehensively survey the state of the art in SDM-based OFS, detailing the operating principles and applications of multi-core fibers (MCFs) for ultra-dense sensor arrays and 3D shape sensing, as well as few-mode fibers (FMFs) for mode-division multiplexing and enhanced multi-parameter discrimination. However, the unprecedented spatial parallelism provided by SDM introduces significant challenges, including inter-channel crosstalk, complex signal demultiplexing, and massive data volumes. This paper systematically explores how AI, particularly machine learning (ML) and deep learning (DL), is being leveraged not merely as a tool but as an indispensable core technology to mitigate these impairments. We critically analyze AI’s role in digital crosstalk suppression, intelligent mode demultiplexing, signal denoising, and solving complex inverse problems for parameter estimation. Furthermore, we highlight how this AI–SDM synergy enables capabilities beyond the reach of either technology alone, such as super-resolution sensing and predictive analytics. The discussion is extended to include the critical supporting pillars of this ecosystem, such as advanced interrogation techniques and the associated data management challenges. Finally, we provide a forward-looking perspective on the trajectory of the field, outlining a path toward cognitive sensing networks that are self-calibrating, adaptive, and capable of autonomous decision-making. This review is intended to serve as a foundational reference for researchers and engineers at the intersection of photonics and intelligent systems, illuminating the pathway toward tomorrow’s intelligent sensing infrastructure. Full article
(This article belongs to the Collection Artificial Intelligence in Sensors Technology)
24 pages, 3524 KB  
Article
An Intelligent Micromachine Perception System for Elevator Fault Diagnosis
by Li Lai, Shixuan Ding, Zewen Li, Zimin Luo and Hao Wang
Micromachines 2026, 17(4), 401; https://doi.org/10.3390/mi17040401 (registering DOI) - 25 Mar 2026
Abstract
Elevator fault diagnosis heavily relies on high-precision sensing of microscopic physical states. Although Micro-Electro-Mechanical System (MEMS) sensors can capture such subtle features, they are constrained by high-frequency data streams, environmental noise, and the semantic gap between raw sensor data and actionable maintenance decisions. [...] Read more.
Elevator fault diagnosis heavily relies on high-precision sensing of microscopic physical states. Although Micro-Electro-Mechanical System (MEMS) sensors can capture such subtle features, they are constrained by high-frequency data streams, environmental noise, and the semantic gap between raw sensor data and actionable maintenance decisions. This study proposes a collaborative edge–cloud intelligent diagnosis framework specifically designed for elevator systems. On the edge side, a lightweight temporal Transformer model, ELiTe-Transformer, was designed and deployed on the Jetson platform. This model enhances sensitivity to event-driven MEMS signals through an industrial positional encoding mechanism and by integrating linear attention and INT8 quantization techniques, achieving a real-time inference latency of 21.4 ms. On the cloud side, retrieval-augmented generation (RAG) technology was adopted to integrate physical features extracted at the edge with domain knowledge, generating interpretable diagnostic reports. The experimental results show that the overall accuracy of the system reaches 96.0%. The edge–cloud collaborative framework improves the accuracy of complex fault diagnosis to 92.5%, and the adoption of RAG reduces the report hallucination rate by 71.4%. This work effectively addresses the bottlenecks of MEMS perception in elevator fault diagnosis, forming a closed loop from micro-signal acquisition to high-level decision support. Full article
(This article belongs to the Special Issue Human-Centred Intelligent Wearable Devices)
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16 pages, 2916 KB  
Article
Deep Learning-Based Relay Selection in a Decode-and-Forward Cooperative System with Energy Harvesting and Signal Space Diversity
by Ahmed Oun, Divyessh Maheshwari and Ahmed Ammar
Electronics 2026, 15(7), 1363; https://doi.org/10.3390/electronics15071363 - 25 Mar 2026
Abstract
Deep learning techniques have been widely applied in wireless communication systems to enhance resilience and reduce computational complexity. This paper investigates both traditional and deep learning-based approaches for real-time relay selection in a cooperative communication system with multiple energy-harvesting relays and signal space [...] Read more.
Deep learning techniques have been widely applied in wireless communication systems to enhance resilience and reduce computational complexity. This paper investigates both traditional and deep learning-based approaches for real-time relay selection in a cooperative communication system with multiple energy-harvesting relays and signal space diversity. The assumed relay decoding scheme is decode-and-forward (DF), with selection criteria based on successful decoding from the source, sufficient energy availability, and the best channel to the destination. The system performance is evaluated in terms of outage probability. Monte Carlo simulations are used to determine the exact outage probability of the system and to generate datasets for training machine learning models. The traditional machine learning models implemented include Decision Tree (DT), Logistic Regression (LR), K-Nearest Neighbor (KNN), and Support Vector Machines (SVMs). The deep learning-based method used is the deep neural network (DNN). Two datasets—one with six features and another with nine features—were used for training and testing. The 6-feature datasets are comparatively less random and complex than the 9-feature datasets. The results indicate that among traditional models KNN achieves the highest accuracy and is thus used as a benchmark to compare against DNN performance. For the 9-feature datasets, both KNN and DNN struggle to accurately approximate the exact outage probability, suggesting that the 9-feature datasets are too complex and noisy for effective modeling. However, on the 6-feature datasets, KNN achieves 77% accuracy, while DNN achieves a significantly higher accuracy of 99%. Due to its high accuracy, the DNN model closely approximates the exact outage probability while offering greater computational efficiency compared to the KNN model. These results underscore the potential of deep learning in optimizing real-time relay selection for energy-harvesting cooperative communication systems. Full article
(This article belongs to the Special Issue Advances in Networked Systems and Communication Protocols)
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21 pages, 38078 KB  
Article
Development and Evaluation of a Deep Learning Model for Ovarian Cancer Histotype Classification Using Whole-Slide Imaging
by Dagoberto Pulido and Nathalia Arias-Mendoza
J. Imaging 2026, 12(4), 144; https://doi.org/10.3390/jimaging12040144 - 25 Mar 2026
Abstract
The histopathological classification of ovarian carcinoma is fundamental for patient management. While microscopic evaluation by pathologists is the current diagnostic standard, it is known to be subject to interobserver variability, which can affect consistency in treatment decisions. This study addresses this clinical need [...] Read more.
The histopathological classification of ovarian carcinoma is fundamental for patient management. While microscopic evaluation by pathologists is the current diagnostic standard, it is known to be subject to interobserver variability, which can affect consistency in treatment decisions. This study addresses this clinical need by developing and validating a deep learning-based diagnostic support tool designed to enhance the objectivity and reproducibility of this classification. In this work, we address a key challenge in computational pathology—the tendency of attention mechanisms to overfit by concentrating on limited features—by systematically evaluating a direct regularization method within multiple instance learning (MIL) models. The models were trained and validated using 10-fold cross-validation on a public training set of 538 whole-slide images and further tested on an independent public dataset for the more challenging task of molecular subtype classification. We utilized features from a foundational model pre-trained on histopathology data to represent tissue morphology. Our findings demonstrate that directly regularizing the attention mechanism with a stochastic approach provides a statistically significant improvement in accuracy and generalization, highlighting its power as a robust technique to mitigate overfitting for this clinical task. In direct contrast to the reported variability in manual assessment, our final model achieved high consistency and accuracy, with a balanced accuracy of 0.854 and a Cohen’s Kappa of 0.791. The model also demonstrated strong generalization on the molecular classification task. Its attention mechanism provides visual heatmaps for pathologist review, fostering interpretability and trust. We have developed a highly accurate and generalizable artificial intelligence tool that directly addresses the challenge of interobserver variability in ovarian cancer classification. Its performance highlights the potential for artificial intelligence to serve as a decision support system, standardizing histopathological assessment. Full article
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14 pages, 1297 KB  
Article
Deep Learning-Based Classification of Zirconia and Metal-Supported Porcelain Fixed Restorations on Panoramic Radiographs
by Zeynep Başağaoğlu Demirekin, Turgay Aydoğan and Yunus Cetin
Diagnostics 2026, 16(7), 972; https://doi.org/10.3390/diagnostics16070972 - 25 Mar 2026
Abstract
Background/Objectives: This study aimed to automatically classify Zirconia-based fixed restorations and porcelain-fused-to-metal (PFM) restorations on panoramic radiographs using an artificial intelligence-based model. Unlike previous studies that mainly focused on classifying types of restorations (e.g., crowns, fillings, implants), this research concentrated on material-based [...] Read more.
Background/Objectives: This study aimed to automatically classify Zirconia-based fixed restorations and porcelain-fused-to-metal (PFM) restorations on panoramic radiographs using an artificial intelligence-based model. Unlike previous studies that mainly focused on classifying types of restorations (e.g., crowns, fillings, implants), this research concentrated on material-based differentiation, aiming to provide a more specific contribution to clinical decision support systems. Method: Panoramic radiographs obtained from the archive of Süleyman Demirel University Faculty of Dentistry were included in this study. Radiographs with poor image quality or insufficient visibility of the restoration area were excluded. A total of 593 cropped region-of-interest (ROI) images, labeled by expert prosthodontists using ImageJ software (version 1.54r; National Institutes of Health, Bethesda, MD, USA), were included in the analysis. In order to reduce class imbalance, data augmentation was applied only for images in the Zirconia-based fixed restorations class. By using various image processing techniques such as rotation, reflection and brightness change, the number of samples in the zirconia-based restorations class was increased and thus a balanced dataset was obtained with a close number of samples for both classes. For model training, the pre-trained VGG16 architecture was used with a transfer learning method, and the final layers were retrained and fine-tuned. The model was configured specifically for binary classification. The entire dataset was randomly split into 70% training, 20% validation, and 10% testing. Model performance was evaluated using accuracy, F1-score, sensitivity, and specificity. Results: The model correctly classified 90 out of 94 images in the test dataset, achieving an overall accuracy rate of 96%. For both classes, the precision, recall, and F1-score values were measured in the range of 95% to 96%. Additionally, the Area Under the Curve (AUC) of the ROC curve was calculated as 0.994, and the Average Precision (AP) score was determined to be 0.995. According to the confusion matrix results, only 4 images were misclassified, consisting of 2 false positives and 2 false negatives. Conclusions: The deep learning model demonstrated high accuracy in differentiating zirconia and metal-supported porcelain restorations on panoramic radiographs, suggesting that material-based AI classification may support clinical decision-making in restorative dentistry. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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22 pages, 4545 KB  
Article
An Interpretable Hybrid SFNet Deep Learning Framework for Multi-Site Bone Fracture Detection in Medical Imaging
by Wijdan S. Aljebreen, Da’ad Albahdal, Shuaa S. Alharbi, Naif S. Alshammari and Haifa F. Alhasson
Diagnostics 2026, 16(7), 966; https://doi.org/10.3390/diagnostics16070966 - 24 Mar 2026
Abstract
Background/Objectives: Accurate bone fracture detection is essential for orthopedic diagnosis and trauma management. Manual interpretation of X-ray or CT images can be time-consuming and may lead to inter-observer variability, particularly in subtle or multi-site fracture cases. This study proposes an interpretable Hybrid [...] Read more.
Background/Objectives: Accurate bone fracture detection is essential for orthopedic diagnosis and trauma management. Manual interpretation of X-ray or CT images can be time-consuming and may lead to inter-observer variability, particularly in subtle or multi-site fracture cases. This study proposes an interpretable Hybrid Selective Feature Network (Hybrid SFNet) to improve multi-site bone fracture detection performance and boundary localization. Methods: The proposed Hybrid SFNet extends the original SFNet architecture by incorporating multi-scale convolutional feature extraction and a semantic flow mechanism to enhance structural representation and fracture boundary delineation. Preprocessing techniques, including Canny edge detection, normalization, and data augmentation, were applied to improve feature quality. Model interpretability was addressed using Gradient-weighted Class Activation Mapping (Grad-CAM) to visualize regions contributing to predictions. The model was evaluated on publicly available multi-site fracture datasets using both standard and class-weighted loss configurations. Results: For binary fracture classification, the proposed model achieved 90 accuracy, 94% precision, 77% recall, and an F1-score of 85% for fractured cases. When class-weighted loss was applied, recall improved to 85%, reducing false negatives from 145 to 94 cases (approximately 35%). Under the weighted configuration, Cohen’s Kappa reached 0.79 and the Matthews Correlation Coefficient (MCC) reached 0.76. Conclusions: The proposed Hybrid SFNet provides an interpretable and effective framework for multi-site bone fracture detection. The integration of multi-scale feature extraction and semantic flow mechanisms enhances detection performance and boundary localization, while Grad-CAM supports clinical interpretability. These results indicate the model’s potential for supporting clinical decision-making in orthopedic imaging. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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12 pages, 1203 KB  
Article
Interpretable Machine Learning for Emergency Department Triage: Clinical Insights from 133,198 Patients Using the Korean Triage and Acuity Scale (KTAS)
by MyoungJe Song, Jongsun Kim, Eun-Chul Jang and SoonChan Kwon
Diagnostics 2026, 16(6), 954; https://doi.org/10.3390/diagnostics16060954 - 23 Mar 2026
Viewed by 29
Abstract
Background/Objectives: Emergency room severity classification (KTAS) is essential for patient safety but has limitations due to its reliance on subjective judgment. Existing machine learning models have not been trusted in clinical settings due to their opaque ‘black box’ nature in decision-making processes. To [...] Read more.
Background/Objectives: Emergency room severity classification (KTAS) is essential for patient safety but has limitations due to its reliance on subjective judgment. Existing machine learning models have not been trusted in clinical settings due to their opaque ‘black box’ nature in decision-making processes. To overcome this, this study aims to develop an explainable machine learning framework that provides a transparent basis for judgment with high accuracy. Method: We retrospectively analyzed 133,198 emergency room visits from 2022 to 2024. We trained Random Forest (RF) and XGBoost models using vital signs and pain scores and applied explainable AI (XAI) techniques to ensure model transparency. Results: Although XGBoost showed the highest predictive performance (94.7% accuracy within a ±1 error margin), we ultimately selected the RF model, which provides a good balance of predictive power (91.6%) and interpretability for clinical use. The results of the XAI analysis confirmed that pain score, age, and systolic blood pressure were the key variables in prediction, strongly aligning with clinical logic. Conclusions: This study demonstrates that explainable AI can provide transparent insights for KTAS prediction beyond the limitations of traditional black-box models. These models may support emergency department triage by improving consistency and assisting clinicians in identifying potentially high-risk patients. However, further external validation is required before routine clinical implementation. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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17 pages, 1057 KB  
Review
Integrating Multiparametric MRI and PSMA PET Imaging in Prostate Cancer: Toward a Unified Diagnostic and Risk-Stratification Paradigm
by Rosa Alba Pugliesi, Roberto Cannella, Karim Ben Mansour, Daniele Di Biagio and Pierpaolo Alongi
Medicina 2026, 62(3), 610; https://doi.org/10.3390/medicina62030610 - 23 Mar 2026
Viewed by 47
Abstract
Prostate cancer represents a highly prevalent malignancy affecting men globally, necessitating precise staging and risk stratification for effective patient management. Multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography (PSMA PET) have individually revolutionized the diagnosis and management of prostate [...] Read more.
Prostate cancer represents a highly prevalent malignancy affecting men globally, necessitating precise staging and risk stratification for effective patient management. Multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography (PSMA PET) have individually revolutionized the diagnosis and management of prostate cancer. Recent developments emphasize the integration of these imaging modalities to improve detection capabilities, inform therapeutic interventions, and facilitate personalized management. This narrative article reviews existing literature on the clinical utilization of mpMRI and PSMA PET in prostate cancer. Key areas encompass initial diagnosis, both local and systemic staging, detection of biochemical recurrence, and their influence in treatment strategies. The integration of mpMRI and PSMA PET offers complementary insights, with mpMRI demonstrating superior capability in local tumor characterization and PSMA PET enhancing the detection of nodal and distant metastases. Quantitative imaging biomarkers, including apparent diffusion coefficient (ADC) and standardized uptake values (SUV), have the potential to improve risk stratification and inform personalized treatment strategies. Hybrid imaging techniques may improve diagnostic accuracy and guide decisions regarding surgery, radiotherapy, and systemic treatment. The integration of mpMRI and PSMA PET allows a potentially transformative advancement in the realm of precision imaging for prostate cancer. This integrated approach can improve diagnostic accuracy, better define disease extent, and support personalized management strategies. Full article
(This article belongs to the Special Issue Advances in Use of PET-CT Imaging in Disease Diagnosis)
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21 pages, 2227 KB  
Article
Emotion and Context-Aware Artificial Intelligence Recommendation for Urban Tourism
by Mashael Aldayel, Abeer Al-Nafjan, Reman Alwadiee, Sarah Altammami, Abeer Alnafaei and Leena Alzahrani
J. Theor. Appl. Electron. Commer. Res. 2026, 21(3), 95; https://doi.org/10.3390/jtaer21030095 - 23 Mar 2026
Viewed by 91
Abstract
The rapid growth of digital tourism platforms has intensified information overload and decision complexity for both locals and travelers, while operators struggle to differentiate their offerings and sustain profitable, data-driven e-commerce models. This paper presents Doroob, a big data and artificial intelligence (AI)-driven, [...] Read more.
The rapid growth of digital tourism platforms has intensified information overload and decision complexity for both locals and travelers, while operators struggle to differentiate their offerings and sustain profitable, data-driven e-commerce models. This paper presents Doroob, a big data and artificial intelligence (AI)-driven, context-aware recommendation system that integrates traditional recommender techniques with real-time facial emotion recognition (FER) to enable intelligent tourism commerce. Doroob combines three AI-based recommendation strategies: smart adaptive recommendation (SAR) collaborative filtering, a Vowpal Wabbit-based context-aware model, and a LightFM hybrid model. It trained on datasets built from the Google Places API and enriched with ratings adapted from MovieLens. FER, implemented with DeepFace and OpenCV, analyzes short video segments as users browse destination details, converts emotion scores into 1–5 satisfaction ratings, and stores this implicit feedback alongside explicit ratings to support adaptive, emotion-aware personalization. Experimental results show that the context-aware model achieves the strongest top-K ranking performance, the hybrid LightFM model yields the highest AUC of 0.95, and the SAR model provides the most accurate rating predictions, demonstrating that combining contextual modeling and FER-based implicit feedback can enhance personalization, mitigate cold-start, and support data-driven promotion of local tourist services in intelligent e-commerce ecosystems. Full article
(This article belongs to the Special Issue Human–Technology Synergies in AI-Driven E-Commerce Environments)
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21 pages, 359 KB  
Review
Restoration of Muscle Function Following Distal Biceps Tendon Reinsertion: A Narrative Review
by Michał Harasymczuk, Ewa Bręborowicz, Aleksandra Bartkowiak-Graczyk, Anna Madziewicz, Tomasz Balcerek and Leszek Romanowski
J. Clin. Med. 2026, 15(6), 2430; https://doi.org/10.3390/jcm15062430 - 22 Mar 2026
Viewed by 117
Abstract
Background/Objectives: Distal biceps tendon rupture (DBTR) significantly impairs upper-limb function, particularly in movements requiring elbow flexion and forearm supination. This condition continues to attract clinical interest due to its complex biomechanics, evolving surgical strategies, and the growing emphasis on comprehensive rehabilitation. Contemporary [...] Read more.
Background/Objectives: Distal biceps tendon rupture (DBTR) significantly impairs upper-limb function, particularly in movements requiring elbow flexion and forearm supination. This condition continues to attract clinical interest due to its complex biomechanics, evolving surgical strategies, and the growing emphasis on comprehensive rehabilitation. Contemporary evidence highlights the value of a multidisciplinary approach that integrates precise surgical repair with structured, progressive physiotherapy to optimize outcomes effectively. Methods: We performed a comprehensive review of the literature by searching PubMed/MEDLINE, and a narrative review format was adopted to synthesize the available evidence. Results: Studies comparing single-incision and double-incision techniques show that both achieve excellent outcomes, although the decision should be tailored to patient-specific factors, surgeon expertise, and the reported complication risk, which may vary between 5% and 63%. Regardless of technique, restoring tendon integrity is essential for regaining normal strength and supination capability. Rehabilitation following DBTR repair relies on a phased and carefully monitored program. Early physiotherapy focuses on a controlled range of motion and the prevention of stiffness while protecting the repair. As healing progresses, strengthening exercises targeting the biceps, triceps, and brachialis are introduced, alongside endurance training to enhance overall functional capacity. Evidence strongly supports early mobilization protocols, where active motion and graded resistance are initiated within the first postoperative week, resulting in faster and more complete functional recovery compared to prolonged immobilization. Conclusions: Long-term outcomes after DBTR repair are consistently favorable. Most patients return to full activity or sport at an average of 5.4 months, although timelines vary with rehabilitation intensity and baseline fitness. Notably, 93–100% recover their pre-injury activity level, including participation in competitive sports. Full article
(This article belongs to the Special Issue Shoulder and Elbow Surgery: Clinical Updates and Perspectives)
20 pages, 2647 KB  
Article
Explainable Artificial Intelligence Unravels the Possible Distinct Roles of VKORC1 and CYP2C9 in Predicting Warfarin Anticoagulation Control
by Kannan Sridharan and Gowri Sivaramakrishnan
Med. Sci. 2026, 14(1), 156; https://doi.org/10.3390/medsci14010156 - 22 Mar 2026
Viewed by 116
Abstract
Background: Warfarin pharmacogenomics is critical due to its narrow therapeutic index and significant interpatient variability. While machine learning (ML) can predict anticoagulation control status (ACS), its “black-box” nature limits clinical translatability. Explainable Artificial Intelligence (XAI) addresses this by providing interpretable insights. This study [...] Read more.
Background: Warfarin pharmacogenomics is critical due to its narrow therapeutic index and significant interpatient variability. While machine learning (ML) can predict anticoagulation control status (ACS), its “black-box” nature limits clinical translatability. Explainable Artificial Intelligence (XAI) addresses this by providing interpretable insights. This study applied ML and XAI to a warfarin pharmacogenomic dataset to predict poor ACS and explain model decisions. Methods: A post hoc analysis was conducted on a cross-sectional dataset of 232 patients receiving warfarin for ≥6 months. Data included age, gender, interacting drugs, SAMe-TT2R2 score, and genotypes for CYP2C9, VKORC1, and CYP4F2. Poor ACS was defined as time in therapeutic range (TTR) < 70%. The dataset was split into training (70%) and testing (30%) cohorts. Three models, Random Forest, XGBoost, and Logistic Regression, were developed and evaluated using AUC-ROC, sensitivity, and specificity. XAI techniques, including permutation importance and SHapley Additive exPlanations (SHAP), were employed for global and local interpretability. Results: Of 232 patients, 141 (60.8%) had poor ACS. XGBoost and Random Forest demonstrated comparable predictive accuracy (AUC-ROC: 0.67), outperforming Logistic Regression. Sensitivity was 0.83 and 0.79 for XGBoost and Random Forest, respectively. However, specificity was modest for both ensemble methods (Random Forest: 0.48; XGBoost: 0.41) and extremely low for Logistic Regression (0.04), indicating poor discrimination, particularly for identifying patients with adequate anticoagulation control. Globally, important predictors included the age, SAMe-TT2R2 score, CYP2C9 (*2/*2), female gender, and VKORC1 (C/T). XAI revealed predictions were primarily driven by VKORC1, CYP4F2, SAMe-TT2R2 scores, and drug interactions. Concordance between XAI predictions and actual ACS was 78% for adequate and 88.6% for poor ACS. SHAP analysis showed VKORC1 provided a stable risk signal (mean absolute SHAP: 1.44 ± 0.49 in concordant cases), while CYP2C9 was a high-variance, high-impact driver of discordance (mean SHAP: 3.44 ± 3.79 in discordant cases). Conclusions: ML models, particularly ensemble methods, show modest ability to predict poor warfarin control with limited ability to correctly identify patients with adequate control from our dataset. XAI transforms these models into interpretable tools, with SHAP analysis attributing predictions to specific genetic and clinical features. While predictive accuracy remains modest, this approach enhances transparency and provides a foundation for generating hypotheses that may ultimately support clinical decision-making in pharmacogenomic-guided warfarin therapy. Full article
(This article belongs to the Special Issue Artificial Intelligence (AI) in Cardiovascular Medicine)
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32 pages, 1987 KB  
Article
Hybrid Multiple-Criteria Decision-Making (MCDM) Framework for Optimizing Water-Energy Nexus
by Derly Davis, Janis Zvirgzdins, Thilina Ganganath Weerakoon, Ineta Geipele and Lahiru Cheshara
Sustainability 2026, 18(6), 3097; https://doi.org/10.3390/su18063097 - 21 Mar 2026
Viewed by 176
Abstract
The growing urgency of resource-efficient construction in water-stressed and rapidly urbanizing regions necessitates integrated decision support frameworks that move beyond isolated sustainability metrics. This study operationalizes the water-energy nexus within building design evaluation by developing a structured hybrid multi-criteria decision-making (MCDM) framework tailored [...] Read more.
The growing urgency of resource-efficient construction in water-stressed and rapidly urbanizing regions necessitates integrated decision support frameworks that move beyond isolated sustainability metrics. This study operationalizes the water-energy nexus within building design evaluation by developing a structured hybrid multi-criteria decision-making (MCDM) framework tailored to the Indian construction context. Unlike conventional sustainability assessments that treat water and energy independently, the proposed approach integrates life cycle-based water consumption, operational and embodied energy demand, environmental impacts, economic feasibility, and project constraints within a unified analytical hierarchy. A Delphi-validated criterion structure comprising five main criteria and twenty sub-criteria is weighted using the Analytic Hierarchy Process (AHP), and ranked using the VIKOR compromise solution method. To strengthen methodological robustness, ranking outcomes are validated across three independent MCDM logics including TOPSIS, PROMETHEE, and COPRAS. The framework evaluates four representative building strategies aligned with Indian regulatory and certification systems (NBC, ECBC, IGBC/GRIHA, and net-zero water-energy design). Using expert-informed weights derived from a Delphi–AHP involving a panel of experienced practitioners, the VIKOR compromise ranking consistently identifies the net-zero alternative as the most favorable option within the evaluated framework. The results are therefore interpreted as an expert-informed assessment demonstrating the applicability of the proposed decision support methodology rather than as statistically generalizable priorities for the entire Indian construction sector. The study contributes by (i) embedding nexus-based resource interdependence into building-level MCDM modeling, (ii) enhancing transparency through explicit benefit-cost classification and decision matrix disclosure, and (iii) demonstrating ranking stability across multiple validation techniques. The proposed framework provides a transferable methodological approach that can be adapted to different regional contexts through locally derived expert inputs. Full article
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Article
Exploring and Examining an Investor-Oriented ESG Intelligence Transformation Model: Insights from Chinese Analyst Reports
by Hua Guo and Jiayao Hong
Sustainability 2026, 18(6), 3076; https://doi.org/10.3390/su18063076 - 20 Mar 2026
Viewed by 189
Abstract
Environmental, social, and governance (ESG) information is increasingly vital in driving capital markets to promote sustainable development. However, significant barriers remain in effectively transforming ESG information into intelligence that supports investor decision-making. Drawing upon information chain theory and intelligence transformation theory, this study [...] Read more.
Environmental, social, and governance (ESG) information is increasingly vital in driving capital markets to promote sustainable development. However, significant barriers remain in effectively transforming ESG information into intelligence that supports investor decision-making. Drawing upon information chain theory and intelligence transformation theory, this study constructs an ESG intelligence transformation model tailored for investor decision-making, aiming to address relevant challenges within China’s unique capital market environment. Through a mixed deductive-inductive content analysis of analyst reports issued by Chinese securities firms, this study identifies underlying issues in current ESG information utilization: excessive focus on social dimensions at the expense of integrated consideration of environmental and governance issues; inadequate conversion of environmental and governance data into decision-relevant information; and incomplete pathways for transforming ESG knowledge into intelligence supporting investment decisions. These constraints significantly undermine the potential of ESG information to guide sustainable investment strategies and support green economic transformation. To bridge these gaps, this study proposes an integrated multi-stakeholder optimization strategy encompassing: enhanced disclosure standards by regulators; greater corporate emphasis on environmental and governance disclosures; more sophisticated assessment techniques by rating agencies; and optimized information channels between corporations and investors by financial institutions. This study provides a theoretical foundation and practical pathways for enhancing the quality and utility of ESG information, contributing to sustainable finance research. Full article
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