Search Results (2,799)

Heart failure (HF) poses a substantial global burden due to its high morbidity, mortality, and healthcare costs. Accurate prognostication is crucial for optimizing treatment, resource allocation, and patient counseling. Prognostic tools range from simple clinical scores such as ADHERE and MAGGIC to more complex models incorporating biomarkers (e.g., NT-proBNP, sST2), imaging, and artificial intelligence techniques. In acute HF, models like EHMRG and STRATIFY aid early triage, while in chronic HF, tools like SHFM and BCN Bio-HF support long-term management decisions. Despite their utility, most models are limited by poor generalizability, reliance on static inputs, lack of integration into electronic health records, and underuse in clinical practice. Novel approaches involving machine learning, multi-omics profiling, and remote monitoring hold promise for dynamic and individualized risk assessment. However, these innovations face challenges regarding interpretability, validation, and ethical implementation. For prognostic models to transition from theoretical promise to practical impact, they must be continuously updated, externally validated, and seamlessly embedded into clinical workflows. This review emphasizes the potential of prognostic models to transform HF care but cautions against uncritical adoption without robust evidence and practical integration. In the evolving landscape of HF management, prognostic models represent a hopeful avenue, provided their limitations are acknowledged and addressed through interdisciplinary collaboration and patient-centered innovation. Full article

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

Both ground source heat pumps (GSHPs) and energy underground structures are engineered systems that utilize shallow geothermal energy. However, due to the construction complexity and associated costs of energy tunnels, their heat exchange efficiency relative to GSHPs remains a topic worthy of in-depth investigation. In this study, a thermal–hydraulic (TH) coupled finite element model was developed based on a section of the Torino Metro Line in Italy to analyze the differences in and influencing factors of heat transfer performance between energy tunnels and GSHPs. The model was validated by comparing the outlet temperature curves under both winter and summer loading conditions. Based on this validated model, a parametric analysis was conducted to examine the effects of the tunnel air velocity, heat carrier fluid velocity, and fluid type. The results indicate that, under identical environmental conditions, energy tunnels exhibit higher heat exchange efficiency than conventional GSHP systems and are less sensitive to external factors such as fluid velocity. Furthermore, a comparison of different heat carrier fluids, including alcohol-based fluids, refrigerants, and water, revealed that the fluid type significantly affects thermal performance, with the refrigerant R-134a outperforming ethylene glycol and water in both heating and cooling efficiency. Full article

Adhesive capsulitis is a painful and progressive condition marked by significant limitations in shoulder mobility, particularly affecting external rotation. Although magnetic resonance imaging is regarded as the reference standard for assessing intra-articular structures, its high cost and limited availability present challenges in routine clinical use. In contrast, musculoskeletal ultrasound has emerged as an accessible, real-time, and cost-effective imaging modality for both the diagnosis and treatment guidance of adhesive capsulitis. This narrative review compiles and illustrates current evidence regarding the role of ultrasound, encompassing static B-mode imaging, dynamic motion analysis, contrast-enhanced techniques, and sonoelastography. Key sonographic features—such as thickening of the coracohumeral ligament, fibrosis in the axillary recess, and abnormal tendon kinematics—have been consistently associated with adhesive capsulitis and demonstrate favorable diagnostic performance. Advanced methods like contrast-enhanced ultrasound and elastography provide additional functional insights (enabling evaluation of capsular stiffness and vascular changes) which may aid in disease staging and prediction of treatment response. Despite these advantages, the clinical utility of ultrasound remains subject to operator expertise and technical variability. Limited visualization of intra-articular structures and the absence of standardized scanning protocols continue to pose challenges. Nevertheless, ongoing advances in its technology and utility standardization hold promise for the broader application of ultrasound in clinical practice. With continued research and validation, ultrasound is positioned to play an increasingly central role in the comprehensive assessment and management of adhesive capsulitis. Full article

To prolong the service life of asphalt pavement and reduce its maintenance cost, a fiber Bragg grating (FBG) sensor encapsulated in carboxylated carbon nanotube (CNT-COOH)-modified gel material suitable for strain monitoring of asphalt pavement was developed. Through tensile and bending tests, the effects of carboxylated carbon nanotubes on the mechanical properties of gel materials under different dosages were evaluated and the optimal dosage of carbon nanotubes was determined. Infrared spectrometer and scanning electron microscopy were used to compare and analyze the infrared spectra and microstructure of carbon nanotubes before and after carboxyl functionalization and modified gel materials. The results show that the incorporation of CNTs-COOH increased the tensile strength, elongation at break, and tensile modulus of the gel material by 36.2%, 47%, and 17.2%, respectively, and increased the flexural strength, flexural modulus, and flexural strain by 89.7%, 7.5%, and 63.8%, respectively. Through infrared spectrum analysis, it was determined that carboxyl (COOH) and hydroxyl (OH) were successfully introduced on the surface of carbon nanotubes. By analyzing the microstructure, it can be seen that the carboxyl functionalization of CNTs improved the agglomeration of carbon nanotubes. The tensile section of the modified gel material is rougher than that of the pure epoxy resin, showing obvious plastic deformation, and the toughness is improved. According to the data from the calibration experiment, the strain and temperature sensitivity coefficients of the packaged sensor are 1.9864 pm/μm and 0.0383 nm/°C, respectively, which are 1.63 times and 3.61 times higher than those of the bare fiber grating. The results of an applicability study show that the internal structure strain of asphalt rutting specimen changed linearly with the external static load, and the fitting sensitivity is 0.0286 με/N. Combined with ANSYS finite element analysis, it is verified that the simulation analysis results are close to the measured data, which verifies the effectiveness and monitoring accuracy of the sensor. The dynamic load test results reflect the internal strain change trend of asphalt mixture under external rutting load, confirming that the encapsulated FBG sensor is suitable for the long-term monitoring of asphalt pavement strain. Full article

Despite significant advancements in indoor navigation technology over recent decades, it still faces challenges due to excessive dependency on external infrastructure and unreliable positioning in complex environments. This paper proposes an autonomous localization system that integrates advanced adaptive pedestrian dead reckoning (APDR) and binocular vision, designed to provide a low-cost, high-reliability, and high-precision solution for rescuers. By analyzing the characteristics of measurement data from various body parts, the chest is identified as the optimal placement for sensors. A chest-mounted advanced APDR method based on dynamic step segmentation detection and adaptive step length estimation has been developed. Furthermore, step length features are innovatively integrated into the visual tracking algorithm to constrain errors. Visual data is fused with dead reckoning data through an extended Kalman filter (EKF), which notably enhances the reliability and accuracy of the positioning system. A wearable autonomous localization vest system was designed and tested in indoor corridors, underground parking lots, and tunnel environments. Results show that the system decreases the average positioning error by 45.14% and endpoint error by 38.6% when compared to visual–inertial odometry (VIO). This low-cost, wearable solution effectively meets the autonomous positioning needs of rescuers in disaster scenarios. Full article

In recent years, data augmentation techniques have become the predominant approach for addressing highly imbalanced classification problems in machine learning. Algorithms such as the Synthetic Minority Over-sampling Technique (SMOTE) and Conditional Tabular Generative Adversarial Network (CTGAN) have proven effective in synthesizing minority class samples. However, these methods often introduce distributional bias and noise, potentially leading to model overfitting, reduced predictive performance, increased computational costs, and elevated cybersecurity risks. To overcome these limitations, we propose a novel architecture, FADEL, which integrates feature-type awareness with a supervised discretization strategy. FADEL introduces a unique feature augmentation ensemble framework that preserves the original data distribution by concurrently processing continuous and discretized features. It dynamically routes these feature sets to their most compatible base models, thereby improving minority class recognition without the need for data-level balancing or augmentation techniques. Experimental results demonstrate that FADEL, solely leveraging feature augmentation without any data augmentation, achieves a recall of 90.8% and a G-mean of 94.5% on the internal test set from Kaohsiung Chang Gung Memorial Hospital in Taiwan. On the external validation set from Kaohsiung Medical University Chung-Ho Memorial Hospital, it maintains a recall of 91.9% and a G-mean of 86.7%. These results outperform conventional ensemble methods trained on CTGAN-balanced datasets, confirming the superior stability, computational efficiency, and cross-institutional generalizability of the FADEL architecture. Altogether, FADEL uses feature augmentation to offer a robust and practical solution to extreme class imbalance, outperforming mainstream data augmentation-based approaches. Full article

Background/Objectives: Sunk cost bias—continuing failing endeavours due to prior investments—is among the most studied decision-making biases. Despite decades of vignette-based research, these measures lack systematic psychometric validation. We examined whether widely-used sunk cost scenarios reliably measure the same psychological construct. Methods: Across two experiments (N = 395), we tested established sunk cost vignettes, including classic scenarios from Arkes and Blumer (1985). English-speaking participants from Prolific Academic completed vignettes alongside cognitive reflection and social desirability measures. We assessed internal consistency and intercorrelations between scenarios. Results: Internal consistency was consistently poor (ω = 0.14–0.57) with weak intercorrelations between scenarios. Even highly similar vignettes correlated only moderately. External validity was problematic, showing inconsistent relationships with cognitive reflection and social desirability across vignettes. Conclusions: These measurement failures have critical implications for neuroimaging research, where unreliable behavioural measures may be mistaken for genuine neural differences. The field needs systematic categorization of scenarios to identify which vignettes engage specific psychological processes and neural circuits, enabling more targeted theoretical development. Full article

Urban areas are responsible for most of Europe’s energy demand and emissions and urgently require building retrofits to meet climate neutrality goals. This study evaluates the energy efficiency potential of three public school buildings in western Macedonia, Greece—a cold-climate region with high heating needs. The buildings, constructed between 1986 and 2003, exhibited poor insulation, outdated electromechanical systems, and inefficient lighting, resulting in high oil consumption and low energy ratings. A robust methodology is applied, combining detailed on-site energy audits, thermophysical diagnostics based on U-value calculations, and a techno-economic assessment utilizing Net Present Value (NPV), Internal Rate of Return (IRR), and SWOT analysis. The study evaluates a series of retrofit measures, including ceiling insulation, high-efficiency lighting replacements, and boiler modernization, against both technical performance criteria and financial viability. Results indicate that ceiling insulation and lighting system upgrades yield positive economic returns, while wall and floor insulation measures remain financially unattractive without external subsidies. The findings are further validated through sensitivity analysis and policy scenario modeling, revealing how targeted investments, especially when supported by public funding schemes, can maximize energy savings and emissions reductions. The study concludes that selective implementation of cost-effective measures, supported by public grants, can achieve energy targets, improve indoor environments, and serve as a replicable model of targeted retrofits across the region, though reliance on external funding and high upfront costs pose challenges. Full article

In modern vehicles, Autonomous Driving Systems (ADSs) are designed to operate partially or fully without human intervention. The ADS pipeline comprises multiple layers, including sensors, perception, localization, mapping, path planning, and control. The Robot Operating System (ROS) is a widely adopted framework that supports the modular development and integration of these layers. Among them, the path-planning and control layers remain particularly challenging due to several limitations. Classical path planners often struggle with non-smooth trajectories and high computational demands. Meta-heuristic optimization algorithms have demonstrated strong theoretical potential in path planning; however, they are rarely implemented in real-time ROS-based systems due to integration challenges. Similarly, traditional PID controllers require manual tuning and are unable to adapt to system disturbances. This paper proposes a ROS-based ADS architecture composed of eight integrated nodes, designed to address these limitations. The path-planning node leverages a meta-heuristic optimization framework with a cost function that evaluates path feasibility using occupancy grids from the Hector SLAM and obstacle clusters detected through the DBSCAN algorithm. A dynamic goal-allocation strategy is introduced based on the LiDAR range and spatial boundaries to enhance planning flexibility. In the control layer, a modified Pure Pursuit algorithm is employed to translate target positions into velocity commands based on the drift angle. Additionally, an adaptive PID controller is tuned in real time using the Differential Evolution (DE) algorithm, ensuring robust speed regulation in the presence of external disturbances. The proposed system is practically validated on a four-wheel differential drive robot across six scenarios. Experimental results demonstrate that the proposed planner significantly outperforms state-of-the-art methods, ranking first in the Friedman test with a significance level less than 0.05, confirming the effectiveness of the proposed architecture. Full article

Automated generative design is increasingly used across engineering disciplines to accelerate innovation and reduce costs. Generative design offers the prospect of simplifying manual design tasks by exploring the efficacy of solutions automatically. However, existing generative design frameworks rely heavily on expensive optimisation procedures and often produce customised solutions, lacking reusable generative rules that transfer across different problems. This work presents a bioinspired generative design algorithm utilising the concept of evolutionary development (EvoDevo). This evolves a set of developmental rules that can be applied to different engineering problems to rapidly develop designs without the need to run full optimisation procedures. In this approach, an initial design is decomposed into simple entities called cells, which independently control their local growth over a development cycle. In biology, the growth of cells is governed by a gene regulatory network (GRN), but there is no single widely accepted model for this in artificial systems. The GRN responds to the state of the cell induced by external stimuli in its environment, which, in this application, is the loading regime on a bridge truss structure (but can be generalised to any engineering structure). Two GRN models are investigated: graph neural network (GNN) and graph-based Cartesian genetic programming (CGP) models. Both GRN models are evolved using a novel genetic search algorithm for parameter search, which can be re-used for other design problems. It is revealed that the CGP-based method produces results similar to those obtained using the GNN-based methods while offering more interpretability. In this work, it is shown that this EvoDevo approach is able to produce near-optimal truss structures via growth mechanisms such as moving vertices or changing edge features. The technique can be set up to provide design automation for a range of engineering design tasks. Full article

This paper proposes an energy-efficient current control strategy for drive modules of permanent magnetic actuators (PMAs) to reduce the cost and volume of DC-link capacitors. The drive module of the PMA does not receive the input power from an external power source during operation. Instead, the externally charged DC-link capacitors are used as internal backup power sources to guarantee the reliable operation even in the case of an emergency. Therefore, it is important to use the charged energy efficiently within the limited DC-link capacitors. However, conventional control strategies using a voltage open loop have trouble reducing the energy waste. This is because the drive module with the voltage open loop uses unnecessary energy even after the PMA mover has finished its movement. To figure it out, the proposed control strategy adopts a current control loop to save energy even if the displacement of the PMA mover is unknown. In addition, the proposed strategy can ensure the successful operation of the PMA by using the driving force analysis. The efficacy of the proposed strategy is verified through the experimental test. It would be expected that the proposed strategy can reduce the cost and volume of the PMA drive system. Full article

Three-dimensional imaging technologies are increasingly used in breast reconstructive and plastic surgery due to their potential for efficient and accurate preoperative assessment and planning. This study systematically evaluates the accuracy and consistency of six commercially available 3D scanning applications (apps)—Structure Sensor, 3D Scanner App, Heges, Polycam, SureScan, and Kiri—in reconstructing the female torso. To avoid variability introduced by human subjects, a silicone breast mannequin model was scanned, with fiducial markers placed at known anatomical landmarks. Manual distance measurements were obtained using calipers by two independent evaluators and compared to digital measurements extracted from 3D reconstructions in Blender software. Each scan was repeated six times per application to ensure reliability. SureScan demonstrated the lowest mean error (2.9 mm), followed by Structure Sensor (3.0 mm), Heges (3.6 mm), 3D Scanner App (4.4 mm), Kiri (5.0 mm), and Polycam (21.4 mm), which showed the highest error and variability. Even the app using an external depth sensor (Structure Sensor) showed no statistically significant accuracy advantage over those using only the iPad’s built-in camera (except for Polycam), underscoring that software is the primary driver of performance, not hardware (alone). This work provides practical insights for selecting mobile 3D scanning tools in clinical workflows and highlights key limitations, such as scaling errors and alignment artifacts. Future work should include patient-based validation and explore deep learning to enhance reconstruction quality. Ultimately, this study lays the foundation for more accessible and cost-effective 3D imaging in surgical practice, showing that smartphone-based tools can produce clinically useful scans. Full article

The Carbon Emissions Trading System (ETS) serves as a market-based mechanism to drive renewable energy (RE) investments, yet its heterogeneous impacts on different stakeholders remain underexplored. This paper treats the carbon market as an exogenous shock and develops a multi-agent equilibrium model incorporating carbon pricing, encompassing power generation enterprises, power transmission enterprises, power consumers, and the government, to analyze how carbon prices reshape RE investment layouts under dual-carbon goals. Using panel data from Zhejiang Province (2017–2022), a high-energy-consumption region with 25% net electricity imports, we simulate heterogeneous responses of agents to carbon price fluctuations (CNY 50–250/ton). The results show that RE on-grid electricity increases (+0.55% to +2.89%), while thermal power declines (–4.98% to −15.39%) on the generation side. Transmission-side RE sales rise (+3.25% to +9.74%), though total electricity sales decrease (−0.49% to −2.22%). On the consumption side, RE self-generation grows (+2.12% to +5.93%), yet higher carbon prices reduce overall utility (−0.44% to −2.05%). Furthermore, external electricity integration (peaking at 28.5% of sales in 2020) alleviates provincial entities’ carbon cost pressure under high carbon prices. This study offers systematic insights for renewable energy investment decisions and policy optimization. Full article

Background/Objectives: Tumor budding (TB)—clusters of one to five tumor cells at the invasive front—has emerged as a prognostic marker in various cancers. Its prognostic value in head and neck squamous cell carcinoma (HNSCC) is unclear. Methods: We retrospectively analyzed 98 HNSCC patients. The tumor buds were counted on hematoxylin–eosin-stained sections as per the 2016 International Tumor Budding Consensus Conference (ITBCC) guidelines. An optimal cutoff was determined by ROC analysis using excisional lymph nodes and five-year overall survival (OS) as the endpoint, stratifying patients into low- (≤4 buds) and high-risk (>4 buds) groups. The associations with clinicopathological features, OS, and disease-free survival (DFS) were assessed using Kaplan–Meier curves and Cox regression. Results: Among the 98 patients (median follow-up 58 months, range 18–108), 32 (32.7%) died. The optimal TB cutoff was 4.5 (AUC 0.85, 95% CI 0.76–0.93). High TB was associated with poorer five-year OS (26.4% vs. 85.3%). Multivariate Cox regression identified TB and extranodal extension as independent predictors of OS (TB HR: 3.4, 95% CI 1.3–9.2, p = 0.013). In the laryngeal cancer subgroup, TB was associated with worse survival in the univariate analysis (HR 7.5, 95% CI 1.6–35.6, p = 0.011), though this was not significant in the multivariate modeling. High TB independently predicted neck lymph node metastasis (multivariate OR 4.9, 95% CI 1.2–20.5, p = 0.029), which was present in 65.8% of the high-TB vs. 31.7% of the low-TB patients. High TB correlated with advanced AJCC stage and lymphovascular invasion. No clinicopathological factors, including TB, independently predicted DFS, in either the full cohort or the laryngeal subgroup. Conclusions: High tumor budding denotes an aggressive HNSCC phenotype and may guide decisions on elective neck dissection. Its assessment is simple, cost-effective, and potentially valuable for routine pathology, pending external validation. Full article