Search Results (32)

Peripheral artery disease (PAD) is associated with an elevated risk of major adverse cardiovascular events (MACE). Despite this, few reliable biomarkers exist to identify patients at heightened risk of MACE. Growth differentiation factor 15 (GDF15), a stress-responsive cytokine implicated in inflammation, atherosclerosis, and thrombosis, has been broadly studied in cardiovascular disease but remains underexplored in PAD. This study aimed to evaluate the prognostic utility of GDF15 for predicting 2-year MACE in PAD patients using explainable statistical and machine learning approaches. We conducted a prospective analysis of 1192 individuals (454 with PAD and 738 without PAD). At study entry, patient plasma GDF15 concentrations were measured using a validated multiplex immunoassay. The cohort was followed for two years to monitor the occurrence of MACE, defined as stroke, myocardial infarction, or death. Baseline GDF15 levels were compared between PAD and non-PAD participants using the Mann–Whitney U test. A machine learning model based on extreme gradient boosting (XGBoost) was trained to predict 2-year MACE using 10-fold cross-validation, incorporating GDF15 and clinical variables including age, sex, comorbidities (hypertension, diabetes, dyslipidemia, congestive heart failure, coronary artery disease, and previous stroke or transient ischemic attack), smoking history, and cardioprotective medication use. The model’s primary evaluation metric was the F1 score, a validated measurement of the harmonic mean of the precision and recall values of the prediction model. Secondary model performance metrics included precision, recall, positive likelihood ratio (LR+), and negative likelihood ratio (LR-). A prediction probability histogram and Shapley additive explanations (SHAP) analysis were used to assess model discrimination and interpretability. The mean participant age was 70 ± SD 11 years, with 32% (n = 386) female representation. Median plasma GDF15 levels were significantly higher in PAD patients compared to the levels in non-PAD patients (1.29 [IQR 0.77–2.22] vs. 0.99 [IQR 0.61–1.63] pg/mL; p < 0.001). During the 2-year follow-up period, 219 individuals (18.4%) experienced MACE. The XGBoost model demonstrated strong predictive performance for 2-year MACE (F1 score = 0.83; precision = 82.0%; recall = 83.7%; LR+ = 1.88; LR− = 0.83). The prediction histogram revealed distinct stratification between those who did vs. did not experience 2-year MACE. SHAP analysis identified GDF15 as the most influential predictive feature, surpassing traditional clinical predictors such as age, cardiovascular history, and smoking status. This study highlights GDF15 as a strong prognostic biomarker for 2-year MACE in patients with PAD. When combined with clinical variables in an interpretable machine learning model, GDF15 supports the early identification of patients at high risk for systemic cardiovascular events, facilitating personalized treatment strategies including multidisciplinary specialist referrals and aggressive cardiovascular risk reduction therapy. This biomarker-guided approach offers a promising pathway for improving cardiovascular outcomes in the PAD population through precision risk stratification. Full article

The reduction in disaster risk in urban regions due to natural hazards (e.g., earthquakes, landslides, floods, and tropical cyclones) is primarily a development matter that must be treated within the scope of a broader urban development framework. Natural hazard assessment is one of the turning points in mitigating disaster risk, which typically contributes to stronger urban resilience and more sustainable urban development. Regarding this challenge, our research proposes a new approach in the signal processing chain and feature extraction from microtremor data that focuses mainly on the Horizontal-to-Vertical Spectral Ratio (HVSR) so as to assess liquefaction potential as a natural hazard using AI. The key raw seismic features of site amplification and resonance are extracted from the data via bandpass filtering, Fourier Transformation (FT), the calculation of the HVSR, and smoothing through the use of moving averages. The main novelty is the integration of machine learning, particularly stacked ensemble learning, for liquefaction potential classification from imbalanced seismic datasets. For this approach, several models are used to consider class imbalance, enhancing classification performance and offering better insight into liquefaction risk based on microtremor data. Then, the paper proposes a liquefaction detection method based on deep learning with an autoencoder and stacked classifiers. The autoencoder compresses data into the latent space, underlining the liquefaction features classified by the multi-layer perceptron (MLP) classifier and eXtreme Gradient Boosting (XGB) classifier, and the meta-model combines these outputs to put special emphasis on rare liquefaction events. This proposed methodology improved the detection of an imbalanced dataset, although challenges remain in both interpretability and computational complexity. We created a synthetic dataset of 1000 samples using realistic feature ranges that mimic the Rif data region to test model performance and conduct sensitivity analysis. Key seismic and geotechnical variables were included, confirming the amplification factor (Af) and seismic vulnerability index ($K_g$) as dominant predictors and supporting model generalizability in data-scarce regions. Our proposed method for liquefaction potential classification achieves 100% classification accuracy, 100% precision, and 100% recall, providing a new baseline. Compared to existing models such as XGB and MLP, the proposed model performs better in all metrics. This new approach could become a critical component in assessing liquefaction hazard, contributing to disaster mitigation and urban planning. Full article

Background/Objectives: The increasing prevalence of diabetes underscores the urgent need for non-invasive, rapid, and cost-effective diagnostic alternatives. This study presents a breath-based multiclass diabetes classification system leveraging only three gas sensors (CO, alcohol, and acetone) to analyze exhaled breath composition. Methods: Breath samples were collected from 58 participants (22 healthy, 7 prediabetic, and 29 diabetic), with blood glucose levels serving as the reference metric. To enhance classification performance, we introduced a novel biomarker, the alcohol-to-acetone ratio, through a feature engineering approach. Class imbalance was addressed using the Synthetic Minority Over-Sampling Technique (SMOTE), ensuring a balanced dataset for model training. A nested cross-validation framework with 3 outer and 3 inner folds was implemented. Multiple machine learning classifiers were evaluated, with Random Forest and Gradient Boosting emerging as the top-performing models. Results: An ensemble combining both yielded the highest overall performance, achieving an average accuracy of 98.86%, precision of 99.07%, recall of 98.81% and F1 score of 98.87%. These findings highlight the potential of gas sensor-based breath analysis as a highly accurate, scalable, and non-invasive method for diabetes screening. Conclusions: The proposed system offers a promising alternative to blood-based diagnostic approaches, paving the way for real-world applications in point-of-care diagnostics and continuous health monitoring. Full article

This study applies machine learning (ML) techniques to classify fertile [for porphyry Cu and (or) Au systems] and barren adakites using geochemical data from New Brunswick, Canada. It emphasizes that not all intrusive units, including adakites, are inherently fertile and should not be directly used as the heat source evidence layer in mineral prospectivity mapping without prior analysis. Adakites play a crucial role in mineral exploration by helping distinguish between fertile and barren intrusive units, which significantly influence ore-forming processes. A dataset of 99 fertile and 66 barren adakites was analyzed using seven ML models: support vector machine (SVM), neural network, random forest (RF), decision tree, AdaBoost, gradient boosting, and logistic regression. These models were applied to classify 829 adakite samples from around the world into fertile and barren categories, with performance evaluated using area under the curve (AUC), classification accuracy, F1 score, precision, recall, and Matthews correlation coefficient (MCC). SVM achieved the highest performance (AUC = 0.91), followed by gradient boosting (0.90) and RF (0.89). For model validation, 160 globally recognized fertile adakites were selected from the dataset based on well-documented fertility characteristics. Among the tested models, SVM demonstrated the highest classification accuracy (93.75%), underscoring its effectiveness in distinguishing fertile from barren adakites for mineral prospectivity mapping. Statistical analysis and feature selection identified middle rare earth elements (REEs), including Gd and Dy, with Hf, as key indicators of fertility. A comprehensive analysis of 1596 scatter plots, generated from 57 geochemical variables, was conducted using linear discriminant analysis (LDA) to determine the most effective variable pairs for distinguishing fertile and barren adakites. The most informative scatter plots featured element vs. element combinations (e.g., Ga vs. Dy, Ga vs. Gd, and Pr vs. Gd), followed by element vs. major oxide (e.g., Fe₂O₃T vs. Gd and Al₂O₃ vs. Hf) and ratio vs. element (e.g., La/Sm vs. Gd, Rb/Sr vs. Hf) plots, whereas major oxide vs. major oxide, ratio vs. ratio, and major oxide vs. ratio plots had limited discriminatory power. Full article

Background and Objectives: Kidney failure (KF) is associated with high mortality, especially among critically ill patients in the intensive care unit (ICU). Conversely, age is an independent risk factor for the development of KF. Therefore, understanding the mortality risk profile of elderly critically ill patients with KF can help clinicians in implementing appropriate measures to improve patients’ prognosis. The aim of this study was to construct high-performance mortality risk prediction models for elderly ICU patients with KF using machine learning methods. Materials and Methods: Elderly (≥65 years) ICU patients diagnosed with KF were selected and relevant information (including demographic details, vital signs, laboratory tests, etc.) was collected. They were randomly divided into training, validation, and test sets in a 6:2:2 ratio. Logistic regression (LR), random forest (RF), support vector machine (SVM), and extreme gradient boosting (XGBoost) methods were employed to develop prediction models for the risk of death in these elderly KF patients. The model’s performance was evaluated by the receiver operating characteristic curve, precision rate, recall rate, and decision curve analysis. Finally, breakdown plots were utilized to analyze the mortality risk of elderly KF patients. Results: A total of 8010 elderly ICU patients with KF were included in this study, among whom 1385 patients died. Mortality prediction models were constructed using various methods, with the areas under the curve (AUC) for the different models being 0.835 (LR model), 0.839 (RF model), 0.784 (SVM model), and 0.851 (XGBoost model), respectively. The integrated Brier score (IBS) for these models were 0.206 (LR model), 0.158 (RF model), 0.217 (SVM model), and 0.102 (XGBoost model), indicating that the XGBoost model and RF model exhibited superior differentiation and calibration capacity. Further analysis revealed that the XGBoost model outperformed the others in terms of both prediction accuracy and stability. Finally, based on the ranking of important features, the primary influencing factors for elderly KF patients were identified as urine output, metastatic solid tumor, body weight, body temperature, and severity score. Conclusions: Several high-performing predictive models for mortality risk in elderly ICU patients with KF have been developed using various machine learning algorithms, with the XGBoost model demonstrating the best performance. Full article

Decolorization is an image processing technique that converts a color input image into a grayscale image. This paper discusses the decolorization process and provides an overview of the methods based on the different principles used: basic conversion from RGB to YUV format using ITU Recommendations 601, 709, and 2020; basic conversion from RGB to LAB color space; the method using cumulative distribution function of color channels; one global decolorization method; and one based on deep learning. The grayscale images produced by these methods were evaluated using four objective metrics, allowing for a thorough analysis and comparison of the decolorization results. Additionally, the execution speed of the algorithms was assessed, providing insight into their performance efficiency. The results demonstrate that different metrics evaluate the decolorization methods differently, highlighting the importance of selecting an appropriate metric that aligns with the subsequent image processing tasks following decolorization. Furthermore, it was shown that the decolorization methods depend on the content of the images, performing better on natural images than on artificially generated ones. The decolorization methods were also examined in the context of object segmentation and edge detection. The results from segmentation and edge detection were aligned with the decolorization results, revealing that certain objective metrics for evaluating decolorization more effectively assessed the properties of the decolorized images, which are crucial for successful object segmentation and edge detection. Full article

Background/Objectives: Necrotizing enterocolitis (NEC), a devastating neonatal gastrointestinal disease mostly seen in preterm infants, lacks accurate prediction despite known risk factors. This hinders the possibility of applying targeted preventive therapies. This study explores the use of vital signs, including cerebral and splanchnic oxygenation, measured with near-infrared spectroscopy in early NEC prediction. Methods: Several machine learning algorithms were trained on data from very preterm patients (<30 weeks gestational age). Time Series FeatuRe Extraction on the basis of scalable hypothesis tests (TSFRESH) extracted significant features from the vital signs of the first 5 postnatal days. We present the F1-scores and area under the precision-recall curve (AUC-PR) of the models. The contribution of separate vital signs to the selected TSFRESH features was also determined. Results: Among 267 patients, 32 developed NEC Bell’s stage > 1. Using a 1:4 NEC:control ratio, support vector machine and logistic regression predicted NEC better than extreme gradient boosting regarding the F1-score (0.82, 0.82, 0.76, resp., p = 0.001) and AUC-PR (0.82, 0.83, 0.77, resp., p < 0.001). Splanchnic and cerebral oxygenation contributed most to the prediction (40.1% and 24.8%, resp.). Conclusions: Using vital signs, we predicted NEC in the first 5 postnatal days with an F1-score up to 0.82. Splanchnic and cerebral oxygenation were the most contributing vital predictors. This pioneering effort in early NEC prediction using vital signs underscores the potential for targeted preventive measures and also emphasizes the need for additional data in future studies. Full article

Background: This study aimed to analyze image biomarkers of the parotid glands in ultrasonography images with reduced shape effects, providing a reference for the radiomic diagnosis of parotid gland lesions. Methods: Ultrasound (US) and sialography images of the parotid glands, acquired from September 2019 to March 2024, were reviewed along with their clinical information. Parotid glands diagnosed as within the normal range were included. Overall, 91 US images depicting the largest portion of the parotid glands were selected for radiomic feature extraction. Regions of interest were drawn twice on 50 images using different shapes to assess the intraclass correlation coefficient (ICC). Feature dimensions were statistically reduced by selecting features with an ICC > 0.8 and applying four statistical algorithms. The selected features were used to distinguish age and sex using the four classification models. Classification performance was evaluated using the area under the receiver operating characteristic curve (AUC), recall, and precision. Results: The combinations of the information gain ratio algorithm or stochastic gradient descent and the naïve Bayes model showed the highest AUC for both age and sex classification (AUC = 1.000). The features contributing to these classifications included the first-order and gray-level co-occurrence matrix (high-order) features, particularly discretized intensity skewness and kurtosis, intensity skewness, and GLCM angular second moment. These features also contributed to achieving one of the highest recall (0.889) and precision (0.926) values. Conclusions: The two features were the most significant factors in discriminating radiomic variations related to age and sex in US images with reduced shape effects. These radiomic findings should be assessed when diagnosing parotid gland pathology versus normal using US images and radiomics in a heterogeneous population. Full article

Landslides are one of the major disasters that exist worldwide, posing a serious threat to human life and property safety. Rapid and accurate detection and mapping of landslides are crucial for risk assessment and humanitarian assistance in affected areas. To achieve this goal, this study proposes a landslide recognition method based on machine learning (ML) and terrain feature fusion. Taking the Dawan River Basin in Detuo Township and Tianwan Yi Ethnic Township as the research area, firstly, landslide-related data were compiled, including a landslide inventory based on field surveys, satellite images, historical data, high-resolution remote sensing images, and terrain data. Then, different training datasets for landslide recognition are constructed, including full feature datasets that fusion terrain features and remote sensing features and datasets that only contain remote sensing features. At the same time, different ratios of landslide to non-landslide (or positive/negative, P/N) samples are set in the training data. Subsequently, five ML algorithms, including Extreme Gradient Boost (XGBoost), Adaptive Boost (AdaBoost), Light Gradient Boost (LightGBM), Random Forest (RF), and Convolutional Neural Network (CNN), were used to train each training dataset, and landslide recognition was performed on the validation area. Finally, accuracy (A), precision (P), recall (R), F1 score (F1), and intersection over union (IOU) were selected to evaluate the landslide recognition ability of different models. The research results indicate that selecting ML models suitable for the study area and the ratio of the P/N samples can improve the A, R, F1, and IOU of landslide identification results, resulting in more accurate and reasonable landslide identification results; Fusion terrain features can make the model recognize landslides more comprehensively and align better with the actual conditions. The best-performing model in the study is LightGBM. When the input data includes all features and the P/N sample ratio is optimal, the A, P, R, F1, and IOU of landslide recognition results for this model are 97.47%, 85.40%, 76.95%, 80.95%, and 71.28%, respectively. Compared to the landslide recognition results using only remote sensing features, this model shows improvements of 4.51%, 35.66%, 5.41%, 22.27%, and 29.16% in A, P, R, F1, and IOU, respectively. This study serves as a valuable reference for the precise and comprehensive identification of landslide areas. Full article

Migraine is one of the most common neurological disorders, characterized by moderate-to-severe headache episodes. Autonomic nervous system (ANS) alterations can occur at phases of migraine attack. This study investigates patterns of ANS changes during the pre-ictal night of migraine, utilizing wearable biosensor technology in ten individuals. Various physiological, activity-based, and signal processing metrics were examined to train predictive models and understand the relationship between specific features and migraine occurrences. Data were filtered based on specified criteria for nocturnal sleep, and analysis frames ranging from 5 to 120 min were used to improve the diversity of the training sample and investigate the impact of analysis frame duration on feature significance and migraine prediction. Several models, including XGBoost (Extreme Gradient Boosting), HistGradientBoosting (Histogram-Based Gradient Boosting), Random Forest, SVM, and KNN, were trained on unbalanced data and using cost-sensitive learning with a 5:1 ratio. To evaluate the changes in features during pre-migraine nights and nights before migraine-free days, an analysis of variance (ANOVA) was performed. The results showed that the features of electrodermal activity, skin temperature, and accelerometer exhibited the highest F-statistic values and the most significant p-values in the 5 and 10 min frames, which makes them particularly useful for the early detection of migraines. The generalized prediction model using XGBoost and a 5 min analysis frame achieved 0.806 for accuracy, 0.638 for precision, 0.595 for recall, and 0.607 for F1-score. Despite identifying distinguishing features between pre-migraine and migraine-free nights, the performance of the current model suggests the need for further improvements for clinical application. Full article

Edge detection is an essential image processing act that is crucial for many computer vision applications such as object detection, image segmentation, face recognition, text recognition, medical imaging, and autonomous vehicles. Deep learning is the most advanced and widely used tool of them all. In this paper, we present a novel deep learning model and use image datasets to test it. Our model uses a fractional calculus tool, which could enhance gradient approaches’ performances. Specifically, we approximate the fractional-order derivative-order neural network (GLFNet) using a Grünwald–Letnikov fractional definition. First, the original dataset is subjected to a Grünwald–Letnikov fractional order. After that, the CNN model is updated with the new dataset, concluding the standard CNN procedure. The training rate, the improvement in the F-measure for identifying the effective edge while maintaining the CNN model’s memory consumption, and the values of the loss errors between the prediction and training processes were all tested using the MNIST dataset. Our experiments show that GLFNet considerably enhances edge detection. GLFNet outperformed CNN with an average loss error ratio of 15.40, suggesting fewer loss mistakes. The F1-measure ratio of 0.81 indicates that GLFNet can compete with CNN in terms of precision and recall. The training time for GLFNet was lowered by an average ratio of 1.14 when compared to CNN, while inference time was faster with a ratio of 1.14, indicating increased efficiency. These findings demonstrate the efficacy of introducing Grünwald–Letnikov fractional convolution into deep learning models, resulting in more precise and reliable edge detection while preserving comparable memory utilization. Full article

With the continuous advancement of petroleum extraction technologies, the importance of horizontal and inclined wells in reservoir exploitation has been increasing. However, accurately predicting oil–water two-phase flow regimes is challenging due to the complexity of subsurface fluid flow patterns. This paper introduces a novel approach to address this challenge by employing extreme gradient boosting (XGBoost, version 2.1.0) optimised through Bayesian techniques (using the Bayesian-optimization library, version 1.4.3) to predict oil–water two-phase flow regimes. The integration of Bayesian optimisation aims to enhance the efficiency of parameter tuning and the precision of predictive models. The methodology commenced with experimental studies utilising a multiphase flow simulation apparatus to gather data across a spectrum of water cut rate, well inclination angles, and flow rates. Flow patterns were meticulously recorded via direct visual inspection, and these empirical datasets were subsequently used to train and validate both the conventional XGBoost model and its Bayesian-optimised counterpart. A total of 64 datasets were collected, with 48 sets used for training and 16 sets for testing, divided in a 3:1 ratio. The findings highlight a marked improvement in predictive accuracy for the Bayesian-optimised XGBoost model, achieving a testing accuracy of 93.8%, compared to 75% for the traditional XGBoost model. Precision, recall, and F1-score metrics also showed significant improvements: precision increased from 0.806 to 0.938, recall from 0.875 to 0.938, and F1-score from 0.873 to 0.938. The training accuracy further supported these results, with the Bayesian-optimised XGBoost (BO-XGBoost) model achieving an accuracy of 0.948 compared to 0.806 for the traditional XGBoost model. Comparative analyses demonstrate that Bayesian optimisation enhanced the predictive capabilities of the algorithm. Shapley additive explanations (SHAP) analysis revealed that well inclination angles, water cut rates, and daily flow rates were the most significant features contributing to the predictions. This study confirms the efficacy and superiority of the Bayesian-optimised XGBoost (BO-XGBoost) algorithm in predicting oil–water two-phase flow regimes, offering a robust and effective methodology for investigating complex subsurface fluid dynamics. The research outcomes are crucial in improving the accuracy of oil–water two-phase flow predictions and introducing innovative technical approaches within the domain of petroleum engineering. This work lays a foundational stone for the advancement and application of multiphase flow studies. Full article

A deep-seated landslide could release numerous microseismic signals from creep-slip movement, which includes a rock-soil slip from the slope surface and a rock-soil shear rupture in the subsurface. Machine learning can effectively enhance the classification of microseismic signals in landslide seismic monitoring and interpret the mechanical processes of landslide motion. In this paper, eight sets of triaxial seismic sensors were deployed inside the deep-seated landslide, Jiuxianping, China, and a large number of microseismic signals related to the slope movement were obtained through 1-year-long continuous monitoring. All the data were passed through the seismic event identification mode, the ratio of the long-time average and short-time average. We selected 11 days of data, manually classified 4131 data into eight categories, and created a microseismic event database. Classical machine learning algorithms and ensemble learning algorithms were tested in this paper. In order to evaluate the seismic event classification performance of each algorithmic model, we evaluated the proposed algorithms through the dimensions of the accuracy, precision, and recall of each model. The validation results demonstrated that the best performing decision tree algorithm among the classical machine learning algorithms had an accuracy of 88.75%, while the ensemble algorithms, including random forest, Gradient Boosting Trees, Extreme Gradient Boosting, and Light Gradient Boosting Machine, had an accuracy range from 93.5% to 94.2% and also achieved better results in the combined evaluation of the precision, recall, and F1 score. The specific classification tests for each microseismic event category showed the same results. The results suggested that the ensemble learning algorithms show better results compared to the classical machine learning algorithms. Full article

Accurate and reliable pose estimation of boom-type roadheaders is the key to the forming quality of the tunneling face in coal mines, which is of great importance to improve tunneling efficiency and ensure the safety of coal mine production. The multi-laser-beam target-based visual localization method is an effective way to realize accurate and reliable pose estimation of a roadheader body. However, the complex background interference in coal mines brings great challenges to the stable and accurate segmentation and extraction of laser beam features, which has become the main problem faced by the long-distance visual positioning method of underground equipment. In this paper, a semantic segmentation network for underground laser beams in coal mines, RCEAU-Net, is proposed based on U-Net. The network introduces residual connections in the convolution of the encoder and decoder parts, which effectively fuses the underlying feature information and improves the gradient circulation performance of the network. At the same time, by introducing cascade multi-scale convolution in the skipping connection section, which compensates for the lack of contextual semantic information in U-Net and improves the segmentation effect of the network model on tiny laser beams at long distance. Finally, the introduction of an efficient multi-scale attention module with cross-spatial learning in the encoder enhances the feature extraction capability of the network. Furthermore, the laser beam target dataset (LBTD) is constructed based on laser beam target images collected from several coal mines, and the proposed RCEAU-Net model is then tested and verified. The experimental results show that, compared with the original U-Net, RCEAU-Net can ensure the real-time performance of laser beam segmentation while increasing the Accuracy by 0.19%, Precision by 2.53%, Recall by 22.01%, and Intersection and Union Ratio by 8.48%, which can meet the requirements of multi-laser-beam feature segmentation and extraction under complex backgrounds in coal mines, so as to further ensure the accuracy and stability of long-distance visual positioning for boom-type roadheaders and ensure the safe production in the working face. Full article

Image decolorization is an image pre-processing step which is widely used in image analysis, computer vision, and printing applications. The most commonly used methods give each color channel (e.g., the R component in RGB format, or the Y component of an image in CIE-XYZ format) a constant weight without considering image content. This approach is simple and fast, but it may cause significant information loss when images contain too many isoluminant colors. In this paper, we propose a new method which is not only efficient, but also can preserve a higher level of image contrast and detail than the traditional methods. It uses the information from the cumulative distribution function (CDF) of the information in each color channel to compute a weight for each pixel in each color channel. Then, these weights are used to combine the three color channels (red, green, and blue) to obtain the final grayscale value. The algorithm works in RGB color space directly without any color conversion. In order to evaluate the proposed algorithm objectively, two new metrics are also developed. Experimental results show that the proposed algorithm can run as efficiently as the traditional methods and obtain the best overall performance across four different metrics. Full article