Search Results (117)

Background: Predicting recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC) remains important for post-transplant risk stratification and surveillance planning. The Milan criteria discriminate only moderately and some machine-learning re-analyses report overly optimistic results because of information leakage. Aim: The current study aimed to re-evaluate a previously published transplant cohort under a leakage-free survival-analysis framework and to benchmark post-transplant, explant-informed survival learners against the Milan criteria as a fixed pre-transplant reference. We hypothesised moderate rather than near-perfect discrimination, similar performance across learners of differing complexity, and better discrimination than the Milan criteria. Methods: This secondary analysis included 356 patients with HCC who underwent LT. The primary endpoint was recurrence-free survival, analysed from the observed event indicator and follow-up time rather than from a derived risk label. Seven survival learners were benchmarked with repeated nested cross-validation, using three repeats of a five-fold outer loop with a three-fold inner tuning loop. All data-dependent preprocessing, including robust multivariable outlier handling and imputation, was fitted within training folds only. Performance was assessed by the concordance indices of Harrell and Uno, the time-dependent area under the curve, the integrated Brier score, calibration, decision-curve analysis and descriptive competing-risk assessment. Results: Recurrence developed in 183 of the 356 patients over a median follow-up of 52 months. Discrimination was moderate rather than near-perfect and similar across learners; the random survival forest ranked highest and the Elastic-Net Cox model performed comparably. All learners showed higher descriptive concordance than the Milan criteria, and dependency-corrected comparisons supported higher concordance for the full-feature Cox model than for the Milan criteria, whereas the random survival forest and Cox did not differ materially. Out-of-fold calibration of the Elastic-Net Cox model at 36 months was acceptable, decision-curve analysis indicated positive net benefit across clinically relevant thresholds, and tumour size and alpha-fetoprotein were the leading contributors to prediction. Findings were stable in ablation and threshold-sensitivity analyses. Conclusions: Leakage-free survival modelling gave moderate but internally validated prediction of post-transplant recurrence and higher concordance than the Milan criteria in this cohort, supporting the stated hypotheses. Careful study design may matter more than architectural complexity in this setting, and leakage-free survival analysis is a practical standard for prognostic modelling in transplant oncology. Full article

This study focuses on how modulating the electrical pulse frequency alters both the topographic features and corrosion resistance of ceramic coatings produced via micro-arc oxidation (MAO) on an AZ31B magnesium substrate. In a silicate-based electrolyte, MAO treatments were executed utilizing four distinct frequencies: 300, 500, 800, and 1000 Hz. Phase configurations, microstructural features, and surface patterns were thoroughly evaluated using X-ray diffraction (XRD), scanning electron microscopy (SEM) integrated with energy dispersive spectroscopy (EDS), and an ultra-depth-of-field microscope. Furthermore, the fabricated coatings underwent rigorous assessments for their porosity, contact angle, Vickers hardness, and electrochemical attributes. The outcomes demonstrate that the surface appearance, phase structure, defect state, and density of the MAO coatings are highly sensitive to variations in pulse frequency. Notably, although the coating prepared at 800 Hz exhibited elevated surface roughness (Ra), it achieved a highly consolidated microstructure and the lowest porosity level, underscoring that roughness alone is not a definitive quality indicator. This structural refinement was driven by the presence of well-crystallized Mg₂SiO₄ and MgO phases. This group recorded a peak inner barrier layer resistance (R_b) of 1.62 × 10⁴ Ω·cm² alongside a minimum corrosion current density (I_corr) of 3.38 × 10⁻⁷ A·cm⁻², confirming its exceptional protective capacity. Consequently, the structural quality and corrosion resistance of MAO coatings can be strategically enhanced by tuning the electrical frequency, offering valuable engineering guidelines for utilizing AZ31B alloy parts under aggressive environmental conditions. Full article

Amid the growing need to reconcile agricultural development with ecological security in ecologically fragile regions, CFGT has become a critical pathway for shifting agricultural systems from vulnerability toward resilience. The NARC is a typical ecologically fragile area. It faces unprecedented pressure from natural conditions and unsustainable agricultural practices. Developing a rigorous, logically coherent indicator system, together with a systematic assessment of the spatiotemporal evolution of regional CFGT, is essential for objectively identifying its current developmental stage, revealing key bottlenecks, and forming policy optimization and transition acceleration. This paper constructs a comprehensive evaluation indicator system based on the Driver–Pressure–State–Impact–Response (DPSIR) framework. Using panel data from six provinces in the NARC from 2004 to 2023, the Entropy Weight Method is applied to quantify CFGT performance. Kernel Density Estimation and the Coefficient of Variation Method are further employed to examine the spatiotemporal evolution, distributional dynamics, and regional disparities of CFGT. In addition, an obstacle severity model is used to identify the key constraints affecting CFGT. The results show that (1) the CFGT performance of the NARC exhibited a substantial improvement during 2004–2023. Its temporal evolution indicates a transition from an initial adjustment phase to steady advancement phase, followed by a more rapid improvement phase after 2017. (2) The overall enhancement of CFGT performance was mainly driven by improvements in the Driving Force and Impact subsystems. (3) CFGT performance exhibited marked regional heterogeneity across the six provinces. Qinghai, Shaanxi, and Xinjiang formed the leading group, Ningxia and Inner Mongolia occupied intermediate positions, while Gansu consistently recorded the weakest performance. (4) The major constraints on CFGT were concentrated in resource-state conditions and governance response capacity. Overall, this paper provides an assessment framework based on evidence for understanding CFGT in ecologically fragile arid regions, offering policy implications for promoting resilient agricultural green development. Full article

This paper develops a unified probabilistic framework for the simultaneous assessment of reliability and robustness of series structural systems. Part I formulates an axiomatic theory of structural robustness: the robustness factor F_rob is defined as the negative decadic logarithm of the ratio between the damaged-state system failure probability and a normalised target failure probability, and five formal properties are proven—normalisation, monotonicity in damage severity, exact combination bounds under independent damage scenarios, invariance under reliability-preserving transformations, and boundedness. Part II describes the computational core, the evaluation of series system failure probability: the principal approximation methods (simple bounds, the complement-product reformulation, Ditlevsen’s narrow bounds) are formally derived, and a geometric mean-bound approximation over a dominant-element subset is introduced, with four propositions establishing consistency with bounds, monotonicity, convergence, and a complete characterisation of the error direction under positive equicorrelation, including a provably conservative regime above a threshold correlation. Part III synthesises both parts into a computational framework that evaluates F_rob from first-order reliability method (FORM) outputs alone, avoiding repeated multi-dimensional numerical integration in the inner loop of design optimisation, with an explicit, computable error bound guaranteeing invariance of the robustness classification; a two-sided Slepian envelope further extends this guarantee to systems with non-equicorrelated, non-negative inter-element correlation. The framework is illustrated through a numerical example and validated against a published case study of a glued–laminated timber truss. Full article

Inner Triangle Outer Diamond (ITOD) Framework, presented and published in 2025, informed and guided the introduction of Artificial Intelligence (AI) ethics education into a Medical Humanities course for medical students. Central to the ITOD Framework is the premise that education takes place in an ecosystem, with outcomes shaped by the dynamic interplay and interactions among multiple components. In planning and designing the instruction, the ITOD’s inner triangle helped connect pedagogy (team-based learning), curriculum (AI in Medical Humanities), and assessment (reflective practice). The outer diamond’s elements were also considered to ensure proper alignment of the educational intervention with programme requirements, with special emphasis on resources, policies, instructional design, curricular structure, standard practices, including the educational ecosystem dynamics, and alignment of outcomes with overall programme objectives. Very importantly, the ITOD also aided in calibrating an effective response to external conceptual factors such as technological and cultural advances, and professional advancements. A pre- and post-intervention survey design was adopted to evaluate the impact of the educational intervention (n = 113 pre-session; n = 103 post-session). Results showed significant positive shifts in self-reported AI understanding, increased support for formal AI integration into the curriculum, and enhanced confidence in critically engaging with AI outputs (94.1% reporting ‘yes’ or ‘somewhat’ post-session). Following the educational intervention and the feedback received from the learners, it is accurate to state that the ITOD was a reliable framework for introducing technology-related topics, specifically Artificial Intelligence ethics education, into Medical Humanities within an undergraduate medical programme. The approach is hereby presented in this work and recommended to educators, academic leaders, and other stakeholders. Full article

Wing rock motion observed in low-aspect-ratio flying-wing unmanned aerial vehicles (UAVs) severely degrades maneuverability and flight safety, making effective recovery control a challenging task. This paper proposes an Enhanced Incremental Nonlinear Dynamic Inversion (EINDI) control framework for autonomous wing rock recovery, in which aerodynamic angular rate feedback is introduced into the outer-loop control design, while an INDI scheme is employed in the inner loop. The proposed controller is evaluated using a six-degree-of-freedom (6-DOF) flying-wing UAV model. Recovery performance is assessed for multiple initial conditions distributed along the wing rock trajectory, and the results are compared with those obtained using linear outer-loop control, nonlinear dynamic inversion (NDI) outer-loop control, and a simplified NDI-based outer-loop control strategies. Simulation results demonstrate that the proposed method can achieve successful recovery from arbitrary initial states along the wing rock trajectory. It is found that the required recovery altitude exhibits a negative correlation with the Euclidean distance between the initial and target states. Under nominal conditions, the EINDI controller achieves higher control accuracy and better stability than linear outer-loop control and exhibits performance comparable to NDI-based control. In the presence of aerodynamic model uncertainties, the sideslip suppression capability of linear outer-loop control degrades, while the angle-of-attack tracking performance of NDI-based outer-loop control deteriorates. These results indicate that, although the attitude control loop itself possesses strong inherent robustness, the proposed EINDI framework provides improved control accuracy under model uncertainty, making it well suited for high-maneuverability flight control of flying-wing UAVs. Full article

Effective thermal insulation of cryogenic liquid hydrogen (LH₂) storage tanks remains a critical engineering challenge, as conventional vacuum-based or monolithic systems are constrained by manufacturing complexity, mechanical vulnerability, and poor geometric adaptability. This study presents the design and numerical verification of a four-layer octagonal composite thermal shield fabricated via additive manufacturing: an AA5083 structural layer (5 mm), a boron nitride-doped ceramic plate (1 mm), up to 290 stacked graphene sheets in a sealed compartment, and an outer Fe₃S₄-TiO₂ nanocomposite layer (~30 µm). Steady-state and transient FEA in ANSYS evaluated three convective boundary conditions (h = 10, 15, and 20 W/m²·K), with the inner wall fixed at 20 K. Temperature distributions remained essentially invariant across all cases (20 K inner, ~20.12 K outer), confirming that thermal performance is governed by the multilayer architecture rather than convective intensity. The shield achieved a mean heat flux of 1684 W/m², R_total ≈ 0.163 m²K/W, and a boil-off rate of 13.9 g/hour. Comparative FEA against NASA US9617069 (q = 193.35 W/m²) and JP2018-119634A (q = 37.975 W/m²) highlights the compactness advantage of the proposed 6 mm shield; the coupled thermo-structural assessment yielded a safety factor of 64,182, confirming elastic-regime operation at 20 K. Full article

Background: Parents of children with attention-deficit/hyperactivity disorder (ADHD) and sleep problems can experience challenges and negative health effects. The aim of this study was to explore parents’ own health-related experiences as their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket. Methods: A convergent mixed methods design was undertaken. Sociodemographic and questionnaire data were collected from 68 parents at baseline and at the 16-week follow-up. Paired-samples t-tests were used to analyze the data. An inductive qualitative content analysis was used to analyze interviews with 21 parents after the follow-up. An integrative analysis was performed and assessed for confirmation, expansion, or disconfirmation. Results: At the follow-up, parents reported improvements in their own health status (EQ-5D-3L—index 0.83 ± 0.15 vs. 0.87 ± 0.13; p = 0.034), in well-being (Outcome Rating Scale—individual 7.08 ± 2.22 vs. 7.55 ± 1.82; p = 0.045), and in family life (the Brief Child and Family Phone Interview—family comfort score 5.62 ± 1.62 vs. 5.14 ± 1.66; p = 0.003). Parents’ health-related experiences were described as: (1) having a sense of well-being, including being well rested, sustaining energy, reaching a state of calm, and finding hope, (2) balancing family life, including reclaiming personal sphere and nurturing relationships, and (3) managing everyday life, including keeping to the daily schedule and dealing with household chores. The integrative analysis resulted in the overarching themes of health through: (1) inner strength (confirmed), (2) recovery (expanded), (3) close relationships (confirmed), and (4) social engagements (expanded). Conclusions: The findings suggest that sleep interventions for children with ADHD and sleep problems may also be associated with positive changes in aspects of parents’ health, well-being, and family life. Full article

Sleep quality is closely associated with cardiovascular, metabolic, and mental health outcomes, yet the clinical gold standard, polysomnography (PSG), is costly and intrusive for long-term home monitoring. Ballistocardiography (BCG) enables unobtrusive in-bed sensing and is therefore attractive for low-burden sleep assessment in natural environments. However, most existing BCG studies are PSG-referenced and mainly focus on sleep staging, while movement and out-of-bed episodes are often treated as artifacts rather than modeled jointly. In this study, we propose an interpretable unsupervised proxy-state modeling framework for three-state in-bed monitoring from BCG signals under an unlabeled setting. BCG recordings were segmented into 30 s windows with 50% overlap, and multi-domain features were extracted from waveform morphology, spectral power, heart rate-related dynamics, and wavelet energy distribution. K-means clustering (K = 3) was used to construct cluster-derived proxy labels, TreeSHAP-based feature ranking together with inner-CV-guided Top-N subset selection was used for training-only feature screening, and multiple classifiers were compared under a strict leave-one-subject-out protocol, with an ROA-optimized RBF-SVM achieving the best overall performance. Using data from 32 volunteers, the framework achieved an accuracy of 0.9932 ± 0.0047 (mean ± SD), together with consistently strong Macro-F1 and MCC scores. Overall, it outperformed the alternative methods compared in this study. Full article

Foreign object intrusion in railway tracks is a major threat to train operation safety, yet current detection methods face challenges in identifying small distant targets and adapting to low-light conditions. Moreover, existing systems often lack the ability to assess intrusion risk levels, limiting real-time warning and graded response capabilities. To address these gaps, this paper proposes a novel method for intrusion detection and risk assessment based on keypoint spatial discrimination. First, an XS-BiSeNetV2-based track segmentation network is developed, incorporating cross-feature fusion and spatial feature recalibration to improve track extraction accuracy in complex scenes. Second, an enhanced STI-YOLO detection model is introduced, integrating a Shuffle attention mechanism for better feature interaction, a high-resolution Transformer detection head to improve small-target sensitivity, and the Inner-IoU loss function to refine bounding box regression. Detected targets’ bottom keypoints are then analyzed relative to track boundaries to determine intrusion direction. By combining lateral distance and motion state features, a multi-level risk classification system is established for quantitative threat assessment. Experiments on the RailSem19 and GN-rail-Object datasets show that the method achieves a track segmentation mIoU of 88.19% and a detection mAP of 82.6%. The risk assessment module effectively quantifies threats across scenarios and maintains stable performance under low-light and strong-glare conditions. This work offers a quantifiable risk assessment solution for intelligent railway safety systems. Full article

Background: Despite recent breakthroughs in pharmacological treatment for Alzheimer’s disease, high costs and the complex procedure to monitor safety have limited access for many patients. Less invasive and more accessible non-pharmacological therapies that support neuroplasticity and slow cognitive decline are needed. Processing Inner Strength Toward Actualization (PISTA) stimulation applies structured tactile input to promote cortical–subcortical activation. This study evaluated the long-term effects of PISTA on cognition and pain in older adults with mild cognitive impairment or early dementia. Methods: This single-arm, prospective trial enrolled 100 outpatients aged 47–70 years at outset (50 women, 50 men) with no control group. Participants received clinician-supervised PISTA stimulation three times weekly for 48 months. Each 30 min session delivered rhythmic tactile input calibrated to individual sensory thresholds. Cognitive performance was assessed monthly using the Mini-Mental State Examination (MMSE). Perceived pain was measured monthly with the Numeric Pain Rating Scale. Outcomes were analyzed using ANCOVA, adjusting for age, sex, and baseline cognitive status. Results: Cognitive scores improved significantly across all age strata, with a mean annual MMSE increase of 0.75 points (95% CI: 0.26–1.21; p < 0.0025). Pain intensity decreased in parallel (mean reduction: 0.56 points; 95% CI: 0.34–0.78; p < 0.001). Improvements in cognition and pain were moderately correlated (r = 0.38). The greatest combined benefits occurred in participants aged 55–62 years. No serious adverse events were observed during the 48-month trial. Conclusions: PISTA stimulation produced sustained improvement in cognition and reduced perceived pain, supporting its promising role as a safe, non-invasive adjunct for neurodegenerative cognitive decline. These findings suggest peripheral sensory activation as a promising driver of functional neuroplasticity and warrant verification in randomized, controlled trials. Full article

Forestry projects have long faced the inherent tension between stringent conservation objectives and the enhancement of human well-being, making it increasingly important to assess the sustainable livelihoods of participating households. The Natural Forest Management Project in the Northeast and Inner Mongolia state-owned forest region (NSFR) aims to transform high-quality ecological products and services into inclusive public benefits while providing reasonable compensation for ecological conservation and restoration efforts. This approach seeks to achieve synergies among ecological protection, economic development, and livelihood improvement. Drawing on six consecutive years (2017–2022) of longitudinal micro-level household survey data, this study quantifies the sustainable livelihood levels of households participating in natural forest management. A Natural Forest Involvement (NFI) index was constructed to measure their degree of participation. Furthermore, the well-being effects of frontline participants in natural forest management activities were investigated. The findings indicate that the overall sustainable livelihood capital of these households shows a steady upward trend across NSFR, significant disparities exist among different areas. Moreover, approximately half of forestry worker households are deeply embedded in the natural forest management system, and this engagement pattern negatively affects households’ sustainable livelihood capital. These results not only enrich the empirical literature on forestry project effectiveness but also offer relevant insights for forestry project design and policy formulation in other developing countries. Full article

Cardiolipin (CL), a unique dimeric phospholipid predominantly enriched in the inner mitochondrial membrane, is a crucial determinant of mitochondrial structure and function. Its content, fatty acyl composition, and oxidation state are associated with mitochondrial bioenergetics, dynamics, and cellular signaling. Disruptions in CL metabolism are increasingly implicated in the pathogenesis of various central nervous system (CNS) disorders, including Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, epilepsy, and traumatic brain injury. This narrative review summarizes recent advances in the analytical techniques employed for CL analysis. The principles and applications of mass spectrometry-based platforms, nuclear magnetic resonance, Fourier-transform infrared spectroscopy, atomic force microscopy-infrared spectroscopy, and fluorescent probes were discussed, with an emphasis on their strengths in revealing the structure, composition, dynamics, and spatial distribution of CL. Furthermore, the evidence of CL abnormalities in various CNS disorders was assessed, often showing decreased CL levels, loss of polyunsaturated species, and increased oxidation associated with mitochondrial dysfunction and neuronal apoptosis. Furthermore, the nutritional interventions for CL modulation were discussed, such as polyunsaturated fatty acids, polyphenols, carotenoids, retinoids, alkaloids, and triterpenoids, which summarize their potential health-beneficial effects in remodeling the CL acyl chain, preventing oxidation, and regulating mitochondrial homeostasis. Overall, this review provided insight into integrating CL analysis and dietary modulation in understanding CL-related pathologies in CNS disorders. Full article

Blood sampling by venipuncture is a routine procedure used in animal experiments and veterinary diagnostics. It can cause stress due to restraint and pain associated with penetration of the skin by a needle. When stressful procedures are repeated, stress can increase through anticipation after negative experiences or decrease due to habituation and/or positive reinforcement. The aim of this study was to describe the reaction to repeated blood sampling on the affective state of the animals. We wanted to observe how repeated blood sampling would affect stress parameters in goats that underwent an intensive cooperative vet care training protocol and were managed with a focus on gentle handling. Eight dairy goats underwent weekly blood sampling over a four-month period as part of a transfer study. Stress parameters were assessed using serum cortisol concentration, temperature changes in the inner corner of the eye measured by infrared thermography, and an ethogram showing voluntary and aversive behavior. Neither the serum cortisol concentration nor the eye temperature changed significantly over time during blood sampling. However, the ethogram showed that the goats approached the blood sampling position significantly faster and more voluntarily. In this study, we did not observe changes within the measured physiological stress parameters due to repeated blood sampling over three months. However, the voluntary behavior of the trained goats increased over time as a result of positive reinforcement training and habituation. Full article

Background/Objectives: The aim of this study was to evaluate the relationship between foveal avascular zone (FAZ) enlargement, retinal ganglion cell (RGC) dysfunction, and structural retinal measurements in glaucoma suspects (GS), using pattern electroretinogram (PERG) and optical coherence tomography angiography (OCTA) parameters. Methods: Thirty-one eyes (20 subjects) of GS status underwent comprehensive ophthalmologic evaluation including steady-state PERG, optical coherence tomography (OCT), and OCTA. FAZ area was measured using ImageJ software (version 1.54p), and PERG parameters (Magnitude, MagnitudeD, and MagnitudeD/Magnitude ratio) were analyzed. Partial correlation analyses were performed to assess associations between FAZ area, PERG parameters, and structural metrics including retinal nerve fiber layer (RNFL), ganglion cell layer–inner plexiform layer (GCL + IPL), and macular thickness. Results: After controlling for age, sex, central corneal thickness (CCT), intraocular pressure (IOP), and spherical equivalent, partial correlation analysis showed that FAZ area was significantly associated with both lower Magnitude (r < −0.503, p < 0.05) and MagnitudeD (r < −0.507, p < 0.05) values. PERG parameters were significantly correlated with superior and average RNFL thickness, as well as superior and superior temporal GCL + IPL thickness. FAZ area was significantly associated with multiple GCL + IPL and macular thickness sectors, but not with RNFL thickness. Conclusions: FAZ enlargement is significantly associated with RGC dysfunction and inner retinal layer thinning in GS. Full article