Search Results (224)

Background/Objectives: Limited research has evaluated the association between the triglyceride-to-high-density lipoprotein (TG/HDL) ratio and premature coronary artery disease (PCAD), particularly in Saudi Arabia. Therefore, this study aimed to investigate the association of the TG/HDL ratio with PCAD and to assess its sensitivity and specificity in a young Saudi population. Methods: This comparative retrospective case–control study utilized data collected from patients’ electronic medical records at King Saud University Medical City (KSUMC) between 2015 and 2023. The vessel score and Gensini score were used to evaluate the severity of coronary occlusion. The study population was divided into two groups: (1) a healthy control group consisting of blood bank donors, selected to exclude individuals with chronic diseases such as metabolic disorders and hypertension, with no evidence of coronary artery disease and aged ≤50 years (as confirmed by a cardiologist to rule out cardiovascular disease); and (2) patients with PCAD, aged ≤51 years, who underwent selective coronary angiography using the standard hospital procedure (right femoral artery approach). Coronary angiographic images were evaluated using right and left oblique views with cranial and caudal angulations. Results: A total of 898 subjects were included in the study, comprising 440 healthy controls and 458 patients with PCAD. Higher HbA1c levels were significantly associated with PCAD (adjusted OR = 13.03, 95% CI [7.32, 23.18], p < 0.001). Importantly, the TG/HDL ratio, the primary biomarker of interest, remained significantly associated with PCAD after full adjustment. Each unit increase in the TG/HDL ratio was associated with more than a threefold increase in the odds of PCAD (adjusted OR = 3.39, 95% CI [2.22, 5.16], p < 0.001), independent of age, sex, BMI, HbA1c, smoking, and total cholesterol levels. Among females, the TG/HDL ratio demonstrated an area under the curve (AUC) of 0.796, with an optimal cut-off value of 0.91, yielding 77.8% sensitivity and 71.4% specificity. Among males, the TG/HDL ratio yielded an AUC of 0.786, with a higher optimal cut-off value of 1.09 providing 73.4% sensitivity and 65.4% specificity. Conclusions: Our study indicates that the TG/HDL ratio and HbA1c are significantly associated with PCAD in young Saudi male and female populations, demonstrating good sensitivity and specificity. Females exhibited a lower cut-off value than males. Smoking and elevated cholesterol levels were also identified as prominent risk factors. However, the TG/HDL ratio did not distinguish between moderate and severe coronary stenosis, as assessed by the Gensini score. Full article

Background/Objectives: Preterm (<37 weeks) and very preterm (<32 weeks) infants face considerably higher mortality and morbidity rates than full-term infants. We compared clinical outcomes between small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) preterm infants. Methods: This retrospective cohort study used a prospectively collected database, obtained from 2014 to 2025. Propensity score matching (PSM), multivariate regression, and subgroup analyses of very preterm infants were performed to minimize confounding. Results: Among the 5890 neonatal admissions, 2331 preterm infants met the inclusion criteria. After PSM, 298 SGA and 298 AGA preterm infants were analyzed. Multivariate analysis showed that SGA preterm infants had significantly higher risks of the composite outcome of mortality or major morbidity (adjusted risk ratio [aRR], 1.89; 95% confidence interval [CI], 1.18–3.02), mortality (aRR, 3.53; 95% CI, 1.57–7.95), and mortality or moderate-to-severe bronchopulmonary dysplasia (aRR, 2.13; 95% CI, 1.30–3.48). In the subgroup analysis after PSM, 190 very preterm infants showed similar results, with SGA infants having increased risks of the composite outcome of mortality or major morbidity (aRR, 1.81; 95% CI, 1.02–3.23), mortality (aRR, 3.23; 95% CI, 1.09–9.62), mortality or moderate-to-severe bronchopulmonary dysplasia (aRR, 2.03; 95% CI, 1.10–3.72), and mortality or treated retinopathy of prematurity (aRR, 2.62; 95% CI, 1.03–6.65). Conclusions: SGA status is associated with a higher risk of mortality and major morbidity in preterm and very preterm infants. In resource-limited settings, the focused management of SGA infants is critical to improving short- and long-term outcomes. Full article

Background: Heart failure (HF) remains a major complication of acyanotic congenital heart disease (CHD) in children. Evidence integrating clinical and echocardiographic variables for HF severity stratification in pediatric acyanotic CHD remains limited. This study aimed to identify factors associated with moderate HF and develop an exploratory internally validated prediction model. Methods: This retrospective single-center outpatient study included 219 children aged 0–16 years with acyanotic CHD, identified from medical records spanning January 2023 to December 2025. Moderate HF was defined as Ross score 7–9 (≤5 years) or NYHA class III (>5 years). Multivariable analysis was performed using Firth’s penalized logistic regression. Internal validation used bootstrap optimism correction and leave-one-out cross-validation (LOOCV). Model discrimination was assessed using area under the receiver operating characteristic curve (AUC). Results: Moderate HF was identified in 131 patients (59.8%). LV remodelling defined by LVIDD z-score > +2 (adjusted OR 3.70, 95% CI 1.22–11.24; p = 0.021) and higher mean pulmonary arterial pressure (MPAP) (adjusted OR 1.03 per mmHg, 95% CI 1.00–1.06; p = 0.049) were independently associated with moderate HF. Premature birth showed an inverse association with moderate HF (adjusted OR 0.25, 95% CI 0.13–0.48; p < 0.001). The exploratory five-variable model demonstrated acceptable discrimination (apparent AUC 0.780, 95% CI 0.728–0.849; bootstrap-corrected AUC 0.760; LOOCV AUC 0.749, 95% CI 0.681–0.811), with adequate calibration. An MPAP threshold of ≥26.4 mmHg yielded 78.6% sensitivity for moderate HF identification. Conclusions: LV remodelling and elevated MPAP were independently associated with moderate HF in children with acyanotic CHD. The exploratory internally validated model demonstrated acceptable discrimination using routinely available variables. This model is exploratory and not yet ready for clinical use; prospective multicenter external validation is required before any clinical implementation. Full article

Wireless sensor networks (WSNs) deployed for seismic monitoring must sustain long-term operation under strict energy constraints, where premature node failure degrades spatial coverage and detection reliability. This paper presents a safety-constrained reinforcement learning framework for transmission scheduling in energy-harvesting seismic WSNs. The proposed approach integrates Proximal Policy Optimisation (PPO) with action masking and a runtime guard-layer safety filter that enforces battery-preservation and load-balancing constraints without retraining. The guard layer intercepts policy actions and substitutes safe alternatives when constraint violations are detected, using a scoring function that combines battery headroom with network-wide load equity. Experiments across three network scales (10, 15, and 30 nodes) with solar energy harvesting demonstrate that the guard-enhanced PPO achieves 99.46% transmission success at 30 nodes while maintaining 66.47% node survival—a 58.3% improvement in survival over the highest-reward baseline (Closest) at the cost of only a 6.2% reduction in cumulative reward. Crucially, the guard-enhanced policy outperforms the unconstrained PPO baseline simultaneously on cumulative reward ($+11.4\%$), transmission success ($+0.8$ pp), and node survival ($+15.4\%$), demonstrating that hard safety constraints, when properly aligned with the system’s energy model, provide both performance and safety gains rather than a fundamental trade-off. Sensitivity analysis across event rates ($p_{\mathrm{event}}=0.5$ and $0.9$) confirms that the guard layer’s advantage persists under both moderate and extreme monitoring conditions. Analysis across scales reveals distinct operational regimes: at 10 nodes, heuristic baselines are near-optimal; at 30 nodes, learned policies dominate, and safety filtering becomes critical for sustained operation. Full article

Background/Objective: Bedside ultrasonographic measurement of optic nerve sheath diameter (ONSD) has increasingly been used as a non-invasive method for evaluating intracranial dynamics. In preterm infants, interpretation of these measurements is complicated by the strong influence of gestational maturity. The objective of this study was to examine the relationship between ONSD and respiratory support in preterm infants and to determine whether this relationship reflects an independent physiological effect or is mainly related to maturational confounding. Methods: This retrospective single-center study included 110 preterm infants. ONSD measurements were obtained at the bedside using a standardized ultrasonographic technique. Infants were categorized according to the need for invasive mechanical ventilation. Associations between ONSD, respiratory parameters, and clinical variables were evaluated with correlation analyses and multivariable logistic regression after adjustment for gestational age and birth weight. Results: ONSD values were lower in infants who required invasive mechanical ventilation and who also had lower gestational age and birth weight. After adjustment for these variables, the association between ONSD and invasive ventilation became less pronounced. Although ONSD showed a moderate unadjusted correlation with SpO₂, no consistent independent association with respiratory parameters remained after adjustment for maturational factors. The difference in ONSD between groups was small (0.48 mm) and within the expected range of measurement variability. Conclusions: In this cohort, differences in ONSD according to respiratory support appeared to be more closely related to maturational status than to respiratory disease severity. ONSD measurements in preterm infants should therefore be interpreted within the clinical context of prematurity rather than used alone as indicators of respiratory status. Full article

In this paper, a flexible steady-state model of a highly integrated, natural convection-driven condensing methanol reactor was developed. The flowsheet model includes 1D submodels of the different sections of the integrated reactor–condenser and includes a method to estimate the maximum possible natural convection-driven flow. Experimental data are used to create a shortcut description for the heat transfer coefficients in the model. The model results indicate that when heat losses can be mitigated, autothermal operation is possible. The major part of the heat integration takes place in the economizer section; however, a significant amount of heat transfer occurs at the catalyst bed also. The model predicts that the loop mass flow and single-pass conversion strongly depend on the catalyst bed inlet temperature. Experimentally measured catalyst preheater and condenser duties suggest, however, that the model-calculated mass flow is likely too low and that it is less dependent on the catalyst bed inlet temperature than the model predicts. A possible cause for this is the neglect of radial temperature gradients in the catalyst bed in the model, overestimating the conversion. Another possible cause is a measurement error in the bed inlet temperature, causing the actual temperature to be lower than the measured value. Natural convection calculations show that the maximum achievable flow strongly depends on the single-pass conversion and that given a single-pass conversion, a minimum temperature difference is required for flow in the right direction. Sensitivity analyses (neglecting heat losses to the environment) show that with the current heat transfer description, the feasible operating range for autothermal, natural convection-driven flow is sizeable. However, at lower recycle mass flows, heat transfer is too fast, leading to premature condensation in the economizer section. If the heat transfer coefficient is smaller than the currently predicted value, autothermal operation is possible in a wide range of conditions. If heat losses are mitigated, the maximum productivity of 2000 ${\mathrm{kg}}_{\mathrm{MeOH}}{\mathrm{m}}_{\mathrm{cat}.}^{-3}{\mathrm{h}}^{-1}$ is achievable at high pressure, a moderate catalyst bed inlet temperature and a low condenser temperature. Full article

Background/Objectives: Upper-limb motor dysfunction is common after stroke, and patients often have limited recovery during rehabilitation. In this study, we aimed to investigate the relationship between contralesional neurophysiological parameters and the effects of rehabilitation on upper-limb motor function in stroke patients with corticospinal tract damage. Methods: Forty patients with subacute stroke with an absent MEP response on the ipsilesional side before admission were included. Contralesional neurophysiological parameters, including resting motor threshold, contralesional MEP, contralesional short-interval intracortical inhibition (short-ICI), and contralesional long-interval intracortical inhibition (long-ICI), were assessed via transcranial magnetic stimulation (TMS) pre-admission. The coefficients of variation for MEP, short-ICI, and long-ICI were calculated to assess cortical stability. Rehabilitation effect was measured using changes in the Fugl–Meyer assessment score after 21 days of rehabilitation. Results: No single contralesional parameter significantly predicted rehabilitation effect. Further exploratory analysis revealed that a model combining contralesional neurophysiological parameters was associated with proximal limb motor function recovery. Short-ICI played a prominent role in this exploratory model. Conclusions: Contralesional neurophysiological markers demonstrated limited predictive value in patients with stroke with moderate-to-severe motor dysfunction and damaged corticospinal tract function on the ipsilesional side. However, a model combining multimodal contralesional TMS measures, particularly short-ICI, may offer incremental value in predicting proximal limb motor improvement following 21-day rehabilitation. Although this mechanism was not directly measured, the findings suggest a compensatory role of the cortico-reticulo-spinal pathway. These exploratory results should be interpreted with caution regarding their clinical applicability and are premature as a predictive tool, pending rigorous external validation. Full article

Background/Objective: Preterm birth poses notable neurodevelopmental risks, with cerebral microcirculatory disturbances potentially contributing to long-term impairment. Existing monitoring modalities lack bedside capacity to evaluate these microvascular changes during critical brain development. We characterized cerebral microperfusion and functional maturation patterns in preterm versus full-term neonates using combined ultra-micro angiography (UMA) and an amplitude-integrated electroencephalogram (aEEG). Methods: In this prospective study, 76 neonates (23 extremely/very preterm [EP/VPT], 27 moderate-late preterm, and 26 term controls) were assessed at term-equivalent age. UMA helped quantify regional microperfusion (color pixel percentage, abbreviated as CPP in this context to differentiate from cerebral perfusion pressure), whereas aEEG (Burdjalov scores) helped evaluate functional maturation at 37–38 and 40 weeks’ postmenstrual age. Results: EP/VPT infants demonstrated significant cerebral hyperperfusion with distinct cortex–white matter perfusion gradients. Although preterm infants showed advanced aEEG maturation at 37–38 weeks, this difference normalized by 40 weeks. Conclusion: Gestation-dependent cerebral hyperperfusion and transient EEG maturation differences in EP/VPT infants at term-equivalent age support the value of UMA–aEEG integration for neurovascular assessment. The observed perfusion–EEG patterns suggest prematurity-specific neuroadaptation, warranting further investigation of long-term functional correlates. Full article

Background: The first 1000 days of life, from conception to 2 years of age, represent a critical window during which nutrition can exert long-lasting effects on neurodevelopment, immune maturation, and susceptibility to prematurity-related morbidity. Docosahexaenoic acid (DHA) is a key structural n-3 long-chain polyunsaturated fatty acid of the brain and retina, characterized by rapid fetal accretion during the third trimester. Methods: We conducted a narrative review of studies published from March 2015 up to December 2025, including randomized controlled trials, follow-up studies, and systematic reviews/meta-analyses about DHA supplementation during pregnancy, lactation, infancy and early childhood, and its role on development. Results: Across the first 1000 days, DHA supplementation improves biochemical DHA status, particularly in populations with low baseline levels (moderate to high level of evidence), while clinical outcomes remain heterogeneous. During pregnancy, some benefits in specific cognitive and behavioral domains have been demonstrated, whereas effects on global cognition and long-term behavior are frequently null (moderate evidence). Visual outcomes appear favorable, with improvements in visual acuity (moderate evidence). In preterm infants, enteral DHA—often combined with arachidonic acid (ARA)—is feasible and well tolerated. DHA may reduce inflammatory markers and necrotizing enterocolitis risk when in equilibrium with ARA (low to moderate evidence), while no evidence supports the link between DHA and reduced risk of bronchopulmonary dysplasia and retinopathy of prematurity (moderate evidence). Neurodevelopmental outcomes are mixed: neuroimaging studies suggest enhanced white matter maturation with DHA + ARA, whereas most trials show no clear benefit regarding standardized developmental scores (moderate evidence). Conclusions: DHA is biologically essential during the first 1000 days, but its clinical impact depends on timing, dose, baseline status, and prematurity-related context. The balance between DHA and ARA, rather than DHA supplementation alone, emerges as a key determinant of clinical efficacy, supporting a shift toward precision-based nutritional strategies in early life. Full article

This study systematically investigates the effect of trace Ti addition on the impact toughness and underlying deformation mechanisms of high-Mn austenitic steel from 298 K to 4.2 K through instrumented Charpy impact testing, dynamic J-R curve analysis, and multi-scale microstructural characterization (SEM, TEM). The results show that Ti addition leads to the formation of Ti(C,N) precipitations, which act as microcrack initiation sites and significantly reduce the impact-absorbed energy at room temperature (298 K) from 249 J to 189 J. However, as the temperature decreases to liquid nitrogen (77 K) and liquid helium (4.2 K) temperatures, the impact toughness of the Ti-added steel does not deteriorate further and remains comparable to that of the Base steel. This temperature-dependent behavior originates from a transition in the dominant deformation mode. At room and moderately low temperatures, deformation is primarily governed by dislocation slip, whose strong interaction with coarse precipitates leads to premature cracking. At cryogenic temperatures, the significantly reduced stacking fault energy (SFE) shifts the deformation mechanism to the predominant formation of high-density nano-twins. These dense deformation twins enhance the matrix via the dynamic Hall–Petch effect and mitigate the detrimental effect of precipitates by alleviating interactions between dislocations and precipitates. Full article

Background: Neonatal hyperglycemia is a common metabolic complication in extremely preterm (EP) infants; however, early risk factors and associated outcomes remain incompletely defined. Objective: To evaluate the association between neonatal hyperglycemia in the first postnatal week and key neonatal morbidities including early neurodevelopmental risk in EP infants. Methods: We conducted a retrospective cohort study of EP infants born in 2018–2019 at the Women’s Wellness and Research Center. Neonatal hyperglycemia was defined as a blood glucose level > 8.3 mmol/L. Maternal factors, delivery room interventions, early physiological markers, neonatal morbidities, and follow-up outcomes were compared. Propensity score matching was applied to balance the baseline demographic and perinatal differences. Results: Among 225 EP infants, 131 (58.2%) developed neonatal hyperglycemia in the first week (mild, 21.4%; moderate, 42%; severe, 36.6%). Before matching, infants with neonatal hyperglycemia had lower gestational age and birth weight and required more delivery-room surfactant, and their mothers had lower rates of premature rupture of membranes. After matching, neonatal hyperglycemia was associated with higher rates of ventilator-associated pneumonia (1.45 vs. 0.37; IRR 6.2, 95% CI 1.4–27.6), longer duration of invasive ventilation (19.8 ± 25.3 vs. 8.9 ± 24.8 days; mean difference −10.9 days; p = 0.042), higher postnatal steroid exposure (18.2% vs. 5.5%; OR 4.6, 95% CI 1.6–14.4; p = 0.040), and severe retinopathy of prematurity (ROP) (21.6% vs. 6.4%; OR 4.0, 95% CI 1.0–15.5; p = 0.032). A trend toward moderate-to-severe bronchopulmonary dysplasia was observed (33.3% vs. 15.9%; p = 0.054). Mortality did not differ significantly between groups; however, among non-survivors, age at death was higher in the neonatal hyperglycemia group. Conclusions: In EP infants, early neonatal hyperglycemia is associated with higher respiratory morbidity and severe ROP even after propensity score matching. These findings support neonatal hyperglycemia as a clinically relevant early risk marker and justify further prospective and interventional studies. Full article

Buried oil and gas pipelines, the critical arteries of global energy infrastructure, are increasingly vulnerable to severe geological hazards such as reverse faulting, yet their structural integrity is often pre-compromised by stochastic corrosion damage accumulated during service. However, quantifying the coupled impact of spatial corrosion heterogeneity and large ground deformation remains a formidable challenge due to the complex nonlinearities involved in soil–structure interactions and wall thinning. This study establishes a probabilistic assessment framework integrating random field theory, nonlinear finite element analysis, and a generative conditional diffusion model to characterize realistic 2D non-Gaussian corrosion morphologies. The numerical results reveal a significant geometric stiffening effect induced by internal pressure, where moderate operating levels effectively suppress cross-sectional distortion by counteracting the Brazier effect. Consequently, this mechanism facilitates a fundamental transition in failure modes from localized tensile rupture to ductile buckling, significantly extending the critical fault displacement threshold. Furthermore, probabilistic fragility analysis demonstrates that the spatial dispersion of pitting, rather than just average wall thinning, governs the initiation of premature failure. Mechanistic analysis indicates that high internal pressure, while providing pneumatic support, exacerbates tensile strain localization at corrosion pits, leading to a heightened probability of premature rupture under minor fault deformations, a critical hazard that traditional deterministic models significantly underestimate. These findings provide a quantitative theoretical foundation for the reliability-based design and maintenance of energy lifelines traversing active tectonic zones. Full article

Background/Objectives: Comprehensive management of lifestyle factors is important for long-term survival. This study aims to examine whether a comprehensive healthy lifestyle score (HLS) incorporating overall diet assessment predicts all-cause, cancer, and cardiovascular mortality in Korean population. Methods: This prospective cohort study was conducted among men and women (n = 111,633, 64.6% women) aged 40 to 85 years who participated in the Korean Genome and Epidemiology Study_Health Examinees (Mean age = 55.2, SD = 8.8). Participants completed a baseline questionnaire between 2004 and 2013 and were followed until December 2023. The HLS consisted of five components classified as healthy behaviors: never or former smoking; engaging in ≥30 min/day of moderate-to-vigorous physical activity on ≥5 days/week; alcohol intake ≤40 g/day for men and ≤20 g/day for women; a BMI of 18.5–24.9 kg/m²; and an unhealthful plant-based diet index (uPDI) in the bottom 40th percentile, which reflects overall diet quality and aligns with the traditional plant-rich dietary pattern of Koreans. Diet was assessed using data from baseline and the first follow-up, while the remaining components were measured at baseline only. Cox proportional hazards models were applied to evaluate multivariable-adjusted associations between the HLS and all-cause, cancer, and cardiovascular mortality. Results: During 1,538,490 person-years of follow-up, 5246 all-cause deaths, 2362 cancer deaths, and 815 cardiovascular deaths were documented. Compared with the lowest HLS category, men with the highest HLS had lower risks of all-cause (HR: 0.65, 95% CI: 0.53–0.80), cancer (HR: 0.62, 95% CI: 0.46–0.85), and cardiovascular mortality (HR: 0.34, 95% CI: 0.17–0.66). Among women, the corresponding HRs were 0.38 (95% CI: 0.26–0.55), 0.52 (95% CI: 0.29–0.90), and 0.30 (95% CI: 0.11–0.84), respectively. The inverse association was stronger in older adults (≥55 years) than in younger adults. All five individual lifestyle components, including diet (quintile 5 vs. quintile 1 of uPDI: HR 0.74, 95% CI: 0.66–0.83 in men; HR 0.67, 95% CI: 0.58–0.76 in women), were significantly associated with a lower risk of all-cause mortality. However, when smoking was excluded from the HLS, the inverse association was attenuated, particularly among men. Conclusions: Greater adherence to a healthy lifestyle score was strongly associated with reduced risks of all-cause, cancer, and cardiovascular mortality. These findings underscore the importance of promoting integrated, multi-behavior lifestyle interventions, especially smoking cessation, to reduce premature mortality. Full article

In this study, we develop a regression analysis method, namely, the Semiparametric Binary Logistic Regression (SBLR), by extending the classical logistic regression that integrates both parametric and nonparametric components, which allows it to simultaneously model linear and non-linear relationships. Here, to obtain the estimation of a nonparametric component in the form of a non-linear curve (sigmoid curve), we use the penalized spline, which is a smoothing technique used in the nonparametric approach due to its ability to produce smooth and adaptive curves for fluctuating data. In this smoothing technique, selecting the optimal smoothing parameters plays an important role in fitting the model. Commonly, this selection is based on the minimum value of ordinary Cross-Validation (CV) or Generalized Cross-Validation (GCV). However, these CV and GCV criteria cannot be used when the CV and GCV curves continuously decline and never rise; the minimum CV and GCV values would not be achieved because they are not directly applicable due to the non-quadratic nature of the log-likelihood function. Therefore, a Generalized Approximate Cross-Validation (GACV) criterion is used to address such cases. This distinguishes it from previous studies that used the CV or GCV criterion. In the application to real data, we define an SBLR model of Coronary Heart Disease (CHD) risk factors that can be used for prediction and interpretation purposes. The results of the study successfully demonstrate the efficacy of the proposed method in identifying critical non-linear thresholds for CHD risk factors, and it is statistically valid and highly effective for CHD risk prediction. In the future, we can use the results of this research as a basis of an early warning system, specifically alerting individuals with moderate stress levels and dietary habits exceeding the identified thresholds to be aware of the heightened probability of developing CHD. In addition, this research aligns with point three of the Sustainable Development Goals (SDGs), namely, premature mortality reduction from non-communicable diseases by 2030. Full article

Premature deterioration of reinforced concrete is driven largely by moisture and chloride ingress, which accelerate steel corrosion and shorten service life. This study investigates a dual strategy to enhance durability while supporting circular-economy goals: (i) incorporating coal-fired biomass ash (CBA) as a fine-aggregate replacement (0%, 20%, and 50%) and (ii) applying bio-inspired surface treatments to reduce transport pathways. To capture variability in CBA performance across different environmental and material contexts, two concrete systems—produced in India and the UK—were evaluated, each subjected to a distinct coating approach: a bacterial self-healing treatment or a cinnamaldehyde (CNM) organic barrier. Mechanical, transport, and multi-scale characterization was performed, including compressive strength, capillary absorption, chloride migration (NT Build 492), SEM/EDS, XRF, and XRD. The 20% CBA mixes maintained or slightly improved strength, while higher CBA contents increased porosity but reduced chloride transport in the UK mix. The bacterial coating reduced long-term water absorption by over 80% through CaCO₃ mineralization, offering strong moisture resistance. The CNM coating decreased chloride migration by up to 68% via hydrophobic and ionic-blocking effects. Overall, moderate CBA with self-healing treatment enhances moisture control, whereas higher CBA with CNM provides effective chloride protection, extending the service life of CBA-based concrete. Full article