Search Results (877)

Children with Autism Spectrum Disorder (ASD) frequently exhibit marked impairments in nonverbal communication, particularly in eye contact, which serves as a foundational element for social interaction and relational development. This study evaluated the effectiveness of an early intervention program utilizing interactive games supported by Augmented Reality (AR) technology to enhance eye contact behaviors, specifically initiation and maintenance, in children with autism. Using a multiple baseline across participants single-case experimental design, four boys (aged 5–7 years) diagnosed with ASD participated in an 8-week intervention at a specialized center in Saudi Arabia. The intervention featured tablet-based, gamified AR tasks incorporating real-time visual feedback, graduated difficulty levels, and reinforcement mechanisms designed to elicit social gaze and sustained eye contact. Eye contact duration and frequency were measured during structured social interactions via systematic direct observation. The results demonstrated significant improvements across all participants, with the mean duration of eye contact increasing from a baseline of 2.0 s to 5.8 s post-intervention. Visual analysis revealed robust treatment effects, further supported by substantial Tau-U effect sizes (range = 0.89–0.96; M = 0.93). Follow-up data collected three weeks post-intervention confirmed the maintenance of gains for three of the four participants. These findings suggest that AR-based interventions provide an effective and culturally responsive approach for enhancing specific nonverbal communication behaviors among children with autism in Middle Eastern contexts. Implications for clinical practice and directions for future research are discussed. Full article

Background/Objectives: Acute coronary syndromes (ACS) encompass a spectrum of clinical entities from unstable angina to non–ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI), all associated with significant morbidity and mortality. Inflammation plays a central role in the pathophysiology of ACS, contributing to atherosclerotic plaque destabilization, myocardial injury, and adverse clinical outcomes. Inflammatory biomarkers, together with N-terminal pro–B-type natriuretic peptide (NT-proBNP), are increasingly used for risk stratification, yet their prognostic value across different ACS presentations remains unclear. This study aimed to assess the prognostic value of inflammatory status in patients with acute coronary syndromes in a single-center cohort. Methods: This prospective observational study included 100 consecutive patients with ACS and elevated inflammatory biomarkers, enrolled in 2024–2025 at a tertiary cardiovascular center. Inflammatory status was assessed by using C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII); NT-proBNP was also measured. The primary endpoint was in-hospital MACE, defined as cardiovascular death, recurrent myocardial infarction, stroke, urgent coronary revascularization, or acute heart failure requiring escalation of therapy. Multivariable logistic regression and ROC analyses were performed. Results: Among the 100 ACS patients, half experienced in-hospital MACE. Compared with those without events, patients with MACE were older (p = 0.003) and had higher inflammatory biomarkers—CRP (p < 0.001; strongest association), NLR (p = 0.030), and SII (p = 0.042)—as well as higher NT-proBNP (p = 0.002). Patients with MACE also showed reduced renal function (p < 0.001) and lower left ventricular systolic function, reflected by reduced LVEF (p = 0.001), indicating concomitant renal impairment and ventricular dysfunction. Hypertension was more prevalent in the MACE group (p = 0.028), and new-onset atrial fibrillation was significantly more common among these patients (p < 0.001). In multivariable analysis, LVEF emerged as an independent predictor of short-term outcomes (OR 0.934 per 1% increase; p = 0.047). Conclusions: Inflammatory activation appears closely linked to the occurrence of in-hospital adverse events in patients with acute coronary syndromes. While left ventricular ejection fraction remained an independent determinant of short-term outcomes, inflammatory biomarkers may provide complementary insight into the inflammatory burden accompanying ACS. Full article

Background and Objectives: Shortages of dermatologists create significant barriers to care, particularly for inflammatory and history-dependent conditions where image-only artificial intelligence (AI) classifiers have limited applicability. Current teledermatology solutions largely focus on single-task, morphology-based neoplasm classifiers, leaving the vast majority of dermatologic presentations underserved. This study evaluated the diagnostic accuracy and management plan quality of Dermflow (Prava Medical, Delaware, USA), a proprietary dermatology-focused Multimodal Image-and-Data Assistant (MIDA) that autonomously gathers dermatology-specific history, integrates data with patient-submitted images, and outputs structured differential diagnoses and management summaries. Materials and Methods: Two AI systems, Dermflow and Claude Sonnet 4 (Claude, a leading vision–language model), analyzed 87 clinical images from the Skin Condition Image Network and Diverse Dermatology Images databases, representing 10 inflammatory dermatoses and 9 neoplastic conditions stratified across Fitzpatrick Skin Tone (FST) categories (I–II, III–IV, V–VI). For the diagnostic comparison, Dermflow received images and autonomously gathered clinical history, while Claude received identical images without history. For the management plan comparison, both systems received the correct diagnosis and the clinical histories gathered by Dermflow. The primary outcome was diagnostic accuracy. The secondary outcome was management plan quality, assessed by two blinded dermatologists across eight clinical dimensions using 5-point Likert scales. Chi-square tests compared diagnostic accuracy between models; t-tests and ANOVA compared management quality scores. Results: Dermflow achieved markedly superior diagnostic accuracy compared to Claude (86.2% vs. 24.1%, p < 0.001). Both models maintained consistent diagnostic performance across FST categories without significant within-model differences (Dermflow p = 0.924; Claude p = 0.828). Management plan quality showed no significant overall differences between models. However, composite management quality scores declined significantly for darker skin tones across both systems: Dermflow scored 4.20 (FST I–II), 3.99 (FST III–IV), and 3.47 (FST V–VI); Claude scored 4.35, 3.97, and 3.44, respectively (p < 0.001 for most pairwise FST comparisons within each model). Conclusions: Multimodal AI integrating targeted history with image analysis achieves substantially higher diagnostic accuracy than image-only approaches across both inflammatory and neoplastic dermatologic conditions. Autonomous history gathering addresses fundamental limitations of morphology-only classifiers and enables scalable, patient-facing triage across the full spectrum of dermatologic disease. However, both models demonstrated reduced management plan quality for darker skin tones despite receiving the correct diagnosis, suggesting persistent training data limitations that require targeted bias-mitigation strategies beyond domain-specific instruction. Full article

Background and Objectives: Cardiac Syndrome X (CSX), a clinical entity within the Ischaemia with Non-Obstructive Coronary Arteries (INOCA) spectrum, is increasingly recognised as an inflammatory and systemic vascular disorder. Remnant cholesterol (RC) and inflammation are emerging contributors to residual cardiovascular risk; however, their combined role in microvascular angina remains unclear. This study aimed to evaluate the association between the remnant cholesterol inflammation index (RCII), integrating RC and high-sensitivity C-reactive protein (hs-CRP), and the clinical presence of CSX. Methods: This single-centre, retrospective observational study included 392 individuals who underwent coronary angiography between January 2023 and January 2025. The study population comprised 197 patients diagnosed with CSX and 195 control subjects with normal coronary anatomy and no objective evidence of myocardial ischaemia. RC was calculated as total cholesterol minus the sum of LDL-C and HDL-C, and RCII was derived as RC × hs-CRP. Importantly, invasive microvascular testing (e.g., CFR or IMR) was not performed. Logistic regression analyses were performed to identify independent predictors of CSX, and receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance. Results: Patients with CSX exhibited significantly higher levels of hs-CRP, SII, and RCII compared with controls (all p < 0.001). In the multivariable logistic regression analysis, RCII demonstrated an independent association with CSX (odds ratio 1.095, 95% confidence interval 1.060–1.131; p < 0.001). ROC curve analysis showed that RCII provided moderate but significant discrimination for CSX (area under the curve [AUC] 0.765, 95% CI 0.695–0.795). Pairwise comparisons confirmed that RCII had a significantly higher AUC than RC, hs-CRP, or SII individually. Conclusions: Higher RCII levels appear to be significantly associated with the clinical diagnosis of CSX. By integrating atherogenic remnant cholesterol burden and systemic inflammation, RCII may serve as a valuable composite biomarker for identifying residual inflammatory lipid risk. Rather than acting as a definitive diagnostic tool, these findings warrant further validation in large-scale prospective cohort studies. Full article

Background/Objectives: Antimicrobial resistance (AMR) remains a major global health threat, strengthening the case for antimicrobial stewardship strategies that limit unnecessary broad-spectrum empiric therapy while preserving timely escalation when clinically warranted. Before any clinical deployment of large language model (LLM)-based antibiotic decision support can be considered, structured offline evaluation is needed to assess whether model outputs align with auditable stewardship constraints under real-world admission contexts. We therefore evaluated whether post hoc LLM-generated empiric antibiotic recommendations showed greater concordance with a pre-specified stewardship benchmarking framework than clinician-initiated regimens in a retrospective shadow-mode setting. Methods: Single-center retrospective paired evaluation at Clinical Emergency Hospital of Bucharest (Internal Medicine, 2020–2024). The unit of analysis was the admission (N = 493), with paired 24 h empiric regimens (clinician-prescribed vs. post hoc LLM-recommended via OpenAI API; not visible to clinicians; no influence on care). Local laboratory-derived epidemiology was precomputed from microbiology exports and provided as structured prompt context to approximate information parity with clinicians’ implicit local ecology knowledge. Primary (prespecified) endpoint: any contextual guardrail violation (unjustified carbapenem/antipseudomonal/anti-MRSA under prespecified structured severity/MDR-risk rules), exact McNemar. Key secondary (prespecified): Δ contextual guardrail penalty (LLM − Clin), sign test and Wilcoxon signed-rank (ties reported). Ethics committee approval was obtained. Results: Guardrail violations occurred in 17.0% of clinician regimens vs. 4.9% of LLM regimens (paired RD −12.2%; matched OR 0.216, 95% CI 0.127–0.367; McNemar exact p = 1.60 × 10⁻¹⁰). Δ penalty had median 0 with 398/493 ties; among non-ties, improvements (Δ < 0) exceeded adverse shifts (79 vs. 16; sign-test p = 3.47 × 10⁻¹¹). Conclusions: In this offline, non-interventional paired evaluation, LLM-generated empiric regimens showed greater concordance with a pre-specified stewardship benchmarking framework than clinician empiric regimens for the same admissions. These findings should not be interpreted as evidence of clinical superiority, patient safety, or causal effectiveness, but rather as process-level benchmarking within a rule-based stewardship construct. As such, reproducible guardrail-based benchmarking may serve as an early pre-implementation step to identify alignment and potential failure modes before prospective, safety-governed evaluation. Full article

Metallic Shear Plate Dampers (MSPDs) are essential components in passive vibration control systems and require rapid post-earthquake inspection to assess damage and determine replacement needs. Traditional visual inspection methods suffer from low efficiency and limited ability to detect concealed damage. This study proposes a novel MSPD damage detection method based on active sensing and the k-nearest neighbor (KNN) algorithm, featuring high accuracy, efficiency, and low cost. Quasi-static tests were conducted to simulate various damage states. Sweep-frequency excitation was applied using a charge amplifier, and piezoelectric sensors were employed to generate and receive stress wave signals corresponding to different damage conditions. The acquired signals were processed using wavelet packet transform (WPT) and energy spectrum analysis to extract discriminative time–frequency features, which were used to train and validate the KNN model. Results show that the model achieved a validation accuracy of 98.9% using all valid data and 98.1% using a single excitation-sensing channel. When tested on an MSPD with a similar overall structure but lacking stiffeners, the model achieved an accuracy of 92.6% in distinguishing between healthy and damaged states. This indicates that the proposed method has good robustness and practical potential for MSPDs with similar damage evolution and failure modes despite certain structural variations. Full article

In this study, Chinese medicinal herbs were evaluated as potential antibiotic substitutes for Chinese soft-shelled turtle (Pelodiscus sinensis). Forty-five herbs were initially screened for antibacterial activity against Salmonella enteritidis, Escherichia coli, and Shigella flexneri. Nine herbs exhibiting broad-spectrum inhibitory effects were selected and subjected to microbial fermentation, after which their antibacterial activities were reassessed and applied as dietary supplements in feeding trials. The results showed that fermentation altered the antibacterial activities of several herbs and enhanced their overall functional performance. Dietary supplementation with fermented Chinese herbal medicine did not adversely affect feed utilization but significantly improved hematological parameters, liver and kidney function indicators, antioxidant capacity, and nonspecific immune responses. Furthermore, turtles fed fermented herbal diets exhibited higher survival rates following bacterial challenge. Intestinal microbiota analysis based on 16S rRNA gene sequencing indicated that fermented herbal supplementation modulated microbial community structure by reducing potential pathogens and increasing beneficial bacterial taxa associated with intestinal health. These findings suggest that microbial fermentation effectively enhances the biological efficacy of Chinese medicinal herbs. Fermented herbal feed additives represent a promising green alternative to antibiotics for soft-shelled turtle aquaculture. The global ban on prophylactic antibiotics drives the need for safe, effective feed alternatives. Microbial fermentation of Chinese herbs (FCM) is proposed to enhance efficacy and detoxification, but its comprehensive effects in aquaculture require deeper investigation. This study evaluated compound unfermented (CM) and fermented (FCM) Chinese herbal supplements on the Chinese soft-shelled turtle (Pelodiscus sinensis). Initial screening showed fermentation generally enhanced the antibacterial activity of the herbs against common enteric pathogens (S. enteritidis, E. coli, S. flexneri). Results indicated that the FCM diet significantly improved physiological status, leading to higher red blood cell counts, better liver/kidney function (reduced ALT/AST, UREA), and stronger immune/antioxidant responses (increased Lysozyme and T-AOC) compared to CM or control diets. Critically, the FCM group achieved the highest survival rates across all single and combined pathogen challenges, demonstrating superior protective efficacy. Furthermore, FCM effectively modulated the gut microbiota, enriching beneficial fermentative bacteria. In conclusion, microbial fermentation significantly amplifies the health-promoting and protective benefits of Chinese herbal supplements in soft-shelled turtles, positioning FCM as a promising green alternative for disease control in aquaculture. Full article

Background: The recognition of autism spectrum disorder (ASD) has been a challenge due to the heterogeneity in symptoms and complex variations in brain function. Resting-state functional magnetic resonance imaging (rs-fMRI) has become instrumental in studying these disorders by accessing underlying abnormal neural activity and connectivity. Recently, deep learning approaches have shifted the analysis of brain networks by capturing spatiotemporal information from fMRI sequences. Nonetheless, most existing studies are limited by relying on a single representational scale, typically restricting analysis to either voxel-level spatiotemporal patterns or static connectivity matrices. Additionally, the dynamic reconfiguration of functional coupling and its variations across different anatomical parcellations are often ignored, which obscures neurobiologically meaningful dynamics. Methods: In this regard, we propose a multi-atlas dynamic connectivity transformer fused with 4D spatiotemporal modeling for ASD recognition (MADCT-4D). Specifically, the framework comprises two complementary branches. The 4D spatiotemporal branch encodes raw rs-fMRI volumes to learn hierarchical representations of evolving neural activity, while the dynamic-connectivity branch models time-resolved functional connectivity sequences constructed from multiple atlases, enabling the network to capture dynamic reconfiguration at the connectome level under different parcellation granularities. Moreover, we perform late fusion by combining the branch-specific decision scores with a learnable gate, allowing the model to adaptively weight voxel-level dynamics and multi-atlas connectivity evidence for each subject. Results: Extensive experiments on the publicly available ABIDE dataset demonstrate that the proposed method achieves 90.2% accuracy for ASD recognition, outperforming multiple competitive baselines. Conclusions: The proposed framework yields interpretable biomarkers based on learned dynamic connectivity patterns that are consistent with altered functional coupling in ASD. Full article

In industrial robots, harmonic drive flexible bearings are prone to faults, and fault diagnosis is essential for preventing unexpected downtime. However, vibration signals acquired from robot joints are often non-stationary and contaminated by strong multi-source interference, including motion-induced interference and vibrations induced by the deformation of flexible components. Such interference severely masks the subtle signatures of faults. To address this issue, this paper proposes a fault diagnosis framework that leverages multi-channel vibration signals to enhance fault-related features. First, angular resampling is applied to eliminate speed-induced non-stationarity. Second, envelope extraction is utilized to obtain demodulated signals suitable for independent component analysis (ICA). Subsequently, ICA is employed to extract fault-related components from the multi-channel signals. Finally, the fault-related independent component is identified and analyzed via envelope order spectrum analysis. Experimental validation on an industrial robot under both single-joint and multi-joint operating conditions demonstrates the effectiveness of the proposed framework. The method suppresses multi-source interference and achieves accurate fault diagnosis for flexible bearings under complex operating conditions, with quantitative validation confirming the diagnostic performance of the proposed framework. Full article

Based on the Direct Probability Integral Method (DPIM), this study investigates the global seismic reliability of reinforced concrete (RC) frame structures considering the randomness of material parameters and the non-stationarity of ground motions. A doubly non-stationary ground motion model is established using evolutionary power spectrum theory combined with the spectral representation–stochastic function method. A dimensionality reduction technique is adopted to generate ground motion samples compatible with the design response spectrum. A finite element model of the RC frame is developed in Abaqus. Modal analysis and deterministic time history analysis are conducted to obtain the dynamic characteristics and seismic responses of the structure. Based on 600 representative ground motion time histories generated using the maximum frontier (MF) discrepancy sampling method, nonlinear time history analyses are performed. The DPIM is then employed to calculate the statistical characteristics of structural responses and quantify response variability, enabling a rational evaluation of the structural safety margin. Finally, based on the equivalent extreme value event theory and DPIM, the reliability of the structure under a single failure mode and the global reliability under multiple failure modes are computed. The results show that the global reliability of the structure is 82.088%, which is significantly lower than that of any single failure mode. This study provides a quantitative reference for evaluating the global seismic reliability of RC frame structures subjected to nonstationary seismic excitation. Full article

To meet the requirements of quantitative elemental analysis in the ultraviolet (UV) spectrum, a UV single-photon imaging system was developed, integrating a digital micromirror device (DMD) and a single photon-counting imaging detector, enabling high sensitivity, high resolution, and a wide dynamic range. However, intrinsic geometric distortion poses a significant challenge to accurate spectral calibration. A hybrid correction framework is proposed, cascading polynomial coarse correction with multilayer perceptron (MLP) fine regression, improving calibration accuracy. The method utilizes a full-field dot-array mask projected by the DMD to acquire distortion-reference image pairs. The polynomial model rapidly captures the dominant high-order distortion, while a lightweight MLP performs non-parametric fine regression of residual displacements, achieving a mean error of 0.84 pixels. This approach reduces the root mean square (RMS) error to 1.01 pixels, outperforming traditional direct linear transformation (5.35 pixels) and pure polynomial models (1.33 pixels), while the nonlinearity index decreases from 0.35° to 0.05°. In addition, the method demonstrates stable performance across multi-scale checkerboard patterns ranging from 128 to 280 pixels, with RMS errors remaining around the 1-pixel level. These results validate the high-precision distortion suppression and robust cross-scale performance of the proposed framework. By leveraging DMD-generated patterns for self-calibration, this method eliminates the need for external targets, offering a scalable solution for high-end spectrometer calibration. Full article

Ripple currents on the direct current (DC) bus in variable frequency drive (VFD) systems originate from motor load current fluctuations and the high-frequency switching of power devices. The resulting Joule heating within the DC-link capacitors is a primary driver of lifespan degradation. To address the lack of systematic models for multi-phase H-bridge inverters and the over-design caused by empirical methods, this paper proposes a novel analytical method that incorporates the 2kπ/N phase difference of parallel units for precise ripple current quantification. First, a dynamic DC-link capacitor model is established based on a single-phase H-bridge inverter, and the expressions for the instantaneous, average, and root mean square (RMS) input currents are derived. Furthermore, by introducing the 2kπ/N phase difference (where k = 0, 1, …, N − 1) among N parallel H-bridge units, a universal analytical expression for the RMS input current and its harmonic spectrum in a multi-phase system is obtained. The analysis reveals that ripple current harmonics concentrate at 2m × f_sw (where m is a positive integer and f_sw is switching frequency) and their sidebands (2m × f_sw ± f_o, f_o is output fundamental frequency), and the coupling influence of modulation index and power factor angle on ripple amplitude is quantitatively characterized. A 12 × 160 kW twelve-phase H-bridge inverter is taken as a case study, and MATLAB (v2023b) simulations and hardware experiments demonstrate that the theoretical calculations are in close agreement with the simulated and measured results, with the errors of input current harmonic amplitudes all below 5%. Compared with traditional empirical design, the proposed method reduces the capacitor volume and cost by approximately 15–20% while ensuring system reliability. This method is directly extensible to other multi-phase inverter topologies, providing a theoretical foundation for the accurate selection of DC-link capacitors. Full article

Heavy and overloaded freight traffic strongly affects pavement performance, yet short-term weigh-in-motion (WIM) measurements are not easily converted into design-oriented traffic inputs. Using the Nairobi Southern Bypass in Kenya as a case study, this study develops axle load spectrum (ALS) and equivalent single axle load (ESAL) indicators from more than 1.5 million axle group records collected between June and December 2025 and proposes an XGBoost-based conditional axle load spectrum (CA-ALS) framework. The data revealed strongly right-skewed load distributions, with a limited number of heavily loaded axle groups dominating pavement damage. Compared with the static ALS by axle group type baseline, the CA-ALS reduced log loss from 2.7563 to 2.6709 in conditional spectrum prediction. In the December 2025 tandem axle benchmark, the CA-ALS increased the ESAL-based verification input by 6.0% at b = 4 and 11.1% at b = 5 relative to the stronger static reference. A legal-load-capped counterfactual analysis further showed that, for all heavy vehicles, observed overloading increased ESAL by 161.0% at b = 4 and 239.4% at b = 5. These results indicate that the CA-ALS provides condition-sensitive traffic inputs for design traffic verification, scenario-based pavement checks, and overload-sensitive evaluation based on short-term WIM observations. Full article

Accurate endpoint control in basic oxygen furnace (BOF) steelmaking is essential for reducing production costs and improving steel quality. To overcome the limited mechanism support and poor transparency of purely data-driven models, this study proposes a physics-aware and interpretable framework for cumulative decarburization prediction based on real industrial data. Historical multi-heat data from the same converter were integrated, and an averaged full-spectrum cross-correlation method was used to estimate and correct the transport delay of off-gas signals, thereby constructing a heat-wise large-sample dataset. Key elemental features with clear physical significance were then extracted from high-dimensional flame spectra by incorporating their underlying radiation mechanisms. On this basis, a Stacking-based ensemble model was developed for cumulative decarburization prediction, and SHAP was introduced to interpret the model decision logic. Results show that the proposed framework outperforms conventional single models and purely data-driven dimensionality reduction methods. SHAP analysis further indicates that model decisions are mainly dominated by four core elemental spectral features, namely Fe, C, O, and Mn. Overall, the proposed method combines predictive performance, physical constraints, and interpretability, and provides a new solution for auxiliary soft sensing and decision support in BOF endpoint control. Full article

Rapid post-disaster building damage assessment requires recognizing explicit structural failures and interpreting implicit situational cues in visually complex scenes. Whereas conventional automated methods are often confined to detecting explicit damage patterns, human perception naturally integrates both types of information into a holistic risk judgment. This study presents an exploratory investigation into the neural signatures underlying this integrated judgment process using electroencephalography. A modified paradigm was employed to probe the cognitive dynamics of risk evaluation in participants with civil engineering backgrounds. Although participants were instructed only to identify damaged buildings without explicit severity grading, event-related potential analysis revealed systematic, graded neural responses that scaled with damage severity. This suggests that the brain encodes damage-related information not as a binary state but as a continuous spectrum of perceived risk, implicitly processing severity, even in the absence of explicit instructions. Furthermore, single-trial analysis demonstrated that time-domain features contain robust discriminative information, verifying the feasibility of decoding these latent judgments from brain activity. These findings provide a physiological basis for developing future cognition-informed algorithms and human-in-the-loop frameworks, bridging the semantic gap to enhance the reliability of automated disaster assessment. Full article