Search Results (18,794)

Children with Down syndrome may experience developmental differences in communication, social participation, adaptive functioning and peer interaction. However, they also possess individual strengths, learning potential and adaptive capacities that can be enhanced through structured, responsive and contextually relevant early intervention. This study aimed to design and develop an Early Intervention Module for Social Skills of Children with Down Syndrome in Malaysian Taska OKU settings. A Design and Development Research approach was applied across three phases: needs analysis, module design and development, and usability evaluation. Phase 1 involved semi-structured interviews with teachers to identify contextual challenges, existing strengths, available practices and support needs in teaching social skills to children with Down syndrome. Phase 2 focused on module development through expert consensus using the Fuzzy Delphi Method. Phase 3 examined the usability of the developed module among teachers in real daycare settings. The findings from the needs analysis showed that teachers required a structured module that could support children’s social participation, communication, turn-taking, emotional expression and interaction with peers and adults. At the same time, the findings highlighted the importance of recognising children’s strengths, including their responsiveness to visual cues, enjoyment of routine-based activities, imitation skills and ability to participate when appropriate support is provided. The developed module consists of structured social skill domains, learning outcomes, teaching activities, visual support, play-based strategies, parental involvement components and progress monitoring tools. The usability evaluation indicated that the module was practical, understandable and relevant for use in Taska OKU settings. Teachers reported that the module supported clearer planning, more consistent implementation and better opportunities for children to participate socially. This study contributes to the development of a locally adapted early intervention module that is grounded in stakeholder input, expert consensus and inclusive education principles. The module also reflects strength-based and functioning-oriented terminology aligned with the International Classification of Functioning, Disability and Health framework. The findings suggest that contextually developed modules can support teachers and caregivers in enhancing the social participation of children with Down syndrome in Malaysian early childhood settings. Full article

Civil engineering is essential to the transportation industry, and the maintenance of concrete components is a critical aspect. Recently, the IE (Impact-Echo) method has become a significant technique for void detection. However, conventional IE approaches have limitations and are susceptible to subjective factors. Consequently, AI (artificial intelligence) methods have attracted increasing attention. Although progress has been made, many issues persist in real-world situations. To address these shortcomings, such as weak transient characteristic comprehension, insufficient analysis of periodic features, and inadequate handling of impact-induced resonance and boundary reflection, we propose a novel three-stream input heterogeneous fusion framework. Our contributions are as follows: (1) GAF (Gramian Angular Field) representations that refine the analysis of energy distribution and asymmetric acoustic fingerprint variation rate; (2) MTF (Markov Transition Field) representations that enhance analysis of state transitions; (3) a BiLSTM (Bidirectional Long Short-Term Memory) module with dynamic constraints and the Flood Algorithm to improve time-frequency domain information comprehension. Experimental results demonstrate an average recognition accuracy of up to 96% across four tasks in complex working conditions, approaching competitive performance and indicating practical application value. Full article

Pulmonary involvement in primary Sjögren’s syndrome (pSS) is common and exhibits significant clinical heterogeneity, particularly in cases where interstitial lung disease (pSS-ILD) develops. Reported variability in prevalence, radiologic phenotypes, and clinical outcomes indicates both underlying biological diversity and differences in classification criteria, case ascertainment, and diagnostic approaches. Pulmonary manifestations may be subclinical, and early interstitial abnormalities are frequently undetected due to the limited sensitivity of chest radiography. Presentations such as ILD-first or non-sicca onset, seronegative disease, and coexisting or mimicking conditions, including lymphoproliferative disorders and amyloidosis, increase the difficulty of diagnosis. High-resolution computed tomography (HRCT) demonstrates a wide range of patterns, including inflammatory, fibrotic, and mixed phenotypes, which often overlap and change over time. Reliance on pattern-based categorization may not adequately reflect the underlying pathobiology; for example, those with usual interstitial pneumonia (UIP)-like morphology have significant prognostic implications within the pSS spectrum. A structured, multidomain assessment that integrates symptoms, pulmonary function, and HRCT findings, ideally inside a multidisciplinary discussion (MDD), may boost diagnostic accuracy and risk stratification. Nevertheless, heterogeneity in definitions and reporting continues to impede comparability across patient cohorts. Additional research is necessary to standardize phenotyping frameworks and identify predictors of disease progression to inform individualized diagnostic and management strategies. Full article

Multi-intersection traffic signal coordination and control improves urban traffic efficiency by coordinating signal timing across suitable corridors or groups of intersections. However, most existing work focuses on optimizing the signal timing plan for predefined intersection groups such as all intersections on an arterial, whereas the question of which intersections should be coordinated together for maximum efficiency is often overlooked. Moreover, as traffic patterns vary throughout the day, the most suitable intersection groups may not be fixed across different Time-of-Day (ToD) demand conditions. To address this gap, this study proposes a network partitioning approach to adaptively identify effective groups of intersections for traffic signal coordination. A Signal Coordination Network (SCN) is constructed to quantify the coordination benefit between intersections based on traffic volume, spatial proximity, and cycle length compatibility. By solving a maximum set-packing problem, the proposed approach partitions the SCN into the most effective intersection groups, including isolated intersections, arterial progression groups, and network progression groups. Compared with the best-performing baselines, the proposed method reduces average travel time by 2.7% and average delay by 7.0% across the tested network–ToD scenarios, while the experiments under demand variation show statistically significant improvements in all AM and PM peak scenarios and comparable performance during off-peak periods. These results suggest that explicit coordination-group selection can provide additional operational benefits beyond local retiming, adaptive control, and predefined corridor or network coordination. The proposed framework offers a practical planning-level tool for designing ToD-sensitive signal coordination plans in urban networks. Full article

Objectives: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease with increasing prevalence and mortality. High-resolution computed tomography (HRCT) is routinely performed in IPF assessment and can provide additional quantitative information. However, the prognostic utility of these HRCT-based parameters in IPF remains uncertain. This study aimed to investigate the prognostic value of quantitative HRCT findings in predicting mortality among patients with IPF. Methods: In this retrospective cohort study, 48 patients diagnosed with IPF between 2014 and 2024 were analyzed. Demographics, pulmonary function tests, HRCT findings, and quantitative measurements, including coronary artery calcium (CAC) score; densities of hepatic, paraspinal muscle, and lumbar vertebral bone mineral; and HRCT-derived fibrosis scores, were collected at baseline and after at least two years. The primary outcome was all-cause mortality. Results: The mean age was 66.8 ± 8.5 years; 77.1% were male. During a median follow-up of 63.3 months, 22 patients (45.8%) died, mainly from IPF-related causes (71.4%). Non-survivors had significantly higher HRCT fibrosis scores both at diagnosis (p = 0.006) and at two years (p = 0.002). Fibrosis scores increased significantly over time in non-survivors (p = 0.019). CAC scores rose in both groups, with a greater increase in non-survivors, but their independent prognostic value was limited after adjustment. Multivariable analysis identified male sex (hazard ratio [HR]: 5.46, p = 0.031) and second-year fibrosis score (HR: 1.10, p < 0.001) as independent predictors of mortality. Conclusions: HRCT-derived fibrosis burden is an independent predictor of mortality in IPF, alongside male sex. While other HRCT-based measures showed limited prognostic significance, longitudinal increases in CAC scores suggested potential cardiovascular implications. Full article

Polyisocyanurate (PIR) insulation boards are widely used in buildings because of their low thermal conductivity, however their long-term performance is affected by aging. This study investigates the effect of accelerated thermal aging at +70 °C on the thermal conductivity and gas composition of pentane-blown PIR boards. Thermal conductivity was monitored over time, while changes in blowing-agent composition were analyzed using gas chromatography/mass spectrometry (GC/MS). Thermal conductivity increased from 0.0201–0.0211 W/(m·K) to 0.0243–0.0247 W/(m·K), corresponding to an increase of approximately 18–22%, with the most pronounced changes occurring during the first 40–50 days before stabilizing. GC/MS identified isopentane, cyclopentane, and pentane as the main gases in the foam cells, with isopentane as the dominant component. Accelerated aging caused a progressive decrease in blowing-agent concentration, explaining the deterioration in thermal insulation performance. Thermal outgassing proved more reliable than solvent extraction, providing higher sensitivity and reproducibility. Sample location, sample size, and outgassing temperature significantly affected the measured gas quantities, while higher outgassing temperatures improved analytical sensitivity without changing gas composition trends. The results confirm that the aging-induced increase in thermal conductivity is primarily caused by the loss of low-conductivity blowing agents, improving understanding of the long-term performance of PIR insulation materials. Full article

Failures at large-scale open-pit mines and tailing dams pose critical risks to human life, environmental systems, and economic sustainability. Although Interferometric Synthetic Aperture Radar (InSAR) has proven effective in detecting long-term surface deformation, a scientifically robust early-warning framework has not yet been established because standardized quantitative thresholds that are capable of distinguishing benign consolidation settlement from instability-driven deformation remain unavailable.InSAR has proven effective for detecting long-term surface deformation. However, a scientific early-warning framework has not yet been proposed or developed due to the absence of standardized quantitative thresholds that distinguish benign consolidation settlement from instability-driven deformation. This research proposes a novel InSAR-based Failure-Risk Index (FRI) that integrates displacement, velocity, and, most importantly, deformation acceleration into a single, normalized metric as an early warning system for mining infrastructure instability. The framework that we propose (i) emphasizes acceleration as a leading indicator of change in mechanical regime, (ii) incorporates a statistically guided separation of long-term consolidation settlement from anomalous deformation based on baseline variability, (iii) applies a statistical standardization and change-point detection system. The methodology is validated through a retrospective analysis of the heap leach failure—that occurred in Çöpler Gold Mine in Erzincan, Türkiye, on 13 February 2024—by using a set of Sentinel-1 time-series images collected between 2014 and 2024. The results prove that while displacement and velocity remained within ranges typically interpreted as stable, deformation acceleration exhibited a statistically significant increase that began around 2020, exceeded baseline variability by approximately two orders of magnitude, which is approximately four years before the collapse, and marked the onset of tertiary creep and progressive instability. The proposed FRI framework successfully captures this transition and provides a transferable, meaningful early-warning framework to support proactive risk management and improve the safety of mining infrastructure. Full article

Background: Chronic kidney disease (CKD) is characterized by persistent inflammation, metabolic dysregulation, and mineral and bone disorder (CKD-MBD), all of which may affect ocular tissues. While retinal manifestations of CKD have been increasingly investigated, data regarding clinical anterior segment modifications and their relationship with systemic biochemical parameters remain limited. Methods: We performed a cross-sectional study including 130 participants: 53 non-CKD subjects, 29 patients undergoing maintenance hemodialysis (HD), and 48 kidney transplant recipients (KTRs). All participants underwent comprehensive ophthalmic examination, including best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement using Goldmann applanation tonometry, Schirmer I test, tear break-up time (TBUT) and assessment of cataract and blepharitis prevalence. Serum creatinine estimated glomerular filtration rate (eGFR), calcium, phosphate, parathyroid hormone (PTH), magnesium, 25-hydroxyvitamin D, and Activin A were recorded. Associations between ocular and systemic parameters were evaluated using correlation and regression analyses. Results: TBUT, Schirmer I and IOP did not differ significantly among groups (all p > 0.05). After adjustment for age, sex, BMI and diabetes mellitus (DM), HD patients showed worse visual acuity than the non-CKD reference group, reflected by higher logMAR BCVA values (adjusted B = +0.128, p = 0.024). In KTRs, higher corrected calcium was independently associated with reduced tear film parameters, correlating with both shorter TBUT (B = −0.903, p = 0.037) and lower Schirmer I values (B = −5.947, p = 0.008). Circulating Activin A increased progressively from controls to KTR to HD patients (median 189.5 vs. 273.0 vs. 314.0 pg/mL, p < 0.001) but showed no independent association with any anterior segment parameter; it was instead associated with cumulative glucocorticoid exposure (B = +1.602, p = 0.024). Conclusions: In CKD, clinical anterior segment and ocular surface differences were largely explained by age, sex, and comorbidity rather than renal replacement modality, with visual acuity deficit persisting in HD after adjusting for these covariates. At the individual level, corrected calcium was the parameter most consistently associated with tear film parameters in KTRs, whereas elevated Activin A was not independently associated with ocular involvement and likely reflects systemic disease activity. Full article

Silicone oil is a promising dielectric coolant for battery immersion cooling, yet the ability of commercially available conductivity sensors to detect battery-related contamination remains poorly quantified. In this study, simulated carbonaceous particles, electrolyte, and mixed solid–liquid contaminants were introduced into silicone oil under controlled conditions using a closed-loop circulation platform, and conductivity was monitored in real time. Pristine silicone oil exhibited a baseline conductivity near the instrumental detection limit (approximately 1.26 μS·cm⁻¹). No measurable conductivity increase was observed for particle concentrations up to 10 g·L⁻¹ or electrolyte additions up to 3.0 vol%. Only under an intentionally extreme condition involving 20 vol% electrolyte and vigorous mixing were transient conductivity spikes of 350–550 μS·cm⁻¹ detected. Thus, within the application-relevant concentration range examined, conductivity monitoring showed limited sensitivity to progressive contamination. These findings concern the response of a commercial low-field conductivity sensor and do not constitute a complete assessment of leakage current, dielectric strength, or full thermal-runaway conditions. Full article

Facial aging is a multifactorial process characterized by progressive structural and functional changes involving skin, soft tissues, muscles, and skeletal support. Current conceptual models primarily rely on static anatomical descriptions and regional assessment scales that evaluate visible signs such as wrinkles, folds, and volume loss. Although these approaches provide useful clinical reference points, they may only partially capture the dynamic interactions between muscular activity, tissue aging, and gravitational forces that shape facial morphology over time. In this article, we propose a conceptual framework for interpreting facial aging based on the vectorial dynamics generated by facial mimic muscles. Within this perspective, facial muscles can be considered sources of contraction vectors that exert mechanical influences on facial tissues throughout life. Under physiological conditions, facial appearance reflects a dynamic equilibrium between opposing vectorial influences. However, progressive tissue weakening combined with repetitive muscular activity may gradually alter this balance. This hypothesis-generating, vector-based model integrates muscular dynamics with tissue aging and gravitational effects to offer a complementary interpretative framework for facial aging. It is not intended as a validated biomechanical theory, but rather as a conceptual tool to stimulate further anatomical, imaging-based, and clinical investigation. Full article

Addressing multi-factor coupling, progressive degradation, and time-varying operating conditions in substation equipment under high-penetration renewable energy integration, this paper proposes a Time-varying Hidden Markov Model (T-HMM) for transformer fault diagnosis using multi-source heterogeneous data. Unlike conventional HMM with fixed transition matrices and initial parameter sensitivity, the proposed framework introduces a forgetting-factor-driven online transition matrix updating mechanism, enabling adaptive state tracking under varying operating conditions. A multi-dimensional feature system is constructed incorporating fundamental state, coupling correlation, and temporal evolution characteristics, with state-dependent sliding window standardization and adaptive wavelet denoising to enhance early-stage fault discriminability. Parameter optimization employs pre-clustering and multi-start strategies to circumvent local optima in the Baum–Welch algorithm, while an improved decoding strategy achieves real-time health state identification and multi-step probability prediction. Experimental results demonstrate that the proposed method accurately tracks state evolution trends and effectively identifies fault categories, achieving significantly superior state recognition accuracy and multi-step prediction hit rates compared to conventional HMM, with substantially reduced mean absolute error. The method effectively captures subtle precursors during normal-to-fault transitions, providing reliable theoretical foundations for early fault warning and condition-based maintenance. Full article

To investigate the application potential of ultrafine composite powder (UCP) as a novel supplementary cementitious material to replace ground granulated blast-furnace slag (GBFS) in cement-based materials and its underlying mechanism, this study first compared the activity differences between UCP and GBFS and their effects on mortar workability. Subsequently, multiple characterization techniques including XRF, XRD, TG/DTG, FTIR, mapping, SEM-EDS, and BET were employed to systematically examine the morphology, composition, particle size distribution, and pore structure characteristics of the two powders. Results show that UCP exhibits slightly higher 3 d and 28 d strength activity indices than GBFS, but contributes less to strength progression between 3 and 28 days. In terms of chemical composition, UCP contains lower combined CaO + MgO + Al₂O₃ content but significantly higher C and Fe levels and alkalinity than GBFS. Phase and microstructural analyses further reveal that UCP is predominantly composed of GBFS, fly ash (FA), steel slag, limestone powder, gypsum, superplasticizer, and alkaline activator, and is characterized as a mesoporous material with pores arising from fragmented FA, unburned carbon residues, and grinding-induced cracks. Quantitatively, the BET specific surface area, Blaine specific surface area, and total pore volume of UCP are 2.47, 1.59, and 3.31 times those of GBFS, respectively. Therefore, the early-age activity advantage of UCP is mainly attributed to the filling effect, the additional nucleation sites provided by its larger specific surface area, and the chemical activation induced by alkali and gypsum. Full article

The long-term productivity of hydraulically fractured deep coalbed methane (CBM) wells is jointly governed by desorption-driven gas supply from the coal matrix, the effective-stress response and time-dependent creep of natural cleats, and the progressive degradation of hydraulic-fracture conductivity. To address the difficulty of conventional models in consistently describing the time-dependent transport capacities of natural cleats and hydraulic fractures, this study develops a productivity-prediction model for hydraulically fractured deep CBM wells that couples gas storage in the coal matrix, dynamic natural-cleat permeability, and dynamic hydraulic-fracture conductivity. Based on mass conservation, the model accounts for free- and adsorbed-gas storage, single-phase gas flow, matrix-fracture mass transfer, and wellbore production. The evolution of natural-cleat permeability incorporates effective-stress-induced closure, Langmuir desorption shrinkage, and fractional-order creep, whereas the evolution of hydraulic-fracture conductivity considers fracture compaction, elastic deformation and embedment of proppants, and creep-induced closure of the coal rock. The nonlinear coupled equations are solved using a fully implicit finite-difference scheme. The field dataset comprises daily production records from six deep CBM wells and is used only to constrain physically reasonable ranges of field parameters and provide reference production characteristics. The results indicate that effective stress primarily controls the rapid closure of flow pathways during the early production stage, while the relative contribution of coal creep increases with production time. Neglecting either coal creep or stress sensitivity leads to an overestimation of cumulative gas production over the medium and long term. The proposed model provides a physically constrained analytical framework for evaluating the long-term productivity of hydraulically fractured deep CBM wells and comparing alternative production strategies. Full article

Background/Objectives: Adenomyosis is a chronic gynecological disorder characterized by the presence of endometrial tissue within the myometrium, causing pelvic pain, abnormal uterine bleeding, and infertility. Despite its high prevalence, the molecular mechanisms underlying disease initiation and progression remain incompletely understood. Current evidence implicates disruption of the endometrial–myometrial interface, epithelial–mesenchymal transition, and progesterone resistance in driving tissue invasion and remodeling. Diagnosis relies mainly on imaging modalities, while reliable non-invasive biomarkers are lacking. MicroRNAs, as stable post-transcriptional regulators of gene expression, have emerged as key modulators of proliferation, inflammation, and hormonal signaling, and represent promising candidates for novel diagnostic strategies. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42025637752). A comprehensive search of the Medline, Embase, Scopus, and Cochrane databases was performed in April 2025. Studies investigating miRNA expression in patients with adenomyosis compared with controls were included. The quality of the studies and the risk of bias were assessed using the Newcastle–Ottawa scale. Two reviewers independently performed study selection, data extraction, and quality assessment. Results: Twenty-seven studies published between 2015 and 2025 met the inclusion criteria. Thirty-nine distinct miRNAs were reported as significantly dysregulated in adenomyosis. Recurrently altered miRNAs included let-7a, miR-145, miR-10b, miR-30c-5p, miR-141-3p, miR-143, and miR-191. Functional analyses have consistently implicated miRNAs in key pathogenic pathways, including Hippo-YAP, PI3K/AKT, MAPK/ERK, JAK/STAT, and Wnt/β-catenin signaling. These alterations were associated with enhanced epithelial–mesenchymal transition, increased cellular proliferation and migration, progesterone resistance, chronic inflammation, and immune modulation. Emerging evidence highlights exosomal and circulating miRNAs as promising non-invasive biomarkers, with a few studies already demonstrating diagnostic potential using serum, plasma, or urine samples. However, substantial heterogeneity in tissue types, sampling timing, and analytical methods precluded meta-analysis. Conclusions: MiRNAs play a central role in the molecular pathogenesis of adenomyosis and show strong potential as non-invasive diagnostic biomarkers. However, large-scale validation studies and standardized methodologies are required before clinical implementation. Full article

Taking Lankao County as a case study, this study extends the established StrawFeed framework by linking NHPI-derived harvest dates to spatially differentiated straw release and seasonal equipment scheduling. Time-series Sentinel-2 observations were used to characterize harvest timing, while observed road routes were used to calibrate the detour parameter. The mapped harvest progression was compared with reported aggregate harvest progress and provided spatially differentiated timing inputs for logistics simulation. The results demonstrate that: (1) The spatial-economic framework effectively refine the spatial representation of traditional models in complex fragmented plots. (2) Under the annual shared-fleet baseline, the simulated delivered cost was 28.40 USD t⁻¹. (3) Route calibration yielded a road-detour coefficient of 1.36, demonstrating the effect of road geometry on transport distance. The simulated cost represents the result under the specified demand, road, equipment, and price assumptions rather than a causal penalty attributable to land fragmentation. Consequently, we suggest that land management policies should shift toward “precision-targeted” subsidies, and rural spatial planning should prioritize the layout of decentralized pre-processing hubs to optimize spatial logistics efficiency and economic viability. Full article