Search Results (1,756)

Rheumatoid arthritis (RA) has traditionally been managed after the onset of clinically apparent synovitis; however, accumulating evidence indicates that disease-related immune abnormalities precede clinical diagnosis by several years. This preclinical phase is characterized by systemic autoimmunity, early musculoskeletal symptoms, and subclinical inflammation in genetically and environmentally susceptible individuals. In this review, we summarize current concepts regarding the pathogenesis, risk stratification, and therapeutic interception of preclinical RA. Particular attention is given to the mucosal origin hypothesis and to the roles of immunosenescence, peripheral helper T cells, and fibroblast-like synoviocytes in early disease evolution. Recent advances in clinical, serological, and imaging-based risk stratification have improved the identification of individuals at high risk of progression to clinical RA, and emerging intervention trials have shown that selected therapies may delay disease onset or reduce early inflammatory burden. Although complete prevention of RA has not yet been achieved, these findings support a paradigm shift from the treatment of established RA toward earlier, risk-adapted intervention before irreversible joint damage occurs. Future efforts should focus on refining predictive biomarkers, optimizing the timing and intensity of intervention, and establishing safe, individualized preventive strategies. Full article

Accurately forecasting the weighted mean temperature (Tm) is critical for converting the zenith wet delay (ZWD) into global navigation satellite system (GNSS)-based precipitable water vapor (PWV) for real-time sensing and forecasting applications. The forecast Vienna Mapping Function 1 (VMF1-FC) is a global forecast product developed by TU Wien based on numerical weather prediction models and can provide grid-wise Tm one day ahead. In this study, we evaluate the accuracy of VMF1-FC-forecasted Tm using observations from 319 global radiosonde (RS) sites during 2019–2021. The results indicate that VMF1-FC-forecasted Tm shows a relatively low RMSE but a relatively large bias (0.75 K) relative to the widely used Global Pressure and Temperature 3 (GPT3) model. To improve the accuracy of VMF1-FC-forecasted Tm, three refined models, XTm, LTm, and CTm, are developed using Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), and Categorical Boosting (CatBoost), respectively, based on observations from 319 RS sites. The models use longitude, latitude, ellipsoidal height, floating day of year (fdoy), and VMF1-FC Tm as input features, and RS Tm as the target variable. Validation using RS data from 2022 that are not involved in model development shows that the refined models significantly reduce bias, with biases of 0 K, 0 K, and −0.03 K for XTm, LTm, and CTm, respectively. Benefiting from the effective reduction in bias, the root mean square error (RMSE) is correspondingly reduced. The RMSEs of XTm, LTm, and CTm are 1.45 K, 1.45 K, and 1.46 K, respectively, achieving improvements of 18.50%/64.93%, 18.44%/64.91%, and 18.11%/64.76% compared with the VMF1-FC and GPT3 models. In addition, three refined models demonstrate higher accuracy and improve stability across different latitude bands, ellipsoidal height ranges, and temporal scales. The refined models provide more accurate global-scale Tm and offer strong potential for GNSS meteorological applications, particularly real-time GNSS-based PWV sensing and weather forecasting. Full article

Background: Higher-risk myelodysplastic neoplasms ( HR-MDS) are associated with poor survival and a substantial risk of leukemic transformation. Although azacitidine is a standard treatment in this setting, comparative real-world data remain limited. We evaluated the association between azacitidine exposure and clinical outcomes in patients with HR-MDS. Methods: We performed a retrospective single-center cohort study including 72 adults with HR-MDS, defined by the Revised International Prognostic Scoring System(IPSS-R) as High or Very High risk. Patients were categorized as azacitidine-treated (Aza, n = 44) or managed with best supportive care alone (No Aza, n = 28). Overall survival (OS) was defined from diagnosis to death from any cause. Progression-free survival (PFS) was defined as the time to acute myeloid leukemia transformation or death. Leukemic transformation (LT) was analyzed using Kaplan–Meier estimates and competing-risk cumulative incidence, with death without prior LT treated as a competing event. Univariable and multivariable Cox regression models were applied. Results: Azacitidine exposure was associated with longer OS compared with best supportive care, with a median OS of 13 vs.10 months and 24-month OS rates of 27% vs. 14% (p = 0.0239). PFS was also prolonged in the Aza group, with a median of 11 vs. 7 months (p = 0.0406). LT-related outcomes similarly favored azacitidine. In multivariable analyses, azacitidine remained independently associated with improved OS, PFS, and LT-related outcomes. IPSS-R Very High risk remained an adverse prognostic factor across endpoints, while a higher baseline bone marrow blast percentage independently predicted leukemic transformation. Conclusions: In this real-world HR-MDS cohort, azacitidine exposure was associated with improved survival outcomes and delayed leukemic transformation compared with best supportive care alone. Full article

Healthcare artificial intelligence (AI) is moving from the laboratory into the infrastructure of care. As these systems become embedded in imaging, electronic health records, triage, and clinical decision support, their failures can affect not only individual encounters but also institutions and patient populations. Yet governance still centers on model development, local validation, and one-time compliance, with limited attention to cross-site failure after deployment. This article examines how public health preparedness can help close that gap. It presents a conceptual analysis grounded in two cases: a pneumonia-screening convolutional neural network that learned institutional confounders rather than portable clinical signals, and a widely deployed sepsis prediction model whose external performance and alert burden fell short of developer claims. Together, these cases reveal five governance features of systemic healthcare AI risk: population-level exposure, cascade effects across shared infrastructures, unequal vulnerability, delayed recognition, and coordination needs beyond any single institution. In response, we propose a tripartite framework combining stronger pre-deployment assurance, post-deployment surveillance with escalation thresholds, and tertiary response through investigation, rollback, remediation, and cross-site learning. The argument is not that AI failures are epidemics, but that high-impact clinical AI systems now function as critical digital health infrastructure requiring preparedness alongside lifecycle oversight. Full article

Iso-cetane serves as an ideal component representing branched-chain alkanes in surrogate fuels for diesel. However, the predictive accuracy of existing detailed chemical kinetic models for iso-cetane requires improvement. In this study, focusing on the reaction processes of iso-cetane and its key intermediates, we first updated the thermodynamic data of iso-cetane and some of its intermediates, systematically analyzed the effects of various reactions on ignition delay time (IDT), and made targeted modifications to the relevant reaction rate constants. The reaction types involved include fuel cracking reactions of iso-cetane, hydrogen abstraction reactions, cracking reactions of fuel radicals, as well as the oxidation of fuel radicals, isomerization of alkylperoxy radicals (RO₂ )  concerted elimination reactions, formation of cyclic ethers, and the formation and decomposition of ketohydroperoxides (KHP). Additionally, reactions related to the formation and consumption of p-alkyl-dihydroperoxides (P(OOOH)₂) were supplemented. Based on the above work, we developed a detailed chemical kinetic model for iso-cetane, comprising 4541 species and 18,359 elementary reactions. Through systematic validation against experimental data on ignition delay time and concentration variations of key species during oxidation, the improved predictive performance of the proposed model was demonstrated. Furthermore, using sensitivity analysis and reaction pathway analysis for the ignition process, we revealed that the formation of the low-temperature negative temperature coefficient (NTC) region for iso-cetane is intrinsically associated with the competition between chain-branching and chain-propagating pathways. Full article

Under turbulent wind conditions, rapid wind speed fluctuations can markedly increase the fatigue loads borne by wind turbine blades and towers. In practice, conventional PID pitch control based on speed feedback often struggles to deliver satisfactory load mitigation, mainly because the wind turbine system is highly nonlinear, strongly coupled, and subject to time-delay effects. To overcome these limitations, this paper proposes a load-predictive pitch control strategy built on a Long Short-Term Memory (LSTM) network. Specifically, the LSTM model is first employed to predict the hub-fixed tilt and yaw moments ahead of time. These predicted values are then introduced as feedforward signals and combined with the conventional speed-based pitch control signal as well as a proportional feedback term. After that, the inverse Coleman transformation is used to generate the individual pitch commands for each blade. To verify the effectiveness of the proposed method, co-simulations were carried out in FAST and MATLAB/Simulink on a 5000 KW distributed pitch-controlled wind turbine under IEC Kaimal spectrum wind conditions, with a mean wind speed of 18 m/s and Class B turbulence intensity. The results show that the LSTM prediction model achieves an R² of 0.998 on the test dataset, with an RMSE as low as 0.0051. Compared with the conventional pitch-based power control strategy, the proposed approach maintains the same average power output while significantly reducing fatigue loads, thereby contributing to a longer service life for the wind turbine. Full article

Reliable short-term prediction of bus travel time on signalized urban arterials is essential for improving service reliability and may provide a useful forecasting basis for prediction-informed transit signal priority (TSP) and arterial coordination applications. However, bus operations on urban arterials are highly variable due to stop dwell times, signal delays, and interactions with mixed traffic, leading to nonlinear and nonstationary travel time patterns with strong spatiotemporal dependence. This study proposes a hybrid KNN–ConvLSTM framework for short-term arterial bus travel time prediction using real-world field data. A K-nearest neighbors (KNNs) module is first employed to retrieve historical operation sequences that are most similar to the current corridor state, thereby reducing interference from mismatched traffic regimes and improving robustness. Smart-card (IC card) transaction data are incorporated as demand-related features to represent passenger activity and its impact on dwell time and travel time variability. The selected sequences are then organized into a corridor-ordered spatiotemporal representation and further refined by lightweight temporal enhancement operations, including relevance gating, multi-scale aggregation, adaptive feature fusion, and residual enhancement, before being fed into the convolutional long short-term memory (ConvLSTM) predictor. The proposed approach is evaluated using weekday service-hour data extracted from 30 days of real-world bus operation records collected from a typical urban arterial corridor in Changchun, China, and is compared with several benchmark models, including ARIMA, KNN, LSTM, CNN, ConvLSTM, Transformer, and DCRNN. The results indicate that the proposed KNN–ConvLSTM framework achieves an MAE of 40.1 s, an RMSE of 55.8 s, a SMAPE of 10.7%, and an R² of 0.878, outperforming all benchmark models. Specifically, compared with the Transformer baseline, the proposed framework reduces MAE by 1.5%, RMSE by 5.1%, and SMAPE by 7.0%, while increasing R² by 0.014. Compared with the DCRNN baseline, it reduces MAE by 10.7%, RMSE by 1.9%, and SMAPE by 2.7%, while increasing R² by 0.008. These findings demonstrate that similarity-aware retrieval combined with spatiotemporal deep learning can substantially enhance short-term bus travel time prediction on signalized urban arterials. More accurate short-term forecasts may support prediction-informed transit signal priority and arterial coordination by providing more reliable downstream arrival-time estimates. However, the generalizability of the reported results is still constrained by the relatively short 30-day observation period and the single-corridor case setting, and the operational and environmental effects of downstream applications remain to be validated through dedicated closed-loop control evaluation in future work. Full article

Background/Objectives: Visuomotor interception requires aligning action with the future state of moving targets under sensory and motor delays. This constraint provides a tractable framework to examine how predictive and feedback-driven processes interact. This narrative review evaluates theoretical and empirical accounts of interception, with emphasis on how prediction and online control are integrated across behavioral and neural levels. Methods: We conducted a narrative synthesis of behavioral, eye-tracking, computational, and neurophysiological studies on visuomotor interception. Literature was identified through searches of PubMed, Web of Science, and Google Scholar using search terms including “visuomotor interception,” “predictive motor control,” “eye–hand coordination,” “time-to-contact,” “sensorimotor delay,” and related combinations. Studies published between 1986 and 2026 were considered, with emphasis on peer-reviewed empirical and theoretical work. Preprints were included only when directly relevant and are identified as such. The review compares internal model, ecological, and hybrid frameworks, and organizes evidence around spatial (“where”) and temporal (“when”) components of control. Results: Across paradigms, interception behavior is not well accounted for by purely predictive or reactive mechanisms. Instead, trajectories reflect a continuous interaction between anticipatory guidance and online correction. Spatial and temporal components show partial dissociation across tasks and manipulations. Available evidence supports the involvement of distributed circuits, including parietal, frontal, cerebellar, and subcortical systems, while indicating that eye movements play an active role in both information sampling and motor planning. Conclusions: Interception is best understood as the product of interacting biological, environmental, and learned constraints. Similar behavioral signatures can arise from distinct mechanisms, arguing against a unitary account. Progress requires integrating behavioral analyses with model-based and neural approaches to dissociate underlying computations. Full article

Camellia japonica is a widely cultivated woody ornamental plant. However, current studies mostly focus on the onset of flowering, neglecting the overall flowering time distribution patterns of the blooming process. In this study, we used uniform 5-year-old potted cuttings of C. japonica ‘Jinjiang Mudan’ to evaluate six candidate distribution models, including normal, log-normal, skew-normal, gamma, Weibull, and exponential, to model flowering time distribution. These candidates were compared to obtain an optimal distribution model using three-fold cross-validation, six evaluation indicators, and three goodness-of-fit tests in the control. The optimal distribution model was used to compare and analyze the different effects of the control, shading, and exogenous hormone treatments. The results showed that the skew-normal distribution model emerged as the most suitable distribution model among the six candidates and captured the flowering time distribution characteristics effectively in all treatments. Shading treatments were found to delay and extend the flowering period, with moderate treatments (50% and 70% shading) demonstrating better performance, extending the flowering period by approximately 40%. In terms of exogenous hormone treatments, BG (a mixture of the 6-BA and GA₃) concentrations could prolong and delay the flowering period. Lower concentrations (100 and 250 mg L⁻¹) of 6-BA and GA₃ were effective in extending the flowering period, with BA250 exhibiting the most pronounced effect, delaying flowering onset by approximately 12% and extending the flowering period by approximately 17%. Considering that this study is based on single-location and single-season trials, these findings provide a valuable methodological resource for quantifying and predicting flowering time distribution in C. japonica, other ornamentals, and crops. Full article

Communication latency is one of the main factors limiting the practical scalability of unmanned aerial vehicle (UAV) swarms operating with distributed formation control. In real-time UAV missions, such as coordinated swarm navigation, autonomous inspection, and aerial monitoring, delayed information exchange directly affects formation stability and operational safety. In practical aerial networks, inter-UAV communication latency is influenced by stochastic effects including jitter, burst delays, and multi-hop propagation, which are rarely captured by the simplified deterministic delay assumptions commonly adopted in analytical formation-control studies. This paper introduces a measurement-informed stochastic delay model and a communication–control delay-feasibility framework that jointly account for per-link latency behavior, multi-hop delay accumulation, and controller-level delay tolerance. The proposed framework is evaluated using an attractive–repulsive distance-based potential field (ARD–PF) formation controller, for which the maximum admissible end-to-end delay is quantified as a function of swarm size and inter-UAV separation. The delay model is calibrated and validated using more than 15,000 in-flight communication delay samples collected from a multi-UAV LoRa platform operating under realistic flight conditions. The results show that different mechanisms limit swarm operation under different operating scenarios. In some configurations, stochastic communication latency becomes the dominant constraint, whereas in others, formation geometry or network load determines the feasible operating region. Based on these elements, the proposed framework characterizes delay-feasible operating regions and predicts the maximum feasible swarm size under distributed formation control and realistic multi-hop communication latency. Full article

Light-responsive hydrogel-based oscillators typically exhibit small oscillation amplitudes because solvent diffusion is intrinsically slow, and their dependence on external periodic light modulation further results in limited amplitude, poor stability, and insufficient autonomy. Inspired by the trigger and sliding mechanism of the ancient crossbow, this study introduces an innovative system that integrates a sliding-block mechanism with time-delay feedback, breaking from conventional approaches that rely on hydrogel inertia or external modulation, within a purely theoretical and simulation-based framework. By establishing a nonlinear dynamic model coupling solvent diffusion, photoisomerization, and optical attenuation, this research shows through numerical simulations that the system can exhibit two distinct modes under constant illumination: a stable state and a self-sustained oscillatory state. The model predicts that the oscillation frequency can be flexibly tuned by varying key parameters, including the crosslinking density, Flory–Huggins interaction parameters of the spiropyran and hydrophilic polymer, ring-opening reaction rate, light intensity, fraction of light-sensitive molecules, and sliding displacement, whereas the initial absorption coefficient has only a minor influence. The slider displacement is also identified as an effective means to regulate the oscillation amplitude. Furthermore, the expansion force at the container bottom is predicted to oscillate synchronously with the hydrogel’s volume change. This theoretical framework represents a paradigm shift from “static small deformation” to “dynamic large-amplitude oscillation”, significantly enhancing the mechanical responsiveness of the material. This work provides a novel and controllable strategy for the conceptual design of autonomous light-driven micromechanical systems. Full article

Recurring socio-temporal events, such as Ramadan in Middle Eastern cities, introduce pronounced non-stationarity in urban traffic demand. During these periods, daytime traffic volumes typically decline, while congestion becomes more severe in the evening around the Iftar (fast-breaking) period and persists into late-night hours, making conventional fixed-time signal plans less effective. An additional challenge is that demand is not only time-varying, but also unevenly distributed across competing movements: attempts to prioritize high-volume phases can inadvertently cause excessive delays—or even starvation—on lower-demand approaches. To address these issues, this study presents an adaptive, regime-aware traffic signal control framework that combines predictive modeling with constrained optimization. Short-term phase-level delays are forecast using Long Short-Term Memory (LSTM) models, and a Model Predictive Control (MPC) scheme then determines the green time allocation at each control cycle through a receding-horizon strategy. The optimization explicitly represents phase interactions by including constraints that prevent excessive delay in competing movements, thereby yielding a balanced and operationally realistic control policy. The approach is validated with one-minute-resolution TomTom delay data from a signalized intersection in Jeddah, Saudi Arabia, covering both Normal and Ramadan conditions. The LSTM models show stable predictive performance, achieving root mean square errors (RMSEs) of 19.8 s under Normal conditions and 17.1 s during Ramadan. In general, the results show that the proposed framework cuts total intersection delay by about 0.3% to 2.8% compared to standard control strategies. Even though these total-delay improvements are small, they come with big drops in delay for lower-demand phases (about 12–20%) and keep the delay increases for higher-demand phases under control. This shows that the method makes the whole process more efficient by fairly spreading out the delay instead of just making one phase better on its own. The results show that combining forecasting with constrained optimization is a strong and useful way to handle changing traffic demand. This is especially true during times of high demand when flexibility, stability, and fairness across movements are all important. Full article

This study proposes an integrated artificial intelligence-based framework for modeling and predicting quay crane productivity and operational delays in conventional container terminals, addressing key limitations in the existing port analytics literature. The research introduces a novel dual-mode machine learning architecture that explicitly separates retrospective prediction (forecast mode) from pre-operational decision support (decision mode), addressing a critical gap in existing literature where predictive models are rarely aligned with real-world informational constraints. The framework is applied to a high-resolution, real-world dataset comprising ship-level operations over a three-year period (2023–2025), incorporating a structured representation of 27 delay types and multiple resource allocation variables. A multi-indicator modeling strategy is employed, simultaneously analyzing four productivity metrics (RQCP, GMPH, WBMPH and NMPH), thus allowing for a systematic comparison of their structural sensitivities to delays, congestion, and equipment utilization. The results reveal a clear hierarchy of predictability and operational behavior: structurally driven indicators such as RQCP and GMPH exhibit high predictive stability, while delay-sensitive indicators such as NMPH display greater variability, reflecting real-time operational disruptions. The consistent model performance in forecasting and decision-making indicates significant predictive value in pre-operational variables, endorsing its utility for uncertain decision-making. Sensitivity analysis reveals a critical nonlinear congestion threshold affecting predictive accuracy under extreme operational strain. Employing a combination of multi-indicator productivity modeling, structured delay classification, and ensemble learning within an integrated analytical framework, this research enhances both methodological and practical insights into port operations, aiding in merging predictive analytics with operational decision-making in container terminals to enhance resource allocation, delay handling, and container terminal efficiency. Full article

Transarterial chemoembolization (TACE) is the standard treatment for patients with intermediate-stage hepatocellular carcinoma (HCC), yet nearly half of treated patients fail to achieve durable benefit, and reliable biomarkers enabling early therapeutic stratification are still lacking. Treatment response is typically assessed by imaging one month after TACE and at three-month intervals, potentially delaying timely access to alternative therapies in non-responding patients. Circulating microRNAs (miRNAs) represent promising biomarkers due to their stability in body fluids and ease of detection. Here, we evaluated circulating miR-22 as an early predictor of TACE non-responder status and as a mechanistically relevant therapeutic target. Circulating miR-22 levels were measured by microarray and quantitative RT–PCR in three independent cohorts of early-to-intermediate-stage HCC patients undergoing TACE. Circulating miR-22 increased significantly in non-responders as early as 48 h after treatment, and fold changes consistently predicted treatment failure across two independent validation cohorts. Mechanistically, we identified the G2/M checkpoint kinase WEE1 as a direct functional target of miR-22. Modulation of the miR-22/WEE1 axis affected cell-cycle progression, proliferation, apoptosis, and DNA damage response in HCC cell lines and xenograft models. Under hypoxia-mimicking conditions combined with doxorubicin exposure, pharmacological inhibition of WEE1 induced mitotic catastrophe in highly proliferative miR-22-silenced cells. Collectively, these findings identify early post-TACE elevation of circulating miR-22 as a biomarker of non-response and highlight the miR-22/WEE1 axis as a potential target for precision treatment strategies in HCC. Full article

Background/Objectives: Postoperative pulmonary complications (PPCs) following abdominal surgery are associated with prolonged hospitalization, delayed recovery, and increased mortality. Because nursing surveillance is essential for early detection and timely intervention, this study aimed to develop a holistic nursing surveillance decision support system integrating PPC risk prediction with structured nursing action recommendations. Methods: In this retrospective cohort study, electronic medical record (EMR) data from approximately 6900 adult patients who underwent abdominal surgery at a single institution between January 2015 and September 2023 were analyzed. The study protocol was approved by the Institutional Review Board, and the requirement for informed consent was waived because of the retrospective study design. PPC risk was predicted using a tabular multilayer perceptron (MLP) encoder with SHapley Additive exPlanations (SHAP)-based feature weighting and a random forest classification head optimized via Optuna. Class imbalance was addressed using weighted sampling, class weighting in BCE(Binary Cross Entropy) With Logits Loss, and decision-threshold optimization. For clinical decision support, a large language model generated structured nursing surveillance recommendations in an action–evidence–rationale JSON format and was aligned through supervised fine-tuning (SFT) using human-evaluated cases. Results: The prediction model achieved an AUROC of 0.810, with an accuracy of 0.811, precision of 0.547, and recall of 0.545. In expert evaluation, the SFT-aligned model improved recommendation quality, reducing incorrect nursing actions from 19.3% to 8.0%. Conclusions: The proposed system demonstrates the feasibility of an end-to-end nursing surveillance decision support framework linking PPC risk prediction with structured clinical recommendations. The findings suggest its potential to support more accurate risk prediction and more actionable nursing surveillance for patients undergoing abdominal surgery. Full article