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464 papers

Multimodal emotion recognition using hybrid deep feature fusion under speaker-independent evaluation.

Ibrahim E et al. · Jun 25, 2026

Emotion recognition is one of the most important and complex challenges for machines to understand, as most robots and AI agents struggle with human-centric perception and interpretation. Therefore, this paper introduces a novel multimodal emotion recognition system that analyzes emotions through two complementary channels: voice and facial expressions. The proposed approach is evaluated on the RAVDESS and CREMA-D datasets, which consist of acted emotional expressions across multiple discrete emotion categories. Utilizing an advanced multimodal deep feature fusion technique, the system combines handcrafted audio features (e.g., Mel-Frequency Cepstral Coefficients (MFCCs)) with deep visual features extracted from an attention-based VGGFace model. These features are integrated into a unified representation through a hybrid fusion strategy that jointly employs concatenation, cross-attention, gated fusion, and multiplicative fusion mechanisms to capture complementary cross-modal interactions. To ensure a comprehensive and realistic assessment, the model is evaluated under both random-split and strict speaker-independent protocols. On the RAVDESS dataset, the proposed system achieves an accuracy of 95.83% under random-split evaluation and 48.06% ± 9.76% accuracy under speaker-independent Leave-One-Speaker-Out (LOSO) testing, while on the CREMA-D dataset it attains 73.54% accuracy using random splits and 53.12% ± 2.65% accuracy under subject-exclusive speaker-independent 5-fold cross-validation.

Psychology

Influence of Ketogenic Diet Lipid Composition on Anxiety-Like Behavior and Neurometabolic Profile in Healthy Rats.

Gurgel GG et al. · Jun 25, 2026

Ketogenic diets (KDs) modulate brain function, but how their fatty acid composition impacts behavior remains poorly understood. Male Wistar rats were fed a control diet (CD, n = 6), a classic ketogenic diet (CKD, n = 6) rich in saturated fatty acids (SAFAs), or a modified ketogenic diet (MKD, n = 6) enriched with polyunsaturated fatty acids (PUFAs) and DHA. After 100 days, both KDs induced similar ketosis and increased brain glucose metabolism ( 1 ⁸F-FDG PET/CT), while reducing some cerebral pro-inflammatory cytokines (IL-1β, IL-6) and oxidized LDL. Notably, the CKD group exhibited an anxiety-like phenotype in the Elevated Plus Maze versus controls, significantly reducing open arm entries [1.58(0.60) vs. 5.08(1.03); p = 0.025], increasing closed arm time [3.33 min(0.22) vs. 1.70 min(0.19); p = 0.001], and elevating the Anxiety Index [0.92(0.04) vs. 0.70(0.07); p = 0.048], which correlated with SAFA incorporation in the frontal lobe. In contrast, the MKD group did not induce this anxiety-like effect, maintaining behavioral parameters comparable to the CD group, while showing an intense incorporation of omega-3 fatty acids and DHA in the hippocampus. These findings demonstrate that the behavioral divergence between KDs occurred despite shared reductions in the specific neuroinflammatory and oxidative markers evaluated. Overall, our results suggest that the dietary fatty acid profile, rather than the magnitude of systemic ketosis level, plays a critical role in modulating behavioral outcomes under ketogenic conditions.

Medicine

Multiphysics Modeling and Analysis for Dendrite Problems in Solid-State Lithium/Sodium Metal Batteries.

Yu B et al. · Jun 25, 2026

The commercialization of liquid lithium-ion batteries has revolutionized the consumer electronics industry. However, conventional lithium-ion batteries with graphite anodes and organic electrolytes are approaching their intrinsic performance limits and struggle to meet the growing demands for higher energy density, reliability, and safety in electric vehicles and large-scale energy storage. Solid-state batteries utilizing lithium or sodium metal anodes are considered promising next-generation energy storage solutions. Despite this potential, the formation of dendrites during charge-discharge cycling remains a critical challenge. Dendrite growth can initiate a destructive feedback loop of crack propagation and further dendrite intrusion, ultimately leading to battery failure and performance degradation. Previous studies have predominantly focused on single physical domains, such as electrochemical, stress, or thermal fields. However, such single-physics approach limits the understanding of dendrite evolution under realistic, coupled multiphysics conditions. This review first compares the morphological characteristics of dendrites in liquid and solid-state metal batteries. It then critically examines the key factors and predictive models of dendrite formation, initially from single-physics and subsequently from an integrated multiphysics perspective. Finally, strategies for mitigating dendrite growth via multiphysics field regulation are summarized. By establishing a comprehensive framework that integrates morphology evolution, multiphysics modeling, and suppression strategies, this work provides a foundational theoretical understanding for addressing dendrite formation in solid-state lithium and sodium metal batteries.

Engineering

Appraisal of sexual functioning before and after cancer: insights from adolescent and young adult (AYA) cancer survivors and matched healthy controls.

Acquati C et al. · Jun 25, 2026

Purpose Adolescence and young adulthood (AYA) are developmental phases in which individuals establish their identity. A cancer diagnosis during this stage disrupts sexual health, but research remains limited, particularly outside of reproductive-organ cancers. This study examined perceived changes in sexual functioning from pre- to post-diagnosis among survivors and compared their current sexual functioning and satisfaction with matched controls. Methods Dutch-speaking AYA cancer survivors (N = 174; age = 32.7 years; 85.6% female) recruited via convenience sampling and N = 348 matched controls completed self-reported measures of sexual functioning [MOS-SF] and satisfaction [GMSEX]. Paired sample t-tests assessed perceived changes in sexual functioning. Repeated measures ANOVAs tested the effects of sociodemographic and cancer-related factors on these variations. Independent sample t-tests compared current sexual functioning and satisfaction between survivors and controls. Results Survivors reported significant declines in multiple domains of sexual functioning, including interest, arousal, orgasm function, pleasure, and lubrication (women). Greater dysfunction was observed among females, individuals diagnosed in their 30s, those in early survivorship, and those who remained with the same partner. Survivors who had engaged in partnered sexual activity reported less dysfunction than those who had not. Compared with controls, survivors reported significantly greater dysfunction and lower sexual satisfaction, while retrospectively rating their pre-diagnosis sexual functioning as more positive. Conclusions AYA cancer survivors reported declines in sexual functioning over time, worse outcomes than controls, and more favorable recollections of their pre-diagnosis sexual health, a pattern consistent with response shift. Findings emphasize the need for comprehensive survivorship care that includes routine, proactive sexual health discussions, and tailored interventions responsive to survivors' evolving needs.

Medicine

Corticosteroids in immunocompromised ICU patients with pneumonia: risks, evidence, and clinical practice.

Morales-Olivera JA et al. · Jun 25, 2026

Adjunctive corticosteroids are increasingly used in Severe Community-Acquired Pneumonia (sCAP) requiring admission to the intensive care unit (ICU), based on evidence derived largely from immunocompetent populations. Immunocompromised hosts, however, represent a distinct and growing subgroup among critically ill patients with sCAP, characterised by baseline immune defects, broader pathogen spectra, and a heightened susceptibility to treatment-related harm. Whether corticosteroid strategies validated in the general population can be safely and effectively extrapolated to immunocompromised ICU patients with sCAP remains uncertain, despite their growing use in contemporary ICU practice. Immunocompromised patients admitted to the ICU with sCAP experience compounded alterations in host defence, driven by pre-existing immune dysfunction and superimposed critical illness-associated immune dysregulation. In this setting, corticosteroids may attenuate inflammation-mediated lung injury, but may also deepen immune suppression, distort clinical evolution, and increase susceptibility to opportunistic superinfections and pathogen reactivation. Randomised trials and meta-analyses supporting corticosteroid use in sCAP have systematically excluded immunocompromised patients, treating immunosuppression as an exclusion criterion rather than a stratification variable, and commonly rely on short-term endpoints that fail to capture delayed infectious complications relevant to this population. Available observational data and pathogen-specific evidence suggest substantial heterogeneity of treatment effect (HTE) across immunocompromised subgroups, influenced by immune substrate, pathogen context, and cumulative immunosuppressive burden. Among the pathogen-specific contexts in which corticosteroids have the strongest evidence, Pneumocystis jirovecii pneumonia (PJP) stands out as the principal indication: adjunctive corticosteroids have demonstrated clear mortality benefit in AIDS-associated severe PJP, though this benefit does not extend uniformly to HIV-negative immunocompromised patients with PJP. Consequently, standard corticosteroid treatment in all CAP subgroups is unlikely to be appropriate. In immunocompromised ICU patients with sCAP, corticosteroid therapy should neither be routinely applied nor categorically avoided. Instead, decisions should be individualised, guided by a clearly defined therapeutic target, careful assessment of immune status, and consideration of the risk for opportunistic infections. When used, corticosteroids should be administered at the lowest effective dose and for the shortest feasible duration. Dedicated studies incorporating immune stratification, pathogen-informed approaches, and outcomes relevant to delayed infections are urgently needed. Until such evidence is available, careful risk-balance assessments to decide steroids in these patients.

Medicine

Mycobacterium tuberculosis partitions the Krebs cycle under iron starvation.

Serafini A et al. · Jun 25, 2026

In this study, we investigated how iron limitation alters central metabolism in Mycobacterium tuberculosis using metabolomics and stable isotope tracing. Our findings reveal a well-orchestrated metabolic programme to enable Krebs cycle activity despite the inefficient action of its iron-dependent enzymes. Under such conditions, carbon flux through the oxidative branch of the Krebs cycle is stalled, resulting in the accumulation of metabolites that are partially secreted. As a result, carbon flux from glycolysis is partially diverted to the reductive branch of the Krebs cycle to support the production of oxaloacetate and malate through the activity of phosphoenolpyruvate carboxykinase and pyruvate carboxylase. Both branches terminate with the synthesis of malate, which is secreted. This unprecedented split of the Krebs cycle and malate secretion in a bacterial pathogen facilitates the continuous flow of carbon through the core of carbon metabolism, overcoming the metabolic stalling triggered by iron starvation.

Materials Science

SynaptoTagMe, a toolkit for in vivo mapping and modulating neurotransmission at single-cell resolution.

Cuentas-Condori A et al. · Jun 25, 2026

Understanding the organization and regulation of neurotransmission at the level of individual neurons and synapses requires tools that can track and manipulate transmitter-specific vesicles in vivo. Here, we present SynaptoTagMe, a suite of genetic tools in Caenorhabditis elegans to fluorescently label and conditionally ablate the vesicular transporters for glutamate, GABA, acetylcholine, and monoamines. Using a structure-guided approach informed by protein topology and evolutionary conservation, we engineered endogenously tagged versions for each transporter that maintain their physiological function while allowing for cell-specific, bright, and stable visualization. We also developed conditional knockout strains that enable targeted disruption of neurotransmitter synthesis or packaging in single neurons. We applied this toolkit to map co-expression of vesicular transporters across the C. elegans nervous system, revealing that over 10% of neurons exhibit co-transmission. Using the ADF sensory neuron as a case study, we demonstrate that serotonin and acetylcholine are trafficked in partially distinct vesicle pools. Our approach provides a powerful platform for mapping, monitoring, and manipulating neurotransmitter identity and use in vivo. The molecular strategies described here are likely applicable across species, offering a generalizable approach to dissect synaptic communication in vivo.

Biochemistry, Genetics and Molecular Biology

The Challenge of Determining the Etiology of Encephalopathy in an Elderly Patient.

Ionescu VA et al. · Jun 25, 2026

Encephalopathy is a heterogeneous clinical syndrome with numerous neurological and systemic etiologies. We report the case of a 67-year-old man, a chronic ethanol consumer, admitted with a one-week history of confusional syndrome. Initial laboratory tests revealed severe hypercalcemia, acute kidney injury, mild anemia, and hyperproteinemia. Serum ammonia levels were within normal limits, reducing the likelihood of hepatic encephalopathy despite the patient's chronic ethanol use. Cerebral imaging excluded acute cerebrovascular events, while abdominal ultrasound demonstrated splenomegaly and normal-sized kidneys. Serum protein electrophoresis and immunofixation identified a monoclonal IgG-kappa component, strongly suggestive of multiple myeloma. The patient's neurocognitive symptoms improved rapidly following systemic corticosteroid therapy and fluid-electrolyte rebalancing, confirming hypercalcemia as the primary mechanism of encephalopathy. Hypercalcemic encephalopathy as an initial manifestation of multiple myeloma is exceedingly rare. This case highlights the diagnostic complexity in elderly patients with multiple potential contributors to altered mental status, including chronic ethanol exposure and renal dysfunction. The presence of normal renal dimensions, unexplained hypercalcemia, and a monoclonal component should prompt evaluation for plasma cell malignancy. Early recognition of hypercalcemia-induced encephalopathy and prompt investigation for underlying hematologic malignancy are essential to prevent irreversible organ damage and to ensure timely initiation of specific therapy.

Medicine

A Case Series Demonstrating the Spectrum of Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Disease.

Mbombo E et al. · Jun 25, 2026

Introduction Staphylococcus aureus , although a common colonizer of skin and mucous membranes in humans, is associated with severe infections in both healthy and debilitated individuals. The mortality induced by invasive MSSA disease is high, especially in patients diagnosed late. In children, skin and joint manifestations are most common. Septic shock is a major contributing factor to early mortality. To date, reported cases of invasive MSSA disease in children are infrequent, especially in Sub-Saharan Africa. Case report We present 4 cases of previously healthy children who presented with various clinical manifestations, but skin lesions and fever were common in all of them. They had multisystem involvement and eventually required aggressive multifactorial therapy. Antibiotic treatment was tailored to the results of antimicrobial sensitivity tests following blood culture. Though the hospital stay was quite long, intensive care and appropriate antibiotics contributed to a good prognosis. Conclusion In children with invasive MSSA disease, early diagnosis and prompt management are key factors to improved prognosis. Skin lesions with tender joints in a febrile infant should raise suspicion for a staphylococcal infection. Intensive care and infection source control are the cornerstones of the management.

Medicine

Incidental Breast Findings on Chest CT: Rates of Report and Follow-Up.

Hui J et al. · Jun 25, 2026

Objective This study aims to determine the incidence and types of breast findings detected on chest CTs at our institution and assess rates of subsequent follow-up imaging and breast cancer screening. Methods A retrospective review of all chest CTs performed at our institution over a 2-year period (1/1/2022-1/1/2024) was conducted, demonstrating 1540 patients above the age of 40 with incidental breast findings identified using a text search of the reports, and follow-up recommendations were documented. Clinical outcomes were analyzed for cases with recommended dedicated breast imaging. Results Incidental breast findings were detected in 14.3% of chest CTs in women above or at the age of 40. Further breast imaging was recommended in 54 cases, with 21 cases having associated dedicated breast imaging performed. Of these, corresponding dedicated workup revealed predominantly benign findings, with 82% representing benign or likely benign etiologies and only 4 cases representing malignancy. The likelihood of performing follow-up imaging was influenced by the language used in the report, with a 40% completion rate for studies using definitive wording as compared to 0% for optional wording. Conclusion There is a considerable rate of incidental breast findings visualized on chest CTs, which are predominantly benign. However, as there is a potential for visualization of malignant lesions, standardized reporting and follow-up protocols are essential to ensure proper evaluation and management. Further research is needed for evaluating and standardizing the potential use of chest CTs for assessing incidental breast lesions.

Medicine