Search Results (33,389)

Earthen heritage in desert oases reflects local identity, craftsmanship and traditional knowledge but is facing increasing threat of disappearance from material vulnerabilities, social abandonment and unsuitable interventions. This study develops and validates a novel decision-making tool to guide stakeholders in selecting the most suitable building technology for the adaptive reuse of earthen heritage complexes to ensure their long-term sustainability while maintaining their cultural and social values. The proposed methodology combines the Integrated Value Model for Sustainability Assessment (MIVES) and Delphi technique to evaluate the cultural, economic, environmental and social aspects. Quantitative and qualitative indicators were defined through literature review and weighted by experts in two rounds of Delphi to obtain comparable sustainability index for each building technology. The evaluation of economic and environmental aspects was based on literature data, while cultural and social aspects were assessed through a third round of Delphi with local participants. The tool was applied to the Adrere Amellal Ecolodge in Siwa Oasis, Egypt, comparing three building technologies: Karshif traditional earthen technique, commonly used red bricks and innovative 3D-printed saltblocks. Karshif achieved the highest sustainability index (0.77) due to its cultural values, social acceptance and environmental performance. The findings demonstrate the potential of traditional earthen techniques to ensure sustainable adaptive reuse, providing a replicable method for sustainable adaptive reuse of earthen heritage in desert oases in Egypt and worldwide. Full article

Background: Celiac disease (CeD) is a chronic, immune-mediated enteropathy triggered by gluten ingestion in genetically predisposed individuals. While a lifelong gluten-free diet (GFD) remains the cornerstone of treatment, inadequate follow-up can lead to persistent symptoms, nutritional deficiencies, and long-term complications. Aim: This narrative review summarizes best practices in celiac disease follow-up, with emphasis on multidisciplinary, nutritional, clinical, and preventive care strategies to optimize long-term outcomes. Main Findings: High-quality follow-up requires coordinated care involving gastroenterologists, dietitians, primary care providers, and other specialists. Nutritional challenges of the GFD include high cost, limited fortification, suboptimal nutrient content, and increased risk of obesity and metabolic dysfunction. Patients also face psychosocial and behavioral burdens such as anxiety, social isolation, and disordered eating. Evidence-based strategies for follow-up include structured clinical and serologic monitoring, laboratory assessments, bone health evaluation, cancer risk reduction, and preventive care. Novel tools such as gluten immunogenic peptide testing, digital health platforms, and artificial intelligence are emerging as adjuncts to clinical management. Implications: Structured, patient-centered follow-up that integrates medical, nutritional, and psychosocial dimensions is essential to achieving mucosal healing, maintaining long-term health, and improving quality of life in individuals with CeD. Full article

This study presents a multi-resolution and multi-temporal remote sensing approach to assess human-induced changes in cultural landscapes, with a focus on the archaeological site of Amrit (Syria) within the MapDam project. By integrating satellite archives (KH, Landsat series, NASADEM) with ancillary geospatial data (OpenStreetMap) and advanced analytical methods, four decades (1984–2024) of land-use/land-cover (LULC) change and shoreline dynamics were reconstructed. Machine learning classification (Random Forest) achieved high accuracy (Test Accuracy = 0.94; Kappa = 0.89), enabling robust LULC mapping, while predictive modelling of urban expansion, calibrated through a Gradient Boosting Machine, attained a Figure of Merit of 0.157, confirming strong predictive reliability. The results reveal path-dependent urban growth concentrated on low-slope terrains (≤5°) and consistent with proximity to infrastructure, alongside significant shoreline regression after 1974. A Business-as-Usual projection for 2024–2034 estimates 8.676 ha of new anthropisation, predominantly along accessible plains and peri-urban fringes. Beyond quantitative outcomes, this study demonstrates the replicability and scalability of open-source, data-driven workflows using Google Earth Engine and Python 3.14, making them applicable to other high-risk heritage contexts. This transparent methodology is particularly critical in conflict zones or in regions where cultural assets are neglected due to economic constraints, political agendas, or governance limitations, offering a powerful tool to document and safeguard endangered archaeological landscapes. Full article

In this paper, an integrated geometric and thermal-induced errors prediction approach for active error compensation in machine tools is proposed and evaluated. The proposed approach is based on a hybrid of physical and neural network predictive modeling to drive an adaptive position controller for real-time error compensation including geometric and thermal-induced errors. Error components are formulated as a three-dimensional error field in the time-space domain. This approach involves four key steps for its development and implementation: (i) simplified experimental procedure combining a multicomponent laser interferometer measurement system and sixteen thermal sensors for error components measurement, (ii) artificial neural network-based predictive modeling of both position-dependent and position-independent error components, (iii) tridimensional volumetric error mapping using rigid body kinematics, and finally (iv) implementation of the real-time error compensation. Assessed on a turning center, the proposed approach conducts a significant improvement of the machine accuracy. The maximum error is reduced from 30 µm to less than 3 µm under thermally varying conditions. Full article

One of the sources of risk inherent to construction projects is the quality of spatial data. Damage to buried pipes and cables often causes accidents, delays, or stoppages of construction works. Fuzzy logic is a method for studying the risk. It is employed to describe complex or poorly defined phenomena that can hardly be characterised with probabilistic methods. The article proposes a method for assessing the risk of damaging underground utilities based on a fuzzy inference engine. The author first defined linguistic variables and assigned them values based on risk factors. The membership functions for the linguistic variables were modelled using expert judgement. Then, the author determined qualitative fuzzy sets with the rule base. Finally, the values were converted into crisp values. The defuzzification technique employed was the centre of gravity. The proposed method can assess the risk of damage to underground utilities for spatial data exhibiting diverse quality classes. It will be employed to generate large-scale risk maps. The proposed fuzzy logic solution is an effective and appropriate tool for assessing the risk of damage to underground utilities arising from the quality of subsurface data. It should not be regarded as a universal substitute for PRA (Probabilistic Risk Assessment) but as a complementary methodology that is particularly well-suited to risk assessment in data-poor environments characterised by epistemic uncertainty and reliance on qualitative expert judgement. Full article

Nervousness results from variance and changes in the verdicts of supply and logistics networks and activities. Nervousness is considered a source of confusion in supply chain (SC) systems because it is associated with frequent decision changes. New SC techniques are necessary to handle the growing supply chain nervousness (SCN) from globalization. Although they can be challenging to create, SCN metrics are crucial for assessing and optimizing the operations of a SC. The evaluation of SCN and future improvements in SC performance depend on correctly identifying SCN metrics. In this study, a method for measuring SCN was proposed, and a model was developed. The SCN measurement model seeks to quantify SCN for inclusion in the SC structure to support decision making. To assist organizations in determining the effect of nervousness on SCs and enhancing their general performance and competitiveness, this study quantified SCN, defined SCN metrics, and modeled and assessed SCN indicators. The model includes key SCN measurements, simulating, and evaluation, which can enhance future SC performance and resilience by enabling more precise SCN quantification. The importance of the designated SCN metrics was then determined using a fuzzy decision-making trial and evaluation-laboratory method (FDEMATEL). This method was used to evaluate and resolve complicated, interrelated scenarios, as it can demonstrate how metrics are interdependent and form a map that illustrates their relative relationships. The findings distinguish between cause and effect measurements as well as their interactions. Additionally, the results show the importance of the rankings of the SCN measurements. These outcomes can be used to establish a solid foundation for developing effective decision-making tools for SCN. Full article

Background: Geographic Information Systems (GIS) have emerged as a critical tool in healthcare research, facilitating the assessment of healthcare accessibility through spatial analysis and data visualisation. This scoping review synthesises literature published between 2020 and 2024, a period marked by the COVID-19 pandemic and rapid methodological innovation, providing a timely overview of how GIS has been applied to evaluate healthcare access across European countries. Methods: The review underscores the role of GIS methodologies in identifying geographic disparities, optimising resource distribution, and informing policy decisions. Results: Key findings highlight significant urban-rural differences in healthcare access, shaped by factors such as transportation infrastructure, population density, and healthcare facility distribution. Additionally, GIS has proven valuable in examining the link between healthcare accessibility and utilisation, with better access generally correlating with higher service use. Conclusions: Despite its potential, challenges including data availability, methodological variability, and uneven adoption across regions limit its broader implementation. The review emphasises the need for integrating advanced technologies to foster more equitable healthcare access throughout Europe. Full article

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder characterized by recurrent nodules, abscesses, and sinus tracts in apocrine gland-bearing areas. Surgery plays a key role in moderate-to-severe disease. As patients increasingly rely on the internet for decision-making, the quality of online information on HS surgery requires critical evaluation. Previous studies have shown poor quality and limited coverage of surgical aspects. This study systematically assesses publicly available websites on the surgical and reconstructive management of HS, quantifies their quality using the modified Ensuring Quality Information for Patients (mEQIP) tool, and identifies areas needing improvement to support informed decisions. Methods: Google, Bing, and Yahoo were searched using five HS surgery-related keywords. The first 50 results per keyword and engine were collected (n = 750), and 214 websites met the inclusion criteria. Sites were categorized by provenance (practitioners, hospitals, healthcare portals, professional societies, encyclopedias) and assessed using the 36-item mEQIP checklist. High quality was defined as ≥23/36 (75th percentile). Comparisons were made by publication era (pre-/post-COVID-19) and source type. Results: The mean mEQIP score was 21.7; only 51 websites (23.8%) met the high-quality threshold. No significant difference emerged between pre- and post-COVID publications. Healthcare portals scored highest (22.8), followed by practitioners (21.5) and hospital sites (21.2); professional societies (19.7) and encyclopedias (17.3) performed worst. Major deficiencies included limited discussion of surgical risks, quality-of-life outcomes, and postoperative care. Conclusions: Online resources on HS surgery are frequently incomplete and omit essential details on risks, recurrence, and reconstructive options. Surgeons should direct patients toward vetted sources, and professional societies should develop accessible, evidence-based patient guidelines. Full article

Contract manufacturing is a pivotal strategy for brand owners, yet small-to-medium enterprises (SMEs) in emerging economies struggle to evolve beyond transactional roles into sustainable strategic partners. This study addresses this gap by empirically validating and refining the Mahove–Matope Sustainable Contract Manufacturing Company Maturity Model (SCMC-MM), a novel framework designed to guide SMEs through a holistic transformation. Through a seven-month longitudinal case study grounded in design science research approach within a South African food manufacturing SME, the model was implemented and evaluated using structured assessments, in-depth interviews, and longitudinal operational data. The application catalysed a system-wide transformation, yielding significant results, including a 133% increase in revenue, ISO 22000 certification, and perfect delivery reliability. Furthermore, the study theoretically refines the framework by identifying and incorporating novel critical success factors for contract manufacturing companies, such as industrial clustering and transformational leadership. The results demonstrate that the SCMC-MM offers a practical, actionable, and scalable tool for building resilient supply chain partnerships. It provides a structured pathway for SMEs to achieve simultaneous gains in economic performance, social equity through enhanced workforce capability and ethical practices, and environmental stewardship via formalised safety, health, and environmental and risk management systems, thereby contributing directly to the United Nations Sustainable Development Goals (SDGs) 8 and 9 in emerging markets. Full article

This study examines the characteristics of stretch film used to secure palletized cargo, with the aim of rationalizing its use. Growing consumption of packaging materials requires scientifically substantiated film selection that accounts for the forces ensuring cargo stability during transportation. This study used a patented mobile device to measure the static and dynamic forces generated by different types of stretch film. Experimental data revealed a linear relationship between the number of turns, the degree of pre-stretching, and the stabilizing forces, enabling optimization of wrapping parameters and a reduction in material costs. The results contribute to improved transportation safety, reduced energy consumption and carbon footprint, and lower polymer waste. This study is relevant because it develops tools for objectively assessing the effectiveness of packaging materials and for the rational selection of stretch film, thereby supporting sustainable logistics and transportation systems. Full article

Background: The maintenance of an aseptic barrier between the surgical team and patient aids in the prevents the exposure of the patient to pathogens. Variations in gloving practice may have safety implications due to glove failure. Indicator gloving, where two pairs of different colored gloves are worn, is thought to add protection as it alerts the wearer to a breach. The aim of this systematic review and meta-synthesis was to assess the evidence in the literature on the benefit of indicator systems versus other forms of double gloving on puncture identification during surgery. Methods: A four-arm, parallel, systematic review of the literature was undertaken in accordance with the PRISMA statement using four distinct research questions regarding glove fit, double gloving, indicator gloves, and the association between glove damage and glove change frequency. Searches on PubMed, Embase, Cochrane Collaboration of Systematic Reviews and Metanalyses, and Google Scholar were performed between 1 May 2022 and 24 January 2023. Studies were assessed for eligibility against pre-defined inclusion and exclusion criteria. Risk of bias was determined using multiple assessment tools. Results: This systematic review included 32 studies, 10 of which were high-quality Level IA trials, alongside multiple observational analyses. Across studies, indicator glove systems consistently demonstrated a two- to six-fold higher detection rate of glove perforations compared with standard double-gloving using identical glove colors. The majority of studies confirmed that early perforation identification significantly reduces intraoperative contamination risk and improves maintenance of the aseptic barrier. However, evidence regarding the direct impact on surgical site infections remains limited due to study heterogeneity. Conclusions: The use of an indicator glove provides a two- to six-fold higher rate of glove perforation detection, compared to two standard gloves of the same color, therefore aiding the maintenance of the aseptic barrier between surgical team members and patients. Further research into the impact of double gloving on the incidence of surgical site infections is required. Full article

This study investigates the mechanical behavior and fatigue performance of orthotropic steel bridge decks, with a focus on rib-to-deck welded connections and the impact of geometric symmetry on stress distribution. Two full-scale models with full-penetration butt welds were tested under static compression loads, yielding failure forces of 27 kN (experimental) and 26 kN (analytical), with only a 3% difference. Finite element simulations using ANSYS 16.1 validated these results and enabled parametric studies. Rib plate thicknesses ranging from 5 mm to 9 mm were analyzed to assess their influence on stress distribution and deformation. The geometric ratio h′/tr, which reflects the symmetry of the trapezoidal rib web, was found to be a critical factor in stress behavior. At h′/tr = 38 (tr = 7 mm), compressive and tensile stresses are balanced, demonstrating a symmetric stress field; at h′/tr = 33 (tr = 8 mm), and fatigue performance at the RDW root drops by 47%. Increasing h′/tr improves fatigue life by increasing the number of load cycles to failure. Stress contours revealed that compressive stress concentrates in the rib plate above the weld toes, while tensile stress localizes at the RDW root. The study highlights how symmetric geometric configurations contribute to balanced stress fields and improved fatigue resistance. Multiple linear regression analysis (SPSS-25) produced predictive equations linking stress values to applied load and geometry, offering a reliable tool for estimating stress without full-scale simulations. These findings underscore the importance of optimizing h′/tr and leveraging structural symmetry to enhance resilience and fatigue resistance in welded joints. This research provides practical guidance for improving the design of orthotropic steel bridge decks and contributes to safer, longer-lasting infrastructure. Full article

Background/Objectives: Optic neuropathies (ON) are a clinically heterogeneous group of disorders that can cause profound and lasting visual disability, with wide-ranging effects on patients’ quality of life. Although the NEI-VFQ-25 is an instrument for assessing vision-related quality of life (VRQoL), few studies have systematically compared patient-reported outcomes across multiple ON subtypes, especially in underrepresented populations. We aimed to delineate how etiological differences and longitudinal visual acuity trajectories shape VRQoL in a diverse Portuguese cohort with ON. Methods: This retrospective, cross-sectional study included 152 patients diagnosed with ON and followed at São João University Hospital, Portugal. All participants completed the validated NEI-VFQ-25. Diagnosis-specific differences in VRQoL were interrogated using ANCOVA and linear mixed-effects models, controlling for age and sex. Visual acuity changes over time were analyzed in relation to patient-reported outcomes. Results: Substantial heterogeneity in VRQoL was observed across ON subtypes. Patients with MS-related ON (MS-RON) and idiopathic ON reported significantly higher NEI-VFQ-25 scores in domains such as general vision, mental health, and dependency (F = 3.30, p = 0.013; ηp² = 0.08), while those with ischemic or other inflammatory etiologies showed persistently lower scores. Notably, both final visual acuity and diagnosis were independently associated with NEI-VFQ-25 composite scores, highlighting the correlation between objective and subjective measures of visual function. Age and diagnosis independently predicted poorer VRQoL. Conclusions: This study provides the first comprehensive evaluation of vision-related quality of life (VRQoL) across a diverse cohort of optic neuropathy patients in a Portuguese tertiary center, using the NEI-VFQ-25. Our results underscore the heterogeneity of functional impact across ON subtypes, emphasizing the value of integrating sensitive, multidimensional assessment tools into neuro-ophthalmic clinical care, especially in populations historically underrepresented in research. Full article

Premenstrual dysphoric disorder (PMDD) is a psychological condition that significantly influences female students’ behavior, cognitive ability, and mental health status. It has a critical role in mental health and well-being and in the academic success and professional performance of nursing students. Objectives: This study aimed to assess the relationship between PMDD, perceived stress levels and sleep quality among female nursing students in Saudi Arabia. Methods: This study utilized a cross-sectional, correlational, descriptive design. The sample size was 144 students, and we used a convenience sampling technique. Data were collected using the following tools: Demographics and Gynecological Data Sheet, Premenstrual Symptoms Screening Tool, Pittsburgh Sleep Quality Index, and Perceived Stress Scale. Results: The levels of premenstrual symptoms and sleep disturbances among the participants can be regarded as moderate, whereas the level of perceived stress was found to be at its highest level, with 63.9% of participants experiencing a moderate level and 14.6% reporting severe stress. There was a significant positive correlation between premenstrual symptoms and perceived stress (r = 0.39, p = 0.005). Thus, as premenstrual symptoms increase, so does perceived stress. Additionally, there is a noteworthy correlation between perceived stress and sleep disturbance (r = 0.28, p = 0.04), indicating that higher levels of stress are associated with more sleep disturbances. Conclusions: PMDD symptoms have a detrimental influence on female students’ emotional state; thus, mental health experts play an important role in identifying variables that mitigate the severity of PMDD among female’s students. Full article

Human daily physical activity (PA), monitored via wearable devices, provides valuable information for real-time health assessment and disease prevention. However, analyzing time-domain PA data is challenging due to large data volumes and high inter- and intra-individual heterogeneity. Traditional PA analyses often rely on demographics, while advanced methods utilize time-domain summary statistics (e.g., L5, M10) or functional principal component analysis (FPCA). This study presents a data-efficient approach utilizing the Discrete Fourier Transform (DFT) to convert time-domain data into a compact set of frequency-domain variables. Our research suggests that adding these DFT variables can significantly enhance model performance. We demonstrate that incorporating DFT-derived variables substantially improves model performance. Specifically, (1) a small subset of DFT variables effectively captures major PA levels with effective dimensionality reduction; (2) these variables retain known associations with factors like age, sex, and weekday/weekend status; (3) they enhance the performance of classifiers. Mathematical and empirical analyses further confirm the reliability and interpretability of DFT-based features in dimension reduction. Across three mental health studies, these DFT-derived variables successfully capture key PA characteristics while retaining known associations and strengthening model performance. Overall, the proposed DFT-based framework offers a robust and scalable tool for analyzing accelerometer data, with broad applicability in health and behavioral research. Full article