Search Results (269)

Background: The gluten-free diet (GFD) remains the cornerstone of treatment for celiac disease (CeD), yet it is associated with a substantial psychosocial and practical burden. As novel therapies are being developed, understanding patient priorities, and their alignment with physician perceptions, is essential to guide future therapeutic strategies. Methods: We conducted a multicenter, cross-sectional online survey of adults with confirmed CeD followed at tertiary referral centers in Italy (Salerno), the UK (Sheffield) and Malta (La Valletta). The questionnaire collected demographic data, a 0–10 visual analogue scale (VAS) assessing self-reported adherence to the GFD, and responses to a single-choice question exploring what participants missed most since starting the GFD. A parallel survey was administered to healthcare providers to assess their perception of patients’ unmet needs. Descriptive statistics and between-groups comparisons were performed. Results: A total of 486 patients (74.7% female; mean age 43.2 years; 215 from Italy, 196 from the UK and 75 from Malta) and 134 physicians were included. GFD adherence was high, with a median score of 10. The most frequently reported unmet need among patients was the desire for an unrestricted diet (25.9%), followed by a preference for a medication allowing occasional gluten exposure (16.9%), greater availability of gluten-free options during travel (15.0%), and improved safety when eating out (13.6%). Interest in a lifelong pharmacological alternative to the GFD was limited (9.5%). Despite minor differences in the distribution of responses across centers, the overall pattern of patient priorities was remarkably consistent. Among 134 physicians (76 (56.7% from the United Kingdom, 20 (14.9%) from Malta, and 38 (28.4%) from Italy)), the most frequently perceived patient need was also an unrestricted diet (17.9%), but a higher proportion attributed importance to lifelong pharmacological therapy (16.4%). The distribution of responses differed significantly between patients and physicians (χ² test, p < 0.001). Conclusions: Patients with CeD across different European healthcare systems report consistent unmet needs driven primarily by lifestyle constraints and the burden of maintaining a strict GFD. Importantly, most patients do not seek complete replacement of the GFD, but rather strategies that provide greater flexibility and protection against occasional gluten exposure. A significant mismatch exists between patient priorities and physician perceptions, with clinicians overestimating the demand for a definitive cure and underestimating the importance of day-to-day disease burden. Future efforts should improve GFD practicality and prevent accidental gluten exposure, while an unrestricted diet remains the ultimate therapeutic goal. Full article

This study presents a sensor-fused field investigation and simulation-based analysis of four horizontal and vertical traffic-calming devices—two raised speed tables, a speed hump, and a raised crosswalk—installed along a 5250-ft two-lane residential collector in Nashville, TN, USA. A dual-sensor architecture combining a Miovision Scout video-based vehicle counter and WAAS/EGNOS-augmented GPS probe-vehicle logging (5 m 3-D RMS horizontal accuracy, 1 Hz sampling) was used to reconstruct 30 quality-controlled free-flow vehicle trajectories and 12-h per-lane volume counts. A spatial kinematic transform (a = v·dv/dx) was applied to extract device-specific approach-deceleration and post-device recovery-acceleration rates, and a three-parameter log-logistic cumulative-distribution function was fitted to the field-observed desired-speed percentiles (root-mean-square error below 0.043 for both speed-table devices). The camera- and GPS-derived observations were used to calibrate and statistically validate a PTV VISSIM microsimulation replica of the corridor, achieving a mean-speed calibration error of 0.71% or better at every device, a GEH statistic below 1.5 at all four analysis turning movements, and independent travel-time validation errors of 5.7–12.1%, within the accepted 15% threshold. The validated model was then used to reconstruct device- and spacing-specific May–Keller macroscopic speed–density–flow relationships, calibrated against simulated capacities of 650–775 vehicles per hour per lane at 350-, 700-, and 1050-ft device spacing. Results show capacity reductions of 20–33% relative to free-flow conditions and yield kinematically derived maximum recommended spacings of 265–630 ft to maintain crossing speeds at or below 15 mph, depending on device geometry. The findings demonstrate a reproducible, low-cost sensor-fusion workflow for quantifying the safety–capacity trade-off of traffic-calming corridors and for informing the design of sensor-in-the-loop adaptive-calming infrastructure. Full article

Multi-UAV missions for remote sensing and environmental monitoring under extreme conditions require task allocation and path optimisation to efficiently distribute goals across vehicles. These methods must also be executed reliably inside an autonomous robotics framework. Several methods for the multiple travelling salesman problem (mTSP) show robust offline routeing efficiency. However, system-level validation under realistic operational conditions including waypoint management and inter-UAV separation remains limited. This research transforms the previously proposed Distance Efficient Clustering Kmeans Genetic Algorithm (DECK_GA) from an offline model into a deployment-focused multi-UAV remote sensing framework implemented in ROS2, Aerostack2, and Gazebo. A uniform waypoint management interface integrates planning, Rviz visualisation, and autonomous execution. The system combines Dynamic Centroid Kmeans (DCKmeans) for spatially coherent waypoint allocation with a Distance Efficient Genetic Algorithm (DEGA) for individual UAV route optimisation. The evaluation is conducted in a high-fidelity Antarctic environment where waypoints represent survey desired objectives in moss regions, and altitude is managed using terrain-referenced control involving two to five UAVs and 30 to 120 waypoints. The framework was evaluated against two baselines under identical mission configurations, with 10 trial runs for each: a Traditional GA Divide & Conquer planner and a Classical Kmeans DEGA planner, which utilises the same route optimisation method and differentiates the outcomes of the allocation stage. DECK_GA showed reduced mean planned and executed distances compared to the Traditional GA Divide & Conquer baseline across all configurations, achieving planned distance reductions ranging from 15.99% to 75.36%. Additionally, it produced shorter path than Classical Kmeans DEGA in 14 out of 16 configurations. The average minimum inter-UAV separation was greater than the Traditional GA Divide & Conquer baseline in 15 of the 16 configurations and higher than Classical Kmeans DEGA in 14 of the 16, which demonstrates that the DCKmeans allocation improves spatial separation. This research focuses on the framework for planning to execution instead of the introduction of a new optimisation method, as DECK_GA was proposed in previous research and is now incorporated and tested within an autonomy framework. This evaluation is simulation only. Real world flying, hardware in the loop testing, wind, communication latency, and location error prediction tend to be future developments. Full article

Background/Objectives: Evacuation policies for childbirth in Nunavut, Canada, continue to profoundly shape the lives of Inuit women, their families, and communities. The evacuation policy is known to disrupt kinship networks and contribute to the erosion of Inuit birthing knowledge. Addressing a gap in Inuit-led understandings of sexual and reproductive health priorities, this paper presents findings from research conducted in 2024 with Kivallirmiut women (‘People of’ in Inuktitut is miut; Kivallirmiut means people of the Kivalliq Region. Nunavummiut means people of Nunavut, and Arviarmiut means people of Arviat, Nunavut, Canada). The study took place in two communities in the Kivalliq Region of Nunavut. Methods: Employing a highly participatory, community-based Indigenous methodology, this study was underpinned by Inuit Qaujimajatuqangit, Indigenous feminist and postcolonial and decolonial theories, and principles of health equity. Data from a survey were generated to identify needs and priorities related to perinatal health and care. Results: Findings identify that Inuit women in these communities hold an interest in accessing perinatal information and support, with a strong desire for learning from Inuit Elders, as well as support via peer networks. Participants also emphasized a desire for more information concerning travelling for birth (medical evacuation), breastfeeding, and healing after birth. Different models for delivery of this information and perinatal support were also identified. Conclusions: Collectively, the priorities of Inuit women in this survey offer insights concerning a structural misalignment between existing perinatal care supports and services that rely on evacuation-based perinatal care and the needs and priorities within Kivalliq communities. This disconnection reveals enduring colonial assumptions embedded within current healthcare systems. The findings suggest a need for perinatal supports that centre culture, kinship, and relational forms of support. Full article

The middle trough of spirals serves simultaneously as a buffer zone for variations in hydrodynamic parameters and as a region where mineral particles of different densities are prone to mixing, exerting a profound influence on particle-separation effect. This study employed a multi-fluid volume of fluid (VOF) model incorporating the Bagnold effect to simulate the ilmenite–chlorite slurry flow in a custom-designed Φ400 mm short-travel spiral concentrator with three turns. This study systematically investigated the influence of the transverse inclination angle of the middle trough (ranging from 3.5° to 9.5°) on separation indicators, flow film morphology, secondary circulation characteristics, and particle force dynamics. The results indicate that employing a lower transverse inclination angle is more conducive to improving the technical separation indicators for ilmenite and chlorite. When using enrichment ratio and separation efficiency as criteria, the optimal inclination angles range from 3.5° to 5° and 3.5° to 6.5°, respectively. Meanwhile the separation efficiency and its sensitivity to the middle trough transverse inclination angle vary remarkably with different feeding sizes. Feeding of 112 μm ilmenite and 19 μm chlorite yields the premium separation performance and is minimally affected by the middle trough transverse inclination angle. Conversely, as the ilmenite particle size decreases or the chlorite particle size increases, the separation indicators decline but become significantly regulated by the middle trough transverse inclination angle, exhibiting a desirable angle range of 3.5–6.5°. Hydrodynamic parameter analyses indicate that a moderate flow film depth, continuous secondary circulation morphology and stabilizing inner circulation in the middle trough can be obtained at a middle trough transverse inclination angle scope of 3.5–6.5°. Once the inclination angle exceeds 6.5°, a distinct ridge forms in the flow film of the middle trough, and extensive disruptions occur in the outward circulation, which subsequently impedes the outward transport of low-density particles along with the fluid. At a middle trough transverse inclination angle scope of 3.5–6.5°, the Bagnold force exerted on the ilmenite particles in the middle trough remains low during the initial stage of flow field evolution, which favors their retention in the lower fluid layer to become the concentrate product. Concurrently, the chlorite particles near the inner region experience a higher Bagnold force, which facilitates their suspension into the upper outer circulation, thereby amplifying the kinematic differences between the chlorite and ilmenite particles. This study demonstrates that fluid dynamic parameters and the force characteristics of mineral particles can effectively characterize the separation process of mineral particles in spirals. Full article

Although social media influencers (SMIs) play a pivotal role in destination marketing, the underlying factors through which they shape tourists’ interest and travel intentions remain underexplored. Based on the modified attention interest desire action (AIDA) model, this study addresses this gap by investigating how the characteristics of SMIs influence travel intentions through destination perceived trust and destination perceived attractiveness. A total of 416 valid questionnaires were analyzed using partial least squares structural equation modeling (PLS-SEM) and an artificial neural network (ANN). The results revealed that SMIs’ similarity, expertise, physical attractiveness, social attractiveness, sincerity, and visibility enhanced tourists’ destination perceived trust and destination perceived attractiveness, thereby influencing travel intentions. Additionally, the ANN analysis complements the PLS-SEM results by comparing predictive performance and identifying the relative importance of SMI characteristics. These findings provide several suggestions for destination management organizations to improve influencer marketing. Full article

This paper investigates fault-tolerant control for active suspension systems with some actuator faults. The objective is to design a fault-tolerant controller such that the closed-loop systems are stable while having a prescribed level of disturbance attenuation performance. First, by introducing an output vector to describe the actuator faults, a quarter-car active suspension model including actuator faults is obtained. Second, based on the linear quadratic optimal control technique and linear matrix inequality theory, the optimal feedback controller is obtained such that the closed-loop system achieves desirable disturbance attenuation performance. Moreover, the fault estimation and compensation methods are also discussed based on matrix techniques and mathematical operations. The proposed method estimates online both the system’s critical state variables and the actual fault force of the actuator, which demonstrates strong practicality. In the end, simulation results demonstrate that the obtained observer can achieve high-precision estimation of state variables and fault forces. Moreover, when the suspension system is controlled by the obtained fault-tolerant controller, the root mean square values of body vertical acceleration and suspension dynamic travel are decreased by 14.59% and 16.98% respectively, compared with the controller without fault consideration. The effectiveness of the proposed method is verified. Full article

This paper presents an integrated optimal preview control strategy where an active suspension system (AAS) collaborates with an active aerodynamic control surface (AACS), utilizing the information of incoming road disturbance. The optimal preview controller utilizes a feedforward and feedback controller to anticipate future road disturbances while addressing the conflicting objectives of passenger comfort and road-holding attributes. The active aerodynamic surface generates a desired lift or downward force to change the sprung mass vertical load distribution, further improving the ultimate target indices. The preview-based optimal controller was synthesized by optimizing and tuning two sets of weighting factors, each based on passenger comfort and road-holding preferences. A numerical simulation study was performed for a 2-DOF quarter-of-vehicle (QoV) model in MATLAB^® (R2025b). Detailed time- and frequency-domain analyses were performed to validate the performance of the proposed scheme. The mean squared values of the total performance measure, vertical sprung mass acceleration, suspension travel, and road-holding indices were calculated and compared with the passive, active, active suspension with preview controller, and active suspension with an active aerodynamic surface (AAS). From the numerical results, it can be concluded that the proposed control strategy extraordinarily improves both ride comfort and road-holding capabilities of the vehicle model while maintaining the suspension rattle space requirements within the bounds and ensuring the dynamic stability of the vehicle. Full article

Although tourism is increasingly seen as a key component of sustainable regional development and economic diversification, its extraordinary expansion raises governance and environmental issues at the local level. The current study assesses the influencing factors of inbound tourism demand to Saudi Arabia, a strategic empirical study due to its rapid and ambitious transformation under Vision 2030. This national strategy is designed to cultivate diverse tourist destinations, including coastal eco-resorts, mountain nature escapes, and urban cultural hubs. The unique sustainability hurdles in each area make the Kingdom a prime location for analyzing the development of regional tourism. This research focuses on the vibrant interfaces among sustainable practices, logistical efficiency, perceptions of safety and uncertainty, and macroeconomic environments that shape the Kingdom’s competitiveness as a tourism region. The study draws several beneficial findings using balanced panel data of 16 origin countries during the period of 2009–2023 and is assessed using a dynamic panel Generalized Method of Moments model. The findings state extensive perseverance within tourism flows, such that past arrivals significantly enable simultaneous inflows. Inbound tourism is strongly and favourably influenced by destination-side factors, particularly logistical performance, human rights conditions, and Saudi Arabia’s socioeconomic prosperity. In a similar vein, the demand for outward travel is strongly reinforced by origin-country prosperity. But travel expenses attenuate, environmental pressures and political risk reduce arrivals, and relative prices and pandemic uncertainty play a negligible role. The findings highlight the need to upgrade the country’s logistics infrastructure, enhance rights protection and governance, integrate sustainable practices, and capitalise on prosperity to make Saudi Arabia a desirable travel destination by Vision 2030. A key contribution of this study is to demonstrate how infrastructure, environmental stewardship, and institutional quality shape a region’s tourism attractiveness. The study illustrates how sustainability must be incorporated into regional-specific strategies to balance economic goals with ecological and social imperatives, providing a framework for other countries interested in sustainable tourism. Full article

The China–Pakistan Economic Corridor (CPEC) represents a transformative transport infrastructure initiative with the potential to reshape tourism in South Asia. However, the behavioral mechanisms through which corridor development translate into travel willingness remain insufficiently understood, particularly between domestic and cross-border tourism. This study investigated the determinants of domestic tourism willingness within Pakistan and cross-border tourism willingness toward China using a stated preference survey of 441 Pakistani respondents collected through an online questionnaire. To balance behavioral interpretation and predictive performance, this study integrated ordinal logistic regression (OLR) with multiple machine learning classifiers. The results revealed clear behavioral asymmetries between domestic and cross-border tourism decisions. Domestic tourism willingness was primarily driven by attitudinal evaluations, particularly perceived desirability, pleasantness, and comfort of travel along the CPEC. In contrast, cross-border tourism willingness was more strongly constrained by knowledge-related and institutional factors, including awareness of visa procedures, accommodation arrangements, and destination information. Comparative performance analysis indicated that machine learning models outperformed ordinal logistic regression, improving predictive accuracy by approximately 12.6 percentage points for domestic tourism (93.6% vs. 81.0%) and 1.7 percentage points for cross-border tourism (81.1% vs. 79.4%). These findings demonstrate that corridor-induced tourism demand is governed by distinct behavioral mechanisms across domestic and international contexts, highlighting the need for differentiated tourism development strategies. From a policy perspective, the results suggest that domestic tourism development along the CPEC should prioritize experiential quality and travel comfort, whereas cross-border tourism promotion should focus on reducing informational and procedural barriers such as visa knowledge, accommodation awareness, and travel facilitation. Full article

Uncertainty in travel and service times poses significant challenges for vehicle routing in logistics systems. This paper proposes a stochastic model predictive control (SMPC) strategy to manage a Vehicle Routing Problem with time windows (VRPTW) under stochastic service times with correlation across customers. The approach combines a dynamic optimization model with single and joint chance constraints and a forecasting tool for updating travel plans as new information becomes available. A deterministic reformulation of the stochastic constraints is developed so that the problem can be solved via mixed-integer programming. The aim of this paper is to demonstrate that the SMPC strategy can maintain a high level of time-window reliability (meeting customer time windows with high probability) at a reasonable cost by re-optimizing routes over a moving horizon. In numerical case studies, the SMPC approach achieves the desired reliability levels while incurring only modest increases in total cost, and it flexibly adjusts the cost–risk tradeoff by switching between single and joint chance constraints. These results illustrate the potential of the proposed method for real-time distribution routing under uncertainty and highlight the novel contribution of integrating chance-constrained optimization with Model Predictive Control in a VRPTW context. Full article

In automated driving, drivers may sleep during rides, making it important to study napping preferences and wake-up scenarios for human-centered system design. We conducted an online study with 280 participants, balanced by age and gender, examining how often, when, and how long individuals would nap if given the opportunity. The study also explored preferred wake-up methods when the vehicle nears the end of its operational design domain. Using a mixed 2 × 2 design, participants were assigned to one of two travel purposes (“commuting” vs. “holiday trip”) and two minimal risk conditions (rest area vs. hard shoulder). The results showed that 40% intended to sleep during automated driving, highlighting a strong interest in in-car sleeping. Wake-up preferences varied by travel purpose and minimal risk condition, with many favoring awakening before the drive ended. Participants also anticipated sleep inertia and desired post-wake-up support. The findings allow suggestions for designing wake-up concepts that mitigate sleep inertia. Full article

Rural tourism is defined as a tourism activity in which the visitor’s experience is linked to agricultural activities, rural lifestyles, and traditional cultures. In many geographical contexts, especially in Europe, because the rural economy is so deeply tied to family farming, this form of tourism is referred to as “agritourism”, even though agrotourism is a specific subset of rural tourism defined by the integration of tourism with a working farm or agricultural operation. The entry delineates the transformative dynamics of rural tourism in the context of global shifts towards personalized, experiential travel. It examines how contemporary tourists increasingly seek authentic and immersive experiences as a response to the superficiality of mass tourism. This trend leads travellers to engage deeply with local cultures, thereby fostering connections with community life and prioritizing sustainability. Amidst challenges such as environmental degradation and overtourism, rural tourism emerges as a viable alternative, offering unique, less-congested destinations that cater to travellers’ desire for exclusivity and genuine discovery. The paper traces the historical evolution of rural tourism from its European origins in mid-20th-century agricultural practices to its current status as a vital component of rural development strategies. Through a comparative analysis of two distinct regional scenarios, Europe and Oceania, this article elucidates how local contexts shape tourism practices. The analysis highlights the pivotal role of gastronomy in enriching tourist experiences and emphasizes the need for digital literacy and eco-effectiveness in rural tourism operations. Although the entry does not provide a comprehensive global perspective on rural tourism or a quantitative environmental account of the sector’s impact, it ultimately conveys that rural tourism is a critical engine of regional vitality and sustainability, illustrating the juxtaposition of historical roots and contemporary trends that define this evolving sector. Full article

Tourism has become a key sector of the global economy and a driver of economic growth. The Wine Routes are a specialized tourist offering that meets the needs of a segment of travelers, contributing to the enhancement and preservation of rural areas. Recent studies have highlighted that among the reasons driving tourists to choose Slow tourism is the desire to discover local food and wine as an expression of territorial culture. This study assumes that the characteristics of Wine tourists may have changed in recent years. An extensive survey was conducted on visitors of Sicilian Wine Routes. The results examine Wine tourism and Slow tourism and their overlap for tourists who travel around rural territories following the lure of food and wine. The results highlight a new segmentation and the existence of a new profile of Eno-Slow tourists with new primary motivations and needs. On a global level, the new Eno-Slow tourist fits perfectly into the international trends of responsible and sustainable tourism, strengthening the image of wine-producing regions as models of balance between culture, nature, and quality of life. These findings are very important as they provide useful guidance for policymakers and stakeholders committed to the sustainable competitiveness of rural tourist destinations, both locally and internationally. Full article

The increase in population and demand for the various needs of citizens increases the interaction with the geo-environment. Thus, the rate of natural events affecting daily human life increases. Such an event occurred on a rock cliff in a densely populated area in İstanbul (Türkiye). More than four rock blocks (approximately 3–5 m³) belonging to the Paleozoic sequence of İstanbul, composed of nodular limestone with sandy-clay interlayers, detached and fell. The blocks traveled along a path of approximately 60 m and stopped by crushing a couple of buildings downslope. The path was rough and contained various surface conditions (e.g., bedrock, talus, and plants). This study was initiated by the examination of the dimensions of failed rock blocks, their paths, and topographic conditions. Unmanned vehicles (drones) facilitated the generation of 3D numerical models of topographic changes on the site. Quantifying discontinuity properties (such as persistence, spacing, roughness, etc.) and defining weathering properties comprises the second stage, along with sampling. Based on digital topographic data and field observations, cross-sections were defined by means of possible rockfall areas within the area of potentially unstable blocks. Numerical analysis and rockfall analysis were conducted along these critical sections. Interpretation of laboratory data and results obtained from numerical studies leads to an understanding of the mechanism of the recent rockfall event and demonstrates the most critical areas to be considered and reinforced. The research comprises proposing appropriate reinforcement techniques due to the strong Turkish regulations along the “Bosphorus Waterfront Protected Zone”. The study advises pre-cleaning of potentially unstable blocks after a fence production on paths where rocks could fall, and rock anchors in some localities with varying lengths. The latest part of the research covers the re-assessment of mitigation processes with numerical models, which shows that the factor of safety increased to the desired levels. The reinforcement applications at the site match well with the proposed prevention methods. Full article