Search Results (464)

Objectives: We aimed to develop expert-informed recommendations for colleges and universities to support students with celiac disease (CeD) managing a gluten-free (GF) diet. Methods: A multidisciplinary panel of 40 stakeholders, including physicians, dietitians, a disability rights attorney, university staff, and students, was convened by the Celiac Disease Foundation to create expert-based and experience-informed recommendations. Over a 6-month period, the group conducted literature reviews, stakeholder interviews, and expert consensus discussions to identify common barriers and accommodations aligned with federal disability law. The expert panel collaboratively developed and revised an initial set of recommendations. Two rounds of structured voting were held during which panelists provided feedback to refine content and ensure clarity. All final recommendations were adopted with at least 90% of panelists voting in support. Results: The panel identified 24 accommodations across four domains: academics, housing, dining, and campus life. Academic recommendations include flexibility for illness-related absences, support for remote learning, and classroom modifications. Housing recommendations emphasize access to priority placement, appropriate appliances, and proximity to safe dining. Dining accommodations address GF food availability, ingredient transparency, staff training, and meal plan flexibility. Campus life recommendations ensure full participation in athletics, study abroad, social events, and internships, with supports for psychosocial well-being. Conclusions: This manuscript presents the first expert-informed recommendations focused specifically on the needs of college students with CeD. These recommendations are intended to support institutions as they develop strategies to enhance access to GF food, quality of life, educational supports, and student experience for those living with this chronic autoimmune condition. Full article

Background: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor training for individuals with OA has not yet been established. Thus, the aim of this study was to compare the effects of a 24-week Gyrokinesis method (GK) versus Pilates (PL) intervention on balance control, function, pain and kinesiophobia in women with knee OA. Methods: Twenty women (aged 60 ± 7 years) with grade 2 or 3 knee OA were assigned to either GK (n = 12) or PL (n = 8). Both groups trained twice weekly for 24 weeks. Pre- and post-intervention assessments included postural sway parameters (RMS, velocity, frequency), physical function tests (e.g., TUG, Sit-to-Stand), flexibility, pain (Brief Pain Inventory), kinesiophobia (Tampa Scale), and quality of life (SF-36). Results: GK resulted in significantly greater improvements than PL in postural sway mean velocity AP right (GK −53.85% vs. PL −20.17%), AP left (GK −43.48% vs. PL +13.45%), and ML left (GK −40.18% vs. PL +37.95), pain reduction (GK −82.5% vs. PL −33.3%), and physical function (Sit-to-Stand: GK +75.9% vs. PL +3.7%; TUG: GK −16.4% vs. PL −13.8%; Step Test right: GK +34.2% vs. PL +19.9%; Step Test left: GK +41.4% vs. PL +18.1%) (all, p < 0.05). No significant between-group differences were observed for kinesiophobia or SF-36 scores (both, p > 0.05). Conclusions: Gyrokinesis method may be more effective than Pilates in enhancing balance, reducing pain, and improving physical function in women with knee OA. These findings support the use of the Gyrokinesis method in rehabilitation programs for individuals with OA. Full article

This paper presents a compact four-beam dual-polarized phased array with the high performance front-end module based on system-in-package (SiP) technology. By employing high-temperature co-fired ceramic (HTCC) substrates, the proposed design achieves efficient thermal management and high level of integration within a tile-type architecture. The front-end module based on SiP can simultaneously generate four independent beams with switchable left- and right-hand circular polarizations, providing flexible beam control. To verify the proposed method, a Ku-band 256-element phased array receiver with four beams has been designed and experimentally verified using HTCC and SiP process. Operating in 14–14.5 GHz, the proposed low-profile array demonstrates stable radiation characteristics, beam pointing accuracy and excellent beam consistency across the entire frequency range. The measurement results confirm that the SiP-based phased array maintains efficient thermal management, high polarization purity and robust beam-scanning capability, validating its suitability for mobile satellite communication. Full article

The division of labor in mixed-gender couples has been a popular research topic for several decades, including discussions about household labor, childcare, and paid employment. However, few studies have examined these processes as they apply to highly religious couples, whose perspectives on labor division show some evidence of diverging from those who are less devout. To better understand how successful mixed-gender, highly religious couples from a broad range of faith traditions conceptualize the division of paid and unpaid labor, we employed a strengths-based, qualitative approach, examining data from 103 interviews with highly religious, highly satisfied couples (N = 206 participants). Viewed within an interdependence theory framework, findings across numerous religions and ethnicities revealed evidence of communal relationships, with themes emphasizing partnership, shared responsibility, and varied labor arrangements that required commitment, trust, and sacrifice. While spouses evidenced high levels of agreement with each other, a strong emphasis on a husband’s responsibility to provide financially contrasted with a more nuanced view of women’s roles, with some participants stressing women’s roles at home and some highlighting their right to choose employment and a more flexible household labor division. Difficulties mentioned revolved around traditional labor arrangements and work–life balance for husbands. Full article

This study analyzed the impact of human drivers’ Keep Right Rule noncompliance on sustainable freeway operations in mixed traffic. Using the microscopic traffic simulation tool, a total of 36 scenarios were examined based on variations in driving behavior, presence of slow vehicles in the passing lane, desired speed, and number of lanes. The Wiedemann-99 car-following model and autonomous driving logic were applied for simulation. Simulation results revealed that the occupation of the passing lane by a human-driven slow vehicle increased the recovery time and variability in right-side rule compared to free lane selection. Also, 20 km/h was a threshold desired speed gap that activated the bottleneck by the slow vehicle in a passing lane. Lastly, as the number of lanes increased, bottleneck formation was diminished. The findings point to a mixed traffic systemic paradox. Human drivers can alleviate bottleneck formation by flexibly performing right-side overtaking even though it is illegal, whereas autonomous vehicles cannot perform right-side overtaking, which unintentionally activates a bottleneck under strict rule compliance. These results show that in mixed traffic conditions, even minor violations of traffic rules by human drivers can lead to congestion. Therefore, to achieve sustainable and safe road traffic by harmonizing mixed traffic, institutional improvements are necessary alongside advances in autonomous driving technology. Full article

Background: Flexible flatfoot is a common pediatric condition. Surgical intervention is indicated for symptomatic cases unresponsive to conservative treatment. This study evaluates the outcomes of two established procedures, Grice extraarticular subtalar arthrodesis and subtalar arthroereisis, in children treated for symptomatic flatfoot. Methods: A retrospective analysis was conducted on 158 patients (286 feet) treated between 2013 and 2024. Among them, 34 underwent Grice arthrodesis and 124 underwent arthroereisis. Demographic and procedural data were collected, including age, sex, neurological impairment (cerebral palsy), laterality, and concurrent Achilles tendon lengthening. Radiographic parameters assessed pre- and postoperatively included Meary’s, Pitch, and Kite’s angles (frontal and sagittal view), uncovering of the talus, and Cyma line. Only patients with both pre- and postoperative measurements were included in paired analysis. Statistical tests included paired t-tests within groups and Welch’s t-tests for between-group comparisons. Results: Grice patients were younger (mean age 9.0 ± 3.1 years) and included all cerebral palsy cases (18/34; 52.9%), while arthroereisis patients were older (10.8 ± 2.6 years) and typically neurologically normal. Achilles tendon lengthening was performed in 100% of Grice and 48% of arthroereisis cases. Both groups showed significant radiographic improvement across all measured parameters (all p < 0.05). Grice arthrodesis produced greater reductions in Meary’s angle (right Δ = −19.8° ± 9.2 vs. −13.1° ± 7.5; p = 0.024), while arthroereisis yielded larger increases in Pitch angle (left Δ = +9.2° ± 7.2 vs. +5.5° ± 6.2; p = 0.055). Other angular improvements (Kite’s, uncovering, and Cyma line) were statistically significant within both groups but not between groups. Conclusions: Symptomatic flat-valgus foot in children remains a relevant public health issue. Treatment should be individualized, while cases secondary to unrecognized or untreated congenital conditions often require surgery to restore normal foot biomechanics. Full article

The transfer price of land management rights, as a key component of deepening rural reform at the 20th National Congress, profoundly influences the direction of agricultural production. Analyzing the land transfer management rights price differences can provide a deep understanding of regional transfer patterns and promote efficient land transfer. This study employs the SES framework to investigate factors of land transfer price differences by integrating correlation regression with the Boosted Regression Tree model. The results showed that (1) resource units determine land transfer management rights prices, with agricultural output value and net arable land income serving as core determinants. (2) City W is in the nascent land market, where the resource systems (RS) exert stronger influence. Key drivers include the transportation accessibility index and the proportion of flexible land. Compared to County K, where the land market exhibits full competition, the primary drivers of price shift from the resource systems to the governance systems and actors. Land transfer participants and the number of rural economic organizations become the main factors. Within the same Eastern black soil region, the transfer price differed by several thousand yuan per hectare. This disparity stems from differences in the two driving structures, necessitating the precise implementation of land transfer policies. Full article

Demographic trends over the last decades and future projections clearly indicate a steady increase in the proportion of older adults (65+) relative to both the working-age (15–64) and child populations (0–15) across Europe. This demographic shift—driven by rising life expectancy and declining fertility—raises pressing challenges for intergenerational equity and questions the sustainability of the implicit formal and informal “social contract” that links generations through the distribution of rights, responsibilities, and resources. In particular, the two fundamental pillars of European post-industrial societies, namely an extensive welfare state and a liberal–democratic institutional framework, appear to be at risk. To address this issue, the notion of “intergenerational fairness”, recently adopted by social policies in both USA and Europe, appears flexible and fundamentally ambiguous. As a substantial variant of neoliberal austerity policies, it is simply used as a justification for further austerity measures, the withdrawal of entitlements to social and economic rights by citizens and the dismantling of welfare states. A second meaning of “intergenerational fairness” is possible starting from the concept of ambivalence used to describe the mix of conflict and solidarity that characterizes intergenerational relations in contemporary post-industrial societies. In this respect, the two concepts of “successful ageing” and “active ageing”, often considered as overlapping, actually involve very different perspectives: successful ageing adopts a substantially reductionist, individualistic, and static approach to the process of ageing, whereas active ageing is a more comprehensive and dynamic strategy that seeks to overcome all these limitations by a life-course perspective. This recognizes that a person’s path to old age is not predetermined but depends primarily on earlier life experiences and their influence: the ageing process affects people of all ages, not just the elderly. And since the subjectivization of ageing in contemporary societies has challenged the conventional notion of “natural life stages”, the new theoretical concept advanced in the article of “ageing styles” becomes central to understanding the ageing process today. Ageing styles are the outcome of the interplay between the objective and subjective dimensions of the life course, represented, respectively, by life chances (social structure) and life choices (agency). A theoretical framework is proposed for analyzing ageing styles that can be used from a life-course perspective to highlight their complex and dynamic nature. An evidence-based European political strategy aimed at promoting active ageing from a perspective of intergenerational fairness, based on the eight principles indicated, can be flexible enough to ensure that everyone can adopt their preferred ageing style without top-down imposition and contribute to the maintenance of the intergenerational social contract. Full article

The electrification of vehicle chassis systems is increasingly important due to benefits such as vehicle lightweighting, enhanced safety, and design flexibility. However, faults in these systems can seriously compromise safety, making Fault Tolerant Control (FTC) essential. This study investigated FTC of four-wheel independent Electro-Mechanical Brake (EMB) actuators and proposed a method to prevent lane departure under actuator faults. Fault Tolerant Robust Control (FTRC) of four-wheel independent EMB actuators using Time Delay Control (TDC) was applied without Fault Detection and Diagnosis (FDD) to maintain real-time capability, and without steering control to reduce system complexity. In addition, for actuator faults causing large lateral displacements, a control strategy applying relative weighting to lateral velocity and yaw rate was introduced. The results showed that, even when the faults of the EMB actuators were severe and asymmetric between the left and right sides of the vehicle, overall vehicle stability—including lateral and yaw motions—was preserved through the proposed FTRC approach without FDD and steering control. Moreover, the relative weighting strategy effectively reduced lateral displacement, preventing lane departure. These findings highlight the significance of the proposed method for ensuring FTRC in electrified braking systems, enhancing safety, reducing lateral displacement, preventing lane departure, ensuring real-time capability, and reducing the complexity required in practical FTC. Full article

Temporary agency work (TAW) has expanded globally as organizations seek flexibility amid skill shortages and demand volatility. In 2015 the United Nations recognized ‘decent work’ as Sustainable Development Goal (SDG 8), emphasizing sustainable economic growth, fair employment opportunities accessible to all without discrimination, environmental responsibility, and social inclusiveness. This study examines why user organizations (clients) adopt TAW and how these drivers materialize in stakeholder practices that align—or fail to align—with SDG-8 dimensions of decent work. Within a qualitative-dominant, explanatory sequential mixed-methods case study, documentary and statistical analyses were combined with 19 semi-structured interviews across agencies, clients, agency workers, trade unions, and relevant authorities. Inductive thematic analysis identified seven demand-side driver categories and assessed their effects using the SDG-8 pillars as an analytical lens (employment creation, rights at work, social protection, social dialogue). Findings indicate that TAW is primarily deployed to buffer volatility and labour shortages, accelerate hiring, and shift HR administration and parts of risk to agencies, with limited integration of SDG-8–consistent practices. Three cross-cutting gaps emerged: (i) social dialogue is narrow and compliance-oriented, with little strategic focus on decent-work outcomes; (ii) agency-worker voice and representation are weak, and agencies are not consistently recognised as social partners; and (iii) social-sustainability efforts are sparse and ad hoc, with few structured measures for skill development, equal treatment, or clear conversion pathways, while environmentally friendly initiatives are almost completely absent. In Slovenia, TAW fills systemic labour gaps but remains weakly integrated with SDG-8 practices. The study links demand-side drivers to specific decent-work shortfalls and proposes a multi-level policy roadmap—regulatory, industry, TAW agency, and social-dialogue platforms—to advance progress toward social sustainability and environmental responsibility. Full article

Robust control over the coupling and propagation of surface plasmon polaritons (SPPs) is essential for advancing various plasmonic applications. Traditional planar structures, commonly used to design SPP directional couplers, face limitations such as low extinction ratios and design complexities. These issues frequently hinder the dense integration and miniaturisation of photonic systems. Recently, exceptional points (EPs)—unique degeneracies within the parameter space of non-Hermitian systems—have garnered significant attention for enabling a range of counterintuitive phenomena in non-conservative photonic systems, including the non-trivial control of light propagation. In this work, we develop a rigorous temporal coupled-mode theory (TCMT) description of a non-Hermitian metagrating composed of alternating silicon–germanium nanostrips and use it to explore the unidirectional excitation of SPPs at EPs in the visible spectrum. Within this framework, EPs, typically associated with the coalescence of eigenvalues and eigenstates, are leveraged to manipulate light propagation in nonconservative photonic systems, facilitating the refined control of SPPs. By spatially modulating the permittivity profile at a dielectric–metal interface, we induce a passive parity–time ($\mathcal{PT}$)-symmetry, which allows for refined tuning of the SPPs’ directional propagation by optimising the structure to operate at EPs. At these EPs, a unidirectional excitation of SPPs with a directional intensity extinction ratio as high as 40 dB between the left and right excited SPP modes can be reached, with potential applications in integrated optical circuits, visible communication technologies, and optical routing, where robust and flexible control of light at the nanoscale is crucial. Full article

Background: Augmented reality (AR)-based exercise offers a low-cost option for home training, but the lack of supervision increases the risk of incorrect performance. Therefore, AR systems must demonstrate accuracy and effectiveness comparable to therapist-led training. To address this need, this study examined whether an AR-supported multi-component exercise program improves six key components of physical fitness. Methods: Twenty-eight healthy adults from South Korea were recruited and randomly assigned to either the AR group or the physical therapist (PT) group. Participants were assessed for six components of physical fitness: muscular strength, muscular endurance, balance, cardiorespiratory endurance, flexibility, and coordination. Each group performed the exercise program three times per week for four weeks, with each session lasting at least 30 min. Statistical analyses were conducted using paired t-tests to evaluate pre- and post-intervention effects within each group and independent t-tests to compare differences between the two groups. The level of statistical significance was set at p < 0.05. Results: Exploratory analyses showed that both groups demonstrated post-intervention improvements in muscular endurance, balance, flexibility, and coordination, while cardiorespiratory endurance and grip strength showed no notable changes. Between-group comparisons revealed significant differences only in right-hand relative grip strength at both baseline and post-intervention, with no other domains differing between groups. Conclusions: First, the AR-based intervention significantly improved muscular endurance, balance, flexibility, and coordination. Second, there were no significant differences between the AR-based and therapist-led interventions. Consequently, AR-based exercise programs may enhance specific components of physical fitness and could be effectively utilized to complement and extend therapist-led training sessions. Full article

Capacitive ECG (cECG) technology offers significant potential for improving comfort and unobtrusiveness in long-term cardiovascular monitoring. Nevertheless, current research predominantly emphasizes basic heart rate monitoring by detecting only the R-wave, thereby restricting its clinical applicability. In this study, we proposed an advanced cECG mattress system and conducted a systematic evaluation. To enhance user comfort and achieve more accurate cECG morphological features, we developed a multi-layered cECG mattress incorporating flexible fabric active electrodes, signal acquisition circuits, and specialized signal processing algorithms. We conducted experimental validation to evaluate the performance of the proposed system. The system exhibited robust performance across various sleeping positions (supine, right lateral, left lateral and prone), achieving a high average true positive rate (TPR) of 0.99, ensuring reliable waveform detection. The mean absolute error (MAE) remains low at 1.12 ms for the R wave, 7.89 ms for the P wave, and 7.88 ms for the T wave, indicating accurate morphological feature extraction. Additionally, the system maintains a low MAE of 0.89 ms for the RR interval, 7.77 ms for the PR interval, and 7.85 ms for the RT interval, further underscoring its reliability in interval measurements. Compared with medical-grade devices, the signal quality obtained by the cECG mattress system is sufficient to accurately identify the crucial waveform morphology and interval durations. Moreover, the user experience evaluation and durability test demonstrated that the mattress system performed reliably and comfortably. This study provides essential information and establishes a foundation for the clinical application of cECG technology in future sleep monitoring research. Full article

This paper introduces the Marshall–Olkin unit-exponentiated-half-logistic (MO-UEHL) distribution, a novel three-parameter model designed to enhance the flexibility of the unit-exponentiated-half-logistic distribution through the incorporation of the Marshall–Olkin transformation. Defined on the unit interval $(0,1)$, the MO-UEHL distribution is well-suited for modeling proportional data exhibiting asymmetry. The Marshall–Olkin tilt parameter $\alpha$ explicitly controls the degree and direction of asymmetry, enabling the density to range from highly right-skewed to nearly symmetric unimodal forms, and even to left-skewed configurations for certain parameter values, thereby offering a direct mathematical representation of symmetry breaking in bounded proportional data. The resulting model achieves this versatility without relying on exponential terms or special functions, thus simplifying computational procedures. We derive its key mathematical properties, including the probability density function, cumulative distribution function, survival function, hazard rate function, quantile function, moments, and information-theoretic measures such as the Shannon and residual entropy. Parameter estimation is explored using maximum likelihood, maximum product spacing, ordinary and weighted least-squares, and Cramér–von Mises methods, with simulation studies evaluating their performance across varying sample sizes and parameter sets. The practical utility of the MO-UEHL distribution is demonstrated through applications to four real datasets from environmental and engineering contexts. The results highlight the MO-UEHL distribution’s potential as a valuable tool in reliability analysis, environmental modeling, and related fields. Full article

Background: Marker-based motion capture systems are commonly used for three-dimensional movement analysis in sports. Novel, markerless motion capture systems enable the collection of comparable data under more time-efficient conditions with higher flexibility and fewer restrictions for the athletes during movement execution. Studies show comparable results between markerless and marker-based systems for kinematics of the lower extremities, especially for walking gait. For more complex movements, such as throwing, limited data on the agreement of markerless and marker-based systems is available. The aim of this study is to compare the outcome of a video-based markerless motion capture system with a marker-based approach during an artificial basketball-throwing task. Methods: Thirteen subjects performed five simulated basketball throws under laboratory conditions, and were recorded simultaneously with the marker-based measurement system, as well as two versions of a markerless measurement system (differing in their release date). Knee, hip, shoulder, elbow and wrist joint angles were acquired and root mean square distance (RMSD) was calculated for all subjects, parameters and attempts. Results: The RMSD of all joint angles of the marker-based and markerless systems ranged from 7.17° ± 3.88° to 26.66° ± 14.77° depended on the joint. The newest version of the markerless system showed lower RMSD values compared to the older version, with an RMSD of 16.68 ± 5.03° for elbow flexion, capturing 93.84% of the data’s RMSD of 22.22 ± 5.52, accounting for 87.69% of the data. While both versions showed similar results for right knee flexion, lower differences were observed in the new version for right hip flexion, with an RMSD of 8.17 ± 3.75 compared to the older version’s 13.24 ± 5.78. Additionally, the new version demonstrated lower RMSD values for right hand flexion. Conclusions: Overall, the new version of the markerless system showed lower RMSD values across various joint angles during throwing movement analysis compared to the older version. However, the differences between markerless and marker-based systems are especially large for the upper extremities. In conclusion, it is not clearly explainable if the detected inter-system differences are due to inaccuracies of one system or the other, or a combination of both, as both methodologies possess special limitations (soft tissue vibration or joint center position accuracy). Further investigations are needed to clarify the accordance between markerless and marker-based motion capture systems during complex movements. Full article