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Search Results (1,152)

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8 pages, 205 KiB  
Proceeding Paper
Large Language Model-Assisted Course Search: Parsing Structured Parameters from Natural Language Queries
by Max Upravitelev, Naomi Schoppa, Christopher Krauss, Truong-Sinh An, Bach Do and Aziz Md Abdul
Eng. Proc. 2025, 103(1), 18; https://doi.org/10.3390/engproc2025103018 (registering DOI) - 14 Aug 2025
Abstract
We propose a method to address the challenge of course discovery on search platforms by employing large language models (LLMs) to parse extended search parameters from natural language queries. We developed a set of algorithms that augment a course search platform prototype by [...] Read more.
We propose a method to address the challenge of course discovery on search platforms by employing large language models (LLMs) to parse extended search parameters from natural language queries. We developed a set of algorithms that augment a course search platform prototype by integrating an LLM-based assistant to facilitate 55,000 vocational training sessions. The developed method supports natural language queries and parses optional search parameters. For parameter optionality and to evaluate the feasibility of parameter parsing, we introduce a relevance check mechanism based on cosine similarity. The parsing process was conducted by using a guided generation strategy with grammar-based restrictions to limit the generation possibilities. The developed method enhanced the precision and pertinence of course searches. Full article
22 pages, 5109 KiB  
Article
Machine-Learning-Driven Stochastic Modeling Method for 3D Asphalt Mixture Reconstruction from 2D Images
by Jiayu Zhang and Liang Huang
Materials 2025, 18(16), 3787; https://doi.org/10.3390/ma18163787 - 12 Aug 2025
Viewed by 219
Abstract
Three-dimensional reconstruction programs are essential tools for understanding the behavior of asphalt mixtures. On the basis of accurate 3D models, it is convenient to identify the complex relationship between spatial structures and physical properties. In this work, we explore a low-cost and data-efficient [...] Read more.
Three-dimensional reconstruction programs are essential tools for understanding the behavior of asphalt mixtures. On the basis of accurate 3D models, it is convenient to identify the complex relationship between spatial structures and physical properties. In this work, we explore a low-cost and data-efficient way to create a collection of 3D asphalt mixture models. The core idea is to introduce a foundational segmentation program and stochastic modeling into the asphalt mixture reconstruction framework. First, our approach captures a 2D image to present spatial structures of the investigated sample. The integration of a smartphone camera and an image quilting method has been designed to understand fine-grained details and facilitate full coverage. Aiming at realizing high-quality segmentation, we propose the Segment Anything Model (SAM)-driven method to distinguish aggregate grains and asphalt binder. Second, Multiple-Point Statistics (MPS) is activated to build 3D models from 2D training images. To speed up the reconstruction step, we apply Nearest Neighbor Simulation (NNSIM) to improve pattern searching efficiency. Aiming at calculating 3D conditional probabilities, the probability aggregation framework is introduced into the asphalt mixture investigation. Third, our program focuses on the modeling evaluation procedure. Determination of a two-point correlation function, analysis of distance and a grain size distribution assessment are separately performed to check the reconstruction quality. The evaluation results indicate that our program not only preserves spatial patterns but also expresses uncertainty during the material production step. Full article
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29 pages, 1827 KiB  
Article
One-Step Enhancement Method for Data Registration Based on the Lidargrammetric Approach
by Antoni Rzonca and Mariusz Twardowski
Remote Sens. 2025, 17(16), 2774; https://doi.org/10.3390/rs17162774 - 11 Aug 2025
Viewed by 244
Abstract
The present paper introduces a novel methodology for LiDAR point transformation and adjustment, grounded in two primary concepts. In the initial phase of the process, LiDAR data are mapped onto synthetic images, known as lidargrams, through the utilization of exterior orientation parameters (EOPs) [...] Read more.
The present paper introduces a novel methodology for LiDAR point transformation and adjustment, grounded in two primary concepts. In the initial phase of the process, LiDAR data are mapped onto synthetic images, known as lidargrams, through the utilization of exterior orientation parameters (EOPs) of a virtual camera. Secondly, unique lidargram point identifiers (ULPIs) are assigned to each LiDAR point, ensuring the preservation of the relationship between specific LiDAR points and their corresponding lidargram projections. This process facilitates the reconstruction of ground points from their respective projections. The integration of these concepts facilitates the alignment and adjustment of blocks of lidargrams, thereby enabling the estimation of novel EOPs. The exchange of arbitrary EOPs and the intersection of the transformed point cloud based on the ULPIs are facilitated by these refined EOPs. The LiDAR data undergo a three-dimensional transformation using photogrammetric algorithms. This is in accordance with the fundamental principles of lidargrammetry. The accuracy of the new approach and its implementation in a research tool were verified on a range of data types, encompassing synthetic, semisynthetic, and real data. By evaluating the approach across a wide range of data sources, the authors were able to assess its effectiveness and reliability in different scenarios. The method’s flexibility is evidenced by its ability to reduce the final 3D root mean square error of discrepancies measured at check points by 30 times in synthetic data tests, 12 times in semisynthetic data tests, and 96 times in real data tests. The quantitative results obtained provide substantial support for the validity of the presented methodology. The efficacy of the proposed method was also evaluated by way of a comparative analysis with a selection of widely utilized LiDAR processing software developed by TerraSolid Ltd. Full article
(This article belongs to the Section Engineering Remote Sensing)
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15 pages, 1536 KiB  
Article
Impact of Digitalization on Carbon Emissions in Guangdong’s Manufacturing Sector: An Input–Output Perspective
by Jiao Jingren, Helmut Yabar and Takeshi Mizunoya
Sustainability 2025, 17(16), 7234; https://doi.org/10.3390/su17167234 - 11 Aug 2025
Viewed by 345
Abstract
As global pressure to reduce emissions intensifies, China is increasingly turning to digital technologies to drive sustainable industrial development, aiming to boost production while keeping carbon emissions in check. This study takes a micro-level approach by dividing the industry into 17 sectors and [...] Read more.
As global pressure to reduce emissions intensifies, China is increasingly turning to digital technologies to drive sustainable industrial development, aiming to boost production while keeping carbon emissions in check. This study takes a micro-level approach by dividing the industry into 17 sectors and applying an environmentally-extended input–output (EEIO) model combined with structural decomposition analysis (SDA) to quantify the impact of digital transformation on carbon emissions across sectors. This study used input–output data from 2012 and 2017. The results indicate that (1) technological improvements driven by digitalization play a key role in reducing industrial carbon emissions, and (2) while high-carbon sectors show substantial emission reductions due to digital transformation, industries such as textiles—where digital adoption is more challenging—exhibit only limited improvements. These findings underscore the need to further advance technological upgrading and transformation in less digitally integrated sectors. Full article
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17 pages, 507 KiB  
Article
The Impact of Rural Energy Poverty on Primary Health Services Efficiency: The Case of China
by Xiangdong Sun, Xinyi Zheng, Shulei Li, Jinhao Zhang and Hongxu Shi
Systems 2025, 13(8), 675; https://doi.org/10.3390/systems13080675 - 8 Aug 2025
Viewed by 213
Abstract
Primary healthcare is vital to achieving universal health coverage, as emphasized by Sustainable Development Goal 3 (SDG 3). However, energy poverty remains a critical yet overlooked barrier to the efficiency of primary healthcare services in rural China—precisely the focus of this study. It [...] Read more.
Primary healthcare is vital to achieving universal health coverage, as emphasized by Sustainable Development Goal 3 (SDG 3). However, energy poverty remains a critical yet overlooked barrier to the efficiency of primary healthcare services in rural China—precisely the focus of this study. It employs panel regression models and threshold analysis methods using data from 31 Chinese provinces for the period 2014–2021, sourced from the EPSDATA data platform. Robustness checks are performed using bootstrap procedures, accompanied by detailed mechanism analyses. The empirical results demonstrate that rural energy poverty significantly reduces primary healthcare efficiency, particularly in provinces initially characterized by lower healthcare performance. The mechanism analysis identifies four critical transmission channels—off-farm employment, internet intensity, food safety, and health education—through which rural energy poverty undermines healthcare outcomes. Furthermore, threshold regressions uncover nonlinear relationships, indicating that the negative impacts of rural energy poverty intensify when household medical expenditures exceed 10.9%, the old-age dependency ratio surpasses 22.61%, and the rural energy poverty index is higher than 0.641. In theoretical terms, this study identifies rural energy poverty as a critical determinant of primary healthcare efficiency, thereby addressing an important gap in the existing literature. At the policy level, the findings emphasize the necessity for integrated measures targeting both rural energy poverty and primary healthcare inefficiencies to achieve SDG 3 and sustainably promote equitable, high-quality healthcare access in rural China. Full article
(This article belongs to the Section Systems Practice in Social Science)
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21 pages, 2365 KiB  
Article
Development of an Optimization Algorithm for Designing Low-Carbon Concrete Materials Standardization with Blockchain Technology and Ensemble Machine Learning Methods
by Zilefac Ebenezer Nwetlawung and Yi-Hsin Lin
Buildings 2025, 15(16), 2809; https://doi.org/10.3390/buildings15162809 - 8 Aug 2025
Viewed by 414
Abstract
This study presents SmartMix Web3, a framework combining ensemble machine learning and blockchain technology to optimize low-carbon concrete design. It addresses two key challenges: (1) the limitations of conventional models in predicting concrete performance, and (2) ensuring data reliability and overcoming collaboration issues [...] Read more.
This study presents SmartMix Web3, a framework combining ensemble machine learning and blockchain technology to optimize low-carbon concrete design. It addresses two key challenges: (1) the limitations of conventional models in predicting concrete performance, and (2) ensuring data reliability and overcoming collaboration issues in AI-driven sustainable construction. Validated with 61 real-world experiments in Cameroon and 752 mix designs, the framework shows major improvements in predictive accuracy and decentralized trust. To address the first research question, a stacked ensemble model comprising Extreme Gradient Boosting (XGBoost)–Random Forest and a Convolutional Neural Network (CNN) was developed, achieving a 22% reduction in Root Mean Square Error (RMSE) for compressive strength prediction and embodied carbon estimation compared to traditional methods. The 29% reduction in Mean Absolute Error (MAE) results confirms the superiority of Extreme Learning Machine (EML) in low-carbon concrete performance prediction. For the second research question, SmartMix Web3 employs blockchain to ensure tamper-proof traceability and promote collaboration. Deployed on Ethereum, it automates verification of tokenized Environmental Product Declarations via smart contracts, reducing disputes and preserving data integrity. Federated learning supports decentralized training across nine batching plants, with Secure Hash Algorithm (SHA)-256 checks ensuring privacy. Field implementation in Cameroon yielded annual cost savings of FCFA 24.3 million and a 99.87 kgCO2/m3 reduction per mix design. By uniting EML precision with blockchain transparency, SmartMix Web3 offers practical and scalable benefits for sustainable construction in developing economies. Full article
(This article belongs to the Section Building Materials, and Repair & Renovation)
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21 pages, 1187 KiB  
Article
Identification of Bottlenecks in Passenger Handling Processes Using Data-Driven Tools
by Edina Jenčová, Tatiana Gajdušková, Martin Jezný and Pavol Hudák
Appl. Sci. 2025, 15(15), 8760; https://doi.org/10.3390/app15158760 - 7 Aug 2025
Viewed by 193
Abstract
The paper focuses on the identification of “bottlenecks” in the passenger handling process at the airports. In the current era of digital transformation and the emergence of Industry 4.0 and 5.0 concepts, optimizing passenger flows through data-driven tools is becoming an essential part [...] Read more.
The paper focuses on the identification of “bottlenecks” in the passenger handling process at the airports. In the current era of digital transformation and the emergence of Industry 4.0 and 5.0 concepts, optimizing passenger flows through data-driven tools is becoming an essential part of intelligent airport management. While many solutions focus on high-end software or AI-based systems, this study demonstrates the value of preparatory models built in widely accessible platforms such as Microsoft Excel. A simulation model was developed to analyze check-in and security screening, integrating discrete event simulation (DES), queueing theory, and elements of Monte Carlo simulation. The model enables the segmentation of the handling process into key events, including probabilistically generated arrivals and service durations. Although the model is built in a basic environment, it serves as a prototype platform for potential integration into broader digitalization strategies, offering a preparatory framework for future implementation in more sophisticated systems. Full article
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30 pages, 4817 KiB  
Article
A Robust Multi-Port Network Interface Architecture with Real-Time CRC-Based Fault Recovery for In-Vehicle Communication Networks
by Sungju Lee, Sungwook Yu and Taikyeong Jeong
Actuators 2025, 14(8), 391; https://doi.org/10.3390/act14080391 - 7 Aug 2025
Viewed by 280
Abstract
As the automotive industry continues to evolve rapidly, there is a growing demand for high-throughput reliable communication systems within vehicles. This paper presents the implementation and verification of a fault-tolerant Ethernet-based communication protocol tailored for automotive applications operating at 1 Gbps and above. [...] Read more.
As the automotive industry continues to evolve rapidly, there is a growing demand for high-throughput reliable communication systems within vehicles. This paper presents the implementation and verification of a fault-tolerant Ethernet-based communication protocol tailored for automotive applications operating at 1 Gbps and above. The proposed system introduces a multi-port Network Interface Controller (NIC) architecture that supports real-time communication and robust fault handling. To ensure adaptability across various in-vehicle network (IVN) scenarios, the system allows for configurable packet sizes and transmission rates and supports diverse data formats. The architecture integrates cyclic redundancy check (CRC)-based error detection, real-time recovery mechanisms, and file-driven data injection techniques. Functional validation is performed using Verilog HDL simulations, demonstrating deterministic timing behavior, modular scalability, and resilience under fault injection. This paper presents a fault-tolerant Network Interface Controller (NIC), architecture incorporating CRC-based error detection, real-time recovery logic, and file-driven data injection. The system is verified through Verilog HDL simulation, demonstrating correct timing behavior, modular scalability, and robustness against injected transmission faults. Compared to conventional dual-port NICs, the proposed quad-port architecture demonstrates superior scalability and error tolerance under injected fault conditions. Experimental results confirm that the proposed NIC architecture achieves stable multi-port communication under embedded automotive environments. This study further introduces a novel quad-port NIC with an integrated fault injection algorithm and evaluates its performance in terms of error tolerance. Full article
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18 pages, 2653 KiB  
Article
Clustering of Countries Through UMAP and K-Means: A Multidimensional Analysis of Development, Governance, and Logistics
by Enrique Delahoz-Domínguez, Adel Mendoza-Mendoza and Delimiro Visbal-Cadavid
Logistics 2025, 9(3), 108; https://doi.org/10.3390/logistics9030108 - 7 Aug 2025
Viewed by 338
Abstract
Background: Growing disparities in development, governance, and logistics performance across countries pose challenges for global policymaking and Sustainable Development Goal (SDG) monitoring. This study proposes a classification of 137 countries based on multiple structural dimensions. The dataset for 2023 includes six components [...] Read more.
Background: Growing disparities in development, governance, and logistics performance across countries pose challenges for global policymaking and Sustainable Development Goal (SDG) monitoring. This study proposes a classification of 137 countries based on multiple structural dimensions. The dataset for 2023 includes six components of the Logistics Performance Index (LPI), six dimensions of the Worldwide Governance Indicators (WGIs), and four proxies of the Human Development Index (HDI). Methods: The Uniform Manifold Approximation and Projection (UMAP) technique was used to reduce dimensionality and allow for meaningful clustering. Based on the reduced space, the K-means algorithm was employed to group countries with similar development characteristics. Results: The classification process allowed the identification of three distinct groups of countries, supported by a Hopkins statistic of 0.984 and an explained variance ratio of 87.3%. These groups exhibit structural differences in the quality of governance, logistics capacity, and social development conditions. Internal consistency checks and multivariate statistical analyses (ANOVA and MANOVA) confirmed the robustness and statistical significance of the clustering. Conclusions: The resulting classification offers a practical analytical tool for policymakers to design differentiated strategies aligned with national contexts. Furthermore, it provides a data-driven approach for comparative monitoring of the SDGs from an integrated and empirical perspective. Full article
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10 pages, 616 KiB  
Communication
Brief Prompt-Engineering Clinic Substantially Improves AI Literacy and Reduces Technology Anxiety in First-Year Teacher-Education Students: A Pre–Post Pilot Study
by Roberto Carlos Davila-Moran, Juan Manuel Sanchez Soto, Henri Emmanuel Lopez Gomez, Manuel Silva Infantes, Andres Arias Lizares, Lupe Marilu Huanca Rojas and Simon Jose Cama Flores
Educ. Sci. 2025, 15(8), 1010; https://doi.org/10.3390/educsci15081010 - 6 Aug 2025
Viewed by 452
Abstract
Generative AI tools such as ChatGPT are reshaping educational practice, yet first-year teacher-education students often lack the prompt-engineering skills and confidence required to use them responsibly. This pilot study examined whether a concise three-session clinic on prompt engineering could simultaneously boost AI literacy [...] Read more.
Generative AI tools such as ChatGPT are reshaping educational practice, yet first-year teacher-education students often lack the prompt-engineering skills and confidence required to use them responsibly. This pilot study examined whether a concise three-session clinic on prompt engineering could simultaneously boost AI literacy and reduce technology anxiety in prospective teachers. Forty-five freshmen in a Peruvian teacher-education program completed validated Spanish versions of a 12-item AI-literacy scale and a 12-item technology-anxiety scale one week before and after the intervention; normality-checked pre–post differences were analysed with paired-samples t-tests, Cohen’s d, and Pearson correlations. AI literacy rose by 0.70 ± 0.46 points (t (44) = −6.10, p < 0.001, d = 0.91), while technology anxiety fell by 0.58 ± 0.52 points (t (44) = −3.82, p = 0.001, d = 0.56); individual gains were inversely correlated (r = −0.46, p = 0.002). These findings suggest that integrating micro-level prompt-engineering clinics in the first semester can help future teachers engage critically and comfortably with generative AI and guide curriculum designers in updating teacher-training programs. Full article
(This article belongs to the Special Issue ChatGPT as Educative and Pedagogical Tool: Perspectives and Prospects)
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18 pages, 973 KiB  
Article
Machine Learning-Based Vulnerability Detection in Rust Code Using LLVM IR and Transformer Model
by Young Lee, Syeda Jannatul Boshra, Jeong Yang, Zechun Cao and Gongbo Liang
Mach. Learn. Knowl. Extr. 2025, 7(3), 79; https://doi.org/10.3390/make7030079 - 6 Aug 2025
Viewed by 380
Abstract
Rust’s growing popularity in high-integrity systems requires automated vulnerability detection in order to maintain its strong safety guarantees. Although Rust’s ownership model and compile-time checks prevent many errors, sometimes unexpected bugs may occasionally pass analysis, underlining the necessity for automated safe and unsafe [...] Read more.
Rust’s growing popularity in high-integrity systems requires automated vulnerability detection in order to maintain its strong safety guarantees. Although Rust’s ownership model and compile-time checks prevent many errors, sometimes unexpected bugs may occasionally pass analysis, underlining the necessity for automated safe and unsafe code detection. This paper presents Rust-IR-BERT, a machine learning approach to detect security vulnerabilities in Rust code by analyzing its compiled LLVM intermediate representation (IR) instead of the raw source code. This approach offers novelty by employing LLVM IR’s language-neutral, semantically rich representation of the program, facilitating robust detection by capturing core data and control-flow semantics and reducing language-specific syntactic noise. Our method leverages a graph-based transformer model, GraphCodeBERT, which is a transformer architecture pretrained model to encode structural code semantics via data-flow information, followed by a gradient boosting classifier, CatBoost, that is capable of handling complex feature interactions—to classify code as vulnerable or safe. The model was evaluated using a carefully curated dataset of over 2300 real-world Rust code samples (vulnerable and non-vulnerable Rust code snippets) from RustSec and OSV advisory databases, compiled to LLVM IR and labeled with corresponding Common Vulnerabilities and Exposures (CVEs) identifiers to ensure comprehensive and realistic coverage. Rust-IR-BERT achieved an overall accuracy of 98.11%, with a recall of 99.31% for safe code and 93.67% for vulnerable code. Despite these promising results, this study acknowledges potential limitations such as focusing primarily on known CVEs. Built on a representative dataset spanning over 2300 real-world Rust samples from diverse crates, Rust-IR-BERT delivers consistently strong performance. Looking ahead, practical deployment could take the form of a Cargo plugin or pre-commit hook that automatically generates and scans LLVM IR artifacts during the development cycle, enabling developers to catch vulnerabilities at an early stage in the development cycle. Full article
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27 pages, 4690 KiB  
Article
Research and Development of Test Automation Maturity Model Building and Assessment Methods for E2E Testing
by Daiju Kato, Ayane Mogi, Hiroshi Ishikawa and Yasufumi Takama
Software 2025, 4(3), 19; https://doi.org/10.3390/software4030019 - 5 Aug 2025
Viewed by 331
Abstract
Background: While several test-automation maturity models (e.g., CMMI, TMMi, TAIM) exist, none explicitly integrate ISO 9001-based quality management systems (QMS), leaving a gap for organizations that must align E2E test automation with formal quality assurance. Objective: This study proposes a test-automation maturity model [...] Read more.
Background: While several test-automation maturity models (e.g., CMMI, TMMi, TAIM) exist, none explicitly integrate ISO 9001-based quality management systems (QMS), leaving a gap for organizations that must align E2E test automation with formal quality assurance. Objective: This study proposes a test-automation maturity model (TAMM) that bridges E2E automation capability with ISO 9001/ISO 9004 self-assessment principles, and evaluates its reliability and practical impact in industry. Methods: TAMM comprises eight maturity dimensions, 39 requirements, and 429 checklist items. Three independent assessors applied the checklist to three software teams; inter-rater reliability was ensured via consensus review (Cohen’s κ = 0.75). Short-term remediation actions based on the checklist were implemented over six months and re-assessed. Synergy with the organization’s ISO 9001 QMS was analyzed using ISO 9004 self-check scores. Results: Within 6 months of remediation, mean TAMM score rose from 2.75 → 2.85. Inter-rater reliability is filled with Cohen’s κ = 0.75. Conclusions: The proposed TAMM delivers measurable, short-term maturity gains and complements ISO 9001-based QMS without introducing conflicting processes. Practitioners can use the checklist to identify actionable gaps, prioritize remediation, and quantify progress, while researchers may extend TAMM to other domains or automate scoring via repository mining. Full article
(This article belongs to the Special Issue Software Reliability, Security and Quality Assurance)
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18 pages, 810 KiB  
Article
The Impact of Technology, Economic Development, Environmental Quality, Safety, and Exchange Rate on the Tourism Performance in European Countries
by Zeki Keşanlı, Feriha Dikmen Deliceırmak and Mehdi Seraj
Sustainability 2025, 17(15), 7074; https://doi.org/10.3390/su17157074 - 4 Aug 2025
Viewed by 262
Abstract
The study investigates the contribution of technology (TECH), quantified by Internet penetration, in influencing tourism performance (TP) among the top ten touristic nations in Europe: France, Spain, Italy, Turkey, the United Kingdom, Germany, Greece, Austria, Portugal, and the Netherlands. Using panel data from [...] Read more.
The study investigates the contribution of technology (TECH), quantified by Internet penetration, in influencing tourism performance (TP) among the top ten touristic nations in Europe: France, Spain, Italy, Turkey, the United Kingdom, Germany, Greece, Austria, Portugal, and the Netherlands. Using panel data from 2000–2022, the study includes additional structural controls like environment quality, gross domestic production (GDP) per capita, exchange rate (ER), and safety index (SI). The Method of Moments Quantile Regression (MMQR) is employed to capture heterogeneous effects at different levels of TP, and Driscoll–Kraay standard error (DKSE) correction is employed to make the analysis robust against autocorrelation as well as cross-sectional dependence. Spectral–Granger causality tests are also conducted to check short- and long-run dynamics in the relationships. Empirical results are that TECH and SI are important in TP at all quantiles, but with stronger effects for lower-performing countries. Environmental quality (EQ) and GDP per capita (GDPPC) exert increasing impacts at upper quantiles, suggesting their importance in sustaining high-level tourism economies. ER effects are limited and primarily short-term. The findings highlight the need for integrated digital, environmental, and economic policies to achieve sustainable tourism development. The paper contributes to tourism research by providing a comprehensive, frequency-sensitive, and distributional analysis of macroeconomic determinants of tourism in highly developed European tourist destinations. Full article
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36 pages, 1202 KiB  
Article
Exploring Service Needs and Development Strategies for the Healthcare Tourism Industry Through the APA-NRM Technique
by Chung-Ling Kuo and Chia-Li Lin
Sustainability 2025, 17(15), 7068; https://doi.org/10.3390/su17157068 - 4 Aug 2025
Viewed by 285
Abstract
With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism [...] Read more.
With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism and medical services, which is health tourism. This growing demand has prompted many service providers to see it as a business opportunity and enter the market. Tourism can help travelers release work stress and restore physical and mental balance; meanwhile, health check-ups and disease treatment can help them regain health. Consumers have long favored health and medical tourism because it helps relieve stress and promotes overall well-being. As people age, some consumers experience a gradual decline in physical functions, making it difficult for them to participate in regular travel services provided by traditional travel agencies. Therefore, this study aims to explore the service needs of health and medical tourism customers (tourists/patients) and the interrelationships among these service needs, so that health and medical tourism service providers can develop more customized and diversified services. This study identifies four key drivers of medical tourism services: medical services, medical facilities, tour planning, and hospitality facilities. This study uses the APA (attention and performance analysis) method to assess each dimension and criterion and utilizes the DEMATEL method with the NRM (network relationship map) to identify network relationships. By combining APA and NRM techniques, this study develops the APA-NRM technique to evaluate adoption strategies and identify suitable paths for health tourism services, providing tailored development strategies and recommendations for service providers to enhance the service experience. Full article
(This article belongs to the Special Issue Inclusive Tourism and Its Place in Sustainable Development Concepts)
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21 pages, 328 KiB  
Review
Adjuvant Immunotherapy in Stage IIB/IIC Melanoma: Current Evidence and Future Directions
by Ivana Prkačin, Ana Brkić, Nives Pondeljak, Mislav Mokos, Klara Gaćina and Mirna Šitum
Biomedicines 2025, 13(8), 1894; https://doi.org/10.3390/biomedicines13081894 - 4 Aug 2025
Viewed by 496
Abstract
Background: Patients with resected stage IIB and IIC melanoma are at high risk of recurrence and distant metastasis, despite surgical treatment. The recent emergence of immune checkpoint inhibitors (ICIs) has led to their evaluation in the adjuvant setting for early-stage disease. This [...] Read more.
Background: Patients with resected stage IIB and IIC melanoma are at high risk of recurrence and distant metastasis, despite surgical treatment. The recent emergence of immune checkpoint inhibitors (ICIs) has led to their evaluation in the adjuvant setting for early-stage disease. This review aims to synthesize current evidence regarding adjuvant immunotherapy for stage IIB/IIC melanoma, explore emerging strategies, and highlight key challenges and future directions. Methods: We conducted a comprehensive literature review of randomized clinical trials, observational studies, and relevant mechanistic and biomarker research on adjuvant therapy in stage IIB/IIC melanoma. Particular focus was placed on pivotal trials evaluating PD-1 inhibitors (KEYNOTE-716 and CheckMate 76K), novel vaccine and targeted therapy trials, mechanisms of resistance, immune-related toxicity, and biomarker development. Results: KEYNOTE-716 and CheckMate 76K demonstrated significant improvements in recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) with pembrolizumab and nivolumab, respectively, compared to placebo. However, no definitive overall survival benefit has yet been shown. Adjuvant immunotherapy is linked to immune-related adverse events, including permanent endocrinopathies. Emerging personalized approaches, such as circulating tumor DNA monitoring and gene expression profiling, may enhance patient selection, but remain investigational. Conclusions: Adjuvant PD-1 blockade offers clear RFS benefits in high-risk stage II melanoma, but optimal patient selection remains challenging, due to uncertain overall survival benefit and toxicity concerns. Future trials should integrate biomarker-driven approaches to refine therapeutic decisions and minimize overtreatment. Full article
(This article belongs to the Section Gene and Cell Therapy)
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