Seamless integration of air segment in the overall multimodal mobility chain is a key challenge to provide more efficient and sustainable transport services. Technology advances offer a unique opportunity to build a new generation of transport services able to match the evolving expectations and needs of society as a whole. In this context, the passenger-centric approach represents a method to inform the design of future mobility services, supporting quality of life, security and services to citizens traveling across Europe. Relying on the concepts of inclusive design, context of use and task analysis, in this article, we present a comprehensive methodological framework for the analysis of passenger characteristics to elicit features and requirements for future multimodal mobility services, including air leg, that are relevant from the perspective of passengers. The proposed methodology was applied to a series of specific use cases envisaged for three time horizons, 2025, 2035 and 2050, in the context of a European research project. Then, passenger-focused key performance indicators and related metrics were derived to be included in a validation step, with the aim of assessing the extent of benefit for passengers that can be achieved in the forecasted scenarios. The results of the study demonstrate the relevance of human variability in the design of public services, as well as the feasibility of personalized performance assessment of mobility services.
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It is expected that future transportation technologies will positively impact how passengers travel to their destinations. Europe aims to integrate air transport into the overall multimodal transport network to provide better service to passengers, while reducing travel time and making the network more resilient to disruptions. This study presents an approach that investigates these aspects by developing a simulation platform consisting of different models, allowing us to simulate the complete door-to-door trajectory of passengers. To address the future potential, we devised scenarios considering three time horizons: 2025, 2035, and 2050. The experimental design allowed us to identify potential obstacles for future travel, the impact on the system’s resilience, and how the integration of novel technology affects proxy indicators of the level of service, such as travel time or speed. In this paper, we present for the first time an innovative methodology that enables the modelling and simulation of door-to-door travel to investigate the future performance of the transport network. We apply this methodology to the case of a travel trajectory from Germany to Amsterdam considering a regional and a hub airport; it was built considering current information and informed assumptions for future horizons. Results indicate that, with the new technology, the system becomes more resilient and generally performs better, as the mean speed and travel time are improved. Furthermore, they also indicate that the performance could be further improved considering other elements such as algorithmic governance.
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Multimodal prehabilitation programs to improve physical fitness before surgery often include nutritional interventions. This study evaluates the efficacy of and adherence to a nutritional intervention among colorectal and esophageal cancer patients undergoing the multimodal Fit4Surgery prehabilitation program. The intervention aims to achieve an intake of ≥1.5 g of protein/kg body weight (BW) per day through dietary advice and daily nutritional supplementation (30 g whey protein). This study shows 56.3% of patients met this goal after prehabilitation. Mean daily protein intake significantly increased from 1.20 ± 0.39 g/kg BW at baseline to 1.61 ± 0.41 g/kg BW after prehabilitation (p < 0.001), with the main increase during the evening snack. BW, BMI, 5-CST, and protein intake at baseline were associated with adherence to the nutritional intervention. These outcomes suggest that dietary counseling and protein supplementation can significantly improve protein intake in different patient groups undergoing a multimodal prehabilitation program.
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This article provides a description of the emergence of the Spanish ‘Occupy’ movement, Democracia real ya. The aim is to analyse the innovative discursive features of this movement and to connect this analysis to what we consider the innovative potential of the critical sciences. The movement is the result of a spontaneous uprising that appeared on the main squares of Madrid and Barcelona on 15 May 2011 and then spread to other Spanish cities. This date gave it its name: 15M. While the struggle for democracy in Spain is certainly not new, the 15M group shows a series of innovative features. These include the emphasis on peaceful struggle and the imaginary of a new democracy or worldview, transmitted through innovative placards and slogans designed by Spanish citizens. We consider these innovative not only due to their creativity, but also because of their use as a form of civil action. Our argument is that these placards both functioned as a sign of protest and, in combination with the demonstrations and the general dynamics of 15M, helped to reframe the population’s understanding of the crisis and rearticulate the identity of the citizens from victims to agents. In order to analyse the multimodal character of this struggle, we developed an interdisciplinary methodology, which combines socio-cognitive approaches that consider ideological proposals as socio-cognitive constructs (i.e. the notion of narrative or cognitive frame), and Critical Discourse Analysis (CDA) in the analysis of discourses related to processes of social imagination and transformation. The socio-constructivist perspective is used to consider these discourses in relation to their actors, particular contexts and actions. The use of CDA, which included a careful rhetoric analysis, helped to analyse the process of deconstruction, transformation and reconstruction that 15M uses to maintain its struggle. The narrative analysis and the discursive theoretical concept of articulation helped to methodologically show aspects of the process of change alluded to above. This change was both in terms of cognition and in the modification of identity that turned a large part of the Spanish population from victims to indignados and to the neologism indignadanos, which is a composition of indignado and ciudadano (citizen).
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Introduction Radical cystectomy (RC) is the standard treatment for patients with non-metastatic muscle-invasive bladder cancer, as well as for patients with therapy refractory high-risk non-muscle invasive bladder cancer. However, 50–65% of patients undergoing RC experience perioperative complications. The risk, severity and impact of these complications is associated with a patient’s preoperative cardiorespiratory fitness, nutritional and smoking status and presence of anxiety and depression. There is emerging evidence supporting multimodal prehabilitation as a strategy to reduce the risk of complications and improve functional recovery after major cancer surgery. However, for bladder cancer the evidence is still limited. The aim of this study is to investigate the superiority of a multimodal prehabilitation programme versus standard-of-care in terms of reducing perioperative complications in patients with bladder cancer undergoing RC.Methods and analysis This multicentre, open label, prospective, randomised controlled trial, will include 154 patients with bladder cancer undergoing RC. Patients are recruited from eight hospitals in The Netherlands and will be randomly (1:1) allocated to the intervention group receiving a structured multimodal prehabilitation programme of approximately 3–6 weeks, or to the control group receiving standard-of-care. The primary outcome is the proportion of patients who develop one or more grade ≥2 complications (according to the Clavien-Dindo classification) within 90 days of surgery. Secondary outcomes include cardiorespiratory fitness, length of hospital stay, health-related quality of life, tumour tissue biomarkers of hypoxia, immune cell infiltration and cost-effectiveness. Data collection will take place at baseline, before surgery and 4 and 12 weeks after surgery.Ethics and dissemination Ethical approval for this study was granted by the Medical Ethics Committee NedMec (Amsterdam, The Netherlands) under reference number 22–595/NL78792.031.22. Results of the study will be published in international peer-reviewed journals.Trial registration number NCT05480735.
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People with a visual impairment (PVI) often experience difficulties with wayfinding. Current navigation applications have limited communication channels and do not provide detailed enough information to support PVI. By transmitting wayfinding information via multimodal channels and combining these with wearables, we can provide tailored information for wayfinding and reduce the cognitive load. This study presents a framework for multimodal wayfinding communication via smartwatch. The framework consists of four modalities: audio, voice, tactile and visual. Audio and voice messages are transmitted using a bone conduction headphone, keeping the ears free to focus on the environment. With a smartwatch vibrations are directed to a sensitive part of the body (i.e., the wrist), making it easier to sense the vibrations. Icons and short textual feedback are viewed on the display of the watch, allowing for hands-free navigation.
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Interdisciplinary multimodal pain therapy (IMPT) is a biopsychosocial treatment approach for patients with chronic pain that comprises at least psychological and physiotherapeutic interventions. Core outcome sets (COSs) are currently developed in different medical fields to standardize and improve the selection of outcome domains, and measurement instruments in clinical trials, to make trial results meaningful, to pool trial results, and to allow indirect comparison between interventions. The objective of this study was to develop a COS of patient-relevant outcome domains for chronic pain in IMPT clinical trials. An international, multiprofessional panel (patient representatives [n = 5], physicians specialized in pain medicine [n = 5], physiotherapists [n = 5], clinical psychologists [n = 5], and methodological researchers [n = 5]) was recruited for a 3-stage consensus study, which consisted of a mixed-method approach comprising an exploratory systematic review, a preparing online survey to identify important outcome domains, a face-to-face consensus meeting to agree on COS domains, and a second online survey (Delphi) establishing agreement on definitions for the domains included. The panel agreed on the following 8 domains to be included into the COS for IMPT: pain intensity, pain frequency, physical activity, emotional wellbeing, satisfaction with social roles and activities, productivity (paid and unpaid, at home and at work, inclusive presentism and absenteeism), health-related quality of life, and patient's perception of treatment goal achievement. The complexity of chronic pain in a biopsychosocial context is reflected in the current recommendation and includes physical, mental, and social outcomes. In a subsequent step, measurement instruments will be identified via systematic reviews.
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Anxiety among pregnant women can significantly impact their overall well-being. However, the development of data-driven HCI interventions for this demographic is often hindered by data scarcity and collection challenges. In this study, we leverage the Empatica E4 wristband to gather physiological data from pregnant women in both resting and relaxed states. Additionally, we collect subjective reports on their anxiety levels. We integrate features from signals including Blood Volume Pulse (BVP), Skin Temperature (SKT), and Inter-Beat Interval (IBI). Employing a Support Vector Machine (SVM) algorithm, we construct a model capable of evaluating anxiety levels in pregnant women. Our model attains an emotion recognition accuracy of 69.3%, marking achievements in HCI technology tailored for this specific user group. Furthermore, we introduce conceptual ideas for biofeedback on maternal emotions and its interactive mechanism, shedding light on improved monitoring and timely intervention strategies to enhance the emotional health of pregnant women.
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The project X-TEAM D2D (Extended ATM for Door-to-Door Travel) has been funded by SESAR JU in 2020 and completed its activities in 2022, pursuing and accomplishing the definition, development and initial assessment of a Concept of Operations (ConOps) for the seamless integration of ATM and air transport into an overall intermodal network, including other available transportation means (surface, water), to support the door-to-door connectivity, in up to 4 hours, between any location in Europe. The project addressed the ATM and air transport, including Urban Air Mobility (UAM), integration in the overall transport network serving urban and extended urban (up to regional level) mobility, specifically identifying and considering the transportation and passengers service scenarios expected for the near, medium and long-term future, i.e. for the project baseline (2025), intermediate (2035) and final (2050) time horizons. In this paper, the main outcomes from the project activities are summarized, with particular emphasis on the studies about the definition of future scenarios and use cases for the integration of the vertical transport with the surface transport towards integrated intermodal transport system and about identification of the barriers towards this goal. In addition, an outline is provided on the specific ConOps for the integration of ATM in intermodal transport infrastructure (i.e. the part of the overall ConOps devoted to integration of different transportation means) and on the specific ConOps for the integration of ATM in intermodal service to passengers (i.e. the specific component of the ConOps devoted to design of a unique service to passengers). Finally, the main outcomes are summarized from the validation of the proposed ConOps through dedicated simulations.
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It is expected that future transportation technologies will positively impact how passengers travel to their destinations. Europe aims to integrate air transport into the overall multimodal transport network to provide better service to passengers, while reducing travel time and making the network more resilient to disruptions. This study presents an approach that investigates these aspects by developing a simulation platform consisting of different models, allowing us to simulate the complete door-to-door trajectory of passengers. To address the future potential, we devised scenarios considering three time horizons: 2025, 2035, and 2050. The experimental design allowed us to identify potential obstacles for future travel, the impact on the system’s resilience, and how the integration of novel technology affects proxy indicators of the level of service, such as travel time or speed. In this paper, we present for the first time an innovative methodology that enables the modelling and simulation of door-to-door travel to investigate the future performance of the transport network. We apply this methodology to the case of a travel trajectory from Germany to Amsterdam considering a regional and a hub airport; it was built considering current information and informed assumptions for future horizons. Results indicate that, with the new technology, the system becomes more resilient and generally performs better, as the mean speed and travel time are improved. Furthermore, they also indicate that the performance could be further improved considering other elements such as algorithmic governance.
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