Search Results (1,418)

Background/Objectives: Maintaining independent mobility among older adults requires complex cognitive and physical health and is influenced by various health-related factors. This study sought to examine the relationship between health-related factors and driving among community-dwelling older adults by comparing the health status of currently driving individuals and those who have ceased driving. Methods: A secondary data analysis was conducted using the 2023 Korean Elderly Survey, collected between 4 September and 12 November 2023. A total of 4114 individuals aged 65 years or older were included. Statistical analyses were performed using chi-square tests, independent t-tests, and weighted binary logistic regressions via IBM SPSS for Windows. Results: Significant health-related factors for driving cessation included having ≥2 chronic diseases (OR = 1.22, p = 0.041), diagnosed depression (OR = 3.64, p = 0.030), Instrumental Activities of Daily Living dependency (OR = 1.67, p = 0.001), visual discomfort (OR = 1.18, p = 0.048), depression risk (OR = 1.34, p = 0.015), suspected cognitive impairment (OR = 1.73, p < 0.001), and poor self-rated health (OR = 1.21, p = 0.029). None of the participants with Parkinson’s were currently driving, whereas polypharmacy (≥5 medications) was not statistically significant (OR = 0.77, p = 0.222). Chronic diseases that may affect driving were also not statistically significant. Conclusions: This study highlights the fact that older drivers may have difficulty recognizing health-related risks that affect driving. To support safe mobility, it is essential to implement a health-centered assessment of driving fitness, including an appropriate evaluation cycle, and promote continuous education to raise awareness among older adults. Full article

This study examines the determinants of financial sustainability in Turkish maritime industry by analyzing firm-level panel data from 190 ship and boat maintenance firms and 208 coastal shipping companies for the 2010–2022 period, comprising 5174 firm-year observations. Fixed-effects models with Driscoll–Kraay robust standard errors are employed to evaluate how asset structure, liquidity, and energy efficiency jointly affect firm profitability across subsectors, using the Operating Return on Assets (OROA) as the principal indicator of operational performance. The empirical results indicate substantial heterogeneity between maintenance and shipping firms. For maintenance firms, OROA shows a positive association with the Non-Current Assets to Total Assets ratio (NCATA) and the Economic Efficiency Ratio (EER) but a negative association with the Current Ratio (CR), suggesting that capital deepening and operational efficiency tend to correlate with stronger performance, whereas excess liquidity is associated with weaker outcomes. For shipping firms, OROA is positively associated with EER and Total Asset Turnover (TATR) but negatively associated with Fixed Asset Turnover (FATR) and CR, indicating relationships consistent with efficiency gains from energy management and asset utilization but linkages suggesting challenges from fleet aging and liquidity mismanagement. Overall, the findings suggest that the drivers of financial sustainability are associated with different structural conditions across maritime subsectors, highlighting the importance of targeted modernization, port efficiency, and energy-transition investment strategies. Full article

Road traffic accidents are a major global public health concern, ranking among the top three causes of death worldwide and constituting the leading cause of death among individuals aged 15–29. Monitoring traffic safety status and trends is a vital element of effective road safety management. This study investigates road traffic casualties involving young car drivers (aged 18–24) in the Republic of Serbia from 1997 to 2024, analyzing historical patterns and introducing a predictive model for casualty outcomes. The analytical framework employs machine learning techniques, specifically Long Short-Term Memory (LSTM) networks, to estimate the number of casualties (FSI = Fatal + Serious Injuries) based on various contributing factors. Accurate prediction of accident outcomes is essential for designing targeted road safety measures and reducing casualty numbers. Full article

Mitochondrial dysfunction and oxidative stress have been suggested as potential contributors to the initiation and progression of primary open-angle glaucoma (POAG). Nicotinamide and pyruvate are important in the human body for maintaining metabolic function and preserving cytoskeletal structures. Both substances show an age-dependent decline in humans which may contribute to metabolic dysfunction and POAG vulnerability. Pilot works suggest their consumption may help prevent retinal ganglion cell deterioration under elevated intraocular pressure (IOP) and oxidative stress. Currently, there are no approved POAG treatments to mitigate risks from non-IOP drivers of disease, including oxidative stress. The purpose of this review is to summarize and critically evaluate interventional studies that have investigated nicotinamide and pyruvate supplementation in attempts to treat metabolic dysfunction in POAG patients. A review of the relevant literature from October 1979 to November 2025 was performed using related search terminologies through PubMed, ClinicalTrials.gov, and Google Scholar, and by reference cross-matching of all related articles. Current pilot data suggests that supplementation with nicotinamide and pyruvate demonstrates certain aspects of retinal neuroprotection and produces short-term improvements in visual function. However, much of the existing work has been conducted in animal models, and human study data are severely limited in scope and duration. Several clinical trials are registered as being in progress that aim to determine the chronic effects of nicotinamide and pyruvate in humans. Long-term longitudinal investigations with significantly larger and diverse sample sizes tied to functional and structural outcomes are needed for the safety and potential clinical utility of nicotinamide and pyruvate for POAG. Full article

Laboratory-simulated aging fails to fully replicate the complex aging behavior of asphalt binder under actual environmental conditions. This study aims to preliminarily investigate and analyze the differences between natural aging and PAV aging of asphalt binder. To achieve this objective, the asphalt binder was aged using three distinct methods: PAV aging, natural thermal-oxidative aging, and all-weather aging. The divergence in asphalt binder aging behavior was systematically investigated through encompassing low-temperature performance, chemical structure, elemental composition, molecular weight, and macroscopic and microscopic performance correlation analyses. Key findings include: the harsh environment in the cold and arid regions resulted in inferior low-temperature performance of asphalt binder after 12 months of natural thermal-oxidative and all-weather aging compared to PAV-aged asphalt binder, with the stiffness modulus at −12 °C increasing by 114.8% and 105.3%, respectively. Natural aging induced more significant asphalt binder’s chemical structural changes than PAV aging but exhibited less prominent oxidative reactions and macromolecular structure formation. Whether from a macroscopic or microscopic perspective, thermal-oxidative conditions were identified as the primary driver behind both the natural aging behavior and the aging pathway of asphalt binder. The influence of other factors on the aging behavior of asphalt binder was not significant. The poor correlation (R² < 0.62) between oxygen content, molecular weight, and low-temperature performance across different aging modes underscores a fundamental divergence in aging pathways between PAV and natural aging. This study preliminarily identifies the key differences between laboratory-accelerated aging and natural aging of asphalt binder and paves the way for optimizing the parameters of laboratory-accelerated aging protocols. Full article

Human papillomavirus (HPV) vaccination is a cornerstone of cancer prevention across genders. In the United Kingdom (UK), the programme now includes boys, yet uptake remains below target, with persistent disparities by gender and region. This commentary examines the drivers of these gaps, including the historical framing of the HPV vaccine as a vaccine for girls, limited public awareness of boys’ eligibility, and challenges in school-based delivery. Gendered misconceptions, cultural norms, and inadequate communication continue to limit uptake in boys, while healthcare professionals, including general practitioners, dentists, and pharmacists, remain underused in supporting vaccine access and tackling parental hesitancy. Schools are central to equitable delivery, but teachers often lack training and possess low-to-moderate knowledge of HPV-related topics, including HPV vaccination availability for boys and HPV-related cancers affecting men. Drawing on health behaviour theory, we propose evidence-informed, multi-level recommendations to improve uptake, from gender-inclusive messaging and more efficient consent processes to digital engagement tools that support parents. We also highlight our ongoing research into parental attitudes toward HPV vaccination for boys aged 9–12 in England, which will inform future targeted interventions and policy development. Full article

ROS1 gene rearrangements define a distinct molecular subtype of non-small cell lung cancer (NSCLC), occurring in approximately 2% of cases and frequently associated with younger age, non-smoker status, and a high incidence of brain metastases. The discovery of ROS1 as an oncogenic driver has led to the development of targeted tyrosine kinase inhibitors (TKIs). Crizotinib first demonstrated substantial clinical benefit, but its limitations, including poor central nervous system (CNS) penetration and acquired resistance, highlighted the need for next-generation inhibitors. Several agents have since been developed, including entrectinib, lorlatinib, repotrectinib, taletrectinib, and zidesamtinib, each offering improved intracranial (IC) activity and efficacy against resistance mutations, notably ROS1^G2032R. Despite these advances, optimal sequencing strategies remain undefined, and resistance ultimately emerges in most patients. This review provides an updated overview of ROS1 biology, diagnostic approaches, clinical outcomes with currently available TKIs, mechanisms of resistance, and ongoing challenges, emphasizing the rapidly evolving therapeutic landscape. Full article

Background: Beverage intake is a consequential yet underappreciated driver of health in Mediterranean settings. Comparative evidence for Spain and Italy based on harmonised measures is scarce. This study addresses that gap by profiling beverage portfolios and their sociodemographic correlates in parallel adult samples from both countries. Methods: We conducted a cross-sectional analysis of adults in Spain (n = 483) and Italy (n = 403) using aligned, validated instruments (NutSo-HH; NutSo-HH-Ita). Outcomes were water (Wtr), sugar-sweetened soft drinks (Sfd), juice (Juc), energy drinks (End), coffee (Cff), alcohol (Alc), and episodes of intoxication (Gtd). Associations were assessed via non-parametric tests, multivariable linear models, and an EBIC-selected Gaussian graphical model (GGM). Main results: Italians reported higher Alc and Gtd; Spaniards reported higher Sfd and Juc. Wtr was comparable across countries, and Cff differences were marginal. Age and sex emerged as the most consistent correlates (older age and male sex with higher Alc; younger age with higher Sfd), whereas education and income were not stable determinants. The GGM suggested behavioural clustering of Sfd–Juc–End, with weak partial correlations for other beverages after adjustment. Implications: Distinct country profiles imply differentiated priorities. In Spain, interventions could prioritise reducing sugar-sweetened beverage intake among younger adults through age-targeted primary care counselling, mandatory water (and unsweetened milk) availability in schools, tiered excise taxes on sugar-sweetened drinks, and restrictions on child- and youth-directed marketing of high-sugar beverages. In Italy, primary care and community health services could routinely screen adults for risky alcohol use and deliver brief, culturally attuned advice that promotes lower-risk patterns of wine consumption during meals. Given the cross-sectional design, self-report measures, and non-probabilistic sampling, findings should be interpreted as context-sensitive markers rather than causal determinants; nevertheless, they highlight concrete prevention approaches and regulatory levers for each country’s beverage-related health risks. Full article

Type 3 diabetes (T3D) is characterized by chronic insulin resistance and insulin deficiency in the brain, leading to neuronal death, inflammation, oxidative stress, apoptosis, and synaptic dysfunction. These pathological processes contribute to cognitive decline and neurodegenerative disorders such as Alzheimer’s disease. However, despite increasing evidence that links insulin resistance to cognitive impairment, the precise mechanisms that underly T3D remain largely unknown. This highlights a critical gap in research and potential therapeutic strategies. Given the significant impact of diet on metabolic health, investigating the correlation between the gut–brain axis may offer novel insights into the prevention and management of T3D. This review aims to elucidate the potential connections between insulin resistance and cognitive decline while also proposing interventions to slow aging and reduce the risk of early cognitive decline. At the same time, we acknowledge that the classification of type 3 diabetes is debatable and there is uncertainty as to whether insulin resistance is a primary driver or secondary manifestation of neurodegeneration. Full article

Transition-age youth exiting foster care (TAY) are at high risk for housing instability, with nearly half experiencing homelessness before age 26. Multi-level factors are associated with greater risk, including individual, social, and geographic contexts. This study explored experiences of TAY in a large region of Texas to identify drivers of housing stability during the transition out of care. Youth aged 18–25 who were connected to the region’s foster care transition center were recruited to participate in a mixed-methods, semi-structured interview (n = 25). Youth were prompted to identify networks of up to 20 people who had provided support over the past year. Interview questions explored what happened when youth turned 18, including changes in their housing situations, and delved into relationships with the network members. An iterative coding process was used to create a matrix to examine housing transitions and social supports within and across cases, then identify themes and subthemes. Housing instability was common, with 13 of 25 participants reporting episodes of homelessness after turning 18. Abrupt transitions were driven by systemic factors related to placement settings, strict rules, and a lack of available housing options. Social network data illuminated the close link between housing and the social network, along with the importance of “housing-capable” adults who helped prevent homelessness. Findings call for the development of more youth-friendly housing options for TAY transitioning out of care and interventions that help to build enduring social supports. Full article

The paper assesses the change in air pollutant emissions from a petrol passenger vehicle with changing mileage. The search for solutions enabling the assessment of the change in air pollutant emissions, considering the phenomenon of vehicle ageing, justifies the need to verify the actual air pollutant emissions from used vehicles. The fleet of vehicles used in Poland has an operational age exceeding 12 years, and the number of vehicles imported from Western Europe each year reaches almost 1 million. The research method used in the paper included conducting road tests, known as real driving emissions (RDE) tests of air pollutant emissions for a single vehicle, at different times and with various mileages. The petrol vehicle was operated by one driver whose driving style and routes were comparable and constant throughout the year. The RDE results were compared with data specifying the vehicle’s operating age and mileage to verify the research hypothesis, assuming increased emissions with increasing vehicle mileage. The emissions of basic air pollutants were determined as part of the research conducted using specialist equipment. The research results were obtained for one vehicle, and the experiment was carried out over several years. The results show differences in the emissions of selected chemical compounds depending on the petrol vehicle’s mileage and operating age while ensuring comparable driving technique and operation of one vehicle over a longer time period of 8 years. The vehicle’s age and mileage influence air pollutant emissions. The obtained results show a change in the emission of selected chemical compounds depending on the mileage, thereby confirming the validity of the adopted hypothesis. Full article

Background: Go-karting has become an increasingly popular motorsport and leisure activity among children of all ages. However, go-karting is not without risks. The main purpose of this study was to assess the number of pediatric patients presenting at the emergency department of a level-I trauma center following a go-kart-related injury event over a nine-year period. Additionally, this study aimed to provide a comprehensive overview of patient characteristics, trauma mechanisms, injury types and use of safety devices. Methods: A retrospective single-center cohort study identified all patients that presented at the emergency department from January 2015 to December 2023. Data from the Dutch Nationwide Trauma Registry and medical files were assessed, descriptive statistics were conducted, and cohorts—defined by date—were compared: the first cohort from January 2015 to December 2021, and the second from January 2022 to December 2023, with December 2021 marking the moment when Max Verstappen became the first dutchman to win the Formula One World Driver’s Championship. Results: A total of 14 patients were identified, with an incidence rate of respectively 0.86 and 4.0 per year for the cohorts. In the total study population, 86% were male and the mean age was 12 years (range 4–17). Collision was the most common trauma mechanism with velocities even exceeding 70 km/h. Reported use of a helmet and seatbelt were respectively 64% and 29%. The mean Injury Severity Score (ISS) was 8.6 (±8.6). 57% of the patients encountered minor injuries (ISS ≤ 8), encompassing mostly soft tissue injuries, whereas truncal injuries occurred most frequently in moderately (ISS 9–15) and severely (ISS ≥ 16) injured children. Conclusions: This study has found that although the number of cases was relatively low, an increase in injuries was seen after 2021 in go-karting in children. Almost half of patients were seriously injured, requiring admission at the least. Resulting from this, considerations on minimum age for participation, enforcement of the use of safety devices including additional safety measures targeting truncal protection, and more clear laws and regulations are advised. Full article

A new and transformative era in semiconductor packaging is underway, wherein, there is a shift from transistor scaling to system scaling and integration through advanced packaging. For advanced packaging, interconnect scaling is a key driver, with interconnect density requirements for chip-to-substrate microbump pitch below 5 μm and half-line pitch below 1 μm for Cu redistribution layer (RDL). Here, we present a comprehensive theoretical comparison of thermal cycling behavior in accordance with JESD22-A104D standard, intermetallic thickness evolution, and steady-state thermal analysis of Cu-microbump assembly for different bonding materials and substrates. Bonding materials studied include solder caps such as SAC105 (Sn98.5Ag1.0Cu0.5), eutectic Sn-Pb (Sn63Pb37), eutectic Sn-Bi (Sn42Bi58), Pb95Sn5, Indium, and Cu-Cu TCB structure. Effect of substrates including Si, glass and FR-4 is evaluated for various microbump structures with varying pitches (85 µm, 40 µm, 10 µm, and 5 µm) on their fatigue life. Results indicate that for Cu-microbump assemblies at an 85 µm pitch. The Pb95Sn5 exhibits the longest predicted fatigue life (3267 cycles by Engelmaier and 452 cycles by Darveaux), while SAC105 shows the shortest (320 and 103 cycles). Additionally, the Cu-Cu TCB structure achieves an estimated lifetime of approximately 7800 cycles, which is significantly higher than all solder-based Cu-microbump assemblies. The findings contribute to advanced packaging applications by providing valuable theoretical references for optimizing solder materials and structural configurations. Full article

Background/Objectives: Breast cancer is a heterogeneous disease, and the role of the transcription factor SPDEF remains controversial. We aimed to clarify the prognostic value of SPDEF, explore demographic and molecular correlates of its expression, and investigate potential regulatory mechanisms underlying its dysregulation. Methods: Genomic and clinical data for 1218 breast cancer tumors were obtained from The Cancer Genome Atlas (TCGA). SPDEF mRNA expression was compared across intrinsic subtypes, age, and race, and prognostic significance was evaluated by Kaplan–Meier analysis. Promoter methylation patterns and DNA methyltransferase (DNMT) expression were examined as potential regulatory drivers. Co-expression analysis was performed using gene panels representing luminal differentiation, basal identity, EMT, proliferation, DNA repair, and immune signaling. Results: Low SPDEF expression was significantly associated with worse overall, relapse-free, and metastasis-free survival across all breast cancers. Expression was lowest in Basal tumors, as well as among younger and Black or African American patients. Promoter methylation at six CpG islands correlated with both reduced SPDEF expression and inferior survival, and DNMT1, DNMT3A, and DNMT3B overexpression also aligned with poor prognosis and Basal enrichment. Co-expression analysis revealed that SPDEF downregulation coincided with loss of luminal markers and increased EMT, proliferation, DNA repair, and immune pathways. Conclusions: SPDEF functions as a tumor suppressor in breast cancer, with reduced expression linked to poor outcomes, aggressive molecular features, and epigenetic regulation. These findings highlight SPDEF and DNMT-driven methylation as potential prognostic biomarkers for enhanced risk stratification and targets for novel therapies, particularly in Basal breast cancers. Full article

In developed countries such as Spain, where the population is increasingly aging, retirement planning and longevity risk represent major societal challenges. In Spain, in particular, a significant proportion of household wealth is concentrated in real estate, primarily in the form of owner-occupied housing. For this reason, one emerging financial product in the retirement savings space is the reverse mortgage (RM). This study examines the determinants of acceptance of this financial product using survey data collected from Spanish individuals. The intention to take out an RM is explained through performance expectancy (PE), effort expectancy (EE), social influence (SI), bequest motive (BM), financial literacy (FL), and risk (RK). The analysis applies machine learning techniques: decision tree regression is used to visualize variable interactions that lead to acceptance; random forest to improve predictive capability; and Shapley Additive Explanations (SHAP) to estimate the relative importance of predictors. Finally, Importance–Performance Map Analysis (IPMA) is employed to identify the variables that merit greater attention in the acceptance of RMs. SHAP values indicate that PE and SI are the most influential predictors of intention to use RMs, followed by BM and EE with moderate importance, whereas the positive influence of RK and FL is more reduced. The IPMA highlights PE and SI as the most strategic drivers, and RK and BM act as relevant barriers to the widespread adoption of RMs. Full article