Search Results (339)

As Thailand transitions into a super-aged society, falls are a rising public health issue. However, limited research focuses specifically on independent older adults in rural areas. This study examined intrinsic and extrinsic factors associated with falls among independent older adults in a rural district of southern Thailand, contributing to localized fall prevention strategies. A cross-sectional study was conducted using multi-stage probabilistic sampling with 325 older adults aged 60–79 years residing in Nakhon Si Thammarat. Data were collected through structured interviews, and multivariate logistic regression was used to identify fall predictors. A fall was defined as an unintended fall to a lower level within the previous 12 months. The fall prevalence was 29.8%, with the majority resulting in minor injuries. Multivariate analysis revealed protective factors, including sociodemographic factors such as higher monthly income (adjusted OR = 0.47; 95% CI: 0.30–0.74) and agricultural employment (adjusted OR = 0.50; 95% CI: 0.27–0.95), as well as the extrinsic factor of pet ownership (adjusted OR = 0.53; 95% CI: 0.35–0.81), were significantly associated with reduced fall risk. The study highlights context-specific protective factors that could inform community-based interventions. Future research should assess causality and intervention effectiveness in broader populations. Full article

The invasion of alien species has emerged as a global ecological challenge and invasive species can seriously threaten the habitats of native plants and intensify interspecific competition, ultimately exerting significant impacts on local ecosystems. Therefore, it is necessary to implement effective prevention and control strategies to reduce these impacts and maintain ecological stability. Against this backdrop, it is especially critical to analyze the influencing factors of invasive alien species and predict their future trends. Given China’s vast territory, complex natural geography, and diverse climatic conditions, the problem of invasive alien species in China is particularly severe, and scientific countermeasures are urgently required. Up to now, the number of invasive alien plant species in China has exceeded 520. Based on the number of invasive plant species in each province of China, this study analyzes the intrinsic connection between various influencing factors and invasive species, and through correlation analysis identifies the influencing factors, which are then used to analyze and predict the future invasion risks that each region may face. Full article

With the rapid advancement of high-precision optical systems, increasingly stringent demands are imposed on the surface figure accuracy of optical components. The magnitude of residual stress in multilayer films directly influences the post-coating surface figure stability of these components, making the control of multilayer film stress a critical factor in enhancing optical surface figure accuracy. In this study, which addresses the process constraints and substrate damage risks associated with conventional annealing-based stress compensation for large-aperture optical components, we introduce an active stress engineering strategy rooted in in situ deposition process optimization. By systematically tailoring film deposition parameters and adjusting the thickness modulation ratio of TiO₂ and SiO₂, we achieve dynamic compensation of residual stress in multilayer structures. This approach demonstrates broad applicability across diverse optical coatings, where it effectively mitigates stress-induced surface distortions. Unlike annealing methods, this intrinsic stress polarity manipulation strategy obviates the need for high-temperature post-processing, eliminating risks of material decomposition or substrate degradation. By enabling precise nanoscale stress regulation in large-aperture films through controlled process parameters, it provides essential technical support for manufacturing ultra-precision optical devices, such as next-generation laser systems and space-based stress wave detection instruments, where minimal stress-induced deformation is paramount to functional performance. Full article

What motivates industrial companies to decarbonise? While climate policy has intensified, the specific factors driving corporate decisions remain underexplored. This article addresses that gap through a mixed-methods study combining qualitative insights from a leading automotive supplier with quantitative data from over 800 manufacturing companies in Germany. The study distinguishes between internal motivators—such as risk reduction, future-proofing, and competitive positioning—and external drivers like regulation, supply chain pressure, and investor expectations. Results show that internal economic logic is the strongest trigger: companies act more ambitiously when decarbonisation aligns with their strategic interests. Positive motivators outperform external drivers in both influence and impact on ambition levels. For instance, long-term cost risks were rated more relevant than reputational gains or regulatory compliance. The analysis also reveals how company size, energy intensity, and supply chain position shape motivation patterns. The findings suggest a new framing for climate policy: rather than relying solely on mandates, policies should strengthen intrinsic motivators. Aligning business interests with societal goals is not only possible—it is a pathway to more ambitious, resilient, and timely decarbonisation. By turning external pressure into internal logic, companies can move from compliance to leadership in the climate transition. Full article

According to the guidelines of the American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO), the most significant genetic factor in the diagnosis and treatment of breast cancer is the mutation status of the BRCA1 and BRCA2 genes. Additional genes with a significant influence on cancer risk were selected for genetic panel screening. For these genes, the disease risk score was predicted to be greater than 20%. In clinical practice, it is observed that rare genetic variants have a significant impact in young patients, characterized by increased pathogenesis and a poorer overall prognosis. The ability to predict the potential effects of these rare variants may reveal important information regarding possible phenotypes and may also provide new insights leading to more efficacious treatments and overall improved clinical management. This paper presents the case of a 38-year-old woman with bilateral breast cancer who is likely a carrier of a pathogenic point mutation in the LZTR1 gene (LZTR1: c.1260+1del variant). With this clinical case report herein described, we intend to display the usefulness of performing detailed molecular tests in the field of genetic diagnostics for patients with breast cancer. Understanding the pathogenesis of hereditary cancer development, which is more predictable and reliable than that of sporadic tumors, will allow for the discovery of hitherto hidden intrinsic signaling pathways, facilitating replicable experimentation and thereby expediting the discovery of novel therapeutic treatments. Full article

P. aeruginosa strain NL201 was cultured from an urban water drain in a populated subway underpass as an environmental isolate for the ST111 global high-risk P. aeruginosa clone. In addition to carrying generally present intrinsic P. aeruginosa antibiotic resistance genes, this serotype O4 isolate also carries a set of additional acquired resistance determinants, including aadA2, bla_OXA-10, sul1, and an aac(6′)-Ib family gene. The NL201 isolate features the bla_PDC-3 allele, which was found to confer significantly higher catalytic efficiency against cefepime and imipenem compared to bla_PDC-1, as well as the potent P. aeruginosa virulence factors exoS, exoT, and algD. Serotype O4 isolates of the ST111 global high-risk P. aeruginosa clone have been reported from clinical samples in Canada and the USA, human stool samples in France, and environmental samples (such as cosmetic, hospital drains, and urban water drain) from various European countries. These observations underscore the effective dissemination of the ST111 global high-risk P. aeruginosa clone between different hosts, environments, and habitats, and they warrant targeted investigations from a One Health perspective on the possible routes of its spread and molecular evolution. Full article

Background: Basal cell carcinoma (BCC) is the most common skin cancer worldwide, with a multifactorial aetiology involving environmental and intrinsic factors. A small subset of patients develops high-frequency BCC (HF-BCC), defined as ≥9 BCCs within 3 years. Objective: To analyse demographic, clinical, and histopathological features of non-syndromic HF-BCC in a Belgian cohort, compared with low-burden BCC patients and healthy controls. Methods: A retrospective cohort study was conducted at Erasme Hospital (Brussels) using data from the EUSCAP platform. Clinical, behavioural, and histopathological data were collected and statistically analysed. Results: Of 783 patients, 16 with HF-BCC were identified. For comparison, 32 patients with 1–2 BCCs and 117 patients without BCC were selected. HF-BCC patients showed distinct characteristics, including a higher proportion of superficial BCCs (68.3% vs. 50%, p = 0.01) and fewer nodular subtypes (43.2% vs. 63.5%, p = 0.01). Their tumours were less frequently located on the nose and ears compared with patients having 1–2 BCCs. HF-BCC was associated with a personal history of squamous cell carcinoma (SCC) and actinic keratosis (AK). Conclusions: HF-BCC patients display distinct anatomical, histopathological and clinical characteristics, with a predominance of superficial BCC and an association with a personal history of SCC and AK. They show a lower frequency of tumours on the nose and ears, with a stronger tendency for localisation on the trunk and extremities. Identifying risk factors and genetic markers may contribute to improved early detection strategies, preventive measures, and the development of targeted therapies. Full article

Aging is associated with structural and functional changes in the gastrointestinal tract; however, its impact on gastric secretion remains unclear. This scoping review examines whether gastric secretion declines with age and explores its clinical implications. Following the PRISMA guidelines, PubMed, Web of Science, Embase, and Google Scholar were systematically searched from inception to December 2024. Fifteen studies (both animal and human) met the inclusion criteria: they were written in English, directly relevant to aging and gastric secretion, and had a clearly stated methodology. Evidence strength was assessed using the GRADE framework, revealing predominantly low to moderate certainty due to small sample sizes and observational study designs. Animal studies have demonstrated reduced acid secretion in older rats, which is attributed to mucosal atrophy and diminished responsiveness to gastrin. Recent human studies suggest that aging does not directly reduce acid output, as reduced acid secretion may result from a higher prevalence of atrophic gastritis, Helicobacter pylori infection, and the widespread use of proton pump inhibitors. Antisecretory therapy may lack benefits in older adult patients with hypochlorhydria/achlorhydria and increase the risk of adverse effects. Pepsin output declines with aging due to reduced chief cell function, although its clinical impact on digestion is unclear. Since intrinsic factor secretion far exceeds the amount necessary for its physiological function, even low amounts seem to be sufficient to prevent cobalamin deficiency. Age-related decline in gastric secretion is mostly attributed to age-associated disorders; however, impairment of secretory function in older people is frequent. Future research should prioritise longitudinal studies, larger cohorts, and histology-stratified analysis. Full article

Background: Community-acquired bacterial pneumonia (CABP) is a common and costly cause of hospitalization. Although severe CABP (sCABP) occurs in 10–25% of all pneumonia hospitalizations, little generalizable data examine its characteristics and outcomes or hospital resource utilization. Methods: We conducted a retrospective single-group cohort study of adults within the IQVIA hospital Charge Data Master, 2018–2022. We identified CABP via an ICD-10 code algorithm and sCABP was defined as an episode requiring ICU care. We examined baseline characteristics and outcomes, including mortality, costs, and readmission rates. We developed models to identify risk factors associated with readmissions. Results: Among 24,149 patients with sCABP, 14,266 (58.4%) were ≥65 years old and 55.2% were male. The majority were hospitalized in large (300+ beds, 50.9%), urban (91.9%) teaching (62.7%) institutions in the US Southern region (52.3%). The mean (SD) Charlson Comorbidity Index was 1.35 (2.33). The most common comorbidities were hypertension (16.7%), diabetes mellitus (15.7%), and chronic obstructive pulmonary disease (COPD) (12.9%). Hospital mortality was 15.9%. The mean (SD) hospital length of stay (LOS) and costs were 13.6 (12.1) and USD 91,965 (USD 133,734), respectively. An amount of 20% required a readmission within 30 days. Readmission was most strongly associated with older age and the presence of select comorbidities (diabetes mellitus, congestive heart failure, and COPD), each with an odds ratio > 1.4 and 95% confidence intervals excluding 1.0. Conclusions: Patients with sCABP comprise a large population with high mortality and 30-day readmissions. The intrinsic factors related to the latter lend themselves to early recognition and aggressive efforts at reducing complications. Full article

The intrinsic hazards associated with high-pressure hydrogen, combined with electromechanical interactions in hybrid architectures, pose significant challenges in predicting potential system risks during the conceptual design phase. In this paper, a risk analysis methodology integrating systems theoretic process analysis (STPA), D-S evidence theory, and Bayesian networks (BN) is established. The approach employs STPA to identify unsafe control actions and analyze their loss scenarios. Subsequently, D-S evidence theory quantifies the likelihood of risk factors, while the BN model’s nodal uncertainties to construct a risk network identifying critical risk-inducing events. This methodology provides a comprehensive risk analysis process that identifies systemic risk elements, quantifies risk probabilities, and incorporates uncertainties for quantitative risk assessment. These insights inform risk-averse design decisions for hydrogen–electric hybrid powered aircraft. A case study demonstrates the framework’s effectiveness. The approach bridges theoretical risk analysis with early-stage engineering practice, delivering actionable guidance for advancing zero-emission aviation. Full article

Mitral annular calcification (MAC) is usually considered an incidental, benign, age-related finding without serious complications in patients evaluated for cardiovascular or pulmonary disease with imaging studies that may result in mitral regurgitation or stenosis when severe. Therefore, it is usually not considered a significant alteration. However, there is accumulating evidence that it is associated with a higher risk of cardiovascular events, such as atherosclerotic coronary artery disease, aortic artery disease, carotid artery disease, peripheral artery disease, stroke, atrial fibrillation, atrioventricular and/or intraventricular conduction disturbance, systemic embolization, infective endocarditis, heart failure and mortality. The presence of MAC also significantly influences the outcome of mitral valve transcatheter and surgical interventions. Several conditions may predispose to MAC. MAC is strongly related to cardiovascular risk factors, such as hypertension, diabetes, smoking and cardiovascular atherosclerosis, and inflammation may also play a role in the pathogenesis of MAC. Also, conditions that increase mitral valve stress, such as hypertension, aortic stenosis and hypertrophic cardiomyopathy, predispose to accelerated degenerative calcification of the mitral annulus area. Congenital disorders, e.g., Marfan syndrome and Hurler syndrome, are also associated with MAC, due to an intrinsic abnormality of the connective tissue composing the annulus. Full article

Background/Objectives: Previous studies have typically investigated injury risk factors either by body region or sport type in isolation, limiting their practical applicability to real-world settings where multiple factors interact. However, injury risk is inherently multifactorial—shaped by a complex interplay of demographic, physiological, and training-related characteristics that differ by anatomical site and sport context. This study addresses that gap by simultaneously analyzing predictors across multiple body regions and sport-specific environments. This integrated approach is critical for developing more precise, evidence-based injury prevention strategies tailored to the specific demands and risk profiles of amateur athletes. This study aimed to identify key predictors of injury risk across various body regions and sport-specific contexts among amateur athletes. Specifically, we sought to (1) develop predictive models that include demographic and body composition variables, and (2) compare the relative predictive strength of these variables across models, highlighting differences in their influence by injury location and sport type. Methods: A total of 454 amateur athletes (219 males and 235 females) participated. Data on anthropometry, body composition, training load were collected. Injury history was obtained via self-administered questionnaires, with participants reporting injuries that had occurred during the 12 months prior to the time of data collection. Logistic regression models were used to identify significant predictors, and Nagelkerke’s R² was calculated to assess model fit. Results: Overall, 49.78% of athletes experienced injuries, with a higher proportion in females (54.47%) than in males (44.75%). Age demonstrated divergent effects: it was protective against both upper and lower limb injuries in male individual-sport athletes (OR = 0.62 and OR = 0.69, respectively) and in female athletes across sport types (ORs = 0.75–0.64), but conversely increased the risk of upper limb injuries in male team-sport athletes (OR = 1.88). In female individual athletes, higher Skeletal Muscle Index (SMI) predicted upper limb injuries (OR = 1.18, p = 0.034). In female team athletes, higher Muscle-to-Fat Ratio (MFR) (OR = 2.46, p = 0.017) and BMI (OR = 1.67, p = 0.008) predicted upper limb injuries, while higher Fat Mass Index (FMI) predicted lower limb injuries (OR = 1.70, p = 0.009). Models showed moderate explanatory power (Nagelkerke’s R² ranging from 0.03 to 0.33). Conclusions: These findings suggest that injury risk profiles are highly context-dependent. Preventive strategies should be tailored by sex and sport type, for example, younger athletes in team sports may benefit from age-sensitive load monitoring, while in female team athletes, targeted interventions addressing both fat and muscle balance could be essential. Age, body composition, and sport-specific demands should be considered in individualized injury prevention planning. Full article

Background: Exposure to early life stress significantly increases the risk of psychopathology later in life. However, the impact of early life stress on the gut microbiome and its potential role in mental health outcomes remains insufficiently understood. This narrative review examines the current knowledge on how early life stress and its associated consequences may affect the gut microbiome, with a particular focus on conditions such as anxiety, depression, and post-traumatic stress disorder. Method: A comprehensive literature search was conducted in the PubMed and Web of Science databases between January and February 2025, covering studies published between 2015 and 2025. Results: Early life stress can profoundly impact cognitive function and neurodevelopment, with maternal early-life nutrition playing a significant role in modulating the effects of prenatal and postnatal stress. Early life stress influences the gut microbiome, disrupting its composition and function by altering the synthesis of microbial metabolites, neurotransmitters, and the activation of key metabolic pathways. However, the precise role of the gut microbiome in modulating stress responses during childhood and adolescence has not yet been fully elucidated. Conclusions: Several studies have demonstrated an association between early life stress and the gut microbiome. However, causality has not yet been established due to the numerous intrinsic and extrinsic factors influencing the microbiome-gut–brain axis. In the coming years, research on key microbial regulators, such as short-chain fatty acids, amino acids, and psychobiotics, may represent a promising approach for addressing central nervous system alterations linked to early life stress. Thus, further studies will be necessary to evaluate their potential as therapeutic agents. Full article

The human coagulation pathway orchestrates a complex series of events vital for maintaining vascular integrity, in which the intrinsic pathway plays a pivotal role in amplifying and propagating the coagulation response. Dysregulation of this pathway can lead to various bleeding disorders and thrombotic complications, posing significant health risks. In this pathway, the activation of Factor (F) X zymogen is catalyzed by the FVIIIa-FIXa binary complex, but knowledge about this is still incomplete. Understanding the structural and functional intricacies of the FVIIIa-FIXa-FX (zymogen) complex is imperative for unraveling the molecular mechanisms underlying coagulation regulation and guiding the development of targeted therapeutic interventions. In this study, utilizing Alphafold-Multimer and molecular dynamics (MD) simulations, we provide insights into factor interactions within the ternary complex and propose novel functional mechanisms contributing to the functional defects inflicted by their cross-reactive material (CRM) positive mutations. The amino acid residue replacement impairs the coagulation function by interfering with structure elements, including the following: (1) a knot-like structure between Arg-562 of FVIIIa’s 558-Loop (residue 555–571) and the 333-Loop of FIXa (residue 333–346) contributes to FVIIIa-FIXa binding; (2) the a2 region of FVIIIa (residue 716–740) opens the lid of active site (FIXa’s 266-Loop, residue 256–270) and facilitates substrate binding; (3) the activation peptide (AP) of FX zymogen (residue 143–194) not only assists in the activation of itself but also adheres the interface of the three factors like a double-sided tape. Our work provides novel insights for the pathogenesis of a number of reported clinical CRM-positive mutations and may lay the groundwork for the structure-based development of therapeutic interventions. Full article

This longitudinal study investigated the incidence and characteristics of injuries among U9, U11, and U13 male football players in an academy setting over a six-season period, from 2016/17 to 2021/22. A total of 374 injuries were analyzed, with a particular focus on muscle injuries, including Delayed Onset Muscle Soreness (DOMS), muscle ruptures, and contusions. The study revealed that the highest injury incidence occurred in the U13 group, with quadriceps injuries being most prevalent in both the U13 and U11 groups. The study found that muscle injuries accounted for a significant proportion of all injuries, particularly in the U13 group, where muscle injuries increased over time. Intrinsic factors such as physical development during puberty and extrinsic factors like training intensity and psychological pressures may contribute to the higher injury rates in older age groups. Additionally, seasonal fluctuations in injury rates were observed, with a notable decline during the COVID-19 lockdowns in 2019/20 and 2020/21, followed by an increase post-lockdown due to deconditioning. The study highlights the vulnerability of young athletes to muscle injuries, particularly during growth spurts, and calls for further research into training methods and injury prevention strategies to mitigate these risks. Full article