Search Results (1,449)

Long-term effects of concussions, particularly in contact sport athletes, have been linked to changes in neuronal health. Lipid dysregulation has emerged as a potential contributor to neuronal injury and may serve as a measurable biomarker of brain pathology. This study investigated cognitive scores and serum lipid biomarkers in retired rugby players with a history of concussion to assess their association with concussion exposure. Serum levels of 24-hydroxycholesterol (24-HC), 25-HC, 27-HC, total triglycerides, and ceramide were compared between retired rugby players with a history of repeated concussions (n = 26) and non-contact sport controls (n = 19). ELISA-based quantification and statistical analyses identified significant group differences. Concussed athletes exhibited significantly lower serum 24-HC and significantly higher levels of 27-HC, triglycerides, and ceramide compared to controls, while no significant difference was observed for 25-HC. These findings indicate that repeated concussion is associated with reductions in cognitive performance and persistent alterations in serum lipid profiles. The observed lipid changes, particularly in 24-HC, 27-HC, ceramide, and triglycerides, may serve as measurable biomarkers of concussion-related biochemical alterations, providing a foundation for future studies aimed at monitoring neurological health in at-risk populations. Full article

The rapid increase in retired lithium-ion batteries (LIBs) from electric vehicles (EVs) highlights the urgent need for accurate and automated end-of-life (EOL) assessment. This study proposes an AI-integrated smart grading system that combines hardware diagnostics and deep learning-based evaluation to classify the residual usability of retired batteries. The system incorporates a bidirectional charger/discharger, a CAN-enabled battery management system (BMS), and a GUI-based human–machine interface (HMI) for synchronized real-time data acquisition and control. Four diagnostic indicators—State of Health (SOH), Direct Current Internal Resistance (DCIR), temperature deviation, and voltage deviation—are processed through a deep neural network (DNN) that outputs categorical grades (A: reusable, B: repurposable, C: recyclable). Experimental validation shows that the proposed AI-assisted model improves grading accuracy by 18% and reduces total testing time by 30% compared to rule-based methods. The integration of adaptive correction models further enhances robustness under varying thermal and aging conditions. Overall, this system provides a scalable framework for automated, explainable, and sustainable battery reuse and recycling, contributing to the circular economy of energy storage. Full article

Financial literacy, defined as the set of knowledge, skills, and attitudes that enable individuals to make informed economic decisions and manage resources efficiently, is fundamental for social inclusion and the reduction of inequalities. This study, through a systematic review of the scientific literature using the PRISMA methodology, selected 120 primary studies that met the inclusion and exclusion criteria and presented a low risk of bias. These studies examined aspects related to financial literacy programs, the populations benefited, their effects, the challenges encountered, and the lessons that can guide the replication of these initiatives. The results show that the most frequent programs include training in basic financial concepts—savings, budgeting, access to banking services and microfinance—as well as workshops, seminars, and group training sessions. The populations most benefited were rural communities and women, although informal workers, migrants, and refugees could also significantly improve their financial inclusion and economic resilience. Among the positive effects, improvements were observed in income and expense management, increased savings, investment planning, preparation for emergencies and retirement, and the strengthening of economic empowerment and the sustainability of microenterprises and small enterprises. These findings highlight the importance of implementing financial literacy programs adapted to specific contexts to promote inclusion and economic well-being. Full article

Objectives: To identify patient-reported key disease-related challenges of macular and cone–rod dystrophies (MDs/CRDs) in a large consecutive cohort of individuals with molecularly confirmed diagnoses. Methods: Out of the 281 patients contacted, 194 (69.0%; 55.2% female) responded to an anonymized survey exploring the effects of MD/CRD on vocational training, professional careers, social participation, family life, personal well-being, and experience with ophthalmologic care. Results: While vocational training was generally less affected, professional careers were frequently disrupted, with 20.6% of patients aged ≥ 50 retiring early. A majority (54.7%) reported feeling restricted in public life. Financial constraints were noted by 20%. A negative impact on familial life (12.3%) was less frequently reported compared to anxiety (74.2%) and depression (15.8%). Diagnostic delays (≥2 years) were common (34.2%), along with a notable rate of initial misdiagnoses (22.1%). The lack of adequate psychological support was a major complaint in professional care. Conclusions: Compared to a previous study in retinitis pigmentosa, MD/CRD patients reported differing patterns of burden, especially in early retirement and family impact. Our findings underscore the need for ophthalmic and social care providers to accelerate the diagnostic process and enhance access to financial assistance and psychological support as key areas to improve patient care. Full article

The rapid growth of electric vehicle markets is producing large volumes of retired lithium-ion batteries retaining 70–80% of their original capacity, suitable for stationary energy storage. This study assesses the techno-economic and environmental viability of second-life battery energy storage systems (SLBESS) in a California commercial building, using one year of operational data. SLBESS performance is compared with equivalent new battery systems under identical dispatch strategies, building load profiles, and time-of-use tariff structures. A dispatch-aware framework integrates multi-year battery simulations, degradation modeling, electricity cost analysis, and life cycle assessment based on marginal grid emissions. The economic analysis quantifies the net present value (NPV), internal rate of return (IRR), and operational levelized cost of storage (LCOS_op). Results show that SLBESS achieve 49.2% higher NPV, 41.9% higher IRR, and 13.8% lower LCOS_op than new batteries, despite their lower round-trip efficiency. SLBESS reduce embodied emissions by 41% and achieve 8% lower carbon intensity than new batteries. Sensitivity analysis identifies that economic outcomes are driven primarily by financial parameters (incentives, acquisition cost) rather than technical factors (degradation, initial health), providing a clear rationale for policies that reduce upfront costs. Environmentally, grid emission factors are the dominant driver. Battery degradation rate and initial state of health have minimal impact, suggesting that technical concerns may be overstated. These findings provide actionable insights for deploying cost-effective, low-carbon storage in commercial buildings. Full article

This study addresses the critical challenge of designing retirement savings systems that effectively balance liquidity needs and long-term accumulation in contexts characterized by high unemployment and labor market instability, with a focus on South Africa. Traditional pension schemes often assume uninterrupted careers and stable incomes, assumptions frequently violated in low- and middle-income countries, leading to inadequate retirement security and consumption volatility during working life. Motivated by this gap, we develop a stochastic two-pot retirement savings model that explicitly integrates labor market uncertainty using a Markov chain-based Monte Carlo simulation. The model allocates annual contributions between an accessible savings pot and a locked retirement pot, with individuals optimizing consumption and withdrawal decisions to maximize expected lifetime utility under Constant Relative Risk Aversion (CRRA) preferences. Our findings, derived from calibration to South African labor data, reveal that high unemployment and career uncertainty significantly increase the welfare-maximizing preference for liquidity. This result challenges conventional policies prescribing fixed contribution allocations, such as the one-third/two-thirds split in the new two-pot system, and underscores the importance of flexible retirement savings designs. We conclude that tailoring pension design to labor market realities can enhance both retirement security and welfare in volatile economies. Full article

Background: Research on psychological abuse among patients with breast cancer and survivors of breast cancer in Saudi Arabia is scarce. This study aimed to identify psychological abuse and its associated factors among these individuals. Methods: This cross-sectional study included 146 patients with breast cancer and survivors of breast cancer. Data were collected from December 2024 to April 2025 using a modified survey instrument based on the United Nations Economic Commission for Europe violence against women module. An online questionnaire comprised two parts: the first collected demographic characteristics, including age, education, employment, breast cancer diagnosis, and mastectomy duration, and the second assessed psychological abuse via four items: insults, belittlement/humiliation, intimidation, and undermining of relationship stability. The association between psychological abuse and sociodemographic factors was assessed using the chi-square test. Significant associations in bivariate analyses were subsequently analyzed using exploratory logistic regression. Results: Approximately 20.5% of participants reported experiencing at least one form of psychological abuse. The most commonly reported behaviors were insults and undermining of relationship stability (both 20.5%), followed by belittlement/humiliation (17.8%) and intimidation (15.1%). Bivariate analyses indicated a greater incidence of humiliation among women whose spouses were unemployed or retired, as well as among those with more than six children. Logistic analysis indicated that spouse unemployment or retirement (OR = 5.36, 95% CI 1.62–17.74, p = 0.006) and having more than six children (OR = 5.84, 95% CI 1.33–25.55, p = 0.019) were associated with belittlement/humiliation, even after FDR correction. No significant correlations were identified regarding patient age, education, mastectomy status, or duration since diagnosis. Model diagnostics demonstrated a satisfactory fit (Nagelkerke R² = 0.22; accuracy = 82.2%) and a lack of multicollinearity (VIF = 1.00–1.03). Conclusions: Psychological abuse affects around 20% of women diagnosed with breast cancer, especially those with unemployed spouses and larger families. These results highlight the need for psychological screening and couple-based therapies in cancer care to mitigate marital stresses and enhance survivors’ well-being. Full article

Background: Multiple sclerosis (MS) leads to early retirement in one-third of patients. The aim of this study is to analyze the difficulties at work and to collect suggestions for support measures at the workplace to maintain the ability to work for people with MS. Methods: Qualitative interviews were conducted with 20 people affected by MS. The participants’ experiences with workplace support were summarized and suggestions for workplace measures were presented. Results: Lack of offers of health-related measures and missing adjustments of the workplace has been analyzed. Offering flexible working hours and measures against fatigue is desired. Intensifying the cooperation between labor market service, health care providers and companies can help reintegrate affected people. Conclusions: Workplace education about MS and health-related measures is needed. Technical adaptations and flexible working hours can support in maintaining workability. Measures against fatigue must be developed and companies must set further measures to support people with illnesses. Full article

As the Buddhist monastic community in Korea has entered an era marked by aging demographics, the issues surrounding the welfare of the order’s monastics in their retirement years have become increasingly pressing. In response, in 2011, the Jogye Order enacted the Monastic Welfare Act and established the Monastic Welfare Society with the aim of enabling monks to fully devote themselves to their religious duties by assuming institutional responsibility for their healthcare, pension, residential welfare, and end-of-life needs. Over a decade since the system’s implementation, the Jogye Order has achieved notable progress towards achieving the Monastic Welfare Act’s aims. However, while the order has stabilized medical coverage for its clergy, there remain considerable gaps in its provisions for income and housing for elderly monastics. This article surveys the Jogye Order’s efforts to establish systemic care for its elderly monastics, with a particular focus on the Jogye Order’s 2011 Monastic Welfare Act and subsequent activities of the Monastic Welfare Society. It then critically examines the current state of eldercare within the order, along with its strengths and weakness, before engaging in a comparative discussion regarding the clerical eldercare and welfare systems provided by both the Korean Catholic Church and the Thai Buddhist community. Full article

Depressive symptoms are increasingly common in middle-aged and older adults and have become a major public health problem. People may experience transitions across different underlying states due to symptom variability over a course of many years. And risk factors may have different impact on different symptom states. However, existing research rarely considers the identification of important factors related to symptom conversion. The purpose of this study was to examine the risk associated with transitioning between various stages of depressive symptoms and their influencing factors, utilizing a multi-state model with a simultaneous feature selection method. We used the four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) and 3916 participants were selected after screening. Five states of depressive symptoms were defined including no symptom, new symptom episode, symptom persistence, remission and relapse. We included 13 variables on demographic background, health status and functioning, and family and social connectivity, along with their interactions. Multi-state models were used to evaluate the risks of state transitions. The regularized (adaptive Lasso) partial likelihood approach was employed to simultaneously identify the important risk factors, estimate their impact on the state transition rates and determine their statistical significance. There were 1392 new depressive episodes events, 402 symptom persistence events, 639 remission events and 118 relapse events. We identified nine significant risk factors for the new onset of depressive symptoms: urban–rural residence, sex, retirement status, income, body pain, difficulty with basic daily activities, social engagement, education by income interaction and number of conditions by income interaction. The effects of the identified risk factors on new symptom episode weakened as those symptoms became persistent or went into remission. In terms of symptom relapse, sex by age was identified as a significant influencing factor. This study identified key factors and explored their effects on the various depressive symptom states among older Chinese adults. The findings could serve as a foundation for the development and implementation of targeted policies aimed at enhancing the mental well-being of China’s elderly population. Full article

Intergenerational contact is a key component of the informal support systems that contribute to the wellbeing of older adults. As societies age and migration patterns diversify family structures, understanding how contact is sustained across generations becomes increasingly relevant for health equity and the sustainability of care systems. In this study, we conceptualise sustainability not in environmental terms but as social and health-system sustainability—that is, the long-term ability of families and care systems to maintain intergenerational ties, ensure equitable access to support, and remain resilient under demographic and social pressures. Drawing on theories of intergenerational solidarity and social capital, this study situates contact as both a resource for individual wellbeing and a pillar of care sustainability in diverse societies. We examine the frequency of contact between parents and adult children among adults aged 50 and above, comparing migrant and non-migrant populations across 25 European countries. Using data from Waves 7, 8, and the COVID-19 wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), we assess both in-person and digital forms of contact before and during the pandemic. Results show that older migrants have less frequent contact with parents but more frequent contact with children than do non-migrants, with similar patterns attested across repeated cross-sections (2017, 2019, 2021). The strong contact observed in each cross-section, facilitated by digital tools, implies resilient family ties under public-health stress. However, resilience is uneven: weaker contact with parents among migrant populations reflects structural barriers such as visa restrictions, caregiving responsibilities, discrimination, language barriers, and unequal digital access. Moreover, differences in access and proficiency with digital tools suggest that digital contact did not compensate equally across groups. These findings underscore the importance of sustainable and inclusive strategies in ageing and health policy. Specifically, targeted digital literacy programmes for older migrants, policies supporting transnational caregiving, affordable internet access, mobility solutions, and anti-discrimination measures in family visitation are crucial to reducing inequities. Full article

The echelon utilization of electric vehicle batteries is regarded as an effective method for treating waste batteries, enabling the recycling and reuse of retired electric vehicle batteries. However, the efficiency of battery disassembly is a crucial factor that impacts the potential for battery recycling. When manufacturers take disassembly efficiency into account during the design phase of new electric vehicle batteries, they can significantly reduce disassembly costs at the time of decommissioning. This, in turn, incentivizes recycling and echelon utilization of waste batteries. Our research aims to promote the echelon use of waste batteries and analyze how market competition intensity and profits from battery echelon utilization influence decision-making within the battery recycling supply chain. This paper explores the effect of market competition on battery recycling and echelon utilization, while developing a supply chain model that includes a battery manufacturer responsible for determining the level of battery disassembly design and recycling waste batteries from the market, as well as a new energy vehicle manufacturer that focuses solely on recycling waste batteries. The findings indicate that as market competition increases, the battery manufacturer tends to lower both the level of battery disassembly design and the recycling price for waste batteries. Additionally, the recycling price for waste batteries offered by new energy vehicle manufacturers is also influenced by the intensity of market competition. In scenarios with low competition intensity, the recycling price tends to rise as competition intensifies. Conversely, in highly competitive markets, the recycling price decreases with increased competition. Furthermore, the overall volume of battery recycling is impacted by the intensity of market competition; in highly competitive markets, waste battery recycling is hindered. To enhance the echelon utilization of battery recycling, relevant government agencies should strive to maintain market competition at lower levels while also encouraging the recycling of batteries that do not meet usage standards. This dual approach will improve the benefits associated with the echelon utilization of waste batteries, thereby fostering greater enthusiasm for recycling among the involved enterprises. 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

Background: Few studies have simultaneously examined how blood biomarkers for inflammation, metabolic, and cardiovascular function are associated with disability incidence. This study aimed to comprehensively examine these associations. Methods: We used data from adults aged 50 and older in the Health and Retirement Study (n = 9250) and the China Health and Retirement Longitudinal Study (n = 6844), with biennial follow-up over a 4-year period. We defined abnormal biomarker values using standard clinical cut-off points for three biological systems. Disability burden was quantified as the cumulative number of impairments in basic and instrumental activities of daily living. Multivariate linear mixed-effects models were used to analyze the associations. Results: At baseline, 42% of participants had abnormal biomarker values in at least one system, 28% in two systems, and 7% in all three. A dose–response relationship was observed between the rate of disability accumulation and the number of systems with abnormal biomarker values. Compared to individuals with normal values across all systems, those with abnormalities in two systems had a significantly faster annual increase in disability burden (β = 0.06, 95% CI: 0.02–0.09), while those with abnormalities in all three systems exhibited an even steeper increase (β = 0.1, 95% CI: 0.05–0.16). Conclusions: The presence of abnormal levels in any two or all three of the systems significantly accelerated the rate of disability accumulation over a 4-year period. These findings highlight the importance of integrated biomarker monitoring for early identification of individuals at risk and inform the development of targeted preventive strategies. Full article

Background: Direct clinical training on real patients is essential in dental education. However, the declining patient inflow increasingly challenges this objective. This cross-sectional study aimed to assess patients’ experiences and preferences to derive recommendations for improving patient recruitment. Material and Methods: Over a period of one year, patients treated by students in the courses and final examinations at the dental school of conservative dentistry were questioned using a specially designed questionnaire and reviewed using their medical records. They were asked about their complete treatment process, and patient files were used to record socio-demographic as well as economic and appointment-specific data. Results: We analysed 297 patients (142 women, 47.8%; 155 men, 52.2%) treated by undergraduates across two semesters (four courses) and two final examinations. Median age was 57.0 years (IQR 46–67; mean 55.2, SD 15.2; range 14–85) with no sex-based difference (p > 0.05). Arrival was predominantly by car (72.7%, n = 216); median one-way distance was 20.5 km (IQR 11.2–32.1); and 58.4% were employed, while 41.6% were not employed (33.7% retired, 7.9% unemployed). The leading reason for course attendance was “satisfaction with previous treatments” (65.32%). Information sources were reported by 290/297 (98%); the most common was already being a course patient (143, 48.1%). Most patients attended one appointment (109, 36.7%). Median travel cost per appointment (including parking) was €17.0 (typically €10.0–€23.5). Of 285 respondents, 93.68% answered “Yes” to satisfaction with student treatment. Conclusions: Important steps include enhancing parking facilities, optimizing recall systems and appointment accessibility, and strengthening relationships with regular patients to encourage word-of-mouth referrals. The main focus is to maintain high clinical quality, ensure affordability, and further reduce patient copayments where possible. Full article