Interventions addressing routine childhood immunization and its behavioral and social drivers.

Introduction: Despite the advances in vaccination, there are still several challenges in reaching millions of children in low- and middle-income countries (LMICs). In this review, we present an extensive summary of the various strategies used for improving routine immunization in LMICs to aid program implementers in designing vaccination interventions. Methods: Experimental and quasi-experimental impact evaluations conducted in LMICs evaluating the effectiveness of interventions in improving routine immunization of children aged 0-5 years or the intermediate outcomes were included from 3ie's review of systematic reviews. Some additional impact evaluation studies published in recent years in select LMICs with large number of unvaccinated children were also included. Studies were coded to identify interventions and the barriers in the study context using the intervention framework developed in 3ie's Evidence Gap Map and the WHO's Behavioral and Social Drivers (BeSD) of vaccination framework, respectively. Qualitative analysis of the content was conducted to analyze the intervention strategies and the vaccination barriers that they addressed. Results and conclusion: One hundred and forty-two impact evaluations were included to summarize the interventions. To address attitudinal and knowledge related barriers to vaccination and to motivate caregivers, sensitization and educational programs, media campaigns, and monetary or non-monetary incentives to caregivers, that may or may not be conditional upon certain health behaviors, have been used across contexts. To improve knowledge of vaccination, its place, time, and schedule, automated voice messages and written or pictorial messages have been used as standalone or multicomponent strategies. Interventions used to improve service quality included training and education of health workers and providing monetary or non-monetary perks to them or sending reminders to them on different aspects of provision of vaccination services. Interventions like effective planning or outreach activities, follow-up of children, tracking of children that have missed vaccinations, pay-for-performance schemes and health system strengthening have also been used to improve service access and quality. Interventions aimed at mobilizing and collaborating with the community to impact social norms, attitudes, and empower communities to make health decisions have also been widely implemented.

Identifying interactions among factors related to death occurred at the scene of traffic accidents: Application of "logic regression" method.

Aim: Traffic accidents are caused by several interacting risk factors. This study aimed to investigate the interactions among risk factors associated with death at the accident scene (DATAS) as an indicator of the crash severity, for pedestrians, passengers, and drivers by adopting "Logic Regression" as a novel approach in the traffic field. Method: A case-control study was designed based on the police data from the Road Traffic Injury Registry in northwest of Iran during 2014-2016. For each of the pedestrians, passengers, and drivers' datasets, logic regression with "logit" link function was fitted and interactions were identified using Annealing algorithm. Model selection was performed using the cross-validation and the null model randomization procedure. Results: regarding pedestrians, "The occurrence of the accident outside a city in a situation where there was insufficient light" (OR = 6.87, P-value<0.001) and "the age over 65 years" (OR = 2.97, P-value<0.001) increased the chance of DATAS. "Accidents happening in residential inner-city areas with a light vehicle, and presence of the pedestrians in the safe zone or on the non-separate two-way road" combination lowered the chance of DATAS (OR = 0.14, P-value<0.001). For passengers, "Accidents happening in outside the city or overturn of the vehicle" combination (OR = 8.55, P-value<0.001), and "accidents happening on defective roads" (OR = 2.18, P-value<0.001) increased the odds of DATAS; When "driver was not injured or the vehicle was two-wheeled", chance of DATAS decreased for passengers (OR = 0.25, p-value<0.001). The odds of DATAS were higher for "drivers who had a head-on accident, or drove a two-wheeler vehicle, or overturned the vehicle" (OR = 4.03, P-value<0.001). "Accident on the roads other than runway or the absence of a multi-car accident or an accident in a non-residential area" (OR = 6.04, P-value<0.001), as well "the accident which occurred outside the city or on defective roads, and the drivers were male" had a higher risk of DATAS for drivers (OR = 5.40, P-value<0.001). Conclusion: By focusing on identifying interaction effects among risk factors associated with DATAS through logic regression, this study contributes to the understanding of the complex nature of traffic accidents and the potential for reducing their occurrence rate or severity. According to the results, the simultaneous presence of some risk factors such as the quality of roads, skill of drivers, physical ability of pedestrians, and compliance with traffic rules play an important role in the severity of the accident. The revealed interactions have practical significance and can play a significant role in the problem-solving process and facilitate breaking the chain of combinations among the risk factors. Therefore, practical suggestions of this study are to control at least one of the risk factors present in each of the identified combinations in order to break the combination to reduce the severity of accidents. This may have, in turn, help the policy-makers, road users, and healthcare professionals to promote road safety through prioritizing interventions focusing on effect size of simultaneous coexistence of crash severity determinants and not just the main effects of single risk factors or their simple two-way interactions.

When does a parasite become a disease? eDNA unravels complex host-pathogen dynamics across environmental stress gradients in wild salmonid populations.

Infectious diseases stem from disrupted interactions among hosts, parasites, and the environment. Both abiotic and biotic factors can influence infection outcomes by shaping the abundance of a parasite's infective stages, as well as the host's ability to fight infection. However, disentangling these mechanisms within natural ecosystems remains challenging. Here, combining environmental DNA analysis and niche modelling at a regional scale, we uncovered the biotic and abiotic drivers of an infectious disease of salmonid fish, triggered by the parasite Tetracapsuloides bryosalmonae. We found that the occurrence and abundance of the parasite in the water-i.e., the propagule pressure- were mainly correlated to the abundances of its two primary hosts, the bryozoan Fredericella sultana and the fish Salmo trutta, but poorly to local abiotic environmental stressors. In contrast, the occurrence and abundance of parasites within fish hosts-i.e., proxies for disease emergence-were closely linked to environmental stressors (water temperature, agricultural activities, dams), and to a lesser extent to parasite propagule pressure. These results suggest that pathogen distribution alone cannot predict the risk of disease in wildlife, and that local anthropogenic stressors may play a pivotal role in disease emergence among wild host populations, likely by modulating the hosts' immune response. Our study sheds light on the intricate interplay between biotic and abiotic factors in shaping pathogen distribution and raises concerns about the effects of global change on pathogen emergence.

Analysis of the multiple drivers of vegetation cover evolution in the Taihangshan-Yanshan region.

The Taihangshan-Yanshan region (TYR) is an important ecological barrier area for Beijing-Tianjin-Hebei, and the effectiveness of its ecological restoration and protection is of great significance to the ecological security pattern of North China. Based on the FVC data from 2000 to 2021, residual analysis, parametric optimal geodetector technique (OPGD) and multi-scale geographically weighted regression analysis (MGWR) were used to clarify the the multivariate driving mechanism of the evolution of FVC in the TYR. Results show that: (1) FVC changes in the TYR show a slowly fluctuating upward trend, with an average growth rate of 0.02/10a, and a spatial pattern of "high in the northwest and low in the southeast"; more than half of the FVC increased during the 22-year period. (2) The results of residual analysis showed that the effects of temperature and precipitation on FVC were very limited, and a considerable proportion (80.80% and 76.78%) of the improved and degraded areas were influenced by other factors. (3) The results of OPGD showed that the main influencing factors of the spatial differentiation of FVC included evapotranspiration, surface temperature, land use type, nighttime light intensity, soil type, and vegetation type (q > 0.2); The explanatory rates of the two-factor interactions were greater than those of the single factor, which showed either nonlinear enhancement or bifactorial enhancement, among which, the interaction of evapotranspiration with mean air and surface temperature has the strongest effect on the spatial and temporal evolution of FVC (q = 0.75). Surface temperature between 4.98 and 10.4 °C, evapotranspiration between 638 and 762 mm/a, and nighttime light between 1.96 and 7.78 lm/m2 favoured an increase in vegetation cover, and vegetation developed on lysimetric soils was more inclined to be of high cover. (4) The correlation between each variable and FVC showed different performance, GDP, elevation, slope and FVC showed significant positive correlation in most regions, while population size, urban population proportion, GDP proportion of primary and secondary industries, and nighttime light intensity all showed negative correlation with FVC to different degrees. The results can provide data for formulating regional environmental protection and restoration policies.

Exploring the Environmental Influences and Community Assembly Processes of Bacterioplankton in a Subtropical Coastal System: Insights from the Beibu Gulf in China.

Due to rapid urbanization, the Beibu Gulf, a semi-closed gulf in the northwestern South China Sea, faces escalating ecological and environmental threats. Understanding the assembly mechanisms and driving factors of bacterioplankton in the Beibu Gulf is crucial for preserving its ecological functions and services. In the present study, we investigated the spatiotemporal dynamics of bacterioplankton communities and their assembly mechanisms in the Beibu Gulf based on the high-throughput sequencing of the bacterial 16S rRNA gene. Results showed significantly higher bacterioplankton diversity during the wet season compared to the dry season. Additionally, distinct seasonal variations in bacterioplankton composition were observed, characterized by an increase in Cyanobacteria and Thermoplasmatota and a decrease in Proteobacteria and Bacteroidota during the wet season. Null model analysis revealed that stochastic processes governed bacterioplankton community assembly in the Beibu Gulf, with drift and homogenizing dispersal dominating during the dry and wet seasons, respectively. Enhanced deterministic assembly of bacterioplankton was also observed during the wet season. Redundancy and random forest model analyses identified the physical properties (e.g., salinity and temperature) and nutrient content (e.g., nitrate) of water as primary environmental drivers influencing bacterioplankton dynamics. Moreover, variation partitioning and distance-decay of similarity revealed that environmental filtering played a significant role in shaping bacterioplankton variations in this rapidly developed coastal ecosystem. These findings advance our understanding of bacterioplankton assembly in coastal ecosystems and establish a theoretical basis for effective ecological health management amidst ongoing global changes.

Transferability of Effective Consultation Skills for Decision-Making Support in the Voluntary Surrender of Older Adult Drivers' Licences in Super-Aged Japan.

INTRODUCTION: Previously, we identified eight effective consultation skills to support decision-making in the voluntary surrender of older adult drivers' licences in super-aged Japan. This study aimed to clarify the transferability of these skills. METHODS: We collected text data by interviewing 11 safe-driving counsellors (four police officers, four clerical staff and three nurses) in the License Division of the National Police Agency from February to March 2022. Interviews were semi-structured and conducted by telephone or email. During the interview, participants were asked to recall their experiences as counsellors providing decision-making support to older drivers and to compare their experiences with the eight consultation skills. We analysed the content of the responses by quantitative text analysis with KH Coder 3 software. RESULTS: As a characteristic of the words and phrases used by counsellors in their narratives about consultation skills, the most frequently extracted words from among 3147 words were think, parties and family, and promote had the highest mediation centrality. The eight subgraphs were 'Respecting the will of relevant parties from their standpoint is natural', 'Listening attentively and empathetically to relevant parties is effective', 'Presenting objective data to guide decisions is successful', 'Showing cognitive functioning test results is often effective', 'Counselors with medical expertise can elicit positive counseling outcomes', 'Intervention by medical or police counselors facilitates the decision to surrender voluntarily', 'Counseling skills need to be improved' and 'A diagram of the 8 skills is helpful for inexperienced counselors'. CONCLUSION: The results suggest that the eight consultation skills have similarities and are transferable. This transferability might contribute to practical application or cohort follow-up study research. These skills can be incorporated into counsellor training, and counsellors can be expected to use these skills in the future. Regardless of the safe-driving counsellor's years of experience, the skills can help them provide uniform and accurate support in decision-making regarding the voluntary surrender of older adult drivers' licences. These skills are a promising approach to help older adults lead safe and secure lives as they age.

Gossip and coping with social isolation: the case of migrant truck drivers in Western Europe.

This article examines how employees use gossip as a resource to cope with social isolation. Building on a qualitative study with 32 truck drivers in a Western European company, our research identified gossip in close relationships and gossip in distant relationships as distinct patterns playing a different role in coping with social isolation, and a third pattern in which gossip was not beneficial. First, gossiping with close friends at work helped drivers engage in emotion-focused coping by reducing stress and loneliness. Second, gossiping with distant colleagues helped drivers engage in problem-focused coping by exchanging knowledge involving people in the organization. Third, gossip avoidance occurred in distant relationships, where drivers limited gossip exchanges going beyond instrumentally useful information. Overall, these findings show that drivers relied on different layers of their social network to cope with social isolation. Enriching previous research, this study shows that gossip represents an essential resource for emotion-focused and problem-focused coping.

Understanding consumer acceptability of verjuice, its potential applications and sensory and chemical drivers of liking.

The wine sector is working to add value, enhance sustainability and reduce waste, yet often creating new products with unknown consumer acceptance. Verjuice, juice made from discarded unripe thinned grapes, is an example. Whilst verjuice has various culinary uses, its versatility in beverages continues to expand. However, its sensory drivers of liking when consumed as a drink, and their potential impact on its application remain unclear. Chemical drivers of sensory characteristics are also unknown representing a critical knowledge gap needed to guide product innovation. This study aimed to provide new knowledge regarding consumer acceptability of verjuice by identifying its sensory drivers of liking as a beverage, evaluating its potential use in different applications and identifying chemical drivers of its sensory characteristics. New Zealand consumers (n = 93) evaluated 13 verjuice samples from different countries. Furthermore, verjuice familiarity and its influence on emotional response was investigated to determine likely future consumer engagement. Sweetness was the most positive driver of liking in verjuice overall, followed by fruity and floral notes, smoothness, and to a lesser extent citrus flavour. Consumers expressed varied preferences for verjuice's sensory profile, with fruity, floral, and honey flavours driving beverage application, whilst winey and green apple notes were more associated with culinary scenarios. Some association between chemical parameters and sensory attributes were evident (e.g. sugars were highly associated with perceived sweetness, fruity, and floral attributes; these attributes also shared proximity with 1-hexanol and cyclohexanol). The general idea of verjuice elicited positive valence emotions, but consumers who were 'not familiar' felt more curious, and those 'familiar' felt happier and more satisfied. Findings highlight the potential to tailor verjuice for specific applications by understanding desired sensory profiles and related chemical parameters. Recognising the interplay between familiarity level and emotional response is crucial for positioning the product in the marketplace and fostering consumer engagement. Marketing initiatives are needed to increase verjuice familiarity and support product innovation, leading to increased product appeal.

Pleistocene climate oscillations have shaped the expansion and contraction speciation model of the globose Eriosyce sect. Neoporteria cacti in Central Chile.

BACKGROUND AND AIMS: Pleistocene climatic oscillations, characterized by arid (interglacial) and pluvial (glacial) phases, have profoundly impacted the floras of Mediterranean climates. Our study investigates the hypothesis that these climatic extremes have promoted phases of range expansion and contraction in the Eriosyce sect. Neoporteria, resulting in pronounced genetic structuring and restricted gene flow. METHODS: Utilizing nuclear microsatellite markers, we genotyped 251 individuals across 18 populations, encompassing all 14 species and one subspecies within the Eriosyce sect. Neoporteria. Additionally, Species Distribution Models (SDMs) were employed to reconstruct past (Last Interglacial, Last Glacial Maximum, Mid-Holocene) and current potential distribution patterns, aiming to delineate the climatic influences on species' range dynamics. KEY RESULTS: The gene flow analysis disclosed disparate levels of genetic interchange among species, with marked restrictions observed between entities that are geographically or ecologically separated. Notably, E. subgibbosa from Hualpen emerged as genetically distinct, warranting its exclusion for clearer genetic clustering into north, central, and south clusters. The SDMs corroborated these findings, showing marked range expansions during warmer periods and contractions during colder times, indicating significant shifts in distribution patterns in response to climatic changes. CONCLUSIONS: Our findings emphasize the critical role of Pleistocene climatic fluctuations in driving the dynamic patterns of range expansions and contractions that have led to geographic isolation and speciation within the Eriosyce sect. Neoporteria. Even in the face of ongoing gene flow, these climate-driven processes have played a pivotal role in sculpting the species' genetic architecture and diversity. This study elucidates the complex interplay between climatic variability and evolutionary dynamics among Mediterranean cacti in central Chile, highlighting the necessity of considering historical climatic millenial oscillations in conservation and evolutionary biology studies.

Analyzing variation of water inflow to inland lakes under climate change: Integrating deep learning and time series data mining.

The alarming depletion of global inland lakes in recent decades makes it essential to predict water inflow from rivers to lakes (WIRL) trend and unveil the dominant influencing driver, particularly in the context of climate change. The raw time series data contains multiple components (i.e., long-term trend, seasonal periodicity, and random noise), which makes it challenging for traditional machine/deep learning techniques to effectively capture long-term trend information. In this study, a novel FactorConvSTLnet (FCS) method is developed through integrating STL decomposition, convolutional neural networks (CNN), and factorial analysis into a general framework. FCS is more robust in long-term WIRL trend prediction through separating trend information as a modeling predictor, as well as unveiling predominant drivers. FCS is applied to typical inland lakes (the Aral Sea and the Lake Balkhash) in Central Asia, and results indicate that FCS (Nash-Sutcliffe efficiency = 0.88, root mean squared error = 67m³/s, mean relative error = 10%) outperforms the traditional CNN. Some main findings are: (i) during 1960-1990, reservoir water storage (WSR) was the dominant driver for the two lakes, respectively contributing to 71% and 49%; during 1991-2014 and 2015-2099, evaporation (EVAP) would be the dominant driver, with the contribution of 30% and 47%; (ii) climate change would shift the dominant driver from human activities to natural factors, where EVAP and surface snow amount (SNW) have an increasing influence on WIRL; (iii) compared to SSP1-2.6, the SNW contribution would decrease by 26% under SSP5-8.5, while the EVAP contribution would increase by 9%. The findings reveal the main drivers of shrinkage of the inland lakes and provide the scientific basis for promoting regional ecological sustainability.

Microscale is key to model current and future Maritime Antarctic vegetation.

Despite being one of the most pristine regions in the world, Antarctica is currently also one of the most vulnerable to climate change. Antarctic vegetation comprises mostly lichens and bryophytes, complemented in some milder regions of Maritime Antarctica by two vascular plant species. Shifts in the spatial patterns of these three main vegetation groups have already been observed in response to climate change, highlighting the urgent need for the development of comprehensive large-scale ecological models of the effects of climate change. Besides climate, Antarctic terrestrial vegetation is also strongly influenced by non-climatic microscale conditions related to abiotic and biotic factors. Nevertheless, the quantification of their importance in determining vegetation patterns remains unclear. The objective of this work was to quantify the importance of abiotic and biotic microscale conditions in determining the spatial cover patterns of the major functional types, lichens, vascular plants and bryophytes, explicitly determining the likely confinement of each functional type to the microscale conditions, i.e., their ecological niche. Microscale explained >60 % of the spatial variation of lichens and bryophytes and 30 % of vascular plants, with the niche analysis suggesting that each of the three functional types may be likely confined to specific microscale conditions in the studied gradient. Models indicate that the main microscale ecological filters are abiotic but show the potential benefits of including biotic variables and point to the need for further clarification of vegetation biotic interactions' role in these ecosystems. Altogether, these results point to the need for the inclusion of microscale drivers in ecological models to track and forecast climate change effects, as they are crucial to explain present vegetation patterns in response to climate, and for the interpretation of ecological model results under a climate change perspective.

[Driving competence in older age: psychological assessment and interventions]. / Fahrkompetenz im Alter: Psychologische Diagnostik und Interventionen.

The article introduces the issue of psychological assessment and training for driving safety, driving competence, and the mobility of older drivers. The psychological methods for assessing driving competence and the training approaches for maintaining mobility in old age are outlined and illustrated with examples. Preserving driving ability in old age remains a task for which development needs and research gaps must be specified. Although periodic mandatory examinations based on age do not yield any relevant improvement in enhancing traffic safety, they do not cause harm and are widely accepted. It is desirable to move away from a theory focusing on deficits of older age and instead develop an assessment of the comprehensive functions, abilities, and resources of elderly drivers to help preserve the mobility and participation of that specific demographic in traffic.

Road traffic accidents and the contributing factors among drivers of public transportation in Mizan Aman town, Ethiopia: a Community-Based Cross-Sectional Study.

Background: Traffic accidents on the road is an accident is a terrible accident that causes death, injury, and property damage. However, limited studies were addressed to investigate the prevalence of traffic accidents on the road and the contributing factors among drivers that help in developing strategies to cop-up the incidence within the research domain in Ethiopia, particularly in the study area. Objective: This study aimed to assess the prevalence of road traffic accidents and the contributing factors among drivers of public transportation in Mizan Aman town, Ethiopia. Methods: A community-based cross-sectional survey was employed among 376 drivers of public transportation. Every research subject was selected by using a simple random sampling technique. Semi-structured and open-ended questionnaires which comprised demographic characteristics, risky personal behaviors and lifestyles, driver's factors, vehicle condition, and environmental conditions were used to gather data. And then after, data was collected through interviewer-administered using KoBo Collect tools. Completed data were edited and cleaned in the Kobo collect toolbox and then exported for additional analysis to a statistical tool for social science statistics version 26. The descriptive statistics were displayed as figures, tables, and texts. Binary logistic regression was analyzed to identify the contributing factors. Statistically significant was decided with a p-value of ≤ 0.05. Results: The results showed that the prevalence of road traffic accidents among drivers of public transportation in Mizan Aman town was 17%. The study identified factors influencing traffic accidents on the roads including marital status (being single), employee condition (permanent), monthly income (1001-2500 Ethiopia Birr), alcohol use, vehicle maintenance (not), road type (non-asphalt), and weather conditions (being windy). Conclusion: The overall prevalence of road traffic accidents among drivers of public transportation in Mizan Aman town was relatively low. Despite this, sociodemographic characteristics, driver factors, vehicle conditions, and environmental conditions [road type and weather conditions] were the predicting factors of traffic accidents in town. Therefore, reduction strategies should be the highest priority duty for concerned bodies like Mizan Aman town road and transport office, Bench Sheko zone transport and logistics office, and Southwest Ethiopia People Regional State (SWEPRS) transport bureau in the study area.

Promising Therapeutic Targets for Recurrent/Metastatic Anaplastic Thyroid Cancer.

OPINION STATEMENT: Anaplastic thyroid cancer presents formidable challenges, particularly in cases of recurrence or metastasis. Timely BRAF V600E testing is imperative at diagnosis, initially through immunohistochemistry, followed by comprehensive genomic profiling encompassing genes such as NTRK, RET, ALK, and assessment of tumor mutation burden (TMB). FDA-approved treatment options include dabrafenib and trametinib for patients with BRAF mutations, while those exhibiting high TMB may benefit from pembrolizumab. Further therapeutic decisions hinge upon mutational profile, urgency of response required, airway integrity, and access to targeted therapies There is growing use of immunotherapy for ATC based on published reports of activity, but currently there is no FDA approved agent for ATC. The off-label utilization of "precision medicine" combinations imposes a considerable financial strain, underscoring the necessity for further clinical trials to elucidate promising therapeutic avenues for this orphan disease. There is a pressing need for the development and support of clinical trials investigating genomically driven and immune-based therapies for anaplastic thyroid cancer.

Exploring drivers of environmental degradation in urban centres of developing countries: a case study.

A serene and pollution-free environment is the desire of the United Nations through its Sustainable Development Goal 11. This research was designed to explore various human endeavours that drive pollution in urban environs in the developing countries with Iwo, Nigeria, as a case study. Out of the four hundred and fifty (450) respondents that were randomly selected, 410 copies of structured questionnaire were completed and returned for analysis. Descriptive and inferential analytical methods were adopted for the purpose data analysis. Of all the respondents, 69.5% were females, and 95.1% were between the ages of 18 and 65 years, while 85.3% of the respondents have a minimum of secondary education. The dataset was further subjected to KMO and Bartlett's Test, the results which showed that the data is factorable with 68% at confidence level of p ≤ 0.05. Factor analysis extracted 7 variables out of the 21 variables analysed. The identified and extracted variables explained 87.745% of the variance explained by the extracted factors and their respective explanation variance are as follows: (i) palm oil activities in urban centres (20.521%); (ii) food vending outlets (14.153%); (iii) individual households within cities (13.786%); (iv) activities in the slaughter slabs and houses (11.384%); (v) auto repair workshops (9.812%); (vi) unplanned refuse dumpsites (9.571%); and (vii) in-urban free-range keeping of animals (8.745%). This research should give further insights to stakeholders, especially the policy makers in urban planning on subduing the challenges of unabated urban degradation in developing nations if human comfort and sustainability will be enhanced and that SDG 11 will be a reality come 2030.

Young novice drivers' road crash injuries and contributing factors: A crash data investigation.

OBJECTIVE: Collisions are a significant cause of injury and fatality among young novice drivers. Using real crash data, this study further explores the multifaceted and complex nature of young novice drivers' crash injury risk by synthesizing different driver attributes and crash scenarios in order to update and validate previous research findings and provide more feasible recommendations for preventive measures. METHODS: Detailed data on traffic crash of young novice drivers were extracted from the National Automobile Accident In-Depth Investigation System (NAIS) in China, and a mixed research methodology using a Random Forest and multinomial logit modeling framework was used in order to explore and study the important influences on traffic crash injuries of young novice drivers in Songjiang District, Shanghai, during the period from 2018 to 2022. RESULTS: The results of the study showed that human, vehicle, road and environmental characteristics contributed 36.83%, 22.65%, 17.07% and 23.45% respectively to the prediction of crash injury level of novice drivers. Among the various single factors, driver negligence was the most important factor affecting the crash injury level of novice drivers. Age of the vehicle, crash location, road signal condition and time of crash all had a significant effect on the crash injury level of young novice drivers (95% of the confidence level). CONCLUSIONS: The study comprehensively analyzed young novice driver crash data to reveal the crash injury risk and its severity faced by young novice drivers in different contexts, and suggested targeted safety improvements. There are similarities and differences with the results of previous studies, in which there are new contributions to understanding the driving risks of young novice drivers in daytime and nighttime.

Determinants of medical care-seeking behavior for musculoskeletal conditions during US: Marine Corps training: A thematic analysis.

CONTEXT: Musculoskeletal injuries (MSK-I) are a well-documented problem in military populations and a leading contributor to disability across military services. However, only a portion of Service members who sustain MSK-I report it to medical providers. Although several studies have identified barriers to seeking medical care in military populations, less is known about what motivates Service members to seek care for MSK-I. OBJECTIVE: To describe determinants of medical care-seeking behavior for MSK-I and/or musculoskeletal pain (MSK-P) in recently-enlisted Marines during military training. DESIGN: Qualitative Study. SETTING: School of Infantry-West (SOI-W), US Marine Corps Base XXX, XXX. PATIENTS OR OTHER PARTICIPANTS: 1,097 US Marines entering Infantry Training Battalion or Marine Combat Training at SOI-W. DATA COLLECTION AND ANALYSIS: Participants completed written surveys at entry to (baseline) and graduation from SOI-W. Closed-ended question responses were used to calculate MSK-I/MSK-P and care-seeking frequencies. Open-ended responses describing determinants of care-seeking behavior were analyzed using inductive thematic analysis. RESULTS: Ten percent of participants self-reported sustaining MSK-I during basic training, while 14% self-reported sustaining MSK-I in SOI-W training. A greater proportion reported seeking medical care for their MSK-I/MSK-P during basic training compared to SOI-W training. The thematic analysis resulted in three main themes that describe drivers and barriers for seeking medical care: 1) Self-perceived need for medical care; 2) Prioritizing military training; and 3) Training-specific influences. CONCLUSION: Understanding determinants of care-seeking behavior is valuable when designing intervention strategies to promote early MSK-I treatment. Our findings add to previous research to elucidate reasons underlying the decisions about care-seeking for MSK-I/MSK-P. Interventions, including educational strategies and direct approaches, like embedding medical providers within units, to minimize barriers to seeking medical care in the military may reduce the burden of MSK-I/MSK-P on Service members throughout their military careers.

Environmental correlates of the forest carbon distribution in the Central Himalayas.

Understanding the biophysical limitations on forest carbon across diverse ecological regions is crucial for accurately assessing and managing forest carbon stocks. This study investigates the role of climate and disturbance on the spatial variation of two key forest carbon pools: aboveground carbon (AGC) and soil organic carbon (SOC). Using plot-level carbon pool estimates from Nepal's national forest inventory and structural equation modelling, we explore the relationship of forest carbon stocks to broad-scale climatic water and energy availability and fine-scale terrain and disturbance. The forest AGC and SOC models explained 25% and 59% of the observed spatial variation in forest AGC and SOC, respectively. Among the evaluated variables, disturbance exhibited the strongest negative correlation with AGC, while the availability of climatic energy demonstrated the strongest negative correlation with SOC. Disturbances such as selective logging and firewood collection result in immediate forest carbon loss, while soil carbon changes take longer to respond. The lower decomposition rates in the high-elevation region, due to lower temperatures, preserve organic matter and contribute to the high SOC stocks observed there. These results highlight the critical role of climate and disturbance regimes in shaping landscape patterns of forest carbon stocks. Understanding the underlying drivers of these patterns is crucial for forest carbon management and conservation across diverse ecological zones including the Central Himalayas.

On the road to retirement: Predicting nighttime driving difficulty and cessation using self-reported health factors.

Introduction: Older drivers now expect to drive longer than previous cohorts and will make up about 25% of licensed U.S. drivers by 2050. Identifying early predictors of nighttime driving difficulty, a precursor to driving retirement, can inform screening procedures and timely linkage to interventions supporting driving or transitioning to driving cessation. Methods: We examined self-reported physical and mental health baseline predictors of greater nighttime driving difficulty in five and ten years using weighted multivariate logistic analyses of 2261 drivers, aged 57 to 85, from the National Social Life, Health, and Aging Project (NSHAP). Transition matrix models describe probabilities of having greater, lesser, or the same nighttime driving difficulty after five years based on baseline driving conditions and the significant logistic model factors. We built a transition matrix tool that offers users the ability to calculate expected probabilities of change in nighttime driving difficulty based on the identified salient factors. Results: Five-year predictors of greater nighttime driving difficulty included perceived poor physical health (OR = 3.75), limitations to activities of daily living (ADLs; OR = 1.97), and clinical levels of depressive and anxiety symptoms (OR = 1.63; OR = 1.71). Excellent physical health (OR = 0.52), mental health (OR = 0.60), and any frequency of physical activity compared to 'never' were protective (OR = 0.37-0.51). Physical health, walking pain, and limitations to ADLs were predictive at ten-years. Transition models showed physical health and anxiety were most indicative of greater nighttime driving difficulty at 5-years for those reporting no difficulty at baseline, but limitations to ADLs were more predictive otherwise. Conclusions: Lay practitioners could capitalize on the use of self-report screening measures to identify older adults who may experience near-term nighttime driving difficulty. Earlier identification may better guide long-term driving retirement planning or engagement in appropriate health interventions. The transition matrix modeling tool is freely available to facilitate development and validation of related measures.