Distinct Preferences Research Articles

In-Cell Mass Spectrometry and Ultraviolet Photodissociation Navigates the Intracellular Protein Heterogeneity.

Directly probing the heterogeneous conformations of intracellular proteins within their native cellular environment remains a significant challenge in mass spectrometry (MS). Here, we establish an in-cell MS and ultraviolet photodissociation (UVPD) strategy that directly ejects proteins from living cells into a mass spectrometer, followed by 193 nm UVPD for structural analysis. Applying this approach to calmodulin (CaM), we reveal that it adopts more extended conformations within living cells compared with purified samples in vitro, highlighting the unique influence of intracellular environments on protein folding. Furthermore, UVPD analysis of calcium ion (Ca2+)-binding variants of CaM unveils not only the conformational heterogeneity induced by multiple Ca2+ modulations but also reveals distinct preferences of Ca2+ binding sites across different conformations. This strategy provides a powerful tool for interrogating the structure-function relationships of intracellular protein variants with sophisticated metal ion binding, paving the way for a deeper understanding of protein conformations within their native cellular context.

Temporal and Topographical Heterogeneities in Clinical Manifestations of Atopic Dermatitis in China

Background/Objective: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by diverse clinical manifestations. However, variations in its clinical presentations across different ages, genders, anatomical sites, and seasons remain incompletely understood. The objective was to explore the clinical heterogeneities of AD using data from the Chinese non-selective registration system. Methods: A prospective analysis was conducted on 3829 AD patients enrolled in the Chinese Non-selective Registry for AD (CNRAD) at hospital settings from 2020 to 2022. Demographic profiles; distribution, type, and severity of the skin lesion; laboratory findings; allergic comorbidities; family history; and exacerbating factors were analyzed. Results: The male-to-female ratio was 0.92 among adolescent and adult AD patients but increased to 2.11 in elderly AD patients, highlighting an age-dependent gender difference in AD prevalence. Age groups displayed distinct anatomical preferences for lesion distribution, with reduced involvement of the cubital and popliteal fossae in adult and elderly patients. Based on skin lesion characteristics, ten clinical subtypes of AD were proposed. Elderly AD patients exhibited higher severity, compared to adolescence and adult AD patients, with male patients being more severe than females. Elderly AD patients showed a lower proportion of extrinsic type, compared to childhood AD patients. Seasonal change emerged as the most important factor triggering AD flares. Conclusions: This study provides new insights into the heterogeneities of AD clinical manifestations in the Chinese population, demonstrating their significant dependence on temporal factors, including age and season.

Engineering of Cyclodextrin Glucosyltransferase from Paenibacillus macerans for Improved Regioselectivity and Product Specificity Toward Hydroxyflavone Glycosylation

The regioselective glycosylation and product specificity of hydroxyflavonoid compounds profoundly influences their biological activity and stability, offering significant therapeutic potential. However, most cyclodextrin glucosyltransferases (CGTases) inherently lack regioselectivity and product specificity for flavone glycosylation. Herein, a CGTase from Paenibacillus macerans was engineered for enhanced glycosylation regioselectivity and product specificity by combining molecular docking analysis and saturation mutagenesis strategies. K232L (favoring 4′-and 6-hydroxyflavones) and K232V (favoring 7-hydroxyflavone) were identified with distinct preferences. In addition, H233Y (preferring for 4′-hydroxyflavones), H233T (preferring for 6′-hydroxyflavones), and H233K (preferring for 7′-hydroxyflavones) also demonstrated distinct regioselectivity. These variants further exhibited enhanced hydrolytic activity, enabling the efficient production of short sugar-chain glycosides. Molecular dynamics (MDs) simulations revealed that the variants adopted optimized catalytic conformations with increased loop region flexibility near the binding pocket, enhancing substrate accessibility. These findings underscore the pivotal roles of K232 and H233 in broadening the substrate scope of CGTase and offer valuable guidance for enzyme engineering targeting regioselective glycosylation.

β-Glucosidase VmGlu1 is required for toxin production and pathogenicity of Valsa mali

Flavonoids, serving as crucial secondary metabolites, are widely distributed in plants and play a key role in inhibiting microbial growth, protecting plants from pathogen invasion, and conserving energy. Our previous study revealed that the β-glucosidase VmGlu2 effectively catalyzes the degradation of phloridzin, a typical flavonoid in apples, and regulates the pathogenic process of Valsa mali. However, VmGlu2 exhibits a lower efficiency in degrading rutin, another characteristic flavonoid in apples. In this study, we found that the expression level of the β-glucosidase gene VmGlu1 was induced by 9.42-fold following rutin treatment, and VmGlu1 possessed the capability to degrade both rutin and phloridzin, but under the same conditions, VmGlu1 showed a distinct preference for rutin degradation, with an initial degradation rate 8.66 times higher than that of VmGlu2. Targeted deletion of VmGlu1 resulted in a 99.32% reduction in pycnidia production, a nearly 33% decrease in toxin production, and a significant decrease in pathogenicity on apple twigs and leaves. Furthermore, we verified that VmGlu1 and VmGlu2 exhibit functional redundancy in pycnidia production, toxin-related β-glucosidase activity, and pathogenicity by generating double-deletion mutants. The results of this study provide valuable insights into the roles of VmGlus in the interaction of V. mali and apple during the infection process.

Comparing the efficacy of live vs. video instructional demonstrations in dental education: a systematic review and meta-analysis

BackgroundThis systematic review and meta-analysis were conducted to investigate the effects of live and video demonstrations of various dental procedures on undergraduate students’ performance and satisfaction scores.Materials and methodsA comprehensive search was conducted across multiple databases, including MEDLINE (OVID), PubMed, Scopus, and Web of Science, supplemented by a manual search of bibliographic references from retrieved articles. The aim was to identify relevant randomized controlled trials and quasi-experimental trials that compared live demonstrations to video demonstrations in dental education, specifically focusing on undergraduate students’ performance and satisfaction scores assessed using practical assessment rubrics and satisfaction questionnaires. The quality of included studies was assessed using the modified Downs and Black quality assessment tool.ResultsA total of 3686 studies were identified, of which 2222 studies remained following duplicate removal. Based on title and abstract screening 2188 studies were excluded and full text of 34 studies were comprehensively appraised for eligibility. This resulted in the inclusion of 10 studies in the systematic review, nine of which were classified as good, while one study was considered as fair. Of these, 8 studies were included in the meta-analysis.Students’ feedback reveals distinct preferences, with video demonstrations being commended for repeatability and clarity, while live demonstrations were valued for real-time interaction and guidance. Meta-analysis revealed that video-based learning significantly enhanced educational outcomes across various measures, including knowledge acquisition and practical skills over live demonstrations.ConclusionVideo demonstrations emerge as viable alternatives to live demonstrations in dental education for teaching clinical procedures. Video demonstrations offer distinct benefits, including accessibility and repeatability, while live demonstrations provide essential interactive opportunities that contribute significantly to the learning experience in dental education.

Multi-faceted examination of a deepwater seamount reveals ecological patterns among coral and sponge communities in the equatorial Pacific

Spatial changes in benthic community structure have been observed across natural gradients in deep-sea ecosystems, but these patterns remain under-sampled on seamounts. Here, we identify the spatial composition and distribution of coral and sponge taxa on four sides of a single central Pacific equatorial “model” seamount within the US EEZ surrounding the Howland and Baker unit of the Pacific Islands Heritage Marine National Monument. This seamount rises from 5,000 + m to mesophotic depths of 196 m, and is influenced by the Equatorial Undercurrent. Four remotely operated vehicle (ROV) transects were completed, one on each flank of the seamount. Shallower than ~ 250 m, the mesophotic seafloor was composed of scoured carbonate pavement with sediment accumulation only found in rocky depressions. Waters below 500 m hosted communities predominantly composed of octocorals, however, several coral taxa showed seamount flank preference (higher abundance on one or more flanks than the others) even though strong vertical (depth) zonation of corals and sponges was observed on all flanks. Euplectellidae, Plexauridae and ​​Chrysogorgia spp. corals each showed a distinct preference for flank. To help visualize the influence of current flow, oxygen, depth, and substrate type on the zonation of seamounts, we created an Alexander Von Humboldt-style infographic to illustrate the observed biodiversity patterns. Given the importance of seamounts to ocean biodiversity and productivity, this study is an early attempt at a holistic visualization of seamount biology that can advance new hypotheses about seamount ecology.

In silico characterization of defense system hotspots in Acinetobacter spp.

The bacteria-phage arm race drives the evolution of diverse bacterial defenses. This study identifies and characterizes the defense hotspots in Acinetobacter baumannii using a reference-free approach. Among 4383 high-quality genomes, we found a total of 17,430 phage defense systems and with 54.54% concentrated in 21 hotspots. These hotspots exhibit distinct preferences for different defense systems, and co-occurrence patterns suggest synergistic interactions. Additionally, the mobile genetic elements are abundant around these hotspots, likely facilitating horizontal transfer and evolution of defense systems. The number of hotspots increases in species phylogenetically closer to Acinetobacter baumannii, but the number of defense systems per hotspot varies due to particular selective pressures. These findings provide critical insights into the genetic organization of phage defense systems, contributing to a broader understanding of bacterial immunity and the evolutionary dynamics that shape Acinetobacter genomes. This knowledge lays the foundation for developing targeted interventions to combat antibiotic resistance Acinetobacter baumannii.

The Influence of Organizational Culture, Leadership Style and Generational Differences on Employee Loyalty to the Company

This study explores the influence of organizational culture, leadership style, and generational differences on employee loyalty to the company. Employee loyalty is a critical factor for organizations seeking long-term success and competitiveness, as loyal employees are more engaged, productive, and committed. The research uses a qualitative approach based on literature review and library research to understand the interactions between organizational culture, leadership style, and the generational factors that impact employee loyalty. Organizational culture is a key determinant in shaping employees' attitudes and behaviors, influencing their level of commitment and engagement with the company. Leadership style, whether transformational, transactional, or laissez-faire, also plays a significant role in motivating employees and fostering a sense of loyalty. Additionally, the study highlights the growing importance of understanding generational differences in the workforce, as Baby Boomers, Generation X, Millennials, and Generation Z exhibit distinct values, expectations, and work preferences. This research aims to provide a comprehensive understanding of how these factors collectively influence employee loyalty and offer insights for organizations to enhance loyalty across different generations. The findings suggest that a positive organizational culture, combined with effective leadership that aligns with the expectations of different generations, can significantly improve employee loyalty. The study recommends that companies invest in developing a supportive work environment, adaptive leadership strategies, and policies that recognize generational differences to foster loyalty and reduce turnover.

Spatiotemporal dynamics of fetal liver hematopoietic niches.

Embryonic hematopoietic cells develop in the fetal liver (FL), surrounded by diverse non-hematopoietic stromal cells. However, the spatial organization and cytokine production patterns of the stroma during FL development remain poorly understood. Here, we characterized and mapped the hematopoietic and stromal cell populations at early (E12.5-14.5) FL stages, revealing that while hepatoblasts were the primary source of hematopoietic growth factors, other stromal cells-including mesenchymal, mesothelial, and endothelial cells-also contributed to this signaling network. Using a dedicated image analysis pipeline, we quantified cell distances to tissue structures and defined neighbor relationships, uncovering that different hematopoietic progenitors exhibit distinct preferences for neighboring stromal cells and show developmental changes in spatial distribution. Notably, our data suggest that the sub-mesothelium region plays a prominent role in early fetal hematopoiesis. This approach offers a valuable tool for studying complex cellular interactions in biological systems, providing new insights into hematopoietic niche organization during development.

Insights into substrate recognition and export tunnel preferences in the efflux transporter AcrB.

In Escherichia coli AcrB is a major multidrug exporter, which confers the bacterium resistance to many antibiotics with diverse structural and chemical proprieties. Studies have identified three possible tunnels (or channels) within AcrB that different substrates use before reaching the distal pocket, from which they are subsequently extruded. Recently, we reported that mutations in the AcrB gate loop may affect the conformational change kinetics involved in substrate export rather than directly affecting molecular interactions with this loop, and we highlighted the distinct export tunnel preferences between erythromycin and doxorubicin. To further understand the gate loop's role in AcrB's export activity and the rationale behind substrate preferences among the three possible export tunnels, namely tunnel-1, -2, and -3, we investigated the structural and functional effects of several single and multiple mutations in the gate loop of AcrB. Our findings indicate that all three tunnels are energetically favorable for the substrates studied, with the majority forming more hydrogen bonds in any tunnel compared to the distal pocket. Moreover, our experimental and computational data revealed that some substrates with high molecular similarity exhibited different export tunnel preferences, as strongly suggested by their MIC values. To explain this unexpected outcome, we propose a generalized explanation that the conformational change kinetics in AcrB is substrate-dependent.

Sown wildflower fields and hedgerows synergistically promote insectivorous bats

AbstractDespite their relevance for anthropogenic impacts on biodiversity, synergistic effects are rarely considered in conservation science or management. However, the implementation of single agri‐environment measures may limit their potential benefits for biodiversity since species often require a multitude of complementary key resources, particularly in homogeneous and structurally poor landscapes. To advance conservation management, we studied whether hedgerows promote benefits of sown wildflower fields for insectivorous bats in temperate agro‐ecosystems. At 12 study sites, we simultaneously monitored bat activity and insect abundances from early to late summer at paired locations, that is, the ecotone of a sown wildflower field bordering a hedgerow and an open boundary of the same wildflower field. Particularly in early and mid‐summer, we found distinct preferences of bats for the ecotone of wildflower field and hedgerow. Yet, independent of the season, neither insects nor specifically moths showed a significant preference for the ecotone. Finally, both bat activity as well as insect abundances shifted towards the ecotone when distance to the nearest forest patch was high. We showed that synergies of hedgerows and wildflower fields promote benefits of the latter for both edge‐ and open‐space foraging bats, particularly in homogeneous and structurally poor agricultural landscapes. Therefore, successful conservation management should take advantage of synergies between complementary conservation measures at the local patch scale and at the same time, account for landscape composition and configuration.

Significance of demographic variables on perceived attention restoration using biophilic strategies in luxury hotels in Nigeria

AbstractNatural environments have been discovered to promote restoration from mental fatigue and improve cognitive performance. In hotels, patrons creating these restorative environments is of great importance to ensure a truly rejuvenating stay for patrons. However, luxury hotels in Nigeria often struggle to effectively incorporate restorative elements that cater to their diverse international clientele, which leads to suboptimal guest experiences. This study examines the impact of biophilic design strategies on creating restorative spaces in luxury hotels in Abuja, Nigeria, and how demographic variables moderate these effects. It adopts Attention Restoration Theory (ART) as a conceptual framework and employs a quantitative approach to evaluate the influence of biophilic elements on perceived restorativeness. Data was gathered from a survey of 415 hotel guests in Abuja. Major findings indicate that visual connections with nature, spacious environments, and a balance of complexity and order significantly contribute to attention restoration. Age and cultural background were identified as significant moderators, with older adults and non-Nigerian guests perceiving higher levels of restoration in certain aspects. In contrast, gender did not substantially affect the association between biophilic elements and perceived restorativeness. The study therefore highlights the importance of tailoring hotel environments to diverse demographic needs to enhance guest well-being. The findings provide a practical framework for hotel designers to integrate biophilic design principles efficiently and it emphasizes the design of environments that cater to the distinctive preferences of different age groups and cultural backgrounds. Recommendations include strategic placement of natural elements, advocating for sustainable design policies, and further research into optimizing biophilic interventions for various hotel types.

Exploring Fungal Biodiversity in Crop Rotation Systems: Impact of Soil Fertility and Winter Wheat Cropping.

This study investigated soil fungal biodiversity in wheat-based crop rotation systems on Chernozem soil within the Pannonian Basin, focusing on the effects of tillage, crop rotation, and soil properties. Over three years, soil samples from ten plots were analyzed, revealing significant fungal diversity with Shannon-Wiener diversity indices ranging from 1.90 in monoculture systems to 2.38 in a fertilized two-year crop rotation. Dominant fungi, including Fusarium oxysporum, Penicillium sp., and Aspergillus sp., showed distinct preferences for soil conditions such as pH and organic matter (OM). Conservation tillage significantly enhanced fungal diversity and richness, with the highest diversity observed in a three-year crop rotation system incorporating cover crops, which achieved an average winter wheat yield of 7.0 t ha-1-47% higher than unfertilized monoculture systems. Increased OM and nitrogen levels in these systems correlated with greater fungal abundance and diversity. Canonical correspondence analysis revealed strong relationships between fungal communities and soil properties, particularly pH and calcium carbonate content. These findings highlight the importance of tailored crop rotation and tillage strategies to improve soil health, enhance microbial biodiversity, and boost agricultural sustainability in temperate climates, providing valuable insights for mitigating the impacts of intensive farming and climate change.

A Systematic Search for Candidate Supermassive Black Hole Binaries Using Periodic Mid-infrared Light Curves of Active Galactic Nuclei

Periodic variability in active galactic nuclei (AGNs) is a promising method for studying subparsec supermassive black hole binaries (SMBHBs), which are a challenging detection target. While extensive searches have been made in the optical, X-ray, and gamma-ray bands, systematic infrared (IR) studies remain limited. Using data from the Wide-field Infrared Survey Explorer (WISE), which provides unique decade-long mid-IR light curves with a six-month cadence, we have conducted the first systematic search for SMBHB candidates based on IR periodicity. Analyzing a parent sample of 48,932 objects selected from about half a million AGNs, we have identified 28 candidate periodic AGNs with periods ranging from 1268 to 2437 days (in the observer frame), by fitting their WISE light curves with sinusoidal functions. However, our mock simulation of the parent sample indicates that stochastic variability can actually produce a similar number of periodic sources, underscoring the difficulty in robustly identifying real periodic signals with WISE light curves, given their current sampling. Notably, we find no overlap between our sample and optical periodic sources, which can be explained by a distinct preference for certain periods due to selection bias. By combining archived data from different surveys, we have identified a candidate exhibiting periodic behavior in both the optical and IR bands, a phenomenon that warrants further validation through observational tests. Our results highlight the potential of IR time-domain surveys, including future missions such as the Nancy Grace Roman Space Telescope, for identifying periodic AGNs, but complementary tests are still needed to determine their physical origins, such as SMBHBs.

Seasonal changes in the feeding aggregation structure of male sperm whales (Physeter macrocephalus) in Northern Norway

AbstractThe sperm whale (Physeter macrocephalus) is one of the most widely distributed cetaceans. Adult males commonly occupy high latitudes, whereas females and juveniles occupy lower latitudes. In Northern Norway, previous studies focused on the summer period limiting our understanding of the seasonal dynamics of male foraging aggregations. We used year‐round capture–mark–recapture data based on photo identification between 2009 and 2023 to examine seasonal patterns within a male aggregation off Andøya, Northern Norway. Our analysis encompassed 426 days of data, 111 days in winter (October–April) and 315 days in summer (May–September). Among 365 identified individuals, 29% were encountered across multiple years. A higher number of individuals could be identified in winter compared to summer. The mean estimated residency time was shorter in winter (13 days) than in summer (18 days). We identified four groups with distinct seasonal preferences in occurrence and residency, suggesting seasonal and individual foraging and social patterns. Despite the marked seasonal patterns, the relatively short residency times imply this area constitutes only a fraction of the broader foraging range of sperm whales in the Northeast Atlantic. This study highlights the year‐round presence of sperm whales in the area, emphasizing their individual seasonal preferences.

The Perceptions and Attitudes of Residents Towards Urban Green Spaces in Emilia-Romagna (Italy)—A Case Study

Rapid urbanisation has highlighted the importance of urban green spaces (UGS) in promoting environmental sustainability and human wellbeing, yet the gap between urban planning practices and community preferences remains a significant challenge. This study investigated residents’ perceptions and attitudes towards UGS in a neighbourhood of an Italian city (Quartiere Marconi, Imola), focusing on understanding both the strengths and limitations of existing public green spaces from users’ perspectives. Through a comprehensive questionnaire survey of 126 residents, we examined the associations between socio-demographic characteristics and four aspects of UGS utilisation: visiting purposes, barriers to visits, satisfaction levels, and suggestions for improvement. Chi-square tests were conducted to identify significant relationships. The results indicate that life stage, rather than scattered socio-demographic factors, plays a crucial role in shaping UGS perceptions and usage patterns. Particularly, the 31–45 and 46–60 age groups, characterised by family-caring and career responsibilities, showed distinct preferences for social activities, while individual users focused more on nature enjoyment. Although accessibility was generally sufficient, satisfaction levels varied significantly based on living arrangements, with families emphasising facility-related issues and individual users prioritising natural features. These findings suggest that successful UGS planning requires attention to both high-quality natural elements and user-oriented facilities to meet the diverse needs of different life stages. This study represents the preliminary phase of a project, which concerns the redevelopment of the area under study, in order to create a more inclusive and high-quality UGS, taking into account the needs of the resident population.

Comprehensive Analysis of Physicochemical Properties and Sensory Attributes of Original-Cut Potato Chips in the Chinese Market.

This study investigates the Chinese market's physicochemical properties and sensory attributes of 14 original-cut potato chip brands. Color characteristics, compositional analysis, sugar content, acrylamide levels, and textural properties were examined alongside sensory evaluations. Significant variations were observed across all the parameters. Color analysis revealed diverse L*, a*, and b* values, with total color difference (ΔE) strongly correlating with sensory scores (r = 0.73, p < 0.01). A compositional analysis showed substantial differences in protein (5.19-8.51%), fat (27.91-40.16%), and moisture (0.67-3.78%) contents. Acrylamide levels varied widely (166.7-1101.78 mg/kg), positively correlating with the sucrose content (r = 0.57, p < 0.05). A textural analysis demonstrated significant variations in hardness (379.38-1103.6 gf) and fracturability (167.5-857.77 gf), with fracturability negatively correlating with sensory scores (r = -0.75, p < 0.01). A sensory evaluation revealed distinct brand preferences, with the total scores ranging from 65 to 85. This comprehensive analysis provides valuable insights into the complex interplay between the physicochemical properties and consumer perception of potato chips in the Chinese market and offers potential directions for product optimization and quality control in the snack food industry, inspiring hope and innovation among industry professionals.

HIGH-PROFICIENCY AND LOW-PROFICIENCY LEARNERS’ COMPENSATION STRATEGIES USE IN ENGLISH LANGUAGE LEARNING

Compensation strategies are vital for foreign language learners to overcome difficulties in acquiring a second language. According to Oxford (1990), these strategies help learners “overcome knowledge limitations in all four skills” (p. 90), making them essential for effective language acquisition. This study investigates the preferred compensation strategies of high- and low-proficiency English learners at Jagannath University, Dhaka, Bangladesh, using a mixed-methods approach. Data collection involved the Strategy Inventory for Language Learning (SILL) questionnaire designed by Oxford, alongside semi-structured interviews to enrich the qualitative findings. Results indicate distinct preferences based on proficiency levels: high-proficiency learners frequently employed Strategy 6: “If I can’t think of an SL word, I use a word or phrase that means the same thing” (40%). Meanwhile, low-proficiency learners favored Strategy 1: “To understand unfamiliar SL words, I make guesses” (66.66%). These findings highlight the significance of adapting teaching approaches to address diverse learner needs, ultimately enhancing language learning efficiency and effectiveness.

Differences in Perspectives Between Experts and Residents on Living Heritage: A Study of Traditional Chinese Villages in the Luzhong Region

The differences in the heritage perspectives of key stakeholders form an indispensable basis for formulating appropriate conservation strategies for living heritage. However, in existing practices, the differences in heritage perspectives between experts and local residents, who are both key stakeholders, often arise from expert experiences rather than being accurately measured. This study regarded traditional Chinese villages in the Luzhong region as a living heritage case for investigation and quantified such differences. Initially, this study provided a comprehensive description of living heritage using four dimensions: heritage value, heritage attributes, heritage composition, and heritage characteristics. Subsequently, a questionnaire tailored to traditional Chinese villages was developed, and a survey was conducted in the sample villages, resulting in 394 valid responses. According to the Pearson chi-square tests, the findings suggest that expert and local resident respondents showed slight disagreement regarding heritage attributes (x2 = 5.619); however, they presented varying degrees of differences concerning heritage value (x2 = 36.066) and heritage composition (x2 = 36.525), accompanied by distinct preferences. Furthermore, significant discrepancies were evident regarding heritage characteristics. Regarding the four aspects of heritage characteristics, there was a slight difference in the symbiosis of heritage elements (x2 = 3.877) but significant differences in the local resident as a heritage element (x2 = 36.525); there was a minor difference in vitality and continuity (x2 = 3.709) but a rare contradiction for integrity (x2 = 47.649). This study can furnish case data support for surmounting the drawbacks of blindly relying on expert experiences, particularly by integrating local perspectives to safeguard living heritage globally.

In varietate concordia - cluster analysis of EQ-5D-5L value sets in European Union countries.

The transferability of health policies in the European Union (EU) faces challenges due to economic, political, and healthcare system factors,including cross-country differences in health preferences. In order to aid policymaking,previous research has grouped EU countries based on geographical proximity or literature-based criteria, but not on health preference data. The EQ-5D-5L instrument, which measures health-related quality of life and reflects unique national health preferences shaped by cultural and social factors, is used to evaluate policies, technologies and interventions, but has not been used to group countries. Thus, this study aims to identify clusters of EU-27 countries with similar preference patterns using published EQ-5D-5L value sets. Hierarchical agglomerative clustering was employed on 13 EU-27 countries' EQ-5D-5L value sets, first analyzing regression coefficients for each dimension-level and then creating a simulated coefficient distribution considering uncertainty. Five clusters of EU-27 countries emerged: (1) Belgium, Netherlands, Sweden, Germany); (2) Hungary, Italy, Portugal; (3) Poland, Romania; (4) France, Spain; (5) Denmark, Ireland. All clusters except cluster5 gave higher importance to "Pain and Discomfort"; all clusters except cluster1 gave less importance to "Usual Activities". "Anxiety and Depression" and "Pain and Discomfort" had the largest heterogeneity in valuation across severity level. Identified clusters of countries with distinct health preferences provide insights for health policy transferability in the EU. Recognizing countries with similar health preferences can aid EU policymaking and transferability efforts, particularly in early-stage policymaking, while also fostering closer collaboration on health policy decisions and best practice sharing. Further development of national value sets within the EU is necessary for a more accurate representation.