Population Scale Research Articles

Psychometric Analysis of Disrespect and Abuse Scale.

Disrespect and abuse of laboring and child-birthing women in health care is a global problem that violates the universal human rights of childbearing women. There is a lack of reliable and valid tools for measuring these behaviors. One instrument, the Disrespect and Abuse scale, has preliminary data with no established psychometrics in diverse populations. Further analysis is required to ensure the reliability and validity of this tool in diverse populations and health care settings. We examined the psychometric properties of the Disrespect and Abuse scale in diverse international nursing and midwifery populations. A cross-sectional descriptive design was used to measure disrespect and abuse toward women during childbirth. Data were collected from 231 nurses and midwives across international labor and delivery units. Exploratory factor analysis was conducted using principal component analysis with oblimin rotation as the factor extraction method. The psychometric assessment yielded a two-factor structure. Factor 1 consisted of 13 items characterizing physical and verbal abuse. Factor 2 contained nine items reflecting disrespectful behaviors. The Cronbach's alpha coefficients reflected high internal consistency. The scale was shown to be reliable and valid in assessing self-reported disrespectful and abusive behaviors among nurses and midwives in a diverse international sample. Use could assist in the assessment of these behaviors in maternal health care facilities. Further research is warranted to confirm the scale's robustness and applicability across various populations and settings and use the Disrespect and Abuse scale to identify the burden and predictors of mistreatment of women in different health care settings.

N35 Psycological discomfort in patients with Inflammatory Bowel Disease

Abstract Background IBD can affect seriously to mental health(1). Social life, relationships and emotional well-being can be challenging day after day. Patients can suffer from frustration, sadness and psychological discomfort during diagnosis, remission and specially during flares. Depression and anxiety are common in patients with IBD, and are associated to a higher chance of relapse. Furthermore, there is a two-way relationship between anxiety and depression(2) and IBD, which worsen the quality of life(3). The aim of this study is to determine the presence of anxiety and/or depression in patients with IBD Methods A transversal study was carried out in Hospital Universitario del Henares. 50 patients with IBD were enrolled, both genders, 18-65 years old, with no cognitive deterioration. All patients were seen at the outpatient nursing clinic during first quarter of 2023. Data were collected in Hospital Anxiety and Depression Scale (HADS)(4) and in a questionnaire ad hoc. Variables: sociodemographic, IBD activity, health status and lifestyle. Anxiety and depression level was considered with a higher punctuation of 8. A descriptive analysis was carried out with qualitative and quantitative variables. Students-T for quantitative variables and Chi-square for qualitative variables Results Women: 52%, 52.78 years old (SD 12), Chron disease: 60%, IBD for more than 10 years: 42%; biologic treatment: 57%. Activity: remission: 60%, mild: 26%. Smoking: 18%, regular physical exercise: 53%. Body Max Index (BMI): 27.21 kg/m2 (SD 5.95), overweight 28%, obesity 16%. HADS: anxiety 9 (SD 12) and depression 5.76 (SD 3.7). 66% presented anxiety scores, and 28% depression scores. Bilateral analysis between anxiety variable and independent variables, showed that women presented higher anxiety levels (p=0.036). The hypothesis of independence is rejected, that is to say, anxiety and independent variables are associated. Regarding to depression, those living with a partner suffer from higher depression levels (p=0.05). Conclusion Patients with IBD present higher percentages of anxiety and depression. Anxiety is associated with being a woman, meanwhile depression is associated with living with a partner. It is essential to evaluate psychological discomfort by using customized tools to local circumstances, so to suggest intervention strategies resulting in a better quality of life References (1)Bisgaard TH, Allin KH, Keefer L, Ananthakrishnan AN, Jess T. Depression and anxiety in inflammatory bowel disease: epidemiology, mechanisms and treatment. Nat Rev Gastroenterol Hepatol. 2022;19(11):717-726. doi:10.1038/s41575-022-00634-6 (2)Feng L, Cai X, Zou Q, et al. Exploring the management and treatment of IBD from the perspective of psychological comorbidities. Therap Adv Gastroenterol. 2024;17:17562848241290685. Published 2024 Oct 16. doi:10.1177/17562848241290685 (3)Barreiro-de Acosta M, Marín-Jiménez I, Panadero A, et al. Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients. Gastroenterol Hepatol. 2018;41(2):118-127. doi:10.1016/j.gastrohep.2017.10.003 (4)Herrero MJ, Blanch J, Peri JM, et al. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277-83.

Real-world satisfaction and experience with injection and autoinjector device for ofatumumab indicated for multiple sclerosis

BackgroundTo evaluate the overall satisfaction, device usability, and injection experience of MS patients self-administering ofatumumab using the Sensoready® autoinjector device in the United States (US).MethodsThis US-based, cross-sectional survey study included patients with MS (≥ 18 years) who self-administered ofatumumab using the Sensoready device within the previous 12 months of the survey. Eligible patients were administered a 30-item de novo questionnaire that focused on overall device satisfaction, device usability, convenience/flexibility for travel with the device, user confidence, injection experience, and time to administer the injection. Ratings were measured on Likert and numeric rating scales, with higher scores indicating positive responses.ResultsOverall, 105 patients with MS (disease-modifying therapy [DMT]-experienced: 65; DMT-naïve: 40) were included. The mean (standard deviation [SD]) age was 42.5 (12.2) years. The majority of patients (86.7%) expressed high satisfaction (i.e., rated either 4 [satisfied] or 5 [extremely satisfied] on a 5-point Likert scale) in study population. The overall mean (SD) satisfaction score with Sensoready device was 4.4 (0.7), with a higher device satisfaction reported in the DMT-experienced vs. DMT-naïve group (4.6 [0.66] vs. 4.1 [0.69]). A higher proportion of DMT-experienced patients reported high satisfaction scores as compared to DMT-naïve patients (90.8% vs. 80.0%). The most common reasons for high satisfaction included reasonable administration time (90.5%), overall ease of use (89.5%), a monthly dosing schedule of ofatumumab (89.5%), the time required for device preparation (86.7%), ease of device preparation (81.9%), device ergonomics (76.2%), and portability (73.3%). Regardless of prior DMT experience, the majority of patients felt confident to self-administer ofatumumab using the Sensoready device; moreover, the majority expressed their intention to continue with the Sensoready device and would recommend ofatumumab to others. Furthermore, 77.1% reported that the use of Sensoready device to self-administer ofatumumab was not found to interfere with their daily activities; patients reporting non-interference with their daily activities were higher in the DMT-experienced vs. DMT-naïve group (83.1% vs. 67.5%).ConclusionsRegardless of prior DMT experience, patients with MS report high satisfaction levels and positive experiences with the use of the ofatumumab Sensoready device in real-world practice, mostly driven by reasonable administration time and ease-of-use.

Development and initial validation of the group exercise motivation scale and associated factors in an Asian population

ABSTRACT Backgrounds Physical activity is crucial in health promotion. Exercise in groups can strengthen the benefits of exercise itself. However, the scale measuring the motivation for group exercise is scare. Aim To develop and preliminarily validate the Group Exercise Motivation Scale (GEMS) in a global Asian population. Methods A total of 1021 participants from seven regions across the world were recruited. Based on the theory of planned behavior, we developed an initial 20-item scale for the measurement of group exercise motivation and conducted an exploratory factor analysis (EFA). Then, a confirmatory factor analysis (CFA) was performed to replicate the factor structure obtained through EFA with a refined 15-item scale, among 510 and 511 participants, respectively. Results Four dimensions have been derived including personal attitude, subjective norms, perceived behavioral control, and behavioral intention. The GEMS showed acceptable factorial validity, satisfactory reliability (Cronbach’s α 0.779 and McDonald’s omega 0.745), and no floor/ceiling effect. The scale was developed in Chinese language. Conclusions The GEMS has utility as an assessment for group exercise motivation. This study provides evidence for future longitudinal studies to evaluate the effectiveness of group exercise in the field of public health.

Hyperplex PCR enables highly multiplexed analysis of point mutations in wastewater: Long-term SARS-CoV-2 variant surveillance in Sweden as a case study.

Wastewater-based surveillance (WBS) allows the analysis of pathogens, chemicals or other biomarkers in wastewater to derive unbiased epidemiological information at population scale. After re-gaining attention during the SARS-CoV-2 pandemic, the field holds promise as a surveillance and early warning system by tracking emerging pathogens with pandemic potential. Expanding the current toolbox of analytical techniques for wastewater analysis, we explored the use of Hyperplex PCR (hpPCR) to analyse SARS-CoV-2 mutations in wastewater samples collected weekly in up to 22 sites across Sweden between October 2022 and December 2023. The samples were tested using a probe panel ranging from 10- to 18-plex, continuously adapted within 1-2 weeks to quantify relevant mutations of concern over time. For cross-validation, the samples were simultaneously analysed with commonly used methods including quantitative PCR (qPCR) and next-generation sequencing (NGS). hpPCR is demonstrated herein to provide (1) systematic single nucleotide specificity with a straightforward probe design, (2) high multiplexity with minimal panel re-optimization requirements and (3) 4-5-week earlier mutation detection relative to NGS with comparable performance of mutation frequency quantification (Pearson r = 0.88, n = 50). Hence, hpPCR is shown to be a powerful complementary tool to the current workflow involving NGS and qPCR by facilitating the assembly of dynamic high-plex panels compatible with high-frequency monitoring of multiple key pathogens and/or variants in WBS.

Brisk Walking Pace Offsets Venous Thromboembolism Risk Equivalent to Established Monogenic Mutations.

Mendelian mutations in the Prothrombin gene (F2) and the factor V Leiden gene (F5) genes are established risk factors for venous thromboembolism (VTE). Walking pace is associated with the risk of coronary artery diseases, but no study has investigated its association with VTE. This study aimed to investigate the association and causality between walking pace and VTE, compare its population risk with established Mendelian mutations, and determine if blood biomarkers mediate its effect. We followed up 445,261 UK Biobank participants free of VTE at baseline. Self-reported walking pace was collected via touchscreen questionnaire at baseline. The carrier status of two Mendelian mutations in F2 and F5 genes was determined by the genotypes of rs1799963 (G20210A, c.*97 G > A) and rs6025 (p.R534Q), respectively. Cox proportional hazard model was used to estimate the effect of walking pace on incident VTE. We conducted a bidirectional Mendelian randomization (MR) analysis, by using 70 single-nucleotide polymorphisms (SNPs) from a walking pace genome-wide association studies (GWAS) and 93 SNPs from a VTE GWAS as instrumental variables. We used both individual-level data and GWAS summary statistics for mediation analysis. Over a median follow-up period of 12.8 years, 11,155 incident VTE cases were identified. The 10-year incidence rates for brisk and slow walking pace were 1.32% (confidence interval [CI]: 1.27-1.37%) and 3.90% (CI: 3.71-4.09%), respectively. For noncarriers, F2 and F5 carriers, the 10-year incidence rates were 1.70% (CI: 1.66-1.73%), 2.94% (CI: 2.66-3.22%), and 3.62% (CI: 3.39-3.84%), respectively. The overall risk of VTE for F5 mutation carriers with a brisk walking pace (2.65%) was smaller than that for noncarriers with a slow walking pace (3.66%). For F5 mutation carriers, brisk pace (but not steady pace) reduces the risk of VTE (p interaction < 0.05). MR analyses displayed a causal relationship (inverse variance weighted: p = 3.21 × 10-5) from walking pace to VTE incidence. Mediation analysis showed that serum albumin (ALB) and cystatin C (CYS) levels partially mediated the effect of brisk walking pace on the risk of VTE incidence, with mediation proportions of 8.7 to 11.7%, respectively. On the population scale, the protective effect of brisk walking pace offsets the risk of VTE caused by Mendelian mutations. We provided preliminary evidence that a brisk walking pace causally reduces the risk of VTE. Serum ALB and CYS partially mediate this effect.

Patterns of interpopulation variation and physiological trade-offs of the acute thermal tolerance of juvenile Chinook salmon (Oncorhynchus tshawytscha)

IntroductionThe capacity of species and populations to respond to rapid environmental change will be pivotal for their resilience in the coming decades. To explore thermal plasticity, physiological trade-offs, and associations with environmental characteristics, we assessed the heat hardening response and acclimation capacity of juvenile Chinook salmon (Oncorhynchus tshawytscha) from seven hatchery populations spanning diverse ecoregions along the West Coast of the United States.MethodsProgeny from each population were acclimated to one of three temperatures (11, 16, or 20°C) and subjected to two acute thermal maximum (CTMAX) trials 24 h apart. The heat hardening response (ΔCTM) was calculated as the difference between an individual's second and first CTMAX trials. Acclimation capacity was determined as the maximum difference in CTMAX between fish acclimated to 11°C and 20°C during their second trial, capturing the full acclimatory scope. Bayesian models were employed to test the thermal trade-off hypothesis, which posits that individuals or populations with higher thermal tolerance have reduced capacity for acclimation. Trade-offs were analyzed at both individual and population scales. Associations between ΔCTM, acclimation capacity, and source population environmental characteristics were also examined using data from a landscape-scale, regional, river temperature model.ResultsFish acclimated to 16°C or 20°C exhibited heat hardening (positive ΔCTM), while those acclimated to 11°C exhibited “heat weakening” (negative ΔCTM), a rare phenomenon in the literature. At the individual level, fish adhered to the thermal trade-off hypothesis, with higher thermal tolerance associated with reduced plasticity. However, no such trade-off was observed at the population level. Acclimation capacity was positively correlated with latitude and the temperature of the natural rearing environment. Additionally, ΔCTM performance improved when fish were acclimated to temperatures closer to those of their natural habitats.DiscussionIndividual fish exhibited a trade-off between thermal tolerance and plasticity, while populations did not. Thermal plasticity was associated with environmental conditions, with populations from warmer habitats demonstrating greater acclimation and heat hardening capacities. This study highlights the importance of understanding interpopulation variation to identify at-risk populations, such as those from colder habitats or with limited thermal plasticity, like the Trinity population. These findings emphasize the need to account for interpopulation differences when predicting species responses to climate change and developing conservation strategies.

From Chaos to Fractals: A Review of Mathematical Modeling of Population Dynamics

The dynamic changes in population size are a core issue in ecological research and are crucial for understanding ecosystem stability and biodiversity. Chaos theory and fractal theory offer new perspectives for exploring population dynamics. Through mathematical modeling and computational methods, the complexity and intrinsic patterns of population changes can be revealed. This paper reviews the application of chaos theory and fractal theory in the study of population dynamics. The research covers the role of chaos theory in revealing the nonlinear characteristics of population dynamics and sensitivity to initial conditions, as well as the ability of fractal theory to describe population spatial distribution patterns and scale effects. Special attention is given to the application of the fractal model (_p_ model) proposed by Su et al. in analyzing species abundance distributions (SAD) within communities, and the potential value of chaos and fractal theories in practical ecological conservation and management. This paper finds that chaos theory and fractal theory provide powerful analytical tools for studying population dynamics, helping to understand the complexity and unpredictability of population size changes. The application of these theories not only enhances the understanding of population spatial structure and distribution patterns but also provides a scientific basis for biodiversity conservation and ecosystem management. Future research may further deepen the application of these theories, develop new mathematical models and computational methods to better predict and manage population dynamics. Through interdisciplinary collaboration, these theories are expected to play a greater role in ecological conservation and resource management

From Lesions to Lessons: Two Decades of Filamentous Plant Pathogen Genomics.

Filamentous plant pathogens pose a severe threat to food security. Current estimates suggest up to 23% yield losses to pre- and post-harvest diseases and these losses are projected to increase due to climate change (Singh et al. 2023; Chaloner et al. 2021; Stukenbrock and Gurr 2023; Fisher et al. 2012; Steinberg and Gurr 2020). Understanding how filamentous plant pathogens emerge, spread and adapt to their hosts and new environmental niches is crucial to address their devastating impact on global agriculture. Over the past two decades, genomics has emerged as a central technology to advance our understanding of the population dynamics and coevolution of filamentous plant pathogens. The first genome of a filamentous plant pathogen, the blast fungus Magnaporthe oryzae, was sequenced 20 years ago. Since then, plant pathogen genomics has not only provided a deep understanding of the genomic makeup of plant pathogen populations, but has emerged as a fundamental technology for gene discovery, disease diagnostics, and has accelerated molecular biology. In merely two decades, we have witnessed several revolutions in the field, including the first reference genomes of many filamentous plant pathogens, population scale genomics of thousands of individuals, long-read and chromosome conformation sequencing for highly continuous assemblies and recent intersections of genomics and structural biology. Here, we commemorate the 20th anniversary by presenting important technological advances (Fig. 1) and lessons we learned from the past two decades of filamentous plant pathogen genomics, with a focus on cereal diseases.

Artificial Intelligence in Precision Nutrition: Innovations in Delaying Disease Onset and Promoting Longevity

Artificial Intelligence (AI) is transforming precision nutrition by enabling tailored dietary interventions that not only delay the onset of chronic diseases but also enhance longevity. This article delves into the pivotal role of AI in addressing the unique challenges posed by aging populations, with a particular emphasis on its influence at the policy level. By harnessing data-driven insights, stakeholders such as policymakers, health insurers, and public health programs can strategically optimize resource allocation, improve health outcomes on a population scale, and achieve significant cost reductions in healthcare. Through a synthesis of case studies, cutting-edge research, and practical recommendations, we aim to provide a roadmap for incorporating AI-driven precision nutrition into comprehensive national health strategies.

Development and validation of a high-throughput qPCR platform for the detection of soil-transmitted helminth infections.

Historically, soil-transmitted helminth (STH) control and prevention strategies have relied on mass drug administration efforts targeting preschool and school-aged children. While these efforts have succeeded in reducing morbidity associated with STH infection, recent modeling efforts have suggested that expanding intervention to treatment of the entire community could achieve transmission interruption in some settings. Testing the feasibility of such an approach requires large-scale clinical trials, such as the DeWorm3 cluster randomized trial. In addition, accurate interpretation of trial outcomes requires diagnostic platforms capable of accurately determining infection prevalence (particularly as infection intensity is reduced) at large population scale and with significant throughput. Here, we describe the development and validation of such a high-throughput molecular testing platform. Through the development, selection, and validation of appropriate controls, we have successfully created and evaluated the performance of a testing platform capable of the semi-automated, high-throughput detection of four species of STH in human stool samples. Comparison of this platform with singleplex reference assays for the detection of these same pathogens has demonstrated comparable performance metrics, with index assay accuracy measuring at or above 99.5% and 98.1% for each target species at the level of the technical replicate and individual extraction respectively. Through the implementation of a rigorous validation program, we have developed a diagnostic platform capable of providing the necessary throughput and performance required to meet the needs of the DeWorm3 cluster randomized trial and other large-scale operational research efforts for STH. Resulting from the rigorous developmental approach taken, the platform we describe here provides the needed confidence in testing outcomes when utilized in conjunction with large-scale efforts such as the DeWorm3 trial. Additionally, the successful development of an evaluation and validation strategy provides a template for the creation of similar diagnostic platforms for other neglected tropical diseases.

Simplifying coronary artery disease risk stratification: development and validation of a questionnaire-based alternative comparable to clinical risk tools.

Coronary artery disease (CAD) comprises one of the leading causes of morbidity and mortality both in the European population and globally. All established clinical risk stratification scores and models require blood lipids and physical measurements. The latest reports of the European Commission suggest that attracting health professionals to collect these data can be challenging, both from a logistic and cost perspective, which limits the usefulness of established models and makes them unsuitable for population-wide screening in resource-limited settings, i.e., rural areas. Therefore, the aim of this study was to develop and externally validate a questionnaire-based risk stratification model on a population scale at minimal cost, i.e., the Questionnaire-Based Evaluation for Estimating Coronary Artery Disease (QUES-CAD) to stratify the 10-year incidence of coronary artery disease. Cox proportional hazards (CoxPH) and Cox gradient boosting (CoxGBT) models were trained with 10-fold cross-validation using combinations of ten questionnaire variables on the White population of the UK Biobank (n=448,818) and internally validated the models in all ethnic minorities (n=27,433). The Lifelines cohort was employed as an independent external validation population (n=97,770). Additionally, we compared QUES-CAD's performance, containing only questionnaire variables, to clinically established risk prediction tools, i.e., Framingham Coronary Heart Disease Risk Score, American College of Cardiology/American Heart Association pooled cohort equation, World Health Organization cardiovascular disease risk charts, and Systematic Coronary Risk Estimation 2 (SCORE2). We conducted partial log-likelihood ratio (PLR) tests and C-index comparisons between QUES-CAD and established clinical prediction models. In the external validation set, QUES-CAD exhibited C-index values of CoxPH: 0.692 (95% Confidence Interval [CI]: 0.673-0.71) and CoxGBT: 0.699 (95% CI: 0.681-0.717) for the male population and CoxPH: 0.771 (95% CI: 0.748-0.794) and CoxGBT: 0.759 (95% CI: 0.736-0.783) for the female population. The addition of measurement-based variables and variables that require a prior medical examination (i.e., insulin use, number of treatments/medications taken, prevalent cardiovascular disease [other than CAD, and stroke diagnosed by a doctor]) and the further addition of biomarkers/other measurements (i.e., high-density lipoprotein [HDL] cholesterol, total cholesterol, and glycated haemoglobin) did not significantly improve QUES-CAD's performance in most instances. C-index comparisons and PLR tests showed that QUES-CAD performs and fits the data at least as well as the clinical prediction models. QUES-CAD performs comparably to established clinical prediction models and enables a population-wide identification of high-risk individuals for CAD. The model developed and validated herein relies solely on ten questionnaire variables, overcoming the limitations of existing models that depend on physical measurements or biomarkers. University Medical Center Groningen.

Blood DNA virome associates with autoimmune diseases and COVID-19

Aberrant immune responses to viral pathogens contribute to pathogenesis, but our understanding of pathological immune responses caused by viruses within the human virome, especially at a population scale, remains limited. We analyzed whole-genome sequencing datasets of 6,321 Japanese individuals, including patients with autoimmune diseases (psoriasis vulgaris, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), pulmonary alveolar proteinosis (PAP) or multiple sclerosis) and coronavirus disease 2019 (COVID-19), or healthy controls. We systematically quantified two constituents of the blood DNA virome, endogenous HHV-6 (eHHV-6) and anellovirus. Participants with eHHV-6B had higher risks of SLE and PAP; the former was validated in All of Us. eHHV-6B-positivity and high SLE disease activity index scores had strong correlations. Genome-wide association study and long-read sequencing mapped the integration of the HHV-6B genome to a locus on chromosome 22q. Epitope mapping and single-cell RNA sequencing revealed distinctive immune induction by eHHV-6B in patients with SLE. In addition, high anellovirus load correlated strongly with SLE, RA and COVID-19 status. Our analyses unveil relationships between the human virome and autoimmune and infectious diseases.

Spatiotemporal characteristics and influencing factors of non-CO2 greenhouse gas emission intensity from China's livestock sector.

The livestock sector is a major source of non-CO2 greenhouse gas (GHG). As China has the world's largest livestock production, analyzing factors influencing GHG emission intensity of livestock (GEIL) is crucial for guiding its emission reduction policies. Yet, most current studies on livestock GHG focus on emission amount (GEAL) over GEIL, neglecting comprehensive utilization of spatial econometric models. Furthermore, the influencing factors mainly focus on population, economic level, urbanization, and industrial structure, while the exploration of factors such as technological innovation, consumers' age structure, and industrial agglomeration remains insufficient. This study first applied the standard deviation ellipse (SDE) model to describe the spatiotemporal evolution of GEAL and GEIL across 31 Chinese provinces from 2006 to 2022. Then, using extended STIRPAT theory, we analyzed GEIL's influencing factors with exploratory spatial data analysis (ESDA) and the geographically and temporally weighted regression (GTWR) model. The results showed that: (1) GEAL was concentrated in resource-rich grassland pastoral and grain-producing areas. Provincial GEAL trends varied, while national GEAL declined rapidly and then fluctuated slightly. Cattle, pigs, and sheep/goats contributed the most to GEAL. (2) GEIL significantly decreased nationwide and provincially, with Tibet having the highest reduction rate but still leading in GEIL. (3) GEAL followed a northeast-southwest distribution, whereas GEIL exhibited an east (slightly north) to west (slightly south) pattern. (4) Spatial analysis revealed significant GEIL clustering, with higher values in western provinces and lower in central and eastern regions. (5) Population scale, urbanization, age structure, proportion of ruminant animal production value, location quotient of livestock, employment income per capita of agricultural personnel, patent-granted intensity, and educational level in rural areas had diverse spatiotemporal impacts on GEIL across provinces. Tailored emission reduction policies and regional collaborative governance are recommended.

Validation of the Portuguese version of the Movement Disorder Society non-motor rating scale (MDS-NMS) in Parkinson's disease.

The Movement Disorder Society Non-Motor Rating Scale (MDS-NMS) serves as a comprehensive clinical assessment tool for non-motor symptoms in Parkinson's disease (PD) OBJECTIVES: This study aims to validate the Portuguese version of the MDS-NMS, addressing the critical need for culturally adapted rating scales in Portuguese-speaking populations. This multicenter, cross-sectional study engaged native Portuguese-speaking PD patients from 16 Movement Disorders Centers across Portugal and Brazil. We conducted a meticulous translation process into Portuguese, including forward-backward translation and cognitive pretesting. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to evaluate the psychometric properties and structural validity of the Portuguese version in comparison to the original English version. Tertiary analyses assessed the acceptability and reliability of domain scores within the cohort. The scale was administered to 386 PD Portuguese-speaking patients. CFA, conducted with a final sample of 303 participants, confirmed that the Portuguese version maintained a factor structure consistent with the English original, with Comparative Fit Index (CFI) values meeting or exceeding the 0.90 threshold across all subscales. High CFI values in domains such as Depression, Psychosis, and Cognition underscored the robustness of the translation. EFA revealed generally strong item-factor relationships, although domains like Gastrointestinal and Non-Motor Fluctuations exhibited more complex structures. Reliability analyses demonstrated strong internal consistency, with Cronbach's α ranging from 0.50 to 0.86 across domains, further corroborated by McDonald's ω and Greatest Lower Bound values. The Portuguese version of the MDS-NMS demonstrates psychometric properties and structural validity that closely aligns with the original version.

Irregular Pulse and Cardiovascular Disease From NHANES (1999-2018): A Cross-Sectional Study.

Pulse is an easily accessible life sign, while irregular pulse could be easily detected in daily life during blood pressure test. However, whether irregular pulse was associated with cardiovascular disease (CVD) or mortality has not been reported on a large population scale. Here, we investigated the association between irregular pulse, CVD, and CVD mortality, to explore the potential of irregular pulse as screening indicator for CVD and mortality, thus influencing health policy. This cohort study used National Health and Nutrition Examination Survey data from 1999 through 2018 and linked mortality information until 2019. Eligible participants were adults with valid records of self-report CVD and pulse characteristics. We included data from 49,681 participants in the analysis. Compared with regular pulse group, irregular pulse group demonstrated an increased risk of CVD (1.34, [1.14, 1.58]), especially heart failure (1.75, [1.37, 2.24]) and coronary heart disease (1.27, [1.01, 1.60]). Irregular pulse group showed an increased risk for all-cause mortality (HR 1.29, [95% CI, 1.17-1.42]) and CVD mortality (HR 1.53, [95% CI, 1.30-1.81]) compared with regular pulse group. The findings suggest that irregular pulse was associated with CVD and mortality. Participants with irregular pulse were associated with a significantly increased risk of all-cause mortality (HR 1.29, 95% CI [1.17, 1.42], p < 0.001), and CVD mortality (HR 1.53, [1.30, 1.81], p < 0.001). Our study found that people with irregular pulse have a higher incidence of cardiovascular disease and cardiovascular disease mortality than people with regular pulse. These findings highlight the importance of health screening and risk management for people with irregular pulse.

PLEIOTROPIC HEALTH BENEFITS OF TIME-RESTRICTED FEEDING

Abstract The global epidemic of obesity is driving a rapid increase in metabolic syndrome, which in turn contributes to several chronic diseases, including type 2 diabetes, certain cancers, and dementia. To combat this diverse set of diseases, there is an urgent need for simple yet effective measures with widespread benefits across multiple organ systems that can be implemented at a population scale. Time-Restricted Feeding/Eating (TRF or TRE) is a circadian-based dietary intervention where daily energy intake is limited to a consistent 6-12 hour window without explicitly changing the quantity of food consumed. In laboratory animals, this approach sustains circadian expression of the majority of protein-coding genes in a tissue-specific manner. When fed an obesogenic diet, TRF can mitigate metabolic disorders such as adiposity, dyslipidemia, hypercholesterolemia, fatty liver disease, atherosclerosis, and gut dysbiosis. Research from various labs has also shown that this method can reduce the risk and impact of dementia and certain cancers. Genetic and multi-omics studies are beginning to uncover the extensive molecular pathways engaged during time-restricted feeding. This foundational research is likely to drive large clinical trials across diverse populations to assess the feasibility and sustainability of TRE as a population-level intervention to reduce the global burden of diseases.

Intracellular Quantification of an Antibiotic Metal Complex in Single Cells of Escherichia coli Using Cryo-X-ray Fluorescence Nanoimaging.

Bacterial resistance is a major public health challenge. In Gram-negative bacteria, the synergy between multidrug efflux pumps and outer membrane impermeability determines the intracellular concentration of antibiotics. Consequently, it also dictates antibiotic activity on their respective targets. Previous research has employed spectrofluorimetry and synchrotron radiation-based DUV microscopy as tools for monitoring the accumulation of fluoroquinolone antibiotics in bacteria at population and single-cell scales, respectively. Here, we show that cryo-XRF nanoimaging allows intracellular localization and quantification of a fluoroquinolone metal complex accumulation in Escherichia coli with different efflux pump expression levels. This method offers a promising avenue for elucidating the intracellular behavior of a range of metallodrugs in bacteria and for designing novel agents with unique mechanisms of action.

Perceived mistreatment in patients with rheumatic diseases: The impact of the underlying diagnosis.

Mistreatment is a complex problem that impacts people's quality of life, morbidity, and mortality. In aged people, it has been associated with female sex, poor general health, depression, functional and cognitive decline, and increased dependence levels, all of which are well-recognized characteristics of patients with rheumatic diseases (RMDs). The objective was to describe the mistreatment phenomenon in Mexican patients with RMDs. We additionally report the adaptation and validation of the Geriatric Mistreatment Scale (GMS) in the target population. This cross-sectional study was developed in two phases (June 28, 2023-February 2, 2024), and three convenience samples were used: S-1 (n = 30), S-2 (n = 260), and S-3 (n = 372). Phase 1 consisted of adapting the GMS to RMDs (RMD-MS) (experts' agreement), followed by RMD-MS face validity (pilot testing, S-1), content validity (experts' agreement), concurrent criterion validity (family APGAR score ≤3, S-2), construct validity (exploratory factor analysis and convergent validity, S-2), reliability (internal consistency and temporal stability, S-2) and feasibility (in S-1). Phase 2 consisted of the mistreatment description in S-3. Patients represented typical RMD outpatients with substantial disease duration. There were 187 (50.3%) patients with overall mistreatment, and psychological was the most frequent in 142 (75.9%) patients, followed by neglect mistreatment in 96 (51.3%), sexual in 30 (16%), physical in 23 (12.3%), and economic mistreatment in 20 (10.7%) patients. Patients' perceived mistreatment was related to the underlying RMD in 13.3% of sexual mistreatment and 53.3% of psychological mistreatment. The number of "I do not want to answer" responses raised to 21.7%-67.7% for abusers' sex and 40%-72.9% for the abusers' relationship with the participant. The RMD-MS was valid, reliable, and feasible. Half of the Mexican patients with RMDs perceived some mistreatment, most frequently psychological mistreatment, which is also often perceived as related to the underlying RMD.

Geopolitical Alliances in Context of Strategic Advantages Phenomenon

The global geopolitical turbulence that began in 2022 has its explanation in the context of the theory of strategic advantages, an important direction of which is its interconnection with the scale effect and its extension to the global civilizational development. The study of the peculiarities of the formation of a particular state from the point of view of this approach allows us to rethink Wallerstein's technological model of the world economic system, according to which all countries belong to one of three groups – leaders, semi-periphery or periphery, and to supplement it with a political model of sovereignty, based on the assessment of self-styled (natural) development of a state and allows us to assess the true place of each country in the geopolitical system. The ability of a state to self-styled development is determined by its relations with the hegemon and the presence of hidden potential in the form of strategic advantages, which are expressed in the presence of qualitative advantages of the country in relation to its competitors in five or six key attributes: area of territory, wealth of natural resources, scale of economy, population, technological and military achievements. The comparative analysis of relative indicators of the potential of a number of countries has shown that the United States today has strategic advantages over Russia in a number of respects. However, the exhaustion of economies of scale by the U.S. against the background of Russia's significant potential, as well as Russia's building of strategic alliances, has led to the current global confrontation. The assessment of the indicators of the strategic advantage of the alliance of Russia and China over the US has shown its multiple superiority over the hegemon, which is a serious threat to the position of the US as a world leader in the world economic system. The BRICS alliance, co-founded by China and Russia, is an even greater threat to the hegemon. The article outlines Russia's strategy in the current circumstances, aimed at the realization of three key areas – demographic, economic and technological. All three directions imply the solution of extremely ambitious tasks, which are practically unattainable in normal conditions, but become more realistic in the conditions of geopolitical turbulence and the breakdown of the old order that is currently sweeping the world.