The 25-item Geriatric Locomotive Function Scale is widely used to identify locomotive syndrome, a condition characterized by progressive decline in motor function. Although its reliability in older adults has been established, item-level properties across age groups remain unclear. This study examined item discrimination and difficulty using an item response theory approach and compared item characteristics between younger and middle-aged adults and older adults. Community-dwelling adults aged 18 years or older were classified as younger and middle-aged (< 65 years) or older (≥ 65 years). The graded response model estimated item discrimination and difficulty. Discrimination was interpreted using Baker's classification, while values between 0.5 and 2.5 were considered empirically acceptable. Difficulty parameters ranged approximately from -3 to +3. Model fit was assessed using the root mean square error of approximation. Wald tests compared item parameters between age groups, and sensitivity analyses used age thresholds of 60, 70, and 75 years. Among 866 participants, most items showed acceptable discrimination and difficulty. Pain- and social participation-related items were more discriminative in younger and middle-aged adults, whereas mobility- and anxiety-related items were more discriminative in older adults. Model fit was good (root mean square error of approximation = 0.04-0.05), and Wald tests confirmed significant item-level differences between groups. Sensitivity analyses supported the robustness of the 65-year cutoff. The Geriatric Locomotive Function Scale demonstrated statistically validated age-related item patterns. These findings support developing age-tailored short forms and adaptive screening tools for locomotive syndrome.

International validation of a staging system for ciliary body and choroidal melanomas using estimated tumour volume.

Myocardial infarction (MI) is the most common cardiovascular disease that has a serious impact on human health and is one of the most common causes of death in the world. Apoptosis and myocardial fibrosis after MI are the key pathological features of poor myocardial remodelling, which further lead to heart failure, and are also the main reason for the high mortality from MI. Exosomes (Exos) from GATA4-overexpressing bone marrow mesenchymal stem cells (BMSCs) were extracted and identified using transmission electron microscopy (TEM), nanoscale tracking analysis (NTA), and marker detection. Tandem mass tags (TMT) quantitative proteomics, Agilent miRNA microarray, and GO/KEGG function analysis were used to obtain differentially expressed proteins/miRNAs. The expression levels using the Wald test and RT-qPCR to identify and validate. Their related mRNA-miRNA-circRNA regulatory networks were constructed. Hypoxic mouse cardiomyocytes were cultured, and MI mice were used for subsequent experiments. Cell differentiation, apoptosis, and marker gene expression were detected using RT-qPCR, IF, flow cytometry, and Western blot. Four key apoptosis proteins, CXCL12, CLU, CD44, and IGF1, and 20 key differentially expressed miRNAs. Among them, CLU and IGF1 were upregulated, but CXCL12 and CD44 were downregulated in Exos from the GATA4-overexpressing BMSCs group. The expression of mmu-miR-467g and mmu-miR-5127 was downregulated in Exos from the GATA4-overexpressing BMSCs group, whereas the other 18 key miRNAs were upregulated. Exos from GATA4-overexpressing BMSCs inhibit apoptosis, activate the LXR/RXR pathway, and improve MI. Knockout of CLU reversed this effect. Our research further discovered that GATA4-overexpressing BMSCs-derived Exos improved MI through downregulation of CLU. GATA4-overexpressing BMSCs-derived Exos may regulate MI via the aforementioned four key proteins and may be related to the LXR/RXR signalling pathway.

BACKGROUNDAnxiety disorders are highly prevalent in patients with bipolar disorder (BD) and are associated with a more severe illness course and poorer outcomes. A significant clinical challenge is the frequent initial misdiagnosis of BD as anxiety, leading to prolonged diagnostic delays and suboptimal treatment. Growing evidence suggests that early intervention in individuals at high risk for BD can improve prognosis. Established clinical high-risk factors include early onset, family history of BD, and subthreshold manic symptoms. This creates a clinical dilemma whereby the administration of first-line antidepressants (e.g., sertraline) for anxiety is debated in patients with a bipolar diathesis, given the associated risk of mood destabilization. Conversely, mood stabilizers like lithium are foundational in BD treatment, but their role in treating anxiety in high-risk populations is unproven. Therefore, we conducted this randomized controlled trial to evaluate whether early intervention with a combination of sertraline and lithium is more effective than sertraline monotherapy for anxiety disorder patients with clinical high-risk factors for BD.AIMTo investigate whether early intervention has a more positive outcome for anxiety disorders in patients who present with clinical high risk factors for BD.METHODSA total of 66 patients were enrolled in this study from January 2021 and December 2022 in Huzhou Third Municipal Hospital. They were randomly assigned to two groups to receive either an antidepressant (sertraline, n = 32) or a combination therapy (sertraline and lithium, n = 34). The main variables included alterations in Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores from the initial assessment to the final evaluation. A thorough combined Wald test was conducted to examine the intention-to-treat differences in scale assessment across treatment and time conditions.RESULTSSignificant differences in the change of Hamilton Anxiety Rating Scale scores were observed between the two groups at week 1, week 2, and week 4 (P < 0.05). However, after 8 weeks and 12 weeks of treatment, there were no significant different (P = 0.485 and P = 0.206). There was no significant difference in the change over time in Hamilton Depression Rating Scale scores between the treatment groups (P = 0.2), except at week 12 (P = 0.034). No significant differences were observed in the adverse effects reported between patients treated with sertraline alone (18%) and those treated with the combination therapy (21%).CONCLUSIONThis current double-blind, case-controlled study assessed the effectiveness and tolerability of combined therapy vs monotherapy for anxiety disorder in patients with clinical high-risk factors for BD. In light of the constraints associated with this initial study, the results imply that the combination of sertraline and lithium may provide a more favorable prognosis.

Probiotics, whether consisting of a single strain or multiple strains, are attracting growing interest in the management of type 2 diabetes mellitus (T2DM). However, their efficacy remains a matter of controversy and requires careful consideration. Accordingly, this meta-analysis aimed to compare the efficacy of single-strain to that of multi-strain probiotics supplementation on glycated haemoglobin (HbA1c) and fasting blood glucose (FBG) levels in adults with T2DM. Nineteen articles published between 2017 and 2024 obtained from 4 databases (Cochrane, Web of Science, Scopus, and PubMed) were included. These interventions, conducted in a total of 1159 participants, lasted from 6 to 24 weeks and were based on clearly identified probiotic formulations, with assessments of HbA1c and FBG. The results showed that, overall, probiotic supplementation had no significant effect on HbA1c (−0.24%; 95% CI [−0.76; 0.27]; p = 0.36), although a trend towards reduction was observed for single-strain formulations (−0.57%; p = 0.05). Regarding FBG, only the multi-strain group showed a significant reduction (−0.76; 95% CI [−1.18; −0.34]; p &lt; 0.001), while the effect of the single-strain formulation was not significant. The comparison between the two formulations (Wald test) showed that there was no significant difference (p ≤ 0.05). However, high heterogeneity (I2 &gt; 75%) and variable strains/doses limit confidence in these findings.

Unbalanced data can adversely affect measurement equivalence/invariance (ME/I) testing. However, no studies have yet systematically compared the performances of currently available methods. Thus, in this study, we compared the performances of the Chi-squared difference ( Δ χ 2 ) test, the multivariate Wald test (MWT), cutoffs of dynamic measurement invariance (DMI), and the commonly used alternative fit index cutoffs based on raw and subsampled data ( Δ AFIs) with simulations. The design factors included ratios of group sizes, proportions of non-invariant items, locations, percentages, and magnitudes of non-invariant parameters. The results indicate the type I error rates of the Δ AFI cutoffs are often too conservative. The Δ χ 2 test and MWT can control type I error rates, while except in some specific loading non-invariance conditions, MWT generally outperforms the Δ χ 2 test in power when data are unbalanced. Overall, our findings suggest MWT is relatively robust for ME/I testing with unbalanced data. Some related issues are also discussed.

This analytical cross-sectional study assessed the evolution of maternal health indicators in the Marrakech province by comparing data from 2014-2015 and 2020-2022. A total of 1,070 pregnant women were surveyed in three health facilities using a self-administered questionnaire and non-probability accidental sampling. Statistical analyses (Chi-square, Student's t-tests, and logistic regression with Wald tests) were performed using SPSS 21.0. The results showed a significant improvement in prenatal care utilization over time. The percentage of women completing four recommended antenatal visits (ANC) increased from 36.9% to 49.5%, and early initiation of care in the first trimester rose from 55.3% to 82.8%. Completion rates of ANC1, ANC3, and ANC4, as well as the medicalization of consultations, also improved significantly. Logistic regression revealed strong associations between the 2020-2022 period, rural residence, and enhanced maternal health indicators. These findings underscore the positive impact of public health strategies and the resilience of Morocco's health system during the COVID-19 pandemic.

IntroductionFalls in adults aged ≥65 years contribute substantially to emergency department presentations and mild traumatic brain injury, with variable risk of intracranial hemorrhage. Existing CT decision tools often exclude older adults, resulting in potentially unnecessary imaging. This study aimed to identify predictors of intracranial pathology in all adults and compare older versus younger patients to inform a future prospective study.Materials and methodsIn preparation for a prospective study, we performed a retrospective imaging-selected cohort study analyzing all CT brain studies performed for suspected head injury between June and August 2024. Patients under 18 years and those undergoing imaging for non-traumatic indications were excluded. Clinical variables, including GCS, premorbid function, and anticoagulation status, were extracted for analysis. Logistic regression was employed to assess associations with intracranial pathology, with odds ratios and 95% CIs calculated, and statistical significance determined using a Wald test (p < 0.05).ResultsA total of 110 patients were included in this study, with a median age of 73.5 years (IQR 43.5-82.0). Positive CT brain findings were identified in 9 (8.2%) patients. Anticoagulation status demonstrated a statistically significant association with positive CT findings (p = 0.047).ConclusionsIn adults presenting after a fall, anticoagulation, older age, and new neurological deficits emerged as potential indicators of intracranial pathology, while vomiting and suspected skull fracture showed weaker associations. The small number of CT-positive cases and imaging-selected cohort limit precision and preclude assessment of decision-rule performance. These hypothesis-generating findings will inform a prospective study and the development of a predictive framework to guide safer, more targeted cranial imaging in older adults.

This study evaluates Bank Indonesia Certificates (SBI), IndONIA, and gold as zero-beta proxies for Indonesian equities. Using daily returns for 213 firms listed on the Indonesia Stock Exchange (2017–2023) and the Jakarta Composite Index as the market return, we estimate firm-level zero-beta CAPMs and compute Wald statistics test to identify the appropriate risk- free asset proxy for each individual company; and firm-level outcomes are then aggregated under a Bernoulli/Binomial criterion with a 95% threshold. Empirical results show that gold satisfies the zero-beta condition for 207 of 213 firms (97.18%), whereas SBI and IndONIA satisfy it for five (2.35%) and six (2.82%) firms, respectively. The findings indicate that, despite nonzero variance, gold behaves as a zero-beta asset for Indonesian equities during 2017–2023; practitioners may consider gold as an alternative risk-free proxy in CAPM applications, while noting limitations related to daily data frequency, exchange-rate influences, and the need for robustness checks.

This study examines the impact of key economic growth indicators on the carbon credit market in India, highlighting how selected macroeconomic variables shape its dynamics in an emerging economy. Using secondary data covering 11 years from the Reserve Bank of India (RBI) and BSE India, the research applies rigorous econometric methods, including the Augmented Dickey-Fuller (ADF) and Phillips-Perron (PP) Unit Root Tests, the Vector Error Correction Model (VECM), and Ordinary Least Squares (OLS) regression, to explore both short- and long-run relationships among variables. The analysis considers crude oil prices, automobile sales (AMS), the Housing Price Index (HPI), GDP, the Index of Industrial Production (IIP), and the Green Exchange Index—an indicator of sustainable finance performance and investor confidence in carbon markets. These variables capture economic activity, market sentiment, and energy dependence, all of which influence carbon credit pricing and demand. Empirical results indicate that crude oil prices and AMS negatively affect carbon credits, whereas HPI, GDP, and IIP positively impact them. The Wald test indicates no long-run relationship between carbon credits and crude oil, AMS, or HPI. However, GDP, IIP, and the Green Exchange Index significantly boost carbon credits in the short run. A robustness check using 2024 data confirms the consistency and structural stability of these associations over time. The study concludes that macroeconomic and industrial indicators are decisive in shaping carbon credit movements. Strengthening industrial productivity, promoting sustainable finance, and aligning macroeconomic management with green policy objectives can enhance the efficiency of carbon markets. These findings provide valuable insights for policymakers, investors, and environmental economists seeking to harmonise economic growth with emission reduction goals. The Indian experience also offers a strategic reference for other emerging economies pursuing sustainable carbon trading frameworks.

Long journey is an animal welfare concern. For this reason, in Europe, (EC) No 1/2005 regulates journey conditions. According to the law, if the maximum journey time is exceeded, animals must be unloaded for resting, watering, and feeding at control posts (CPs) for at least 24 h. At CPs, animals are checked by Official Veterinarians (OVs) to ensure their welfare and fitness for transport. This study documented the activity of a CP in Southern Italy (2019–2024) analysing journey logs and OVs’ inspection reports. Different transport-related issues—i.e. welfare (e.g. dead on arrival, DOA), documentation, and general transport problems (e.g. non-compliance with space requirements or mandatory rest periods)—recorded for stopover journeys were analysed in relation to various factors, such as the species of animals transported, the origin and destination of the journeys, their duration, and the identity and behaviour of the drivers. A total of 97 vehicles stopped at the CP, transporting 24,135 animals. Vehicles came mainly from France (71.1%) and went mainly to Greece (73.2%), with sheep as the main cargo (78.4%). DOA cases were recorded in 4 vehicles and pigs were confirmed as the species at higher risk of poor welfare during transport (Fisher’s Exact Test p-value < 0.001). Longer journeys—especially those from Northern Europe or involving multiple CPs—were more frequently associated with general transport problems (Wald test p-value = 0.002). This study documented recurring patterns of higher-risk journeys and provides evidence to support potential policy changes aimed at protecting animal welfare during long journeys.

To achieve accurate forecasting of future gold prices and thereby provide effective references for investors' decisions, this study selects time-series data of gold prices (gold), the U.S. Dollar Index (DXY), and WTI crude oil futures prices (WTI) from 2015 to 2020. Employing a comprehensive empirical framework that integrates stationarity tests, lag order selection, VAR model estimation, Wald tests, unit circle tests, Granger causality tests, impulse response analysis, and out-of-sample forecasting, this research systematically examines the dynamic interactive mechanisms among the three variables. The findings reveal a distinct asymmetric linkage effect: DXY exerts a more pronounced impact on gold prices than WTI, with a significant short-term negative correlation between first-order lagged DXY and gold. Granger causality tests confirm that DXY is a Granger cause of gold prices, while gold serves as a Granger cause for both DXY and WTI. Impulse response analysis further demonstrates that gold prices exhibit high short-term sensitivity to DXY shocks, with a negative inhibitory effect persisting for the first three periods before gradually weakening. Moreover, a 6-period ahead forecast of gold price first-order differences shows that the VAR model’s predicted values align closely with actual values in terms of trend and magnitude, verifying its reliability in forecasting. This study offers actionable insights for investors to mitigate risks and for policymakers to monitor the stability of the gold market.

The study is done to examine the relationship between financial markets and economic growth with the macro-economic variables and financial variables. Economic growth directly or indirectly influences financial market development, depending on each country's macroeconomic context. This research is aimed at verifying whether economic growth directly influences financial sector development via the Karachi Stock Exchange, using variables such as bank credit, market turnover, market capitalization, and broad money supply as financial development indicators. The other macro-economic variables are exchange rate (EXR), Gross domestic product (GDP) on the other hand. Namely, the study aims at examining the causality that exists between the economic growth (GDP) and financial development via Karachi stock Exchange in Pakistan both in the short and long term to confirm the existence or lack of demand-following hypothesis. The problem of the research is to determine whether Pakistan is based on the demand-following hypothesis. It also explores how KSE all shares Index is affected by the influence of major financial variables, including, but not limited to, bank credit, Market turnovers, broad money, market capitalization, Gross domestic product. Empirical time-series analysis uses cointegration, VECM, Wald, and Granger Causality tests for causality. Banks credit and market capitalization impact LKSEG negatively and positively, respectively; exchange rate's negative effect is especially significant. The study finds a stable long-term relationship but no direct link between Karachi stock exchange development and Pakistan's economic growth, highlighting the need for concerted efforts for sustainable development.

Abstract Aim Cardiopulmonary exercise testing (CPET) is established in the risk stratification of patients undergoing oesophagectomy but there is limited data for its utility in patients undergoing gastrectomy. This study examines the relationship between CPET and patient outcomes following gastrectomy. Method Consecutive subtotal/total gastrectomy outcomes from a single Scottish high-volume unit from 2010-24 were retrospectively analysed from a prospectively maintained database. Selected high-risk patients as identified by surgeon/anaesthetist underwent further preoperative workup including CPET, performed at the time of diagnosis prior to any neoadjuvant chemotherapy. Descriptive statistics, Wald testing, and multivariate analysis were used with primary outcome measures defined as in-hospital mortality, unplanned intensive care (ITU) admission, and all cause Clavien Dindo ≥III (CD3+). Results 404 patients underwent subtotal (213) or total gastrectomy (191). Median age was 68 years, 63.38% male, and 59.62% underwent neoadjuvant chemotherapy. CPET was undertaken in 213 patients (52.72%), with median AT 11.4 (57.75% AT &amp;gt;11). In-hospital mortality in the entire cohort was 2.48% (n=10). In patients assessed by CPET, in-hospital mortality was 2.35% (n=5) and unplanned ITU admission 7.04% (n=15). Statistically significant outcomes associated with lower AT included peri-operative blood transfusion (p=0.03), in-hospital mortality (p=0.02), CD3+ complications (p=0.03), and LOS (p=0.03). AT &amp;lt;9 correlates with unplanned ITU admission (p=0.03), reintubation (p&amp;lt;0.01), and in-hospital mortality (p=0.01). Conclusions Gastrectomy remains a significant operative insult with a sizeable risk profile. Though with lower cutoff than patients undergoing oesophagectomy, low AT predicts medium-term outcome and can further inform preoperative counselling in patients under consideration for gastrectomy.

Non-linear association of coagulation factor XI with mortality.

This study examines the performance of Pakistan’s middle-order batsmen in T20 Internationals. The middle-order remains a critical concern for Team Pakistan, as wickets are falling at an accelerated rate. Data were sourced from ESPNcricinfo, covering T20 matches from to , including players across innings. Survival analysis techniques were applied, including the Kaplan-Meier (KM) method, Cox proportional hazards model, and the Log-Rank Test. The KM analysis reveals that Asif Ali and Iftikhar Ahmad excel in terms of strike rate, while Fakhar Zaman, Shoaib Malik, and Shadab Khan stand out for total runs. Players demonstrating greater resilience at the crease include Haidar Ali, Fakhar Zaman, Imad Wasim, and Shoaib Malik. In the Cox-Proportional Hazard Model (Cox-PH), all statistical tests yield significant Likelihood Ratio Test (LRT), Wald Test, and Log-Rank Test highlighting the model’s robustness. Iftikhar Ahmad and Shan Masood spent the most time at the crease, while Fakhar Zaman, Iftikhar Ahmad, Shoaib Malik, and Shadab Khan faced the most deliveries. The Log-Rank Test reveals a significant difference in performance based on average runs , but not on strike rate . These insights can support data-driven player selection and middle-order strategy for Pakistan’s T20 team.

The class of simplex regression models figures prominently as an empirical model for rates and proportions data, since it is based on the interesting, flexible and tractable simplex family of distributions. In this paper, we derive closed-form expressions for the asymptotic expansions of the cumulative distribution functions of the likelihood ratio, Wald, Rao score, and gradient test statistics under a sequence of local Pitman alternatives. The asymptotic expansions are derived for testing a subset of regression parameters, and for testing the precision parameter. The second-order local power of these four likelihood-based tests is compared analytically by making use of the asymptotic expansions derived in this paper. We provide general analytical conditions in which one test may be more locally powerful than the other one, and, hence, the practitioner may choose the most powerful test to make inferences on the parameters in the class of models. Monte Carlo simulations are presented and discussed. We also provide a real data application for illustrative purposes.

Purpose The study examines the long-term and short-term relationships among economic growth, exports, imports, exchange rate and trade openness (TOPN) in the Indian economy for the period from Q1:2011–12 to Q4:2023–24. Design/methodology/approach The econometric techniques such as Johansen cointegration test, vector error correction model (VECM) and Wald tests, are employed for the analysis. Findings The results suggest that both exports and imports have a positive and beneficial impact on economic growth, while the exchange rate and TOPN negatively affect economic growth. The empirical results suggest that 1% increase in exports and imports leads to economic growth by 0.45 and 0.54%. However, 1% appreciation in exchange rate and TOPN leads to a decreases economic growth by 0.0462 and 0.994% respectively. In the long run, export-induced imports are the stronger determinants of economic growth than exports. It may be concluded that the import content of export promotes economic growth in India. Research limitations/implications The policy of export promotion and import liberalisation, has the potential for economic growth, should be promoted and encouraged. The policy should focus on leveraging trade and exchange rate management to enhance India’s economic growth. By promoting exports, selective optimising imports, stabilising the exchange rate and selectively liberalising trade, India can strengthen its global competitiveness and sustain accelerated long-term economic stability. Therefore, policymakers should consider more balanced trade strategies that optimise, rather than minimise, imports aligned with export needs. These findings suggest incorporating sector-specific market-oriented liberalisation for duty-free imports of capital goods and critical inputs intended for export, for the promotion of India’s exports. The specific sectors include Engineering, Textiles, Chemicals, Electronics, Gems and jewellery, Pharmaceuticals, Dairy, Green technology and Service exports to achieve the Foreign Trade Policy 2023 targets sustainably. Originality/value This study contributes to the extant literature: first, by examining the linkages between the economic growth, exports, imports, exchange rate and TOPN in the context of post-global financial crisis in India; second, this study used Johansen co-integration test and VECM to identify and establish stable long-term linkages and short-term adjustments.

Background: Child marriage in Sigi Regency has shown an increasing trend from year to year between 2020 and 2025. In 2020, a significant surge was recorded, which rose even more sharply in 2023. This increase is driven by various factors such as premarital pregnancy, economic pressure, and the influence of social media, especially in remote areas. Objective: To determine the influence of sociodemographic factors, literacy, and self-identity on adolescents’ attitudes toward early marriage in Sigi Regency. Method: This study employed a quantitative approach with a cross-sectional design. The research was conducted in three sub-districts in Sigi Regency: Dolo Barat, Dolo Selatan, and Marawola, with a total sample of 100 respondents. Results: The Wald Test results for the variables Last Education (p = 0.046), Income (p = 0.048), Culture (p = 0.002), Literacy (p = 0.035), and Self-Identity (p = 0.040) indicate that education, income, culture, literacy, and self-identity have a significant influence on adolescents’ attitudes toward early marriage in Sigi Regency. Culture emerged as the most dominant factor, followed by literacy, education, self-identity, and income. Adolescents with these favorable conditions are more likely to reject early marriage practices. Conclusion: The study shows that education, family income, culture, literacy, and self-identity significantly influence adolescents’ attitudes toward early marriage in Sigi Regency, with culture being the strongest factor influencing adolescents’ attitudes toward early marriage.

Purpose This study quantifies how regulatory divergence in pesticide maximum residue limits (MRLs) affects bilateral trade between Mercosur countries and the European Union for soybeans and corn, examining both demand-enhancing quality effects and supply-restricting compliance costs simultaneously. Design/methodology/approach We develop dual stringency indices comparing exporters' MRLs with Codex standards and measuring exporter-importer regulatory gaps for specific pesticides used in soybean and corn production. A structural gravity model with country-pair, importer-year and exporter-year fixed effects is estimated using Poisson Pseudo-Maximum Likelihood (PPML) for a biennial Mercosur-EU panel covering 2010–2018. The analysis examines trade probability, import values and unit prices separately. Findings Stricter exporter MRLs relative to Codex standards increase market-entry probabilities and trade volumes, signaling quality compliance. However, when EU limits exceed Mercosur standards, compliance costs reduce trade probability and volumes. Exporters can transfer these costs to importers through higher unit prices. Wald tests indicate that quality premiums offset compliance costs, yielding a statistically neutral net effect on trade values, though individual cost and quality components remain economically significant. Research limitations/implications The analysis period (2010–2018) reflects access constraints to paid data from the Homologa platform. Results apply specifically to standardized commodities (soybeans and corn) between Mercosur and EU. This specificity aligns with literature recommendations on the need for sectoral analyses of non-tariff measures. Practical implications Mercosur exporters can recover compliance costs through price premiums when meeting stricter EU standards. Exporters should develop capacity for multiple regulatory regimes, focusing on key pesticides in grain production. EU policymakers can maintain strict MRL requirements without creating prohibitive trade barriers, as costs transfer through pricing mechanisms. The findings support targeted technical assistance for developing country producers and inform trade negotiations on regulatory cooperation frameworks balancing consumer protection with market access. Originality/value Unlike previous studies that examine either cost burdens or demand shifts in isolation, this research simultaneously captures both dimensions using distinct indices for quality perception and compliance costs. The focus on specific pesticides used in soybean and corn production reduces measurement bias compared to studies using all registered pesticides with equal weights.